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Egg Collection

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What a mindfuck that was.  Here’s what I’m leaning – you’re going to be blindsided at every point.

We went down to the clinic and I was the first patient of the day. We had the embryologist come in and talk to us to make sure that we wanted to wait till Day 5 to freeze, because it meant we may not get any viable embryos. Because I have so few follicles, typically you freeze earlier, because the longer they aren’t in a uterus the higher the chance they’ll be damaged. But… You don’t know if they’re viable until you test. You shouldn’t test until they’re blastocysts because else you’re taking cells that will damage the embryo. 

If the embryos are not viable, they won’t result in a healthy pregnancy anyway, they’ll miscarry or not attach. There’s no point freezing possible non-viable eggs and hoping, better to grow them, and test them and then freeze the viable ones.

So, that was The Plan – wait till Day 5 to see which would grow and then test the blastocysts. I panicked because I felt she was questioning The Plan. In times of stress, things like knowing The Plan give me something to hold on to.  It was not exactly what I wanted right before I went into egg collection. Having her question The Plan had me running all the reasons in my head right up till I was in theatre. 

Another blind side moment – finding out they stuck suppositories up your behind at the last minute (gross). And having the anaesthetist treat me like I was ‘Thursday Morning’ and not a real person.

Also, turns out I don’t do so well under general anyway. I was quite groggy and asked the same questions repeatedly, without really being conscious. I wanted to know immediately how many eggs they retrieved. I remember coming to and demanding to know (little did I know that I’d already asked at least seventy times before that moment).

Three eggs.

I got three eggs. I want to cry. I know the odds, I know that it’s a downward pyramid to success, where you lose some at every stage. And our downward pyramid starts with three. It seems almost impossible that we’re going to get through all the gates to a viable embryo…

Next gate: fertilisation. And then growing to blastocyst stage, and then testing for chromosomal normal embryos.

Three gates, where 70% of our embryos are expected to drop off. My body is sore, and I’m cramping and starving and annoyed at everyone for fussing.

And I’m gutted. I’m so sad. Three feels like such a pitiful number… especially when I know other ladies get 20+ eggs, three just feels so impossible, like the odds are destined to fail.

I’m scared that for all the time we’ve spent, all the injections and scans and tears, and all the money (sad face) that we’ll end up with no embryos at the end. I’m scared that even with pumping my body full of hormones for two weeks, we only got three. That if I wasn’t full of stimulants, I’d have none. I’m scared I’ll never get pregnant and have a baby. It’s a terrifying thought.

Phew. All of the fears. 

I was told to try balance the fear with the positive, so here is the other side: I’m grateful that I know now what my body is doing, and not five years down the track when it’s too late to do anything about it. I’m grateful that I have Zee who hasn’t shied away from any of this, who has been so wonderful and gracious, even when I’ve broken down. I’m grateful that I at this point I have no regrets – I’ll never wonder about what would have happened if we hadn’t don’t IVF. 

Even if the worst happens, we’ll handle whatever comes the best we can. 

Round Two

By Personal No Comments

February 2015.

I went quiet in this round. I didn’t want to talk to anyone, write anything down. After the last round where I ovulated all my eggs away, I feel like I’m being buffeted against waves of fear – constantly holding my breath waiting for something to go wrong.

It went better, this round. Its true when they say they learn from previous rounds. When we got to cycle day 12 we did double orgulatran injections to keep me from ovulating. I also went to daily scans and bloods, just to make sure all was in order and I hadn’t ovulated. The extra monitoring made me feel a bit more secure – it’s reassuring to know exactly what your body is doing. To see your insides and your blood tests correlating. 

I have a handful of follicles over 10mm. We want them to be 20mm or more for collection, and I have six.

Six follicles. Knowing that my ovarian reserve is low, six feels both like a triumph and an epic let down. I feel like my body isn’t doing what it’s meant to and it’s got to be out to foil me somehow.

Still, with the bloods and the scans we have tentatively set a date for two days time. Which means a whole host of injections tonight, the last of the menopur (the stims) first, the last of the orgulatran (the downregs) an hour later, and the trigger shot (mature the eggs) bang on 36 hours before I go in.

I’m nervous. Excited for this round to be over, but nervous. Bonus though, no shots for tomorrow. I’m very excited about that! The end is in sight and oh, I’m so hopeful! 

Fingers crossed all goes well!

Being hopeful, while also giving IVF the side eye

By Personal No Comments

February 2015.

