The Chair

This is one of the chairs in the waiting room of my clinic. It is filled with Gonal-F pens. I have no idea what the story is behind it. Did one lone infertile decide to make a monument to her years of injections? Did she want something tangible for all those cycles of hope and disappointment? Is this a donation from Merck to thank the clinic for all their orders?

I have never seen anyone actually sit in the chair. Perhaps it is a Wishing Chair? Maybe if I sit in it, the chair will sprout wings and take me away from the Land of IF.

Welcome ICLW

If you have found your way over here from ICLW, then welcome. This is my first time participating.

Our reproductive history
1. My husband and I have been trying to have a baby for 26 months.
2. Many things about our reproductive systems seem a little bit off - my tubes are slightly blocked, I have too many intrapelvic adhesions, I ovulate a little bit early, my lining is a little bit thin, his sperm count is a little bit low.
4. All four of our IUIs were unsuccessful.
5. We have had two spontaneous conceptions that ended too soon. We do not know why.
6. We are currently in the middle of our first IVF cycle.

My dreams and wishes
1. It was my new year's resolution to be pregnant by the end of the year. Next year I will be more specific, and resolve to get and stay pregnant.
2. I am very hopeful IVF will be our answer.
3. I dream of reading Winnie the Pooh and Matilda to our child.

About me
1. I haven't really bought any clothes for two years, because I always hope to be pregnant next month.
2. I love Disney but I feel terribly guilty about it because I think the Princesses are terrible role-models.
3. My favourite Starbucks drink is a non-fat white hot chocolate with sugar-free caramel syrup.
4. My favourite ice-cream is Ben & Jerry's Cookie Dough.
5. I am terrified of driving.
6. I don't really like my belly, so I am so looking forward to having a baby bump instead.
7. My current favourite TV shows are Glee, Gossip Girl, and The Big Bang Theory.
8. I love graphs and statistics. I seem to think that if I can chart it, then I can predict it, and if I can predict it, then I can control it.
9. I hate olives.

Cleared for take-off

I had my baseline check today, and we are cleared for stimulation.

I was a little put-off by the midwife who did the scan for me this morning. She wasn't very gentle with the wand, and she couldn't even find my left ovary. She just told me that it would stand out if there was a cyst on it, so it must be okay if she can't see it. Nor did she do a blood test.

I told her that I responded very quickly to Menopur, so she booked me an appointment for Tuesday (day 6 of stims), only to call me and move it to Wednesday (day 7 of stims).

I am not very good about standing up for myself. I don't know what is normal and what is not. Should I have requested a baseline blood test? Should I have insisted on a Day 6 scan? Or do I just need to relax and trust that this clinic knows what they're doing?

Hot Flashes or Hot Flushes?

I always thought that they were called "hot flushes" because you became flushed, but it turns out that the more common term in the scientific literature is "hot flashes". Whatever they're called, I have them in spades.

If you see a woman standing in the rain who is stripping down to a t-shirt, it might be me.

CD1 was yesterday, so now I get to simultaneously experience the symptoms of both menstruation and menopause.

Suppression check tomorrow - hoping everything is quiet on the southern front.

My Dream Cycle

I was inspired by Ms Egghunt today. She wrote about her flowchart for a perfect cycle, and said that she stuck it in on her door for inspiration, ticking off each milestone as it comes.

I think that this is a really positive and energising act, so I too have created my own flowchart for the next few months. Here's hoping that the Chief of the Universe gets the memo, and we both get to tick the boxes all the way to the end.

Bye bye birth control

Yesterday was the last day of my oral contraceptive regime. I should get my period in a few days, and then I am officially beginning my first IVF protocol.

Naturally, all my worries are still there - stim too fast/ stim too slow/ lining too thing/ eggs not mature enough/ no fertilisation/ no division/ no implantation - but I am so excited that things are moving forward.

The Pregnancy Announcement that Broke the Camel's Back

I have a friend. We shall call her Emma. She is 36. She lives in a different country, but we visit each other occasionally.

For the past two years we have been talking getting pregnant. While we have been trying to conceive, she has been holding off, waiting for everything to be perfect. I warned her about waiting. I told her that at our age, it can take a very long time to get pregnant. "Or for some people it can happen straight away" Emma told me. I sighed, and figured that she would have to learn the hard way.

Last time I saw Emma was March, when she told me that they had just "sort of" started trying. I sent her an invitation to fertility friend. I told her that we were planning to start IVF this year. "What's IVF?" she asked me. I sighed again, and figured at her age there was a chance that she might soon have a very good understanding of what it was.

As it was nearing Emma's six month mark of trying to conceive mark , and I was about to send her an email suggesting that she see an infertility specialist without delay. I could pass on my advice on laparoscopies and blood tests and sperm counts. We could commiserate together on the difficulties of falling pregnant, and I would have a good friend with whom I could share stories and complaints.

