Monthly Archives: January 2015

May the odds be ever in our favour (written 15th November 2014)

Two and a half weeks on and I’ve just had the second scan in my evaluation cycle. The cycle is designed to test my body to make sure it can do everything it’s supposed to in order to receive the donated-egg embryos we hope to have once we commence our proper cycle. Amazingly my body has behaved and my endometrial lining is at 10.6mm after only a week of minimal drugs – much more than the 8mm required to pass my mock cycle. I suppose I shouldn’t really be surprised, my body has always been pretty good at this part of the process, it just can’t do the one piece that makes this part worthwhile – grow a decent egg. Nevertheless I’m pretty pleased and am anxiously awaiting an email from San Diego to say we’ve passed and I can stop the drugs….or more to the point, move onto the next ones.

As far as I know our blood tests have come back normal (yay!) and we also ticked off our counselling session, if you can call it that, last week. It’s the third time I’ve seen the counsellor we saw (my fourth counselling session at the clinic) and, having just seen her for our local donor cycle, this one was more of a formality than anything else. Once again we’d already spoken about most of the stuff she bought up and knew exactly how we felt about it. We’re generally a pretty laid back couple so her ‘curveballs’ (“what if your donor had donated to someone else here locally and you ran into the children from that donation”) were kind of like water off a ducks back. We’re prepared for that and will deal with it if it arises, we’d like to think that would be a positive thing rather than something to worry about. What worries me more is the extra risks we’re choosing in the hope of having a child.

We’ve decided to go with the clinic’s ‘Success Guarantee’ which basically means, if we’re accepted into the program, our cycle/s will result in a baby or we get most of our money back. If our first cycle doesn’t work we go back for a cycle or cycles using (should we be lucky enough to have them) our frozen embryos (AKA FET) until those frosties are used up or until we have a baby. If no baby results from this process, refund. The catch with this – other than having to qualify for the program – is that they transfer two embryos each time. Yep, there’s a possibility (although isn’t there always) of us having twins, a thought that both terrifies and excites me.

There’s roughly a 40% chance of our cycle resulting in twins and, should that happen, the risks for both mother and babies go up dramatically. There are higher risks of premature birth, low birth-weight, preeclampsia, gestational diabetes, and complications and/or issues both as newborns and later in life. I’m not going to lie, all of that absolute petrifies me. What if the decision we’re making now severely impacts on the future lives of our children. What if by implanting two we’re effectively issuing them with a life sentence? So why have we made the decision we have?

It certainly hasn’t been made lightly, and I wonder every day if we’re doing the right thing.  It’s partially a question of money – the success guarantee option is roughly only $5,000 more than a one-off, one time only, single-embryo transfer – and that’s clinic fees only. If a single-embryo transfer wasn’t successful we’d not only have to fork out another nearly US$20k, we’d also have to cover the costs of getting to San Diego and staying there again. Admittedly we’d have to cover travel costs under the Success Guarantee cycle too, but at least we wouldn’t be paying the clinic fees again.

Another part of it is that after three failed IVF cycles here (and countless other treatments) it just doesn’t feel like the odds are in our favour. It honestly doesn’t feel like it could work. I know that may seem stupid (especially given we’re using the eggs from a donor in her twenties) but after nearly four years of failure it’s extremely difficult to believe that things could go right. We’ve been conditioned to think negatively and now feel the need to give ourselves the best chance of success.

To further increase our chance of success we’re also opting to pay extra for Pre-implantation Genetic Screening (PGS) where a selection of our embryos are tested pre-transfer (usually around day 5) for any chromosomal abnormalities and the best (or most normal) embryos are selected for transfer. This testing will hopefully reduce our risk of miscarriage further down the track. It’s also possible to test for gender at this time and we’ve been told we have the option of choosing the sex of our child/children before the embryos are transferred into me. WOAH! Hold up there, what?!? Yep, we could potentially choose whether we have boys, girls, or one of each (assuming the embryos stick and make it to full-term). This world is starting to sound a bit Gattaca. Scary. Still, not ones to leave an issue unexplored, it prompts a lengthy discussion about the pros and cons of this.

