IVF: a learning curve!

It’s been an eventful month! Since I last posted, we met with our new specialist and decided to just go straight for IVF. In that time, I’ve learned SO much about IVF.

First up, my hormones went absolutely mental. I ended up getting OHSS despite my specialist starting me on a low dose of the injectables which probably didn’t help. I mean, I know we all know that our hormones go crazy each month and turn us alternately into an irrationally angry, sad, excited, frustrated, giggling, sobbing mess. But I have NEVER experienced this kind of hormonal madness before.

One day, I knocked some shoes off a rack in my bedroom and burst into tears. They weren’t thousand dollar shoes falling into a pit of lava. These were a couple of pairs of shoes, falling less than a metre, onto soft carpet. And voila, I became a trainwreck!
My DH is not SUPER patient withother people, but boy oh boy was he patient with me these last couple of weeks. I literally asked him to tell me every day how brave I was being (as he injected me with the needles I couldn’t even look at) #thestruggleisreal.

I also discovered just how many possible ways IVF can go wrong. No wonder most clinics sit around 55% at the highest end of success rates! When we met with the nurse for our interview, she wanted to prepare us for, not even worst case scenarios, just the non-ideal scenarios: OHSS, getting sick during treatment, identifying polyps/cysts/other issues that weren’t on previous ultrasounds, not having enough follicles, not having any eggs retrieved on the day, the eggs retrieved on the day not being mature enough, DH’s sample not being great quality despite previous good results, everything looking good and the eggs still not fertilising, eggs not going to blastocyst stage, blastocysts not implanting…. seriously this list went ON and ON and bloody ON!

With all of those thoughts, I really struggled with staying positive. Sometimes the guilt of needing to be ‘stress-free’ at one of the most stressful times in my life really got to me, it wasn’t a great headspace and I had to constantly focus on the end-goal to keep myself (relatively) sane.

But despite everything, despite all the potential problems and the mood swings, acne, bloating like nothing I’ve ever experienced before (my jeans will fit me again one day, right?) boobs so sore that even putting a tshirt on sets them off…it is so worth it. And, while I’m having a good old whinge about the whole thing, it actually…wasn’t that bad. The needles weren’t painful, I was able to function like a normal human being for most of it, and out of the whole process we ended up with 18 eggs, and 14 beautiful little embryos sitting in the freezer as we speak.

And now I’m looking forward to what I’m going to do over the next month or 2… more on that soon!

Ciao

Xx

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Questions

Next week, my husband and I will meet our new fertility specialist. I was starting to write down a list of questions to ask at the appointment, when it hit me that… I have no idea what questions to ask at the appointment, ha! 

To recap for context, DH and I have been TTC #1 for almost 2 years, with zero pregnancies. I have PCOS & hashimoto’s hypothyroidism. I’m on thyroxine, as well as metformin, and I take daily vitamin supplements as well as (mostly) eating a low sugar diet. DH has had 2x SA, both have come back within normal ranges. I’ve done 8 months of letrozole cycles, the first on 2.5mg and then moving up to 5mg for the rest, at which point for at least the 2 monitored cycles, I was ovulating. 

Now this is not to say the the doctor won’t answer every single one of these questions without my having to ask. But, I am a bit of a crazy obsessive control freak (aren’t we all when TTC) and having something prepared does make me feel like I’ve got some degree of control over this whole process. Also, I do freaking love lists. 

With that in mind, I’ve put together the below list after doing a bit of research in the hopes that a) I can one day help some other ladies going through something similar and b) and much more selfishly, some other ladies who’ve been through something similar can help me!

Question list:

1. My DH’s SA results – while normal, the morphology in particular seemed to be on the low side, and in some countries at 11% and 12%, would actually be under the ‘normal’ threshold. Given one of our choices is IUI, will those morphology results have any impact on our chances of success? Is there anything we can do to improve those results? 

2. IUI – what is the process here? I know in some countries you’re able to do a sandwich IUI where you are inseminated on 2 consecutive days. Is that an option here, and are there any studies showing an increased chance of success?

3. My aunt, who has very similar conditions to myself, has also let me know that when she was going through fertility treatments she discovered she was the carrier for a genetic illness. Should myself and my DH therefore also be tested, and what is the process for that? What are the next steps if something is revealed?

4. IUI with ovulation induction success rates for someone of my age/medical conditions, VS IVF success rates? 

5. What will the day to day of the treatment look like for each option – IUI vs IVF? Will my work be interrupted by daily blood tests and frequent ultrasounds, as it was in my aunt’s case, or will it be a little less full on? 

6. At what point will they start the treatment – with the start of my next cycle, or will they artificially kick off a new cycle? 

