48 dpo 9w2d - First midwife appointment

I've had my first midwife appointment which was fine.  It took some time, as there seemed to be a lot of information to enter into the system.  I would say the meeting was mostly procedural.  There wasn't necessarily any new information from this meeting. She went over with me what vitamins I should be taking, what I should and shouldn't be eating, that I should be exercising but not adding new hardcore routines. I brought along a printout of the donor profile so I could answer any questions about 'the other side' which was useful. We touched briefly on where I might want to give birth, and who might be in the room with me. I don't know yet enough about my pregnancy to make any decisions about where to give birth, although I know I really don't want to do it at home. I think I will be too high risk for that anyway, but it otherwise it really doesn't interest me. The birth center is literally attached to the delivery hospital (same building) so you can always start off in the birth center and be quickly transferred if needed, which seems reasonable. But I'll find out more about how it works later in the pregnancy. We also discussed my relationship with the boyfriend and she agreed that a doula is probably a good idea for me, even if the boyfriend decides he wants to be involved. So that was good to talk about albeit briefly.

Part of the meeting was clearly to assess risk factors.  Because of my age (almost 42) and my weight (BMI 34.5) and my history of an abdominal surgery (ovary removal) this puts me at various risks for various things. So one of the things she set me up with was a meeting with an obstetrician.  I guess in the UK you don't meet with an obstetrician regularly unless you are high risk. So I'll go to be assessed and either they'll continue to want to see me or they'll release me back to my midwife team/GP. I may also have an extra scan due to my age. I'm also at a higher risk for pre-eclampsia so I'll need to start taking a daily baby aspirin at 12 weeks.

But basically that was all fine.  The next steps are that I scheduled a blood test for Thursday and I need to also provide a urine sample (in the smallest urine pot known to man I might add). I am now expecting 3 letters: a welcome from the midwife detailing our discussion and baby aspirin stuff; an appointment letter for my 12 week scan at the hospital which includes a permission form for the Nuchal screening; and, an appointment letter for a meeting with the obstetrician.  I've also confirmed that they don't do NIPT yet, so I'm going to schedule that next week. The midwife told me about another Cambridge based private clinic that offers it, but it's cheaper at the one I found already, so I think I'll stick to that. I think I'll also go for the Serenity Plus test over the Harmony. I don't think it makes very much difference at all, except I think I'll get the Serenity results quicker.

Oh, and I also asked about the Cyclogest/progesterone because I'm down to just a few days left. The midwife said I needed to call the IVF clinic to ask how long I should be on it, so I called them when I got back and had a very nice chat with one of the nurses who was there throughout my procedures. She said they normally would end around 7 weeks, and they're happy for it to stop at 9 weeks. She said it's up to me if I stop cold turkey or reduce then taper but it shouldn't make any difference at this point. So I think I will do a full dose tomorrow which is officially 9 weeks if you follow the retrieval/fertilization date. Then I will drop to one a day until I run out and I might every other day the last one or two. So that's one bit of good news that I don't have to be sticking things up my bottom twice a day very soon!

In other news, another woman on the forum in my group has miscarried which is just awful. I was hoping that we would not be the standard statistic as a group and yet we have reached it. And there could still yet be more. It's so heartbreaking. I try to stick to my mantra but am well aware there are still some big hurdles to get past. The NIPT and the 12 week scan being the big ones. I know that there is nothing I can do. What is going to happen is going to happen. The not knowing can be just so hard though.

IVF 1 - Day 32 9dp6dt 4w4d

After tomorrow which is the 'official' testing day, I'm going to change the heading to reflect days past ovulation (currently 15dpo) and pregnancy weeks for simplicity's sake.  It's good to know both, I think, and I can't keep calling this IVF 1!

Tested positive again this morning.  The good thing about my cheap eBay strips is that they are showing continual progression.  Today was clearer than  yesterday.  I think I will continue to take them to give myself some confidence that my hCG levels are rising since I can't get the blood tests to otherwise show it.  It's actually a fairly useful way to measure an increase, although obviously I can't tell by how much.

Still having a bit of brown spotting.  Not much, mostly watery and only on the toilet paper wipe.  I'm also having a bit of 'tightness' on my right side where my ovary is.  I am of course now worried that it could mean an ectopic pregnancy.  On the other hand, without a period to 'reset' the ovary post stimulation, it may still just be recovering from being enlarged.  I'm not sure.  This is something an ultrasound would potentially be able to tell me.  But I don't see how I can get one unless something starts to go really wrong.

