Big Fat Negative

Eight days post six day transfer (8dp6dt)

Not sure why we're surprised or upset or heartbroken or shocked or devastated? Once again I didn't even get to test day and once again I have had to endure a very heavy and painful period. 

We were told at Embryo Transfer in no uncertain terms that we needed a miracle to get pregnant. I thought given our recent run of seriously rubbish life experiences that some good karma was due to come our way, and that we would get our January 2015 mini-me.

But it seems it's just not meant to be. Not now anyway.

I can feel myself becoming 'one of those women' who just keeps on having infertility treatment in a quest to become a mother and I don't want to be 'one of those women.' I just want to bonk and get pregnant - is that too much to ask? You ladies who get pregnant the traditional way really have no appreciation for just how lucky you are - for the miracle that has taken place in your womb. There's only a 20% chance of getting pregnant when two healthy people have sex on the right day of the woman's cycle. Eggs need to be in tip-top condition as do the swimmers - after all they have a marathon to swim to reach the egg. A lady's cervical mucus needs to be the right PH, it needs to be swimmer friendly, if not then there's little hope of even the fittest of swimmers reaching the egg in her fallopian tube. Even after conception the embryo still has five days to travel until it gets to the womb and then it has to burrow in, and then after all of that the lady's body needs to accept this foreign body that is trying to feed off her supplies. This is one reason why some women suffer from recurrent miscarriage - their body rejects the embryo, sees it as invading its space and then disposes of it normally in the first trimester. The point I'm trying to make is that we all just presume that we will be able to create mini-mes very easily but as I go to show - it's not always that easy. Every time a woman gives birth a miracle has taken place.

When do you stop with fertility treatment? When do you finally pack it all in and give up on achieving what we are put on this earth to do? I can't see myself ever giving up. I want a baby, I want to be pregnant, I want to get a 'baby-on-board' badge and scowl at commuters on the train home who won't give up their seat for my heavily pregnant belly. I want to moan about indigestion in the third trimester and worry about what my boobs will look like post baby. Unlike most western women I want to go through labour, I want a drug free birth, for my body to take over, to use the pain to help me bring my child into the world. I've imagined all of this and more. I know the names of my much longed for baby girl and boy, I've imagined what they'll look like with their brown hair and blue eyes like their mummy and daddy.

The saddest place in the world is a fertility clinic waiting room. It's full of people from various different backgrounds, some older, some stinking rich, some have flown in from another country and have an interpreter, some are same sex couples, some ladies are trying to become parents all by themselves, some couples are like my wonderful Hubster and I and have saved long and hard to be sat waiting in that room. But what unites every single person in that room is that they all want a child of their own and it reeks of desperation, loss and hope. 

By the time a couple have arrived in that waiting room they have been through quite a tough journey; they have suffered loss and they are grief stricken. They are tired of a life congratulating friends and family as they get pregnant over and over again, tired of suppressing that green-eyed monster called jealousy every time a pregnancy announcement is made, tired of gathering reserves of strength every time they are invited to a baby shower/christening/first birthday party etc, tired of feeling guilty for being jealous, tired of being happy for someone else, tired of looking longingly at baby clothes, tired of being the odd one out, tired of the well meaning questions about when they are starting a family, tired of being asked 'why don't you just adopt?' A fertility clinic waiting room is full of grief for the babies that have never been, and you can hear the tick-tock of biological clocks getting louder and louder the longer you have the misfortune of waiting in that room.

So here's my plea to all of you who are in denial about your fertility and when to start a family.

Chaps: Did you know that most of your sperm is in fact abnormal? Did you know that if you have an abnormal sperm count of 75% you are perfectly normal? Did you know that because of all the crap we put into ourselves on a daily basis that the average sperm count for men has dropped quite significantly over recent years? Did you know that it might not be as easy as you think to get your wife/girlfriend pregnant? If you've been talking about having kids one day (but not just yet as life is just tooooo much fun right now) then have the difficult conversation - work out a strategy, talk about your fears with your lady, take a leap and embark on the biggest adventure of your life. What I'm urging you to do is to is to man-up and grow a pair of balls, get your swimmers tested and find out how they are shaping up. If they are swimming in circles and have two heads then you know that there are changes you need to make to your life to fix that, so when the time is right to have a baby hopefully you are ahead of the game. If your significant other wants babies now (and her age demands it) and you're not quite ready yet - what will you do if it takes years? Have you thought of the consequences? What will you do if you have left it too late? Have you thought about it? 

