IVF Round 3: Done & Dusted

Our IVF cycle has come to an end.

Egg retrieval yesterday was a bloody nightmare. I was in SO much pain during the four hour wait pre-op, and could hardly walk by the end. After four (!) attempts to find a vein for a cannula, they finally got me sedated {did nothing} and after an excruciating egg retrieval, I had 13 eggs retrieved. All was well, I was happy with that.
Unfortunately I had no response to pain medication after the procedure, and was shaking head to toe. They tried a few drugs, and ended up giving me Endone, which settled things down. After a little while in recovery, they got me up and dressed and finishing off my IV drip - and then I came over really nauseous. Felt like I was about to throw up, broke out in head to toe sweat, face as white as a sheet, and they had to wheelchair me back to recovery, as I was on the brink of passing out. That passed, and we tried getting up to go again - and it happened again.
As such, they admitted me upstairs to the ward for monitoring. I just wanted to go home, but they were worried - so after a few hours of being observed, and just a few more episodes, they let me leave. I slept well last night, and feel better today - just swollen and sore, but that's to be expected after egg retrieval.
My 'not impressed about being stuck in hospital' face.
We got the call this morning that we have 8 embryos that have survived. I was disappointed, and was greedily hoping for more, after the discomfort I've had the last few weeks of stimming. Knowing we were doing a freeze all, I figured the more embryos the better. Anyway... that said, from 13 we had 2 immature, and 3 that fertilised abnormally - so left with 8 that are in the freezer. The embryologist has frozen them in batches of 3, 3 and 2 for future growing with frozen cycles.
I've had so many people ask me why my clinic has frozen the fertilised embryos at Day 1 - most people are surprised they're not growing them out to day 3 or 5 before freezing. I still have my doubts about it all too, but it's out of my hands. It's done now. Our journey is over.
So... that's it. Feels so strange to have nothing to hope for or to look forward to. No transfer. No TWW. Just pain & discomfort for what seems like a whole lot of nothing. I'm already petrified those embryos will fail to thaw, or die off during the 5-day growing period, when the time comes to use them. There's just no relaxing on this journey.
Now we wait. 
If I had $1 for every time we had to wait during this journey, I'd be a millionaire & IVF costs would mean nothing to me.

Lowering the OHSS Risk

Another day, another frustrating development in this seemingly hopeless IVF cycle.

I spoke to my fertility specialist today. She rang to confirm the freeze-all and to answer a few questions that I had, which I appreciated. After egg retrieval, they will freeze any viable embryos that have fertilised on Day 1. No growing them out, no freezing at blastocyst stage - just bunches of early embryos. Apparently this is because the early embryos are stronger when it comes to thawing and re-freezing, but it worries me a little. At least with blasties, you know only the good ones have made it this far. The problem I can see with the Day 1 embryos, is that we could potentially lose most/all of them when they're growing them out at the time of transfer. Frustrating.

So once I have retrieval, I should get a period within 7-10 days thanks to the Lucrin trigger. That next cycle, which will be December, is a mandatory rest cycle, so no transfer. My FS has told me to go ahead and take Letrozole/Femara days 3-7 that month, to make sure that I ovulate and that it's a relatively short cycle. It's basically a month of 'just see what happens trying yourself' - ha, yeah, right! And then pigs flew out of my butt-crack. Then after my NEXT period, I can ring them and start the ball rolling for a FET in January. January! It feels like a million years away.

She also let me know that she's worried I will hyper-stimulate. Not because of my follicles going too crazy (they only saw 14 after all, which is well within normal range) but because of the fact that the E2 jumped from 686 to 8407 in just three days. As such, I had to drive back down to the clinic at lunch time today to collect an alternate trigger. Instead of the Ovidrel hcg trigger, I'm now taking a Lucrin trigger. She said this should keep me out of OHSS territory, so I'm happy she was looking out for me.

