I’m bummed that my depression means I have missed out on recording an account of my entire current cycle. This is our third fresh cycle of IVF, but our fourth cycle of fertility treatment when we include our FET in March. So for my own peace of mind rather than anything else, I’m going to just knock out a little history in dot-point form. I must warn any of you who plan to read this – prepare to be bored.
- 1 October – my first day of FSH injections (125 IU Puregon). I have just recovered from pneumonia and returned to work a few days earlier, but we decide to press ahead with the cycle for financial reasons. In Australia we have a Medicare “safety net” that catches patients undergoing any type of expensive medical treatment. Our healthcare system is amazingly subsidised, but patients who need extra help are eligible to receive even more in subsidies once their medical spending for the year reaches the safety net cap amount. You are automatically caught by the safety net, and the subsidies aren’t means tested. I don’t know what that capped amount is, but we reached it in January (ha…ha) and after that point all of our medical bills became cheaper. It brings the cost of each IVF cycle down substantially. This was our last chance to do a cycle for the year, and as of 1 January 2014 the safety net resets to zero and we have to spend money on medical treatment to reach it again. We figured we may as well give this cycle a red hot crack while it was still cheap.
- 5 October – start Orgalutran shots. Hello old friend, I’ve missed you. I enjoy the time we spend together and the searing pain, redness and swelling that flows across my swollen belly like a tsunami every time I inject myself. IVF is fun!
- 8 October – my first scan. As usual, my ovaries are slow responders. My first scan shows a bunch of follicles (which is normal because of my PCOS) but the biggest is measuring 5.7mm. The doctor instructs me to stay on the Orgalutran just for another couple of days until we can check my ovaries again.
- 10 October – Finally something is happening. My left ovary is responding, but the follicles are all small. A couple are around 11mm. My right ovary has shrunk back down. The doctor is worried all but one of the follicles are also going to shrink and my body will try and ovulate again. This didn’t work out for us last cycle, given the fact my tubes are blocked. I am nervous. Doug is optimistic. Stupid husband…
- 12 October – Cooking with gas. The follicles on the left side continue to grow and a few are now 15mm. The doctor is extremely happy because it looks like we are going to get just a few mature follicles and hopefully I will avoid OHSS after pick up. She told me that any doctor can get 30 eggs out of a girl with severe PCOS, but it takes a brilliant doctor to get just 7. Do doctors even realise when they are blowing smoke up their own asses? We decide to do a 50/50 split of IVF and ICSI. Previously we have done ICSI because my husband’s sperm quality is borderline, however I am paranoid about ICSI birth defects and want to try IVF. We have never done straight IVF before and I want to see if we can be successful, but the doctor is concerned none of the eggs will fertilize and we will all feel awful. The 50/50 split is a compromise we are all happy with.
- 14 October – Go time! The scan shows approximately 6 follicles on the left, the largest measuring 20mm and the rest ranging in size from 19mm to 14mm. There are also two follicles measuring 13.5mm that have popped up on the right ovary. The doctor is pleased with how I’m looking and tells me to trigger at 5pm that evening. I am still at work at 5pm so I duck into the bathroom and inject myself. I feel naughty but I don’t know why. What if someone sees me and thinks I’m a heroin addict?
- 15 October – Paranoia. We need to arrive at the hospital at 6am tomorrow for admission, which means a 5am wakeup call. Yay! The time between trigger and pick up is 38 hours. My last clinic did the pick up after 36 hours. This slight difference has resulted in anxiety, sleeplessness and insane googling of phrases like “38 hour egg pick up, did they miss the eggs” and “what happens if they miss the eggs”
- 16 October – Before egg pick up. After arriving at 6am, I am called through to the presurgical waiting room really quickly. I like that there’s no messing about. I am weighed – 76kg. I have put on 3kg during the injection period of my cycle. During my first cycle I had put on double that amount before pick up so I am pleased. I am dressed in a sexy blue hospital gown, an even sexier hair net and told unfortunately I can’t wear any underwear. Not even the mesh type! But then I’m wrapped under warm blankets so I don’t mind. I am wheeled through to the surgical theatre at 7am. We all have to wait outside the room for 5 minutes while they warm the room up for my eggs. My last clinic didn’t do this and it fills me with confidence. Of course the eggs need a consistent temperature. Warming the room up makes sense! While we’re waiting the nurses talk to me. They’re all shocked that I’m there for an egg pick up and keep saying “but you’re just a baby” I try to explain I just look young without makeup, but they insist that most of the women they see having egg pick ups are 40. I think they’re exaggerating. When I’m wheeled into the theatre I tell the doctor I’m worried about the 38 hour time lapse, but she squeezes my hand and tells me the eggs will still be there.
