Thursday, 31 January 2008
Wednesday, 30 January 2008
My nerves are officially shot to pieces, and if one more person tells me to be positive.... I am just very glad that this merry-go-round is nearly at an end.
I have no idea if I am pregnant or not.
*I have been cramping non-stop since OPU (Don't usually get cramps, but could be from OPU?)
*Have had backache & headaches
*Lots of CM
*Strange eating habits, ridiculously hungry one day, can't eat a thing the next, and have gone off meat!
Who really knows. Well I guess I will after tomorrow. Blood test is at 8.30am, results should be in around 4pm. I've arranged to leave work early so that I get the results at home. When our first IVF cycle was cancelled last year, I got told at work and I completely broke down, crying under my desk. I don't want that to happen again, I want to prepare myself.
Tomorrow is going to be either one of the best or one of the worst days of my life.
Monday, 28 January 2008
Saturday, 26 January 2008
I did a POAS test and it came up BFN. Damn it. I really wanted to see the two lines, even if I know in my heart it would be because of the trigger injection. I didn't even get that :-( Now all my positivity is gone. I am working myself up into a state that I don't know if I will be able to get out of.
I think if I make it to Thursday, I have a good chance of getting a positive result. My usual luteal phase is 12 days, and 31/1 is 16 days, but I do know the crinone gel can interfere with your luteal phase.
Please god, let this be it.
Thursday, 24 January 2008
Let me highlight some quotes from the article:
"The inferility goddesses may have snazzy Mercedes convertibles, but I'm hardly going to ask them to keep them garaged at all times just because I fancy having one too."
"Yes I'm fertile. Disgustingly fertile. I'm a fertility goddess. But please don't ask me to apologise for it"
She mentions her "hard working ovaries", and how a friend didn't reveal she was pregnant until (gasp) 22 weeks because her sister-in-law was in the middle of her third IVF cycle. But who made the decision not to say anything? The friend did, not the woman doing IVF. But we are fair game, so lets just blame the infertile woman.
Also that she was the 'spring chicken' in her obstetrician room at age 29, because women "decide to focus on their careers, or come to the conclusion, year after year, that it just isnt the right time". Because of course age is the only factor in infertility isn't it. The guys have nothing to do with, neither does PCOS, endometriosis, or any other cause. Nope it's all because we waited too long, we are all selfish career and money obsessed women. Apparently "if we spent as much time planning out families as we spend planning our mortgages, we wouldn't be in this mess".
I don't know if Jodi who was writing from the infertile perspective got to read the smug fertile's vicious attack, but her article felt really quite weak compared to it. She did make some good points, but her analogy of eating a hamburger after not eating for days, for me doesn't even compare to infertility. Some of the article was self-promotion for her book, at one point she berated infertiles for not telling people about their infertility, letting people know that you are going through IVF, or that you have been trying for a baby for a while. And then she defends older women who have troubles with infertility, which I understand why she did it, but it just adds credibility to the 'other side's' argument that it is 'their own fault'.
I am so riled up at the moment.
Wednesday, 23 January 2008
Monday, 21 January 2008
I was a little nervous heading into the clinic today, but the procedure was over and done with relative ease. It was the the embarrasement and uncomfortable nature of it all I think that affects me the most. Dildo cam with a nurse in the room - no problem. OPU under general anaesthetic? Easy. But having five people in the room poking, prodding and observing - it's just a little too much for me. Hopefully this is the last time that we will go through this so I can deal with it now it's done.
Back to lying on the couch for me, fingers crossed the next two weeks goes super fast!
Sunday, 20 January 2008
What the **** is going on with me!
I can't get tomorrow out of my head. I have so many questions that I want to know the answers to. Like is the success rate lower with IVM because people produce less eggs therefore leading to a lower percentage of embryo transfers taking place? Is it to do with the eggs having to be matured and therefore their makeup altered? And if it is the former, does that mean our chances are now the same as a normal IVF couple? I would much rather take the 55% that was offered with normal IVF than the 25-30% offered with IVM.
There are other questions, like how long could we physically, emotionally and financially go on for if necessary. How much can a person really deal with? So many of my IVF support people have been on this rollercoaster for years- am I going to be one of those people? Or will I be the newbie IVF barbie that got pregnant first time round. Promise there will be no baby dust...
