IVF DIARY VOL I: 11-14 Aug 2015

August 14, 2015August 14, 20157 Comments

Medication(s) administered and dosage(s). Progesterone 1ml, vivelle dot estrogen patches 0.1mg x2.

We hit a blood vessel with the progesterone needle!!! Well mum did the check once the needle was in, drew back a little bit and she saw blood, she coped with it calmly and I told her it was OK we just change the needle and try the other side of my buttock. I explained to her it was just one of those things that happens occasionally and that is why we check. She was so worried she hurt me. Poor mum. She did well not to pass out because I think I would have done if I saw that!! It didn’t actually hurt, but I did get some tingling, numbing sensations running down my leg!!! Then it bruised a little but afterwards, but no different to any of the other injections.

I think I have finally sussed out the Estrogen patches (vivelle dots – which by the way are nothing like a ‘dot’). Sticking them oblong ways round and peeling them off from outwards to inwards towards the belly button is the easiest and least painful way to pull them off…I’ve tried every way round!!! I still haven’t quite found a good way to remove the sticky residue.

2 patches – change every two days

Medical procedures undertaken. Nothing!!! But I returned to work yesterday to find lots of emails – from my medical insurance company notifying me of all the claims that had been submitted by the fertility clinic for all the medical procedures over the last IVF cycle!!! Every single ultrasound, blood test etc has an individual claim number…this is going to be a pain to track as soon as the bills start arriving through the door – time for a spreadsheet!!!

How do I feel today? I am 8 days past my 3 day transfer and honestly – I am not feeling positive anymore. A few nights ago I woke up with horrific pain in my abdominal region. I can’t pinpoint where it was exactly. I cried as I curled up and thought I was going to have to take myself to hospital (I was in a hotel with my mum at the time), but after 15 minutes the pain subdued. The next day I felt the residual pain, which I can only describe it to be like what you might experience after you have cramp in your leg after the cramp goes away, but the muscles ache from the cramp and is on tenterhooks for cramping again if you move too fast. I have not experienced any more of this type of pain since. I wondered if it was implantation cramping, but it was so painful, could it really be that?

The day after this night of pain I was due to do some guest lecturing at an offsite location near DC…let’s just say my office messed up and I was unable to access the site I was visiting because someone decided to handover their work and something fell through the gap. Cue RAGING DANI…..8 hrs of driving and a night in a hotel wasted because someone didn’t properly do their handover when they were leaving. So I called my boss, told him the situation and asked for the rest of the afternoon off – he pointed out that I needn’t have asked – he was actually more worried when I left a message for him to call me back that there was something more serious wrong (i.e. with my health!). So I went shopping with my mum. I will save the details of this for another post dedicated to shopping, but this is when I really started to feel more negative about everything and I have not been able to shake it off since.

What are my symptoms? I I have had lots of mini sharp pains and some dull aches like I have experienced in two of my previous IUI cycles. My boobs are growing fast with much sensitivity! I ache, like having a period time type ache all over my body. The injections are not so bad, but they kind of rule your life a little bit. It know it will be worth it if I do end up successfully carrying huckleberry and huckleberina to term, so it’s something to just live with. (By the way, this is for Chris mostly, and anyone who has missed my previous blog post – we will NOT be naming these poor babies huckleberry or huckleberina, they are just affectionate names whilst they are inside me 🙂 )

How does Chris feel today? Chris had a weird dream last night about using blown up balloons as a rope to do some climbing – he used about 30 balloons, then they burst. I thought it might have been some kind of dream about how he felt about IVF, that we had put all this effort into getting so far, climbing up the mountain and it was all for nothing – a blow out. He said I was being silly, and perhaps I am, but I dream a lot so I always try to think about why I dream certain things.

Any results? No.

What’s next? Enjoy the rest of the time my mum is visiting – we have quite a fun packed weekend planned!

Weight. Fortunately my weight loss was only temporary, I am getting away from the danger zone of being underweight. I have enjoyed plenty of eating out over the last few days of my trip to DC!!!

Waist. Slowly the bloat is disappearing, but not quite back to my normal waist size.

Boobs. Woah they have grown massive! Chris can look, but not touch – they are way too sensitive :-p I’m going to have to change the scale on my chart at this rate!!!

Hours of Sunshine 🙂 Sooooo much lovely sun. What an amazing summer we have had compared to the Augusts of the previous two years.

*Notes. I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily. NSTR = Nothing Significant To Report.

IVF DIARY VOL I: 07-10 Aug 2015

August 11, 2015August 11, 20155 Comments

Medication(s) administered and dosage(s). Progesterone 1ml, vivelle dot estrogen patches 0.1mg x2.

The progesterone injection sites tend to ache for about 24 hours, just in time for the other buttock to start aching! In some ways, it is only painful in that it feels like I have just had a really good gluteus maximus workout (I wish that were the case!!)

Medical procedures undertaken. Nil – hooray!

How do I feel today?For the last few days I have been too busy to think about infertility or being pregnant until proven otherwise! We have done quite a bit of siteseeing which has helped occupy my mind. I am now on a work road trip with my mum in DC so we have filled our time well so far. I’m feeling not too bad.