I called my clinic today which is a day early to report the positives.  I also called because it said in the take home information sheet that if you have a positive test and spotting you should call immediately. I'm still not overly concerned with the amount of spotting I'm seeing- it's not increasing and is now always brown.  But I thought I'd call them anyway.  They arranged an order for more progesterone/Cyclogest.  They were going to send 3 boxes of 15 and I asked for 4.  I don't think the extra progesterone hurts, and it seems more standard to go to week 9 or 10 from others so I asked for an extra box which should get me to week 9.  It wasn't particularly expensive.  I'll need to update the budget.  I guess I'll keep updating the budget until a baby is hopefully born.  I'm also still waiting for the bill for the assisted hatching and blastocyst freezing.

It's really weird because basically my clinic now releases me to the NHS for care.  I feel like this is very quick and that other clinics in other countries continue with the patient until the first scan and then release them.  This means that other than the progesterone, I've got nothing else to do but wait for a letter containing information about my first scan which should be around week 7-8.  I guess there isn't anything else that I can be doing, because what will be will be, it just seems a rather sudden drop off a cliff. I've been so used to constant appointments and 'hand holding' that now I just feel a bit adrift.

I'm sure this will change though.

I'm also still in the 'I can't believe it' stage.  This is helped by the fact that I'm not feeling anything physically.  First trimester symptoms start to occur when the hCG really surges (and then tapers off) so I'm clearly not there yet.  It's so surreal.

IVF 1 - Day 31 8dp6dt 4w3d

This morning, my cheap Ebay test strip had a faint squinter line visible on it.  The First Response test was again positive.  Looks like hCG levels must be rising, and so far I'm positive.  At 4 weeks 3 days it's still very early.  It's 14 days past ovulation.  There's a lot that can go wrong in the next few weeks.

I can't believe it yet.  I don't feel anything at all to indicate there is something growing inside of me. Last night and this morning I had a bit of spotting and last night I felt crampy.  I don't know if that was from the excitement, the spotting, or actual cramps.  But this morning still positive tests, and no cramping, so okay.

I went for the private blood test I paid for this morning and it took her two tries to get it out of me.  I have no idea when I'll get the results or what the results will actually be.  Having already paid for this test and taken it, it could very well be a 'yes you are pregnant' or 'no you are not pregnant' sort of test with no actual beta hCG numbers provided.  I am beyond frustrated with my inability to get beta hCG blood tests here the way everyone else seems to have as standard as part of fertility treatments.  If I was in London, this would be very easy as I see a lot of the fertility clinics offer it.  I've already written to my clinic here in Cambridge suggesting they make it an optional add-on (or just make it standard).  I never heard anything back from my GP who I contacted and offered to pay for it myself.

However, a positive test is a positive test.  So right at this moment, I am pregnant, although we have a long way to go before there is a baby.

Holy shit.

I've told most people who know that I'm trying about the early result.  I'm not a superstitious kind of person.  In fact I'm against most of the 'secrecy' and 'careful' aspects of early pregnancy.  First of all, if I get upset because I miscarry, I want to be able to talk to people who know me and care about me. Secondly, we need to stop freaking women out that they can control miscarriage and it's their fault if they exercise wrong or bend over funny or whatever it is.  The uterus is incredibly good at guarding it's contents.  Think about how hard it is to get rid of a baby that you don't want!  And yet we freak out women that if they sneeze funny, they could damage or lose the fetus.  So I'm going to tell people what's going on with me and continue to go to yoga and ride my bike to work, and what have you. And I will talk to people about things if they go wrong.  And I'm sure I'll put stuff here as well.

IVF 1 - Day 20 3 day report

The embryologist called me this morning to report that I have 6, 3-day embryos.  One of the fertilized seven seems to have stopped after a two cell split and isn't expect to go any further.  Of the 6, four are very good and two are good.  Interestingly, from the thawed frozen eggs, the best looking 3-day embryo is one of the frozen, but the one that stopped after dividing is the other.

I discussed with the embryologist that we will wait until day 5 for a hopeful transfer.  He warned me that from these 6, I would be looking at 2-3 blastocysts comfortably, and that 4 would be an exceptional outcome.  Fingers crossed there is at least one.

I plan to transfer one blastocyst if I'm lucky enough to have more than one.  I really don't want multiples.  If it happens on its own, that's one thing, but I don't want to increase my chances by transferring two.

The laser assisted hatching will be done later today on all of the embryos.  The embryologist told me that if you do it on day 5 you risk injuring the blastocyst.  On day 3, the shell or zona pellucida is still thick and easy to nick with the laser.  It thins towards day 5 so becomes more difficult.  It seems a fairly routine procedure so I'm not too worried about anything going wrong.  Also, I asked, and it's completely fine and normal to freeze a blastocyst which has already had the assisted hatching.  I'm glad they said they'd cap the cost at £250 now!!  Otherwise that would have been £125 per embryo.  I would have spent it of course, but I'm glad for the discount with 6 to do.

