This IVF cycle started quickly and quietly, with little fuss.
I’d spent the past weeks overseas, and hadn’t really had time to consider fertility treatment because I was off having the time of my life.
But stepping off the plane onto Australian soil, our treatment started almost immediately. I didn’t have time to build up anxiety or stress or worries. I highly recommend this way of doing things. It should be mandatory to have a holiday directly before every cycle of IVF. We all pay enough money for treatment, the least the fertility clinics could do is throw in a weekend getaway…
This was our fourth fully stimulated IVF cycle, or as I like to call them “fresh” cycles. Because they aren’t frozen cycles. And because it’s my blog and I can call them what I want.
I have mentioned previously that Doctor B had decided to try something a little different this time and not start day 1 of FSH injections in tandem with my cycle. Normally FSH injections start on CD2 or CD3. But after 30 days of bleeding late last year following a failed pregnancy, I had not had a period in a few months.
Before that, I hadn’t experienced a spontaneous period in over 2 years. Fun! Normally prior to fresh or frozen cycles (yes, I’m still sticking with those terms – deal with it) my period is started artificially through provera or another drug. But the doctor wanted to see how my body would respond by not forcing a period.
So as soon as I got home from Malaysia, I started my cycle by getting a blood test to check to see where I was up to in my reproductive cycle. My first blood draw for 2014 – I wonder how many I will have this year….
The next day, already nursing a sore throat and a headache (because I’m the type of person who gets sick after moving between climates) I went into the clinic to visit Doctor B for a diagnostic scan, so we could decide when to start the cycle. She noted that both my ovaries were quiet and my endometrium was measuring 5.9mm. My LH was 14, my progesterone <0.5 and my oestrogen 184.
Honestly I had no idea what any of those numbers meant. Those types of blood tests are rarely done for me because my body is so silly and useless, so my hormone levels usually don't impact upon my cycles. Ultrasounds on the other hand, they make sense to me. I can read a pelvic ultrasound just as good as my brother. And he reads ultrasounds for a living. Legitimately – he's a radiographer.
Then I was told to have my first injection right there in the clinic. Bam! Just like that! No warning or anything. The cycle had begun.
I absolutely hate injecting myself in front of nurses. They're so….judgy. Like seriously what if this whole time I've been doing it wrong? I don't want to be told I'm not administering injections right during my FOURTH cycle. That'd be really embarrassing.
Luckily the nurse's eagle eyes only picked up one small mistake -I put the cap back on my needles before I remove them from the epi-pen and dispose of them. Apparently that's wrong because you could prick yourself while you're recapping it. But when you unscrew the needle and dispose of it there's no risk of pricking yourself (note my sarcasm here guys).
Anyway, this cycle we decided to inject a Puregon dose of 125+1. If you want to know the basis for that decision, you can read about it here. After my first dose, the doctor told me that she was going away and wouldn’t be around for my egg pick-up. I’m pretty sure my eyes popped out of my head.
This lady is seriously never at work. I’ve bitched in the past (here, and here for starters) about how my doctor is never in the office. On more than one occasion she had significantly delayed a cycle because she was going away. She had literally just come back from 3 weeks of leave over Christmas, and she was already going on vacation??? From here on in, I am officially changing Doctor B’s name to Doctor Holiday.
“You might want to delay your cycle for a month until I come back.” Doctor Holiday suggested.
“No thank you.” I replied.
“It’s just that you have a tendency to hyperstimulate, so I’d like to be here for your egg pick-up to make sure you’re ok.” she explained.
“No thank you.” I replied.
“I suppose you were ok after your last pick-up, so it might be safe to leave you in the hands of my capable replacement doctor.” she muttered.
“Sounds good!” I agreed.
Honestly I just wanted to get the show on the road and didn’t mind if the replacement doctor was a leper. But I did agree to attend all of my scan appointments with her so she could monitor my progress until she went away. In fact, she wanted to see me on day 5 of stims. It’s highly unusual for me to be seen before day 8, and even then the biggest follicle I’ve ever had at that stage was 5.6mm. I thought a day 5 scan sounded like a big ol’ waste of my time but said nothing.
And luckily I didn’t because day 5 showed my lining was already 10.1mm triple, which was excellent for that point in the cycle, and I had follicles! Real, proper, growing follicles! Even in spite of the fact I’d been suffering from a head cold all week!
In the right ovary I had an 11mm follie, and 2 measuring 10.9mm. In the left ovary I had a 10.4mm and a 12.6mm. Yes 12.6!! Doctor Holiday and I were both shocked and she had to put me onto my orgalutran shots early to stop me from ovulating.