Then, I get this email from her yesterday. Four paragraphs in, I read:

"I am 18 weeks pregnant, due in January 2011".

I realised that Emma and I fell pregnant around the same time in May, only two months since they started trying. While my pregnancy ended in miscarriage, hers ended up in a baby bump and pregnancy announcements and decorating a nursery. Which is wonderful. Which is the way that all desired pregnancies should progress.

So of course, I promptly burst into tears. At work. In front of my computer.

I felt so betrayed. She was supposed to be my infertility buddy. I know so much more about ovulation, conception, fertilization, blastocyst formation, and implantation than she does. And yet she just had sex with her partner for a few months, and now Emma is the one who gets to have a baby in January.

The Miscarriage Club

A few months ago, I heard about an English-speaking IVF support group in my area. It was organised by this wonderful woman who, despite six unsuccessful IVFs, is willing to host monthly get-togethers of women involved in IVF.

Four of us met for dinner last night to share war stories and offer support. It was very liberating to talk about injections and ultrasounds, blood tests and urine tests. We all had miscarriage stories to tell, so many stories of hope and worry and disappointment.

We talked about anxiety, and about how there is no magical point at which one can stop worrying. The second beta, the second trimester, even birth - each milestone acheived brings with it new dangers and concerns.

Realising this, I am trying to remind myself that either everything will go well, or it won't. It is unlikely that worrying about an issue will change the outcome. So I am trying to enjoy the journey, treasure all the gifts that each day brings, and know that if something bad happens we will deal with it as best we can.

It is a great comfort of me to find this support network, to know that I am part of a wonderful supportive network of women who live nearby. I am looking forward to the next meeting in September.

Nasal pulverization

I started my suppression today. How exciting. I went to sleep last night like it was the day before my birthday. Then I managed to sleep through my alarm for my first dose.

I will not be taking one shot of Lupron in the belly each night. I will be squirting Suprefact (buserelin) four times a day up my nose (7am, noon, 5pm 10pm). Over here in Europe, they love their nasal sprays. Lupron and Suprefact are both gonadotropin-releasing hormone (GnR) agonists that interact with the GnR receptor. As they both act on the pituitary gland, I suppose that it has a shorter distance to travel if it starts in my nostrils. This will be especially fun at work, when I have to sneak into the bathroom with my handbag several times a day and secretly sniff up my drugs. I hope no-one thinks that I’ve developed a cocain habit.

I don’t even know if I’m doing it right - It feels so weird to inhale it, but at least it’s not another daily injection. Though by the end of this, I wonder if I will prefer one small jab to multiple daily puffs.

Here we go...

Amazon

In preparation for this cycle, I wanted to make sure that I had plenty of home pregnancy tests to use during the two week wait. Over here they keep them behind the counter, and I can still remember the look on the pharmacist’s face when I asked for four at once.

I decided to go with Amazon, they are a lot less judgemental about such things. Or so I thought. Once I navigated to the “First Response” page, I was greeted with these options:



Thank-you Amazon . Do you know something that I do not? Or do you tell all women that they may as well save 15% and have these things shipped monthly, because they’re going to be using them for a while? Or just for the women who have also bought “The Fertility Diet” and “IVF: A Patient’s Guide” in their purchase history?

It’s about to begin

I start my suppression on Sunday, and I go in for my suppression check on the 19th of August. I can’t believe that our first IVF cycle is finally here.

The past few months have been a wonderful month. No worrying about temperature or cervical mucus, no urinating on strips to test for LH of hCG. No hour-long trips to the clinic to get jabbed and probed. No supersensivity to any feelings of nausea or sore breasts.

We were able to take a nice long summer vacation, and focus on relaxation and togetherness. It was traquil and very enjoyable.

Now, however, I am in mission mode.

Back on birth control.

As of today, I am back on the pill, and starting my first IVF cycle, using the standard long suppression protocol. However, my clinic is closed over the summer, so I don’t start Menopur injections until Thursday August 19, which is another seven weeks away.

I am so excited that the time has finally arrived for us to start this cycle. After two clomid IUIs and two injectable IUIs, I am hoping that the process will be familiar, though hopefully with a different outcome.

With my IUIs, I always spontaneously ovulated before my lining had time to thicken. Hopefully the supression from Suprefact will hold everything back a bit so my endometrium has time to mature, if not with a fresh cycle, then maybe a frozen cycle.

I am hoping that work is not too busy around that time, that I don’t have too many early morning meetings, and that there isn’t anything critical when I suddenly have to take a few days off. Once again, I will begin the familiar pattern of trips to the clinic in the morning, anxious afternoons waiting by the phone, and then injections in the evening.

