IVF 1 - Day 12 third scan and tenterhooks

Back from the clinic this morning, my gut was cooperating but the equipment was not.  All week my clinic has had some trouble with their new ultrasound machine in that it won't let the nurse tag the follicles correctly.  This happened on Monday and on Wednesday; today the nurse went and got the old machine because it was happening again.

The uterine lining was looking good and the ovary was clearly visible this time.  There are 6-7 good sized follicles of assorted sizes.  My biggest was 20mm and second was 18mm and then there were 4 or so around 14/15mm and a bunch around 10mm.  This creates a slight quandry.  Typically you can trigger once you have follicles over 18, but I have a bunch just behind.  So do we sacrifice the 20 to get the others to grow?  This decision will determine whether the egg retrieval is on Monday (I trigger tonight) or Wednesday.  Now I'm waiting for a phone call.  In the meantime, I decided to buy more drugs because I'm obviously very much hoping that they decide to do the retrieval on Wednesday.  I mean, obviously I want to do what's best to get the best result, but a Monday retrieval puts me in a 50% chance of having the bad schedule (if I need a 3-day transfer) whereas the Wednesday retrieval will be completely fine.  So now I'm waiting for them to check my blood estrogen levels and have a consultation with the doctors who meet over lunch.  I don't think I'll get a call before 4pm-ish.  So now I just wait.

It took 3 tries for them to get blood out of my fussy veins this time.  One of the nurses is getting super determined that she wants to get it on the first try.  I'm sort of hoping it's possible this is my last go at bloodwork there though.  I mean, I don't think I need another scan because they will just decide today when the collection is and another scan and blood test won't change that.

In the hopes that they will decide that my retrieval will be Monday, I had to buy more drugs; a 300 Gonal F pen and 3 Orgalutran/Ganirelex doses.  Luckily they have all that in the clinic and charge you the same as Healthcare at Home so there's no mark-up on the drugs.  I was also happy they had a 300 Gonal F pen because that's all I need and a larger pen would have cost more.

In other too much information news, all these drugs and what the nurse says are my estrogen levels are causing me to have a lot of vaginal mucus.  This is not so fun and perhaps a bit gross.  I hate wearing pads all the time as the lady bits like to breathe, so I'm just trying to be very clean and remember to go to the bathroom more frequently.  At least that part shouldn't last too much longer!  I think I remember it from my egg freezing cycles but maybe not this much?  I can't remember.

New budget update:

Previous total	£12588
Extra drugs for cycle 1	£241
New total	£12829

IVF 1 - Day 10 second scan

I had a less positive experience at my scan this morning.  Mainly because my body was being very uncooperative and the nurse simply could not get a good view of the ovary no matter how much pushing and twisting of the wand, or pressing down on my belly, or even my going to the bathroom to see if that would make a difference!  The ultrasound stayed very murky and dark with occasional glimpses of the ovary but not a clear picture.

Because it wasn't a clear picture, it was impossible to clearly count how many follicles there were and at what size.  However, it seemed to be that there were 4-5 follicles around 14mm.  This is of course a decrease from the 7 that were visible on Monday.  Given that I tend to not get as many eggs as follicles, I'm now starting to steel myself for a disappointing result.  This then puts a lot of pressure on the frozen eggs and how they perform after defrosting.  Right now I feel like I'll be lucky to get 3 good eggs from this retrieval.  I hope this is not the case, but I'm nervous.

I'm sticking with the 300 Gonal F as they are clearly continuing to grow.  And it's still unclear if the egg retrieval will be Monday or Wednesday.  But I should know this by Friday because either they will want me to trigger over the weekend for a Monday collection, or come in for a scan Monday morning to confirm a trigger and Wednesday collection.  

My clinic only does collection on Monday, Wednesday and Friday.  I'm hoping the collection is on Wednesday because this will be the 'good' plan option.  If it's on Monday I'm going to be stressed that I'll need a three day transfer and have to be absent for the workshop I'm supposed to be running Thursday and Friday.  However, even though this is not ideal, the back up plan is in place for that, so not the end of the world, just not ideal.

I'm hoping for a better scan on Friday.  Also, I'm hoping for a better blood draw on Friday.  It took three tries today, even though we waited until after my scan (and the scan took a while).  So clearly it's not enough time to make a difference to my circulation if cycling is indeed the problem!

IVF 1 - Day 8 First scan of the cycle

I had my first scan today on day 8 of my cycle (day 7 by stimulation days).  I managed to get completely confused about when the appointment was based on how I put it in my diary which meant I showed up at 9:30 for a 9:00am appointment.  Luckily this was no problem at all and they saw me pretty much straight away.  It took the nurse two tries to get blood out of my arms.  I've decided that I think this blood issue is related to the 15 minute cycle ride I take to get to the clinic.  Typically if I've been cycling for over 10 minutes, my hands start to go numb and feel like I'm having circulation problems.  Because the first thing they do at the clinic is the blood draw, I think the problem with getting blood out is related to this.  I suggested next time they do it after the scan, we'll see if that helps.