Then there are the other thoughts that creep in. What's worse than thinking that it might not work, is thinking that it just might. I've been finding myself drifting off, debating the merits of different hospitals, obstetricians and maternity wards. About special ways to tell the parents and other family, whether green and pink are good nursery colours, and the best time to start maternity leave. I have said previously that hope is good. I take it all back. Hope is a bitch. It makes you excited even though logically you know you shouldn't be. It builds you up to potentially break you down. You know the deal, the higher up you are, the further to fall. But at the same time, what if I didn't climb that high? Could I really survive without emotionally attaching myself to this little embryo that is about to be inside me? I'm not sure that I am capable of that either.
Okay, that is it, I am not allowing myself to freak out anymore. At least not tonight. Or at least the next ten minutes.
When Mattel were looking to design their new Barbie, IVF Barbie, they soon realized that there was not one universal Barbie that would accurately portray the spirit of IVF Barbie. So they decided they would come out with a few variations thereof.
Newbie Barbie, also known as BabyDust Barbie is a bright, perky, Barbie, filled with optimism and confidence that IVF Will Work. She is thinner and usually younger than the other IVF Barbies. Her accessories include rose-tinted spectacles, a positive bank balance, healthy insurance coverage and a million questions. Newbie Barbie has lots of other Newbie Barbie friends and they congratulate each other on a job well done. This Barbie only says pleasant, optimistic things and believes that Attitude is Everything. Their motto is Think Positive!!
Pregnant Newbie Barbie:
Pregnant Newbie Barbie is the big sister to Newbie Barbie. She is still slim, now with a cute belly. She is proof that IVF Does Work, usually the first time. She also comes with rose-tinted spectacles, a positive bank balance (only very slightly depleted) and total confidence that All Will Be OK. She glows when pregnant and liberally uses baby dust when playing with her sisters, the Newbie Barbies. She comes with Very Cute maternity clothes, a double stroller, and a fully decorated nursery even though she is only just a few weeks pregnant. Her motto is ‘See! Thinking Positive Works!!’. Newbie Barbie and Pregnant Newbie Barbies are great playmates and you can collect them as a set.
Joiner Barbie is cousin to Newbie Barbie and Pregnant Newbie Barbie. Joiner Barbie comes with a group of friends just like her, and this group calls themselves by the name of a furry animal or has reference to a season. Think Spring Blossoms or Bubbly Bunnies. Accessories include a chart or table of some sorts, lots of smiley faces, baby dust (a glitter-like tub of ground up positive attitude that apparently has the power of hocus pocus to make one pg), declarations of eternal friendship and love and lots of ((((hugs)))).
Veteran Barbies are not at all related to the Barbies above. Veteran Barbies are the Anti-Barbie. They are a whole lot plumper than the Newbie Barbies, less perky (in boobs and attitude), have grayer hair, a largely negative and over-drawn bank balance, plenty of bruises and marks and a slightly cynical attitude. They are dressed in comfy track pants with elasticated waistbands. Their accessories include a wealth of knowledge of reproductive procedures and protocol, the ability to practically do their own cycle, a snarky attitude, little tolerance for stupidity, a well defined sense of humor, the ability to laugh at themselves, a fondness for wine/beer/crack and a aversion to pineapple, baby dust and Newbie Barbies. This aversion in its more severe form can be allergic and acerbic. Veteran Barbies tend to swear quite a bit (especially when playing in the Barbie House with Newbie Barbies and Pregnant Newbie Barbies) and parental guidance is advised.
Pregnant Veteran Barbie:
Very similar to Veteran Barbie, only now with an added dose of neuroses and paranoia. Continuously and obsessively over-analyses every twinge, convinced that the end is nigh. Only buys stroller and decorates nursery when in eighth month. Accessories include disbelief and a sense of not quite belonging, and 10 home pregnancy tests just in case the first one was faulty or the clinic made a mistake with her beta. Pregnant Veteran Barbies have been known to pee on the sticks up until the day before giving birth just to see the two lines.
Celebrity IVF Barbie:
Celeb Barbie comes in two versions: Denial Celeb Barbie and Out the Closet IVF Barbie. Denial Celeb Barbie does not play with the other Barbies and pretends not to be an IVF Barbie at all. She drops the IVF part of her name and thinks 'Donor Eggs' is aswear word. She pretends that her twins at age 49 are Natural and she did it all On Her Own. She also claims her boobs are her own and that she has never had a face life, hence her credibility is not at an all time high. Out the Closet IVF Barbie is the preferred Barbie. We like her.
