Thursday, 30 June 2011

Public Transport Makes Me Happy

I had to share one of the most amusing pick up attempts EVER, with you guys.

Not, you'll be stunned to hear, someone trying to pick me up - now that I am teetering on 35 I have become invisible. I was merely a witness to this masterly display.

An attractive, toned woman got on a bus and sat down near me.  She was shortly followed by a guy. Short dark hair, short generally. He wore a T-shirt tight enough to show muscles that could only have been obtained by careful gym sculpting.

He saw the girl. "You go to the same gym as me don't you?"

She shrugged.

"Yeah." He confirmed earnestly,  "You do.  I've definitely see you there."

Her monosyllabic response conveyed absolute disinterest. So he moved on, slipping into the seat behind her.

He then made a phone call. I know some people are half-deaf and almost shout on the phone, and whilst others speak quietly, but there is always a discernible difference between someone just naturally talking loudly and someone speaking loudly and self-consciously, for the benefit of the people around him. There was no doubt this dude was doing the latter.

The snippets of conversation I overheard went something like this:

"Yeah, I'm flying out to start filming on Tuesday ... So I'll be in LA for the film on Wednesday ... I don't know exactly what yet... Yeah I mean helicopters, and cars and probably bikes.  Because he always uses bikes. If you think of any of his films like, er, um, well, Top Gun had bikes.

"Well, I'm going to have to slim down a bit. So no chocolate for six weeks.  I don't know how I am going to get through the next six weeks filming in LA without chocolate.

"Exactly, I mean it is a great job, I'll earn enough for the year in the next six weeks ...

"Alright, bye mate."

Having concluded his call he turned his attentions back to the aforementioned young lady.

"So what do you do?"

"I'm a barrister" she said in a way that conveyed law rather than coffee maker.

"I'm I stunt man" he needlessly informed her. "I'm going out to LA on Tuesday to work on a film with Tom Cruise..."

No shit.

The conversation flowed much easier after that. She didn't shoehorn in any mention of a 'special friend' and they seemed content to exchange tips on diet and exercise. As you do when you meet someone from the gym (I'm guessing here).

I got off the bus at the same time as the girl, who left with a cheery "see ya" to the guy and spring in her step.

Thing is, I've done what any normal nosey inquisitive of you would do.

And I can confirm that the bloke on the bus wasn't him, or him, not him, certainly not him.

And according to this story (and hundreds of others) the teeny tiny scientologist does his own stunts anyway (favourite line from the article: Generous Cruise also treated the whole group to burgers and fries).

I love the bus.

Sunday, 26 June 2011

If I'm Being Honest ...

I sometimes worry that this blog is unrealistic, that it can give the impression that I find everything pretty easy - except for the occasional blip around a negative - but generally that I trot on cheerfully with treatments, plans, injections and drugs.

I use this blog as a form of therapy. If I know I'm going to blog about a topic I try and think about the humour in the situation. It helps me to work out how I am going to relate my latest appointment in a way that will explain what is still going on but still be entertaining, it keeps me sane.

I don't want to mislead you. I've realised, particularly in the last week, that I'm not fine.

I act normal. I look normal. I haven't lost my appetite (more's the pity).

I can go in to work and function really well (except maybe on Thursday afternoon when I burst into tears in the office). I can write posts about Doctors appointments and crack jokes. I can make optimistic plans about next steps.

But I'm not fine.

About a week after the initial adrenalin of a negative, in which I organised appointments and made lists, things didn't get better, they got worse.  Maybe it is the progesterone come down, or just that I'd ground to a halt with my 'next steps'.

I'm struggling.

I blink up tears several times a day. Sometimes for no apparent reason. Sometimes because a pregnancy has been alluded to on twitter, or facebook, or the office, or a meeting, or a bloody property programme (I swear there has to be a study done showing number of pre-menopausal women on property programmes who get pregnant during the filming - it has to be a fertility charm, sign me up for Grand Designs). I've stopped wearing mascara because it spends more time running down my cheeks than lengthening my lashes.

I've thought about counseling.  Although I'm not sure that is the answer, because what I am feeling is perfectly normal for people going through what I, what we, are going through. I can't be expected to feel normal all the time. I need to grieve for by 26 embryos that never made it.