So anyway, the scan was fine.  The nurse who did it had a little bit of trouble with their new equipment because it wouldn't get to where she could tag the follicles.  This meant I had the wand in me for a while until she managed to reboot the machine and finally get it it to work.  It also means though I got a pretty good look at the ovary.  So far so good.  The Gonal F is clearly working even though I'm not feeling anything yet.  I had around 7 follicles that were all 9.5-10.5mm, so that was great.  The ideal is for them all to be around the same size and they generally were.  It was clear at that magnification which ones were slightly bigger, but anyway, that was good, and there's still pretty much the rest of this week to go and for things to continue to grow and change.  In addition, my uterine lining also looked good.  The nurse was very positive and pleased, so that made me happy.

Of course I don't want to get my hopes up too high because in the last two of my egg freezing cycles, I had I think 9 and then 7 follicles and then only got 4 and then 3 mature eggs.  So even though seven sounds exciting, I'm trying to preparing for a low return.

My next scan is on Wednesday, and then I've already got one scheduled for Friday.  By Friday it should be clear if I'm coming in for a scan on Monday or if  I trigger or what.  I'm still thinking that based on previous egg freezing cycles that my egg retrieval will be next Wednesday, but we'll see.  I did ask this morning about this process as they require someone to take you home and stay with you (for 24 hours - or anyway that's what they say).  A friend of mine has offered to collect me in her car and stay with me for the afternoon, but she can't come until noon give or take.  However, I saw in the reading they gave me that they want the person who is going to take you home to be there from the start.  Well that's crazy- I can't just have random friends taking all day off work to sit around for a few hours while I have a procedure!!  It's hard enough to get people to be able to take time off to collect me at the right time!  This is for sure one of those times where I get very frustrated with the single mother element, and I also was frustrated during the egg freezing process.  Having been looking at doulas recently, I wonder if this isn't a service they should maybe consider starting to offer.  I'll deal with it, but it's annoying.  And now I have to wait to find out if I need someone there 'all day' or if someone can just come at the end.  I don't want to ask the boyfriend as I think it will upset him. Also, he doesn't have a car, so I'd have to book a taxi at which point I get annoyed about why I have to have anyone with me to begin with.  But I will work it out.

In other news I was at a dinner on Saturday night with some of my students who were graduating this weekend.  I had 1/4 a glass of wine.  I'm not going to kill myself over this.  I've been very good at taking all of my vitamins and morning pills, etc.  1/4 glass of wine is not going to make a difference!

Oh yeah, and I've started taking the Ogalutran which is Ganirelex (which I didn't know) in the morning.  I like that it comes in pre-filled syringes unlike the Cetrotide I had to mix and took during the egg freezing cycles.  However, it stings a bit after injecting it which I don't like as much.  For some reason the shots this cycle have all been more bothersome and often quite pokey.  Occasionally I get one in where I really can't feel it, but more often than not they feel pretty sharp.  Annoying!

Anyway, next update  Wednesday I imagine.

IVF 1 - Day 3

So managed to do my first injection last night but forgot I had a dinner to go to and so didn't do it until 10pm which was a bit later than my intended 8pm.  Today I have my drugs with me as I'll have to inject after the movie which will be around 8:30/9:00.  At least I'm moving it in the right direction and should be then back on an 8pm routine.

The shot hurt a bit last night- I don't know why.  Just didn't get the angle quite right so it was very pokey going in and I even moved it to see if it would be less pokey, but no. Anyway, I got it done and that was that.

I forgot that this morning I had an appointment with the counselor up at my clinic so I got in to work a bit late, turned on my computer, looked at my diary and was like, 'Oh shit!' so I had to put all my stuff back on and cycle to the clinic.  Oops.  While I was there I had a chat with the nursing team about when my first scan is scheduled for.  They reassured me that Day 8 (which is their Day 7 since they count stim days, not from period days) is completely regular and fine.  They did offer to give me a scan on Friday if I wanted one, but as I would have only been stimming for three days at that point, they didn't think there would be any adjustments.  So fine.  It really won't make any difference for me to see it on Friday versus Monday so I will just wait.  But I felt better for asking.

The talk with the counselor was good.  She was very nice.  This was a hoop jumping requirement by my clinic due to my use of donor sperm.  Right now I feel okay with everything, so I really just chatted to her and she asked some questions and all that was fine.  We did spend some time talking about the boyfriend because that is complicated.  I don't know that it helped to talk to her about it, but perhaps just again reassured me that I've got this sorted in my  own mind and am prepared for what may happen either way (he sticks around or he doesn't stick around if I get pregnant).  He and I still don't talk about the baby plan although I continue to update him on each step as I'm doing it.  I know he's not properly dealt with it in his own mind yet, but it's really just not my problem.  It would be my problem if I was relying on him, but I'm not.  I enjoy his company for what it is and if I lose it, I'll be sad.  But the baby plan is my primary focus and he's not actively part of that.  It's also why I was pleased to hear from the pregnant ladies at the DCN conference about doulas.  They all advocated for having one with you in the delivery room and I've since looked into it and looks like a great idea.  So I'm not even worried about who is going to be there with me because I will pay someone to be there with me.

I worked out with the counselor that it's not that I'm feeling optimistic about all this, it's just that I'm excited to be actually doing it.  I'm not unrealistic about the odds, but it's exciting to be doing something- moving forward, etc.  Although I may not feel that way a week from now, I feel that way today.