So the trigger is tonight at 10.30pm, and then I have one more day to wait - joy! Egg retrieval is booked for lunchtime on Thursday. All of our hopes lie in some good quality, mature eggs being retrieved - and a bunch would be nice, since we're freezing them all.

This is the only thing I have left to hope for, since everything else has been taken away... so please, please, PLEASE universe, give us a good haul. I'm desperate for our future baby to be inside one of these {very uncomfortable} follicles!

It's a Freeze All

Day 6: E2 was 495 & progesterone 4.4
Day 8: E2 was 686 & progesterone 3.6
Day 11: E2 was 8000 (!!!) & progesterone 5.3

Unfortunately, our cycle is going to be a freeze all. I was quietly holding out a little hope after the progesterone dropped - but obviously the boost in the follicles has resulted in the progesterone level jumping too. Bugger. BUGGER.

The ultrasound today showed 14 follicles, not that I anticipate anywhere near that number at egg collection - but we have a few more to play with, which is nice. I'm glad the E2 levels are matching the scan now, too. The wait is on to see whether those follicles will hold mature, strong eggs.

So we are triggering tomorrow, and having egg retrieval on Thursday. And then, that's it for the year. They'll freeze whatever they get... and we wait until January to plan any transfers. There will be no more pregnancy attempts in 2014. :(

Shit, I hope we get a few good, strong embryos from this. My heart just can't handle any more disappointment.

An Update

So just to REALLY mess with my head, I sent the clinic a message yesterday asking about the numbers, since I hadn't heard. Got this about Friday:
Hi Aly, Yesterday E2 was 686 and P4 was 3.6. Sorry you didn't get a message. (On Wednesday, E2 was 495 and P4 was 4.4.) 
So it's dropped again. Surely that means it must have been residual progesterone levels from the chemical pregnancy last month? And what does it all mean? I guess we'll find out on Monday.

Lost

Where do you go for support when you feel like you don't fit in anywhere?

I have friends who've gone through IVF, but are pregnant now - they've never had to struggle with low numbers or failed cycles. I have friends who have gone through losses, but have no fertility issues - so have conceived again quickly. I have friends who needed help falling pregnant with number one, but managed a natural conception for number two - and they have no idea what it's like to go through this for the second time in a row, for 1+ year, with no end in sight.

And then of course, I have friends that have never experienced any of these things - infertility, IVF, miscarriage, failed cycles... and they legitimately have no idea how to handle any of this. Or how to handle ME.

It's not something you just get over. Yes, talking to people can help - and we've done that, several times. If there was a way to just switch off and think about something else, don't you think we would have done that?

Suggesting we go on a holiday, or to leave things for a few months, or that taking a break might be a good idea... you have no idea how much that hurts. Do you think that if we jetted off on a holiday, things would get better? That I wouldn't spend that entire trip thinking about expanding our family? That I wouldn't be freaking out about the costs involved, costs that could be going towards more fertility treatment? That I wouldn't be watching Georgia playing on her own, and feeling disheartened that the age gap between babies is widening with every passing day?

Every day that we wait feels like a few months. I wish I was exaggerating. I blink and it's this time last year, when we had high hopes for baby #2, good vibes for our frosties, excitement at hopefully having a smoother time second go around. Somehow, it's been a year - and we have nothing to show for it but heartache.

The worst thing would have to be the comments about being grateful for Georgia. As if for one second I don't think of how lucky I am to have her. After the way our frozen transfers ended up, I feel like I need to personally thank the scientist who chose her embryo to transfer first. I don't know how I would keep going without her. But the implication that I should be happy with what I've got, and not be so sad about not conceiving a second child... well, that is totally unfair. Would you say that to a fertile person? Would you tell them to just be happy with what they've got, and to move on, or focus on other things?

I think for the most part I'm doing a pretty good job of putting on my happy face and getting on with things. Georgia won't ever know how much this hurt, because I will make SURE she doesn't see. Sometimes though, I need to be miserable. I need to cry. I can't fake a smile 24 hours a day. There are people out there who are also struggling to conceive - I'm not selfish enough to believe that I'm the only one going through this. I know. I just don't know where I fit in anymore.

