Egg Collection

Monday 4th December 2017
Kingston ACU
Kingston Hospital, London

I was trying not to stress while we were sitting for 50 minutes in rush hour traffic on the way to Kingston Hospital this morning. Luckily we'd left plenty of time to tackle the short 4.3 mile drive and we still arrived at the ACU on time. I decided to listen to my Mindful IVF app whilst we were in the waiting room, to try and divert my thoughts from the upcoming procedure to... well anything else really. We'd had a really tough couple of days, it was difficult to take our minds off the upcoming hurdles that we were facing this week, no matter how hard we'd tried to keep busy. My mum came down for the weekend and went to see Paddington 2 at the cinema, it was good to absorb ourselves in a charming CG world and away from reality for a couple of hours.

Five minutes into focusing on my breathing, we were called into the recovery ward where we met a nurse called Hayley. I was first up (again) so I was the only patient on the ward for twenty minutes or so. Jon helped me change into the flattering hospital gown, fumbling with the ties as usual, and we were greeted by the consultant Mr Tom Brooker. He was overly zealous but reassuring as he made sure we were happy with what would happen during the impending procedure. It's a minor op which involves a needle being passed through the vaginal wall and into the ovary to retrieve the egg. The anaesthetist then did his rounds and of course he was charming, anaesthetists really are the loveliest people on the planet!

Half an hour after I'd walked into the theatre room, I was back on the ward and as I started to regain consciousness, I started to feel groggy and restless. I wanted to know where my husband was and the nurse gently informed me that he was already gone. He was on his very own Challenge Anneka type mission with our silver box, which could only mean one thing... they managed to retrieve an egg! Unbeknown to me, I had already had a totally gibberish conversion with him before he left and I had specifically asked him to take a photo of the box on the train! I have no recollection of seeing him, nevermind any chat, but he is a good husband and he duly obliged!

My euphoric state lasted a few short minutes before I was back into panic mode again. What if he couldn't produce the goods on the day? I thought about texting him but decided against it as it probably wouldn't help his pre-performance nerves.

The IVF process is hard for partners, they largely get overlooked as it's mostly all about the lady. Until now. It's a huge chunk of pressure to place on a man, if he gets stage fright, the whole cycle fails. I started to think that we should have thought about freezing some sperm as back up in case he fluffs his lines. Having proved I was recovering nicely from the sedation by drinking adequate amounts of water and eating a dry biscuit, I was now back in the waiting room watching my phone in anticipation of a call from the boy. It was an agonising wait and one by the one the other ladies started trickling back in from the ward, looking spaced out and as equally anxious.

Two hours after my egg collection I finally received a message saying all was well and he was waiting for the analysis before he was allowed to leave. I was laughing out loud at this text exchange, much to the bafflement of the other women in the room, it felt really good to smile again.

Around forty-five minutes after that text conversation, he called to say he was on his way back to the hospital to collect me. The semen analysis showed that he had super duper swimmers, at least one one of us is working perfectly! The relief I felt at that moment was immense, after all the diagnoses and disappointments, everything had gone as well as we'd possibly hoped today and I couldn't wait to give my boy a massive cuddle. I know people talk about proverbial roller coasters but our experience of IVF so far has certainly been just that - a bloody high one. We've done all we can and we now have an agonising wait for a phone call from the embryologist in the morning to hear if our egg has made it through the night. Come on little one!

Scan Two

Friday 1st December 2017
Kingston ACU
Kingston Hospital, London

Today has been one of the toughest days I've had to get through since we said goodbye to my darling Dad exactly two years ago.

Alongside the sadness that comes with every anniversary, I was feeling calm but not too expectant as we once again got in the car to go to the hospital for another follicle monitoring scan. The initial bloating I had experienced 5-6 days ago had now pretty much subsided and I had expressed my concerns to Jon about the lack of discomfort a couple of days previously. Surely I should feel like my ovaries were ready to explode after seven days of stimulation injections? Luckily for Jon, I've had no manic outbursts, although part of me wished I had felt in the mood to throw a few pans around - at least I'd have some indication that the hormones were working.