IVF 1 - Day 2

First shot tonight.  Happy to get this show on the road.

I called the clinic yesterday to tell them my period had arrived and schedule my first scan.  They said the doctor had put me down for an 'early' scan so they scheduled me to come in on Monday which will be day 8.  This is not early.  I was sort of taken back by this, as when I did egg freezing, or even when I had the IUI I think they scanned within the first 5 days. Day 8 seems a bit late.  I mean, some women even trigger on day 8!  Although I for sure will not.  I feel that day 8 is a bit late to make any adjustments to the medications.  I would have thought I should go in on day 5 which would be Friday. At the moment I'm undecided about whether or not I should call to ask for this or as for the reasoning for putting it off until day 8 or just to suck it up.  In general I'm not a fan of the suck it up approach and I prefer more information to less.  However, I also vaguely assume my clinic knows what they are doing.  Although maybe I shouldn't.  Seeing how many follicles there are in the scan, and how they are growing is supposed to help them decide how much drugs I should be taking.  By day 8, I'll be more than half way through stimulation, and I don't know that there's much more opportunity for adjustments.

The women on the SMC forum all felt I should push for an earlier scan or at least get in touch with the clinic.  I think I'll at least give them a call.  The women on the forum also all unanimously supported ICSI for the fresh eggs and assisted hatching for all embryos.  So that was interesting as well.  I did a bit more google research on ICSI and think it's probably a good idea to just go ahead with that. Assisted hatching also seems like a no brainer although there will be an additional cost per embryo for that.  Still, anything that helps.  And also, what's £125 when you're spending £6k+?

So it's Gonal-F only for the next few days before I add in the Ogalutran in the mornings.  All the drugs are currently taking up the cheese drawer in my fridge.  Huh.  Actually now that I'm thinking about it, I'm going to the movies tomorrow when I need to inject so I'll have to take the drugs with me.  At least they gave me a useful drug carry pouch with a portable sharps container for being away from home.  I'm going to go for an 8pm/8am schedule, or as close to that as possible for my injections.

So, still happy to be starting.  Still feeling positive.  This may obviously be significantly tempered whenever I actually get my first scan and see how many follicles are happening.  But also looking forward to finding out what will come out of the frozen eggs.

IVF 1 - Day 1

My period is here!  My period is here!  Who knew it could be so exciting?  I'm really a bit shocked that it's come so late, but anywhere, here it is.  My last period was particularly early, so I guess it makes sense. On the plus side, this would make a day 17 collection on Wednesday the 25th which would be a good timing, unless they decide for a day 15 collection, but I'll be surprised if this is the case. At any rate, this means I start stims tomorrow night, 300 Gonal F.  I'm excited and also a bit nervous to see how this cycle ends up.  How many fresh and then mature eggs will I get?  How will the frozen eggs defrost?  Will any fertilize?

The only decision I need to make now is whether or not to do ICSI and assisted hatching with all of the eggs or some of the eggs, or what.  I put it out to the ladies on the forum and it was a unanimous opinion that I should go for both.  I have to have ICSI with any of the defrosted frozen eggs, but it's optional for the fresh.  Given my age, ICSI is apparently better.  Assisted hatching is again recommended for things that are being defrosted and for 'older' eggs.  I fit into both categories, so I think I'll just go for both.  I did watch a video of ICSI though and it looked a bit violent.  Apparently there is a risk of damage to the egg, but it doesn't seem conclusive how that weights out against the risk of not fertilizing at all.

One of my best friends is having a frozen embryo transfer this month on almost the same timing as myself which would be a bit crazy for us to be pregnant at the same time.  Of course she's trying for her third child after something like 20+ cycles of various fertility treatments (which gave her the first two), so a little bit different.  But it would be sort of fun for me and my friend to be identically pregnant.

Anyway, fingers crossed for this cycle.  I don't know why I'm allowing myself to feel optimistic given the odds, but I just can't help it.

Drug Delivery

The box itself didn't look like much....

However, inside the box was a shitload of drugs!!

We've got 4 x 900 Gonal F pens, 7 Orgalutran pre-loaded syringes, an Ovitrelle pen, 3 boxes of Cyclogest pessaries, an amoxicillin pill, and of course the sharps box.  My cheese drawer is looking very full at the moment....

No period yet.  If it comes tomorrow that's risky because I think my clinic only does egg collections on Monday, Wednesday and Friday.  That would mean they may try to collect on day 15 (Friday) which would be earlier than all of my egg freezing cycles, but otherwise would have to wait until day 18 (Monday) which could be too late.  If my period comes the day after tomorrow, or the day after that, then they might be going for the Monday collection (day 17 or 16 depending).  I'm pretty sure the clinic does embryo transfers on Saturdays, so if I had a Monday collection, I could have the transfer on the Saturday, avoiding the two days (Thursday/Friday) which will be a horrible work conflict.  If I have the collection on a Friday, the transfer would be on the Wednesday which would not be ideal because I still have some conflicts, but would also be okay, or at least, way better than the Thursday/Friday conflict.  So actually... I might end up alright with the work conflict either way- the only difference would be if they collect on the Monday and if I don't have more than 2 embryos that don't look so great, they could recommend a day 3 transfer which would be on the Thursday.  Complicated!!  I don't care though.  This month is a go, and I'm sort of excited about it.  Even though there's no guarantees in all this, I prefer to be taking action than waiting, that's for sure.

