Monday, January 9, 2017

What next?

Well I still can't really believe that we have three failed IVFs behind us now. How did I end up here? I just really thought that it would be third time lucky for us and I had already planned it all out in my head - how far along in the pregnancy I would be by which month and even when I would be due. It all seems a bit stupid now of course. If it had worked I would have had my first scan last Thursday. Wouldn't that have been something? The odd thing is that our first IVF was actually the most successful in that I was properly pregnant and for the longest, even though it only lasted five weeks. These past several months between the immune testing and treatments not to mention the IVF itself was just so all consuming. Now that it's over I've been feeling at a loss. Sort of aimless and unsure of myself. The support from all of you has helped me a lot. It really means a lot to me, so thank you so much!

While I was googling IVF failure, I came across this article which I found very helpful. There are few resources available for when infertility treatments don't work so it can be a hard and lonely time. It's been difficult as you can imagine but I think I am handling it well all things considering. I was grateful that I had a few days off before I had to go back to the office. I'm still feeling quite fragile. It seems like every time I log onto facebook there's a new pregnancy or baby announcement! How I wish that were us. Yesterday hubby told me that friends of ours had their twins on Christmas day. I am embarrassed to admit this but I burst into tears when I heard. They also went through infertility and had a long journey. Actually when I did my second round of IVF, they did their first and for them it was successful. I am delighted for them, just disappointed for us.

I would have been due this month if the second round had worked. I probably wouldn't have been able to travel to Ireland in that case if I was so far along, and I would have missed out on a lovely Christmas with my family though. I liked the suggestion in that article to take up a new hobby or write a list of things you'd like to do. So I've decided to jot down lots of simple things like restaurants we've been meaning to try out, places I'd like to visit and so on. I've also thought about possible hobbies like doing a dance class, writing a book or taking up painting so maybe I will try something new. It would be good to focus on something else for awhile.

We've gotten an appointment at the other clinic I mentioned for early March. It's actually nearly an hour and a half away but I have heard great stories from people who have gone there. I'm really happy we have this appointment and keen to hear what they tell us. We'll have a long list of questions for them! I've read about some women having success with certain supplements such as DHEA and royal jelly but I'd prefer to get a doctor's advice before taking them. They offer natural IVF at the other clinic and I'm planning to discuss whether that might be something we should try. I'm also wondering whether it would be a good idea to get the scratch done (again) to increase our chances and whether it would make sense to check my tubes to see if one is still unblocked. In the meantime we have to fill out a three page questionnaire and send them all our medical records etc. I'll have to go back to my gyno to get a referral.

Hubby and I watched a few Netflix documentaries recently that revolved around food and health that made an impact on us. The documentaries were basically about how there is way too much processed and fast food these days. And also that people should cut back on animal products and dairy. So we decided to make an effort to eat healthier this month. We have been trying out some new recipes and cooking together more which has been fun! Just trying to incorporate lots more vegetables in our diet, more home made stuff, less sugar. I've also decided to try cutting out gluten. I've been having some digestion issues on and off for awhile now and I've noticed on days I avoid gluten it tends to be better so I'm going to give it a go. I also came across some research indicating that a gluten intolerance could lead to overactive natural killer cells in some women so I've been wondering if that might be what's happening to me. If I can improve my digestion, be healthier and improve the NK cells over the next few months that would be great!

I'm also hoping to get my thyroid values back under control. The day after our transfer I got my blood tested and found out my TSH value had gone up not down (it went from 2.30 to 2.46)! This is despite taking meds to reduce it the previous six weeks. I freaked out, worrying that it would affect the embryos implanting (and maybe it did...) I went to my doctor and she prescribed me stronger thyroid meds as the ideal value for pregnancy is around 1 and definitely under 2. Not sure why mine went up not down though I've read that IVF hormones can affect it. A higher TSH value means underactive thyroid. So my plan is to keep taking the meds and hopefully get my thyroid under control over the next few months.

Several people have asked us recently about adoption. It saddens me a bit as it sounds like they don't think we'll be able to have kids ourselves whereas we haven't moved on from that hope yet. Years ago when we started having problems hubby and I had a chat about what things we would consider and he said he doesn't want to go down the adoption route. I remember feeling sad at the time thinking that if IVF doesn't work then we would end up totally childless but when I thought about it more a few days later I realised that I also don't feel particularly drawn to adoption myself. It's a great thing for loads of people, don't get me wrong, I just don't feel like it's right for us. I can't imagine having the energy to start down that long road either if our other treatment attempts fail. Also for me the biological connection is very important. My Mum died when I was younger and I love the idea of a part of her living on.

