Tuesday, May 31, 2016

IVF 1 - Day 23 Transfer complete

Back from the clinic.  The transfer went very smoothly with minimal discomfort.  I got a few blurry pictures of the blastocyst on the screen before the transfer.  I may try to get one of those off the phone and onto here later.  The procedure itself was relatively simple.  I changed into a hospital gown, went to the treatment room, hopped up on the table.  They cleaned me and inserted a speculum, cleaned the cervix and then put a catheter just through the cervix.  Then they let the embryology team know they are ready and the embryologist loads a small catheter with the embryo and solution.  This is then threaded through the catheter in the womb opening and further up into the uterus.  The plunger is depressed and you can actually see a little white spot on the ultrasound forming where the fluid (and embryo) come out.  The catheters are then removed.  The embryologist then thoroughly checks their catheter to ensure that the embryo didn't get stuck to it anywhere (as they're very sticky at this stage) and if you're given the all clear then they remove the speculum and that's it.  I was given the all clear.  They did warn me that sometimes the embryo gets stuck and they have to reload it and do it again, but luckily that didn't happen.

In the end, I decided to transfer the one blastocyst from the frozen egg.  It had actually been the second best blastocyst (I got that wrong) in the morning but by noon, it was the same quality as the other that emerged faster.  Both were already hatching, so that was all promising.  The reason I decided on one was due to the risk factors of multiples and also that the success rate chances for the frozen egg is better because it's younger.  If it doesn't take and I need to do a frozen embryo transfer, then I may rethink the strategy of how many I put back.

Because.... the two slow emergers from this morning developed into full good quality blastocysts by the afternoon!!  Completely unexpected!  I was really shocked by this news.  So in the end, with 8 fresh eggs collected and 2 frozen eggs successfully thawed, I ended up with 4 good quality blastocysts; 1 from the frozen eggs and 3 from the fresh.  Those are pretty good statistics so I'm very happy with the numbers.  Of course I'll be even more happy with a successful pregnancy, but it seems like a good starting point.  So if this transfer doesn't work, I have 3 embryos to work with.  All in all, a good result.

The clinic gave me a pregnancy test and said that I need to test in 10 days.  I will of course be peeing on sticks well before that.  If today is day 6, then the earliest you could get a pregnancy read is day 8/9.  So I'll give it a few days and probably start testing in the morning like I did before.  Until the 'right' day when I will use the test they gave me.

So that's where I'm at.  Exciting and terrifying.  As usual.

IVF 1 - Day 23 6 Day report and transfer

So the good news is that two of the morulas have emerged to be good blastocysts.  One is from one of the frozen eggs (the leading blastocyst rated good/very good which is partially emerging/hatching) and the other is from the fresh collection (rated good/good).  Two more emerged but have yet to re-inflate so are considered slow growers and perhaps not good for freezing.  Two failed to emerge. This means I am going for a transfer today!

When I was speaking to the embryologist this morning she dropped into our conversation something about transferring two.  I have been reasonably comfortable with the idea of transferring one.  I was a bit surprised that she assumed I would transfer two as my clinic is very much against increasing the risk of multiples and makes a big deal about transferring one.  So I am struck with a conundrum.  Do I transfer one or two?  I can wait until the transfer to decide which is exactly 2 hours away.  I texted a good friend of mine who has undergone many many IVF cycles (15?).  Her first pregnancy was with twins and it did not end happily.  It was a complicated pregnancy (she is tiny) where she delivered prematurely.  One of the babies had problems and was in the NICU for months before finally succumbing to his issues.  While she's been very aggressive about fertility treatment, she says that she would never suggest to anyone to put back more than one now.

The balance is this - as you get older, your chance of successful live birth go down rapidly due to non-viability issues.  If they transfer two, your risk of multiples goes up.  Basically you are playing a game with weighing the risk of multiples against increasing your chances for one healthy baby.  If you do one at a time, you are looking at financial, time, and emotional costs.  If you transfer two, you run the risk of a multiple pregnancy which is higher risk and could result in various complications including increasing your chance of miscarriage.  Basically, for women under 38 they only recommend one but as you get older, the viability issue creeps up and up making it balance out to suggest that they are more comfortable with two.

I have the added complication that the leading embryo is not from 41 year old me but from 38 or 39 year old me, so right on the cusp.  Maybe if it was two 41 year old embryos, I'd feel differently.  But I'm nervous.  I do not want twins.  I am prepared to raise a single child.  I will obviously make due if I get identical twins.  But I do not need to do anything to increase my risks of multiples because it would make life incredibly difficult.

So I'm leaning towards the one and freezing the other.  The clinic says they have a 90-95% success rate with thawing embryos, so it's very likely that if this one doesn't take I can do a frozen embryo transfer.  If that one doesn't take, I can do all of this over again.  It's not like I have so many embryos to freeze.  We're talking about one frozen embryo transfer before I'd have to start anew if this one doesn't take.