I'm floundering around feeling completely lost. I'm trying not to lose total faith in this cycle, but already wishing the next few months away. The fact that March is coming up, our first little one's due date... that doesn't help.

IVF #3: Ultrasound Results

I swear, 2014 has been a complete arsehole. I am SO over this year, and I can't wait for it to be done. Dusted. Outta here.

We had a scan today. I have 7 measurable follicles, and a total of 13 smaller ones -- so a decent response so far. I was really happy with everything, and my lining was a thick & juicy 15mm. All was good. I was happy and positive.

Oh, until we got to the part where I'm probably going to have to freeze all of my embryos, because my progesterone is too high.

Wait, what?

Yep. My clinic has a policy of no fresh transfers when the progesterone is >5. Mine is 4.4 and it's only CD9, and still a good few more days of stimming drugs ahead of me.

I'm furious.

I was so preoccupied with worrying about having a poor ovarian respond to the stim drugs, I never even considered progesterone would be a problem. I mean, shouldn't that be a GOOD thing? I was so hoping for a fresh transfer, since the only successful pregnancy we've had has been off one of those. And a freeze all means a) potentially losing lots of embryos that aren't suitable to freeze, and b) WAITING EVEN LONGER TO TRANSFER THEM. Because of the holiday season, we'll miss out on this year.

The thing I was most scared of, is happening. We're closer and closer to our baby's due date - March 5th.. & we're still not pregnant.

I'm just exhausted.

Our Antagonist Protocol

We're still in the early days of this new cycle, so I figured I'd give you a heads up on what we're trying this time.

If you remember back to 2012, our first two IVF cycles were long down-regulation ones: you take the pill, you take Lucrin/Synarel to lull your body into shut-down mode, and then start pumping in the FSH drugs to stimulate the bejesus out of your ovaries. (You know, if your ovaries decide to play ball.) Both cycles, I had low egg numbers - 5 at first retrieval, 3 at the second retrieval.
Obviously we still got REALLY lucky with that last cycle, since all 3 fertilised and we got our Georgia from there -not to mention our two frozen blastocysts that both implanted, but weren't meant to be. 
Our specialist decided we'd try a different protocol this time around - so we're doing an Antagonist cycle. This time, we skipped the birth control and down regulation, and just headed straight into stimming with FSH drugs on CD2.
I'm on 200 of Puregon this cycle, and added in 250 of Orgalutran (Ganirelex) which is to suppress ovulation. The shots are still no problem, though the double whammy stung a bit this morning & my belly is bruised already - and it's only been a few days!
We have bloodwork done tomorrow, but I don't expect to hear results from the clinic unless the numbers are really low, or really high. If average, we just carry on until Friday, when we do more bloods and our first ultrasound to see how the follicles are responding.

I really, really hope we get better numbers this time! :)

It's Over.. but it's Beginning Again

I'm relieved (happy? sad? devastated?) to say that yesterday at 5.5 weeks pregnant {in theory} the miscarriage officially started. Levels had dropped earlier this week, so I was waiting anxiously for something to happen. On Monday, hcg was 17 & progesterone was 10. By Thursday, they were < 2 and the bleeding started. I'm no longer pregnant.

This has been the longest few weeks of my life, honestly. I'm mentally exhausted. But I really am relieved. I know the baby has been gone for a while now, but I feel like I have a little more closure now that it's happened, you know?
The first time around, the actual loss itself was harder - being that much further along, having seen the baby's heart beating and bonded with them already. This time, it's a bit strange. Nobody wants to talk about it with me, I guess they just don't know what to say. But even though it's earlier, the disappointment is just the same. The hopes being crushed, well, that doesn't get any easier with time, or experience.

But... there's a silver lining to everything happening on its own, and not dragging out too long.
Today is CD2, and I started jabbing with the Puregon this morning. I've never done an antagonist (short) cycle before, so I'm really excited to just get on with things - no long down regulation, no birth control, just getting the show on the road.