People have told me about friends who adopted and then got pregnant naturally implying it might work in our case but that's not a good reason to pursue adoption! We also don't feel comfortable with the idea of donor eggs or sperm. Both are illegal in Germany actually (However it is actually legal to "adopt" already created embryos from another couple here). Update: only donor eggs are illegal here. Basically if it doesn't work with our own DNA we would stop. Hubby didn't even want to try IVF initially but luckily came around to the idea. And at the beginning we had agreed on 3 (or max 4) rounds. I have been starting to wonder about what I would consider depending on what we are told at our next doctor's appointment. Going through infertility means you end up having to think about all sorts of things. One friend even suggested we go to India to find a surrogate! I can't imagine ever doing that and thankfully I haven't been told that I can't carry my own child so we don't need to consider options like that. Our doctor has never said there are any issues with our own eggs or sperm either. Both are good quality. I think the main problem is that I don't respond well to the IVF hormones and we don't end up with many embryos. Maybe our thoughts on donor eggs or adoption might change in the future but for now we are still hopeful that we might be able to have a biological child. I hope that doesn't come across the wrong way. Each couple has to decide what is right for them.

Our plan is to see what they say at the other clinic and then decide our next steps. I am open to doing a fourth round at some point. Hubby isn't so keen on the idea, like I mentioned before, he's already ready to stop and try to move on. However he's open to finding out what the new doctors have to say. He just hates seeing how hard IVF is on me. I have heard of women who take five or six rounds to be successful but I don't know how much more I can take. I tell myself it will be worth it in the end when we have our baby but I do worry about the long term effects. The emotional rollercoaster isn't good for my mental health either. Each failure just feels worse than the last! The hardest thing at the moment is deciding where to draw the line. If IVF is never going to work for me then I would obviously rather stop now than keep putting myself through it (and spending more money)! Our health insurance will pay towards a fourth round and it's great to have that option.

So that's where we are at now. I hope my post didn't sound too sad. It has been an incredibly disappointing time. I'm doing ok though. Feeling a little better each day and I am hopeful that maybe something will still work this year. I would love to be pregnant by the summer. Oh man, we would love that baby (or babies) so much! I would be the happiest woman in the world if it worked out. But I also want the doctors to tell it to us straight. If our chances are slim, I will try to accept that. In which case I will also start moving on. Hubby and I have also discussed what that might mean for us. We could consider getting a pet. Or we could plan some amazing holidays. Hubby has never been to Thailand. We would both love to go to the States together. It would also be such a relief to be done with all the doctor's appointments and injections. I hope by this summer we will have our answer either way. Please God we'll be able to have a healthy baby one day.

We are hoping to fly to Australia for my brother's wedding in April. It would be something to look forward to! Initially I had been thinking about staying here so that any potential treatments wouldn't have to be postponed but then I realised that I would regret missing out on seeing my brother get married and a month or two delay shouldn't make a big difference. My life has revolved around infertility treatments so much the past while and I'd like to focus on other things and try to enjoy life again!

Thursday, December 29, 2016

When IVF fails

Well the title says it all unfortunately. Obviously I wish I could be sharing happy news. The first few days in Ireland when I still thought I could be pregnant, I had a great time. It was really nice spending so much time with family and catching up with friends and it was also an ideal distraction from the stress of the past few weeks. On Christmas eve morning I did a pregnancy test and there was a very faint second line. That told me nothing though as I had given myself a shot of the HCG hormone three days earlier which could have still been in my system. I wanted to test again the next day but hubby wouldn't let me as he didn't want a potential bad result to spoil my Christmas.

The following day I woke up extra early and thought I felt different and decided to try again. I thought it would be a stronger positive and was thinking how nice it would to give my family the good news while I was there. The test was negative. At that stage I was just in shock and really upset. I had been so sure that it had worked this time that I hadn't really thought about the alternative. When I joined my family in the kitchen for breakfast I just burst into tears. They told me it was still early and not to give up hope until the blood test but I just knew. Still, I read some stories of women online who had negative pregnancy tests but nonetheless got a positive result in the end and I was praying for a miracle, though I just knew something like that wouldn't happen to me.

I felt really down that day. Having my sister there helped a lot and it was good to talk about it all. The GerMann was also really supportive and loving. We met up with a relation who has been dealing with serious health problems lately but she said she refuses to think "poor me" since so many other people are going through worse. Everyone has their own struggles (even though you would never think it from facebook sometimes!). Her courage also inspired me. The last few days of our trip I started to feel a bit more optimistic about things. I still knew it would be a negative result but I was able to focus on the good things in my life; that I have a great husband, my health and lots of people who care about me and that we would find a way to be ok whatever happens (even if children are not on the cards for us).

Today has been tough though. Even though I was prepared, getting the negative phone call is never easy. And I also feel a bit homesick. We had such a nice time in Dublin. We were constantly busy actually with so many people to spend time with that out house here in Germany now feels quite empty and quiet. I'm very disappointed as you can imagine. I really thought that IVF round three would work. Especially since I did all the extra immune treatment against my elevated natural killer cells. The GerMann thinks that this means that I don't need the immune treatment but at best your odds of IVF working are only around 30% anyway.