We’re a few days into round two… I’m not excited. The beginning of this round was stressful – AF came early while we were in France. I was distraught and furious at my body. Why can’t it just do the things it’s meant to when it’s meant to? I feel so betrayed by my own body. On CD3 we flew back into Heathrow and caught cab straight to the clinic for bloods, scans and meds. They kept the clinic open for us, which I’m so grateful for. Small kindnesses make my heart explode.

Still, I’m not excited about this round. I hate the diet, and the injections and the weird tasting supplements. I resent this round, my body and that I have to do this to have a family.  I’m the opposite of positive and yet forever hopeful. Hopeful that I’ll get some viable eggs. That they will grow to healthy little embryos that are chromosomal normal. That will freeze well. That a little biological family is not impossible.

It’s a massive up hill struggle. I’m sad to be doing it.

I’m beginning to realise only now what we’ve agreed to. That last round we just dove right in, did some preliminary research, enough to confirm what we felt and off we went.

Now? Since the last round failed? I’ve dug deeper. Started reading books and proper research studies and discovered all the horror stories. Things like the effect BPA has on your cells and how it’s everywhere. In paper receipts and plastic take out boxes and cling film – stuff you touch EVERY DAY.

I’ve been reading about cell make up, and how every little cell has a miniature power factory in it (called mitochondria) and if there isn’t enough power from the factory at the right time, then good bye normal eggs, hello miscarriage, hello failed IVF rounds, hello all the bad things.

Even worse was reading what causes a power outage is BPA (even trace amounts) and insulin spikes (thinking of the high carbohydrate/high sugar diet I enjoyed before this makes me ill).

I’ve read enough to be scared, but not quite enough to know what exactly I should be doing. About what helps and what hinders.

So I ask questions. At my last appointment I asked about chromosome screening (called PGS). I think by doing so I’ve just raised the odds (and the costs! PGA is £3k for 8 blastocysts) of getting a baby at the end of this. A healthy, live baby. There are many points in this journey were it could all go wrong, where an embryo could no longer be viable. Considering I didn’t even make it to egg extraction… I’m hopeful, but a bit pessimistic.

This feels like an uphill battle. This feels like a massive undertaking. This feels like a much bigger thing than it did at the beginning of my first round, where all my thoughts were: “no worries! You give me meds, I take them and then you take out the eggs and freeze! Done!” Oh Sae of two months ago.

Now I know I’m going to need more than one cycle. That I’m going to be visiting the clinic with all the scans and bloods every three days for I don’t know how long. That I’m going to be on this don’t-fuck-up-your-eggs diet for the next three months at least. No carbs. No sugar. No dairy. No all of the things that taste amazing. Sad face.

That Zee will be injecting my belly every night again and as I get all teary (because it HURTS) we go through the routine of hugs and silly plasters and down time.

The meds make me tired. The routine makes me tired. This whole thing is hard. I feel like I’m only just beginning to discover how hard. 

This is our Plan B.  It’s a lot of effort for Plan B. But it’s worth it right? Eye on the prize.

How to be kind to yourself

By Personal No Comments

February 2015.

It’s been a week. And this week has been slow, and mellow. I’m lethargic, no energy or motivation to do… Anything. I’ve been sleeping more, and spending more time holding Zee, and just…

This is grief. There is this epic sense of loss and I recognise you, grief.

I’m okay to be sad. To take the time to sit and look at ultrasounds, to cry when I open the fridge because all my medication is still in the bottom draw, waiting for the next round.

I also found out that although we didn’t get to egg collection, based on the number of follicles I had I’d be considered a poor responder. I think this is the most heartbreaking, because it proves the tests and diagnosis. There is no way to shy away from this – my ovarian reserve is diminished.

I’m sad. 

I’m okay to be sad, though. The world can wait, there is nothing wrong with taking a moment to be sad. It’s been a handful of days… Two since I was meant to do egg extraction, five since the ultrasound… it just seems like everyone is trying to hurry me along, distract me. Lala! Don’t worry about your feelings! Look at this thing, read this thing, eat this thing!

I want to slow down, not speed up. I don’t want to busy away my feelings or be distracted.

I opened a new instagram account (@sae.hopes) and joined a community of ladies in the same boat as me. They use all the acronyms (TTC, waiting for AF, CD2, starting FET, IUI, IVF, BFN… Sad face) and I’m learning them. It’s comforting, having a whole world of these people who are in the same space I am. Watching their heartbreak and longing and happiness all through the Instagram interface. I haven’t opened my old ig account since. It’s not the same.

The Aftermath

By Personal No Comments

February 2015.

I’m struggling. I’m shocked and grieving (is that the right word?) and heart-wrenchingly disappointed.