I've been feeling pretty bloated and a bit crampy since the egg retrieval.  Looking online, this could also be due to starting the progesterone/Cyclogest.  I'm not loving that I've got to take a suppository twice a day for what I hope is something like the next 10 weeks.  I'll do it obviously, I'm just not loving it.  And I hope the bloating and cramps reduce.

I'm sort of amazed when I think about it- that eggs from my body have been fertilized with sperm and there is potential life in a petri dish at the clinic.  It's actually sort of hard to get my head around.  You spend so long focusing on trying to conceive, it's hard to imagine the jump to the next step. I'm not there yet of course, and all of this may not work and could go horribly wrong.  But a thread of me is still pretty hopeful and giddy with anticipation. 

IVF 1 - Day 17 Egg retrieval

Back from the clinic and resting at home now.  Let me jump ahead to the fantastic news that they collected 9 eggs!!  I can't believe it.  I mean, I really can't believe it!  When I did the egg freezing 3 years ago, I never got that many out of any cycle.  I know they may not all be mature or able to be fertilized, but I'm incredibly pleased with this result.

So this morning I was feeling anxious and woke up pretty early because I knew I had to take an antibiotic at 7:30am and the taxi was coming at 7:45.  I think I was awake by 6:00 and was definitely not going back to sleep.  I didn't really have anything to do, because I had plenty of time.  I put a bag together because I didn't know how long I'd be at the clinic waiting for my friend to pick me up.  So I had some snacks and my kindle.

Anyway, I got to the clinic and I was clearly the only person there for a procedure which was fine.  And I was first in the morning, and I was early.  So they were still getting everything put together for the day.  I didn't mind, I'd rather be early than late!  I eventually got shown through to the recovery area where they gave me some tylenol to take and had me change into the hospital gowns (one on backwards and then one as a jacket/cover up that you take off.  Various people came through to talk to me and in preparation for the procedure.  There was a consultant doing the retrieval itself, and then I think a registrar observing.  There were possibly two nurses, the anesthetist, and a midwife who has recently joined the practice also observing.  So a fairly crowded room!  I hopped up on the table and the first thing that had to happen was the anesthetist had to get a cannula in me.  This was, of course, a problem and took her a while and 3 tries to get in.  One sort of went in so she gave me some phenobarbital (I think), but it wasn't good enough.  However, that dose made me relax a bit so I felt nice and cozy.  Eventually she got one in my other hand/arm and we were ready to proceed.  They stuck some monitoring pads on me and had me scoot down the table.  Once I was basically in position, they must have given me the drug because I was out.  I might have vaguely remembered a speculum going in, but the next thing I knew I was having pleasant dreams and was coming alert back in recovery.

I felt completely fine and relaxed.  I think when I come out of sedation I tend to be happy.  I don't know why.  I think this happened before.  Maybe it's some sort of relief that it's over?  Anyway, my alertness levels were quickly coming back and I just snuggled into the bed while they checked on my oxygen, blood pressure, etc.  Again various people came in and out, some to talk to me.  The midwife who was watching over me said that when she left the theater with me, they had collected 5 eggs.  So I was already pretty pleased with that result, but she said they still had more to look through.  Eventually the consultant came through and said that they had 9 eggs.  I mean I really couldn't believe it.

Later the embryology team came through and we confirmed my plans for the next steps and when they would be calling me with information.  I hope not to hear from them today, because if I don't that means everything is basically okay.  I will only hear from them if none or almost none of the 6 eggs defrost, or if none or almost none of the eggs are mature.  Otherwise, they'll perform the ICSI later this afternoon and call me tomorrow to let me know how many fertilized.  Everyone seemed very positive, and I feel pretty positive, so right now the positivity levels are high.  I know there are many things that can go wrong between now and a transfer, but given everything, it seems like I have the best chances I could have at this stage, so that has to be a good thing.

Meanwhile, I'm home relaxing now and taking it easy.  In an hour or so they said I could take more pain medication if I want to.  We'll see how I feel.  Fingers crossed I don't get a phone call until tomorrow.  I'm sure I'll think of more to write about the various questions I asked people, but I thought I'd get all this part down for now!

IVF 1 - Day 16 A Drug Free Day

It's very weird not to be worried about doing my injections today.  I'm trying to make myself drink a lot of water as I was told to, but I keep forgetting.  I am sort of known for not drinking a lot in general.