I've always had a realistic outlook on life and today was no different, we can't change the situation and it's completely out of our hands. The inner control freak in me tried to remember this as I was laying on the bed with an ultrasound probe up my noo noo. I could feel my hopes slowly depleting the longer I laid there, the nurse was certainly having a good look around, I was starting to wonder if she could find anything at all. Eventually she said she was going to get the doctor to get a second opinion, as was always the case with a low follicle count. There, she had said it.

It seemed like an eternity before they both returned, but hardly any time for the doctor to confirm there was only one possible plan going forward. There was one lonely follicle which was considered 'ready' in my right ovary, the rest (maybe two or three) were non-runners, too small and extremely unlikely to grow to maturity, even if I kept up with the stim injections. I was devastated.

In the time it took me to re-robe reality had sunk in and I was fighting back tears. I was trying to keep it together so I could remember everything the nurse was telling me, Jon held my hand as he could see I was getting increasingly distressed and by the time we had sat down, I was inconsolable. The nurse was asking me questions but eventually offered to just talk so I could compose myself. We were told the plan was to bring egg collection forward to Monday, if we leave it any longer the one ripe follicle could become over-mature and we could lose it.

Back the waiting room I became more aware of all the couples who were a similar age to us, I was wondering if they'd had more promising news than we'd just been dealt. Regardless of their situations, everyone was there for the same reason, clutching their bags of medication and looking decidedly anxious. Thankfully, after a short wait we were called back in to see the doctor to go through the protocol for the weekend. The plan is to carry on today as we have been; three Suprecur nasal sprays and two Menopur injections. Tomorrow night, the stim injections will be replaced by a trigger injection (hCG) which has to be administered exactly 36 hours before egg collection. This induces the final maturation of the egg inside the follicle, if indeed there is one. I'm even starting to have doubts about that.

As we were leaving the hospital, we passed a lady pushing twins in a buggy, it was almost too much to bear. By the time we got to the car I was sobbing and I don't think anyone could've said anything to make me feel any better at that point. We drove to a car park in Richmond Park so we could have a chat (and another good cry). I wanted to go home and curl up in a ball on the sofa but I came to the conclusion that going into work and keeping busy would be the best option. I'm glad I made the call to be around people and not restrict myself to my own thoughts today, I'm definitely feeling a smidge more positive tonight.

So this is the hand we've been dealt. I'm completely heartbroken there will be no frozen embryos to have another shot if this one fails. This is it.

Aside from myself and Jon, the other person I'm really feeling for today is my Mum. Not only is she mourning her husband, I've just had to tell her our dreadful news. It has crossed my mind that we might not ever be able to make her a Nanna. For that, I feel awful.

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.

Better Late Than Never

Cycle Day 1

The one time I actually wanted my period to show up so I can start my first IVF cycle, it goes AWOL. I'm usually a regular 28 days kinda gal so the fact that she was a week late was really out of character and quite frankly, bloody stressful! She finally decided to show her ugly face late yesterday, on a Sunday of all days, so I had to wait until this morning to phone the ACU for further instructions. The nurse said if it had been one day later, we would've had to postpone the round for another month, meaning EC would be pushed back until January. The reason being, I have to fit in two weeks of taking the contraceptive pill to regulate my cycle before starting down regulation drugs on the 13th November, if it's less than two weeks, the protocol won't work. I'm just relieved that we are still able to go ahead and have all the treatment before Christmas.

So what have we been doing since our initial consultation last month? Mission IVF is now in full flow and we have ticked off quite a few items of the agenda already.

We've ordered and picked up the drugs from Boots at Kingston Hospital - Maexeni contraceptive pill, Suprecur (buserelin) nasal sprays, Menopur injection vials (stims) and Cyclogest progesterone pessaries. Seeing all the boxes sitting on my kitchen table has definitely made it all seem very real. We've both had all our blood tests - HIV, Hepatitis B & C and Jon has dropped off yet another sperm sample, making sure to keep it warm during the journey! I actually joked about him falling off his bike on the way to the hospital and spilling his precious cargo all over the road, but it probably wouldn't have been that funny come to think of it. I've also booked in my trial embryo transfer for next week. I just assumed this was commonplace but after speaking to a few women online, it seems that this isn't the case. I'm now worrying whether it'll be painful, given my history with painful smear tests and hysteroscopies.