It is hard to know where to go from here. I would like to get a consultation at another clinic which is over an hour away which I've heard good things about. If they think they can help us then I would do a fourth IVF with them. That would be my last one though, I don't want to keep doing IVF over and over. Hubby would stop already. He thinks it would have worked by now if it is going to, that we should just try naturally and start attempting to move on. It can be hard when you aren't on the same page. He's agreed to going for a consultation at the other clinic though. They are closed now over Christmas and they have long waiting times but hopefully we'll get an appointment there within a few months. In the meantime we've been thinking about planning a holiday together. Funds are tight what with all the house related expenses and all the IVF and immune treatment but it would be good for us to have something to look forward to.

I considered the idea of going straight into a fourth round immediately. January and February are normally dull months anyway, maybe I could just get through that and then I would be done with it. Then I wouldn't need to start all the intralipids from scratch either. You see you are meant to get two rounds of intralipids done in the month before you start IVF so if I wait several months I would need to get them done again, that is if I would still continue with the immune treatment. However I think it would be too much for us to go straight into another round and I also feel let down by my clinic and think that the other place might be able to give me a better protocol. They also offer natural IVF there I've heard. Our plan is to just try to get our lives back and take a break from it all over the next few months and then depending on what the other doctor advises we'll decide whether to go for a fourth round or not. We also have an appointment at our current clinic in a few weeks to discuss what went wrong.

We did have a wonderful time in Dublin over Christmas. It had been ages since my whole family was all together. We didn't manage to meet up with everyone we would have liked to but we got to meet the majority of people. We're missing my cousin's wedding though since we thought I would be pregnant at the time and have to be back in Germany for treatment and monitoring but it turns out we could have gone. (Too late now, have already RSVP'd, plus haven't booked the days off work, no flights). Also I missed my Christmas work party which was around the egg retrieval. So that was annoying. Now we are finished IVF for now at least we can start doing things again and being social!

In February we have two friends from Ireland coming over to visit so I'm excited about that. We had some really nice chats in Ireland too. We met up with good family friends and I was open about our struggles to have a baby. It turns out it took them eleven years to have their son and they were able to relate to how hard a time it is when you wonder will you ever have children but can't look into the future. We have so many people praying and hoping for us. It will be sad telling them all that it didn't work. My mother in law sounded really upset on the phone when I spoke to her earlier. Infertility doesn't just affect the couple going through it but also their family, relations and friends. It's been a hard few days but in general I'm feeling ok and I know that we will find a way to keep going forward whatever the future has in store for us. I won't let this beat me.

Thursday, December 15, 2016

Eating for three

Yesterday I had the transfer. The GerMann was able to come with me this time which was nice and hopefully brings us some extra luck! On the way to the clinic I was feeling anxious. If two of my eggs didn't even fertilize maybe it was a bad batch altogether? Or maybe one of the embryos might have arrested and stopped growing. Once we got to the clinic the nurse at the reception remembered who I was and immediately told me that our two embryos were doing great. That was a relief and great to hear!

I listed to the Zita West relaxation meditation tape beforehand to get into the right frame of mind. The transfer itself went absolutely fine. The doctor said the two embryos are schön (beautiful) and four cell. I've since googled it and at 48 hours after egg retrieval you want the embryos to be 2-4 cells so 4 is great!

It was a lovely day. Hubby was very sweet to me and it was nice to feel hopeful. I mainly took it easy. The nurse had advised not to sit too much, so I lay down watching tv (Call the Midwife & New girl), baked some muffins and did a few things around the house. She had also advised me to eat lots of protein so I made some scrambled eggs and avocado for lunch.

A side effect from steroids can be weight gain and apparently increased appetite is the reason. I've already noticed I've been feeling extra hungry! I had a second breakfast after I came home from the transfer. I figure I'm not going to stress about gaining a few kilos. It doesn't matter in the scheme of things at all. When hubby and I were discussing what we'd have for dinner yesterday he remarked that I'm "eating for wait, for three now"! It was a cute moment.

I had my third intralipid infusion today and that went fine. It took almost two hours and was mainly just boring! The GerMann says I get bored easily though. I guess that can be true as I do find it hard to sit still for a long time. At the end of the Intralipid infusion it occurred to me that I'll only be getting the next one done if I'm pregnant in two weeks time. I so wish I could see the future! Tomorrow I'm going to my GP before work to get blood taken to check my thyroid levels have gone down. A TSH level below 2 is better for pregnancy according to the immune doctor.

I've been worrying and feeling anxious a lot lately. And then I worry that all this anxiety could be bad for the embryos so I try to stop myself! Before we started this third round of IVF I had been thinking that if it doesn't work there is always a plan B of going to another clinic for a second opinion and maybe trying the natural protocol. However lately I've just been thinking that I can't bear the thought of going through this all again. And would there even be any point? I'm not exactly an ideal candidate for IVF being a poor responder to the hormones. I would definitely need to take several months off from doctor's appointments and treatments if this fails before I could even contemplate next steps but then the thing with infertility is that time generally isn't on your side. The GerMann is ready to stop with treatments whenever I am. He didn't even want to do IVF in the first place. My desire for a baby has always been stronger.