So I think I'm leaning towards transferring the one, but I will definitely talk to the doctor when I'm at the clinic later to make the final decision.  I'm not against it if they think it's a very good idea.  But I definitely do not want to increase my risk of twins by much at all.

Very excited about the transfer today.  Still can't really believe it.  Still very nervous that it's just going to be negative results.  Trying not to be too hopeful but maintain positivity.

Monday, May 30, 2016

IVF 1 - Day 22 5 day report

The short version: the transfer will hopefully be tomorrow, another day of waiting ahead.

The longer version:

So this morning I was waiting for the phone call.  It didn't come at 9am so I started to get nervous.  I think the phone finally rant around 9:30.  It seemed like forever.  I was particularly feeling anxious because another woman on the SMC forum who was trying this month had 6 day 3 embryos that all arrested on day 4.  So I knew that this could happen, and I was worried I was going to get a call that said there was nothing to come in for.

The embryologist called to tell me that all six zygotes were successfully given laser assisted hatcing on Saturday, and all six have transformed into morulas.  A morula is a transformational stage where the embryo moves from a collection of equal cells to differentiated cells. Not all embryos emerge out of the morula stage, so it could still be that tomorrow there is nothing.  The embryologist was cautiously hopeful though that all 6 made it to morula stage; he said that he didn't expect them all to reach even that far.  So it's not great, because it means they're all a bit slow, but it's also not bad.  Yet.  So, more waiting.

This weekend I've been feeling somewhat emotional.  I don't know if it's due to hormones or what.  My friend came to visit Saturday/Sunday and brought her 22 month old son.  We had a good time, and I enjoyed having them here but I started to wonder what I'm getting myself into.  On the one hand it all seems reasonable, and then on the other hand it's completely overwhelming and terrifying.  I know that it is probably overwhelming and terrifying for everyone who has a child, single parent or no.  Still, I just felt emotional about it.  Am I really prepared for this?  Am I really capable of doing it?  I think these fears are normal.  I'm not overly worried about it, I just had a surge for some reason.

I also think that I might enjoy the baby stage, and I may enjoy post potty training, but I may not love the toddler stage.  I could be wrong.  And I assume everything is always different when it's your kid.  It's one thing to have a strange child in my home getting into everything versus a child who lives here who is used to my home and for whom the home is properly arranged.  I mean, your own kids for sure get into everything, but your life shapes around their presence in it.  Dropping a child into your life is a little bit different.

I think I've also been a bit grumpy because I think the Cyclogest/progesterone is making me have swelling and itching in the privates.  Really not enjoying that.  The swelling has gone down a bit, but the itching flares back up.  I read online that this can be a side effect, especially for women taking it vaginally.  I'm not, but I'm sure it's related.  Some of the online posters suggested getting some Canesten cream for the itch.  If I'm lucky enough to have a transfer tomorrow, then I think I'll also ask about this.

So that's where things are.  I'm feeling anxious.  I will know what's happening soon enough by way of the transfer at least, and then I'll have to wait to see if I'm pregnant.  And if I'm pregnant, I'll be waiting to see if I can get through the benchmarks without a miscarriage.  I'm not sure anyone ever talks about this stage of trying to get pregnant or pregnancy.  I'll be posting everything here, which includes if things go badly.  I'm positive not enough women talk about this and by the time they announce they're pregnant, they've just kept all this to themselves.  That's just not my style I guess.

Saturday, May 28, 2016

IVF 1 - Day 20 3 day report

The embryologist called me this morning to report that I have 6, 3-day embryos.  One of the fertilized seven seems to have stopped after a two cell split and isn't expect to go any further.  Of the 6, four are very good and two are good.  Interestingly, from the thawed frozen eggs, the best looking 3-day embryo is one of the frozen, but the one that stopped after dividing is the other.

I discussed with the embryologist that we will wait until day 5 for a hopeful transfer.  He warned me that from these 6, I would be looking at 2-3 blastocysts comfortably, and that 4 would be an exceptional outcome.  Fingers crossed there is at least one.

I plan to transfer one blastocyst if I'm lucky enough to have more than one.  I really don't want multiples.  If it happens on its own, that's one thing, but I don't want to increase my chances by transferring two.

The laser assisted hatching will be done later today on all of the embryos.  The embryologist told me that if you do it on day 5 you risk injuring the blastocyst.  On day 3, the shell or zona pellucida is still thick and easy to nick with the laser.  It thins towards day 5 so becomes more difficult.  It seems a fairly routine procedure so I'm not too worried about anything going wrong.  Also, I asked, and it's completely fine and normal to freeze a blastocyst which has already had the assisted hatching.  I'm glad they said they'd cap the cost at £250 now!!  Otherwise that would have been £125 per embryo.  I would have spent it of course, but I'm glad for the discount with 6 to do.

I've been feeling pretty bloated and a bit crampy since the egg retrieval.  Looking online, this could also be due to starting the progesterone/Cyclogest.  I'm not loving that I've got to take a suppository twice a day for what I hope is something like the next 10 weeks.  I'll do it obviously, I'm just not loving it.  And I hope the bloating and cramps reduce.