IVF package and drugs - budget update

I've just spent a large sum on the drugs for my first IVF procedure as well as the procedure itself. My clinic has a package deal for IVF which includes:

• Ultrasound scans for monitoring
• Monitoring blood tests
• Blastocyst culture (if needed)
• IVF/ICSI process (if needed)
• Embryo transfer
• Pregnancy scan or review consultation as needed

The cost for this package is £3130 if you are not using ICSI and £4030 if you are.  Because my frozen eggs will need to have ICSI, then I am paying the higher cost.  There is no additional fee for the processing of both types of eggs, or the defrosting, or if they end up doing two different fertilization procedures on the fresh and frozen, or anything else apparently.  So that was good.  At the moment I feel this cost is very reasonable for an IVF cycle with drugs included.  But I don't have a huge amount to base that on.

The drug cost for 12 days of treatment came out to £1858 which includes: 4x900iu Gonal F pens, 7 Orgalutran injections, 1 Ovitrelle injection, and 45 Cyclogest pessaries.  I will probably need to buy some more medication as my cycles tend to run longer (from both the IUI and egg freezing experiences).  But these drug costs seem reasonable.  I should go back and compare them to my old egg freezing costs as they are again from Healthcare at Home.

I'm still trying to pay for the courier to get the frozen eggs from London to Cambridge.  I have left a phone message with the Cambridge clinic today and replied to an email over the weekend, but so far nothing.  I don't think that will be a problem but I will feel better when it is paid for and underway. The courier quote I got was £175 + VAT.  So I'll have to add that to the budget later when I find out how much the tax is.

Apparently I need to fill in yet more paperwork to permit the thawing of the frozen eggs.  Of course I do.

So the budget update:

Previous total	£6490
IVF Inclusive Fee with ICSI	£4030
12 Days of IVF drugs (see above)	£1858
New total	£12378

I've now spent approximately... a little over 1/3 of my savings for this endeavor.  It would be amazing if this would work so I could keep the rest for caring for a child, childcare, etc.  But it also means if I need to do this again, I certainly can.  Of course fingers crossed I won't have to.

More moving eggs

I've just gotten off the phone with the amazingly lovely head embryologist at my clinic.  While I type this post I am also refreshing my email inbox because of course I have more forms I need to fill in. However, he was very helpful about moving forward with arranging the courier to transfer my eggs. As it also happens, he knows the embryologist at the London clinic I used very well, so that's also good, or at least, makes me feel better- for no good reason whatsoever.

Apparently the receiving clinic does arrange the transportation.  So they'll do that, and then I'll just call up and pay.  Then hopefully all being well, my frozen eggs will arrive in Cambridge by the end of next week. That is then on time for me to start my IVF cycle with my next period which is due around May 5.

While chatting to the embryologist I have also learned:

• eggs are defrosted rapidly;
• so if none defrost, there may be time to defrost more; and,
• that for fertilizing both the fresh and frozen eggs at the same time they can use the same vial of sperm even though they have to be done through different methods.

So that was useful.  It was also useful to hear that because I am undergoing treatment, my first year of storage for all things needing storage is covered. It's only after the first year when I may start to have storage fees.  So that was good.  I was thinking I was going to need to cough up some more money to store things in Cambridge.

So the next thing to get on top of is the drug order and delivery.  I have a day in lieu that I need to take for work so ideally I can arrange that for the same day as the drug delivery and just be home to stick everything in the freezer.  As I'll be on 300 Gonal F a day for a while, that's going to be a lot of pens.  Instead of Cetrotide which I took during egg freezing, I'll be on something else (I'll have to look up the name at home) which you inject in the morning.  So Gonal F at 8pm every night and this other drug at 8am every morning starting on day 6 I think.  I also can't remember what she said the trigger was going to be.  But it's also something different because apparently the UK is having a Pregnyl shortage.

I keep refreshing my email but there's nothing there......

By the way, I've had very few comments on this blog, which is fine of course because the blog is a dumping ground for me more than anything else.  But I'd be happy to connect with other people, particularly if you're going through the same, have been through the same thing, or are thinking about it.  I'm on the SMC forum, or you can message me here public or private.

**UPDATED**
Of course there was something wrong with their system and my email address so the embryologist has just called (an hour later) to tell me and I've had to provide a different email.  Luckily, that came through so we should be moving along with the paperwork now!!

Pre IVF consultation

I had my pre IVF consultation with my clinic this afternoon.  I went there thinking I had a perfectly reasonable plan which has been encouraged both by my egg freezing doctor (way back when) and by the first doctor I saw at this clinic.  This was, mainly, to do a fresh IVF cycle and save my frozen eggs as a last resort.