I'm happy that the next two weeks I'll have quite a few distractions between working, visiting my husband's family and then Christmas in Dublin. The doctor gave me a note for the airport to say that I require certain medications so that I should hopefully not have any issues bringing them in my carry on luggage. I've worked out I'll only have to give myself two injections while I'm staying with my family which shouldn't be too tricky. Other than that I'll just need to remember the progesterone three times a day, the steroid tablets plus baby aspirin in the mornings and and a prenatal.

My moods are quite all over the place at the moment, which you might have noticed. Swinging from positivity to despair in a moment. I'm definitely feeling extra sensitive today. The best way for me to not stress as much I've found seems to be by not letting myself think about all the what ifs and just focus on the moment. Trying to do things that make me happy also helps. I created an upbeat 80s music playlist which I've been singing along to, plus drinking large amounts of (decaf)Barry's tea. Tonight we'll watch an Irish movie (Sing street). Other than that we'll just keep praying and crossing our fingers that it might be third time lucky.

Wishing everyone who reads this a lovely Christmas season and all the best for 2017!

Tuesday, December 13, 2016

Finding it all hard going

Where do I start? Yesterday I had the egg retrieval procedure. Even though it was my third time, I don't think it gets any easier. I still felt anxious beforehand. Afterwards I was very tired and groggy which I was expecting but I also had really bad cramps. There was a nice nurse looking after everyone that day and she gave me some strong painkillers. While I was recovering I remember just laying there thinking that I hate putting my body through all this and I don't want to have to do another egg retrieval again. General anesthetics often lead me to feeling quite low afterwards I've noticed in the past so it could be partly down to that. But I at the moment I've been feeling like I've reached my limit and I don't want to do IVF again!

After a few hours and a cup of tea the cramps were much fainter and I felt more like myself again. We went in to the check up with the doctor. This time it was the lady who I nicknamed Dr. Gentle on this blog. She's really nice. She looked at my chart and said they got four eggs from me this time. We were really happy with that news! Four eggs probably doesn't sound like many to the average person doing IVF but me being a poor responder it wasn't too bad at all. Our best result ever considering we got two during the first IVF and only one egg last time! I'd had six follicles so I guess two of them must have been empty. Yesterday afternoon and evening we were feeling generally happy and I texted everyone how it went. I was particularly excited thinking that we could even have extra embryos to freeze this time! That would be great as it would mean if this round fails I wouldn't have to go through the whole injections and retrieval again.

Today I've been feeling more disappointed though. Of course it wouldn't be IVF without being an emotional rollercoaster! The lab called and said that two of the eggs didn't fertilize at all! They didn't know why. We still have two embryos growing now though. And believe me we are grateful to have two, don't get me wrong. But. Sigh. I couldn't help feeling sad that we'd gone from having four eggs and hope for extras to now just having two. I've also been wondering whether I did something wrong. I've barely had any alcohol or caffeine the past few months, tried my best to eat healthy and taken supplements but could I have done more? I guess it's quite common that not all eggs fertilize. I'd just been lucky and had a 100% fertilization rate in the past. Maybe my eggs are starting to get old! Who knows, but I was feeling down today.

Yesterday afternoon ended up being a bit stressful trying to plan and figure out the extra immune treatments. I have so much to keep track of now, what with the usual meds from my fertility clinic doctor such as progesterone tablets every 8 hours and HCG shots on particular days, but now I also have prednisolon which is a low dose steroid, baby aspirin and Granocyte an extra injection. The latter I won't start taking until five days after transfer and then only on certain days. We went to the pharmacy and it costs almost 800€ here in Germany! It's not covered by my health insurance. We remembered that the immune doctor had told us it's much cheaper in France so when we got home hubby spent over an hour researching which pharmacies could have it. We found a place that delivers to Germany via express post and it only costs closer to 400€ which is great. However then I started stressing out that the fertility clinic doctor had given me the wrong amount on the prescription. It looked like I hadn't been prescribed enough to last until the pregnancy test. Anyway we wrote to the place in france to clarify the amounts and it's ok now. If I get pregnant then I would need to get a new prescription asap to order more though. I was chatting to my sister last night and just saying how stressful it is trying to keep track of everything I need to take and when and making sure I have the right amounts!

This morning after the phonecall I had a bit of a cry. I guess I'd had high hopes for the antagonist protocol working wonders and was really hoping it would lead to me getting way more embryos than usual. Maybe the natural IVF would be better in my case. Today just reminded me that you never know what's going to happen. I'm also just feeling down that we have to do IVF at all. And even if I do manage to get pregnant, it would be considered high risk and I'd have to be monitored closely (my immune doctor said)! I'm doing the intralipid infusions and taking low dose steroids to prevent my overactive immune system from treating the embryos as foreign bodies. On top of that I'll be injecting myself with Granocyte, something used for cancer patients, because I am missing certain KIR genes which are important for placenta formation and it is has been found to help reduce the risk of miscarriage in women who lack those genes. It's all just overwhelming sometimes!