7. What are the side effects of each option? 

8. What is the risk of multiples with each option?

9. How many cycles of each treatment option would they recommend if unsuccessful?

10. What additional tests will we need to do before commencing treatment & what will those tests involve?

11. Who will our doctor be throughout treatment? Will we be able to contact them only at appointments, or will we be able to call to ask questions throughout the process?

12.  What will happen if we are successful, who will monitor the early pregnancy? Will we be referred elsewhere straight away? 

Let me know any other questions you can think of, ladies xx

Trying Femara

Lovelies, I thought I would share with you my experience with Letrozole/Femara, which is now coming to an end. Not because I want to sing its praises, not because I want to crap all over it – but just so you can see for yourself the results, from someone with PCOS who’s been there.

My first month on Femara was on 2.5mg dosage, days 2-6 of my cycle. It wasn’t enough – my oestradiol level on CD 14 was still way too low to cause ovulation.

So the next cycle, my specialist upped my to 5mg dosage, the same days. Oh! The miracle of miracles. I had a 28 day cycle, ovulating on CD15 – something I don’t think I’d ever experienced in my life. And all that with only very limited side effects, some hot flushes and dizziness here and there.

And then the next month – another miraculous 28 day cycle. I’ve got this, I thought. I’ll be pregnant in no time now that my eggs are coming! This is all that we needed, and now that it’s happening there’s NOTHING stopping us. The excitement in the air was palpable. I felt filled with renewed hope and optimism. My hubby felt it as well. We both relaxed. We were on holidays on my second cycle and I thought for sure I’d fall pregnant – why not after all? I was SO relaxed, I was ovulating on time… but then. BFN, BFN, and BAM the witch arrived.

Ok, not the end of the world. I had my specialist appointment and she recommended now that my cycles were on track we continue to try with Femara on the same dosage for another 6 months, then come back to see her. So we did. We tried, and tried. And some days, it really felt like the universe was conspiring against us. One month, my cycle was delayed by 5 days, so I ovulated on CD20. My husband was away for work CD 19-21. We missed catching the egg.

Oh well, I thought. Next month, DH will be away CD 14-17, so at least if it’s late again we won’t miss it. But no… that month, ovulation arrived right on time, CD15, smack bang in the middle of DH’s work travel.

Still, I thought, we have next month! And what luck, DH is not travelling for work at all. And then I got food poisoning on CD19, and my O did not come on CD15, it came on CD20, when I was still too sick from the food poisoning to be in any position for BD.

And on, and on it went, the bad luck, the bad timing, and then it got worse. My O-date started to drift later and later. Until this most recent cycle, when my O date was not until CD24, if indeed it happened at all. Meaning DH and I missed it, as I had never o’d that late before, so our impressive BD schedule, from CD9-CD22 with only 1 or 2 days missed, was impressively useless.

And then I saw my specialist, and she recommended we start IUI with ovulation induction, and told me not to worry about increasing the Femara dosage but there was ‘no reason I couldn’t get pregnant’ now. So that is the end of my Femara not-quite-fairytale. I am currently on my last cycle of Femara before our next appointment in a week’s time, and I went ahead and increased it to 7.5mg (why the hell not?), so there’s still one last chance for a miracle…wish us luck!

LAS

xxx

Officially Infertile

Good afternoon, TTC-ers!

So awhile back, I received an official diagnosis: infertility.

Here’s the strange thing. I have known for a long time that there was a strong possibility this day would come. Ever since I first received my PCOS diagnosis, and then the follow up Hashimotos diagnosis as well, I have been advised by doctors that having children would be really difficult, if not impossible for me. And I naturally tend towards pessimism. Yet somehow, this official diagnosis has completely destroyed me.

That’s how I feel when I think about it, utterly destroyed. I am broken. Why? Not why am I experiencing infertility, I know the medical reasons. Not even why me, although I have those thoughts sometimes, I’m sure we all do. I mean, why do I feel this wrecked by the knowledge?

After all, I don’t know if it’s different overseas, but here, medical infertility just means that you’ve been trying for a year without luck. In other words, it doesn’t really mean anything, other than it being the starting point for finding medical solutions to the infertility. Which, if anything, is a positive. I’ve progressed further along that path of medical solutions now, and while it hasn’t all worked out the way I might have hoped, it is still progress.

Again I come back to this question of why. If the next steps are positive, if I was prepared for this diagnosis, why did I feel almost physically ill at the sight of the word ‘infertile’ in my Dr’s handwriting?

I don’t have a complete answer to this question. All I know is, it’s one thing to know your worst fears are a reality in your heart of hearts, but it’s another thing altogether to see it in black and white on a doctor’s notepad.