But don't worry about me I know I will start to feel better soon, once I've let time do its thing.

I'm turning off comments for this post, because it isn't about me. I'm not writing this to elicit sympathy, or to get told how brave I am. I'm writing this because I don't want anyone else to think they are the only one not coping and that I find it easy.  Or worse, I don't want anyone to see a friend struggling with infertility and think that it can't be that bad because Womb For Improvement seems to cope perfectly well.

Thursday, 23 June 2011

Just What The Doctor Ordered

So when you last left our intrepid hero (that'd be me, btw) I was at the doctors and had gone through the tests I thought should be performed - and was mostly rebuffed - now we rejoin the appointment to hear what the Doctor had to say:

The first thing he wants to do is another womb biopsy.

The most difficult thing about the appointment was hearing his assessment of my condition. It is serious, it is really serious.

In fact, the language he used was pretty sobering. (Not that I was drunk, you understand, as a rule I tend to avoid alcohol before Doctors appointments).

He said, and I quote:
"Someone up there is smiling on you."

This might seem a bizarre thing to say to someone cursed with infertility. However, he went on to explain; my first womb biopsy was terrible. He thinks I have had a very narrow escape from womb cancer. He was appalled at the amount of time it took from the first investigations to referral to a specialist (him) and a diagnosis.

He didn't mince his words. I will have to have a hysterectomy. After I have finished with fertility treatments, but pregnancy isn't the solution. The solution is full on removal. (Womboval? Does that work? No? As you were then).

For the rest of my life, until I have the hysterectomy I will either be having fertility treatment or be on the pill.

I had vague yearnings to try again naturally.  I'd read about some alternative therapies with dramatic results.

No chance.

Not just the Doctor, but the husband made that clear. Turns out the husband can't be bothered to go through the whole courting process again to find a new wife, so he is insistent that I don't do anything that might risk my health.  Either that, or he is worried alternative therapies might force him to drink ground up tiger penis, or worse have his taint pricked.

I sort of knew all this before, despite hoping that it might just go away. But the language the Doctor used, and his seriousness scared me. And was hard to hear.

So I get another womb biopsy - funded by the NHS as this is an ongoing, serious, medical condition.

Moving onto what he'd do differently next IVF. He said that next time - as well as giving me intralipids - he'd change my drug protocol.

The next IVF protocol will be Antagonist. Which is what the wombmate had. No I don't really get why either. He did explain, something to do with not wanting me to take Buserlein for the good of my womb-lining.

However, it will increase my risk of Ovarian Hyperstimulation Syndrome.

Meh, you win some, you lose some.

The next thing he said, however, got me very excited. He gave me a glimmer of hope that I might be able to get another round of IVF on the NHS. Unfortunately, a bit more research, has proved that not to be the case.

I shall therefore be spending this IVF-hiatus ferreting down the back of sofas for loose change as I try to amass the £7,000 needed for the next cycle.

Tuesday, 21 June 2011

What Now, Doc?

I'd like to say I went to the Doctor's yesterday with an open mind. That I would see what he had to say, and make my decision based on that.

As it happens I was already pretty convinced of my next moves. I had a list of tests I wanted and I assumed he wouldn't do then, I figured I'd gather up copies of my notes and move on without a backwards glance.

It turns out I was wrong.

The first thing I hadn't counted on was that I like my Doctor. This man has seen my vagina more regularly, and over a longer sustained period, than anyone other than my husband. I'm not a one night stand woman, this to me means real commitment.

So, it was nice to see him again.

The other thing was he didn't dismiss my list of test requests out of hand but gave me clear answers as to how useful he thought they were.

So this is his reaction to my list, and I shall prefix it with a massive disclaimer:


Got it? Good.

I shall continue.

Immuology tests - Theses tests are wide and varied. You can test for Natural Killer cells, for Auto Immune issues, Cytokine ratio, Lymphocyte Antibody Detection, I could go on. The idea behind these tests is that as the embryo is growing in my womb my body might detect it as a foreign body and start attacking it, especially if I am allergic to my husband whose DNA makes up half of the embryo.

Some Doctor's dismiss this as a load of rubbish.

