Monday, 30 January 2012

IVF Admin

Got to love IVF admin.

Tonight I've signed all the consent forms, again:

  • Yes, I consent to IVF
  • Yes, you can use any left over bits for training purposes (no opportunity to caveat with 'as long as any learnings can be immediately used on me')
  • Yes, I know that I've been prescribed steroids as a half-arsed attempt to do something different but appreciate that "The use of this medication in the field of subfertility is still experimental, as the role of immune mediators in the process of embryo implantation has not been confirmed yet."
  • Yes, I understand the risks of a multiple-pregnancy 
  • Yes, you can cryopreserve my embryos.
  • No, I don't have a criminal record.

Tomorrow I go in for a bit more admin. The HIV and Hepatitis tests need to be updated. Even though I know I've done nothing to put myself in harms way on that account.

I'll also have my first official 'Are the eggs growing scan?'.  Now I don't want to count my eggs before they are ovulated but if my full-feeling gut is anything to go by either tonight's carbonara was laced with concrete powder or there is a fair bit of ovarian activity going on.

It is an odd feeling knowing that egg collection is likely to be about a week away but I won't know if this IVF has worked for at least two months. It sort of makes everything feel that little bit less real. Oh well at least I can go back on the booze as soon as the eggs are removed knowing they'll be safely tucked up in a freezer.



Friday, 27 January 2012

A Long Drawn Out Process

We are on like Donkey Kong.

If Donkey Kong was a a self-injecting, egg producing woman rather than a barrel-throwing monkey.

Yesterday I took delivery of my drugs and had a scan to check there wasn't anything untoward happening womb-wise.

Today I started at full throttle with no less than three injections (no more either, to be fair, in fact it was exactly three). I quite like injections at the start of IVF. I have acres of fresh skin ready to be injected, so it isn't painful - unlike towards the end of a cycle when the injections into a rotund egg-filled, multi-stab wounded belly sting to fuck.

It also feels good to be doing something that might possibly result in a pregnancy. Although not for a long time...

This is how the next few months are panning out:


  • Growing eggs until around second week of Feb
  • Egg collection, make some embryos. So far so normal
  • Wait a couple of weeks
  • Get a period
  • Wait ANOTHER couple of weeks
  • Take some pills for two MORE weeks
  • Have ANOTHER period
  • Have a womb scrape
  • Wait two more weeks
  • Return whatever defrosted issue they have into my womb
  • By which time it'll be Easter.
I know good things are supposed to come to those who wait.  But that's a bit bloody ridiculous. Innit?





Tuesday, 24 January 2012

Drugs Bust

I use to be a naive innocent. Trusting and unquestioning of authority.

That was before I realised I was infertile and understood that even trained medical professionals can get things wrong.

I have just ordered my drugs for IVF round four. I say ordered, I got a call from the drugs company who told me what the clinic had prescribed and asked for my credit card details.

I have an awful lot of drugs kicking around from the last three rounds and the cash they were asking for was almost twice what I paid last time so I double checked what they were planning on sending me against my current stash.

They'd me ordered 2,550 mg of Gonal F. Last round I was given a measly 300mg – which means this time they were suggesting eight and a half times more. The additional dose was going to cost a cool £725 ($1,130USD) - probably because it comes in a fancy pen.

So I checked with my nurse who agreed it did seem rather a lot and reduced my prescription to 600mg – I am getting older maybe she thought my ovaries could still do with a bit more of a kick start.

As I was congratulating myself on my parsimony I also mentioned that I didn’t seem to have any growth hormone prescribed when I had been told I would need some. Yes, she replied, I’d certainly need some Zomacton (that was the name I couldn’t remember). Which comes at a price. I ended up paying £20 more than was originally quoted.

This round of drugs came to £1,361.50.

*gulp*

Money well spent.


... If it works


Monday, 16 January 2012

A Heart-Stopping Moment

Before Christmas the husband and I each gave a vial of blood for chromosomal testing.

Whilst the husband and I have the full compliment of 46 chromosomes the issue may be that our, um, issue does not. This could, potentially be why I have experienced ‘recurrent implantation failure' (can you tell I’m loving having a different term to the ubiquitous ‘unexplained infertility’?).

I’ve been checking in with the nurses for my results at regular intervals always to be told they aren’t in yet.

Today, when I called the nurse checked my notes, and cheerfully announced they were in.

“We’ve got them both back” she confirmed “let me just check the results. Yours were normal.”

And then she paused, I’m not sure how long for. She was clearly scanning the notes for the husband's results but whilst waiting I had enough time to mentally rifle through my cohort of male friends and sort the potential sperm donors from the rest.

“And your husband’s were normal too.”

Which is a relief because I hadn't managed to find a suitable alternative.



Thursday, 12 January 2012

Portentous

I awoke on New Years day and before I was even properly conscious, or able to pull together a coherent thought, I was hit with an absolute certainty:


I knew I would never get pregnant and have a child.


Now I am a martyr to The Fear. The Fear being the day after a heavy boozing session I feel on edge and nervous, as though something terrible is about to happen. The night before my prophetic vision, as you’d expect had been a large boozy one, so it is no coincidence that I would awake with such a doom-laden prediction. Equally it is no coincidence that as a result I haven’t drunk alcohol since New Year’s Eve (or New Year’s Day if you want to get pernickety about bedtimes).