LAS

xxx

The End is Nigh (But not in a terrifying way)

TTC-ers! Another post so soon after the last, I’m on a roll (or something).

So I’m coming to the end of my TTC story, for now at least. Oh, it won’t be for at least another year, but there is an end in sight.

What I mean by that, is that within a year we will have exhausted our options. In 2 weeks time, my hubby and I have an appointment to see a specialist to discuss IUI, IVF, and ICSI. I imagine at this point we’ll try IUI first for a couple of cycles and when (if?) that doesn’t work we’ll move onto IVF, and then as a last resort we’ll keep ICSI up our sleeves. But there’s only so many rounds of any of these fertility treatments that you can try before you say enough is enough.

By next year, I’ll either be pregnant, have a child, or we will have given up and moved onto other alternatives – adoption, fostering. Not an option I want to consider at the moment, because I am selfish, but something that is becoming a more real possibility by the day.

With the end in sight, it’s hard not to be a bundle of of nervous anticipation. I’m wound so tightly right now that the slightest thing can set me into a crazy emotional spiral, and I have to say, I DO NOT LOVE IT! I crave distractions at the moment, but nothing seems to work long enough stop the incessant thought-cyclone in my head right now, so writing this seemed the only option.

There are so many what-if’s in life, and  I know it’s not healthy to think that way. My poor hubby, who is as optimistic as they come, can’t stand when I bring these what-ifs up. Am I being too negative by thinking, what if it doesn’t happen for us? Or is that a reality I have to start facing?

Like with everything else in TTC life, it’s just a complete unknown.

Sending baby dust to all you lovely ladies xx

3 Not-So-Helpful Things To Say

Hello lovelies,

Today I’ve been thinking about the things people say to you when you’re trying to conceive. Even the most well-meaning seem to put their 2 cents in where, frankly, it’s not wanted, needed, or even remotely helpful. And it’s not out of spite, or cruelty, or coming from any kind of bad place. It’s just that TTC is such a taboo subject that nobody really knows what to say, even people who’ve been through it.

What got the ball rolling on this idea for me was an article posted on Mamamia, about a woman who had just read about Beyonce + Zoe Foster-Blake’s stunningly beautiful, and very funny pregnancy announcements, after herself going through a miscarriage.

I read the comments underneath the post on Facebook, and there were so many offering advice or tips or things that had worked for them. And while that comes from such a good place, from people who are just trying to share hope and advice, it actually has the opposite effect (at least for me!)

The comment that hit me the hardest was a woman who said, and I’m very much paraphrasing this, ‘if you have PCOS, just try Metformin.’ As someone who’s got PCOS as has been on Metformin for longer than I’ve been TTC, that advice was incredibly, overwhelmingly, USELESS. All it did was serve to remind me that for other people out there, the fix is as simple as can be, and even though I’ve been doing everything I can exactly right from the very beginning, I’m still not pregnant. A reminder that I don’t need, as I think about it every second, of every day, as it is.

So, without further preamble, here’s my list of things that are super unhelpful to say, and because I don’t just want to neg out on people that are probably trying to be nice, some suggested alternatives.