My Hubster's swimmers are in great shape after dietary and lifestyle changes and taking oodles of supplements especially for male fertility, even after spending £7000 at one of the best fertility clinics in the UK we still didn't get pregnant. My message to all the men out there putting off starting a family as their life right now is so great: take control of your fertility and never presume that you'll be able to produce loads of offspring.

Chapettes: If you are are over 35, have a great job and have a packed social life and think 'ah - I'll have kids in a couple of years time,' or 'now's not quite the right time' or your fella just isn't keen on the idea of making babies 'just yet' PLEASE don't make the mistake I made. It took my body 18 months to start 'cycling' normally after coming off the pill - I thought I'd be pregnant within the year. I knew nothing about infertility. Getting pregnant is not as easy as you think, the longer you leave it, the harder it will be - take my word for it (or if you don't believe me go and sit in a fertility clinic waiting room and experience the despair for yourself). 

I am fertile, I have a high AMH of 43 (very unusual for someone my age - the average is 15 - apparently I'm one of the lucky ones as I have a very decent ovarian reserve), and I have a follicle count of 28 on a natural cycle (that means I can make 28 follicles all by myself every month - without the aid of synthetic FSH injections). After four and a half years of trying and this includes two fresh IVF cycles and one frozen cycle I'm still not pregnant. I'm mourning the loss of 18 embryos. 18 potential babies. 18 mini-mes were made in our two fresh IVF cycles, 12 in our first, six in our second and not one of them attached, they all died either in-vitro, in my womb or they didn't survive being defrosted, despite all our love for them and desire to become parents - none of them survived and this breaks mine and my Hubster's hearts. I don't wish our pain on any of you so if you are over 35 and delaying starting a family for one reason or another please don't.

I hate to be the one to tell you this but after the age of 35 your eggs start to diminish, after the age of 37 your ovarian reserve drops off a cliff, after that the quality of your eggs will start to deteriorate quite dramatically. The ideal time to have a baby is in our twenties not in our thirties and forties - no wonder the fertility clinic waiting room is such a sad place, all those ladies know their time is running out and are desperate. Get off your contraception, let your body get back into it's grove and work out when in your cycle it's baby-making time or no jiggy allowed time, learn how your body works, get yourself checked out, find out what your ovarian reserve is, find out if you have adequate thyroid function and whether you ovulate every month? The longer you are on the pill/injection/coil etc the less time you have to fix any problems that you don't even know you have yet. My message to you is the same as the chaps: take control of your fertility and never presume that you'll be able to produce loads of offspring.

If I could speak to my younger self I'd tell her to start trying for a baby straight after she married the love of her life almost eight years ago. I thought by the age of 35 I'd have at least two children by now but I don't have any. There's a massive void in my life and I feel like I'm asking for the impossible - to get pregnant and have a baby.

Laters xx 

Don't count your chickens before they've hatched

Two days post six day embryo transfer (2dp6dt)

'Having a baby is like getting a tattoo on your face. You really need to be certain it's what you want before you commit.' 
Elizabeth Gilbert 

From my last post up until 8:45am on Wednesday 9 April 2014 everything had been going tickety-boo. I've actually got three blog drafts saved that I'll never publish - they're going to remain drafts. In these drafts I've babbled on about The Lister hospital experience and compared it to a stay in a 5* hotel, with room service, great food, Molton Brown goodies and Sky TV. The only difference is you do actually have to go down to theatre and have a general anaesthetic and the nurses check in on you every 30 minutes afterwards. Below is a photo of me a few hours after egg collection, my blood pressure was very low at that point but I was overcome with joy when the food arrived - I was very hungry and I inhaled the lot. It was delicious!

Egg collection via general is FAR more civilised and I thoroughly recommend it. They managed to get 13 eggs, 10 were mature, six fertilised. Yep - we had six mini-mes and apparently fertilisation was easy - to quote the embryologist I spoke to three days post egg collection: 'Very easy fertilisation, in fact so easy I'm surprised you went for IMSI, from what I could see you would have been fine with straightforward IVF - the sample was grade 1 sperm. Your eggs were also top quality.' 

