The final countdown

Embryo Transfer and the dreaded two week wait

Tuesday was ET day, it was a very exciting day and it pretty much marked a conclusion to our IVF treatment; after waiting for so long and then diving headlong into it, and then feeling rubbish (but very upbeat) throughout, would you think it strange if I told you I found this a little sad? Probably!

We got the call from our embryologist around about 9:30am on Tuesday to tell us we had one über top grade blastocyst for transfer and we have a few for freezing, all good quality blastos but the best with the highest possibility of implanting would be meeting me later. Whoop whoop. Despite having quite a few good quality embryos at the three day stage you always worry that they may not live - it has happened but I was ecstatic to hear that ours were still fighting. I gave verbal consent for them to be frozen - we have some babies in the bank so to speak.

Our appointment was at 2:30pm, you need to have a full bladder for ET as it helps the doctor place the embryo in the right section of the womb (the bladder helps flatten out the womb so when it comes to inserting the catheter into your womb - it practically goes in a straight line). Given the sheer amount of liquid I've been drinking to try and beat the OHSS this wasn't a problem, however - we didn't get seen until 3:30pm - I was full to bursting!!! Like egg collection (EC) day, you need to ensure that you're not wearing any makeup (including nail varnish), perfume - anything smelly and the same goes for your significant other - embryos don't like it so you need to make sure when you are going for EC and ET that you are there as God made you. 

ET doesn't hurt and is much like a smear test as it involves a speculum, unlike having a baseline scan you have an ultrasound - it's via the ultrasound the team can see where to transfer the embryo. There were a legion of people in the room with us: the doctor doing the transfer, two other doctors, a trainee doctor and the embryologist. Initially a lovely, petite Indian lady doctor was supposed to do the ET but when I walked into theatre fully gowned up, I was asked if I minded another doctor doing the ET as he wanted try a new softer catheter (a more senior doctor obviously pulled rank)? I didn't really care who did it, as long as they did it properly and got my mini-me in my womb safely - this doctor seemed like he knew how to do the job! You can't be shy if you're having IVF, your foof is on show for everyone to have a look at. As they were trialling a new catheter we had a mock transfer first, this is fine, do as many practice runs as you like as long as when it comes to the real thing - it's done correctly (I didn't doubt the doctor's competence at any time btw). Yes ladies - you can't be shy about this; imagine you are on a dentist like chair with you legs in stirrups, much like a smear there's a speculum and it's clamped in for a good while, your chair is then winched up and there is a bright yellow shining light beaming at your foof where both male and female doctors will be having a look, all to ensure the safe delivery of your mini-me. This is what ET is like! The bonus of all of this is we not only got to see our mini-me hatching out of it's shell in the petri dish on the big plasma screen just before transfer, but we also saw it being inserted into my womb (not very clearly, but you could see it). This was awesome (and it brings a tear to my eye when I think about it - absolutely amazing).

A day five hatching blastocyst - this is what our mini-me looked like before transfer, ripe for attaching and implanting (fingers crossed).

Kings ACU use the Gardener scale for grading Blastocysts, the stage of development of the blastocyst(s) is graded from 1 - 6, and the outer and inner cell masses are graded from A-C. The inner cell mass forms what will become the baby (this is what you can see hatching out of the picture above), the outer cell mass or trophectoderm will become the placenta. The stage of development and quality of the outer and inner cell masses is scored as per the tables below. I've included this technical shizzle as it can be hard to remember everything as and when you're told it due to adrenalin, and given how you are positioned in theatre.