- 16 October – After egg pick up. Suddenly the surgery is over. I don’t remember going to sleep. The nurse in the recovery ward is talking to me, and asking me if I am ok. When I tell her that I am, she informs me that she was very worried about me. Apparently they’d already woken me up once before but I’d complained I was going to vomit and my blood pressure had plummeted then I’d passed out. I have no memory of such an event occuring. There’s a sticker on my left hand and someone has written on it in black pen “7 eggs” and then added a smiley face. They got eggs! I am relieved at that, but also disappointed as I was hoping to get at least 10. I am shocked we have managed to extract my doctor’s perfect number and expect she will gloat about it when I see her next. After I eat something and empty my bladder, the nurse scans my belly and it shows my bladder is still full. We repeat this process several times over the next few hours, but every time I go to the bathroom and think my bladder is empty the ultrasound shows it’s even more full than before. Eventually they have to catheter me because they are worried my bladder isn’t functional. I am terrified of the catheter, but pleasantly surprised that it actually isn’t very painful. Can one be pleasantly surprised by a catheter? Anyway, turns out my bladder was actually empty and had likely been empty the entire time. The ultrasound scan is picking up free floating fluid outside my bladder. This is a bad sign and means I am suffering mild OHSS. The doctor wants me monitored to make sure it doesn’t progress like it did last time.
- 17 October – Road to recovery. I am feeling super. Hardly any cramps, although I am still extremely bloated. So this is what it feels like to have an egg pick up and not almost die. The embryologist phones to let me know they did IVF with 3 of our 7 eggs, and ICSI with the remaining 4. Two of the IVF eggs have fertilized, and two of the ICSI eggs have fertilized. I am really upset that our measly 7 is already reduced to 4. Given this low number, the doctor decides to swap out our day 5 blast transfer to a day 3 cleavage transfer. I am now very upset because I know this lessens our chances. The transfer is scheduled for 19 October.
- 18 October – Winning battles. I research extensively and find evidence that the success rate is slightly higher for day 3 embryos when two are transferred instead of one. First I convince my husband that I want to change up the transfer. He is not keen, but utters those magic words “whatever you want darling” which easily wins me the battle. Next I need to convince my IVF nurse, who is the gatekeeper to my doctor. She is easily persuaded. Finally, I need to convince my doctor. She is the toughest nut to crack. She keeps on stressing the increased birth risks for fraternal twins. I ask her what the risk of fraternal twins is when two embryos are transferred on day 3. “1 in 4” she says. I then ask her what the risk of identical twins is when one blast is transferred on day 5. “1 in 4” she says. I then ask if the risks are higher for identical twins and she says they are. She suddenly sees the point I am making. The original plan was to transfer one embryo on day 5, so my risks of twins are the same either way. She concedes defeat, stresses it’s my decision and says she is happy to sign off on two embryos if that’s what I want. Victory.
- 19 October – Peanut and Butters on board. While filling my bladder for my transfer I sit nervously by the phone, but hoping it doesn’t ring. The clinic will only call me if there are no embryos alive to transfer when they check them in the incubator. Thankfully the phone remains quiet and we head off to the hospital at 11am. I am not in very much pain and wonder if my bladder isn’t full enough. These are the types of stupid concerns you have when you do IVF. You worry when you aren’t in pain. The embryologist shows me the best two embryos available to transfer. A perfect day 3 embryo should have eight cells. Our two embryos are both grade 2. The first is 6 cells (minimum acceptable number of cells for a healthy embryo at day 3), with no signs of fragmentation (good!) but not compacted (bad). The second is 7 cells (slightly behind ideal), with some fragmentation (bad) but showing great signs of compacting (good!). Interestingly these two embryos are both of the ICSI embryos. We have a grade 3 IVF embryo in the incubator which the embryologist doesn’t think will make it, and the other IVF embryo has already arrested. The embryologist says she has never seen anything quite like our grade 3 embryo. The shell is extremely thick because all the reject sperm have clung to it to form a barrier. She said this often happens a little, but for our embryo it has happened big time. She is fascinated but also stresses this is proof that in the future we need to do ICSI. Our IVF experiment has failed. Our two embryos are transferred. I watch them enter my uterus. I name the 6 cell Peanut and the 7 cell Butter. Afterwards we go to breakfast and I tell Doug that Peanut is a boy but Butter is a girl. He looks at me like I’m absolutely insane. Which…I am. He asks if we can call the embryo Butters instead of Butter, because he likes South Park. I reluctantly agree. Peanut and Butters. My little fighters.
- 21 October – Welcome to the family Jelly! The embryologist phones me. She says she was surprised to see our IVF embryo in the incubator was a strong finisher and she was able to freeze it as a grade 2 blastocyst. I am both shocked and thrilled. To have a back up embie on ice was all I ever wanted. She stresses that the shell is still extremely thick and suggests even with assisted hatching the little guy might not be able to wiggle his way out of the shell to implant. But we’ll cross that bridge when we come to it. To match with Peanut and Butters I name the third embryo Jelly. Doug isn’t happy because in Australia we put jam with our peanut butter. I stick with the name Jelly because embryos look kinda like jelly.
- And now….we wait. Official beta day is 30 October.
Congratulations if you’ve read this far! What a boring update. To make it more interesting here’s a photo of Peanut and Butters. They’re cute, huh?
To make up for this boring post, next time I write I’ll update you all on my charming mother-in-law. Everybody loves to read about mothers-in-law! Especially bitchy ones! Am I right or am I right? I am right.