I feel betrayed by my own body. Again. As if it wasn’t enough that my body is all end of the line fertility wise, now it’s ignoring the very strong drugs we went through great pains to inject every night. It released the eggs I’d spent two weeks growing, two weeks of painful injections and hope and tender bellies…

My doctor was all ‘oh dear’ and ‘I’m sorry’ and ‘I’ve never seen this in my entire professional career.’ None of that makes me feel better. I’m the one off, the 0.05% (her number, not mine). I’m that person that ovulates six days early on Orgalutran.

I knew it, too. Right when she did. I’ve done enough ultrasounds now to know how it goes. When she swung around to look at my left ovary and none of the black blobs popped up I knew it was wrong. Two days before there had been many of them, big black blobs crowded around each other, vying for attention. What I saw instead were little sad triangles. Collapsed follicles. Tiny corpus luteums.

I cried. I cried and cried and cried.

Despair. Disappointment. Waste of time, money, energy and pain. Waste of hope, and futures and everything. A waste of everything.

I wasn’t prepared to fail here. Zee was of the opinion that we shouldn’t talk to people… I did, because that’s how I deal… I build little people supports by sharing, like it’s no big thing to share. I wasn’t scared of sharing because I thought nothing would go wrong. We weren’t implanting the eggs, just freezing them.

No one would be asking or waiting for news because it was all going to go to plan. I wasn’t going to get pregnant so no one would be waiting to hear if it worked or not. I wasn’t prepared to fail here.

There were lots of other places to fail, I knew. Like that come egg extraction, a few of my follicles might not have eggs, so we’d get a few less. That perhaps some of the eggs might not fertilise. That of the ones that did, only 40% would reach blastocyst stage. And of those, perhaps only some would be healthy and viable.

But we didn’t even make it to egg extraction. We failed before the finish line was even in sight. I wasn’t prepared to fail here.

Needless to say… I stopped talking to my people. I don’t want to talk about how this round failed. Hear their sorrys and oh dears.

We’re going to try again, because fuck you body. I want my fairytale family, society has sold me a dream, society told me that this is my future and I want it. We still have the means and so we will try again. We will try again with what small ovarian reserve I have left, and we will take all the drugs and we will try again and again as long as we can afford to. We will try until there is nothing left to try. That is how I feel about this right now.

Still, I have to wait for my body to catch up, so I have some time to adjust. To grieve and to feel.

I was on a healthy eating diet, the four hour body one (no carbs, no sugar, no dairy) that was doing wonders for my body, energy levels, and sleep patterns and everything. My skin was awesome too. It was easy to do, too. Especially when I was going it for my little embryos…

I was kind of ashamed at being on the diet though, friends of mine were already making asides about skinny-ness and eating habits, in a way that only friends can do, pointed with a nice glossy coat of well meaning concern. It was easy to push that aside, though. If I didn’t want to talk about IVF I talked about energy levels through out the day and it helping me sleep. My body was in awesome, healthy shape, my doctor was happy, I was happy having something small to take care of, that I could actively do.

Now I think fuck the diet. I’ve eaten a handful of snickers bars. And peanut butter cups. And FRUIT. I’ve missed fruit. And fries. I’m going out to find fries later today, I will eat them all and it will be glorious.

I’ve got a few weeks to be kind to myself. To give myself chocolate and space and time before we start round two and I’m going to take it. We’re going to France for what I thought was going to be a celebratory eggs-in-the-freezer holiday. Still, I’ll take it as a take-your-mind-off-it one instead. We’ll see.

I have some time to be kind to myself, and right now there is nothing else I need to do.

What IVF Looks Like

By Personal No Comments

January 2015.

CD3

The injections are becoming a thing.  Zee and I stand in our little kitchen waving a syringe about. There’s definitely a learning curve – the first time Zee tried he wasn’t fast enough – he slowed down at the last minute because he was scared of hurting me. The second time in it went, sliding into my stomach smooth and easy like butter. Such a bizarre moment, standing there with a syringe sticking out, both of us waiting to see if the other will push it down and inject the medication.

Turns out that it’s that bit that hurts the most – pushing the medication in.  The menopur stings and I grimace. I feel like I’m being a bit of wuss about it and I’m sure if I had to do it every day long term I’d get used to it, but right now I feel delicate about this road we’re on. We’re determined and we reassure ourselves that we can do anything we want to, we have a plan and we’ll follow it. I know I can be stubborn when I put my mind to it but I’m glad Zee’s here. I’m glad he’s leaning in and I’m so grateful we’re in this together.