“Do you know what this is?” she asked me.
“What?” I asked, confused.
“It’s what a normal IVF cycle looks like, Missy.” she gushed. “You’re being normal!”
And there was much rejoicing. For I am never normal, but when it comes to fertility all I want to be is normal. I mean hey, don’t we all?
After that my growth slowed down a little and at my next scan 3 days later I had one 15.5mm follicle on the left and on the right four follicles ranging in size from 15.5mm to 11mm. I was actually starting to become disappointed that I only seemed to have five follicles growing.
I’m 27 and I have PCOS and super high egg reserve so I know my body is capable of more than that. Plus in someone my age usually only 80% of follicles contain eggs, so I was concerned that we were only going to have four picked up. How could I go from having 34 eggs picked up in a cycle to only four?
“It’s not too late.” Doctor Holiday pressed me. “We can cancel this cycle and just start afresh when I come back. You really don’t need to use the replacement doctor. Maybe next time you’ll get more follicles.”
“No.” I shook my head. “I just want my eggs picked up. I don’t care who picks them up.”
“But everyone loves Doctor Eventi.” she sighed. “What if you decide you love him too and never come back to me?”
Ahhh so the plot thickens. The real reason Doctor Holiday didn’t want me to see the replacement doctor was far less noble than her need to protect my health. In that case, I was definitely still going ahead with the replacement doctor.
I agreed to come back and see Doctor Holiday for one more scan before she went away. It was a Saturday 7am appointment. Who has appointments that early on a Saturday? That’s just nasty. No wonder patients were choosing to stay with the replacement doctor…
“Ok!” she said cheerily as she began the scan. “We have lots of follicles now!”
I was flooded with relief as she began to measure and record the follicle growth.
“On the right we’ve got a 22.7mm follicle which is probably too big to contain an egg actually.” she started. “Let’s just forget about that one.”
Well, ok, that’s not such a good start then…
“But the others on the right side look good. We’ve got a 16.6mm, 15.7mm, 14.5mm, 14.3mm and a 12.2mm.” Doctor Holiday said.
Yes five follicles! On one side! Great news!
“So now let’s look at the left ovary.” Doctor Holiday continued. “Well we have a 12.6mm, 12.3mm, a 20.6mm that’s filled with blood, a 17mm…”
“Wait.” I spluttered. “Wait wait wait! What do you mean I have a follicle filled with blood?”
“Oh,” she frowned. “Wasn’t that there before?”
“No!” I shrieked.
I could not believe she didn’t even remember my stats from the scan I’d had days earlier, let alone the fact I had been coming to see her through three fully stimmed IVF cycles and ovulation induction! So unimpressed. My doctor constantly unimpresses me.
“Right. Well. It looks like you have a really large cyst filled with blood.” she said matter-of-factly. “It’s an endometrioma.”
“What caused it?” I asked nervously.
“I don’t know.” she admitted. “It’s probably from your last period.”
“But I haven’t had my period since November.” I said, unable to comprehend that she couldn’t remember we hadn’t started the cycle with my period this time around. “And it wasn’t there three days ago!”
“Oh well,” Doctor Holiday shrugged, clearly confused herself. “If you don’t get pregnant this cycle we’ll investigate it further.”
And after that she promptly dropped the matter and didn’t mention it again. It left me scared and confused, and worried for my egg pick-up which Doctor Holiday had agreed could go ahead on the following Tuesday at 7am. I was worried that the endometrioma was going to detrimentally affect the quality of the eggs, and also concerned that it had grown so large in just three days.
As I was leaving the office, Doctor Holiday wished me luck for my egg pick-up with Doctor Eventi, and then she said something really odd…
“Just remember that women who have a few failed pregnancies in a row often go back for another cycle of IVF and just end up with a negative.” she said. “Don’t feel disheartened if this cycle is negative for you. It doesn’t mean you’re broken.”
Seriously. She said that. Like gee thanks for being a ball of optimism! Thanks for basically slamming my hope and courage into the ground. Thanks for making sure I’m going into the egg pick-up with the mind-set that I’m definitely going to fail. Doctors are just useful like that sometimes, aren’t they? When I got home and told Doug what she said, he was so furious.
On Sunday at 5pm I pushed all negative thoughts to the back of my mind and triggered myself with Ovidrel. It was a messy injection because I somehow managed to pull the needle out of my skin before all of the drug had injected. Then I panicked and shoved the same needle straight back into my stomach, like some kind of reflex. I ended up with a bruised and bleeding tummy, and more anxiety that I hadn’t given myself the correct dose.
And then, after that, there was nothing left to do except wait for 7am Tuesday….
(to be continued)