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

Let's twist again

So I've been in pain, real pain. The type of pain that makes all the colour drain from your face and you need to pant through it. The pain was so bad last night that I actually told the Hubster "I need to go to hospital." Queue blood draining from the Hubster's face, scary times - I don't think I'd realised up until that point how stressful all of this has been on my lovely Hubster. The flat may look like an upside down mess but who am I do have a go at him about that when let's face it - all of his energy has been put into making sure that I'm ok?

The day had started out so well as well, we were up at 8:30am getting ready to go to Kings for embryo transfer (ET). We were told to treat Saturday like ET day and if enough of our little mini-mes had made it to day three and were dividing evenly we could go for a day five (blastocyst) transfer. At 9:15am we got the call from the embryologist to say that 3/4 of our embryos were still going strong and were of a very high quality - we could go for Monday transfer - woo hoo! Absolutely buzzing, this is what I'd been praying for - I knew all my PMA was worth it - go, go, go mini-mes - we're willing you on!

This was the best I'd felt in days, I could actually put my new (stretchy) jeans on as the bloat had decreased and I guess the adrenalin rush had something to do with the feel good factor, so the Hubster and I went out for brunch. Whilst at brunch, my consultant called to check on my symptoms (as it was a Saturday I had the doctor call and not a nurse as usual). I told him I was actually up and out for the first time since Wednesday, the bloat had subsided somewhat but I still was nowhere near 100%. He asked about how much I was peeing and he seemed happy with that, but I'm still under close observation as symptoms of OHSS can fluctuate on an hourly basis. The previous day I had a very bad, sharp stabbing pain in the womb/ovary area, it lasted about 10 minutes then went thankfully. Apparently this is my ovary twisting - WTF?!?! Due to over stimulation my ovaries are very large, they sit independently on both sides of the womb. Sudden movement can make them twist - I had no idea about this. They normally twist back by themselves, if the pain stays, it's what's called an emergency and I'm to call the on-call gyno at Kings ASAP and head to A&E if necessary.

OK!!! I felt reassured to know what that pain was and glad my body had sorted it out by itself. Fast forward 12 hours and I look like a ghost, not communicating with the Hubster other than the odd grunt and pointing at whatever I needed - at that point I was demanding a fresh hot water bottle. It took 30 minutes for the pain to go last night and I was scared, really scared (but I didn't let on to the Hubster how scared I was). Having read the OHSS leaflet again that one of the nurses gave me on Wednesday I've now noticed the section on acute abdominal pain it says to call them immediately if I get it. I never really understood what acute pain was until I got OHSS; I've never felt pain like it - EVER, and I pray I don't feel it again.

After brunch we went to the in-laws, it was there my bloating suddenly came back, I had to undo my jeans and I started waddling again - my pee output had suddenly gone down as well so we rushed home (as much as a person in my condition can rush that is), I got back into bed (boooooo), inhaled some water and then I started peeling again - phew. It's now Sunday morning, the bloat is still there (and as big as ever) but my twisted ovary has twisted itself back - thank f**k for that. I have NEVER felt pain like it.

I've had some well meaning friends try to get me to "think myself better" which normally I am an advocate of but this is something totally different to a bug; do they not think that I have already been willing my body to stop doing what it's doing? My friends should know I'm a glass half full kinda girl so thinking my way out of this horrid condition is already on the agenda. If the power of thought alone was enough to stop my follicles from filling up with protein rich liquid, which then seeps out into my abdomen causing the massive bloat, I really would've kicked this OHSS by now but it ain't as simple as that. Telling me to think myself better is a bit like telling a 15 year old girl who has unwittingly found out she's pregnant (and she doesn't want to be), that she can think herself to not be pregnant! That shizzle doesn't happen! This isn't the lurgy, or a tummy bug or a fit of melodramatic depression, its an overreaction to the Gonal F, it is what it is and it will be gone soon enough; the best thing to do is for me to give-in to what's happening, relax, don't stress about it, drink oodles of liquid and rest, rest, rest. 