I am also feeling lucky!!! After my last diary entry I forgot to write that the evening of my embryo transfer I was on bed rest so I could not go to see Cirque du Soleil (I had booked front row tickets as a Birthday gift for my mum). So we gave my seat up to Chris’s friend and instead my friend came over to keep me company with pizza and a movie. The show started at 8pm, so you can imagine my surprise when I heard someone fumbling with the front door at 9.15pm. Chris and mum were back early. They started telling me some story about how short the show was and that it was pretty disappointing. I was upset!!! But then they told me the truth…the show had been cancelled due to the Storms!! How lucky am I?? I don’t get to miss out on seeing Cirque Du Soleil after-all!!! So I rebooked the tickets for next weekend (no front row tickets available 😦 ) Talk about luck??? I just hope I haven’t used up all my luck just yet ;-P

What are my symptoms? Bloated still, but the pain from my ovaries has reduced. I feel constantly dehydrated despite drinking about 4 times the amount I ordinarily would. Of course this means I am peeing 4 times as often. My weight….I am hope it is not a symptom, but there is definitely a weird correlation!!! See below for surprise trends.

How does Chris feel today? I don’t really know because he is back at home 😦 But I do know he is super happy that he has finally booked our campervan for our road trip out West in October.

Any results? We did not hear from the clinic today whether the two other embryos made it to freezing. I am really disappointed at the lack of communication from them. Especially as we received a questionnaire in the post today requesting feedback on their customer service for this IVF cycle. Seriously??! My cycle isn’t over just yet!

What’s next? Keep calm – I’m pregnant until proven otherwise.

Weight. So my weight is still lower than when I started this cycle, not by a huge amount, but enough to put me on the border of having the ‘underweight’ BMI label. I do not want to be underweight, this is not good for trying to conceive. So I have dutifully been eating more, but with the bloating and re-hydrating there is just sometimes no more room left in there!!! If you look at the chart below you can see my insane waist to weight ratio. It just makes no sense.

Waist. Trying to wear comfy clothes to let the bloat hang out.

Boobs. Tender and filling out a bit.

Hours of Sunshine 🙂 We had some beautiful weather on Sunday, I now have a slight glow to my pale skin!

*Notes. I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily. NSTR = Nothing Significant To Report.

Nurse Mummy to the Rescue

August 11, 2015August 11, 201511 Comments

It dawned on me over a week ago that when I go for my work trip & mini day break with mum up to DC tomorrow, I will not have my handy man (AKA hubby) with me to administer the progesterone in oil injection. Uhoh, I worried that I would not be able to do it on my own – have you seen the size of that needle? It’s 3 times the size of the one that is injected into my abdomen!! The first time I tried to inject myself was a complete failure, I froze to the spot. There was little chance of me administering this 1.5″ long needle myself – in my buttocks. I thought I was going to have to cut our trip short, until I realised that my mum could do it!!!

Now – my mum is a self admitted needle phobe. Fortunately, she is only a needle phobe from needles being administered to herself. She works in a school and has administered an epi-pen to a child before. The challenge to inject me with this ginormous needle still was not insurmountable. So we got mum into training ASAP. Once Chris had tried administering the injection on me once, he then started training my mum.

First night of training – observation. Mum observed Chris and he explained every step he took. Here is a simple 10 step programme.

Step 1: Prepare items: 1.5″ 22G needle, progesterone in oil, gauze, x2 alcohol swabs, sharps container, ice pack for numbing, heat pad for massaging afterwards.

Step 2: Dani lies face down on bed and Dani ices the buttock that will be injected (change from L-R buttock every day)
Step 4: Prepare medication: take lid off progesterone bottle, alcohol swab top, extract 1ml of progesterone using needle, check for air bubbles.
Step 5: Alcohol swab injection area on buttocks, Dani looks away :-s
Step 6: Breathe!!!
Step 7: Pull skin apart at injection site and hold down. Let Dani know you are going to stab her 3-2-1: stab!
Step 6: Pull back on needle slightly to check for blood, if air bubble is seen, all is good
Step 7: Inject progesterone
Step 8: Remove needle and place gauze on injection site & massage.
Step 9. Dani continues to massage injection site area with heat pad for about 10 minutes.
Step 10: Go have a cigarette to calm your nerves (mummy, not Dani!!!)

Second night of training – prepare medicine with Chris’s guidance, observe Chris injecting again. Practice injection using lemon and vegetable oil to get feel of how hard it needs to be ‘darted’ into the skin.

By the way – when life gives you lemons…..stab em with a needle and inject vegetable oil. Waaaaay more fun than making lemonade!!!

Third night of training – prepare medicine without Chris’s guidance (Chris observes), Chris injects again while observing. Continue practicing with lemon.

Fourth night of training – prepare medicine. Inject with Chris’s guidance. (Success!!! Mum has a little lie down with me afterwards, she was nervous, but I hardly felt a thing!!)

Fifth night of training – on own administer everything without Chris’s guidance, Chris observes and only interrupts once to slightly change the grip on the needle. Mum is now fully Qualified!

D-Day: She did it!!!! Mum did this all on her own without any help from me at all. I am so grateful and proud of you Mum!

I tried practicing with the lemon against on my bottom to see if I could do it my self just in case – and it is possible on my left side, but very difficult on the right side, so despite my needle phobia I would probably still need help to inject on my right side.

After Mum qualified and passed her 5 night training plan, she told me that throughout this she has learned that the you can overcome anything for your children. Awwww. Thanks Mum, I love you lots and can’ thank you enough for overcoming your fear to help us out.

Facebook – the good, bad and ugly

August 8, 2015August 8, 201522 Comments

Hi, my name is Dani, and I have been a facebook addict for about ten years. I don’t want to give it up just yet, but we have been having a love-hate relationship recently. Let me explain the good, bad and ugly of facebook to you.

The GOOD.

