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!!

TWW 2 - Day 1

So I managed to trigger with the Pregnyl when I got home on Tuesday, around 6:15pm or so.  The Pregnyl is really fussy and annoying.  This time I managed to break open the glass vials without crushing them which was good.  But then I think a tiny splash of water came out when I snapped off the top of the water bottle.  Then, when I was priming the needle a tiny bubble of fluid came out and fell on the floor.  So I was feeling stressed when I finally managed to inject, only to do it in a funny way that's left a dark point bruise on my belly.

Having done some more reading around the internet, it seems that having two follicles (or three, or even sometimes four) is not at all unusual for an IUI so I think my odds are still 6% (or 11% if you consider both cycles).  I was a little disappointed by that, but I'm still happy that I had two good sized follicles for this cycle because that's got to be better than one!

On Wednesday my morning meetings went late so I only had 20 minutes for lunch and to turn myself around before the taxi came to take me to the clinic.  It's a small indulgence I have to take a taxi to the clinic but the alternative would be to cycle and I don't really want to cycle around the procedure.  In the grand scheme of things, the £14 return is really not an issue.

My procedure was a little bit late because the doctor had to come from the main hospital to the clinic.  Once she arrived it was all very quick and straightforward like the first time.  I was the only patient there.  I changed in the recovery area in my own little cubicle, then when the doctor arrived and all was ready, I walked with the nurse to the procedure room.  It was a little bit different from last time because there was no trainee doctor.  So the regular doctor did the procedure and this meant there wasn't any ultrasound.  I asked her about this afterwards, she said that because embryo transfer is similar to IUI, they would have used the ultrasound to watch the placement of the tube during the IUI for training, but it wasn't necessary.  It also wasn't necessary to scan my ovary to see if the follicles had released she said.  Basically, with IUI, it's a less precise procedure.  There's really nothing they can do other than the insemination at that point.  The ultrasound won't tell you anything and would potentially only be stressful if you didn't see that the follicles had disappeared or released.  So fair enough.

The way the IUI works at my clinic is the doctor gets you all prepped with the tube through the cervix, then the nurse knocks on the window to the embryologist's lab and he hands over the sperm through the window after confirming who you are.  I also have an ID card that I insert into a scanner that I think registers in the embryology lab as well.  At any rate, I had a chat with the embryologist as well with my legs all up in the stirrups.  I asked about the sperm motility since I didn't the first time.  I think he said it was 36 or 37 which was well over the 25 guaranteed by the clinic, so that was good.

The sperm got connected, inserted, the tube was removed and all was done!  They said I could lie there for a bit if I wanted or get up.  I decided to lie there for a bit but asked the doctor some more questions while I did so it ended up being useful.  While obviously I really want this cycle to work, I'm realistic that it may not so I asked the doctor about moving on to IVF.  She explained that I'd need to come in for additional consultation and that there's a lot more HFEA paperwork that needs to be filled out for IVF.  So I wouldn't be able to start an IVF cycle next month, it would have to be the month after.  But that's okay.  April is actually a very busy month for me so it would potentially be difficult to schedule scans around my work commitments.  Again, I obviously hope it doesn't come to that, but I guess I'm more of a realist than an optimist.

So now the two week wait begins again.  I've scheduled my progesterone blood test with my GP for next Thursday.  The clinic also gave me two pregnancy tests and the date to take them on.  I'll probably do the same thing as last time and start with my Ebay ones until the day I'm supposed to take them according to the clinic.  But maybe I'll use the extra one they gave me for the day before.

IUI 2 - Day 12 trigger and GRUMP

The clinic called today at 2pm to tell me that my IUI is scheduled for 2:15pm tomorrow. Of course this conflicts with meetings and would have been much better to have this information earlier, but what can I do? Of course I have to jump when fingers are snapped. Grump.

In addition, the nurse on the phone says to me, 'Take the trigger any time from now'. Wait. What?? What the fuck?! If I'd known they wanted me to do that, I could have brought the Pregnyl with me to work. But they didn't say that. Now I don't have it with me, I feel like I'm 'late'. And also, this is a completely different protocol/timing to the first IUI. The first time, my procedure was at the same time (2pmish) and they told me to trigger between 6-7pm. So what's up with the 'any time from now' bullshit??? I'm trying to think calm and happy thoughts, and console myself with the knowledge that for IUI the timing matters a whole lot less than IVF but I'm frustrated.

I really like my clinic in terms of the people there and my interactions with them. But I do not like getting mixed messages or added stress or just not simply being able to schedule more than 24 hours in advance. This process is stressful. And you really just do not need any extra stress on top of it.

Happy thoughts, happy thoughts. I have hopefully two lovely follicles and possibly a third. Everything looks good, and my appointment is scheduled..... happy thoughts happy thoughts.

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!