The idea of twin boys freaks me out, we both (pre-fertility issues) always wanted a girl first, but if we were having twins then maybe one of each would be nice, or maybe twin girls would be better. In the end boils down to this: all we want is a healthy child (or children!), whether it’s a male or female, two of one or one of the other doesn’t matter to us, and so the choice of sex pre-transfer is irrelevant. All that matters is that the baby is healthy and is ours. End of discussion.

It seems we’re not the only ones freaked out by twins as, although our donor had initially said she’d be happy with an open donation, with her previous cycle resulting in twins, she’s become a bit freaked out about the whole thing and now wants to remain anonymous. However all is not lost. She’s agreed to register with the Donor Sibling Registry so, while we still won’t know who she is, we’ll be able to contact her anonymously to ask questions and share information. That’s enough for us! Our main concern was essentially ‘losing her forever’, having her disappear into the woodwork with no way to ever contact her with questions, and our child or children losing the only connection they have with one half of their genes. Who knows, even our donor herself has admitted that, at some stage in the future, her feelings on contact may change and we may have a more open relationship.

And that’s pretty much where we’re at. We paid San Diego for our donor’s medication today (eek!) so once the last little bits and pieces of our pre-testing are ticked off we’re good to go. Assuming I pass my evaluation cycle, SDFC will soon be providing us with our timeline, we’ll know our rough dates, and the die is cast. May the odds be ever in our favour.

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The ultimate in online shopping (written 21st October 2014)

Ok, so I haven’t been entirely honest on this blog. We’ve actually been more in contact with one of the American fertility centres than I’ve let on. After telling what seemed like the world about our last DEIVF cycle we decided we wanted to be a little bit more discreet, at least initially, with this one. Admittedly I’ve blabbed more than I had intended as it’s just so hard to keep quiet when you’re so excited about something, and my thin disguise has probably been extraordinarily see-through, but at least I’ve tried.

So, feeling frustrated at our lack of progress, the day after we get our failed cycle result we start investigating American fertility clinics. I’ve heard good things about San Diego Fertility Center (including a friend who is pregnant with their help) so we start there, but also check out Shady Grove in Washington DC too. Less than 24 hours later we’ve registered with San Diego’s donor database (as well as with Egg Donor America), which you can do without actually contacting them for treatment. It’s a bizarre thing. I feel like a complete stalker scrolling through the donor databases, it’s like online shopping but for people rather than things. It’s just a surreal, almost sci-fi experience, and we eventually find ourselves getting so hung up or comparing the smallest and craziest things that we have to take a step back and remind ourselves that these are real people we’re debating, not what colour underwear or socks to buy.

After a small discussion (basically me pushing my case) we decide on a donor. Just like that. It seems nuts that it can be done so easily that but this girl just feels right. She looks a little like me, she’s smart, down-to-earth, caring, and the things she writes in her profile sound like things I would write myself. I’m sold.

Two days after our failed donor cycle we email our doctor here in NZ to try and speed up the scheduling of our WTF appointment and seek his advice on next steps, including his thoughts on treatment in the States – our clinic works closely with San Diego Fertility Center so we’re hoping he has some valuable insight. It takes 4 days to get a response, which is pretty impressive given he’s on leave, and we have an appointment locked in for his first week back (three weeks from our failed result).

Hedging our bets we express our interest with San Diego a couple of days after we email our NZ doctor, via their online queries form. They’re super quick, less than 12 hours later we have a reply from them, with more information than we could ever have dreamed possible and our preliminary paperwork (new patient form and medical history) all ready to complete and return. The donor coordinator there is absolutely lovely (not to mention she’s been through DEIVF successfully herself so understands what this is like) and we fire questions and answers back and forth easily. We mention that my husband potentially has a work trip to the States planned in December and that if at all possible we’d like to be able to work with that to save on airfares. She’s unfazed, says that that timeline is totally achievable, and matches us with our donor! Matched, meaning she’s ours and no one else can nab her (but we can also pull out if we decide we don’t want her as our donor or decide not to proceed with treatment). Wow, mind-blowing. And it continues…less than a week later (although it could’ve been even sooner if we’d got our act together) we’ve got a phone appointment with the coordinator and the ball is well and truly rolling.