On Thursday’s egg retrieval we did something very random and spontaneous. After Chris put his ‘egg packing uniform’ on, the nurse asked if we would like a photo of us together. After the nurse snapped a few of us posing together and left chuckling at us (in a nice way), I asked Chris to strike a pose for me in his beautiful attire. (I posted pictures of him posing yesterday) I laughed about putting it on facebook. He said, go on then! I wasn’t quite sure if he really meant it. I pointed out that people would ask why he was wearing it. How would you respond to that?

Chris has been quite adamant in the past that he does not want to post anything on facebook about our infertility, he doesn’t want to share it with the world, and I respect him for that. The only time I have posted something on facebook was when he gave me my first injection on Valentines day. The post was vague enough that only one or two people asked us questions about it. I also shared an article about infertility awareness week, I had only one question about that one.

So I sat there with the photo of the two of us in our surgery attire that the nurse had taken and pondered what to write along with it. I crafted something positive, short and to the point. And then I cried. I was about to chicken out of it, but then a thought popped into my head, what the heck – why should we have to hide this big life event? So I pressed ‘Post‘. 20 seconds later my phone vibrated, and again, and again, and again. I was nervous to look at it. What type of comments would I get? Would people just press like and be too afraid to comment? I was starting to feel sick to my stomach. Here is what I posted:

After the transfer procedure was completed, Chris then posted a picture of our embryos from his own facebook account “Apparently babies come from raspberries”:

Our first post received 232 likes and 73 comments wishing us love and luck. My phone did not stop buzzing all day yesterday. And then came the personal private messages. Statistically speaking, infertility is likely to affect about 20 couples out of this group of people. Of course friends we know who had gone through IVF contacted us either on facebook or privately to wish us luck and offer a hand/advice if ever needed, but then there was some of our friends who we discovered had been silent about their treatment for infertility who messaged us too. We had private messages of inspiration and warm wishes. We were astounded by this response and feel so much love filled in our hearts.

I cannot possibly feel negative for a while after all this support!!!

It is difficult going through infertility when a number of close friends and family are so physically far away. Facebook provides us with the ability to stay connected with them – sure there are other means to do this (Skype, whatsApp, Email etc), but it allows us to deal with the timezone differences and still feel connected. This to me makes facebook a GOOD commodity in helping us build friendships that help carry us through the bad times of infertility.

I can imagine some people reading this will be thinking we are crazy for posting what we did, but it wasn’t something that came naturally, rather it is something that has taken time to learn to be comfortable with. I started to take the stance of not hiding our infertility a few months ago, if moments came up in conversations I would talk about it (awkwardly), and now I feel a lot more comfortable talking about it than I used to, I don’t whisper at work anymore and I may even start a conversation about it. The underlying point is that it has taken time to become comfortable and not ashamed of what we are going through.

The BAD

By posting what we did before the embryo transfer, we have opened up our hearts to a much wider audience, and if things don’t go well for us it’s going to be hard to deal with so much condolence on our hands. We are now vulnerable. We are also vulnerable to comments and unwelcome advice that drive you mad when you are going through infertility. We can’t filter these comments out from facebook. We shouldn’t just de-friend someone because they made a hurtful comment that they didn’t realise they were making. But we can de-friend people who turn out to just not be real friends or purposefully spite us with hurtful comments, at least we can block them from that part of our lives. Fortunately, I have never experienced anything spiteful, malicious or hurtful regarding our infertility.

The other thing about facebook that is just plain BAD are the pregnancy announcements and baby photos that plaster your newsfeed. For some people suffering from infertility, this should probably be in the UGLY section. But I actually don’t mind pregnancy announcements, especially if they are close friends. I do get a little bit tetchy when ultrasound photos are incessant, but you know what I can do? I can edit the facebook options so that I don’t see their posts unless I want to or choose to go to their facebook page when I am feeling good to see what they have been up to.

The UGLY

For me, the ugliest thing about facebook are those targeted ADVERTS. Pregnancy, baby clothes, mom sites, nappies….aghhhhhhhhhh JUST GO AWAY!!!! I can cope with a pregnancy announcement any day over this crap. You know what also gets my goat? THE WORST. Targeted adverts about infertility. Clearly I browse infertility websites, so why does any infertility website think it is OK to use targeted advertising about infertility to appear on my facebook feed? Do their marketing people know anything about infertility?????????? Do people with cancer get adverts about cancer? Do they want to see adverts about cancer, just as they have gone in to remission? I guess it is an individual’s perspective about whether this type of advertising is useful or not. For me, this is just UGLY.

I wonder a lot about the algorithms facebook use to determine if an ad should be placed on my page. They use data from your profile, such as location, age, gender, interests, connections, relationship status, languages, education and workplaces. That is all pretty basic information. However, there is more personal information that facebook uses such as your listed likes and interests, pages you like, apps you use and other timeline content that you have provided. I decided to see what kind of information advertisers need to provide to facebook, and it is indeed seemingly innocent. Here is what I found:

Creating a facebook advert: infertility is an interest that can be directly targeted to a user

The interest “infertility” is possible to target an audience to, these are people who have liked content relating to terms such as PCOS infertility (audience 246,280), unexplained infertility (205, 540) or male factor infertility (31,960) or even resolve (22,850). ( By the way, I found the potential audience numbers really interesting – note how low male factor infertility is? )

Fortunately, I was educated a couple of days ago how to stop this from happening on your facebook page. Nara from the Zero to Zygote blog recently posted how to stop adverts (in fact any type of advert) that you do not like appearing on your facebook feed. You can check out her handy guide here. I am so grateful to her for this post, as soon as I read it I immediately went ahead and clicked on a stupid pregnancy ad I have been receiving over the last few days and changed my setting to block ads like that.