But anyway I need to pull myself out of this slump. We still have two potential future babies growing right now in a lab so I'll try to focus on that. Tomorrow I go in for a two day transfer. Once I have them on board I'll start feeling happy and more hopeful again! There's nothing wrong with a good cry now and then though. No one can be strong all the time.

Saturday, December 10, 2016

So far so good

On Wednesday I had an ultrasound to see how I'm responding after almost a week of IVF hormones. The days leading up to the appointment I started feeling a little nervous. I've had some stomach twinges and light cramps now and then but otherwise no symptoms at all. During my second IVF cycle I barely responded to the meds so I was worried that the same thing might happen again. However I decided that worrying isn't going to change the result either way and I would try my best to just wait and see how the appointment goes.

The ultrasound showed that I only have one follicle growing on the right hand side unfortunately, but the good news is that there are five on the left. Interesting since the right hand side is also where my blocked fallopian tube is. Of course, I won't know how many eggs we'll end up with until after the retrieval and I've had empty follicles both times before. All things considered though, I am feeling happy enough with how things are going. I am trying different meds this time which could lead to a better outcome and we should at least get a few good eggs from the six follicles. All we really need at the end of the day is the one perfect embryo!

I was told to keep doing the injections for three more days and then this evening I'll do the trigger shot. For anyone reading who's not in the know, the trigger shot is the one that brings on ovulation 36 hours later. The timing is crucial! I'll have to give myself two trigger shots this time (Decapeptyl), one at exactly 10pm on one tummy side and the other at 11pm on the other side. The egg retrieval procedure is scheduled for Monday morning. That means today I'll have had a total of five injections! I was just contemplating recently how far I've come. I used to be scared of needles and I didn't know how on earth I would be able to do IVF which involves giving yourself daily injections. The first IVF I found them quite hard to be honest and I would dread doing them each day. The second IVF it was a lot easier and now for the third it's practically a breeze! Ok, it can still hurt a bit and it takes time preparing the meds and so on but I have no big problems with injecting myself anymore! Never thought I'd hear myself say that. It feels good to conquer that fear.

This weekend we don't have any big plans so I'll mainly be taking it easy. Right now is not the time to come down with anything so I'm also thinking of avoiding the shopping crowds in town. I'll be transferring two embryos next week, if all goes well! We decided to stick with two even though our doctor was pushing for three. I've read a German study that says that there is no need for so many, that two is the ideal number (for a three day transfer). We just want the lab technician to select the best two and if there are any decent ones leftover freeze them. Another thing I've heard is that embryos can split so even if you only transfer one it is still possible to end up with twins! Something to be aware of. When I was waiting for my last appointment at the fertility clinic a couple with triplet toddlers arrived! The kids were cute but very loud and it was exhausting just watching them. And that couple are back for more, Yikes!

I mentioned I've been feeling mainly positive this IVF cycle. I've decided to let myself be optimistic and hopeful. Focusing on getting through each day at a time is also helping I find. Plus eating loads of chocolate! I'll update again next week after the egg retrieval, finger's crossed that will go well!

Sunday, December 4, 2016

A new month and a new start

Thanks for all the support and encouragement on my last post where I spoke about some of my thoughts going into my third round of IVF. I'm already a few days into it now and despite a stressful start, everything is going pretty well so far. I've been feeling some occasional twinges in my stomach so hopefully that means something is happening and that I'm responding to the meds.

Why was the start so stressful? So usually I am meant to wait for my period to begin and then go in for my initial appointment at the fertility clinic within the first three days. On Thursday before leaving for work I phoned them to say I'd like to come in early the following day. First they had me on hold for ages and then they told me that Friday they are too busy and that I should go there immediately! I made my way to the clinic as quickly as possible while phoning my manager to explain that I had a doctor's appointment and I wasn't sure how long it would take but probably awhile. It wasn't ideal timing wise since Wednesday morning I'd had my second intralipid infusion and hadn't gotten into work until late morning. However I'd had a doctor's note and that was no problem with HR.

After waiting to see the doctor he gave me a scan then told me my ovaries looked great (you're too kind!), as did my lining and he wanted me to already start injections that same day! He also commented that he really doesn't know why I don't end up with more eggs at the retrieval. You and me both! If you've been following my journey you'll know I only had two eggs at the first IVF and just one at the second. This time I'm doing the antagonist protocol which I haven't tried before. He also gave me lots of forms for us to fill out including one where you choose how many embryos to transfer, either one two or three. He started being really pushy saying we should choose the maximum this time! He's said that before. Hubby and I both think the idea of putting three embryos in, if we even end up with that many, seems a little scary! Anyway I said we would think about it as I wanted to go home and do some more research.

After I'd seen the doctor the nurse explained the treatment plan to me, showing me how to prepare the meds and then gave me the prescriptions. There was a problem with my health insurance as it turned out the clinic were missing the document which confirms it would cover 50% of the costs. The nurse said that technically they aren't meant to prescribe me anything and I shouldn't start before I have the confirmation. The previous approval document had expired you see. However I had already gone to my health insurance back in September and gotten the approval, I just didn't know where the document had ended up so I was still allowed to begin with IVF luckily. She told me to get things sorted asap though!