Over the phone we chat about what’s involved and what our options are, an easier conversation than most as we’ve just completed a donor cycle so know what to expect, and she’s booked us in for a phone appointment not only with one of their nurses but also one of their doctors too, AND the calls are only a week away! The speed at which they move is astounding! I thought I would be freaked out about how fast things are progressing but I’m excited. We don’t feel pressured by them at all and it just feels right.

Then comes the bad news, our donor has just started a new job and doesn’t want to take leave so early in her employment. Although we ask about potential timelines of when she would be able to complete a cycle, she’s unable to give any indication, so it looks like we’re back to the drawing board donor-wise. We have a few donors on our favourites list and there are more donors popping back into the pool everyday so hopefully it won’t be too difficult finding a replacement. We push on.

The call with the nurse and the following day the doctor, go smoothly and quickly. As with the donor coordinator, our recent donor cycle makes things so much easier. The nurse fires us through more information as well as an indication of the drugs I’ll be on, and a list of the pre-work required before we can start a cycle. This includes blood tests for both of us for everything under the sun (Blood Type/Rh, TSH, Varicella, Rubella, Prolactin, HTLV I and II, HIV, Hep C, RPR, Hep B Surface Antigen, Cystic Fibrosis Carrier Status), another semen analysis for my hubby, a request for an updated hysteroscopy for me, and another psychological consult for us both to make sure we’re all over the implications of not only a donor cycle but also one that could potentially be anonymous – something that’s not really approved of here in NZ.

Did I say the ball was rolling? Well now it’s a growing snowball! We sign consents to get our notes sent from our clinic over to San Diego, and it’s all on, we’re really doing this! Time to call the bank for that loan (which they thankfully grant us)! Nothing like the feeling of adding $50k to your mortgage for a chance at what most people can get for free. That’s the one bitter pill to swallow through all of this excitement. I hate owing money and to have to increase our mortgage so significantly really irks me. Still, it will hopefully all be worth it in the end.

So what next? Well, due to the tight timelines of when a hysteroscopy can be performed and where I currently sit in my cycle, I change our scheduled WTF appointment to a theatre booking for my hysteroscopy instead. There’s no going back now, especially as we pay our fee to the NZ clinic for their part in this process. Sheesh, less than two weeks since we approach San Diego and the decision is not only made but in full swing. It’s amazing, exciting, and overwhelming all at the same time.

We go back to the donor drawing board and with a bit of consultation decide on another donor but again there’s a hitch. While her profile indicates she’s available from November, due to the late arrival of her period from her last (and first) donation, she won’t be able to donate until early in the New Year. We’re just not having much luck with this! We go back to the database but after a bit of discussion decide that we just don’t want to compromise that much on a donor. The universe is trying to tell us something and we should listen. December is just not right for this process. We opt to wait for the New Year and stick with our second donor choice. We’re matched. She’s ours and we’re hers, for this cycle at least. According to our donor coordinator this donor is absolutely adorable and one of her favourites in the system, she’s “gorgeous, bubbly, enthusiastic, and just so grateful to be given the opportunity to change lives” which makes me feel really good about this choice. Let’s just hope nothing else goes wrong!

