IVF 1 - Day 15 last scan

Had my last scan this morning to confirm the egg retrieval schedule.  I take my Ovitrelle injection at 9pm tonight and my retrieval is scheduled for 9am Wednesday morning (of course I need to be at the clinic sooner).  I think I'm the first one of the day so that they can defrost the frozen eggs and then let me know if they defrosted okay or if they suggest defrosting anymore.  It looks like there were around 9 or 10 follicles of varrying sizes so I'm hoping for 5 fresh eggs.  If I get 5, that would be a good result all things considered.  On the day of the procedure I will take an antibiotic at 7:30am and I start the progesterone (Cyclogest) the day after the procedure.  I need to make sure I have everything prepared because I'll be away at this workshop Thursday and Friday.  But really, all it is I need is the Cyclogest I think.  I might pee on a stick tomorrow just to see what a positive test looks like from the trigger.  That is perhaps wasteful, but part of me wants to just make sure my ebay tests work.

So close now!  It's going to be hurdle after hurdle to get from here to a successful transfer.  There's a lot of possible failure points.  Fingers crossed.

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 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 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.

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 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 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.