I had a look at my egg freezing cycles charting and I think I was charting stimulation days not period days, so this would be Day 15 on stims and Day 16 counting from period day 1.  By comparison, my egg freezing retrievals were Day 17, 17, and 16.  So I'm on target for tomorrow compared to previous cycles, on the early side.  For some reason I find reassurance in being consistent.

I just got cash out of the machine in preparation for my taxi to the clinic in the morning- no cycling for me!  I also bought some snacks yesterday as they told me I might want to bring my own as all they provide are unexciting biscuits.  And of course I won't be having any food after dinner tonight until around 11ish tomorrow.

My friend is coming around 11:30/12:00 to pick me up in her car and take me home.  I've asked at every single scan if this will be okay- that she's not there 'from the start' as it says in the literature they sent me home with.  If I get any flack about this tomorrow morning I will throw a massive fit. On the off chance my friend is late I'm also bringing my kindle and tablet but I suspect I'll only be coming around fully about 11ish anyway.

Right now this all feels very surreal.  My ovary isn't particularly noticeable.  I haven't done any injections.  I'm sitting at work (procrastinating by writing in my blog).  It's hard to believe this is really happening tomorrow.  And of course there's the caveat of all the possible failure points between now and a successful transfer.

At least I'll be busy at a workshop Thursday and Friday through the majority of the first phases of waiting.  Oh, and I completely forgot to pee on a stick this morning.  I think I can still do it this afternoon to see the double line.  If I remember.

IVF 1 - Day 12 retrieval scheduled

Just a quick update to say that I finally heard back from the clinic after having a mini panic when they hadn't called me by 4:20.  I called them, only to find that they close their phone lines at 4pm (even though they are open until 5pm).  I ended up emailing every email I had for someone there to say please let me know what the fuck is happening (in nicer words).  I finally got a call just past 4:40. Apparently they specifically close the lines so that they can make all the calls back to people but you know, it's the end of the day, it's stressful, maybe not the best plan.

Anyway, retrieval is Wednesday!  I do have another scan and probably blood test on Monday which I don't entirely understand, but fine.  I guess we'll see if I lose the big follicle and if the other slightly smaller ones have caught up.  I have enough drugs to see me through to then.  But yay!  Work crisis averted!  Retrieval scheduled!  Friend with car arranged for pick up!  Kind of exciting....

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.

Change of Plans Again, AH!

Good grief!! I just got called by the clinic to tell me that in June they do a major clean of the lab and facilities and shut down. this means I can't cycle in June.  However, my frozen eggs are now in Cambridge, my drugs are being delivered today, and, most importantly, my period has yet to arrive.  This means I could start this month, like in the next couple of days.  Holy crap!  Just when I was settling in to having a month off, it's all systems go!

This is great, except for one small thing that I have a serious work conflict on the 26/27 of this month.  If I go by my egg collection cycles, my eggs were retrieved on day 16 or 17.  If you add 5 or 6 days for blastocyst transfer, this is squarely around the time of the work conflict, but could just miss it.  That's going to be the only stressful thing.  I suppose the best thing would be for my period to hold off for another couple or few days to put me well past it?  Anyway, it's going to be tricky, but I'm definitely not waiting until July.

I'm actually really excited about starting straight away although I was also fine with waiting a month.  No more alcohol or caffeine for me though!  I suppose it's not great that I've been indulging this month, although not so much, so that's not so terrible.

I'm actually sort of just really excited to be trying this month.  I'm going to try not to stress about the scheduling conflict until my period arrives.  Speaking of which, maybe I need to go to the bathroom.

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!!

Moving Eggs

Following from yesterday's decision I got on the phone straight away this morning with my previous London clinic to see about moving my eggs. I had to leave a message but they called me back within an hour and I explained what I needed.  The clinic manager was able to email me through the consent forms for the transfer and also my credit note for the refunded storage fee (I paid for 10 years up front).  Of course they are also charging for their time in handling the transfer so that was slightly reduced.  But it works out to around £500 refunded, so that's good!  Of course it will probably go straight to storage at the Cambridge clinic, but whatever.

So now it's all about arranging the courier to move the eggs from London to Cambridge.  The London clinic said that usually if a transfer is being done within the UK, the receiving clinic arranges the courier.  So far this morning I've copied in the Cambridge clinic to all correspondence but I haven't had a response yet.  In this instance, the London clinic is winning in terms of quick turn around and responses, but hopefully the Cambridge clinic will check their email at some point today and it will move.

My only fear is that this doesn't happen efficiently and there is a hold up.  But that really shouldn't happen.  If the Cambridge clinic doesn't respond to email today, I will be on the phone with them first thing tomorrow.

In other updates I've also made a counselling appointment to discuss my use of a donor, although not for 3 weeks  yet.  Hoop jumping progress.