I'm sort of amazed when I think about it- that eggs from my body have been fertilized with sperm and there is potential life in a petri dish at the clinic.  It's actually sort of hard to get my head around.  You spend so long focusing on trying to conceive, it's hard to imagine the jump to the next step. I'm not there yet of course, and all of this may not work and could go horribly wrong.  But a thread of me is still pretty hopeful and giddy with anticipation. 

Thursday, May 26, 2016

IVF 1 - Day 18 fertility report

I'm at my workshop this morning, so no time for a long post.  5 of the 8 injected fresh eggs appear to have fertilized this morning, with another that may or may not (likely not) have fertilized.  Both of the frozen eggs that made it through and were injected with sperm have fertilized.  So 7 definite fertilized eggs from the 10 that got injected.  The embryologist said this was a good result as their clinic results for fertilization is 60-65% so I'm a bit higher.  Now, no news until Saturday where it will either be a 3-day transfer or a hold for day 5.  At least I have the workshop to keep me busy!!  Oh yeah, and I've started cyclogest/progesterone suppositories this morning and will be taking them every 12 hours for a while.

Wednesday, May 25, 2016

IVF 1 - Day 17 update

Early this afternoon my phone rang from an unlisted number.  My phone was not supposed to ring today.  I knew instantly that it was the clinic and something was wrong.  The head embryologist whom I had spoken to in recovery immediately told me that while it wasn't catastrophic, it also wasn't a good call.  Basically, out of my 6 frozen eggs, only 2 properly defrosted.  3 completely failed to reform, and 1 seemed to be okay, but then collapsed.  The 2 that defrosted properly were completely fine and able to have ICSI on them.  Out of the 9 fresh eggs collected, 8 were able to have ICSI on them.  So in total, they were able to inject 10 eggs with sperm.  Not catastrophic, but also not the best news.  In particular because the younger eggs should have a higher chance of better quality.  I'm still beyond thrilled to have had such a great fresh cycle, but the risks of chromosomal abnormalities is much greater, and increases every year.

So I'm not devastated or even particularly upset, but I'm now much more wary of the next hurdles that need to be passed.  Tomorrow around 10am I will get a call to let me know how many have actually fertilized as they will check for the double nucleus and for the ejected waste material from the cells.  I have no idea what the attrition rate will be for this next hurdle.  Assuming that some make it past tomorrow's hurdle, they won't look at them again until Saturday and decide then if it will be a 3 day or 5 day transfer.

If I end up with nothing at all to transfer, I will absolutely be devastated.  But we aren't there yet.  The embryologist was still pleased that we have 10 injected eggs.  To be fair, as I was only expecting a collection of 5, I've ended up with a similar number as I'd hoped, it's just that the majority are fresh instead of a 50/50 split.

It's also I suppose worrying for women who freeze their eggs as this is not a good outcome.  I expected 5 out of the 6 to defrost properly and thought I'd lose 1, not 4.  It's also interesting because I asked them to take 2 eggs from each of my 3 egg freezing cycles.  Interesting because the 2 that defrosted well and were healthy came from the same cycle.  2 that completely failed came from the same cycle and the other 2 with the partial came from the same cycle.  This could suggest there was a problem with the freezing.  The embryologist mentioned that on one of them it was difficult to remove the eggs from the 'plate' that they are frozen to.  I went to a very reputable clinic, so I don't think they intentionally screwed up, but it does go to show how tricky this process is.  Also, it was 3 years ago, and you would hope that techniques continue to improve.

So okay.  10 injected healthy eggs.  That's a good result so far - 8 fresh, 2 from frozen.  Tomorrow is another day and another phone call.

IVF 1 - Day 17 Egg retrieval

Back from the clinic and resting at home now.  Let me jump ahead to the fantastic news that they collected 9 eggs!!  I can't believe it.  I mean, I really can't believe it!  When I did the egg freezing 3 years ago, I never got that many out of any cycle.  I know they may not all be mature or able to be fertilized, but I'm incredibly pleased with this result.

So this morning I was feeling anxious and woke up pretty early because I knew I had to take an antibiotic at 7:30am and the taxi was coming at 7:45.  I think I was awake by 6:00 and was definitely not going back to sleep.  I didn't really have anything to do, because I had plenty of time.  I put a bag together because I didn't know how long I'd be at the clinic waiting for my friend to pick me up.  So I had some snacks and my kindle.