I've never been happier to stick myself with pointy needles! :)

I'm hopeful that we might do okay this time around. Maybe one of these eggs can lead to our baby.

What Happens Now?

I never thought I'd feel worse than I did when we found out about our missed miscarriage earlier this year. Apparently, I can.

It's been twelve days since I peed on that first early pee stick, and saw a shadow. It's been a week since I had my official first beta. Full of hope, and excitement, and nervous trepidation. It's been a week since I started getting nervous, when the beta came in at 60. It's been five days since we learned that the beta hadn't doubled, and that things weren't looking good. It's been three days since we found out that the levels had dropped down, and that the pregnancy wasn't viable.

It feels like an eternity.

When we lost our last baby, the time between finding out and having the d&c was short. For 24 hours, I was a nervous wreck. Panicked because I had a baby inside me that was no longer living, that I would start to bleed and have to go through a miscarriage at home. Thankfully, that didn't happen and the surgery went smoothly.

When we found out that this baby wasn't going to make it, everyone assured me I'd start to bleed. I stopped all of the medications last week, my last progesterone pessary was on Thursday night. I've been expecting to see blood every time I visit the bathroom. I've been waiting for this to begin, so that it can end. Once again, my body isn't working. Nothing is happening.

I still feel pregnant. I have sore boobs, the same pulling tightness that I've had during my last two pregnancies. I have crazy hyper-smell nose, and my veins are popping out all over me. This is the most heartbreaking thing to be going through.

I just want to bleed. I want my hcg to drop to zero. I want this early miscarriage to be over, so that we can move forward with our next cycle before the year is out. This morning, I had yet another blood draw, and hopefully I'll find out the results of that hcg level tomorrow morning.

I'm still hoping. Not hoping for miracles, or that this pregnancy can be saved - but I'm hoping for a quick ending, and for the chance to get another cycle in before the year ends. Please, let this be over with soon.

'Where have all the storks gone?': A Review

It's no secret that times have been tough around here lately. I'm grateful for this blog, which became an infertility focused-one a long time ago, as it has introduced me to so many wonderful and supportive people, but also some interesting opportunities.

I was recently asked if I would be interested in reading & reviewing a book, written by a couple who went through their own infertility journey. The book was called 'Where Have All the Storks Gone? A His and Hers Guide to Infertility'.

It arrived on Friday, just after we received word that our pregnancy was non-viable, and to cease all medications. Not the brightest of days, as I'm sure you've guessed, but the perfect time for a distraction.

The authors, Michelle & Chris Miller (from Stork Parenting) are unique, in that they have written their journey together, but separately. It's refreshing to read a story from both perspectives, especially since it's not often you hear about how men cope with infertility. That's not to invalidate a woman's story in any way; it's just that an added perspective adds to the experience and gives a little more insight to their journey as a couple.

The book is a quick read - I started last night while in the tub, and finished it this morning while Georgia napped. It's easy to follow, the authors honest and likeable, and you'll soon find yourself following along for the ride. I won't go into details, because I don't want to spoil anything - however the book would be well suited for couples struggling to conceive, who might soon find themselves heading down the path of assisted reproductive treatments, like IUI or IVF.

I'm not giving too much away (as you can already gather this information by looking at the photograph on the back cover) but it was heart warming to see the family as they are today. But I have to say, the way the book ended was a little too cliché for me. It wrapped up really fast, almost glossing over the fact that the couple managed to conceive their last two children naturally and without any mention of fertility treatments. If I had a dollar for every person, and now every book, that implied that getting knocked up after IVF was easy... well, I wouldn't be blogging right now. That said, lucky them. :)

The lovely folks at Shelton Interactive have an extra copy of the book to giveaway to a lucky winner. Go ahead, get entering!
a Rafflecopter giveaway Breathe Gently was provided with a complimentary copy of the novel to read at my leisure - all reviews are my own. If you are interested in a product review or giveaway appearing on Breathe Gently, please email me.





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