The second question is whether facebook uses data other than what is found on your profile and your actions on facebook, for example when you visit infertility blogs, forums and IVF clinic pages? The answer is yes, like many other websites, cookies and trackers are used to directly target the ads you see on your facebook page. Some people may call this spying, marketers would call this targeting. You may think that you can just turn off cookies and trackers in your browser, it’s easy to do, but facebook will not let you use certain features if you do this. However, you can limit it by following the instructions here: http://gizmodo.com/how-to-stop-facebook-from-sharing-your-browsing-history-1589918083.

Hopefully, for me now, the UGLY has just gotten a whole brand new makeover (thanks Nara!!!), the BAD has been put on the naughty step for a time out, and facebook has become more of the GOOD that I originally signed up for (thanks Chris!!).

Do you have any good, bad or ugly stories about infertility and facebook to share?

IVF DIARY VOL I: 05-06 Aug 2015

August 6, 2015August 6, 201522 Comments

Medication(s) administered and dosage(s). Progesterone 1ml, vivelle dot estrogen patches 0.1mg x2, colace x1

Medical procedures undertaken. We woke up nice and early for our 7AM appointment. As we parked up our doctor also parked up, so there was this awkward moment of where I was walking very slowly (still constipated and sore from the egg retrieval) and she clearly had somewhere to be! Of course Chris had lots of questions for her as he collared her on her way into work about me and my recovery. Anyway, so we were called upstairs to the IVF surgery room and I was ushered to the same cubicle I was in on Monday. The nurses immediately noticed I was waddling and I told them about my constipation and bloating. They were very sympathetic and gave me advice on taking extra colace, prunes, prune juice and apricots to get things moving. They did not want me straining myself to poo!!! One nurse said that she sees so many patients like me and doesn’t understand what causes it. The doctor said it was the progesterone, but I was constipated before I took the progesterone! After I got changed into my gown and deli hat, I walked back to my cubicle and our doctor was looking over our chart, she said we had 2 beautiful strong embryos, but 2 not so strong that needed to be left in culture for longer to see if they survive to blastocysts on Day 5 for cryopreservation. And then off she went….there was no discussion. So I guess we are doing our transfer today then. I turned to Chris and said is that OK?? And he shook his head in a manner that was like sure why not.

The nurse took my vitals and I started to sip my bottle of water; she warned me not to drink too much because I wouldn’t be able to pee until an hour after the transfer :-s I drank 3/4s of a bottle of water and that was plenty…in fact probably a little bit too much. Chris got changed into his ‘egg packing factory suit’ – he looked awesome! He was going to come into the surgical room with me! Brucie bonus! He was well trained by the nurse on when to take photos of the embryos and where he would sit for the procedure.

Twit-twoo!!!!

As we were waiting, I overheard the lady in the cubicle next to me begin to cry. She was going in for her egg retrieval and had just had her Intra-venous drip inserted. The nurse asked her what was making her sad (I like this nurse, she clearly has much experience with these kind of situations). The lady said she was afraid of going to sleep. As the nurse explained the process and how it was just like taking a strong sleeping pill, all I wanted to do was pull back the curtain and giver her the biggest hug ever and tell her it’s OK, it is no where near as bad as general anesthetic and you are going to be just fine – I know it’s scary but it’s going to be easy and won’t hurt. But of course this is a big no-no, talking to other patients.

After about 30 minutes of waiting I was taken into the surgery room on the trolley (very lazy!!!) and I scooted onto the table. I put my knees in stirrups this time and I was fully bare and exposed to the world. Unpleasant. Chris was sat behind me so he could hold my hand.

The surgery room

The doctor knocked on the embryology lab door to give the go-ahead to get the embryos prepared. We watched on a TV screen to check that the embryos had our name on the petri-dish and then we saw our two embryos for about 5 seconds!

Our two little 8 cell embryos – AKA HuckleBERRY and HuckleBERINA (because they look like raspberries)

They did look pretty good! They looked nice in shape and symmetry, the doctor was very complimentary about them. Then two embryologists came into the surgery room, read my wrist band and asked me my name – this is performed by two people so absolutely no mistakes are ever made getting the wrong embryo in the wrong patient!!! The embryologists went away to prepare our embryos. After this moment, the doctor checked my abdomen, both physically and using an ultrasound (not a transvaginal ultrasound for a change woohoo!!!) except my bladder was full, I was constipated and still sore from the egg retrieval – I winced the whole way through. Everything seemed good and he inserted the speculum and washed out my uterus. The nurse came and told me that from what she could see on the screen, my ovaries were super enlarged still and I have a mild case Ovarian Hyper stimulation syndrome that will go away soon, I just need to keep up my fluid intake. Then the doctor knocked again on the embryo lab’s door. This time the embryologist came in with a soft flexible catheter with the two embryos ready and loaded to be inserted into my uterus. Using the ultrasound as a guide he inserted the catheter and we ‘watched’ the embryos be ‘puffed’ in by air into my uterus. I say ‘watched’…I could barely see the screen from the angle I was at. But I nodded my head not wanting to disappoint him that I missed it. Before the speculum was removed the catheter was given back to the embryologist just to check under a microscope that the embryos were not still in the catheter. A few moments later the speculum was removed which was a huge relief, it wasn’t painful, rather very uncomfortable I wanted to pee right there on the table. I was scooted back onto the trolley and wheeled back to my cubicle where we were told not to go anywhere for 1hr…not even the toilet!!! Eeeek!!