Anyway, I got to the clinic and I was clearly the only person there for a procedure which was fine.  And I was first in the morning, and I was early.  So they were still getting everything put together for the day.  I didn't mind, I'd rather be early than late!  I eventually got shown through to the recovery area where they gave me some tylenol to take and had me change into the hospital gowns (one on backwards and then one as a jacket/cover up that you take off.  Various people came through to talk to me and in preparation for the procedure.  There was a consultant doing the retrieval itself, and then I think a registrar observing.  There were possibly two nurses, the anesthetist, and a midwife who has recently joined the practice also observing.  So a fairly crowded room!  I hopped up on the table and the first thing that had to happen was the anesthetist had to get a cannula in me.  This was, of course, a problem and took her a while and 3 tries to get in.  One sort of went in so she gave me some phenobarbital (I think), but it wasn't good enough.  However, that dose made me relax a bit so I felt nice and cozy.  Eventually she got one in my other hand/arm and we were ready to proceed.  They stuck some monitoring pads on me and had me scoot down the table.  Once I was basically in position, they must have given me the drug because I was out.  I might have vaguely remembered a speculum going in, but the next thing I knew I was having pleasant dreams and was coming alert back in recovery.

I felt completely fine and relaxed.  I think when I come out of sedation I tend to be happy.  I don't know why.  I think this happened before.  Maybe it's some sort of relief that it's over?  Anyway, my alertness levels were quickly coming back and I just snuggled into the bed while they checked on my oxygen, blood pressure, etc.  Again various people came in and out, some to talk to me.  The midwife who was watching over me said that when she left the theater with me, they had collected 5 eggs.  So I was already pretty pleased with that result, but she said they still had more to look through.  Eventually the consultant came through and said that they had 9 eggs.  I mean I really couldn't believe it.

Later the embryology team came through and we confirmed my plans for the next steps and when they would be calling me with information.  I hope not to hear from them today, because if I don't that means everything is basically okay.  I will only hear from them if none or almost none of the 6 eggs defrost, or if none or almost none of the eggs are mature.  Otherwise, they'll perform the ICSI later this afternoon and call me tomorrow to let me know how many fertilized.  Everyone seemed very positive, and I feel pretty positive, so right now the positivity levels are high.  I know there are many things that can go wrong between now and a transfer, but given everything, it seems like I have the best chances I could have at this stage, so that has to be a good thing.

Meanwhile, I'm home relaxing now and taking it easy.  In an hour or so they said I could take more pain medication if I want to.  We'll see how I feel.  Fingers crossed I don't get a phone call until tomorrow.  I'm sure I'll think of more to write about the various questions I asked people, but I thought I'd get all this part down for now!

Tuesday, May 24, 2016

IVF 1 - Day 16 A Drug Free Day

It's very weird not to be worried about doing my injections today.  I'm trying to make myself drink a lot of water as I was told to, but I keep forgetting.  I am sort of known for not drinking a lot in general.

I had a look at my egg freezing cycles charting and I think I was charting stimulation days not period days, so this would be Day 15 on stims and Day 16 counting from period day 1.  By comparison, my egg freezing retrievals were Day 17, 17, and 16.  So I'm on target for tomorrow compared to previous cycles, on the early side.  For some reason I find reassurance in being consistent.

I just got cash out of the machine in preparation for my taxi to the clinic in the morning- no cycling for me!  I also bought some snacks yesterday as they told me I might want to bring my own as all they provide are unexciting biscuits.  And of course I won't be having any food after dinner tonight until around 11ish tomorrow.

My friend is coming around 11:30/12:00 to pick me up in her car and take me home.  I've asked at every single scan if this will be okay- that she's not there 'from the start' as it says in the literature they sent me home with.  If I get any flack about this tomorrow morning I will throw a massive fit. On the off chance my friend is late I'm also bringing my kindle and tablet but I suspect I'll only be coming around fully about 11ish anyway.

Right now this all feels very surreal.  My ovary isn't particularly noticeable.  I haven't done any injections.  I'm sitting at work (procrastinating by writing in my blog).  It's hard to believe this is really happening tomorrow.  And of course there's the caveat of all the possible failure points between now and a successful transfer.

At least I'll be busy at a workshop Thursday and Friday through the majority of the first phases of waiting.  Oh, and I completely forgot to pee on a stick this morning.  I think I can still do it this afternoon to see the double line.  If I remember.

Monday, May 23, 2016

IVF 1 - Day 15 last scan

Had my last scan this morning to confirm the egg retrieval schedule.  I take my Ovitrelle injection at 9pm tonight and my retrieval is scheduled for 9am Wednesday morning (of course I need to be at the clinic sooner).  I think I'm the first one of the day so that they can defrost the frozen eggs and then let me know if they defrosted okay or if they suggest defrosting anymore.  It looks like there were around 9 or 10 follicles of varrying sizes so I'm hoping for 5 fresh eggs.  If I get 5, that would be a good result all things considered.  On the day of the procedure I will take an antibiotic at 7:30am and I start the progesterone (Cyclogest) the day after the procedure.  I need to make sure I have everything prepared because I'll be away at this workshop Thursday and Friday.  But really, all it is I need is the Cyclogest I think.  I might pee on a stick tomorrow just to see what a positive test looks like from the trigger.  That is perhaps wasteful, but part of me wants to just make sure my ebay tests work.

So close now!  It's going to be hurdle after hurdle to get from here to a successful transfer.  There's a lot of possible failure points.  Fingers crossed.