So onto the serious stuff. My hysteroscopy. As previously mentioned there is a tight timeframe on this as it needs to be completed between days 7 & 12 of your cycle. The date of our WTF appointment (that I switch to my hysteroscopy appointment) is day 12 for me so there’s no time to lose. Unfortunately it’s also the first day of our annual work conference which I’ve been helping organise for the larger part of this year. Timing couldn’t be worse but thankfully the conference team is made up of some pretty amazing women who completely ‘get it’ and don’t hesitate in telling me to continue with the appointment. So after an insanely early 5:30am breakfast (no eating for 6 hours pre-op just in case) and some last minute conference stuff in the morning, I head off to my operation. For the first time in our whole fertility process I’m off to a big appointment alone. My husband has a major part to play (presenting to 300 people) at the conference so, despite desperately wanting to be there for me, can’t make it along. I’m just hoping like hell I can make it back to the conference in time for his presentation! They say the hysteroscopy should take 30 minutes so I should be ok, but if it gets too painful and they have to sedate me, I’ll be stuck there longer and might miss him present.

Well painful? It was the most excruciating thing ever and I felt like I was about to vomit through a fair chunk of it. On instruction I’d taken three paracetamol tablets an hour before and they’d hoped this would be enough to control the pain. It’s not. My legs go up in the stirrups, ever so dignified, plastic is guided under my back to “catch the fluid”, mmmm delicious. First they insert a speculum much like a regular smear, followed by an internal rinse of the area and the insertion of a little camera. It’s a little uncomfortable, with some mild period-like cramping, but overall not too painful. That is until they get to my cervix. My cervix won’t sit still and keeps running away so they’re forced to clamp it to hold it in place. There’s a little pinch and a shoot of pain but at least it now stays put. And then the excruciating agony begins. I get the cold sweats and honestly feel like I’m about to throw up. I can’t believe people are able to do this without pain relief, and my pain threshold is (or at least used to be) pretty high. I want to cry and actually come close to blacking out – or at least being so much in pain that I don’t really remember what was happening in the room, and the voice of the nurse telling me to take deep breaths seem fuzzy and miles away. Halfway through they dose me up with painkillers, just a small dose so it doesn’t take the pain away but it does help. Apparently I have a tight cervix, great. What else can my body do to make this a nightmare for me.

And then it’s done. I feel weak but relieved it’s over, and so so grateful for the amazing nurse (both of them were really lovely and supportive but there’s one in particular, who’s our favourite at the clinic) who was simply fantastic, held my hand and talked me through the ordeal. I couldn’t have done it without her. They keep me there for observation for another 30 minutes or so, feeding me toast and tea, before I’m allowed to leave. I’m not permitted to drive after the drugs they’ve given me but my amazing friend C (one of the fabulous conference girls) has offered to pick me up and race me back to conference. She drives like the wind and we make it back just in time for my hubby’s (magnificent) presentation. I’m stoked we made it and insanely grateful to have such wonderful friends. I kick into two days of conference and socialising, desperately trying to hide my cramps and other side-effects of the treatment. The physical stuff I can handle and hide ok but it’s the emotional stuff that takes its toll. It’s hard to be happy and social (especially around so many cheery fertiles – “I’ve also got a successful breeding program at home”, yes, that came up in more than one speech to the attendees) when you just want to curl up and cry at the unfairness of the world. I miss one of the functions (more to extreme tiredness than anything else) but manage to make it through pretending it’s all ok.

And here we are another week on, blood tests were ticked of the list this morning, counselling appointment is booked for two weeks time, and evaluation cycle will start with my next period. Hold onto your hats kids it’s full steam ahead, I can only hope that we’ll get the result we dream of at the end of the ride.

 

 

 

 


Down the aisle

11:44am: We’re down in the South Island at what I’ve affectionately titled “The Wedding of the Year”. An easy title to give it turns out as it’s the ONLY wedding we have on this year. The setting is amazing! Nestled amongst the epic mountains that only the South Island can provide, next to the stunningly blue Lake Ohau, in a rugged but fantastic lodge generally occupied in the winter by snow bunnies and in the summer (now) by various tourists and Contiki groups. It’s epic. I’ve been quite anxious about this wedding. Despite looking forward to it and to the weekend away necessitated by it, I can’t help but worry that it will be a repeat of the last wedding we attended just over a year ago.

