Dr Dissection: Part 2

So Part 1 left off with our new IVF cycle for next time. Next time is going to be three periods apart from the last stim cycle, ie. two full cycles break.

I definitely need the break, as I think i made it clear to myself yesterday that I am in no shape to be doing another stim cycle any time soon.

I'm disappointed that we are not doing a minimal stim, as I had kind of got my head around what a great idea it would be - mainly because:

• I have done 7 Letrozole cycles before, with next to no side effect;


• One cycle resulted in a quick 6 week pregnancy; therefore


• the quality had to have been good enough to have formed an embryo and started to implant at least which is equal to the best IVF result we have had so far;


• no risk whatsoever of OHSS!!!!!!!!!!!!!!!!
  

At least i can tell myself if this one doesn't work out then we have a next step and its minimal stim - at lost less angst, gotta be worth a shot.

Something else I came to realise at yesterdays appointment is that there still seem to be plenty of options ie. this IVF injection galore/no syneral cycle; minimal stims; and this other one the FS mentioned re LH injections he might be able to persuade the drug company to give me once they see how difficult a patient I am.

I know as much as I say I don't to do IVF again, I know that I can't give up until our FS says we are out of options or we are wasting our time, and I realistically do not want to be doing this another cycle, let alone until I am 30, but there seems to be enough treatment options to try until I reach that age.

I know that all of this and more would be worth the wait if we actually achieve a full term pregnancy and a healthy baby, but as I have said before, I am now no longer willing to do this at any cost, and I feel that just one more bout of OHSS, will have me totally and irreversibly over it.

Oh and just a reminder for my husband when he reads this: remember the FS did say to spoil me - and that was his professional opinion. Wish he'd written a script for it! :)

Dr Dissection: Part 1

So I have been a bit slack lately with my posts lately, and probably will be for the next 6ish weeks as the whole IVF front gets quiet for a couple of cycles.

My husband and I went and saw our normal FS who is back from leave and missed all of the drama of my last nightmare. I couldn't help but try and analyse him as he went over my results from each of my three cycles to try and work out what the hell is going on. He shook one of his legs (jitteringly) for pretty much the whole conversation which I found a little odd. Did he A) just feel slightly uncomfortable with the difficult conversation or B) did he drink to much coffee or C) was he worried about something - like how I was going to take the conversation? Whether we were going to be all fired up or not???? I don't know? I will have to take more notice of when I shake my leg like that (which i do) and what I am feeling at the time......

Anyways that isn't really important, it was just something I was distracted by in our discussion.

So the discussion went along the lines of one more IVF cycle using a different protocol:
-no syneral
-earlier injections starting at 100 units of Puregon
-more injections towards the end of the cycle
-more expensive cycle

His reasons for doing this one is to try a lesser dose of the original FSH drug used in our first two cycles (puregon); no syneral to try and assist with no OHSS; doing IVF over a minimal stim one last time to try and get a number of suitable eggs, rather than just none or one.

I started to cry when it sunk in that I was going to be doing yet another IVF cycle and through my wobbly voice I explained to him that I'm scared and feel stupid to put myself in a situation where I can get so sick again (OHSS). And that basically covers it to be honest. I'm scared of going through all of this again - injections, surgery, time off work, charging my body up on drugs to end up feeling like a infertile idiot who did it all for nothing and ended up in hospital to boot - all voluntarily.

Wow ok, this post is going to go on forever.............will do part 2 tonight, got to get to work!

Part of moving forwards....

Still dusting myself off

Its now Friday, Day 30 of the disastrous cycle from hell.

I fear my belly is back to its normal size, although I would love to loose an extra few cm's off of it (shouldn't I get something out of this whole ordeal?). My weight has gone down to what it was before this cycle started 30 days ago. I'm slowing down on the whole drinking my weight in fluids each day and actually sleeping through the night without having to go to the toilet numerous times.

Hmmmmm I'm sounding a little bitter.............Well I am and I feel I have every right to be for now anyways.

I'm sensing my period is a matter of days away if not hours and that once that is done for its time for the grieving and being bitter and depressed time to be over and to get up and get going again (with life that is - not with IVF.)

I want to get back into exercising and enjoying the odd alcoholic beverage - just because I can. I want to do some hard work in the garden and on my treadmill and not have to watch my caffeine intake! Yay! I want to do some things that will try and make me feel good about myself again, and not that I'm a pathetic mummawannbe who can't get what she wants.

I've made an appointment to go back and see my acupuncturist and will do so each week at least until we start IVF again.

I've also made an appointment to dissect the whole 'disastrous cycle' and discuss plans for a new one with our FS in a couple of weeks.

I went and saw a psychic yesterday who was not able to confirm whether or not I would have my own biological child (which I know she has done for others) and instead told me I need to try and have several doors open ie, biological child is only one door. I went hoping to be told what I had been told before by another psychic, that I would have two boys and a girl, and instead I came away questioning whether i will ever be a mum even more than I was already....