Friday, May 20, 2016

IVF 1 - Day 12 retrieval scheduled

Just a quick update to say that I finally heard back from the clinic after having a mini panic when they hadn't called me by 4:20.  I called them, only to find that they close their phone lines at 4pm (even though they are open until 5pm).  I ended up emailing every email I had for someone there to say please let me know what the fuck is happening (in nicer words).  I finally got a call just past 4:40. Apparently they specifically close the lines so that they can make all the calls back to people but you know, it's the end of the day, it's stressful, maybe not the best plan.

Anyway, retrieval is Wednesday!  I do have another scan and probably blood test on Monday which I don't entirely understand, but fine.  I guess we'll see if I lose the big follicle and if the other slightly smaller ones have caught up.  I have enough drugs to see me through to then.  But yay!  Work crisis averted!  Retrieval scheduled!  Friend with car arranged for pick up!  Kind of exciting....

IVF 1 - Day 12 third scan and tenterhooks

Back from the clinic this morning, my gut was cooperating but the equipment was not.  All week my clinic has had some trouble with their new ultrasound machine in that it won't let the nurse tag the follicles correctly.  This happened on Monday and on Wednesday; today the nurse went and got the old machine because it was happening again.

The uterine lining was looking good and the ovary was clearly visible this time.  There are 6-7 good sized follicles of assorted sizes.  My biggest was 20mm and second was 18mm and then there were 4 or so around 14/15mm and a bunch around 10mm.  This creates a slight quandry.  Typically you can trigger once you have follicles over 18, but I have a bunch just behind.  So do we sacrifice the 20 to get the others to grow?  This decision will determine whether the egg retrieval is on Monday (I trigger tonight) or Wednesday.  Now I'm waiting for a phone call.  In the meantime, I decided to buy more drugs because I'm obviously very much hoping that they decide to do the retrieval on Wednesday.  I mean, obviously I want to do what's best to get the best result, but a Monday retrieval puts me in a 50% chance of having the bad schedule (if I need a 3-day transfer) whereas the Wednesday retrieval will be completely fine.  So now I'm waiting for them to check my blood estrogen levels and have a consultation with the doctors who meet over lunch.  I don't think I'll get a call before 4pm-ish.  So now I just wait.

It took 3 tries for them to get blood out of my fussy veins this time.  One of the nurses is getting super determined that she wants to get it on the first try.  I'm sort of hoping it's possible this is my last go at bloodwork there though.  I mean, I don't think I need another scan because they will just decide today when the collection is and another scan and blood test won't change that.

In the hopes that they will decide that my retrieval will be Monday, I had to buy more drugs; a 300 Gonal F pen and 3 Orgalutran/Ganirelex doses.  Luckily they have all that in the clinic and charge you the same as Healthcare at Home so there's no mark-up on the drugs.  I was also happy they had a 300 Gonal F pen because that's all I need and a larger pen would have cost more.

In other too much information news, all these drugs and what the nurse says are my estrogen levels are causing me to have a lot of vaginal mucus.  This is not so fun and perhaps a bit gross.  I hate wearing pads all the time as the lady bits like to breathe, so I'm just trying to be very clean and remember to go to the bathroom more frequently.  At least that part shouldn't last too much longer!  I think I remember it from my egg freezing cycles but maybe not this much?  I can't remember.

New budget update:

Previous total£12588
Extra drugs for cycle 1£241
New total £12829

Wednesday, May 18, 2016

IVF 1 - Day 10 second scan

I had a less positive experience at my scan this morning.  Mainly because my body was being very uncooperative and the nurse simply could not get a good view of the ovary no matter how much pushing and twisting of the wand, or pressing down on my belly, or even my going to the bathroom to see if that would make a difference!  The ultrasound stayed very murky and dark with occasional glimpses of the ovary but not a clear picture.

Because it wasn't a clear picture, it was impossible to clearly count how many follicles there were and at what size.  However, it seemed to be that there were 4-5 follicles around 14mm.  This is of course a decrease from the 7 that were visible on Monday.  Given that I tend to not get as many eggs as follicles, I'm now starting to steel myself for a disappointing result.  This then puts a lot of pressure on the frozen eggs and how they perform after defrosting.  Right now I feel like I'll be lucky to get 3 good eggs from this retrieval.  I hope this is not the case, but I'm nervous.

I'm sticking with the 300 Gonal F as they are clearly continuing to grow.  And it's still unclear if the egg retrieval will be Monday or Wednesday.  But I should know this by Friday because either they will want me to trigger over the weekend for a Monday collection, or come in for a scan Monday morning to confirm a trigger and Wednesday collection.  

My clinic only does collection on Monday, Wednesday and Friday.  I'm hoping the collection is on Wednesday because this will be the 'good' plan option.  If it's on Monday I'm going to be stressed that I'll need a three day transfer and have to be absent for the workshop I'm supposed to be running Thursday and Friday.  However, even though this is not ideal, the back up plan is in place for that, so not the end of the world, just not ideal.