Ken is a wanker. Sorry to sound so harsh, but besides being a wanker there is very little that Ken does in IVF land. Sometimes Ken administers shots, hands out tissues and occasionally accompanies the Barbies to their Dr’s visits (normally during the first few cycles only), but mostly he is just a wanker. If you choose an IVF Ken, then try and get one that also cooks or does DIY. Otherwise just sit him down in front of your Barbie TV and let him know when it is time for him to do his, um, contribution. Mostly the Barbies love their Kens, unless Ken is being particularly insensitive or obnoxious, then he becomes a wanker in all senses of the word. Some IVF Barbies don’t even have a Ken and they do just fine. If you do find a good Ken, hang on to him, don’t swap him with your other friends.
RE Ken is the all knowing, all seeing Ken. He might be a wanker, or not, but here we are talking about being a wanker in the figurative sense. He could also be very nice. He may call you by your first name but you may only call him Doctor. His accessories are many and wonderful. He comes with a zooty new car (normally very expensive), a smart house, a very healthy bank balance and a holiday home or two. RE Ken knows every thing and is considered second only to God. Some RE Kens are kind, some are not. They are all rich. Ken’s office is filled with fun toys like ultra sound machines, dildo like probes, waiting rooms filled with the different types of Barbies (some annoyingly come with miniature Barbies or Kens en tow), medicines, procedures rooms etc. RE Ken also comes with a free Nurse (Ratchet) Barbie, who will not return your calls, will hand out annoying platitudes and generally add to your frustration levels. When purchasing RE Ken you will get Ultrasound Ken and BloodDrawer Ken. Unfortunately they come as a package deal and you are not able to get RE Ken without them, they aren’t as much fun. However, you will need a RE Ken if you are going to play the IVF Barbie game.
Mattel foresee a big demand for these Barbies and say that for extra fun and lively interaction, collect the full set of IVF Barbies, put them in the Barbie house together and see the sparks fly.
Saturday, 19 January 2008
Update on our embryos, as of today which is Day 3, we have three 8-cell embryos, one 7-cell embryo, one 5-cell embryo, one 4-cell embryo and one 2-cell embryo.
So from my reading it would suggest that the 2-cell embryo is a goner as is the 4-cell. The 5-cell could still be okay, but we are really focusing on the 7/8-cell embryos to pull through. They are graded on a scale of 1-4 with 1 being the best result. At this point we have one grade 1 embryo, three grade 2 embryos, two grade 3 embryos and one grade 4 embryo which I would assume is the 2-cell. I tried to find information on the internet about the grading system for embryos, but it appears that clinics do it differently all over the world. This is the only thing that I have found about our particular grading convention:
* Grade 1: even cell division, no fragmentation
* Grade 2: even cell division, small fragmentation
* Grade 3: uneven cell division, moderate fragmentation
* Grade 4: uneven cell division, excessive fragmentation
Apparently the next step in the process is for them to grow to morula on Day 4 (Sunday), and then blastocyst on day 5 (Monday). Steve is going to call us on Monday morning to make sure that we have a blast to transfer.
This is what scares me now - that we might have gotten to this point and done so well, yet we still might not have any blasts to transfer. Financially we need to freeze some embryos this cycle, as our PHI doesn't kick in until May this year, and we can't afford the hospital costs associated with OPU before then, so we are relying on doing a FET cycle next should this be unsuccessful. We made the decision to do only one EPU before May for my sanity but we can't afford to do it again as it's an extra $2500 out of pocket cost on top of the IVM cost itself.
Anyhow, our embryo transfer is booked in for Monday at 1.15pm. My nerves are getting the best of me, I wish I could go back to bed and magically sleep through the next two days and be there already!!!
Thursday, 17 January 2008
We should next get a phone call on Saturday to let us know how the emrbyos are growing and then egg transfer is on Monday morning, and my blood test is on 31st January.
I feel like screaming from the rooftops!!!!!
Wednesday, 16 January 2008
Steve said that he will give us a call tomorrow morning with the fertilisation results. I am going to try and be more positive from now on, right now you can't wipe the grin off my face :)
It was freezing in my room so they brought me some heated blankets to relax. The anaesthetist came and saw me and said that although usually OPU patients only have a light sedation, that he would give me a general anaesthetic because the procedure was going to take longer than usual due to IVM. Fine by me, the less I have to think about it better. On the way to theatre, I think the nurses could sense my nervousness, I was almost in tears so they aimlessly chattered away about random stuff to distract me, which worked wonders. When we finally got into theatre, seeing a whole heap of people scared the crap out of me, but out of the blue I saw Doreen (my FS) jump in front of me and give me a big smile and ask how I was. Steve (embryologist) was also there, it was so helpful to have familiar people there to settle my nerves.
Then I totally zonked out, next thing I remember I was in recovery and the first thing I asked was how many eggs I got. The nurse told me, and literally two minutes later I had to apologise to her and say that I had completely forgotten what number she told me! She said that was completely normal and told me that I had 13 eggs. 13 EGGS! Even though in my head I knew that number was above average, I was happy but not overly thrlled.