We read a bit and then played a game of crib whilst we waited. I won! If I hadn’t have won, I am not sure Chris would have survived the rest of the day. That made time fly by and then it was time to go!!! We were given a couple of souvenirs…the petri dish our embryos grew in and a little card with the results of our egg retrieval. Chris took the deli hat too – I think he likes it a bit too much.

Souvenirs!!! Petri dish our embryos grew in, report card and a deli hat. Stash!!!!

How do I feel today? I had a terrible night’s sleep dreaming that we would turn up to the clinic with just 1 weak embryo to transfer 😦 But now we have done the transfer I feel like a weight has been lifted off my shoulders. I feel like I can get on with life right now and enjoy this summer!

What are my symptoms? I woke up with similar pains from the egg retrieval, tender, hard bloated stomach (very hard) and constipated. I was waddling. When we got home I sent Chris out to get prune juice, prunes and apricots. The prune juice worked it’s wonders about an hour or so later. The nurse told me not to strain, so when it was time to go to the toilet I tried my hardest to just let it all come out, but seriously, once it did all come out, it was the BEST feeling. I am no longer waddling in pain and my stomach is not so hard anymore. So I think most of my problem with pain was constipation. I have Irritable Bowel Syndrome (Diarrhea variant) so I am currently sat here with a gurgling tummy, and I am soooo pleased I am back to normal! (Fingers crossed anyway!!)

How does Chris feel today? Feels good. He looks forward to this 2 week wait being over. (He is a man of many words :-))

Any results? Two 8 cell embryos transferred and safely inside me – huckleberry and huckleberina because they look like raspberries and Chris always talks about calling his son Huckleberry. So let’s just say this is a compromise!! 2 other embryos are growing in culture hopefully over the next couple of days, fingers crossed they survive and can be frozen. I’m Pregnant until proven otherwise.

What’s next? Enjoy the two week wait. My mum is visiting so she has been brilliant so far putting up with everything tht is going on, so I’m hoping to take some time off to enjoy some local sights and sounds. The pregnancy test will be the day my mum flies out in 13 days.

Weight. OK so I think I have actually lost weight, if you account for all the fluid I have taken on and my waist size. This isn’t surprising considering I have reduced my intake of food because it won’t physically go in!!

Waist. Still bloated, but hopefully it will improve tonight now I have relieved myself!!!

Boobs. Starting to feel tender from all the hormones!

Hours of Sunshine 🙂 Fat chance! It’s miserable out. Plus I’m on bed rest so I’m pleased about this fact!

*Notes. I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily. NSTR = Nothing Significant To Report.

When to transfer? The pros and cons

August 5, 20158 Comments

Last update I had on the development of our embryos was Wednesday morning (Day 1)…we had 4 fertilised eggs. Today (Day 2) we do not know what has happened to them. Tomorrow (Day 3) at 7AM we are going in to potentially have a day 3 embryo transfer. So we have been debating about our decision to do a day 3 or a day 5 transfer. Without any knowledge of the status of our embryos everything is rather circumspect. So we discussed the pros and cons of each scenario*.

Day 3 Pros

Good chance of actually having a transfer!
Maybe the embryos will be better off developing inside me.
Freezing on day 3 means we have more embryos to freeze.

Day 5 Pros

You get to transfer the best embryos
Physiological conditions – embryos (blastocysts) would normally be in the uterus at the stage – so they are in the right place!
Reduces the chance of multiples
If the embryos don’t make it to day 5, then there isn’t a 2 week wait to find out and therefore less medication.
good quality embryos (blastocysts) frozen.
Better chances body has recovered from egg retrieval.

Day 3 cons

A greater chance of multiples
Embryos normally would be in the fallopian tube on this day
Poorer quality embryos may be frozen
Lower quality or ‘wrong’ embryos may be transferred
Body not fully recovered from egg retrieval procedure – I am actually still massively bloated, my abdomen is sore and hard, walking is still not my greatest past time at the moment, I still have constipation and I am still bleeding a little bit (Initially thought I was peeing blood today!).

Day 5 cons

Embryos may not grow to blastocyst (usually due to abnormal genetics – although isn’t this a good thing?)
There is a risk of no transfer at all (crazy emotions could be a point here)
Potentially less embryos to freeze
May loose some embryos that would have grown inside the body

After our discussions we both believed that we would probably want to wait to transfer to day 5, but we will wait to see what the doctor suggests. I feel like we will have to make a decision on the spot which is a bit scary. And it is both of our decisions, not just mine and not just Chris’s either :-s Eeeek, I’m nervous!!!

*This list was mostly adapted from the book: IVF: A Patient’s Guide by Rebecca Matthews

IVF DIARY VOL I: 04 Aug 2015

August 4, 2015August 4, 201512 Comments

Medication(s) administered and dosage(s).

Doxycycline to reduce chance of infection after the egg retrieval.

Acetaminophen/Codeine #3 300/30mg 1 every 4-6hrs as needed for pain – although I took one this morning, I’m afraid this is not helping with my constipation and I don’t think it is helping with the pain, so I’m not taking anymore.

Colace, to help counter my constipation.

Vivelle Dot Patches x2 (Estrogen usually administered to menopausal women). These are super easy – they stick to my abdomen…now that is something I can do myself!!! I love the fact that they say on the box “Do not use if you are pregnant”. HA!!!