Following that I went to the pharmacy to buy all the meds. I'd brought two cool bags with me which is just as well as they were both full afterwards, plus a third bag. The total came to over one thousand euro, yikes! I don't want to complain about the cost of things too much as I know we are very lucky to live in a country where there is such good health insurance coverage. From what I have seen on blogs and other IVF groups infertility treatments are a lot more expensive in other places. I definitely feel grateful that we are in the position of being able to afford three cycles where we live. The costs do still add up though. Last year we spent over three thousand on IVF and related medical costs and this year we're predicting it will probably be around twice that.

While I was waiting for my tram home I phoned my health insurance to try to get that sorted. They insisted they had given me the document already. (Later that evening I said a prayer to Saint Anthony, the patron saint of finding things who everyone prays to in Ireland, and after searching for awhile the missing document turned up. So that was a relief!) Once I got home I put the meds in the fridge, gave myself the first two shots which went fine and hurried to work. I gave HR my doctor's note, worked a bit and went to lunch with a colleague.

Once I got back my manager called me into his office. I thought he was going to ask me about how I was. When I had told him about IVF a few days earlier he had seemed understanding. However he basically told me that I shouldn't have gone to lunch and that the company was doing something very nice letting me go to these doctor's appointments and I should be working through my lunch and that's what I should do next time. The whole thing caught me off guard and I just said ok and then felt bad afterwards. I had considered skipping lunch but since I had also given lots of blood earlier (they give you a HIV test before starting IVF) and had had two injections I thought it would be best to eat a proper meal. I also had planned to stay till around 7pm that evening. I am not the sort of person to not take my job seriously. I've often done overtime and I always make sure to work my hours, I rarely take sick days and even when I do I tend to feel guilty! So I felt a bit annoyed that none of that seemed to count for anything.

I've two work colleagues who I'm good friends with who know that I'm doing IVF and I asked them what they thought about it when we were on our own later on and they both said that my manager was out of line giving me a hard time. When you have a doctor's appointment here in Germany during work hours, you usually give the note to HR to explain your absence and then work a normal day, you're not required to skip lunch or eat at your desk. The whole thing just made me feel like my manager isn't as supportive as I initially thought. Maybe he doesn't think infertility counts as proper illness. He also told me about friends of his who stopped trying to get pregnant and then it happened and maybe I should try not thinking about it all so much, which was just a ridiculous thing to say! Anyway my next doctor's appointment won't be until Wednesday and it's very early so I don't think I'll need to miss work for it and I've decided I'm not going to talk to my manager about it all again. The main thing is HR are supporting me.

The last few days I've done the injections, one of Menogon, one Gonal-f and then from tomorrow I add a third injection, Orgalutran. So far I've been feeling fine. Some light cramping now and then and a bit bloated and tired but that's it at the moment. I've also been feeling generally happy and optimistic, which is nice. At my scan on Wednesday I'll find out how many follicles are growing so I hope that goes well. The egg retrieval could be as early as next Friday! The antagonist protocol is a lot faster which is great actually. I'm excited to get to the transfer sooner. One day at a time though. I've also been trying to look after myself while I go through this whole process again. The other evening I had a relaxing bubble bath and read one of the many new books I bought myself recently. The GerMann is also being supportive, giving me cuddles and doing the brunt of the housework. I'm posting a picture of the Christmas markets with this post as it's prettier to look at than injections and I'm trying to get into the Christmas spirit! Hope you are all having a nice December.

Tuesday, November 29, 2016

Some thoughts as I approach my third round of IVF

The last few days have already felt like a rollercoaster of emotions and I haven't even started the IVF process yet!

Anxiety and apprehension

I found it hard to sleep the night before last with so many thoughts racing through my mind. How am I going to cope with it all this time around? How will I juggle IVF with my life and job? I have also been feeling stressed about the intralipid infusions which I am meant to get every two weeks at the immune doctor's practice. It's quite far away and awkward to get to so I would have to take at least a half day off work for each appointment.

December is going to be a busy month, busier than I had realised. This year we have loads of people to get Christmas and birthday gifts for and to be honest I always find present buying stressful! Trying to figure out what to get someone that they don't already have and that they would like and then trying to locate it or hoping it will arrive in time if you order it online. Once I start the IVF process I'll be more tired than usual and especially lately with the weather so cold and dark I'm not going to be feeling very much like wandering around the busy shops. I'm hoping to buy a lot of stuff online. It still doesn't solve the problem of figuring out what to get people though!

Not to mention all my worries about how IVF will go this time. Will my body respond better to a different protocol? Will I get more eggs at the retrieval or end up with empty follicles again? How many embryos will we end up with? Is it possible we might have some extras to freeze? Will I get pregnant and please God get to keep the baby this time? Or babies, since in theory we could end up with twins!


Well of course there is always hope, it's what keeps me going through infertility treatments. The dream of having our child or children one day. The idea that we could have a baby by next Christmas. Wouldn't that be wonderful! We already have a room in our house that would be perfect.