Mine didn't, however he did caution a couple of issues with these tests. What happens if immune issues are discovered? Treatment is, at best, controversial.  One treatment is to take steroids during IVF and early pregnancy.  This has been shown to increase the risk of a cleft pallet in children.  Not a life threatening concern - obviously - but equally given the option not one you'd necessarily choose.

Another treatment is IVIg which, you can do your own research on, but my Doctor's concern is the long term effects of this treatment is not known.

Also one's body's immune system ebbs and flows, like when you get hay fever depending on what different pollens are in the air - if I had a test for that when it is particularly bad my blood count would be off the scale and allergens apparent.  In mid-winter I wouldn't show anything. Given that the tests cost in the region of £800 for what might be an inconclusive result he didn't think it was worth doing.

The treatment he best favours for immune issues is Intralipid Infusions. The infusions are a mix of protein and fats and nutrients. The proteins are derived from egg whites. Essentially it sounds like I'll get an intravenous dose of mayonnaise (and apparently it is about as calorific). The infusion was first used in coma patients and the Doctors notice that it has anti-inflammatory properties. So it seems to help with um... inflammation caused by immune issues.

Anyway, the point is the treatment isn't very costly, the tests are. Therefore my Doctor said that if we do IVF again with him he'll just do the Intralipid treatment anyway.

Thrombophilias (MTHFR) - This aptly named motherfucker increases ones propensity to blood clots. It can be a factor in reoccurrent miscarriage. But a) I've never miscarried and b) as a default my clinic prescribed Fragmin for my last two IVFs which would have prevented this being an issue anyway.

DNA Fragmentation -  I was pretty convinced this was the one. DNA fragmentation, in the sperm, doesn't show up on the main tests. Motility, quantity and direction all looks great, however it is only when the lads are scrutinised at DNA level that their flaws are truly revealed.  This, I conjectured, might be why I get embryo's but they don't hang around to be frozen and don't implant.  My Doctor was dismissive, he felt DNA fragmentation was again more likely to result in miscarriage than non-implantation.  And, more convincingly, he said it was likely to be more of a problem with ICSI, when one sperm is chosen to be injected in the egg.  In my case, with hundreds of thousands of the suckers swarming around my egg, he is a believer in fertilisation of the fittest - and thinks it is unlikely to be a factor.

That is the response to my tests enquiries, there's more but frankly this post has gone on far too long already and I am sure we all need a break. 

Monday, 20 June 2011

Summary Sheet

I am not, by nature, an organised person. If my friends get a birthday card within the correct month they can consider themselves lucky (the father's day card I bought remains stubbornly unposted), bills get piled not filed, and I am pretty sure I've lost track of at least one pension from previous jobs.

However, infertility has taught me the importance of notes. In fact the single most useful thing about this blog is I can go back and double check what treatments/drugs/periods I've had and when.

(Yes, yes, the second most useful thing has been meeting you lot. Honestly! Don't log off in a huff.)

Every appointment I go to I take with me reams of paper - letters from doctors with test results, lists of every procedure I can remember, and two copies of the all important summary sheet.

Whether they want it or not I give the doctor a copy of my summary sheet, and I keep a copy so that we can consult it together.

Ideally the summary (like any good CV) should be no longer than one sheet of paper, however I have now edged onto the second page with all the IUIs, IVFs and general fanny fiddling. And prominent, at the top of the page, is my ever increasing age (I tend to leave this off my CV, but in fertility terms it opens rather than closes doors as they note how swiftly I am advancing towards 35 and kamikaze eggs - six weeks to go).

Not all Doctors appreciate this. Many of them try to dismiss it.

I press it on them like an Aunty with a spare handkerchief. Usually it helps, it means when they are leafing through their file, which is currently rivaling the King James Bible for number of pages - if not literary prowess, they can work out chronologically where in their notes the information they want is likely to appear.

Yesterday I excelled myself, I prepared my own file - with dividers:

And I typed out my questions.

This won't actually help me get pregnant but hopefully it will make the appointment as fruitful as possible and, at £200 for a bit of face-to-face time, I intend to get my money's worth with as little faffing as possible.

I would strongly recommend anyone else, whether they are seeing a doctor for the first or umpteenth time, takes along their own summary sheet.