This plan was immediately questioned by the doctor I met to have my consultation with.  It was the same doctor who did my Hycosi although that was the only time I've met with him previously.  He thought I should be going straight to my frozen eggs as this would give me the best chance of success at this stage.  Now, the reason for not using the frozen eggs straight away was if I am fertile now, that gives me an option for the future, if I want one.  I don't at the moment think I want one.  I think that one child would be all I want.  But I liked the idea of holding something in reserve.  However, the doctor was really surprised and encouraged me to not put my body through IVF when I could use frozen eggs.  So this threw my thinking completely out. I held firm at first, and then as we kept talking I started questioning myself.

In addition to this confusion, he was looking at my file and saying that I needed to attend the 'information session' as a matter of policy.  Now, way back when, when I started treatment they said I had to do the information session.  Then, when I explained I'd done egg freezing and was pretty well versed in the fertility sphere, they said I didn't have to.  But apparently now I do have to.  So I got scheduled in to attend an information session where I strongly doubt I will learn anything new.  In addition to this hoop jumping, he informed me that I also needed a consultation with a counselor about the implications of using donor sperm.  I don't mind meeting with a counselor, but again, I feel fairly well versed in the implications of using donor sperm and am in fact this weekend going to a conference hosted by the DCN - so I will jump through this hoop but it annoyed me.

Anyway, back to the consultation.

So the doctor relented that ultimately it was my decision but it was clear he didn't think I should be doing fresh IVF to start.  He was also saying that a lot of things had to happen to start the cycle so I couldn't just assume I could start with my period in May which stressed me out.  He then saw me getting stressed and tried to convey that staying calm through all this is helpful for getting pregnant. In the meantime, I'm thinking to myself that I understand where he's coming from but he's not being particularly helpful in ensuring that I am calm because he's causing all sorts of disruptions to things that I thought were reasonably fixed!

So as we're discussing it back and forth, and he's making me feel not so great by commenting that if I only got 6,4, and 3 eggs on my egg freezing cycles that my chances for IVF retrieval at this stage were not so great, he mentions that I could consider doing a fresh IVF cycle and also at the same time defrosting half of the frozen eggs to increase my chances of having one or two viable embryos.  Now this sounded better to me.  First, because I can plan to start the IVF cycle in May and now it's really about getting in touch with my London clinic to arrange the transfer of my eggs to Cambridge and having them in place for this to happen.  It also allows me to save half of the frozen eggs for a second try either immediately if this doesn't work, or in the future possibly.  So I think out of the 13 frozen eggs I have, I may suggest they start by defrosting 6 for this cycle.  Those will need to be fertilized with ICSI, and they can be watched alongside anything that may be retrieved from the fresh cycle.

So it's a slightly different plan but one I actually feel reasonably good about.  I am also going to email the embryologist to see what would happen for example, if the 6 don't defrost or fertilize for some reason, would there be time to defrost the other 7 in this cycle (I actually have no idea how long it takes to defrost an egg although I assume not so quickly).  This means I am now waiting for them to price up this option and the drugs costs and then I can order my drugs and schedule a counselling session and attend the information evening and be all set to start my IVF drugs on day 2 of my period.

Phew.

So a good result in the end that I have a plan and it's all systems go.  But really more stressful than it needed to be and a bit of a kick from a doctor who was clearly trying to tell me that he didn't think my odds were so great being over 40.  But anyway, I'll see what I get fresh, and I'll give some of those frozen eggs a chance and we'll see where we get to.

But first I need to call my old clinic and see about getting those eggs transferred to Cambridge.  I'm sure I'll need to sign a release or some such even though I will never actually see these eggs and it will all be done clinic to clnic.  The UK is very strict on fertility issues!  So much paperwork.

Anyway, it seems like more updates will be on the way as the planning progresses.

IUI 2 - Day 11 scan 3 and procedure scheduled

This morning I had my third scan. It looks like I have two follicles growing and a third a bit behind. So apparently I'm responding well to treatment this month. The largest of the two main follicles was 16mm (the other was 15mm and the third was 11mm) and they usually want it at 18mm to trigger. So I'm going to trigger tomorrow with my procedure sometime on Wednesday. I say 'sometime' because the clinic has been unable to give me a precise time for it which is only a little bit problematic with work scheduling, etc. Tomorrow would have actually been much easier in some ways. Anyway, we'll see. I'm a tiny bit frustrated with my clinic because they seem to be overstretched sometimes. I think this is probably because it is also the NHS clinic for the Cambridge area. In fact, it's pretty much the only fertility clinic in the city. This isn't terrible because on a whole, I think it's an excellent clinic with good results and friendly staff. However, there's clearly some sort of issue with having enough staff or the scheduling that it ends up being stressful. Of course this process is stressful enough without wondering when your next appointment is going to be, or if they're going to forget that you are supposed to have an appointment! I'm sure this wouldn't happened, and so far hasn't happened, but like I said it adds a level of extra stress during what is already a stressful time. On the plus side, the clinic is relatively easy to get to. Cambridge is a pretty small place. The clinic is what- about 1.5-2 miles from here? And it's literally straight down the same road I work on, so pretty convenient by bicycle or by taxi. I haven't even looked at buses yet because I generally hate dealing with the buses in Cambridge, but I bet there's one that goes that way as well. Anyway. One more Gonal F tonight and then Pregnyl some time tomorrow. Interestingly when I was talking to the nurse who did my scan this morning, she was saying that for IUI the timing is less important than for IVF which makes sense. So I feel less stressed about the timing issue given that it's IUI. On the other hand, if this cycle doesn't work and I move on to IVF, this scheduling malarkey really can't continue like this or I'll be extra stressed!