Realism, bringing myself down to earth

I try to remind myself that IVF generally has higher chances of not working than it does of being successful. For whatever reason it could very well not happen this time and we need to be aware of that and ideally not get our hopes up too much. That is really hard for me though, as the only way I can get through the IVF process.- injections, side effects, etc is the hope that it might lead us to our baby. So I don't know whether I will be able to keep calm going through it.

The GerMann and I have already spoken about what we would do if it doesn't work. Take some time off from it all, plan a holiday and then if we feel up to it go to another clinic for a second opinion. If they think they can help us and say that a fourth round has a good chance of working we would consider it, but only if I feel like I can physically and emotionally go through it all again. It is quite possible that we might both decide that we have had enough with IVF at that stage. And if that happens I've reminded myself it would not be the end of the world. Our lives would not be how we imagined but we could still find a way to be happy..

Optimism and positivity

I've actually been feeling really positive yesterday and today. I had an appointment with my local gynecologist. He hadn't received my emails for some reason but when I told him about the immune treatment that has been recommended for me, he knew all about intralipid infusions and has even supported other patients with them. So the good news is that I'll be able to get the them done at his practice. He'll charge me for it (50€ each time) of course but it means I won't need to miss as much work. So that was a relief. I'll go there tomorrow for my second intralipid infusion.

And then the other thing is that I decided to tell work that I would be going through infertility treatments and explain that I will need to go to a lot of doctor's appointments over the next while. I had been feeling quite nervous about telling them, especially as I am quite a private person about stuff like that but it could not have gone better! Both the HR and my direct manager were really supportive. It won't be a problem at all if I have to come to the office late after attending the various appointments and the HR manager even told me not to worry about work, that I just need to focus on this which is more important! My manager told me he had already suspected but didn't want to ask. He's had lots of friends who've had infertility issues. It felt like a weight has been lifted off my shoulders to get that sort of support since I had been feeling anxious about how to juggle IVF plus the added immune treatments with my job.

So lots of mixed emotions overall but at the moment I am feeling fairly optimistic and ready to face IVF round three.

Thursday, November 17, 2016

First intralipid infusion down

On Tuesday I got my first intralipid infusion done. This was for my elevated natural killer cells. When the doctor inserted the needle into my arm it was sore for a few seconds but otherwise the whole thing was painless. The speed at which the solution was dripping was set extra slow since it was my first time getting it done and it lasted 2.5 hours altogether.

The GerMann came with me since the doctor said I should be accompanied the first time. Just in case something went wrong I guess. I was glad he was there to keep me company as it was quite boring! I had also brought some snacks with me as other women who had gotten the intralipid infusion mentioned feeling hungry. Later that day once we got home I felt exhausted. That could have been a side effect but it could also have just been from the stress of the past week!

Oh man, where do I start? So the first intralipid was due between days 5-10 of my cycle before I start IVF again. When we had the phone call with the immune doc several weeks ago we had explained the timing of things, that we wanted to do IVF in December. She assured us that we would receive the treatment plan and prescriptions in two and a half weeks. I worked out that should still give me a week to get the intralipid meds in time for the first session.

Firstly I didn't realize that getting the intralipid solution itself would be difficult. I asked at two pharmacies here. One took my number and called me back saying it's called Clinoleic in Germany. When I looked up the consistency of that, it's made from different ingredients so I decided it would be better to stick with the exact medicine I had been prescribed. The other pharmacy just said a flat out no they don't have it. The immune doctor had mentioned it's possible to order the intralipid from Austria. I looked up some pharmacies and contacted two in Austria, one in France. One didn't have it, the other said you can only pick it up from there, but the third said they have it and once I send them the prescription they can send it out and it should only take 1-3 days to arrive in Germany. Great.

However three weeks passed and I still hadn't received the prescriptions and treatment plan from the immune doctor. The GerMann phoned and was told that despite our files being marked as urgent, they still hadn't been processed! I asked him to phone back and ask whether they could at least scan the intralipid prescription and send it by email so that I could order the meds in time. They did that though it took another two days for some reason. Once I got it I immediately send the prescription to the pharmacy and ordered the meds. That was last Wednesday and I knew my first infusion should be the following Monday ideally. I did think that if it ended up being a day or two late, it probably wouldn't make a big difference but I wanted to follow the doctor's recommendations ideally as closely as possible. (It didn't end up arriving until Monday but luckily just in time for my appointment on the Tuesday.)

In the meantime I'd been having trouble finding a doctor who would administer the infusion! Initially Dr. Direct at our fertility clinic had said I could get it done there but then during the phone call with the immune doc she mentioned he had written to her saying the opposite! I wasn't sure whether he had sent the letter before or after our appointment with him so we decided to try to find another doctor just in case. The immune doc had suggested we try a regular GP and I'd seen on a facebook group I'm in for German women dealing with infertility that most of them just got the intralipid infusions done with their local GP, no big deal.