You may recall it as I wrote about it here on Waiting for Bumble. It was a disaster and I still to this day feel unbelievably guilty about how things played out. For those who don’t know about it, I basically had a complete meltdown just after the ceremony. It was only a few weeks after our second failed IVF cycle (a cycle that, being a ­­reflector I hadn’t yet dealt with emotionally) and the day after the end of our holiday (post-holiday blues). I turned up at the house we were sharing with two other couples to find that not one but both of the girls in those relationships were pregnant. One I knew about, one I didn’t. Total slap in the face. Add into that the other 30 or so people at the wedding who were either pregnant or had young children, and it was a recipe for disaster.

The tears started rolling down my face about 10 mins after the ceremony ended and I just couldn’t stop them. My hubby and I walked away to the other end of the venue to find some space away from the babies so I could try and compose myself, and they just followed us. It felt like intentional torture although I know those people had no idea of the pain I was suffering and what I was trying to escape. Needless to say I couldn’t get it under control, things only got worse, and I ended up walking back to our accommodation in uncontrollable heartbroken sobs before packing my belongings and driving the hour home alone. I missed the reception. An empty space sat awaiting me at a table and I was nowhere to be seen. So unbelievably rude and something I feel no end of guilt about, but I keep trying to remind myself it was better that than have been creating a scene by bawling for hours in the middle of what was supposed to be a happy occasion.

So I’ve been trying my best to prepare myself for this one. I’ve been pep-talking myself on a daily basis, reminding myself of what will be surrounding me, and trying to build my emotional armour ready for the big day. To add a bit of extra pressure, many of the guests at this wedding are the same as those who attended last year’s debacle. I’m going to have to be mighty strong to avoid a repeat of last year.

So far I’m holding up ok. We’ve been here 24 hours and the onslaught of babies and baby talk has been relentless. It’s like swimming in the ocean a little way out of your depth and having wave upon wave crash over your head trying to suck you down. You gasp as you come up for air, steadying yourself, but never quite recovering before the next wave hits. But I’m doing ok. A small moment last night where I thought I might drown but I managed to haul myself back to the surface with the help of my life-raft of a husband. I can do this, WE can do this.

The wedding is this afternoon, party tonight, brunch tomorrow morning then it’s done. We’ll see how we go. I do love hanging out with these guys so hopefully that’s enough to pull me through. Stay tuned.

1:32pm: Ouch it gets worse. One of the girls in our group is pregnant and the nickname for the 13 week old foetus growing inside her? Bumble Bee. Could life get any more cruel?

2:30pm: Starting to get ready. I can hear all the kids playing in the games room next door.

Approx 9:15pm: I’m doing ok. There are a fair few mentions of kids (the bride and groom have a ten-month old) and quite a few comments on ‘Bumble Bee’ but I’m coping. I can totally do this.

Approx 12:15am: One of the bridesmaids pops over to introduce herself, despite having met her the night before. She’s a little drunk. We exchange names and she asks if M is my husband. Then comes the dreaded question, “Do you have kids?” I’m ready for it, “No” I say and smile. I think we’re done but no, she launches into a tirade. “Oh that is the absolute best time, I mean it’s great having kids, I have a two year old, but that stage you’re at now is just awesome. There’s just the two of you and you can enjoy each other’s company and it’s just great, you make the most of it”. It went on, but you get the gist. I nod and smile and try to terminate the conversation. I may come across as a bit rude but it’s all I can do not too lose it. I know she means well and for any normal person that would probably be a lovely thing to say but for an infertile who’s spent two days bombarded with baby talk and four years trying to have kids, it’s less than ideal. She leaves and I spend the next half hour clenching my teeth so hard my jaw hurts and digging my fingernails into my hands to try and distract my mind from the mental torment, frantically clutching at my insides in an effort not to fall to pieces. I make it, just.

1:24am: I’ve done it, WE’VE done it. My life-raft of a husband has pulled me through. The dance floor is slowly clearing out and it’s a respectable hour to head to bed. Thank goodness cause I’m exhausted. A gorgeous wedding, an AMAZING wedding, but one filled with more than it’s fair share of emotional triggers for this lil infertile.


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