I've bought myself a beautiful IVF diary from Bearface Prints, as you can gather by now, I like to document things. I wrote a cringeworthy journal every day as a teenager and was mortified when one day my Mum found it under my bed when she was having a good tidy. I later found out that she also keeps a diary so I guess it must run in the family! There's space to record all the medication dates which is extremely useful for me, if I don't write everything down, I'll most certainly forget. There are also pages for you to log how you're feeling at certain times during the process. It came with a lovely personalised note from Natalie the store owner, who has obviously been through IVF herself. The diary has certainly been made with a lot of thought and love.

I have also given up caffeine, which has actually been a lot easier than I anticipated. I swapped the humble English Breakfast bag or BST (Bog Standard Tea as my mother-in-law calls it) for peppermint tea a few years ago due to my stomach issues, but I do love a good coffee, especially first thing in the morning. I would even go as far to say, like many of us these days, I'm a coffee snob. There is one brand of instant that I'm more than happy to drink and luckily it also comes in a decent decaffeinated form...

So there's my tip for anyone struggling to find a nice decaff. Nescafé Azera 'Barista Style' Instant Coffee is going to be my saviour over the next couple of months!

As much as I'd love to sit here and write an entire entry dedicated to coffee, there are more pressing matters presently at the forefront of my mind. As I mentioned at the start of the post, today is (finally) cycle day 1, which means the start my IVF protocol. Wish us luck!

IVF Lingo

Since our initial consultation, it's no surprise I've fallen head first down the IVF rabbit hole. I've immersed myself in facebook groups and been reading up a lot on the matter in hand. Most of it has baffled me as it seems like a completely different language! I've also been in touch with a couple of other ladies, Sarah & Vicky, who are cycling around the same time as me and they've been great at keeping my head above water and offering advise.

I've made up a list of the most commonly used terms and abbreviations which might help you understand what I'm talking about over the next few months. It's a lesson for me too.


2WW  Two Week Wait (after ET and before OTD)
6dp3dt  16 days past 3 day transfer
AF  Aunt Flo (period or menstrual cycle)
AFC  Antral Follicle Count
AH  Assisted Hatching
AMH  Anti-Müllerian Hormone (indicator of egg reserve)
BBT  Basal Body Temperature
BCP  Birth Control Pill
BD  Baby Dance (sexy time)
BFP/BFN  Big Fat Positive/Negative (result after POAS)
CD  Cycle Day
CM  Cervical Mucus (my personal favourite)
EC/ER  Egg Collection/Retrieval
ED  Egg Donor
ET  Embryo Transfer
FET  Frozen Embryo Transfer
FMU  First Morning Urine (most concentrated wee)
FRER  First Response Early Result (pregnancy test)
FSH  Follicle-Stimulating Hormone
HPT  Home Pregnancy Test
ICSI  Intracytoplasmic Sperm Injection
IF  Infertility
IUI  Intrauterine Insemination
IVF  In Vitro Fertilisation
LH  Luteinising Hormone (triggers ovulation)
LP(D)  Luteal Phase (Defect)
MF  Male Factor (male IF)
(M)MC  (Missed) Miscarriage
OHSS  Ovarian Hyperstimulation Syndrome
OPK  Ovulation Predictor Kit (another POAS)
OTD  Official Test Day
PCOS  Polycystic Ovary Syndrome
PG  Pregnant (if only)
POAS  Pee On A Stick
POF  Premature Ovarian Failure
PUPO  Pregnant Until Proven Otherwise (during the 2ww)
Stims  Stimulation Injections
TSH  Thyroid Stimulating Hormone
TTC  Trying To Conceive
US  Ultrasound (new best friend)

So there you are, a little insight into the TTC online community!