Bit of a sucky time, but I'll get through it, I have before!

Disastrous cycle end

In my FS' own words this cycle has been 'disastrous.' The dictionary definition of 'disastrous' - 'highly unsuccessful'.


The short version is: OHSS - hospitalisation - nil embies.

The long version:

Thursday morning I called the clinic for two reasons - to let them know how crap I was feeling and to get an embryo update.


Day 3 = Out of the 9 embryos left struggling from the day before we had:

• 5 x arrested;


• 3 x 6 cells;
  
• 1 x 5 cells.
  

Ideally on Day 3 they should be between 6-10 cells - so none were getting A grades or anything...

My FS called be back later that morning to speak to me in person and guage how I was feeling. He advised I take one Cartier aspirin a day to reduce the chance of blood clots, 1L of Powerade etc in addition to plenty of water and to travel down and see him in person that day.

His secretary booked an appointment for 4.00pm that afternoon and the trip down in the car was one of my most painful experiences e.v.e.r! With each lil bump in the road for the 1.5hrs the trip took, my whole mid sectioned absolutely ached!

Once at the appointment the FS did a scan both external and then internal to check how much free fluid there was, and also to check on the size of my ovaries. The ovaries had doubled in size to what they should be ( I think they were 6.5cm diameter), and there was free fluid everywhere.

From what I understand the free fluid fills up the follies that have had eggs taken out of them, and the spills into the spaces around all of your bits down there. The fluid comes from what you consume, (which can make you dehydrated) and it also starts to draw fluid from your blood and tissues (which makes the blood thicker and hence the risk of blood clots.)

My belly was absolutely huge and the FS said I looked terrible, with the pads under my eyes even looking bloated.

He hospitalised me, where he advised they would hook me up to a drip to control the fluids going in, measure the fluids going out (ie pee), give me injections to try and control blood clots and take care of my pain relief.

I felt a strange sense of relief to be hospitalised, knowing that every little thing would be checked and controlled and that there was less pressure on myself to know if everything was getting worse or better etc.

I was hospitalised from Thursday afternoon to Sunday afternoon. During my stay I gained a total of 3 kgs of bloat and my belly was measuring at around 106cm circumference at its biggest time. I was peeing every hour on the hour pretty much, which was good news, because anything I pee'd out obviously didn't have the chance to be kept on as bloat.

I had to record every liquid I consumed ie. every glass of water etc, and every pee had to go into a 'witches hat' that sat under the toilet lid and collected it. The drip went everywhere with me during my stay and I was encouraged to get up and get moving doing laps around the ward to get the blood flowing and try and reduce the bloat.

My FS would come and check on me each day and check my chart to see the in's and out's and measurements and stuff. He was very lovely and explained everything clearly and so didn't have to come in on his weekend off - he could have left that to the clinic FS on call that weekend.

I want to record the daily updates on my pathetic embryo's from when I was hospitalised as well:

Day 4 =

• 3 x 6 cells


• 1 x 7 cells

2 of which are graded as poor and are very fragmented and the remaining 2 are graded as fair and are compacted, but not yet morulas (which then go to blasties.)

Day 5 =

• 1 started to form a morula but only had 4 cells in one of its two sections (ie. one section forms the baby and other section forms the placenta) and was not considered enough to form the placenta, if it formed any further.


• The remaining 3 had not improved from the day before.
  

Day 6 = all arrested

So from 11 precious eggs were were swiftly brought down to nil within 6 days.

I don't quite know where I stand with the whole IVF thing right now, at the moment I am still fuming on the inside at just how pathetic my body is. And I'm angry that I was given a heart and mind that is dying to have children, put with a reproductive system that lets me down every time.

I feel stupid for letting myself get into a situation where I fell sick again and have to feel like crap for so long. It impacts on my work, my husbands work, our finances and our family and most importantly my health. I wonder if it is also impacting on my future health? All of this manipulation of my ovaries with so many drugs etc cannot be healthy........

I feel like I would just like to sign adoption papers and then wait for a child to show up on my doorstep in like 7 years time. That way we could just be somewhat 'normal' for the next 7 years and enjoy ourselves.

I would also like to be a foster parent, with or without my own children, as I feel i have so much to give and no one to give it to. And that there are so many children out there, born to people, that for whatever reason cannot care for them at the time, and I feel I would be more than capable!

This experience has made me realise that I no longer want my own child at any cost, because I have come to realise that I cannot take 'any cost.' I cannot take another bout of OHSS, and if I do, what if its considered severe next time???

We will make an appointment with my normal FS for when he returns later this month and just drill him with questions about what we can try next, how we can avoid OHSS (which I know they can never guarantee) and what he thinks my chances are of IVF still working for us considering how crap my eggs are and what a poor responder I am.