That would have been too easy though! We went to my local doctor (I bought hubby along to help explain it all in German). I knew this particular doctor was pretty anti alternative in general but I figured it was worth a try since the location would have been so handy. Disaster. We started by explaining the blood test results and the recommendation for thyroid meds. She said she had read mixed articles about the ideal thyroid values for pregnancy and isn't convinced that my levels are too high but she reluctantly agreed to give me that prescription and I can come back in six weeks for another blood test there to check my values again. Then we bought up the intralipid treatment and she was totally against it! She called the whole thing "hocus pocus" basically and said she understands our need to "clutch at straws" but we should be wary of people trying to take our money for some new treatment without enough clinical trials. She didn't come across as being very understanding or sympathetic and afterwards I felt pretty pathetic.

We decided to try my other GP in a different part of town next. Yes, I have two since sometimes I can't get an appointment at the one in town and then the local one is handier. Anyway the other doctor was a lot more understanding. She seemed to comprehend how the natural killer cells could be too high and prevent an embryo from implanting. She said she would phone the immune doctor to talk to her about it and then call me to let me know in a few days. It seemed quite promising that she would agree and I felt sure that the immune doctor would explain the whole thing to her and persuade her. Anyway several days came and went but still nothing. The GerMann mentioned that it's very hard to get through to the immune doc so maybe she I should give it more time. After a few more days, I phoned the doctor myself. The receptionist told me that the doctor had said that I can't get it done there and that I should rather ask my gynecologist. It was Thursday at this stage and I was meant to get the first intralipid done by the following Monday, so I was definitely starting to feel stressed! The GerMann and I couldn't get through to our fertility clinic by phone so we wrote an email to Dr. Direct explaining we weren't able to find another doctor and could we get the intralipid done there asap.

He replied saying as per the letter he had written to the immune doctor, he wouldn't administer it in his surgery. Just a short email, no reason. At this stage I was definitely starting to worry! Neither hubby nor I were impressed with our fertility clinic doctor for not helping us out. The other clinic where we had considered going for a second opinion but didn't in the end support immune treatments there. But anyway we wrote a super polite email back saying we had tried other doctors but couldn't find any and thought we could do it there if we were stuck, and could I at least get the first intralipid infusion to give us more time to find someone in time for the next one two weeks later. Then his receptionist phoned and explained that they just don't have the capacity at the moment and that's why they can't help. They wouldn't have anyone to check on me while I was getting the intralipid and they are sorry. So then I emailed my gynecologist who was on holidays explaining the situation but I knew we wouldn't get a reply in time.

Next hubby phoned the immune doc to ask if she knew of any doctors in our area who might do it but she said that she's had other patients from where we live who also couldn't find any doctors willing to administer the intralipid at their practice. So we ended up having to make an appointment to get it done at the immune doctor's practice. We made the appointment for Tuesday, to make sure I'd have the intralipid meds by then (just as well since they didn't arrive till Monday mid morning!). Considering I needed someone to accompany me and how far the immune doctor's place is (two hours with public transport or an hour by car), both the GerMann and I had to take a day off work. I do have a few days left till the end of the year which I'd been saving in case I needed them for IVF so it wasn't too hard getting the time off but it was still awkward and not ideal since I'll need to get the intralipid done every two weeks.

Anyway, so we rented a car via car sharing and the GerMann drove and everything went fine in the end (apart from some arguments in the car. I was using my phone GPS to navigate and there was some miscommunication over when he was meant to take some turns! We ended up missing our motorway exit and taking a slight detour). We made the next appointment there at the same place for my second intralipid which is due in two weeks just in case we still can't find another doctor by then. This time they had an available appointment for the afternoon so I could probably manage by only taking a half day not full day off work.

The immune doctor also gave us a letter to give to the next doctor we ask which says that I had no bad reactions from the medicine and explaining what needs to be done. I scanned it and emailed my gyno again. He still hasn't replied and it's been a week. I'm wondering whether my emails might have ended up in his spam folder! I guess I'd better try to phone tomorrow to find out which also means probably trying to explain the whole thing in German to his receptionist on the phone. I wish getting the immune treatment wasn't all so difficult! Overall I am happy the first intralipid infusion went well though and I guess I'll manage somehow even if it means taking half days off work every two weeks.

There were some baby albums in the waiting room at the clinic full of photos and letters from previous patients who had been helped by the immune doctor. It was really nice reading some of the stories! One wrote that words can't express how grateful they are for the help and that they now have their wonderful child. Another letter in particular stood out.

Roughly translated it says;

Dear other couple who are reading this in the waiting room, don't give up. You are so close to your goal, keep going. It is worth it!

Normally I hate the "never give up" advice you often see on infertility groups, usually said by someone who has their baby because the fact is infertility treatments don't work for everyone. Also there is nothing wrong if a couple reaches the point where they decide to stop and accept a childfree life. That is a brave move. However reading that letter and the others made me wonder whether maybe we are close to being parents, that this might just work for us... And I ended up getting quite teary and emotional in the waiting room! Will we be sending a baby card to the immune doctor thanking her for her help in a year's time? Only time will tell...