I know my friends mean well and if you're reading this and you're one of my well meaning friends who gave me the thinking advice please don't get upset with me, I know none of you want me to go through this and that your heart is in the right place. If you know me at all you'll know that I've read masses on this, I understand the condition and how dangerous it can be and I'm doing what the doctors are telling me to do. All my positivity is being channelled towards our mini-mes, willing them to stay strong and to develop into blastocysts. I finally stumbled across a blog that is as honest as my blog on OHSS - have a read - it really made me feel better and it might give you a better understanding of the excruciating pain that no amount of thought is able to combat; it made me realise that I'm not going mad imagining these symptoms - you just need to look at me to see something isn't right!

Bloated Jojo - not looking too happy about the situation (and most certainly not my most attractive photo but I thought I should share the love). This was taken yesterday (Saturday 2 February 2013) - I'm a bit bigger since then - the irony isn't lost on me that I look rather pregnant!

Despite all of this (and it appears that I have had a rather tough IVF experience so far) I am still in very good spirits. I may have had to jump through hoops with the NHS to get my treatment but you know what? I'm glad I had to jump through hoops as IVF is anything but a quick-fix, it's a long hard slog (physically and emotionally). This is expensive, hardcore, invasive treatment - they need to be certain only the right couples get the treatment.

I'm totally in awe of what the doctors do at Kings and I feel nothing but love for them. The NHS, despite its faults is a wonderful thing and I feel so lucky to be where I am, I am blessed to have my mini-mes dividing away in a petri dish in SE5, I'm a very lucky girl - I just need lady luck to be on my side from this day onwards. I just need one of my mini-mes to take up residence with me and we can get on with getting to know each other. It's gonna happen and I know I'll have some babies left over for another time; I can't possibly have endured all of this for it not to work (and I am banishing those seeds of doubt out of my head this very instant!) Knowing I have mini-mes in a petri dish in SE5 makes me very happy and excited. I know the OHSS is likely to get worse and possibly stay with me for weeks to come if I get pregnant but you know what? I don't care, whatever it takes as two want to become three. Tomorrow is blastocyst transfer day - excited doesn't come close :)

Catch ya later :) x

My own harvest festival

Egg collection and after affects round up

Egg collection was on Wednesday 30 January 2013, its now Friday 1 February and I'm spending another day in bed - oh what I'm going through to get a mini-me - but I'd do it all again - in a heartbeat.

So on EC day I was super calm, chilled and if anything not nervous but EXCITED - really excited. This was the day that the Hubster's DNA and my DNA were going to join to make mini-mes - what's not to be excited about?!

I got told off for admitting to taking a sip of water by the embryologist but we were still allowed to go ahead with the procedure. I won't lie to you - it hurt like a MoFo but I was out of it at the same time so I only remember snippets. The Hubster stayed with me throughout, I have vague recollections of him stroking my hair throughout the whole process. I had a heartbeat monitor and not at any point did it increase, it was a nice constant 70bpm, even when I was told to "take a deep breath in" and then I felt a hot, sharp stabbing pain around my womb / ovaries. The hypnotherapy CDs are obviously working - being relaxed and positive is the name of the game so if you are going through IVF yourself, please chill (and if all else fails, listen to The Orb's little fluffy clouds - works every time - you're allowed to take your iPod in with you if need be, if it helps - do it!!!) I know I bled as I felt them clean me up. I don't recall saying this but every time the embryologist said "deep breath in" I said "no pain, no gain." I winced but I wasn't a pansy and I breathed. This was after all one of the most exciting days of my life. What I'm really chuffed that I remembered was seeing MY EGGS on the big fat plasma screen - I am soooooo glad I was with it for that as it was 100% awesome - there were loads of them! Screw the pain - this is so worth it.