I'm hoping for a better scan on Friday.  Also, I'm hoping for a better blood draw on Friday.  It took three tries today, even though we waited until after my scan (and the scan took a while).  So clearly it's not enough time to make a difference to my circulation if cycling is indeed the problem!

Monday, May 16, 2016

IVF 1 - Day 8 First scan of the cycle

I had my first scan today on day 8 of my cycle (day 7 by stimulation days).  I managed to get completely confused about when the appointment was based on how I put it in my diary which meant I showed up at 9:30 for a 9:00am appointment.  Luckily this was no problem at all and they saw me pretty much straight away.  It took the nurse two tries to get blood out of my arms.  I've decided that I think this blood issue is related to the 15 minute cycle ride I take to get to the clinic.  Typically if I've been cycling for over 10 minutes, my hands start to go numb and feel like I'm having circulation problems.  Because the first thing they do at the clinic is the blood draw, I think the problem with getting blood out is related to this.  I suggested next time they do it after the scan, we'll see if that helps.

So anyway, the scan was fine.  The nurse who did it had a little bit of trouble with their new equipment because it wouldn't get to where she could tag the follicles.  This meant I had the wand in me for a while until she managed to reboot the machine and finally get it it to work.  It also means though I got a pretty good look at the ovary.  So far so good.  The Gonal F is clearly working even though I'm not feeling anything yet.  I had around 7 follicles that were all 9.5-10.5mm, so that was great.  The ideal is for them all to be around the same size and they generally were.  It was clear at that magnification which ones were slightly bigger, but anyway, that was good, and there's still pretty much the rest of this week to go and for things to continue to grow and change.  In addition, my uterine lining also looked good.  The nurse was very positive and pleased, so that made me happy.

Of course I don't want to get my hopes up too high because in the last two of my egg freezing cycles, I had I think 9 and then 7 follicles and then only got 4 and then 3 mature eggs.  So even though seven sounds exciting, I'm trying to preparing for a low return.

My next scan is on Wednesday, and then I've already got one scheduled for Friday.  By Friday it should be clear if I'm coming in for a scan on Monday or if  I trigger or what.  I'm still thinking that based on previous egg freezing cycles that my egg retrieval will be next Wednesday, but we'll see.  I did ask this morning about this process as they require someone to take you home and stay with you (for 24 hours - or anyway that's what they say).  A friend of mine has offered to collect me in her car and stay with me for the afternoon, but she can't come until noon give or take.  However, I saw in the reading they gave me that they want the person who is going to take you home to be there from the start.  Well that's crazy- I can't just have random friends taking all day off work to sit around for a few hours while I have a procedure!!  It's hard enough to get people to be able to take time off to collect me at the right time!  This is for sure one of those times where I get very frustrated with the single mother element, and I also was frustrated during the egg freezing process.  Having been looking at doulas recently, I wonder if this isn't a service they should maybe consider starting to offer.  I'll deal with it, but it's annoying.  And now I have to wait to find out if I need someone there 'all day' or if someone can just come at the end.  I don't want to ask the boyfriend as I think it will upset him. Also, he doesn't have a car, so I'd have to book a taxi at which point I get annoyed about why I have to have anyone with me to begin with.  But I will work it out.

In other news I was at a dinner on Saturday night with some of my students who were graduating this weekend.  I had 1/4 a glass of wine.  I'm not going to kill myself over this.  I've been very good at taking all of my vitamins and morning pills, etc.  1/4 glass of wine is not going to make a difference!

Oh yeah, and I've started taking the Ogalutran which is Ganirelex (which I didn't know) in the morning.  I like that it comes in pre-filled syringes unlike the Cetrotide I had to mix and took during the egg freezing cycles.  However, it stings a bit after injecting it which I don't like as much.  For some reason the shots this cycle have all been more bothersome and often quite pokey.  Occasionally I get one in where I really can't feel it, but more often than not they feel pretty sharp.  Annoying!

Anyway, next update  Wednesday I imagine.

Wednesday, May 11, 2016

IVF 1 - Day 3

So managed to do my first injection last night but forgot I had a dinner to go to and so didn't do it until 10pm which was a bit later than my intended 8pm.  Today I have my drugs with me as I'll have to inject after the movie which will be around 8:30/9:00.  At least I'm moving it in the right direction and should be then back on an 8pm routine.

The shot hurt a bit last night- I don't know why.  Just didn't get the angle quite right so it was very pokey going in and I even moved it to see if it would be less pokey, but no. Anyway, I got it done and that was that.

I forgot that this morning I had an appointment with the counselor up at my clinic so I got in to work a bit late, turned on my computer, looked at my diary and was like, 'Oh shit!' so I had to put all my stuff back on and cycle to the clinic.  Oops.  While I was there I had a chat with the nursing team about when my first scan is scheduled for.  They reassured me that Day 8 (which is their Day 7 since they count stim days, not from period days) is completely regular and fine.  They did offer to give me a scan on Friday if I wanted one, but as I would have only been stimming for three days at that point, they didn't think there would be any adjustments.  So fine.  It really won't make any difference for me to see it on Friday versus Monday so I will just wait.  But I felt better for asking.