IUI2 - Day 10 moody

I seem to have come down with a malaise. I'm feeling quite moody and this has me questioning my decisions. Well, not really questioning my decisions in a virulent way. But more questioning everything. Is this the right path? Will I be a good mom? Am I crazy for trying this? The unknown is a scary place. This is why people often stick with the devil they know. I'm no different. I've certainly spent large portions of my life on 'the comfortable path'. But I've also jumped into the complete unknown on more than one occasion. Usually guided by clarity of purpose. Because that tends to override any lingering doubts or fears. I guess in some ways that's how this is for me. I feel very certain that pursuing single motherhood is the right decision. But perhaps because it's a timely process with no guarantees, it leaves me a bit more time than usual to think about it. In the past the major life decision upheavals I've made have been on a much shorter timescale (although no less disruptive). Moving to another city? Moving to another country? Deciding which graduate schools to go to? Undertaking a PhD? I know that I will adapt to whatever my new situation is. But I guess sometimes, when I'm feeling discouraged and scared, it all seems a bit overwhelming. How will I cope? What if I hate being a mother? Part of it is also the fear of doing it all alone. Who will I turn to? Who can I rely on? I know that I will have help from various sources- both family and friends. But ultimately it's just going to be me. I'm scared I'm not ready. I'm scared it will happen. I'm scared it won't happen. I have no idea if this is related to the low dose of hormones (Gonal F) I've been injecting now for 2 months. It's certainly not PMS- it's the wrong time. I think part of this is also about the boyfriend. He was over yesterday/last night. And that was all fine. But we don't really talk about the baby plan because it causes upset. He did watch me inject. He just doesn't ask any questions and I stick to keeping him informed of the basics. I don't feel like I can talk about my emotions with him without him thinking about how it affects him. If I say I'm scared of doing it alone, he could turn around and say that I am rejecting him as a person to do it with. To be fair, I'm not at all sure he would say that at all, but it's probably what keeps me from talking to him about it. It highlights that I'm doing it separate from him which I know is a point of upset for him. So I just don't. I think also living here in Cambridge.... it's not where my good friends are. The problem is, my closest friends aren't in any one place anymore. There's a couple in London, a couple in Manchester, one is in South Africa, one is moving to Australia at the end of this month, one is in Sheffield, one is in Norfolk, some are in New York. My village is global. Which is great for other reasons. But right now, living here, in a city which isn't my first choice, it feels lonely. I don't have a large base of friends here. The friends I do have are not so close that I want to have an emotional dump with them. Meh. I'm just feeling blah at the moment. I'm sure it will pass. In the meantime, scan tomorrow morning and this will hopefully determine when the trigger is. This IUI cycle seems to have gone incredibly fast. Shame that the two week wait won't, I'm sure!

IUI 2 - Day 8 Scan 2

Had my second scan this morning. It looks like there are two follicles growing- one was 12mm and the other was 11. There were a bunch more that were much smaller. I don't think I mentioned that when I had my scan on Monday there were about 12 follicles as opposed to the first IUI cycle when there were about 6 or 7. So I'm intrigued that I might have two growing for this IUI cycle. I really do not want multiples, but given the high chances of chromosomal abnormalities in eggs of women my age, having 2 eggs would be pretty cool. I go back for a third scan on Monday and I suspect that I will trigger either Monday or Tuesday nights with the IUI on Tuesday or Wednesday. Until then, it's 75 of Gonal-F every night. The nurse who did my scan was very positive. I don't think they're just blowing smoke up my ass, I mean, what would be the point? But she said that my numbers looked great and the ovary looked great and was overall, very positive. We talked a bit about my fertility and she was enthusiastic that I was following a good protocol given where all of my numbers were at. So that made me feel good. I tell you what, it's funny how much quicker the stimulating goes than the two week wait!! In other news, it took them 4 tries to get blood out of me which was a little bit annoying. For some reason the nurses at the clinic are struggling with my veins. My GP doesn't have as much trouble and usually gets it on the first try but at the clinic it's always at least 2 tries and sometimes more. Today they ended up taking it out of the back of my hand (tried there twice!). The nurse who did the scan said that if my scan on Monday looked good and my blood today looked good, then they wouldn't need to take blood again on Monday because all of my results so far have been completely normal and fine and so there's no reason to think it wouldn't be on Monday. They can just make a determination based on the scan. So that's good. Yesterday I had a chance to hold my friend's 8-week old baby. We were in a coffee shop and there was another couple with a 5-week old baby! They're so little!! Although the 8-week old was noticeably bigger than the 5-week old. They do grow fast. It's hard to imagine that I might end up with one of those - even though it's the goal. It's impossible to think that far ahead in the process. Right now all I can think about are follicles and scans. Then it will be the IUI procedure and then the long two week wait with the hope of seeing some faint line appear on a stick. Actual babies just seem so far removed from the now.