The Gardener blastocyst grading system assigns three seperate quality scores to each blastocyst embryo:

1. Blastocyst development stage - expansion and hatching status
2. Inner cell mass (ICM) score, or quality
3. Trophectoderm (TE) score, or quality

Expansion grade	Blastocyst development and stage status
1	Blastocoel cavity less than half the volume of the embryo
2	Blastocoel cavity more than half the volume of the embryo
3	Full blastocyst, cavity completely filling the embryo
4	Expanded blastocyst, cavity larger than the embryo, with thinning of the shell
5	Hatching out of the shell
6	Hatched out of the shell

ICM grade	Inner cell mass quality
A	Many cells, tightly packed
B	Several cells, loosely grouped
C	Very few cells

TE grade	Trophectoderm quality
A	Many cells, forming a cohesive layer
B	Few cells, forming a loose epithelium
C	Very few large cells

What I am really pleased to say is that our mini-me is a grade 5AA - this is the best type of blastocyst that can be transferred, and from what I understand is a bit like gold dust in the murky world of IVF/ICSI. Grade 6 blastos need to hatch in the womb so I was pleased as punch to see that we now have the best possible chance of success, our mini-me was ripe for implantation, fingers and toes crossed.

Test day is Friday 15 February 2013: gulp. 

This is nine long days away. I am so looking forward to that day but it also scares the be-jesus out of me. It's REALLY hard not to dwell and over analyse every twinge (Google at times can be your own worst enemy). Those cramps I can feel, are they implantation cramps or is it my ovaries groaning with the last bit of OHSS or is it the progesterone pessaries? Questions, questions, questions. And it's because of all these questions, lack of activity and waiting that make the two week wait (or the 11 day wait for a five day transfer as in my case) the hardest part of IVF: am I pregnant or not - please somebody tell me!!! BUT one must wait patiently for the outcome of one's endeavours. There's no point in testing too early as you could get a big fat positive (BFP) due to residual HCG being in your system from the trigger shot done 36 hours prior to egg collection. I know of a friend who tested too early and got a BFP, and then ended up getting a big fat negative (BFN) when it came to test day. I can't put myself through that so I shall have to be patient and wait until the morning of 15 February.

I haven't worked out how I will tell people yet, what I do know, if its a BFN I'm not going to want to talk about it and I won't want to have to repeat the news, and I will crumble but for the minute the Hubster and I remain hopeful. Hopeful that our mini-me is bedding down for some VIP womb action and at the moment it feels like that might be happening but only time will tell, as I said - it could be anything. We have done everything humanly possible to make this work and we have a great chance of success but there are no guarantees.

So I'm signing off for now, the next nine days are going to be long but this is where my IVF Belief CD comes into it's own. The third and final message is about deep relaxation and positive visualisation and it really helps me chill and focus all my positive energy to my womb and our mini-me. I'm going to be listening to it lots. Please sprinkle oodles of baby dust our way and pray we get the result we so want.

Catch ya later :) x

My womb is like a tree, my head feels like a battering ram...

Day 6 of stims

Firstly massive apologies for keeping you all in the dark for the past few days - I ended on such a high note then I just disappeared! To be honest - I haven't had a good few days. A lot of people who have gone through IVF have told me that the stims phase is easier to handle than the down regulation phase but I'm not an advocate of that theory as I have felt so rough over the past few days... This blog entry has taken three days to write I've been feeling so rough - gutted as the snow arrived and I've only been able to play a little bit :(

View from Mr & Mrs C's living room - nice and pretty

Today I'm off sick, I really wanted to minimise the amount of days I had off sick due to IVF but this just couldn't be helped. I've had the mother of all headaches since I woke up on Saturday morning (that was day three of stims). It's a common side-affect of the Gonal F / FSH jabs apparently. I've tried pints of water, juice, paracetamol, ibuprofen, 4head, a bath, sleep (lots of sleep) and this headache wavers between being a mild, dull ache to being akin to receiving a wallop to the middle of the forehead; it's smack bang in the middle of my forehead and can rapidly change from being a headache to a full on migraine. So the hot flushes have stopped (woo hoo) but now I feel debilitated by a very bad head :( I decided yesterday that if I still had this headache I wouldn't be going into work as I need it to go and I'd be pretty useless at work feeling like this (even writing this blog is pushing it to be honest but I need to keep you all updated with what its really like - being a hormonal pin cushion - it's not always that good despite PMA).