IUI 2 - Day 6 Budget update

Just a quick one to update the budget since I've paid for this IUI cycle.  Apparently my clinic says the price is the same if you get one Pregnyl or two which made no sense to me.  But, whatever.  I guess I should have asked for 2 then since I paid the same!  But never mind.  Last night I was out to a concert so I had to do my injection in the restaurant toilet.  Good thing my clinic gave me a handy little carry bag with a sharps-tube for used needles to later dispose in the correct bin.  It came in handy!

Previous total	£5472
IUI Inclusive Fee	£638
900 Gonal-F + 1 Pregnyl	£380
New total	£6490

IUI 1 - Day 11 Scan, Trigger (I think)

I'm waiting for the clinic to call me with the timings for what should be my trigger shot this evening, and the time for my IUI procedure tomorrow morning/early afternoon.  It's almost 3pm and I'm still waiting.... frustrating.

The scan this morning was fine.  I've been feeling some crampy 'fullness' in my right side which is the side my ovary is on.  I don't usually get pre-period feelings of any kind, so it's been a bit weird to feel my right side, particularly as this isn't really a stimulation cycle like it was for egg freezing.  Here there's only one good follicle. So why all the pressure??  Maybe it's just the drugs working.

At any rate, the scan showed my uterine lining continuing to grow as desired and a straight line growth of the one good follicle which was at 14mm on Friday and is now 18/19mm this morning.  The nurse said this means my trigger should be tonight and the IUI tomorrow.  We went through how to mix up the Pregnyl which is a bit fussy.  You have to snap tiny glass vials and do the whole powder/water mixing thing.  I asked why they use Pregnyl instead of Ovitrelle and the nurse said that based on their very limited numbers, they had better results with Pregnyl.  So that was good enough for me!  Even if it does come in an easier to use syringe.  I'm sure it will be fine.  If I think about it, I might take pictures of these teeny tiny vials.

The main thing I'm waiting to hear other than the timings for things is whether I need to do one injection of the Pregnyl or two.  This is based on my blood test results.  This time it took her two tries to get the blood out.  The first time she went for the same vein that the nurse went for on Friday so in order to hit a different spot on it she went higher, but no luck. So she ended up going for the same spot on the second try and it gave up the goods.  Hopefully I don't have to give any more blood tomorrow.

I had my second acupuncture appointment on Saturday which went well.  It was very similar to the first one with needles in my abdomen, right ear, arms, hands, calves, and feet.  She again did the warming trick with the needles and put a heat light on my feet.  I managed to doze off during the treatment so that's probably a good thing!

I have very low expectations for this procedure, as in, I do not expect it to work at all.  Of course I will be very disappointed when it doesn't, but right now I feel that it won't.  Which will also mean I'll be scared shitless if it does!  It's really impossible not to think about it and have hopes and worries as you go along.  Minute by minute or second by second even.  I'm trying to just stay sane and go with the flow.  I'm going to have to wait two weeks to know anything at all which I'm sure will be headache inducing with how much my brain will mull it over.

I suspect the procedure tomorrow will be relatively straightforward and quick-ish.  I will write it up after the fact.  They told me that when you're scheduled to come in they defrost the sperm in advance so there's no waiting around.  They also said that there is absolutely no benefit to laying down or what have you for however long.  Either you're going to get pregnant or you're not and that is not going to make a difference in the slightest.  I'm sure I'll take it easy, and may in fact take a taxi from work to the appointment and back (instead of cycling).  But it's pretty much out of my hands at this point.  Not that it particularly ever was in my hands to begin with if you think about it.

Anyway.  It's all very exciting, terrifying, and disappointing all at once at the moment.  Which seems to me to be just about normal.

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.

Statistics

I managed to discourage myself by looking at success statistics for IUI using donor sperm.  Apparently for my age (41) it's around 5%.  That's pretty low odds I have to say.  This was somewhat tempered by a meeting over the weekend with a lesbian couple with a 1-year old who did IUI and got pregnant on the second cycle.  Of course she's ten years younger than me though.  So, a bit of discouragement and a bit of encouragement.  Also encouraging was that this couple used the same clinic that I'm using and spoke very highly of their experience there.  They're starting trying for a second baby now so it's even possible I'll bump into them at the clinic, although probably not.  They also told me that Pregnyl is not intramuscular so that was good news.  Apparently it's a bit annoying to mix and it requires breaking a glass vial, but it just goes in your belly like all the rest, albeit with a longer needle.  But this I can manage.  So that was good.

I am going to try a new approach with the boyfriend this evening in that I'm just going to talk factually about what's going on with me.  He either needs to come to some sort of acceptance about it, or he isn't going to in which case, he won't be able to be with me.  But at the moment I feel like it's this thing hanging over me which is sad and unpleasant.  To be honest, this is a hard enough journey on its own and I don't need something to be feeling bad about that's related.  I really hope that he can come around and find my perspective that our relationship trajectory, and the baby trajectory (that I started before I met him) are just different things.  I get that it's not traditional.  I get that it's hard.  I get that he's upset.  I just don't see that I can do anything else other than I'm doing.  And ignoring it is definitely not making it go away with the clock ticking.

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.