Progesterone in oil – 1mg. Oh my goodness, this is an intra-muscular injection with a 1.5″ needle. I lay down on the bed on my front. Using a cool pack I iced my buttock cheek in the top right hand quadrant where Chris injected it. I hardly felt the needle going in as a result of the ice numbness, but I felt like Chris was pushing really hard so I said he doesn’t need to put pressure on it when it’s in me! He told me that there was hardly an imprint of the needle on my skin, he wasn’t pushing! I guess that is just how a needle feels going into the muscle! Afterwards we massaged the area and then I applied a heat pad to the injection area. Owwww I feel like someone has kicked me in the butt cheek!! It’s really isn’t so bad, but I am not the one adminstering it, so I can look away!!

Medical procedures undertaken. No procedures on me per se, but my mature eggs were “ICSI’d” yesterday afternoon and our fertilised eggs are being looked after by the embryologists so they develop into embryos.

What are my symptoms? I am massively bloated – my waist increased by 4cm and I put on 3lbs despite the fact that I hardly ate anything yesterday. I am constipated, I poo usually 3 times a day and so far nothing. I’ve taken some Colace which takes 12-36 hours to work – not soon enough. My bowels and stomach also hurt whenever I pee and fart. Farting releases a little bit of the pressure, but does not relieve me! It hurts when I walk, the pain is not getting any better. The nurse said I should call tomorrow if the pain continues to worsen or I put on anymore weight because I could be at risk from Ovarian Hyper Stimulation Syndrome. They would need to do an ultrasound to check how my ovaries are doing. I really really hope this starts to go away so I can go to work tomorrow plus I want to be better before my transfer. In the meantime the nurse advised drinking liquids, not just water but juice, gator aid and soup. Eat small portions….I am soooo hungry, but I can’t physically eat a whole meal right now!!

Day 1 – pronuclear stage: 1 cell with 2 dots in the middle. This indicates a normally fertilized egg with each dot representing genetic materials from the mum and the dad.

Any results? This morning I received a phone call from the IVF nurse co-ordinator who gave me an update on egg/embryo status. When I answered the phone she sounded so somber I thought she was going to tell me it had been a complete failure. But here is what she told me. Yesterday they retrieved 9 eggs, 6 were mature, this morning 4 had successfully fertilised, 2 had not, but they may be late developers and so they will call me if they do make it. If they don’t call, they haven’t made it, and 4 will be the number. (They didn’t call in the end 😦 ). I won’t get any more updates until I arrive on Thursday for my transfer procedure (3 days). I’m not sure I like the fact that we won’t receive any more updates, but at the same time, what can I do about it if I was told if they are progressing well? Nothing, so I guess this way it stops us thinking too much about it.

How do I feel today? I am trying to stay positive, I won’t lie that I cried for a very brief while after I got off the phone from the nurse. I was initially upset that less than 1 in 2 eggs made it through to fertilisation. I couldn’t help but think how somehow this is my failure. But I realise this is ridiculous, so I cried for only a minute.

How does Chris feel today? Poor Chris found the intra-muscular injection quite traumatic, I feel really bad. But he did it!!! I will let him tell you all about it in a separate post. He is quite pragmatic about the number of fertilised eggs – 4 today seems like a good number to come away with. However he feels confused, like me, about whether we should wait for a 5 day transfer.

What’s next? I am not sure about the 3 versus 5 day transfer. We do get to discuss things with the doctor on Thursday, but we haven’t talked about it since we started our IVF cycle. I’ve read a lot about the fact that if an embryo doesn’t make it to blastocyst stage at 5 days then it is unlikely to have ever been a viable pregnancy anyway (I am not sure how they can really know that for sure). So wouldn’t it be better to let them get to 5 days to see if they survive to blastocyst stage rather than having false hope with a day 3 transfer and waiting two weeks to see it fail;? This seems like the worst kind of gambling!!!

Weight. I’ve gained 3lbs of whatever over night, it’s not food that’s for sure!!! I’ll keep an eye on it.

Waist. My waist has bloated 4cm in the last 24hrs, which might not sound like much, but it sure is a significant gain for me over this time period!

Boobs. NSTR.

Hours of Sunshine 🙂 I’m not really allowed in the sun because I am taking doxycycline 😦 but I did sneak in a bit (wearing sun cream of course) this morning and had a slow waddle down to the beach.

*Notes. I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily. NSTR = Nothing Significant To Report.

IVF DIARY VOL I: 02-03 Aug 2015

August 3, 2015August 3, 20158 Comments

Medication(s) administered and dosage(s). A whole bunch of anesthesia drugs…who knows what! And some Acetaminophen/Codeine #3 300/30mg 1 every 4-6hrs as needed for pain.

Medical procedures undertaken. Oocyte (egg) retrieval! I arrived at the clinic today nice and early for a 7AM start. No one was in the waiting room, Chris and I literally sat down for 30 secs when we were taken upstairs to the IVF surgery room. We were number 3 out of 4 for egg retrievals today, so we got to see what the deal was before it was my turn!! I was immediately shown to my ‘bed’ area, a curtained off area, like in any hospital I guess. There was a waiting room/small coffee room for partners to wait in, but Chris mostly sat with me. The nurses I met were bright, bubbly and friendly who seem to love their job, but they seemed constantly busy managing four patients at a time, they did a great job!

I was given a hospital gown and ‘Deli Ham Hat’ i.e. a hair net to put on. I was allowed to keep my socks on! Yey!! We waited for about 15 minutes in the bed cubicle with a ‘hot water bottle’ placed on the back of my hands, then the nurse asked Chris to take a seat in the waiting room whilst she put my Intra-Veinous drip in to the back of my hand. Mostly because the nurse wanted Chris’s seat in order to sit down to do her job! But also so that she doesn’t need to worry about him passing out when watching. Clearly this has happened to some poor person in the past! The nurse apologised for not offering me a numbing cream initially, but I pointed out that another needle really wasn’t going to ruin my day after the past 10 days of injections and needles!! She did a great job of getting the IV in and I hardly felt it (she told me about my great veins!), although I couldn’t watch her do it and had to look away. Once I was attached to a the drip she switched it on and I felt a coldness run up my arm. She went to call Chris back from the waiting room.