Once I got back to my room I started feeling really nauseous from the medication, but there was no doctor around to prescirbe me maxalon, so once I discharged myself from the day ward, we went downstairs to the clinic to chat to the nurses and Steve.
Steve told me that they went into a lot of follicles (hence all the pain I was in!) but most didn't have eggs in them, so 13 was a good result for us. He also outlined the next steps for us, overnight the eggs would mature, then Murray needs to come in tomorrow (today) and give his sample which we would use to fertilise the eggs. From there we will try and grow the eggs to the blastocyst stage and then we will have the transfer done on Monday.
The nurse went through what medication to take and when - Progynova (Estrogen) 8-hourly, Crinone (progestrone) 12-hourly, and not to take any anti-inflammatory drugs like nurofen. After all that, we went home and I pretty much slept through until this morning.
Murray went into the clinic this morning to give his sample and had an unfortunate experience by cutting himself on the jar- ouch! He freaked out a bit but apparently Steve came out and talked to him and calmed him down a bit.
Steve also gave him the news of how our eggs did overnight - not well unfortunately. At this point only 5 of our 13 eggs have matured. He did say that it's a possibility that more eggs will mature during the day today, but right now we only have five eggs.
Ever since I heard that I have been freaking out. I honestly don't know how many EPU I can go through. I built all the other parts of the process up - the big bleed, trigger injection, and they were all fine, but the EPU which I thought wouldn't be all that difficult has been the hardest thing so far. I really just want this to work, and to have spares that we can freeze in case it doesn't.
This post has turned into just a myriad of words, I hope it all makes sense. I'm too out of it right now to really go through it again.
Love to you all xxx
Tuesday, 15 January 2008
Sunday, 13 January 2008
Now I have to go to the clinic tomorrow morning for my 'big bleed' and OPU is on Tuesday - it's all hapening!
In the meantime, an IVM update for you all.
Went into the clinic on Friday morning for a blood test and ultrasound which went really well. I now have nine follicles bigger than 5mm and 12 smaller than 5mm on my left hand side. My right ovary is a slow responder and has only four follicles bigger than 5mm and 10 less than 5mm. Endo is at 6.3mm which apparently is on the thin side.
Steve stopped by to have a chat with me about how it's all going, and in his words it is 'perfect'! Not just going well, or good result but perfect. Murray got really excited on hearing that, I don't want to get my hopes up too much, but I am feeling really positive about this cycle.
So OPU has been booked in for Tuesday morning which means I have to do my trigger injection tonight at 8pm. I have to prepare the syringe myself using the glass ampules, as opposed to the pre-filled syringe which I already had. Oh boy I am freaking out big time. I have been trying to distract myself with cleaning the house and writing out lists of things that I need to do, but it really isn't working. I'm going to try some relaxation techniques an hour before the injection to try and calm myself down, hopefully I will come through the other end okay.
Thursday, 10 January 2008
Quick update on the IVM side of things - I did my FSH injections Monday, Tuesday, Wednesday (150iu each day) and now I go in for a blood test and scan on Friday to check how I have responded. The injections were a little more painful this time but I survived, I can definitely notice the difference in hormones already, Murray says I've been PMS'ing all week - poor bugger! Looks like OPU will be early next week but we will know more precisely on Friday!
I'll post some photos up from our trip tomorrow after I get some well needed sleep!
Friday, 4 January 2008
I didn't realise that my FS is on holidays at the moment and wont be back until the 14th January. She is the only FS that can do IVM OPU because it's more difficult than traditional IVF OPU. All of this means that I probably wont start injections tomorrow and will probably wait until Monday/Tuesday next week so the follicles don't grow too fast. Wil have that confirmed this afternoon though. I'm excited though, the IVM process is so much quicker than IVF!! Last time I had to sniff Synarel for 29 days before my cycle was cancelled, and had 15 days of injections. Now I have only 3 days of injection, and voila - OPU is only a week and a bit away!
Already I have had such a different experience than with our first IVF. Just little things that make all the difference, the receptionist knew who I was and that I was doing IVM, the lady who did my blood test talked to me like a human being (believe me, sometimes they are the devil incarnate!), Steve (Dr Junk - I've decided to move to a first name basis) stopped past and said hi, for no other purpose than to say hello. Just that recognition that I am a real person, and not just another name on a piece of paper, has made me feel a lot better about the whole thing. Maybe it's because I'm doing IVM and because it's different they recognise me? Or maybe it's because I've been hanging around too long! It's possible it's me who has changed, because I know what happens now, I'm not so fearful and nervous. Either way it makes me feel a lot more comfortable to have that familiarity.