IUI 2 - Day 5

Got the call from the clinic late yesterday that my blood results were good so I was all set to start injecting for cycle 2.  Yesterday and tonight I do 150 Gonal F and then it drops to 75.  My next scan is Friday.  Like last time, I suspect the trigger will be Monday.  In fact, I think I'm on the same basic schedule?

The one thing that's driving me nuts is that I'm still sick.  The flu I had a couple of weeks ago has settled into some sort of head/sinus infection.  My ears are blocked, I'm blowing out fluorescent snot and I'm coughing a lot.  This is all bad timing and I don't know how this low-grade illness effects my fertility chances.  I'm sure it's not helping.

I have an acupuncture appointment tomorrow afternoon which conflicts with something in my diary which is frustrating.  I need to see if I can get that changed and then work from home the rest of the afternoon.  It should be okay.  Just a stressful period which is not helped by this never ending illness.

On the other hand, I'm sure I'm not doing myself any favors by doing all the things I would otherwise want to do which has involved travelling around the country a bit, going to a workshop last night, and going to a concert tonight.

Bleh.

One Cycle Ends, Another Begins

So I took the clinic pregnancy test on Friday and it was negative.  Additionally, my period basically started on the Thursday night, so cycle one was unsuccessful.  On the plus side, with my period not starting until Friday really, this was perfect timing to start the new cycle. 

I called my clinic on Friday morning because they ask you to report the result of the pregnancy test, plus, I wanted to immediately get going on IUI 2.  This would require me to order the drugs so they are ready for me on Monday.  Unfortunately, no one answered the phone at my clinic and I was forced to leave a message detailing the result of the pregnancy test, and my intentions to start cycle 2.  By 3pm, no one had called me back and I was about to go into a 2-hour meeting which meant I couldn't get in touch with them until Monday.  So with 5 minutes to my meeting I managed to get through and schedule a scan for Monday morning.  However, there wasn't enough time to get the drug order sorted.  The nurse indicated I would be able to buy the Gonal-F at the clinic on Monday.  I really hope this is the case and it's not somehow more expensive for the inconvenience.  Because it's not my fault they were too busy to get to their phone messages.

In the meantime, I've recently read It Starts with the Egg which was recommended on some of the forums I'm now frequenting.  It was an interesting read and has made me think about making a few changes to my current routine.  I was already taking conception vitamins but I think I'm going to add some CoQ10 to my routine.  I'm also looking at replacing some of the plastic food storage containers I use with glass to help reduce my exposure to BPA.  I figure that these are things I can do relatively easily, and that are not going to hurt me.  Similar to acupuncture.  There is a lot of discussion online about DHEA and in this instance I would not start taking it without my clinic's approval and probably some testing.

So how am I feeling with one failed cycle?  Disappointed of course.  Although I started to address that as my negative pregnancy tests kept coming in so that the final one wasn't such a shock.  Maybe a little bit panicked based on how much money I have and how long I feel I can realistically give this a try.  I found myself thinking I should go straight to the frozen eggs and stop fucking around.  I'm pretty sure this was a direct response to feeling like it's just not going to work with my current 'old' eggs due to this cycle not working.  But those eggs are not going anywhere and my current eggs could work.  I think I need to try one more IUI as planned, and then one fresh IVF and then see how all that goes.  If the clinic suggests going to the frozen at that point, then fine.  But it won't be a knee-jerk reaction to things not going as desired.

It's entirely possible that this is going to be an expensive year that doesn't result in a baby at all.  But it's far too early in the process to be thinking that way.  One failed IUI which only had a 6% success rate is not the thing to be basing the entire journey on.  And hey, based on my very poor understanding of how to add odds, by doing two IUI, each at a 6% success rate, the chance of one of them working is 12%, so that's a bit more hopeful for the second one, huh?

IUI 1 - Day 8, Scan 2

Back from my second scan this morning.  It's a different game to egg freezing.  The nurse was very pleased with the scan where there was one growing follicle (around 14mm) and 5 sleeping baby follicles.  Of course with egg freezing, or IVF, you want all the follicles to be growing at an equal rate.  So I was a bit tense when I only saw one follicle emerging.  Of course with IUI, this is exactly what you want!  You don't want multiples because that would risk multiple babies.  The nurse was very positive about what she was looking at, so that was all good.  And my uterine lining was also as desired.  I have another scan on Monday and will continue with the 75 Gonal F injections.  I suspect Monday night or Tuesday night will trigger so Tuesday or Wednesday will be the insemination.

They also took my blood again today to ensure everything is on track and as desired.  I shouldn't get a phone call unless there's something wrong and they want to change the drug dose.  This time it only took two tries to get blood out of me.  On Monday I think I'm going to slug a large glass or two of water before cycling to the clinic.  Being a human pin cushion is not particularly amusing.

Meanwhile, my second acupuncture appointment is scheduled for tomorrow.  I've been good about taking my conception vitamins.  I've also signed up to the Single Mothers by Choice website so I can make use of the forums.  I've added a couple of links to the side of the blog and plan to add more as and when I find them useful or of interest!