Having just spoken to Kings the nurse said what I am experiencing is normal and I've just had a bad reaction, it should start easing today/tomorrow. But I've also read not to take ibuprofen as it can affect the lining of the womb so I'll stick to paracetamol - apparently I'm ok to take co-codamol so I feel a trip to the chemist coming on (via the park so I can crunch on the snow!)

Last week I managed to fall fast asleep on route to work and woke up in North London having missed Blackfriars by 25 minutes, I was very grumpy that day and snapped at a colleague and I cried with friends in the design team who fed me with biscuits and chocolate until I started giggling (natch). On that same day I managed to convince myself that the Hubster had had a car crash on his way home as it took him longer than usual to get home - queue hysterical tears as he didn't answer his phone - I was almost hyperventilating thinking I can't do this without him (obviously!) The Hubster was buying a variety of food in Sainsbury's in an attempt to get me to eat (as my loss in appetite has resulted in my losing 10 pounds - woo hoo - every cloud - don't flap - when I do eat is the healthy stuff and protein rich). Obviously the Hubster is fine and I was balling for no reason. The tears I am pleased to report have subsided (but they're still there), I just can't get rid of this headache...

So I've moved onto the second message on my IVF belief CD and I have to say - its awesome! I can't remember all of what it tells you but in essence, my womb is like a dormant tree at the end of winter, waiting for spring when it can do what it is supposed to do and blossom into life! I quite like that analogy but it's the second part of the message that I REALLY like. You have to get to the top of a very tall building - in my head I'm in a gherkin like building but its predominantly white as opposed to black and I get to the top by walking (well, gliding really as I make it to the top very quickly), then you see a large door and have to imagine what colour and texture it is. Again - this is brilliant white with tiles for the texture and there's a sign that says control room; when I open the door I'm met with loads of bright fluorescent panels with loads of buttons, dials, levers, flashing lights. This is my brain apparently - how awesome is that?!  I basically have a wee look at my brain and switch certain things on such as my ovaries - my ovaries have a bright pink neon background and a MASSIVE lever to switch it to ON; I must admit I rather enjoy pulling that lever! I also turn a neon orange dial for my womb lining to switch it from THIN to THICK - this positive visulation shizzle is cool - it's like being on the starship enterprise and I'm directing the path it has to take, and in essence that's what I'm doing - I'm telling my body to go into warp speed and to start producing lots of lady hormones that I am used to. I just wish the headaches would do one. 

Other things that I'm not loving at the moment include my tummy starting to get fed up of injections... Every time I do a jab now I'm bleeding and it hurts - ouch. I have been told I can do the jabs on my leg but I'd rather stick to my tummy and limit the discomfort to that area of my body please. Other things that are starting to get on my nerves are certain ladies saying: "ah, I know exactly how you feel." Mmmmmm, well unless you've gone through IVF then you haven't a scooby doo how I feel. So if you have a child that was conceived naturally then I'm sorry girlfriend - you don't know how I feel. Just because you are tired and your child is unable to stay asleep all night doesn't mean you know how I feel as you already have a child. I would love to get jiggy with the Hubster and discover two weeks later that I'm pregnant (which is what these ladies had to fortune to experience). Being told that I will continue to feel like shit throughout my pregnancy (fingers crossed that is the outcome; I have however met plenty of women who LOVED being pregnant and they didn't feel like poo and then had babies who slept eight hours a night from week three - not every baby and toddler has sleep issues but shall I just try and get to the baby stage first hey?) Being told that I will from this day onwards be tearful, be exhausted, have hot flushes and have headaches doesn't help thanks! 

225 units of FSH on a pre-loaded pen ...

Delivered via this needle ...

