January Blues

I'm starting to feel a little more like my old self after this latest blow. I've been through this now familiar cycle of being knocked down and then having to pick myself up again a few times recently and quite frankly it's draining, but I'm getting stronger. Some days are still really tough where I can't even look at a child without being sad, but there are definitely more positive days emerging. I've got so much support which I'm hugely thankful for, not only from family and friends, but from my fellow IVF ladies who have reached out to me and offered advice and love.

I'm a shy person and I sometimes struggle in unfamiliar social situations, some people even think I'm standoffish when they first meet me because I'm uncomfortable in new situations. One of my best friends even said she thought I was a 'complete bitch' when she first met me - a couple of days later (and a few drinks down) we were having the best time together during freshers week! Eighteen years down the line and my friendship with Zoe is one of my most treasured. Last weekend I pushed myself out of my comfort zone and I had lunch with a new friend I met at an Endometriosis group back in September. Tijen has also just gone through her first round of IVF and has low AMH levels too. It was good to discuss our health and fertility issues in a more comfortable and relaxed environment and get to know a little about her too, although the people on the next table probably didn't appreciate the specifics! The conclusion we came to was that introspectively we still feel young, a lot younger than our middle(ish) thirties. A couple of years ago we would never have believed we'd be in the situations we're in now, but similar to myself, she wasn't ready to have children in her twenties or maybe even five years ago. Like me, she's only recently been diagnosed with endometriosis, so she's still getting to grips with that side of things on top of tackling the repercussions. I still can't help but feel anger towards the doctors who have missed diagnosing me over the years; I can honestly say that if we'd been aware of my potential fertility issues a few years earlier, we most definitely would have started this journey sooner, now I just feel like it's getting too late.

I've recently found the strength to start looking into our next options and I've been thinking about egg donation a lot more. It's definitely something I'm slowly coming round to, though I would say I'm still not one hundred percent there yet. Some days I think it's the answer to all our problems, others I get really upset because I'm still clinging onto the hope that one day I'll have a biological child of my own. Last week, a colleague of mine told me completely out of the blue that she dreamt I was pregnant with twins! She knows nothing of our IVF escapades so hopefully it's a premonition and not a pipe dream.

This week, I've started to get back on the healthy living bandwagon. I've been back to the gym, kicked the caffeine, cut down on alcohol and started taking Ubiquinol supplements. These massive red capsules (according to 'It Starts with the Egg') are a more absorbable form of CoQ10 and are proven to help with egg quality if taken for at least three to four months - the time it takes for an egg to develop. I'm now taking quite a rainbow selection of supplements to improve my health; vitamin D, selenium, a prenatal, turmeric and now Ubiquinol. If we are to have another shot at IVF with my own eggs, I feel I need to be more prepared. Last time, I went into it completely blind.

Follow-up

Tuesday 9th January 2018
Kingston ACU
Kingston Hospital, London

It's been nearly three weeks since our BFN. I've been feeling a bit more positive about things over the last few days, I guess that's because the acute agony we suffered post IVF is becoming a lousy memory that we can now slowly move on from. I won't say it's been easy - I've had some really low days over Christmas and New Year - but it's definitely becoming less painful. Until today.

The day didn't start too well when we arrived at Kingston Hospital and the car park was rammed as usual. After driving round for 15 minutes and getting increasingly more stressed with the other frustrated drivers, I decided to head in to our appointment on my own. I hadn't been in the waiting room more than five minutes before I was called in, typically the one day I was hoping they were running late. Sitting there feeling extremely vulnerable, the consultant went through all my blood tests and scans over the past few months and told me the results were extremely disappointing for someone of my age (no shit!). She told me I was still young in terms of IVF years but my AMH levels were as low she'd expect to find in someone in their late 40's, someone 10 years older. She asked if there was a history of early menopause in my family, to which I replied there was; Mum was 45 when she went through 'le change'. Although it's been discussed between my mother and I, especially recently, I hadn't really considered that I might have already entered perimenopause. I had hoped unrealistically that it wasn't heritable.

My AMH and FSH levels have been fluctuating over the last few months so she advised that it might not be worth us spending thousands of pounds on another round of IVF, I could get another month like the last where there was pretty much zero response from my ovaries. By this point, I was close to tears so I was relieved when Jon interrupted the delicate conversation about my failing female bits and asked to join us on speaker phone (still no luck with the car park).