As we waited, we heard the other ladies come and go quite quickly. My doctor popped her head in to say hello. She is quite eccentrically introverted, so her bedside manner isn’t the greatest! She asked us how our summer was going, quickly realising where we were, and she said ‘Oh yes, doing IVF, it’s probably quite stressful!’ and then she wondered off. I wasn’t offended by her, she is lovely, but I am not sure she would be everyone’s cup of tea in this regard. In fact the first couple up for retrieval had specifically requested for our doctor to do the egg retrieval procedure because they respect her so much. I am not so sure I would want that. Not because I don’t trust her, but because I’d rather have the surgeon who does it day in day out!

After 30 minutes or so of waiting it was my turn. The anesthetist asked me a few questions, I went to try and empty my bladder – there wasn’t much left at this stage – then she injected something into my IV, I started to feel woosy, like I had had a few alcoholic drinks, my words were slurring as they pushed my bed to the theatre room. They asked me to shuffle onto the operating table, which I just about managed, I put my legs in some stirrups and the anesthetist injected something else. The next thing I knew I was talking to the nurse back in my bed cubicle. Oh the pain was like my worst period times two, I really wanted to just curl up with a hot water bottle and cry. For some reason I had started talking to the nurse about my experience of American military hospitals in Kuwait….I have no idea why! The next thing I knew, I had my eyes open and Chris was holding my hand next to my bed.

During my egg retrieval Chris provided his sperm sample. All in all, I was in and out in 25 minutes. After about 15 minutes of recovery I was up walking to the bathroom – slowly!!! The nurses told me that they thought 9 eggs was the magic number, Which was incidentally the same number of eggs for the two other ladies before me!!! What are the chances of that? Chris and I made a bet, I said 9, he said 11. We find out tomorrow morning how many fertilize successfully. I was made to sit in a wheelchair and taken to the front door by the nurse where Chris picked me up. The drive home wasn’t overly comfortable, I felt every bump. It felt like I was balancing a couple of weights on my ovaries, particularly my right one.

How do I feel today? I’m feeling positive. I also feel like there is absolutely nothing in my control right now, so there is no point in worrying. My mum and Chris are taking care of me whilst I take some time out on the sofa. I really really hope our embryos stay strong to make it to a 5 day transfer because a 3 day transfer would be on Thursday and a few months ago I bought front row tickets to see Cirque Du Soleil for Thursday evening!! Of course if a 3 day transfer is on the cards then I will have to give my ticket to someone else and go another time, just not front row 😦

What are my symptoms? Very tender after the egg retrieval, it feels like I have been punched in the stomach and have weights hanging down from my ovaries so moving slowly is a must!!! Also going to the toilet is quite painful at the moment 😦

How does Chris feel today? He is a soldier. Chris came up with a couple of funny egg based jokes…e.g. Today I will have my eggs ‘poached’…how do you like them? Over ICSI…. (*sigh, groan). But he kept us chipper!

Any results? The nurses said they thought we had 9 eggs retrieved, but tomorrow morning we find out how many eggs fertilise. I’ve finally got all my estradiol results, so I have changed the plot below to show my follicle growth and estradiol together over time.

What’s next? Apart from finding out how many eggs have fertilised, tomorrow I start taking the estrogen patches and Chris starts injecting the progesterone. Oh crap….not looking forward to that.

Weight. I’ve managed to keep the weight off. The nurses said after I told them my weight that I’m the kind of person they dislike! Obviously they were joking 🙂

Waist. NSTR.

Boobs. NSTR

Hours of Sunshine 🙂 It’s 92F outside and I am stuck inside recovering 😦

*Notes. I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily. NSTR = Nothing Significant To Report.

What does it all mean? Pt 2: Drugs & Hormones

August 3, 2015August 3, 20155 Comments

Hormones, hormones, hormones…why am I injecting all these hormones and what do they do?? This is a good question – apart from doing as I am told by the doctor, I thought I should be able to at least answer this question to my friends and family who ask: What does each drug do and why I am taking it? So I am going to have to go back to school with this, I hope I am not patronising. I am sure I could recant all of this from my biology classes if they weren’t almost 20 years ago!!!

There are several ways a doctor can choose to stimulate ovaries for IVF treatment, these are called protocols and they can vary in dosage, type and timings. My doctor has chosen the antagonist protocol for me.

Back to basics...so let’s take it back to school…there are four major hormones involved in the menstrual cycle: FSH (Follicle-Stimulating Hormone), LH (Luteinizing Hormone), Estrogen and Progesterone. Today I am going to focus only on the first two weeks of the menstrual cycle, also known as the follicular phase.

During the folliclar phase, in a normal menstrual cycle the following events occur:

FSH and LH are released from the brain and travel into the blood to the ovaries.
These hormones stimulate 15-20 eggs in the ovaries, each in its own “shell”, called a follicle.
These hormones (FSH and LH) also trigger an increase in the production of estrogen.
As estrogen levels rise, like a switch, it turns off the production of FSH. This careful balance of hormones allows the body to limit the number of follicles that mature to just one.