But the main thing that is REALLY getting my goat at the moment is having menopausal women think they are in competition with me re: who has the most extreme symptoms. Argh - do one will you?! Being told "ah, wait until you've got two kids, then you'll know what exhaustion is really like" or "I know how you feel Jo - I'm going through the same thing." EXCUSE ME? NO YOU'RE BLOODY NOT!!! What I find galling is women who love a good moan about how exhausted their children make them, particularly as they are just entering the menopause. Well sorry love, we don't feel the same - we are poles apart thank you very much, I'm putting myself through all of this in order to get a baby or two you insensitive twonk! My hormones are like this because my Hubster and I have been trying to make babies the traditional way for three years and failed, so I'm having to pump myself full of hormones (via daily doo-lally jabs which you really would make a song and dance over having to do if you were in my shoes), these bring on a shortened, condensed menopause over the space of 2.5 weeks. You on the other hand have been blessed with children and are just entering the menopause; I suggest you go and get some HRT, eat healthily and take supplements that help level you out, but do not compare what you are going through to what I am going through as seriously - if you really want a competition then I'm going to win, you have the family I crave so don't moan about your boisterous kids and going through the change; there's no competing when you think I'll be going through the menopause myself in about 15 years time (and I'd bet a whole Vatican Euro it's nowhere near as full on as down regulation) - so I get double the fun! It's not a competition so if you ask me how I'm feeling and I tell you please just listen, I'm more than happy to empathise with how you are feeling but don't compare your situation to mine unless you are having/have had IVF. 

These incidents of annoyance though are quite rare and you are able to keep them in check - I go back to thinking to my fluffy white cloud that deflects all stress and negative energy. If these ladies really do want to whinge then that's their decision - I no doubt will have a whinge about my children in the future but at the moment I'd just like to make a mini-me for the Hubster and I. Becoming a Mummy and Daddy is what we were made for and I seriously can't wait for that to happen so grumpiness, headaches, menopausal women and mothers of toddlers - all of these things do not deter me - it will be amazing when it happens.

So what I've been craving: snow has arrived and I've been confined to rest, this is very boring. A little play over the weekend was allowed but I'm contemplating a wee walk to the park later (if the head has cleared). In the mean time - check out some pix of the brand new Gonal F jabs. I've been jabbing myself for 22 days - today is day 23 so not much longer to go - please keep your pinkies and toes crossed that this goddamn MoFo of a headache does one asap so I can go make snow angels before all the snow melts.

Catch ya later :) xxx

One of the many boxes of Gonal F jabs currently occupying my fridge

And this is the treat you are met with - all of those needles for only four injections per pen?!

Stimulation time baby!

Day 17 of down regulation

I started writing this post at 4am mid-insomnia attack two nights back when I wasn't feeling too great. I decided to hold off publishing as I knew my first baseline scan was due and I was keeping my pinkies crossed that I might have good news to report.

Anyhow, the Hubster and I had a good giggle last night - having not eaten that much yesterday and having made several mistakes at work I decided that I needed to snap myself out of my melancholy and cook up a bit fat juicy chicken for dinner: it did the trick it - I inhaled every bit and the Hubster and I were on form.

We were talking about the forthcoming scan and what would happen next in our quest to make a mini-me, I admitted how nervous / scared / excited I am about egg collection day - admitting your fears is quite a hard thing to do - it's taken so long for us to get to this stage I'm not about to start asking any "what ifs?" I'm not even contemplating this not working, tackling that possibility is something I'm not willing or able to do right now and I don't think it's the right attitude to be honest - positivity is the only way for Mr & Mrs C. The Hubster on the other hand  was flapping about doing his forthcoming swimmer sample (not quite sure why - he's well practised in this swimmer sample shizzle) - in all honesty - we were hoping that our three months of lockdown had been worth it and that his swimmers had started swimming in the right direction and there were more of them. Compared to daily jabs that send you doo-lally, getting swimmers into a pot and delivered at Kings' Assisted Conception Unit (ACU) is not only quite an enjoyable experience in comparison to daily doo-lally jabs, but let's face it - it's something that most men should be more than capable of! The Hubster, kindly offered to "wa*k every day" if it meant it would make things better!!! Brilliant! That was nearly the title of this blog but I thought it might not get through the Google listings, but it's nice to know that the Hubster is thinking of me!