  1. ‘Just try Metformin, it’s a miracle drug for anyone who has PCOS. I got pregnant after a month on Metformin.’ As I mentioned, this is really not helpful information. There is literally nothing worse you can say to someone who’s been trying to fall pregnant for a long time, than ‘all we did is X and after a few weeks BAM!’  Anyone who has been diagnosed with PCOS and is TTC, has probably had Metformin recommended to them by a doctor. I have maintained a healthy weight, been on Metformin, excercised regularly, and eaten a (relatively) low-sugar diet for years now, and guess what? I didn’t get instantly pregnant, or even not-instantly pregnant. Alternative suggestion? ‘Any ladies out there who have or think they might have PCOS, double check that you’re on the right dosage of Metformin. Studies show that at least 1.5g a day is required to have any impact on fertility, so make sure you check this with your Dr.’
  2. ‘Just relaxxxxxxxxxxxxxxxxxxxxxx’ As cliched as it is, if I had a dollar for every time someone had said that to me or someone I know who’d been trying to conceive, I would literally have at least $1200. Ok, so it’s not like I’d be a millionaire, I don’t even know a million people, but this has to be the most frequently uttered piece of absolute garbage advice I’ve ever heard in my life. Firstly, because ‘just relax’ is not a thing that people are capable of doing. It’s not like you can say, of course! That’s what I’ve been doing wrong. I thought I was just supposed to stress out all the time and now that you’ve so kindly informed me otherwise, I’ll just switch my brain into relax mode, perfecto – instant baby! Secondly, because I guarantee you that every single person out there who is struggling to conceive started exactly the way you did, you smug, relaxed, mother/pregnant lady! (sorry, I promised no judgement against people for their ignorance but… this one really grinds my gears). We all started out hopeful, optimistic, picturing ourselves 9 months from then with a happy, healthy baby, picturing ourselves announcing it to our families, picturing something that was just not on the cards for us. And yes, we were relaxed. And you know why it didn’t work for us? Because we are the ones unlucky enough to be born with a genetic, medical reason for being unable to fall pregnant. Science, b*tch. Now, I know that stress is a huge factor in fertility, but unfortunately it’s just a vicious cycle where the longer it takes, the more stressed you will be, unless you’re one of those #blessed people who do yoga at sunset while drinking chamomile tea on a mountain by the beach every day. So, here’s my alternative: ‘I can’t possibly imagine how stressful this process must be. Here’s a massage voucher.’ 
  3. ‘Try pineapple core/soy isoflavin/the blood of a pregnant virgin.’ Alright, I admit I’ve never actually heard the last one, but I may as well have. People are ALWAYS suggesting ‘natural’ remedies. You know what’s not helpful about that? The people suggesting these are, oddly enough, never doctors. And do you know who I don’t trust? Strangers on the internet who ate pineapple core for 8 days and became pregnant. I trust my doctor. Now look, I’m not saying these remedies don’t help people. There’s a reason they exist. But all they serve to do (for me, at least) is make me spend a fortune on useless remedies as I get my hopes up time and time again  and think, oh this is all I’ve been doing wrong! I just need to take some Maca root powder and my ovaries will start releasing eggs like there’s no tomorrow. Alternative suggestion? ‘Let’s all just listen to our doctors, ok? And then we can stop spending money on useless extras, and start saving up for the horribly expensive IVF we may one day need.’

So ladies, what do you think? Am I alone in being sick & tired of hearing these things? Am I just turning into a bitter shell of a woman? (Honestly, at this point it’s quite possible as I’m going a bit stir crazy waiting to start IUI/IVF). Or are there others like me out there? Does anyone have any other suggestions for the list – I had a million more but this post is already an essay.

LAS

xxx

On Hold

Good morning sunshines!

The other day I found myself thinking about a dress I had seen. I really, really liked the dress. It was a little pricey, but my work-appropriate dress collection could use a lot of work.

And dresses are so easy! Especially in winter when you have to worry about layering up. Tights, dress, jacket/cardi, scarf, done! The only problem? Well here’s a little insight into my inner monologue.

‘Wow great dress. Very practical – could wear it to work… Doesn’t show too much cleavage. And it’s so floaty & pretty! Oh BUT, it’s quite tight in the waist & hip region. What if I get preggers? I wouldn’t be able to wear it anymore, it doesn’t have a lot of give. What a waste of money that’d be.’

The reason I bring up this dress, is not because I’m still thinking about it. I have a million of these moments every month. Where I put my life on hold for the expectation of a baby.

For example: DH & I have a good friend’s wedding coming up in November. It’s in Tasmania, which is either a flight or a very long car trip, followed by a VERY rough boat trip, away from us. The problem? I won’t know until I get this month’s AF, whether I would be able to fly in late Nov/early Dec. at the moment, that would put me in the final trimester. I also wouldn’t want to be taking a very rough boat trip (never mind the drive as well) at that point in time… So we put that decision on hold. Missing out on some amazing flight offers along the way!

These are just 2 examples, but I have a similar inner monologue with almost every decision I make involving any sort of forward planning.

When I realised this, I started consciously trying to stop myself from doing this. It’s tough – I don’t want to waste money on something that I won’t be able to do or wear if I do get pregnant. But equally, I don’t want to put my life entirely on hold for something that may never happen. I have also always been a full believer in spending the months before pregnancy doing whatever I won’t be able to do during pregnancy, or once the baby comes.

Eating unpasteurised cheese (*drool*), drinking beer and wine, travelling, sleeping in (I will miss sleep so much), being alone, doing nothing, watching 7 seasons of The Mentalist for the first time to fill my ‘free time’, shopping for myself and being a touch on the reckless side with my spending habits…

I guess the key thing here is compromise. In Feb, DH & I booked a 3 week trip to the US for July. It’s the sort of thing we (OK, I) would usually have wanted to book almost a full year in advance, for maximum planning time and so that nothing would be fully booked. But we waited until Feb so that we could be sure that I would be safe to travel. We are going to be in Napa Valley, but we haven’t booked any winery or cheese tours yet, because maybe we’ll get pregnant & if so we can just spend the whole time relaxing in a spa instead.

Have any of you had similar experiences? How did you manage it? Do you find yourself thinking ‘but what if I’m pregnant by then?’…or is it just my crazy obsessive mind?

LAS

xx