Right, lecture over. Wish me luck, actually forget luck; I just hope I get more than a sucking of teeth and shrugging of the shoulders when I ask what on earth I should do next.

Saturday, 18 June 2011

Random Folk

What do the following people have in common?

My flatmate from University
An ex-colleague
My ex-boyfriend's wife's boss
An Australian ex-pat living in London

Give up?

All of them have successfully got pregnant, through IVF, in London.

And all of them have been very generous with their advice and recommendations.  I'm not going to go into detail about their advice, if anyone is going to get sued for libel here then it had better be me.

However, what this has done is given me lots of things to think about whilst I research a new clinic.

The clinic where I have been going so far, which combines private and NHS patients gets glowing reviews. And I am sure they are brilliant and doubtless have fantastic statistics. However, I also feel they have had their chance with me, and I'd rather take my eggs out of that particular basket and put them all in another.

If nothing else it will psychologically feel as though I am trying something different.

Those of you who commented on my last post that I was going for the next round of IVF pretty quickly, I'm not. I do want a break, I need a bit of time, if for no other reason than I need the bruises on my stomach to heal before I start creating a whole host of new ones.

However, that doesn't mean I can't do a spot of research in the meantime and start to formulate a plan.

Wednesday, 15 June 2011

Official Test Day

Today was the official, hospital sanctioned test day. 16 days after transfer. The equivalent of 21 days after ovulation.

Of course there wasn't a fairytale ending.  It was as untroubled by HCG as all the others. Negative.

I rang the hospital, the response was sympathetic but equated to: "You've had all the treatment the NHS will provide, you can have the next available appointment with the Doctor for a debrief but he isn't available now until August or September, alternative you could see him privately..."

For those of you who don't know my full background (and why the hell should you?), it isn't quite that simple.  The NHS have been treating me for two conditions:

1) Infertility. It isn't life threatening. My treatment stops here.  Which I think is fair enough, I am incredibly lucky to have had the amount of treatment I have had on the NHS - three IUIs and 2 IVFs is not to be sniffed at.

2) Endometrial Hyperplasia. This is a bit more tricky.  This is when the womb lining grows thick and inhospitable and (in my case) was diseased with precancerous cells. The normal treatment for this condition is a hysterectomy, for blatantly obvious reasons I’m not so keen on this route.

I can't risk the hyperplasia growing back.  Even if I decided to give up trying to conceive altogether I can't become drug free, as the moment I stop birth control the lining starts to grow back and there is a real risk of cancer.

So the Doctor has written out a prescription for birth control to start as soon as the post-IVF bleeding begins (it has been held off by all the progesterone I've taken to date). Not for me then the story of: "We had IVF, it didn't work, and then as soon as we gave up I got pregnant naturally."

I don’t want to wait 2 or 3 months, whilst taking the pill, for an appointment that will essentially say. “Sorry it didn’t work, do you want to pay £7,000 for IVF at my private practice?” Therefore I am paying to see the same Doctor during his non-NHS hours, and remarkably it just so happens that he has an available appointment on Monday. Who knew that cash could be so effective at opening doors?

Oh, Ok.  Everyone.

So this weekend I shall mostly be compiling a shit-load of questions. Working out what tests I’ve had, and which I haven’t  -  because either they are too expensive for the NHS or considered a load of rubbish by my practitioners. I am not sure when we will start treatment again but in the meantime I am more than happy to give up some vials of blood for testing and I am sure that the husband will jump at the chance of another medically-sanctioned wank.

Hopefully this will give us a few more answers whilst we work out what we do next and when we’ll have the energy and emotional stamina for another ride on the IVF rollercoster.

Saturday, 11 June 2011

I Tested

It wasn't a lack of willpower that lead me to test on Friday morning, rather than the long-agonised over Saturday. (Although I double checked this morning too.)

I tested for self-preservation reasons.

As each day passed, with no blood, I became more and more convinced that the IVF had worked. I felt strange, new, sensations in my uterus areas. Not painful exactly, and not like period pains, I can only describe it as an occasional 'tweaking'.

I knew that if I waited too long I would convince myself it had worked and open myself up to a devastating fall.

However, it is difficult to imagine a result more crushing than yesterday's.