I need closure.......I need to know if this is ever going to work, or if we are just wasting so much more than our time. I need to know if we should be moving onto some other treatment ie. donor eggs or giving up all together. The best closure of this journey would of course be a pregnancy that actually goes to term.....but how far away is that - if its in our journey at all???

Where to start?

I am feeling my absolute worst/lowest/crappiest/angriest/saddest at the moment. Since I last posted everything has gone downhill.

• 7 of the 9 embryos are between 2-5 cells (normal) and 2 x 1 cells (poor);
• of those 9 embryos, all are considered to be below average quality;
• 24 hours after the EPU I started to feel bloated and uncomfortable;
• 48hrs after and I am in absolute pain and discomfort, unable to even lie down flat without being in pain.

I'm absolutely confident that this is OHSS yet again, and I am just praying for the strength to get through it, and then I'm telling myself that I am never ever doing this again to reassure myself that this is a twice off, and I can do it, because it won't last forever.

I'm feeling:

• bowel pain;
• a constant discomfort across my whole mid section from under my chest to my lower abdomen;
• waves of pain across this section;
• a tightness in my chest since I spent half the night lying in bed rather than being upright (i think);
• I don't have an appetite but have to keep my my fluids and extra fluids like powerade and pear juice.

When I spoke to the FS yesterday he recommended that we wait out until Day 5 for the transfer as originally planned, as I was feeling to ill for a Day 3 transfer. The problem with this being by Day 5 there may not be a blastie to transfer (not that I think I will be well enough, even if there is one to transfer.)

I can call and get an update on my embryos @ 10am............

EPU results

EPU went according to plan. I woke up to find a neat little 11 written on my hand. Very happy with that number, not too high, not too low.

I struggled a little coming out of recovery (which is not unusal for me) as when I first got up I felt a lil too dizzy and went rather pale.

Six Jatz and a bit of lemonade later though my blood pressure had jumped to a more appropriate level.

This morning I called to get the results on how many of the 11 had fertilized, and I am happy to advise that 9 made it which is a great result so far!!! I just need at least a few of these, well at least one really, to make to a beautiful Day 5 blastie!!!

I'm feeling quite good atm, I haven't needed pain relief since before bed last night and it is only this afternoon that I am starting to feel a bit more bloated than yesterday. I still have a deep, moderate pain in my lower abdomin, mainly felt when I am changing position, ie. getting up or sitting down or rolling over in bed.

I'm hoping I am well enough to be able to keep going without any pain relief and no further bloating. I've been keeping up my fluids and eating small meals with plenty of protein and fibre. Although I would kill for some chicken soup right now!

'D' Day

So today is 'D' Day, surgery day, scary day.......well one of the scary days I guess. Feeling quite calm at the moment, however I know the closer and closer it gets the more nervous I will be. This will be my 4th surgery in 13 months at the same hospital, for the same reason 'infertility.' I know I never imagined having had surgery at all, let alone on 4 occassions, prior to my 28th birthday, like ever.........

I just keep thinking about when I wake up this afternoon I will have a number written on my hand, a number which will tell me a number of things:
1st: How many follices had eggs in them; and
2nd: How close I may be to OHSS...

With my first IVF stim cycle we had the number 15 written on my hand which ultimately resulted in OHSS, 2 FET blastie transfers, one that resulted in a pregnancy lost at 6.5 wks (embie had no heartbeat).

With my second IVF stim cycle we had the number 4 written on my hand which ultimately resulted in 3 crappy embie's - all badly fragmented and a Day 3 fresh transfer to try and clutch at straws. BFN.

I am hoping today for a number inbetween the two for the main reason - hopefully no OHSS.

If I see a number higher than 15 I am permitted to dwell in the land of misery for the next few days assuming the worst and that OHSS will develop....... If I see a number lower than 15 I may take comfort in that, fingers crossed, no OHSS and that hopefully one lil sucker is mean't to be and can be a Day 5 fresh transfer next Saturday.

I'd also like to say a quick hello to amaprincess for becoming a follower - we are very close to the same day of our cycles this time around. By my calcs today is your Day 13 and my Day 19. Good luck to you and I'll be following your blog!

Day 18

Its Day 18 of stim cycle #3 and things are looking up! I had my final scan yesterday morning and I have 6 -10 follies at 17mm or more that are not too big and could potentially hold mature lil eggs for fertilisation!

I did my last injection of Gonal F and sniffed my last puff of Synarel yesterday, and then in the early hours of this morning woke up to have my injection of 10 000 units of Pregnyl.

I'm being admitted to hospital tomorrow at 12.00pm for my EPU @ 1.30pm. This should take about 30 mins and then its about 2 hours in recovery before the long trip home in the car.


If we are lucky enough to get a good grade blastie out of all of this (and no OHSS) I will have a fresh transfer next Saturday!!!

I'm feeling quite good atm. Feeling more confident about the outcome of this cycle and also feeling physically quite well too. I of course feel a bit bloated and uncomfortable from time to time, and I have had super sore breasts for over a week, but overall feeling quite well.