The Two Week Wait

Today marks the halfway point of my 2ww before I find out if I'm with child for the first time ever. While I'd like to report I've been blooming and a joy to be around, this would be a barefaced lie. It's been mental torture and the progesterone supplements I've been prescribed are HELL.

Progesterone, often called 'the pregnancy hormone' (or horror moan as I've renamed it), is produced by ones ovaries after ovulation and it's job is to prepare the lining of the uterus for implantation. Ladies going through assisted reproduction treatments are prescribed progesterone supplements because the egg retrieval process removes cells that would normally create progesterone. The supplements, usually in pessary form, are needed to thicken the lining so the embryo will hopefully implant and grow.

I started taking progesterone pessaries (1 x 400mg Cyclogest, morning and night) from the day of my EC and the next day I was already feeling unsettled. This might me a little TMI for some so feel free to skip this paragraph, but pessaries are messy little buggers and I'd been using the back door to try and limit the pants puddle. Unfortunately this has played havoc with my stomach and the pain from trapped wind and bloating has been excruciating at times. To cut a revolting story short, I’ve tried alternating but now I've had to switch to using solely the front door which has relieved my symptoms a little, although creates a lot more mess. It's the lesser of two evils, though for me it's a close call. The great pessary debate is something that's always discussed within the #ttc community online but ultimately it comes down to personal preference. While there are pluses and minuses for both arguments, I think you just have to suck it (or stick it in) and see, there is no right or wrong orifice!

The other twisted and perverse thing about progesterone is that the side effects mimic early pregnancy symptoms. So far I've experienced intense cramping which is similar to period pain so I'm on constant knicker watch, bloated tummy, sore boobs and the one that tops the rest - thrush. This really is not convenient when you're trying to shove pointy, waxy bullets through an area that feels like a furnace, shoot me now.

This has all been a bit of a head f**k, but I've also had some news from a friend which has quashed my already waning positivity. For the last few weeks I've been in regular contact with a couple of ladies going through the 2ww around the same time as me. While this is good thing because it really is a massive support to be able to vent about symptoms with women who know, it's also really sad when the first one to test gets a BFN. Unfortunately, three days ago, this is what happened to my friend Sarah, though she had her suspicions a few days before. You have all these ideas that we're all going to get our BFPs and we're going to go on to be pregnancy buddies but then reality kicks in - this might not work. My other pal, Vicky, is due to test the day before me so I have everything crossed for her. This process really is torture.

So apart from emotional trauma and pessary issues what have I been up to during my 2ww? I've actually been trying to keep things as normal as possible. I took the day off after transfer and went for my third acupuncture appointment in Kingston, Victoria focused on blood flow this time and I nearly drifted off to sleep during the Zita West meditation. I felt so floaty after my session, I decided I was in the mood to do a little bit of shopping and even allowed myself to feel a little bit festive (very unlike me!). The next day (after feeling guilty about over doing it walking round the shops) I went back to work, partly because I wanted to get back to normality so my mind didn't implode but mainly because I had no holiday left.

Last weekend we bought a Christmas tree and decorated the house, which is very early for us! I enjoyed a lovely (alcohol free) dinner with friends at Côte in Wimbledon which was a welcome distraction from symptom checking and the negative thoughts that have started to creep into my head. Over the last couple of days I've been analysing every twinge, cramp or peculiar feeling as my period is due any day now and I've started to go into panic mode; rushing to the loo to check everything is in order every five minutes. Poor Jon must be really fed up with me now as the more anxious I've been getting, the more clingy I've become; my need for cuddles extreme! I've also been having completely irrational thoughts, such as thinking my bloated tummy is crushing the embryo. What fun!

One week until test day.

Embryo Transfer

Wednesday 6th December 2017

King's Fertility
King's College Hospital, London

I am officially PUPO! This is the closest I've ever come to being pregnant (as far as I know) and I'm not going to lie, it makes me feel a little warm inside. Initially, I was concerned about the two-day transfer as I'd not heard of this before, everyone talks about 3dt or a 5dt but never a 2dt. Why did they want to put it back so early? The reason, we found out during the transfer, was because we only had one egg and the best place for it to continue to fertilise and grow is back in the uterus. If you have more eggs to play with, they will try and nurture them in the lab until day five as they say you have more chance of pregnancy success with a blastocyst. The embryologists can also learn more about the quality of the embryo if it makes it to this stage. I guess they didn't want to risk losing my egg in a petri dish so decided to put it back where nature intended.

For me, the transfer itself was the least stressful stage of this process. I think I was so happy to have made it this far, I was glowing and couldn't wait for our embryo to be back where it belonged - I was even belting out Queen songs on the way in the car! Mr B on the other hand, did not find this part enjoyable at all. After a stressful wait to get into the tiniest hospital car park, I could feel the tension in our cubicle as we were delayed another hour on the ward at King's College Hospital. The nurses seemed a little disorganised and in a muddle about who was supposed to be going into theatre next which only added to his angst. Jon was also quite emotional which I think surprised him (and me!), he was really suffering in the run up to our transfer. I was just keen to get on with things as I had a full bladder that was getting extremely uncomfortable.