Because they had already given me the maximum allowed dose of stims (Menopur 450IU), the consultant said there's not a whole lot they could change if we were to try again with another round. They don't advise to inject that amount of hormones for longer than a few days; it's not good for anyone, let alone someone of my diminutive stature and especially someone with a history of endometriosis. She suggested leaving my body to recover for a few weeks and get my bloods tested again when we felt ready to take the next step, if indeed there is to be one. She mentioned that if we were to try again, using donor eggs might give us more of a chance. We have already talked about this as a possibility but my head isn't quite there yet, I'm not done with grieving my own fertility and I'm not sure I'm ready to give up on my crappy eggs. We have a lot to talk about but unfortunately, unless we have a miracle (and I realise they do happen!) it's looking highly unlikely I'll ever be a biological mother.

After stopping for the obligatory post-appointment sob in Petersham Car Park, I dropped Jon off in Richmond and made my way into work. I felt numb and mentally exhausted and wanted to be anywhere in the world than sitting at my desk putting on a brave face. I pushed through the day and when I got home I had a big cuddle from Jon followed by a very large Gin and Tonic.

OTD

My head was humming with so many thoughts I thought it might actually explode. That on top of a banging headache didn't make for a very successful night's sleep. I woke up every hour and at 5am I could hold my pee no longer. Jon and I dragged ourselves, bleary-eyed into the bathroom and I urinated into a plastic cup. Three minutes and two negative tests later and we were back in bed, devastated and contemplating what what do next. I suggested I'd like to get away for a week on a beach, somewhere hot, anywhere but here would be preferable right now. I cried, I could tell Jon wanted to cry too but he was trying to be brave for me. The tests confirmed the inevitable, the progesterone hadn't done it's job and I'd started bleeding yesterday afternoon; while I was prepared for the worst, I was still clinging on to the tiniest glimmer of hope. We'd already spent most of last night in tears so it was almost a relief to put us out of our misery, our only NHS cycle had failed so we can finally put this to bed and start dealing with life without IVF.

I'd taken the last two days off work as I'd been feeling shitty, it's that all-too-familiar pre-festive bug that you usually get when you work and party too hard in the run up to Christmas. It's a real kick in the teeth as I'd avoided all three of my Christmas parties, hadn't touched a drop of alcohol in six weeks and had been eating healthily. I was now glad of the two days at home as on top of feeling like crap physically, I now have to deal with the emotional agony of our IVF failure. It f***ing hurts.

Unfortunately, Jon had to go to work this morning so I was left at home alone with my thoughts. Messages from friends came through on my phone, all wanting to know how it had gone. While I was grateful for the outpouring of love jumping out from the screen, I soon got tired and upset with trying to refashion the same unfortunate reply. I started to copy and paste the response message which, if you know me, is something I would never usually do. I just wanted to let everyone know as quickly as possible without having to ponder over it. At that moment, I felt a slight pang of regret that we'd told so many of our close friends about the IVF treatment, I did however, appreciate the love and support.

One of the hardest things I had to do was tell my mother, I could tell she was beyond heartbroken for us. Since my father's death (and years before), she's longed for a grandchild and I'd really hoped that we would be able to make this dream possible, not only for myself and Jon, but for her and Jon's parents too.

 After festering in bed all morning, I decided to be more proactive with my afternoon; I washed my hair with nice smelling shampoo, drank a strong coffee and painted my nails - all things that had been part of my self-imposed prohibition. The original plan was for me to travel up to Norfolk to stay with my Mum for a couple of days and to attend a wedding as her plus one. I couldn't bear the thought of being without Jon tonight or driving on my own while I was feeling so dreadful, so Jon returned home early, we packed up the car and drove the three hour journey to the motherland together.

Of course there were tears all round, but sometimes there's nothing better than a big Mama hug.

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!

Egg News

I've been sick with nerves all morning while waiting for the call from Jon. He's just spoken to the embryologist and...

Our precious little egg has fertilised!

Another hurdle crossed. Another box ticked. Another stage completed. How we've ever got this far is beyond belief, but we're here and I've been called in to King's for transfer tomorrow. Hang on a minute...

Tomorrow?

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.

Baby Celebrations

It's been a bit of a strange weekend filled with highs and lows and everything in between, I've really struggled to cope with my feeling at times. I've not only had to deal with us attempting to do my first injection in my best mate's kitchen, but also the emotions that came with attending her surprise baby shower.