All six of our mini-mes were going strong on day three so we enthusiastically agreed to go for a day five / blastocyst transfer. We got a call on Tuesday from one of the embryologists telling us that four of our mini-mes hadn't reached blastocyst stage - they were what they called morulas - the other two were a wee bit behind but we should give it another day and give them a chance to develop a wee bit more. Again this was fine, day six transfers are perfectly normal. So when I got a No Caller ID phone call at 8:45am on Wednesday morning I answered the phone with dread - I knew instantly that it wasn't going to be good news. Four had arrested in development and two were developing slowly but were showing signs of becoming blastocysts, they were at the cavitating morula stage of development. We were advised that we may have to cancel the cycle.

NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO 

HOW CAN THIS BE?

OUR EGGS AND SWIMMERS ARE GOOD? TOP QUALITY YOU SAID.

WHAT WENT WRONG?

The room started spinning and I felt sick. I immediately got on the phone to my Bessie who is travelling in Europe (what would we do without Apple and FaceTime/Viber/WhatsApp? We are in the age of the smart phone and I would be 100% lost without mine).

My Bessie calmed me down, so I could calm my wonderful Hubster down. We were going to go to the clinic, talk to Dr Wren, and I was positive that we were going to transfer. Just because our mini-mes were a bit slow doesn't mean they won't stick. But the journey there was the longest its ever been and it was the most quiet we've ever been. We were supposed to be excited but we were scared.

I was hoping to see my consultant James Nicopoullos but he was on holiday so we saw Dr Wren instead. She was in the main nice but my god she was also VERY blunt. To cut a long story short she said: 'you didn't get pregnant with a 5AA blastocyst so you're not going to get pregnant with these.'

BOOOOOOM - kick me us both in the teeth when we're down why don't you? Up until that morning as far as we were concerned we were on track for a single embryo transfer and hoping to be able to freeze two or three embies for later, but now you tell us four have died and we will need a miracle for the others to progress. A little sensitivity wouldn't go a miss eh? I appreciate that you are a scientist and see everything in black and white but look after your patient's emotions, you work in the field of infertility - by the time ladies have come to you they have been through years of trying for a baby - they're desperate - you're their last hope - your patients have invested EVERYTHING into this process so be mindful of their hearts. You should know better than to say something like that, especially someone in your position. Our mini-mes weren't dead, they were slow, so whilst they are still growing (albeit slowly), there is still hope (even if it is only a glimmer and a miracle is needed).

We took five minutes, we went outside, I called my Bessie on Viber. I didn't know what to do. I felt like I was drowning. On the one hand I have this doctor who I had never met before telling me in no uncertain terms that there is no point in transferring our last two mini-mes (but she'd do it if I wanted her to, the choice was mine), on the other hand I wanted my mini-mes in my womb. I wanted them with me, they'd be better with me than in a petri dish, they belong with me. 

To be told that the only way forward was to abandon your cycle is a million times worse than getting to test day and having a negative. Trust me - I know. I've had a cycle not even let me get to test day and end in a very heavy, painful bleed. I've gotten to test day and got a negative and now I've been told that my cycle is being abandoned and there's not much hope in your remaining embryos progressing - in fact there's no point in transferring. Out of the three scenarios the third is the worst - take my word for it, it sucks.

I felt winded. 
My legs felt weak. 
I was confused. 

I cried and cried and cried. My Bessie cried. My Hubster cried. We all cried.

But you know what? My mini-mes were still going. They might be slow but they are still growing so what did we have to lose? So we transferred them and they are now with me where they belong. Here they are - the one on the left is a bit more developed than the one on the right. They are called cavitating morulas - the stage right before blastocyst.

I've read of day five and day six cavitating morulas resulting in pregnancy. Apparently they usually result in girls? I'm not getting ahead of myself and believing that next week I'll have a positive pregnancy test and I'll be carrying a baby girl - I'm not that silly. I know I need to be positive but not at the expense of dealing with the here and now and the range of emotions that comes with that. I'm being realistic. The opportunity to be cautiously optimistic was taken away from me the moment I was told there's not much point in transferring as I won't get pregnant. They took away my hope. Ladies on the Fertility Friends forum have helped give me a bit of hope, whilst you have an embryo there is always hope (but let's keep that hope in check shall we and not run away with ourselves).

Today my boobs are like rockets, they are swollen and they hurt, so much so I had to wear a sports top to bed with an in-built bra to try and stop them hurting as much. Today I have mild cramping. The hopeful part of my brain tells me that this is a good sign - my embryos would be eight days old (if they are still going), as they were a little slow off the mark the mild cramping could be implantation cramps. But I doubt it. It's the cyclogest pessaries Johanna - YOU KNOW THIS - it's the progesterone, nothing else so stop imagining you're pregnant.