Eventually, after much confusion, we were called into the theatre room. I was surprisingly nonchalant as I clumsily climbed onto the bed and put my legs into the stirrups. It felt like I was in this graceless position with my nethers on show to the whole room for an awfully long time while the consultant went through the procedure, but she did make everything as relaxed as possible for both of us and I felt an incredible calmness. There was a screen on the wall where we could see live images of our embryo in the petri dish in the lab next door, she told us that it looked good (four equally divided cells) for a two-day embryo with little fragmentation. Both of us were completely overwhelmed at this point as reality sunk in that we had made this microscopic seed (with the help of a little bit of science) and it could potentially grow into our very own human. We watched the little dot being sucked up into what looked like a long pipette type receptacle and and a few seconds later, the embryologist emerged from the lab carefully holding the catheter containing our embryo.

I was expecting to find the procedure as uncomfortable as the trial embryo transfer I had experienced a few weeks ago, but I hardly felt a thing as they passed the tube through my cervix and placed the seed into its new home. I knew it was silly but I still asked the consultant if there was any danger of it falling out, to which she said, think of it as a sesame seed stuck in a peanut butter sandwich! After we watched the embryologist check the catheter under the microscope to check it hadn't gotten stuck, we were given the all clear to go.

As soon as we were back in our cubicle, Jon was overcome with emotion and it was a really poignant and touching moment. I was just grinning like a Cheshire cat who desperately needed to pee!

On the way home we stopped at Maccy D's, it's an old wives tale that the salt on McDonald's fries help implantation and some women swear by it. I have no idea how this superstition is supposed to work but do I care? No, it was guilt-free excuse to visit the golden arches if nothing else!

Down-Regulation Scan

The witch arrived a few days ago. On one hand this is fantastic news because it means I can go ahead with the next stage of my treatment, the flip side, I've been suffering with the usual stomach cramps and trauma that comes with this time in my cycle. Pair this with a tortuous liquid diet and a throbbing hole in my mouth where my gum used to be and you have a perfect recipe for self-pity and utter misery.

Once I'd manage to pull myself out of my pit of gloom, I booked my down-regulation scan for this morning. This was another internal ultrasound scan (hello Wanda!) which is carried out to ensure that my lining is thin and my ovaries are quiescent after the down-regulation phase (in my case, sniffing). My scan today confirmed both so we're finally ready to start the stimulation stage.

I don't have a phobia of needles, I can quite happily look down at my arm during a blood test, but something about self-administering fills me with complete fear. I had asked Jon during a conversation a few weeks ago if he could do the injections for me. Unsurprisingly, he wasn't particularly keen but unfortunately it is a necessity so one of us has to be brave. As I'm the one getting punctured, it seems only fair that he plays the nurses role. "It'll be nice for you to be involved at this stage" I keep telling him!

As I mentioned in a previous post, my stimulation protocol is 450IU of Menopur, the highest approved dose in the UK. Menopur comes in vials of 75IU so I need six of these mixed with two bottles of solvent, this means two injections with 225IU in each. After the scan a very steely nurse (that's being kind, she had no compassion whatsoever) showed us how to mix the injections and she administered the first two, one in each thigh. It actually stung more than I was expecting so I think we're going to try in my tummy tomorrow night, there's definitely more flab to grab there!

I read the patient information leaflet a few days ago and aside from the usual instructions on what to do if you take too much/miss a dose/get DVT, I came across this section:

1. What Menopur is and what it is used for
What Menopur is
Menopur contains a medicine called menotrophin. This is a mixture of hormones obtained from the urine of women who have passed the menopause.

WTF?!

Today was another one of those days crammed full of appointments. After my first injection lesson, I scooted across SW London for another dental check-up in another hospital with yet another dentist. She admitted the lady who had performed the surgery nine days ago had made a bit of a cock-up (not her exact words) and my gums were a mess. Fantastic.

I also went to my first acupuncture session which I thoroughly enjoyed and found very relaxing. Victoria spent a long time going through my health and fertility history before deciding on which areas to concentrate on. I don't know if it's going to improve my chances of IVF success, it did however, make me feel less stressed and more calm, which has got to be a good thing.

Natural Products, Nasal Spray & Needles

The last few weeks have flown and I'm already roughly halfway through my five week protocol (originally six weeks but my stupid period had other ideas). I've been through quite a time of it in the three weeks since my last post, some of it completely unrelated to endometriosis or IVF.

I started taking the contraceptive pill in preparation for treatment, which allows the fertility consultant to have complete control over timings of my cycle. It is also said to help the ovaries respond better to the stimulation medication and to decrease the chances of cysts forming which could delay proceedings. It's common for ladies with endometriosis to have ovarian cysts, so while taking the pill seems counter-intuitive, I can kind of see the logic.