I'd been involved with the organisation of Clare's baby celebrations (the arty bits) for a few weeks so after working out the dates, I knew it would fall in the middle of my treatment and possibly stim injections. I also realised it would be mentally tough, as I said in a previous post, we'd talked about having kids together and here she is having her third and I'm still very childless. Ultimately, she is one of my most dear and cherished friends and I wouldn't have missed it for the world.

We drove up to their house in Wollaston, Northamptonshire on Saturday. Clare had no idea about the baby shower, she just assumed we were just visiting for the weekend, as we sometimes do. I did think she might find it a little odd that we'd decided to come up the night we had to do our first lot of injections, but she didn't seem in the least bit fazed by this! As soon as we arrived, the four of us went for lunch which was just perfect as I knew I wouldn't get much time to catch up the following day. Usually, on such occasions we might have a cheeky glass of fizz to celebrate our reunion, so this teetotal get-together was a very novel experience for both of us. By 7pm we were all in our pyjamas and Jon and I made our way into the kitchen to prepare the injections.

I think we'd both been contemplating the task in hand for a couple of hours, I was definitely aware that we were a little subdued. We opened up the box of Menopur and laid all 6 bottles plus the two vials of liquid on the counter, it seemed like a lot to mix for two injections. I was happy to let Jon play the role of chemist as well as nurse, but we pondered over the instruction leaflet for what seemed like an eternity before he took and plunge and mixed the first injection. He was being very slow and deliberate, taking time to make sure he had drawn up all the powder from the vials and rid the syringe of any air bubbles. On any other occasion I probably would have ushered him to 'hurry up' as patience is definitely not my strong point and I can be a bit spirited. The next part seemed a lot less complicated than the mixing and somehow, though both a little shaky, we managed to do two injections in my tummy with little fuss. Although this first attempt took half an hour, I felt proud of us.

Yesterday was the day of Clare's baby shower. I felt excited as I couldn't wait to see her face when we walked into the party room but also anxious to be spending a few hours with women I had never met before. I'm not great with all-female gatherings at the best of times, let alone when I'm feeling vulnerable and not particularly sociable. The surprise was fantastic, she bought into the story that we were going for a drink in the local pub and was suitably overwhelmed when she saw all her friends! They were all lovely and although I felt happy to be part of this special day, I soon felt defenseless and exposed. I was the only non-mum round the table and the only person not joining in with the clinking of Prosecco glasses. I even had my own plate of gluten free afternoon tea treats while everyone else shared. I tried my hardest not to come across as a complete arsehole but as the afternoon progressed, I felt like I was clinging to Clare like a small needy child, though she later reassured me otherwise. After all the present giving and games, Jon, Simon and Clare's two boys joined us and I felt instantly appeased by their familiarity. The most important thing to me was that Clare had a fantastic day and the smile on her face definitely made it all worthwhile.

Driving back to London, I felt a deluge of emotions; happy the day was a success, sad that I had to say goodbye to my best buddy but most of all, mentally drained and exhausted.

We did, however, manage to slash the time it took to do our second lot of injections by half. We're now practically pros!

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.

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.

EndoWhat?

Last night I decided to sit down and watch the film 'EndoWhat' with Jon, something I've wanted to do for a while. It's a very powerful, honest, true-life programme, documenting women's struggles to get diagnosed and the crippling conditions some ladies are forced to live with because their doctors convince them their pain isn't real. It's a good tool for women, men, friends, loved ones and also people in the medical profession to really understand the severity of this disease which is almost a complete mystery to mainstream society. The main topics of discussion are diagnosis, beneficial and counterproductive treatments, anti-inflammatory diets, the impact of the rise in chemical usage and infertility.

While I thought it was a really positive, educational film, I've got myself in a bit of a tizzy as I've now convinced myself that having excision surgery before IVF would be my best option, even though I've been told otherwise. I have my first IVF consultation tomorrow so I guess I just have to put my faith in Mr Kalu, but I am a self-confessed control freak and I feel way out of my depth.

If you fancy getting endo educated, here's the link.

In other news, September has seen a positive change for the endometriosis community in the UK. Brand new NICE guidelines have been released for healthcare professionals, commissioners and women with suspected or confirmed endometriosis. This will hopefully result in ladies getting a painless referral through their GPs, leading to diagnosis and more effective management.

Yay for progress!