So what does this mean for IVF? The goal of IVF is to produce as many mature eggs as possible to create conditions for the greatest chance of successful conception, to do this doctors use injectible hormones to control this phase of the mentrual cycle and stimulate the growth and maturation of the eggs, ready to be fertilised.

So we know that FSH stimulates the growth and number of small follicles, for small follicles FSH is the major survival factor that enables them to develop beyond 5mm in diameter and to avoid apoptosis, i.e. the programmed death of a follicle and egg. In a normal menstrual cycle, multiple small follicles produce inhibin-B to lower FSH levels so that only one follicle will mature. In an IVF cycle, artificially increased FSH overides the inhibin-B levels and therefore allows multiple follicles to grow and mature. This is where the drugs Gonal-F and Menopur come in.

Gonal-F is a follitropin alpha medication (also known as a gonadotropin). It is a synthetic version of the naturally-occurring FSH. Where as, Menopur (also a gonadotropin), a combination of both FSH and LH, however unlike Gonal-F, Menopur is natural; it is extracted and purified from the urine of post-menopausal women -ummmm nice. It is believed that a small quantity of LH during ovarian stimulation produces a better result in some patients. It is for this reason that my doctor prescribes a combination of the natural and synthetic combination of gonadotropins, menopur and gonal-f.

As the gonal-F and menopur start to work, we need to make sure ovulation doesn’t occur prematurely, therefore they use the injectible Cetrotide. The active substance in cetrotide is cetrorelix, this blocks the natural hormone LHRH (Lutenising hormone releasing hormone). LHRH controls the production and release of LH which causes ovulation. The cetrotide stops the production of LH, preventing premature ovulation. This allows the doctors to carefully control when ovulation will occur.

The trigger injection. The controlled hormonal stimulation I have described so far usually lasts for about 8-12 days, and dosages vary depending on how the woman responds to the drugs. This happens all before another drug is injected – Ovidrel. Ovidrel is the trigger injection containing a synthetic form of the hormone human chorionic gonadotropin – hCG. There are several brand names for the hCG trigger shot including Ovidrel, Profasi, Pregnyl, and Novarel. hCG is known as the pregnancy hormone, but it also happens to be molecularly similar to LH. In a natural cycle, LH triggers ovulation. As part of fertility treatment, an injection of hCG is used to trigger the maturation of eggs. Ovulation usually occurs 36 hours after this trigger injection is given. In the case of IVF, egg retrieval is carefully timed to collect the eggs just before ovulation, but long enough that the eggs have matured in the body ready to be extracted for fertilisation.

In part 3 I will focus on explaining the second phase of the menstrual cycle which includes the lovely hormones estrogen and progesterone….yippeeee!!!

IVF DIARY VOL I: 01 AUG 2015

August 1, 2015August 1, 20153 Comments

Medication(s) administered and dosage(s). 2 injections: (AM) Cetrotide 0.25mg, (PM) Ovidrel – HcG trigger shot (yippeee!).

Medical procedures undertaken. Ultrasound and Estradiol blood test, Chris came along this time. The ultrasound was very uncomfortable with all the pressure building up in my ovaries. Today’s appointment was with one of the senior doctors who I had not yet met. The ultrasound seemed to be just a brief check that everything was to his satisfaction before he decided when I will trigger – Monday or Tuesday; this time the nurse wasn’t recording the follicles. The doctor asked me what I was planning on doing this weekend…I said “nothing!!”. He said he thought that was a good idea, perhaps I could just about manage some shopping (Chris was behind me shaking his head, miming ‘Nooooooo!!’). But really, I’m not a shopping kind of gal anyway. He also told me I should drink lots of water or gatorade (2-3 litres) to keep myself hydrated.

How do I feel today? I am super pleased no more menopur or cetrotide injections!!! Those medications are just AWFUL. Just one injection this evening, and I will be drug free until Monday! I’ll take that 24hr break!

What are my symptoms? I struggled with falling asleep last night because I like to sleep in the ‘recovery position’ and that was almost impossible as my ovaries are very painful. I even woke up once from the pain. Today I am still ‘waddling’ and feeling just a little bit sorry for myself. It’s a pain I have never experienced before. It is kind of like the pain after being punched in the stomach and been winded (if you know what that feels like!!), I also just feel generally ‘heavy’. It has been a glorious sunny day, my mum is visiting, we had plans to spend the day on the beach and all I really wanted to was lie on the sofa and watch TV. Not really like me at all 😦

How does Chris feel today? He is pleased the injections are over (well for now anyway), he is sad that my tummy hurts. He bought me some flowers to cheer me up today. He also bought me some cat fishing bait for when I am in bed on monday. What is cat fishing bait I ask you? Well it is a roll of crepe paper party streamers…I think his idea was that I can ‘bait’ the cats to sit on the bed with me and keep me company.

Any results? Today the smaller follicles on the left had caught up, but they are now at 16-18mm, which is just where they need to be. There isn’t an official count, but I know that there are at least 15 follicles in total. I have nothing to compare it to, so as long as the doctor is pleased I’m pleased!!! I don’t know my estradiol results yet.

What’s next? Chris will administer the Ovidrel trigger injection at 10PM this evening in time for my egg retrieval procedure on Monday 7AM! Nice and early :-s

Weight. NSTR

Waist. Despite my little bloating around my ovaries my waist has amazingly stayed the same size throughout the stimulation phase. I think I am lucky, but I have been good about not eating too much crap despite my cravings.

Boobs. NSTR

Hours of Sunshine 🙂 I managed to get out for a short walk to the beach and around the neighbourhood – about 45 mins to soak up a little bit of sun.

*Notes. I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily. NSTR = Nothing Significant To Report.