Anyhow, in recovery I zonked out and slept on and off for about an hour. I could hear a lady in the neighbouring cubicle crying her eyes out prior to her EC - if my head wasn't as woozy and my legs worked I would've gone in there, given her a big hug and would've tried to change her fear to excitement. I can't see how getting yourself in such a tizz is going to help matters? Anyhow - I hope the sedative helped her chill - it most certainly did me and I felt the after affects of it for the rest of the day.

The long and short of it is: I had far more than 26 follicles by the time the embryologist started having a rummage (my ovaries obviously went into overdrive last weekend), they got 18, yes 18 eggs (woo hoo) and Hubster's swimmers stood up to the test and did us proud. Another embryologist came to see us once I'd come round from the sedative in recovery and told us that at least 9 of my eggs would be fertilised via ICSI and 6 via conventional IVF. As per the most recent swimmer analysis, the Hubster's swimmers were on the cusp of ICSI/IVF so why not treat them like that and do a combo? Brilliant, the staff at King's really are amazing and I am in awe of them. How cool would it be to tell people that you're an embryologist? Far more exciting than saying you work in Marketing - I really wish science had been made a lot more appealing when I was at school as I now find it all fascinating. I'm going to make it my mission to get my mini-me(s) interested in science and with a bit of luck they'll go one to do something as amazing as this.

Anyhow, I digress, do you want to know what the different is between ICSI and IVF? ICSI stands for: Intra-cytoplasmic sperm injection. This involves injecting a single swimmer directly into the egg to fertilise it - so the swimmer is given a helping hand. Here's a picture to show you the science bit - seriously - these guys are amazing for being able to do this:

Conventional IVF stands for in-vitro fertilisation, this literally means fertilisation in a glass - here's another picture for the science bit:

I am very chuffed that we are having both, the staff at Kings are keen to keep the whole process of baby-making as natural as possible so we have been lucky enough to have the best of both worlds. This however is where my frank honesty of how many eggs and swimmers successfully fertilised ends; I want to keep this private and don't really want the amount of embryos we have currently dividing away out there on the internet (you can understand that hey?) What I can tell you is that we have mini-mes growing in a petri dish and the embryologist called saying "I have amazing news" and it was amazing - lockdown was worth it and I am so excited about everything (despite feeling like a big fat pile of steaming poo). We're booked in for embryo transfer (ET) at 10:30am tomorrow morning (Saturday 2 February 2013). This would be a three day transfer, I'm hoping our little mini-mes stay strong and keep dividing evenly so they can get to blastocyst stage and we can have a five day transfer.

Here's a bit more science: check the image below to see how embryos develop. If you look at the very first embryo picture that has just two small circles in it - these circles represent the DNA from the mother and the father - how cool is that?! I figure that our mini-mes are currently at the eight cell stage, awesome, awesome, awesome. With a bit of luck the progesterone pessaries I'm now on will help one of my mini-mes implant in my nice, think womb - a blastocyst implantation is the aim.

Since my EC I have been feeling rough. The bloating I had with the HCG trigger shot has increased, I look about six months pregnant. It seems I have mild OHSS, it's quite uncomfortable and painful, I've felt queasy and have had some terrible trapped wind! Kings are checking up on me daily, I have a jug I need to pee in and I need to drink at least two litres of water / juice / tea  etc a day, and I need to monitor my pee output. If my output declines rapidly I need to get myself to Kings quick sharp, if I start to feel breathless I need to get to A&E. I feel like crap but I'm still über optimistic - it is what it is and it will go soon enough - its just one of those things. I had yesterday off sick and I'm off sick again today - I was supposed to work form home but sitting up at a laptop for long periods of time is very uncomfortable (this post has been written in segments). Kings are calling me daily and they are concerned and keeping a close eye on me but I figure it'll be gone soon enough and I'll have a mini-me inside me :)

So that's it from me today, despite feeling like poo this is quite possibly the most exciting time of my life.

Catch ya later :) x