Nothing like a little IVF and large life changing existential questions to bring you together and make your relationship stronger

CD5

Headaches are a thing. Everything I read said it means I’m not drinking enough water so I’m trying to be conscious about drinking more… I started tracking it but struggled with a goal… How much water am I meant to be drinking?? I read some Internet forum things that suggested 4 Litres a day (what?!) – and that seems insane.

CD7

I am tired, my belly is sore from all the injections and from growing all the follicles. I am tender (physically) and delicate (emotionally) and very tiiiiired.  The orgalutran hurts so much more than the menopur. The needle is fine, but it always makes me grit my teeth.  It stings for ages, no matter how much belly massaging I do. Add the weird nausea and it’s peachy.

I’ve also spent too long reading IVF horror stories on the Internet. Oh Internet. I’m not sure about this part of IVF. It’s definitely no fun. 

CD 10

Well, we’re definitely in a routine now. It feels like something we just do. I’m tender all the time, I don’t drink anymore, I eat healthier and every night Zee stabs my belly with medication.

The routine doesn’t make it easy, though. We both hate the injections (though, I enjoy the closeness that comes after). I’m also getting pretty familiar with the clinic, going in every few days.  I had a dream that they only extracted one egg, and after fertilisation it only cleaved to a eight-cell morula and couldn’t be frozen. I woke up in a such a state… That all the time and effort and money was for naught. There was despair at the idea of doing it all over again for another ‘maybe’. I was relieved to wake and realise everything was still fine. Only a few more days to go!

I think I’m really lucky, in that I can afford to have this round. That I had savings I could use… I’m lucky that I had a pot I could use. Without it there would be no Plan B, or IVF or anything. I’m not sure what we would have done… I’m feeling all the weight of privilege right now.

We’re talking about an egg extraction day soon. Hopefully in six more days! I’ll be glad to have Plan B in the freezer.

Today I tried to stab myself with a syringe

By Personal No Comments

January 2015

We started a round of IVF today. Cycle Day 3. I had scans to check the follicles in my ovaries (five in the right, ten in the left) and bloods to check FSH, AMH and estrogeon. It was intimidating. I’ve never been in this situation before. Legs up in the air, wand up my hooha and my doctor is casually telling me how beautiful my uterine lining is. Beautiful, beautiful lining, apparently.

I’m getting the hang of it now. We do a scan, and then shuffle next door into her glorious office for a chat. I was shocked to learn that if my FSH was over 15 we wouldn’t go ahead with the IVF. They’d call me, if it was too high. My doctor thinks it’s unlikely that it will and based on my previous levels we’ll go ahead for now.

Then came a lesson in self medicating. I couldn’t do it. I couldn’t jab myself with a syringe, no matter how much I talked myself into it. I just couldn’t. It was such a mind fuck. I did try. For twenty minutes a nurse and I sat in a little cubicle, syringe in one hand, my belly bunched in the other. I was so upset – I’d start fast and by the end I’d stop just as the needle was touching my skin. It seems impossible and ridiculous and oh. I’ve never felt less capable than I did in that moment. I’m a determined person and I don’t like to admit failure. I was furious with myself and stubbornly kept trying.

In the end the nurse gently took the syringe and did it for me. Just like that, we’ve started. Zee has offered to take over the medication giving and I’ve grateful that I’m not doing this alone. I love him.

I carted a ridiculous amount of medication (boxes and boxes of it) on the tube home, which was a bizarre feeling. If I’ve carried thousands of pounds worth of drugs through the tube, I wonder what other people carry?. My fridge looks ridiculous – there is a whole shelf of medication.

So, I have a plan with medication amounts and times and a million scans booked in. IVF, it’s happening you guys.

The Screening Tests

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January 2015.

I’m on the Victoria line tube, and it’s filled with ordinary Londoners doing ordinary things. I feel different, and outside of their ordinariness.

I’m ahead of myself. Zee and I are on our way back from our screening appointment. (Prepare yourself for TMI….) I got my period today, and I was both relieved and sad. Relieved because its come before the appointment and I can put off all the things till next month. The big scary future not-yet-babies things. Sad because it meant I’d have to wait till next month to do a round of IVF and start The Plan. Anticipation, worry and fear do not go well with months of free time in which to dwell.

I met Zee at the clinic, his first time there. I could see immediately that things were becoming much more real for him… That it was one thing to talk about it on the couch while we watch tv and another to be standing in the clinic reception ready to get on with it.