It was negative. As soon as I got the result it felt tediously inevitable. Of course it didn't work, why would it?

Then I cried.

A lot.

I can't explain to anyone who hasn't gone through this how it feels. So much hope, and anticipation. Knowing that cells that are a mix of you and your husband are growing, dividing, and are transfered into the one place where they should continue to thrive. And then they don't.

I have failed.

I can't, at this moment, ever imagine that I will succeed.

I know I say in my About page that I don't want this blog to be a catalogue of "it's not fair". But today indulge me.  Today I just want to scream it, over and over.

I won't give up yet, I am not sure what the next step is. The husband and I need to regroup and rethink.

Then I am sure I'll be back with the sex gags.

Thursday, 9 June 2011

Frozen Out

I was uncharacteristically tardy about following up on what happened to my left-over embryos. The embryologist had told me, on the day of my transfer, that I had a few embryos just trailing the chosen ones. He was going to check on them the following day and let me know what I had to freeze.

He didn't call me.

I didn't call him.

I reasoned that in this case no news was bad news. Bad news that I didn't want to hear.

Towards the end of the week I reluctantly called a couple of times, leaving unreturned messages. I was transported back to a time when I was single and telling myself if that boy really wanted to speak to me he'd have called. His silence was more telling than an awkward phone call.

Eventually, yesterday I spoke to the embryologist. He confirmed what I had guessed. Only one of the remaining embryos had made it to blastocyst, and that one was too poor quality to freeze.

I have no frozen assets, nothing held on ice for future use.

Currently, being in the two week wait the news is upsetting but I keep telling myself that it might not matter. That I might have real, living embryo(s) here with me right now.

And then a tiny, unwelcome, voice whispers, "14 fertilised, and none were good enough quality to freeze, what makes you think that the two they chose to put back were good enough to grow into babies?"

And it is that fear - not willpower - which stops me testing too early.

Ignorance is bliss.

Tuesday, 7 June 2011

Comments Round Up: When To Test

Thank you for all your tips and advice regarding when to test.  I have read, digested, cogitated and come up with a plan.

For those of you use to IVF speak I am currently 8dp5dt and 13days past egg retrieval. For those of you that aren't, it has been 13 days since my eggs were wrenched from my ovaries, and eight days since my five-day-old embryos were welcomed back some way south of the bosom of our family.

T warned me against a false positive as a result of the HCG shot based on advice here. My shot of 10,000 Iu was on the Monday before my egg collection. Which put me off testing until yesterday - a false positive must surely be more painful than a definitive result. (And it broke my heart to see she'd found this to her cost last year).

A couple of people told tales of testing too early to get a negative followed days later by a positive. MabelB tested 14 days after a retrieval but didn't get a positive until 17 days after. Which for me would be on Saturday. A ModernMedicineMiracle had a similar experience after her IUI, again waiting 17 days.

Most of your clinics aren't as harsh as mine making me wait 16 days post transfer (Which takes me to Wednesday 15 June):

  • The case for today as a test day came from NursLouisa. She said she got a blood test a week after transfer of a six-day blastocyst, adding an extra day (as my embryos were five days old) makes today my equivalent - but remember blood tests are more sensitive than peesticks.
  • Waiting and Wishing's clinic tests fourteen days after egg collection, which would be tomorrow for me.
  • Reinforcing tomorrow as a test day, The Cat Lady was told by her Doctor to test nine days after a five-day embryo was implanted.
  • Slackie O reckons that her clinic suggests a slightly more conservative blood test 15 days after egg collection - that'll be Thursday.
  • Guinevere made the good point that 15 days past egg collection equates with 15 days past ovulation which, based on the fact that my period comes 14 days after ovulation 15 days is officially one day late. And for me, Thursday.
It seems I could really test any time from now with a reasonable expectation of a fairly good idea of whether it'd worked or not.  In fact, I was sorely tempted to test this morning - it is the husband's birthday and I had romantic visions of skipping back into the bedroom pee-stick held aloft proclaiming  a special birthday surprise.  Then I had an alternative vision of spending his birthday lunch crying into my scallops. So I shelved that idea.