Shit Got Real

Only 2½ weeks after receiving the initial referral later we have a date for our first IVF consultation at Kingston Hospital ACU. The bad news is, it's booked in for when we're on holiday in Croatia next month. The good news is, it was easy to change and we have a revised date of Tuesday 26th September. I'm surprised that it's been such a short wait, Mr Kalu said there might be a three month delay so I wasn't expecting it so soon. This has sprung up on me a little and I'm feeling a quite overwhelmed by it at the moment. I know it's going to be tough physically and mentally and now I have to start preparing for the ordeal I'm going to be putting my body through. All kinds of questions are going through my head - how will my endometriosis react to the hormones? What if it doesn't work? We only get one round free round on the NHS but I'm grateful for that as many CCGs (Clinical Commissioning Groups) don't provide any funding for IVF. Earlier this year Croydon CCG became the first London CCG to entirely decommission IVF services, whereas if your GP surgery is in Camden you could receive three free cycles. It's an extremely unfair postcode lottery.

There's been more and more Endometriosis media coverage lately, some completely inaccurate (you can guess the culprits who commonly use scaremongering in their journalism) but most have been really positive and informative. Today's Women's Hour programme on Radio 4 is definitely worth a listen if you have a spare 15 minutes.

Turning Thirty-Seven

We've just returned from a fantastic road trip around Scotland. The lovely weather has surprisingly carried on well into July and our week across the border was just glorious (yes, really!). Our Scottish jaunt actually started with a night in Newcastle before driving up to Fasque Castle in Aberdeenshire for a few days celebrating the wedding of our friends, Jake & Laura.

After a mad but definitely fun-filled few days partying with the Scots in Fettercairn, we made our way down to Edinburgh for a couple of nights. We did a lot of walking and it was lovely to spend a couple of days just the two of us before heading across to Glasgow (via the Trossachs and Loch Lomond) to see friends.

On our way back down to London, we stopped for a final night in Liverpool to celebrate my birthday (a day early) with our friends Rob & Gill. They announced they were getting married on my birthday next year! Whilst we were celebrating with copious amounts of prosecco, it got me thinking about where we would be in a year from now - I could be pregnant.

We drove back to London the following day, the journey took what seemed like a lifetime because we'd been up late and I might have had a wee hangover. I've always liked to celebrate birthdays but they also bring a stark reminder that another year has gone by without being able to conceive. Relieved to be home, we made a cup of tea and started going through the post that had built up over the last week. Hidden within the pile of boring bills and take-away menus was the best birthday present ever... our IVF referral letter!

Yesterday, we continued the celebrations by having a BBQ at our house. Even though there was a deluge of rain which persisted all day (summer is officially over - boo!) I had such a fantastic day. Buoyed by the letter from Kingston ACU and good-spirited friends crammed into our kitchen, it was another birthday down but one to remember.

Copper Coil

Yesterday, was another day of firsts. I ran my first ever Park Run and experienced my first ever coil removal sans anaesthetic - go me! The Park Run was a success, as in I completed the 3 mile course in less than half an hour, but unfortunately I was in pain the whole way round and suffered cramping for some time afterwards. Nevertheless, I felt a sense of achievement and the endorphins put me in a good mood for the day ahead, despite being overtaken by a man pushing a buggy (maybe more than one).

Later that day I had my final appointment with Mr Kalu before he was going to refer us for fertility treatment. We talked about our options and how he thinks referring us straight for IVF is our best chance given my age and the severity of the endometriosis. He said he would refer us as soon as I've had another hysteroscopy to have one final look inside my uterus to check for adhesions and a final clearing of any cobwebs. There is currently a three month waiting list at Kingston Hospital for IVF so all being well, I'll be able to start treatment at the end of the summer. Whilst, I'm not relishing the prospect of having yet another procedure, I'm looking forward to getting our fertility journey underway. After a few months of setbacks, things seem to be finally heading in the right direction.

Mr Kalu then informed me he was going to remove the dreaded coil. Gulp. Although this was my second IUD, I'd never been awake for insertion or extraction before so as I lay on the bed with my legs akimbo, I was a little tense to say the least. I could feel it scraping every millimetre of my cervix as he was pulling the wretched thing out, I can now see why women only have them every 5 years!

After a few minutes of chat while I was fumbling around for my underwear, which were of course tucked neatly under my leggings on the chair (I have no problem with a doctor studying my floodlit private parts but there's no way he's going to see my knickers), I asked to see the coil that he'd just removed. This is what he removed from the waste bin...

I'll just leave that there with you.