First IVF Consultation

Tuesday 26th September 2017
Kingston ACU
Kingston Hospital, London

I was excited but a little nervous while we were waiting for our first IVF consultation at the same hospital I'd been treated at a number of times this year already. The clinic was running late and we had a long wait before we were called into the appointment, which didn't help the with the feeling of imbalance. I couldn't help but look at the other couples in the waiting room, I suddenly wanted to know all their stories. As you can imagine, the demographic was fairly predictable - couples in their late 30's to early 40's.

During the consultation with the Senior Fertility Specialist, Miss Despina Mavridou, we had a baseline scan, which is an internal ultrasound to determine my antral follicle count (AFC). The scan showed a very small number of follicles, two on each ovary to be precise, and my left ovary was tucked high up behind my uterus with little mobility. She discussed that it could potentially be difficult to access at egg collection. I started to feel like we were already fighting a losing battle and we hadn't even started the treatment yet - endometriosis has a lot to answer for! Due to the low AFC and previous blood test results detecting low AMH and elevated FSH levels (a good indication of a woman's ovarian reserve), they decided to put me on the very maximum dose of stimulation drugs. We then went through a number of things in detail, including the reasons treatment might fail, operative risks, side effects and the predicted percentage of success (20%), which I thought was quite high, all things considered.

I'd already started to feel very overwhelmed with information to process but this was nothing compared to how I felt after the second part of our appointment. After a further short wait we were ushered into another room to see lovely nurse Laura MacGreggor to go through a phone book worth of HFEA consent forms that we had to sign and date. This was in fact a contract between the two of us and the clinic outlining all kinds of morbid but necessary scenarios such as:

Do you consent to embryos created before your death being transferred to your partner after your death, and to being registered as the legal parent of any child born from your partner’s treatment after your death (ie, posthumous birth registration)?

We then went through our IVF protocol, highlighting key dates over the next three months. I was frantically trying to scribble everything down as I was so concerned I might mess things up if I had forgotten a vital piece of information (my short-term memory is non-existent). Key things I managed to scrawl on the back of the appointment letter were:

• Order the IVF medication from Boots
• Have blood tests (HIV, Hepatitis B & C)
• Jon to provide (yet another) sperm sample
• Ring clinic to book a trial embryo transfer (due to previous womb history)
• Start taking a birth control pill (they know I'm trying to get preggers right?)
• Start sniffing another drug to turn off my ovaries (see above)
• Phone in to book 1st scan (down regulation)
• Start injecting stimulation drugs
• Egg collection under sedation (preferably knocked out)

Laura then explained that the real embryo transfer would be at a different site at King's College Hospital in Denmark Hill. This means that within minutes of my egg collection, Jon will be handed a medical transportation box (fridge) containing my lovely eggs and he'll have to hotfoot it over to King's on the train where he'll then do his his part of the bargain. The following day, we'll hopefully get a call telling us the magic has happened and we have some beautiful little embryos in a petri dish.

Holy moly.


Guy's Hospital, London

As if my mind wasn't frazzled enough after our consultation, I decided to go to my first ever Endometriosis UK support meeting that evening at Guy's Hospital. I'd joined the London facebook group a few months previous and I'd already gained a lot of information but I wanted to meet ladies in the same position I now found myself in. Jon came with me for moral support as I was feeling very anxious about the session. I'm naturally very shy, especially in situations where I'd be meeting someone for the first time, so this was completely out of my comfort zone. Not one new person, but a whole room of new ladies all with one shared condition.

It turns out I had more than one thing in common with a couple of the ladies there that evening and towards the end of the discussion, a question about infertility and IVF was presented. At the end of the evening I got talking to Tijen and Kelda, both of whom were about to start the IVF process, we swapped email addresses to keep in contact over the next few months. I was aware I was talking really intensely as I blurted out my story to them, I'd had so much information to process that day, I was feeling extremely vulnerable and overwhelmed. On the way home, I had a chance to contemplate everything and I felt happy I had two people I could now talk to.