We have a lot of questions.

Why in our cycle at Kings were we able to get five blastocysts but not at The Lister? Why when we were focusing on quality and not quantity were we unable to get the quality we got in our previous cycle? You told us we didn't need IMSI so why did our embryos not develop? What about sperm DNA fragmentation? Did the awful family bust-up a few weeks ago affect the quality of my eggs? Was the stress partly to blame? What went wrong in the lab? How could this happen? 

Questions. Questions. Questions.

We need a miracle. Please let our mini-mes fight and stick and prove everyone wrong.

I started this post with a quote and I'm ending with a different quote. Repressing your emotions is bad for you, and imposing positivity when you are sad is bad. Don't get me wrong - I am a positive kinda girl, but even people who are naturally positive and reject negativity have their sad days. Being sad and being negative are very different things. I'm finding the strength to acknowledge how the past few days have made me feel and I'm dealing with the tough emotions - I'm allowing myself to feel happy believe it or not. In my acknowledgment of my sorrow I can truly be happy as happiness and sorrow are two sides of the same coin. To be truly happy you must be at one with all of your emotions and you must have the strength to live in the here and now. I may be feeling sad, but I'm ok with that - as it's our emotions that makes us human. 

'Joy and sorrow are inseparable…together they come and when one sits alone with you…remember that the other is asleep upon your bed.' 
Khalil Gibran

Laters xx

Last day of jabs - woo hoo

Day twelve of stimulation, day seven of cetrotide and trigger shot (ovitrelle) day!

This is going to be a rather short and sweet post.

Despite it being less than month since our first consultation at The Lister we are now galloping towards the IVF finish line. It's felt intense, the jabs have hurt more this time round (yes they bruise and I normally bleed after each and every one, my belly also goes bright red and itchy immediately afterwards). Despite a lower dose I have been responding well but I am very glad to not have to jab myself for a good while after today - fingers crossed. Today is the first working day since last week that I haven't be required at hospital, it feels strange. I had roughly 14 follicles that looked ripe for harvesting at my scan yesterday, my hormone levels have been balancing out, I'm learning to relax and I'm trying not to fret about not being at work.

I'm nil by mouth from midnight tomorrow, in at 7am Thursday morning in preparation for egg collection by general anaesthetic later that morning - I'm first on the list. This is the main difference between being treated privately compared to the NHS. At my previous egg collection I was heavily sedated so have vague recollections of what went on and my Hubster was in the room with me. They 'woke me up' and two nurses then walked/carried me to a bed in the treatment waiting ward. I was then shuffled out the moment I was 'compus-mentus' and sent home; at The Lister I'm knocked out via general, I won't be aware of the 'bum torpedo' (this is a term I picked up from a fellow IVFer for the diclofenac suppository they give you rectally before surgery to relax your womb - it's not a pleasant experience I can tell you, I'll let your imaginations work out why), and my Hubster won't be in theatre with me. I'll have my own room and can leave when I am discharged which should be roughly four hours after I've been in theatre - so when I'm ready to go home, not when they need me to go home. There are other differences with this treatment cycle compared to my first fresh cycle: I have been monitored very closely, I've had a lot of blood taken to monitor my hormone levels - this didn't happen at the Kings ACU and I think if had been monitored as closely as I am now I wouldn't have gotten so poorly last time round. 

We're provisionally booked in for embryo transfer this Sunday (6 April) but I'm pretty confident that we'll go to Tuesday (8 April) for a blastocyst transfer. We've paid for a more advanced version of ICSI called IMSI - this stands for intra cytoplasmic morphologically-selected sperm injection. The main difference is that the swimmers will be selected by an extremely strong microscope (x600 times stronger than the one used for standard ICSI) and then injected into my eggs, this should give us the best chance possible of making fabulous mini-mes - together with the endometrium scratch I had a couple of weeks ago should encourage implantation.

So for the interim I'm at home, relaxing trying to put all the nonsense of the past few weeks that could have very easily interfered with our treatment to the back of my mind. I'm focusing my energy on making protein rich, healthy eggs and trying not to focus on the negative - I am repelling stress as there's only one thing that we need to focus on. I have acupuncture at 4pm so I'm certain I will remain zen like in preparation for egg collection and for the transfer of our mini-me(s).

I'll be back in a few days with a round up with how egg collection went - exciting times!

Laters x