Anyhow, today was baseline scan day - OMG - how nervous were we?! We drove to Kings on a very cold morning (even I thought it was a bit chilly), it was so chilly I kept Paul's pot of swimmers under my arm pit to keep them warm! With only an hour allowed from production to delivery, keeping them warm was top priority just in case we got stuck in traffic - if they got too cold they'd start dying and we didn't want that.

We arrived bang on time and got seen at about 11am - a baseline scan - for those of you who don't know is a scan of the womb. Unlike an antenatal scan your bladder must be empty, and the scan is not conducted on your lower belly like when you're pregnant but via your foof! For my first scan this rather alarmed me, but it's nothing really - loads of forums bang on about discomfort and pain but a smear is far, far worse. A baseline scan doesn't hurt at all - you're given a sheet to protect your modesty and the nurse doesn't have a look at your foof, she's more interested in your womb. So if you are reading this and are about to have your first baseline scan please don't flap - it's nothing to worry about and is over really quickly! I don't find the scans that bad as I think its really cool to have a good old look at your womb (as did the Hubster). The scan is to check the lining of your womb and to check that your ovaries are nice and barren; basically it's to check that the daily doo-lally jabs have done what they're supposed to, and you've put yourself through hell and back for a reason - that you've shut down. Your womb lining needs to be no thicker than 5mm thick - even I knew just by looking at the scan that I'd shut down as my womb looked very different when compared to the last time I had a look. I'm very pleased to tell you that and mine is now 4mm thick at best! WOO HOO!!!

So I can move on to the stimulation phase - this is bloody brilliant news. BUT it now means I have to do  two injections a day, I have to stick with 50 units of buserelin a day and start the Gonal F jabs - both jabs at the same time every day, on alternate sides of my belly (apparently I'll start feeling better as my body stocks up on FSH so it's all good). The Gonal F jab is pre-loaded with the follicle stimulation hormone (FSH) so it should be easier to deal with - one injection of each a day for another 10 days and then things will start to moving quickly: VERY EXCITING!

And now for the final bit of good news (drum roll please)... The Hubster's swimmer results are in. There has been a MASSIVE improvement, so much so that we are now on the cusp of having either ICSI (more on that another time) or straight forward IVF, so we are now borderline ICSI/IVF - I can't tell you how impressed I am. So it just goes to show for you chaps out there who are in denial about your manhood and reckon you can drink whatever you want and smoke whatever you want: being well behaved and cutting back on all of those toxins DOES have an impact. If you and your lady are thinking it'd be nice to have a mini-me of your own in a year or two you need to start looking after your health and start tweaking your lifestyle now, and I'm not just talking about cutting back the booze and stopping the fags, I'm talking about vitamins, diet and stress - every aspect of your lifestyle can affect your fertility. Whatever you do don't take your fertility for granted as if you lose it, it can be quite an effort to get it back and before you know it you're off down to your local hospital to have fertility tests. Trust me chaps, ladies are used to getting their foofs checked out but lets face it - you men have issues chatting about your emotions let alone having to get your swimmers analysed by your local NHS trust; if you have the power to do so this should be avoided if at all possible and it's only you chaps who can change that - this is one thing us ladies have no control over. Take it from someone who knows only too well how much anguish this can cause, don't leave baby making to the very last minute thinking you'll get pregnant straight away as that's not always the case (just because so and so did and they were hardcore ravers doesn't mean the same will happen for you), and if you're a lady then I don't even need to mention the dreaded biological clock... I can't tell you what a relief it is to know that three months of exemplary behaviour has actually done something good - that on top of generally winding down over the past 18 months has proven that it can be done, you get what you put in. High-five to the Hubster!

So, I'm signing off for today - next scan is in 10 days time (25 January) and if all is on track, it'll be systems go, go, go! Until then I'm moving on to the 2nd track on my IVF belief CD, I'm keeping positive and taking the side-affects in their stride.

Catch ya later :)