I have decided to stick to my guns, in consultation with the husband we agreed that I will test on Saturday. This seems like a good solution - late enough to give me a result I can feel confident in. I'll still have Saturday and Sunday to digest the result, before facing work. And I can carry out my week off plans without fear of having to cancel because I just want to escape under a duvet.

I just hope that nothing scary happens between now and then to drive me to the peestick.

Friday, 3 June 2011

Harnessing The Power Of The Two Week Wait

Anyone who has tried to get pregnant from more than about two months will know the worse bit about trying is the waiting between sex/IUI/embryo transfer (delete as applicable), and finding out whether it worked.

I would go further.

I would say the worse bit of the two week wait is the final week of the aforementioned.

This is the point when all the happy fluffy thoughts of "we did everything we could" gets swiftly replaced by darker thoughts of "this is shit, it clearly hasn't worked." Admittedly the darker side is usually (in my unsuccessful case) enhanced by a hefty dose of PMT.

The final week of the wait drags like a cricket test match. It is endless.

For this reason I have booked next week off work. If it is going to go slowly I might as well feel like I get an extra long holiday out of it.

I know what you are thinking - that I must be some kind of genius, and you wouldn't be far wrong. Except for the fact that, like so many of the best laid plans of mice and womb for improvement, I have slightly screwed up. The coasting and the fact that they still waited to do a five day transfer meant that actually, officially, my wait doesn't end until a week on Wednesday (the 15 of June). I return to work on Monday the 13th.

That is, of course, if I am good and wait the full sixteen days after the five day transfer before testing - as I have been told to.

Question: What do you think the likelihood of that happening is?

Clue: The answer sounds like "snow dance"

Question 2: When do you reckon it is safe to test to get a pretty conclusive answer? 13 days after transfer should be Ok, right?

(Although this might all be academic as, if I follow the same pattern as last time, I reckon I should start bleeding round about next Thursday or Friday).

Wednesday, 1 June 2011

Drugged Up To The Eyeballs

Despite any contra-indications you might pick up on from this blog; I'm not dumb.

Nevertheless, I find the whole post-IVF medication quite complex.  Far from being left to my own devices the clinic have prescribed me a plethora of medication to help my body welcome its much-longed for resident(s).

In the morning and evening I have to take a Cyclogest pessary. Straight up where the sun don't shine. Cyclogest is progesterone - a hormone I was prescribed even more of last time when I started to bleed. Progesterone is a hormone that your body produces during pregnancy, initially - for the first 8 weeks - by one's ovary and subsequently by the placenta. My clinic believes that by topping up my body's supply it will encourage the pregnancy to start/ stick around.

Three times a day (morning, noon and night) I take a pill called Progynova. This is usually prescribed to women going through the menopause. It releases oestrogen and the idea is that it helps the womb lining thicken - plumping it up to be a comfortable home for my embryos.

I also have a daily dose of aspirin. When I was at school we use to refer to aspirin as "The Pill" because it seemed to be prescribed by the school nurse for everything. True to form it they have thrown it into the mix again. The idea for this one is that it relaxes the blood vessels slightly allowing the blood to pump to areas where otherwise it might not reach, or my womb at least.

Not content with letting up on the injections, I still have to submit my stomach to a nightly jabbing. I give myself a Fragmin injection. This couples well with the asprin, it is a blood thinning agent ensuring it can slip through those relaxed blood vessels.

Finally, of course, there is the vitamins and folic acid. Complete with gurning pregnant woman on the packet.

Whilst IVF and the success of it, is constantly on my mind, I seem to have a bit of a blank when it comes to taking my various medications. I remember taking one pill, but did I take the other one too? Or was that yesterday?

So I have devised a series of reminders. My phone rings an alarm at the appropriate times for various drugs. I have a calendar in my kitchen with each different dose and drug written up and I dutifully tick them off as I ingest the appropriate one.

It isn't a flawless solution - yesterday, when all I did was sit on my ass recovering with nothing more taxing to think about than whether to snack on pineapple or (chocolate) brazil nuts - I completely forgot one of the  Progynovas.

I had yet another blood test today to check that the various levels are as they should be. I am kind of hoping that they are going to tell me everything is progressing nicely and I can reduce my daily intake. If, for no other reason, than there really isn't room on my calendar to list any more drugs.