IUI 1 - Go

This post may be somewhat premature as I'm still waiting to hear the results of my blood test from the clinic this morning to let me know for sure that I can go ahead with the IUI this cycle.  Of course there is no reason to think that my blood test will be anything other than normal.

This morning I cycled over to the clinic for my 8:30am appointment.  First I was taken to have my blood drawn.  After trying in both arms and getting nothing, and after drinking two glasses of water, they decided to do my scan first and then see if the blood cold be drawn after.  The scan was quick and easy.  My uterine lining was thin as expected at the end of my period, and as desired.  The nurse also counted 6-7 follicles on my one ovary (the other is gone remember!).  So all looked in order.  After the scan, the nurse gave me the schedule for my Gonal-F injections.  Tonight and tomorrow I will do 150 and then it drops to 75/night.  My next scan is scheduled for Friday morning at 8:15.  I then have another scan scheduled for next Monday.  On Friday they will determine if I should go ahead with the Pregnyl or wait until Monday.  Since today is day 4 of my cycle, it's hard to say.  My cycle is often a bit longer (~32 days) but then this month it was 28 days. That makes this Friday day 8 and Monday day 11.  We'll see how it goes.

The nurse also gave me a little purple carry bag for the Gonal-F in case I need to inject while not at home.  I didn't get that last time.  It comes with a tube for needle disposal and everything.  Very thoughtful.

After the scan nurse I went back to the blood nurse.  I think she was a bit nervous after not getting anything from either arm so she called in a colleague to try for a third time.  Meanwhile, I drank another glass of water in the hopes of plumping my veins.  This nurse went for a deeper vein but funny enough I didn't feel it at all when it went in!  And she managed to get the blood.  So that was good.  Third time was a charm.  Although I hope that doesn't hold true for the cycle.

It's impossible not to start a cycle and be hopeful even though my chances of success are low low low.  I'm taking my vitamins, I'm off alcohol and caffeine.  I'm eating lots of vegetables and good foods.  I'm doing the best I can!  So of course I'm hoping for the chance that this might actually happen.  Which is a bit better than being utterly terrified.

Tick Tock

So my period ended up coming particularly early while I was away- I think on 28 days.  So definitely starting this month was a no-go.  However, that means February is looking good and everything is now in place to try.  The donor sperm is at the clinic and I've been delivered my drugs for the first IUI cycle.  This includes a 900iu Gonal F pen and 2 Pregnyl which I've not used before.  It looks like the Pregnyl is an intramuscular injection which may be a challenge on my own but I'll find out more at my first scan which should be on day 1 or 2 of my next period, due mid-Feb.

This week I also had to go to the GP to get my virals retested.  This was HIV and Hepatitis B & C screenings.  Apparently whilst  undergoing treatment these need to be within 3 months current which seems excessive.  I showed up at the GP and they were frankly confused because my tests were in date but no, I had to have those again.  Luckily the GP covered it.  I suppose they could get annoyed if this continues and make me pay for it, I can't imagine it's all that much by comparison.

The drug delivery came via Healthcare at Home which if you were at all a reader of my egg freezing blog you will know has the best pricing around on fertility drugs.  Or at least they did two years ago and I have no particular reason to think this has changed.  So new budget:

Previous total	£4454
900iu Gonal F and 2 Pregnyl	£380
New total	£4834

The drug delivery had to be to work which was a little bit annoying but they didn't have a Saturday delivery slot.  It came in a massive cool box which was all very well packaged.  Pretty much discreetly except it said 'laminarmedica' on the side.  The 'medica' part is somewhat obviously 'medical' and it would certainly be recognizable to someone else going through the same.  In fact there is a woman in my group who has suffered from fertility challenges and I was particularly concerned with upsetting her.  I hope I didn't, and she didn't say.  Hopefully in the future I can get the drugs delivered to home.  Of course there's the possibility I may not need any more drugs, but I honestly don't believe that will happen.  On the other hand, it would be wrong of me not to acknowledge it could happen.

So the next thing is to wait.  When my period arrives, I will call the clinic and they will fit me in for a scan either that day or day 2.  They'll let me know what I should start injecting and when I should come back for the next scan and we'll be set to try the first IUI.  I'll also pay for the IUI on that day so will update the budget accordingly and detail what's included later.

Otherwise I need to get much better at being regular about taking my conception vitamins and I'm looking to get some acupuncture appointments set up as well.  Need to lay off the alcohol and caffeine, not that I have particularly much of either to begin with.  Already on a vague healthy eating kick, mostly due to trying to reduce my meat consumption (although I'm not a vegetarian).  I still find this whole thing a little bit surreal.  While I was away (visiting a dear friend with two small children, 3.5 and 1.5) it was very easy to be excited about this journey and look forward to trying.  Now that I'm back in my life though, it just doesn't seem entirely real.  I have so many other things going on and to do.  Part of me is still excited and hopeful, and then the other part is more cautious and whispers that I may not get pregnant anyway after all the trying.  So I guess I end up not wanting to think about it too much at all lest I get either depressed or anxious.  This doesn't stop my progress on my plans, but it does put me in a rather strange state of mind where this is something I'm obviously completely committed to, but then try not to think about it too much in the moment.

That may be challenged and it may become a bit more prominent once the cycle is underway however.  Probably.