First up, a semen analysis… It was crazy to see his little sperm wriggle around (at x50 magnification), funny little organisms with no brain but looking very much like independent little beings as they wriggled about. It felt very bizarre and a bit teary, all those not-babies. I very quickly realised I was getting teary over sperm and pulled myself together (also: period. Go figure).

The Dr man who did the analysis was quite funny. He went out of his way to tell stories and set us at ease. He also said that the sperm was good, good sperm. Lots of active little wrigglers. That’s good.

Bloods after, for both of us. It was late and the lab was a dark and cold. Three vials, a teaspoon of blood on each to make sure we were all happy and healthy and disease free.

And then we found out that actually, despite what I thought, it can start IVF this round. Tomorrow.

I was shocked and felt my future surging forward. Oh fuck. Fuuuck. Okay. Okay, calm, this is alright. We’re just freezing some embryos. We’re just giving ourselves some time, this is our plan b. No need to freak out about injecting yourself with hormones and creating frozen not-yet-babies. Calm. Down.

What got scary was the consent forms… It felt like a massive thing. We spent two hours reading forms so we could agree, legally, what should happen to our unborn embryos in the events of death or disagreement. It was a commitment as big and forever as marriage without the big dress, witnesses and a party… I read all the long, often morbid and scary terms out loud, and we agreed. We’re doing this.

Everything feels much more real now, but also more clear, slightly less scary. We’re doing this. I’m determined and even though I’m not yet 100% aligned with the changes that will come with parenting a small child right this moment, I know what I want and I’m making it happen.

Alright future, come at me.

A green light. IVF straight on.

By Personal No Comments

January 2015.

I did it. I booked the appointment. It was the last thing on my todo list, so I did it. I had to stop thinking to get it done, but I did it just the same. Then, because it was booked, I went. 

My doctors office is huge, the size of my apartment almost. She’s got these white fancy suede chairs and this ridiculously large window and this desk bigger than my dining room table. What does she even need a desk that size for? It’s so big, she has to really lean over to take my hand when she says hello.

I guess that’s where the stupidly expensive fees I’m paying go towards. Ridiculously sized desks.

I’m nervous, because this is the appointment where I say yes to the impending family that I’m about to create. She smiles a lottery winning smile, and pulls out a worksheet that explains The Timeline. When I’ll take all the drugs, the ones that are going to fuck up my cycle by suppressing it, and then make it go crazy…. and when I’ll have scans and the development of my little eggs.

There will be an extraction (she shows a little animation with a wand that will violently stab my ovaries through the wall of my vagina to suck out each little egg one by one. It takes a moment to realise that I’m admiring all the work that went into making that 3D animation look smooth rather than paying attention to the content).

Afterwards, she explains about how we’d fertilise our cache of eggs (we wash them with sperm, or we inject them with sperm… depends on how well they swim apparently) and then we come to a gate.

We can either freeze them (Option a), or let them grow into little blastocysts and then freeze them (Option b). She said that of the eggs we extract and fertilise, only 40% of them are likely to make it to blastocyst stage. We’ll lose most of them, she said. We might even lose all of them (a negative outcome, she called it. When there were no viable embryos for freezing, that’s a negative outcome). That’s true whether we freeze them at day 1 and unthaw later, or whether we wait. Only 40% will make it regardless of the option we choose.

The bonus is that if they make it to Day 5, and their little cells do all that they’re meant to do, they’ll freeze better. They’ll thaw better, and they’ll be more likely to grow into babies. If I’m freezing them, surely it’s better to know that we’ve got some good ones straight up, right? So that if none of my little whatsit reach it to blastocyst stage, then I can do another round while I’m still young and my ovaries still have eggs left to harvest?

I can’t believe I’m doing this. That my thoughts are now consumed about the stages of zygote development (I can draw you the different stages, the difference between a morula and a blastocyst). It seems surreal that I’m debating the various pros and cons of freezing Day 3 or freezing later at Day 5.

This world is unfamiliar and I’ve got my head buried in IVF forums where they use all sorts of acronyms (BFP = big fat positive, FET = frozen embryo transfer, MMC = something miscarriage. Sad face). I read from the sidelines as the ladies from last year cheer each other on with all their highs (BFP) and lows (BFN).

I feel like I’ve just pushed the ‘accelerate’ button on my life. There is this epic since of urgency, and I feel like I’ve been betrayed by my body. That my body had ages faster than I want it to, faster than I’m ready for it to. And in this urgency there’s been a path to give myself more time, so I’m following it. White knuckled on the steering wheel as we accelerate into the big and scary world of IVF, and the world of scientific procreating.

Next up we’re doing all the screening tests. Both of us. Just, woah buddy.