During the two weeks I was on the pill, I took the decision to inform my bosses about my IVF cycle. Initially, I thought I might try and go through the treatment without having to tell anyone at work, but after getting some positive experiences from ladies on a facebook group, I decided to bite the bullet. I have two bosses, one of each sex, so naturally I resolved to approach my manager, who is female. I'm not even sure why I was worried, I've been at the company for 11 years and I'm fortunate that Louise and I have a good relationship. I couldn't have asked for her to be more understanding and supportive and as soon as I'd blurted everything out to her, I felt the weight lift off my shoulders. I can't express what a relief it is to have her backing and she promised she would do everything to help make the next few weeks as painless as she could with regards to time off for appointments. She also said she would talk to our Head of Dept and I knew he would be as equally empathetic.

A couple of weeks ago I had an appointment at the ACU for my trial embryo transfer. Part of me was glad to be having this dummy run, obviously if there were complications I'd rather they were flagged now, but what if it was excruciatingly painful? I'd just be worrying and dreading the real thing the whole way through my treatment. As we all know and get told on a regular basis, stress is not good for the process of baby making. Relax and it'll happen! *rolls eyes*

Again, I had to wait an hour for my appointment at Kingston ACU. I appreciate it's an NHS clinic and they're busy but when you have to go into work afterwards and give an approximate time when you might be there, this is extremely frustrating. Especially as my bosses have been so understanding, I didn't want it to feel like I was already exploiting their kindness. While I was in the waiting room I observed a guy looking very uneasy as he walked out holding a metal box containing his partner's eggs, on his way to King's to (hopefully) add his part to the science. I have to admit, this did make me smile.

The procedure itself was like a more painful smear test, as opposed to the nightmare hysteroscopy I had gotten myself worked up about. Thankfully it was over relatively quickly and without complication so we're good to go.

One way I like to unwind and destress is by having a glass of wine (or three). Following on from my abstention of caffeine, I decided to set a date to forgo my beloved Sauv Blanc before I started my down-regulation drugs. I ringed the 8th November in my diary to start my dry couple of months (hopefully longer). We had tickets to see both Kevin Morby at the Electric Ballroom and Father John Misty at Hammersmith Apollo the week before so we earmarked the latter as our last hurrah! Jon has decided to join me in this period of detox, after all, the health of his swimmers is also vital and we're certainly in this as a partnership. We might as well throw everything at this cycle as we only have one shot at this.

I have also been reading the book 'It Starts with the Egg', which I'm sure every IVF couple must have on their bookshelves. Whilst I think it is unrealistic to cut out everything Rebecca Fett mentions, I've been trying to use more natural products in my already pretty basic beauty regime. I found the Faith In Nature range to be reasonably priced compared to a lot of other organic products. I also wanted a fragrance free shampoo, conditioner and body wash ready for egg collection which they also produce.

Last week, I started sniffing Suprecur (buserelin) nasal spray three times a day. I realise this sounds like I have a solvent abuse problem, but it is in fact the next rung on our IVF ladder, the down-regulation stage. It works by acting on the pituitary gland to stop the production of hormones that control the release of eggs from your ovaries. Buserelin is a GnRH agonist drug (alongside Zoladex, Lupron and Prostap to name a few) and because it suppresses oestrogen production, it is sometimes used to treat endometriosis. I was actually looking forward to this stage, to hopefully give my body a break from the pain and bloating if nothing else.

I have read that lot of women suffer with menopausal side-effects while taking buserelin. Apart from the vile aftertaste it leaves in the back of your throat, I haven't noticed too many grievances so far. I'm only a week in so I guess the night sweats won't be kicking in quite yet. I have, however, been experiencing extremely vivid dreams, every goddamn night. And that my friends is an understatement!

I've had issues with my wisdom teeth for the last twenty years. Four days ago I had my second operculectomy to try and solve the problem of constant infections and pericoronitis. I wasn't particularly worried as I've had the procedure before but this time was a whole new ball game! I was stuck in the chair for a whole hour while the dentist completely butchered my mouth. By the time I'd driven into work, the anaesthetic had worn off and the concoction of ibuprofen and paracetamol weren't touching the pain, I sat there drooling and wincing in agony, desperate to get home for a sympathetic hug.

The dentist has made such a mess of things, I inevitably got an infection and had to go back to the hospital the very next day. I've been on antibiotics and a liquid diet for the last few days, which has meant I've lost quite a lot of weight. The whole ordeal has stressed me out so much, I really wish I had waited until after my IVF cycle to go through with it. Hindsight is a wonderful thing!

On a positive note, I've booked my first acupuncture session next week with a lady called Victoria Busk in Kingston. Hopefully this will counterbalance the trauma of this week and normality will soon be restored.