The talk with the counselor was good.  She was very nice.  This was a hoop jumping requirement by my clinic due to my use of donor sperm.  Right now I feel okay with everything, so I really just chatted to her and she asked some questions and all that was fine.  We did spend some time talking about the boyfriend because that is complicated.  I don't know that it helped to talk to her about it, but perhaps just again reassured me that I've got this sorted in my  own mind and am prepared for what may happen either way (he sticks around or he doesn't stick around if I get pregnant).  He and I still don't talk about the baby plan although I continue to update him on each step as I'm doing it.  I know he's not properly dealt with it in his own mind yet, but it's really just not my problem.  It would be my problem if I was relying on him, but I'm not.  I enjoy his company for what it is and if I lose it, I'll be sad.  But the baby plan is my primary focus and he's not actively part of that.  It's also why I was pleased to hear from the pregnant ladies at the DCN conference about doulas.  They all advocated for having one with you in the delivery room and I've since looked into it and looks like a great idea.  So I'm not even worried about who is going to be there with me because I will pay someone to be there with me.

I worked out with the counselor that it's not that I'm feeling optimistic about all this, it's just that I'm excited to be actually doing it.  I'm not unrealistic about the odds, but it's exciting to be doing something- moving forward, etc.  Although I may not feel that way a week from now, I feel that way today.

Tuesday, May 10, 2016

IVF 1 - Day 2

First shot tonight.  Happy to get this show on the road.

I called the clinic yesterday to tell them my period had arrived and schedule my first scan.  They said the doctor had put me down for an 'early' scan so they scheduled me to come in on Monday which will be day 8.  This is not early.  I was sort of taken back by this, as when I did egg freezing, or even when I had the IUI I think they scanned within the first 5 days. Day 8 seems a bit late.  I mean, some women even trigger on day 8!  Although I for sure will not.  I feel that day 8 is a bit late to make any adjustments to the medications.  I would have thought I should go in on day 5 which would be Friday. At the moment I'm undecided about whether or not I should call to ask for this or as for the reasoning for putting it off until day 8 or just to suck it up.  In general I'm not a fan of the suck it up approach and I prefer more information to less.  However, I also vaguely assume my clinic knows what they are doing.  Although maybe I shouldn't.  Seeing how many follicles there are in the scan, and how they are growing is supposed to help them decide how much drugs I should be taking.  By day 8, I'll be more than half way through stimulation, and I don't know that there's much more opportunity for adjustments.

The women on the SMC forum all felt I should push for an earlier scan or at least get in touch with the clinic.  I think I'll at least give them a call.  The women on the forum also all unanimously supported ICSI for the fresh eggs and assisted hatching for all embryos.  So that was interesting as well.  I did a bit more google research on ICSI and think it's probably a good idea to just go ahead with that. Assisted hatching also seems like a no brainer although there will be an additional cost per embryo for that.  Still, anything that helps.  And also, what's £125 when you're spending £6k+?

So it's Gonal-F only for the next few days before I add in the Ogalutran in the mornings.  All the drugs are currently taking up the cheese drawer in my fridge.  Huh.  Actually now that I'm thinking about it, I'm going to the movies tomorrow when I need to inject so I'll have to take the drugs with me.  At least they gave me a useful drug carry pouch with a portable sharps container for being away from home.  I'm going to go for an 8pm/8am schedule, or as close to that as possible for my injections.

So, still happy to be starting.  Still feeling positive.  This may obviously be significantly tempered whenever I actually get my first scan and see how many follicles are happening.  But also looking forward to finding out what will come out of the frozen eggs.

Monday, May 9, 2016

IVF 1 - Day 1

My period is here!  My period is here!  Who knew it could be so exciting?  I'm really a bit shocked that it's come so late, but anywhere, here it is.  My last period was particularly early, so I guess it makes sense. On the plus side, this would make a day 17 collection on Wednesday the 25th which would be a good timing, unless they decide for a day 15 collection, but I'll be surprised if this is the case. At any rate, this means I start stims tomorrow night, 300 Gonal F.  I'm excited and also a bit nervous to see how this cycle ends up.  How many fresh and then mature eggs will I get?  How will the frozen eggs defrost?  Will any fertilize?

The only decision I need to make now is whether or not to do ICSI and assisted hatching with all of the eggs or some of the eggs, or what.  I put it out to the ladies on the forum and it was a unanimous opinion that I should go for both.  I have to have ICSI with any of the defrosted frozen eggs, but it's optional for the fresh.  Given my age, ICSI is apparently better.  Assisted hatching is again recommended for things that are being defrosted and for 'older' eggs.  I fit into both categories, so I think I'll just go for both.  I did watch a video of ICSI though and it looked a bit violent.  Apparently there is a risk of damage to the egg, but it doesn't seem conclusive how that weights out against the risk of not fertilizing at all.