I am still a bit nervous about the retrieval. The nurse assured me that they administer plenty of pain relief during the procedure, and even put a special note in my file that I can have a Xanax before the procedure. I took something like that before my laparoscopy, and it made the world of difference. Funnily enough, knowing that I won’t be feeling anxious before the procedure is enough in itself to substantially decrease my worries.

So it is time for me to make my way twice around the circle of birth control pills, and then the real adventure will start to begin.

Ectopic ruled out

The doctor called me today, and told me that my hCG level was 19.

While this is good, in terms of no-emergency-surgery-for-an-ectopic, it is the final confirmation that this is indeed the end of this chapter.

Strange to think that I'd probably still produce a positive result on a home urine test.

I wonder how high my hCG levels got. Did they break 1500? Would we have been able to see a sac if we had gone in a week earlier?

It's funny, but this week is actually easier for me than last week. Those days of seeing all that blood, not knowing what was happening, and feeling so helpless were really tough. My heart would sore or dive depending on my symptoms. So much anxiety. Now that it is over, I don't need to worry any more. What's done is done.

In just over a week, I will be submitting my paperwork and picking up my medication for our first IVF cycle.

6w4d Miscarriage

For the first week after my beta, I was very optimistic – looking at dopplers and imagining how to tell my mum. Thinking about a January birth, signing us up for a pregnancy information evening.

From 5 weeks 6 days, the brown spotting became heavier. My husband would look at me and call me his “beautiful pregnant wife”, but I asked him to stop. I still don’t feel comfortable saying that word out loud. Every day was a mixture of hope and anxiety. The days ticked slowly past.

By 6 weeks 3 days, there was tissue, and by 6 weeks 4 days, there was a great deal of bright red blood. I didn’t feel any pain, but I knew that this was not a very good sign.

Today was the day of my scan, and I woke up today a bundle of nerves, pushing my husband out of the house so that we ended up arriving at the hospital half an hour early. They had me down for a 12 week NT scan, and as I corrected the receptionist, I felt like such a sham. I hated hearing myself say “I am seven weeks pregnant”. We turned the corner to the waiting room, and I was confronted with a long line of baby bumps. That was really hard for me, watching them walk out with smiles and little print outs of hands and feet. The wait was excruciating, but eventually my name was called.

I dumped my coat and bag on the floor in the corner, and the nurse chastised me, telling me to hang up my beautiful coat. Seriously, my coat. I threw it on a chair, anxious to just get to the scan. They asked me to pop up on the chair fully clothed, like I was getting an abdominal scan. I tried to tell them that I needed an internal scan, but first they started firing all these questions at me. Last menstrual period. 17th April, ovulation 9 days after that. Name of my family doctor? I told them that I don’t have one. Name of my gynaecologist? I told them that I don’t have one. “But you need one!”, the nurse explained “Who is going to follow you through this pregnancy?” This is when I lost it.

With my eyes full of tears, I said to them “There has been a lot of bleeding, let’s just make sure that there is a pregnancy first, then I can answer these questions”. I could barely stand or speak after that, and my husband gently took over, telling them about our reproductive history. They asked me to take my pants off, and I sat on the table half naked and shaking.

My uterus came into focus, and it was the same as I have always seen it – tight as a clam. The doctor was called quickly. They interrogated me – what made me think I was pregnant? Just a urine test at home? No, I told them, I had a blood test of 477 at 21 days post ovulation. I am so glad I got that blood test. I am glad that the system has some sort of concrete record that I was pregnant, that I wasn’t just mad.

The doctor was quite kind, gently explaining that she could not see anything in the uterus, and now her job was to search for something outside the uterus. She carefully looked along my ovaries and checked for extra fluid in my abdomen. There were no signs of an ectopic pregnancy. She tried to tell me that “at least you can get pregnant”, but I told her that after two years of trying, a miscarriage isn’t that much comfort.

They sent me off to get a blood test to completely rule out an ectopic, and told me they would send a copy of everything to the fertility centre for their records.

I then walked down the hall to the fertility centre to make another IVF intake appointment, and I was glad to hear that they can fit me in next week.

So how am I now?

I am comforted that I don’t have an ectopic, and I am reassured that I should be able to start my IVF cycle with my next cycle.

I am relieved that the worrying and anxiety are over.

I am thankful that I have a wonderful husband who held my hand through the whole ordeal, and who manages to make me smile every day.

But I am very sad that I am no longer pregnant.

I am so disappointed that we will never have a January 2011 baby.

I am worried that even if I manage to get pregnant again, I will not stay that way.

I am bitter than two pink lines will never mean the same thing again.

I am exhausted.