IVF#1: Day 12 of Stims

Lining: 6.9mm
Right ovary: 6 follicles, largest 13.9mm
Left ovary: 3 follicles, largest 16.3mm
E2: 1218
Drugs: 150u Menopur 1xday, Suprefact 3xday


"Well that's bizarre"

These were the words that the midwife greeted with us this morning before my scan. My husband and I shared a worried look. She said that apparently my plasma hormones seem to be racing ahead of my follicles. i.e., my blood is responding correctly to the medication, but my ovaries are not as active as they should be. She said that this is especially odd considering how quickly I responded to the Menopur during my IUIs.

Also, my lining is still below 7mm. In all my monitored cycles I have never managed to break the 7mm barrier. So this cycle looks like it will feature a thin lining and low egg count, both predictors of failure. I don't think I'll be at the top of the class for this assignment.

We go back on Wednesday for another checkup, with a possible retrieval on Friday.

I calculated that a retrieval on Friday would put my due date near my birthday, and this led to daydreams of joint birthday celebrations in Disneyland with matching mouse ears. I would really like that.

IVF#1: Day 9 of Stims

Lining: 6.4mm
Right ovary: 4 follicles, largest ~8mm
Left ovary: 4 or 5 follicles, largest ~10mm
E2: 461
Drugs: 150u Menopur 1xday, Suprefact 3xday

My midwife seemed fairly happy with my scan today. She said that things were growing "not too fast and not too slow". They are keeping me on the same dose of stims, and they don't want to see me until Monday. She estimates my retrieval will be at the end of next week, maybe Friday.

I am really happy with my lining. One of the great things about a slow cycle is that it is giving my endometrium a lot more time to mature, compared to my premature response during IUIs.

Thank-you so much for all your comments, I am reminding myself that we only want one baby, so we just need one good embryo. It's about quality, not quantity.

And my lovely husband (who came with me to the appointment and held my hand throughout) was even thoughtful enough to ask the midwife for a print-out of my follicles because he knew I would be too shy to ask. So here they are - let's hope they're the beginning of something wonderful.

The Drawer of Hope

If you took a quick glance looked around our home, it would look like that of any other child-free couple - holiday photos, thick novels, delicate glass ornaments on display. Open a few cupboard doors, though, and you would find some clues as to our hopes for the future. The shelf containing books like "The Land of IF". The pre-natal vitamins in the kitchen. The Pregnyl in the fridge. The needles and sharps container in the bedroom.

And if you were to open the very bottom drawer in my husband's wardrobe, you would find our Drawer of Hope. The outfit I bought to tell my husband I was pregnant the first time. The hat we bought before our last IUI.The onesie we picked out when I was pregnant the second time. The clock that would be perfect for the nursery.

We don't open the drawer very often, but I am glad that we have it.

IVF#1: Day 7 of stims

Ultrasound report:
Lining: 4.5mm
Right ovary: 3 or 4 follicles, largest ~7mm
Left ovary: 4 follicles, largest ~9mm

So it appears here in my European clinic they like to stim us long and slow (150u Menopur / day), rather than the quick and fast stim protocols in the US. The midwife told me that she expects me to stim for another 7 days.

Once again, I guess I just have to trust that they know what they're doing. Their live birth/cycle rate (25% for < 36) is lower than the US average (41% for < 35), but that could be for many factors, I guess (like compulsory SET). On the up side these cycles are funded by our universal healthcare.

It is hard to give up control - to let someone else make all the decisions. Part of me wishes that we were at the Colorado Center for Reproductive Medicine with their crazy 66.5% live birth/cycle rate, but then again I am glad that our clinic has an 11% rate of twins rather than their 39%.

How am I feeling? I am disappointed with my thin lining and my low number of follicles. I wanted to get 11 eggs at retrieval, so hoped to see around 14 follicles this morning. Instead I only have 7 or 8. I am constantly terrified that I'm going to forget an injection - or I'll forget my Suprefact and the suppression will wear off and I'll lose all my eggs. I am exhausted from constantly worrying about everything that could go wrong with this cycle.

Edit: My clinic called, and my estradiol is only at 139. They said not to worry that things were really quiet on the scan, this is my first IVF so they are taking things slow. They want to see me again in two days (Friday), and they'll increase my dose then if my follicles still aren't growing.

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.