One of my best friends is having a frozen embryo transfer this month on almost the same timing as myself which would be a bit crazy for us to be pregnant at the same time.  Of course she's trying for her third child after something like 20+ cycles of various fertility treatments (which gave her the first two), so a little bit different.  But it would be sort of fun for me and my friend to be identically pregnant.

Anyway, fingers crossed for this cycle.  I don't know why I'm allowing myself to feel optimistic given the odds, but I just can't help it.

Friday, May 6, 2016

Obsessing over timing

No period today.  I did pee on a stick this morning to make absolutely sure that I wasn't actually pregnant somehow and it got missed from the last cycle.  My gut certainly feels like my period is coming.  However, so far, no period.  In order to avoid the conflict I have with the 26/27 I'm not moderately obsessed with trying to work out the likelihood of it being a problem by fixating on dates. In order to stop obsessing I'm going to dump it all here so I can just look at it to confirm what I'm counting.  Indulge me.

If my period arrives tomorrow (May 7) and that was Day 1, then (Option A) Day 17 would be Monday the 23rd and the likely collection day.  If I get a poor collection and they want to do a 3-day transfer, that would be on Thursday the 26th (BAD).  If I have a good collection and they do a 5-day transfer, that would be on Saturday the 28th (GOOD). If collection was Friday the 20th (day 14, Option B) which is unlikely with my history, a 3-day transfer would be on Monday the 23 (GOOD) and a 5-day transfer would be on Wednesday the 25th (GOOD).

If my period arrives Sunday (May 8) then collection would likely be Monday the 23rd (day 16) and we again have Option A.  Or, it could be Wednesday the 25th (day 18, Option C) which would mean a day 3 transfer would be on Saturday the 28th (GOOD) and a 5 day transfer would be on Monday the 30th (GOOD).

If my period arrives Monday (May 9) then collection could be Monday the 23rd (day 15) and we're on Option A again, or collection is more likely to be on Wednesday the 25th (day 17) which would be Option C.

So basically, a 25% chance that the timing will suck.

I have managed to line up a last minute fill in for me if this is the case, but I hope it's not.  However, looking at it like this gives me some comfort because it's only in the case of a less desired outcome (no good embryos collected on Monday the 23rd) that it's the BAD scenario and I'm obviously hoping for good embryos that make it to blastocyst in which case all of the options are good.  Okay. Maybe I can stop obsessing about this now!!

Thursday, May 5, 2016

Drug Delivery

The box itself didn't look like much....

However, inside the box was a shitload of drugs!!

We've got 4 x 900 Gonal F pens, 7 Orgalutran pre-loaded syringes, an Ovitrelle pen, 3 boxes of Cyclogest pessaries, an amoxicillin pill, and of course the sharps box.  My cheese drawer is looking very full at the moment....

No period yet.  If it comes tomorrow that's risky because I think my clinic only does egg collections on Monday, Wednesday and Friday.  That would mean they may try to collect on day 15 (Friday) which would be earlier than all of my egg freezing cycles, but otherwise would have to wait until day 18 (Monday) which could be too late.  If my period comes the day after tomorrow, or the day after that, then they might be going for the Monday collection (day 17 or 16 depending).  I'm pretty sure the clinic does embryo transfers on Saturdays, so if I had a Monday collection, I could have the transfer on the Saturday, avoiding the two days (Thursday/Friday) which will be a horrible work conflict.  If I have the collection on a Friday, the transfer would be on the Wednesday which would not be ideal because I still have some conflicts, but would also be okay, or at least, way better than the Thursday/Friday conflict.  So actually... I might end up alright with the work conflict either way- the only difference would be if they collect on the Monday and if I don't have more than 2 embryos that don't look so great, they could recommend a day 3 transfer which would be on the Thursday.  Complicated!!  I don't care though.  This month is a go, and I'm sort of excited about it.  Even though there's no guarantees in all this, I prefer to be taking action than waiting, that's for sure.

Change of Plans Again, AH!

Good grief!! I just got called by the clinic to tell me that in June they do a major clean of the lab and facilities and shut down. this means I can't cycle in June.  However, my frozen eggs are now in Cambridge, my drugs are being delivered today, and, most importantly, my period has yet to arrive.  This means I could start this month, like in the next couple of days.  Holy crap!  Just when I was settling in to having a month off, it's all systems go!

This is great, except for one small thing that I have a serious work conflict on the 26/27 of this month.  If I go by my egg collection cycles, my eggs were retrieved on day 16 or 17.  If you add 5 or 6 days for blastocyst transfer, this is squarely around the time of the work conflict, but could just miss it.  That's going to be the only stressful thing.  I suppose the best thing would be for my period to hold off for another couple or few days to put me well past it?  Anyway, it's going to be tricky, but I'm definitely not waiting until July.

I'm actually really excited about starting straight away although I was also fine with waiting a month.  No more alcohol or caffeine for me though!  I suppose it's not great that I've been indulging this month, although not so much, so that's not so terrible.

I'm actually sort of just really excited to be trying this month.  I'm going to try not to stress about the scheduling conflict until my period arrives.  Speaking of which, maybe I need to go to the bathroom.