So what to do with the knowledge? Well, there are two mitigating factors.

1) I have the psychic ability of a dishwasher tablet. This has been amply demonstrated as at some point during every previous IUI or IVF I have had a strong suspicion it has worked.

 Every.

Single.

Time.

I haven’t wanted to say anything out loud but you know when you JUST KNOW. (And then it doesn’t work and you know that you didn’t ‘just know’ and suddenly the negative pregnancy test feels overwhelmingly inevitable)?

2) My father-in-law told me during the holidays that I’d have a child.  He even offered to tell me the sex of the child, I declined. He assured me “You will have a child at exactly the right time not too soon, or too late. But you will have one.”

So who to believe?

Well, I have absolutely no intention of acting on my gut feeling and giving up on reproductive intentions as a result of a hungover induced thought. And I very much look forward to being proved wrong.

Even if it means that I'll have to start listening to my father-in-law.

Tell me, have any of you had any psychic premonitions that have come true?






Wednesday, 4 January 2012

This'll Take A Second

I told you, just before Christmas, that my Doctor was brilliant. I didn't tell you the whole story.

The day after my appointment – completely out of the blue, she did the unheard of. She called me, apropos of nothing, to say that she’d been having another look at my notes and decided that next time they’d split the eggs retrieved and let half fertilise normally and use ICSI (manually injecting a sperm into the egg) for the other half. This was because my fertilisation rates for round one and three were quite as high as they’d like (round one, 12 out of 20 fertilised; round two I had a brilliant 14 out of 18 and round three a very disappointing eight out of 18).

No one has ever been so wonderfully proactive on my behalf. But there remained a lingering doubt. This clinic has had three opportunities to impregnate me and failed on each occasion, I wondered whether it was time to move on regardless.

So in December I furtively booked another appointment with a specialist who seems to be the 'go-to' guy for Recurrent Implantation Failure (my current diagnosis - unexplained infertility was getting so passé). This dude tests everything and tries almost anything. So I wanted to know what he would recommend for us.

Luckily I had been warned to do my homework first, and cautioned that his manner didn’t extend to small talk. I had barely sat down in the chair when he asked me why I was there. I didn’t feel “Doh! Why do you think? Dipstick” was an appropriate answer, so started to outline my infertility history, and then the avalanche of questions began.

“What dose of Clexane did you take?”
“How thick was your womb lining on your first and second attempt?”
“How many eggs did they retrieve?”

These questions I felt pretty confident answering but he pretty soon pushed beyond my knowledge:

“What type of growth hormone did you take?” Is there more than one?
“Why did they put you on the long protocol?” Umm... I didn’t think to ask.

I was expected to have the answer to every question at my fingertips and to be fair I literally did because I had lugged with me all 166 pages of my health records, but try leafing through that when you are asked what drugs dosage you were on for IVF number two and them immediately after being questioned on whether you had a specific Chlamydia test in 2009.

It wasn’t a bad experience at all, and he was on the ball scribbling notes and double checking things. But I really felt the pressure and thought longingly of my original clinic who would, in theory, know the answers to these questions because they did the treatment. (Although to be fair I have had to remind my original clinic of a few salient points when they’ve misread/ misunderstood my notes in the past).

This doctor had quite a strong accent so when he began to tell us what he’d recommend and why, I felt pretty confident that I got about half of what he said. The husband meanwhile sat there nodding sagely every so often but he clearly had no idea what was being suggested. I saw him out of the corner of my eye looking bewildered but I daren’t catch his eye in case I got the giggles.

The Doctor wanted to do the following:

Womb lining tests and clear out. My clinic is also planning a complete womb scrape before the next round. So that covers that.

Chromosome testing. We sent off out bloods with our other clinic before Christmas for this and await the results as I type.

The Thyroid test he suggested was also done before Christmas. I got the result yesterday and my thyroid function is quite normal, so that can be crossed off the list.

The big ones, and ones he is famous for, are the immunology tests. These were quite complex; he rattled off a number of tests faster than I could write, and when I asked the receptionist – at the end of the session – to go through them with me she gave me the lab names (FGA 4, FGA 6) which meant even less. Eventually I managed to get them to email me a list of the tests with names that any normal person would understand, you know things like Natural Killer cells and Leukocyte Antibody detection.

What you don’t know what they are?

Losers.

The tests were:
Natural killer cells
TH1/TH2 cytokine ratio
Leukocyte Antibody detection (for both of us)
HLA Antibody DQ alpha Antigens (again we'd both have that)

Ok so I had help from the Fertility Friends encyclopedia of immunology telling me the what the tests were for and what the treatment options are. And frankly this post has gone on long enough already so if you want to know the details I urge you to go over and read - but be warned it is complex and mind blowing.

Suffice to say there was a lot to look through. Most of the tests center round whether the cells in my uterus or antibodies I produce are attacking any embryo's that have the audacity to try and implant.

Adding up the cost of just these tests came to over £1,500.

Ouchy.

However, the majority of the treatment suggestions are Intralipids.

Intralipids.

Intra - bloody - lipids.

My clinic has already said I can do this next time with them anyway, for a fee of just under £300.

So guess what my plan is?

Stay with my current clinic and make sure I get the do get the Intralipid treatment this time, but forget the actual tests.

However, I am really glad I got a second opinion. It has given me a lot to think about and much more confidence in my original clinic's plans.