Thursday, 3 January 2008
- 1935 - IVM in rabbits (Pincus & Enzmann)
- 1965 - IVM of human oocytes (Edwards)
- 1983 - First IVM baby (Veeck)
- 1993 - Further 4 IVM babies (Cha et al)
- 1995 - First IVM babys from PCOS (Trounson et al)
- 1996-2006 - Approx 500 IVM babies born worldwide
Traditional IVF versus In Vitro Maturation (IVM)
- Relatively many oocytes/embryos
- High pregnancy rate/OPU
- Down regulation
- Daily Hormone Injections
- hCG injection
- Emotional stress
- Long treatment time
- Potential side effects eg OHSS
- Fewer oocytes and embryos
- Lower pregnancy rate/OPU BUT
- No down regulation, no manipulation of hormone balance
- None or few hormone injections
- Reduced pyschological impact
- Reduced treatment time (2-3 weeks)
- Reduced interference with daily life
- No known side effects
- Lower cost than conventional IVF
Where are IVM and traditional IVF similar?
- Maturation rate of 70-80%
- Fertilisation rate 70-80%
Where are IVM and traditional IVF different?
- IVM has a lower pregnancy rate per OPU due to lower number of oocytes/embryos resulting lower transfer rate
- IVM has a lower pregnancy rate per ET due to lower number of embryos resulting in lack of selection possibilities, and possibly in a small number of embryos transferred
- IVM has a lower implantation rate due to lower number of embryos resulting in lack of selection possibilities
- Success rates are different. IVF has a success rate of around 30-50% (I was told around 50% for my age group - under 30), while IVM has success rate of anywhere from 15-30%.
The IVM Process
- Day 1/2 Screening ultrasound and endocrine assessment
- Day 3-7 low dose priming with FSH until the leading follicle is around 10-14mm and endometrium is at least 5mm thick. During an IVM cycle, priming with FSH (150iu for 3 days) is beneficial for women with PCOS, however it has not shown to be particularly helpful for non PCOS patients.
- OPU occurs, at the same time as sperm retrieval.
- While the eggs are matured in the lab, you will need to prepare your body for the transfer. Estrogen tablets are taken from OPU, and progestrone pessaries used from transfer.
- Egg transfer takes place anywhere from 2-5 days depending on clinics protocol (mine prefers to go to blastocyst so 5 day transfer)
IVM Pregnancies - what to expect?
- Gestational diabetes (7.5%)
- Preeclampsia (17% - Quite scary!)
- Delivery by caesarian section (33-46%)
Sorry if that was just a huge amount of information to take in at one sitting but I wanted to make sure I took the time to record everything for future reference.
A big part of the excitement is that we are trying something new, something thats not widely used, and most importantly to me, something that doesn't involved me having to sniff or give myself a billion and one injections! I only have to have three days of injections which is to prime my ovaries for OPU. While the priming doesn't make a difference to the success rate for IVM, it does make oocyte pick up a LOT easier because the eggs are that little bit bigger and easier to get. Apparently IVM OPU is more painful than normal IVF OPU because the eggs are smaller and trickier to get out, you need to pierce the ovary wall more times etc. Am not really looking forward to that part of it all, but at least I know about it upfront.
No more of this springing stuff on me. Having our cycle cancelled last time completely broke me down because it wasn't something that I thought was even possible. I am prepared for this not to work. It will hurt if it doesn't result in a BFP, but I know that it could happen. But at least we will be trying and I am going to do everything within my power to help us have our baby :)
Tuesday, 1 January 2008
I've been thinking quite hard about what my new years resolutions should be and have come up with a couple of things that I want to achieve.
- Be more organised. Keep track of bills, keep and file away important receipts, keep a diary of events (don't just rely on my mobile phone calendar!)
- Lose more weight. Go to the gym reguarly, keep doing personal training, and get down to a size 16!
- Really apply myself in my job. I start a new position on Jan 14th and I want to make the job my own and really shine in it. I want to prove that I am more than capable of doing anything that I put my mind to.
- Be positive about my fertility. This doesn't mean that I can't be sad at times, but try and approach things from a positive perspective where I can. I recognise that I am susceptible to depression, so I want to make sure I head it off from the beginning.
Hmmmm... OK I think the champagne has finally gone to my head so I am off to bed. I wish you all the very best for 2008 and beyond.
To 2008 - the year of the baby... correction... the year of OUR BABY!