Weeks 10 - 12 #pregnancyDiary

Week 10 thoughts

This morning I had my ten week appointment at the doctor. It was early so hubby was able to come by for most of it before going to work. I was finally given the elusive Mutterpass (translation: mother passport), which is a booklet pregnant women in Germany get which contains all their relevant information for doctors. This has been categorized as a "high risk" pregnancy due to it being IVF and my 'geriatric' age of 35. That's a joke by the way. 35 is the new 25 don't you know? Anyway, the doctor spoke to us about pregnancy in general, what to avoid doing, what's ok. A lot of stuff I already knew. Some things which are relevant to how things are done in Germany, I didn't. For instance there's an optional test for Toxoplasmosis which health insurance here doesn't cover. It only cost something like 30€ though so I asked to get it done.

Regarding gene defects the doctor said, because I'm 35, the health insurance would pay for an amniotic fluid sample to be taken around week 14 or 16, can't remember now. However he advises against it as it carries risks. He even said that you can end up with a 'dead baby' that could have been perfectly healthy. He certainly doesn't mince his words! I'll be avoiding that test for sure, not taking any unnecessary risks. There is a blood test and based on that plus other factors (my age) will assess the risk of the baby having any gene defects. If it comes back as high risk, such as 1 in 50 then we could consider whether to get another blood check done (this is called the harmony test) which wouldn't be covered by insurance and costs around 450€. The doctor wasn't going to give me a scan at all today as I'd had one recently when I had the scare but I asked nicely! Well I said it would be great just to make sure everything is still ok. Unfortunately hubby had left at that stage as he had to get to work so he didn't get to see it. This time the baby didn't just look like a blob like last time haha! It was great, I could see the tiny little hands and feet moving around!

Oh man, I have so much love for the little baby! I wonder if it will be a boy or a girl. I guess I would have a slight preference for a girl, but honestly either is great! I think hubby prefers the idea of a boy but I also know he would be a great Dad to a daugher. We would like to find out. I'm not sure whether we would tell everyone else or not. Though probably we'd find it hard to keep a secret! I'm delighted to have gotten to the ten week mark. It's definitely starting to feel like a strong pregnancy now!

From around week six I did notice some very mild nausea but not bad at all. Since week nine though it got a lot worse! I also started having a lot more food aversions. The best way to help against the nausea has generally been to eat something pronto, although eating while feeling queasy isn't that pleasant, and it has been hard to figure out what I even feel like eating. Several times I've gagged but not thrown up, but I did end up having to get sick once after brushing my teeth. I've also gone off avocados which I used to love, I hate the idea of fish at the moment plus the dairy free vegan yogurt and ice cream I used to eat a lot of (it's made from a lupine plant) doesn't appeal to me at all anymore. The best food I've found is popcorn! So I end up snacking all day long basically to try to keep the nausea at bay which means I only have an appetite for small portions at meal times. Anyway, overall it is manageable. Being in the office has been a bit challenging as I just get so tired in the afternoons but hopefully it'll be better in a few weeks.

I'm planning to tell my boss and HR manager once I get to the 12 week mark if everything goes well at my check up. I googled something like "when to tell your work you're pregnant" and the first result said not to tell till weeks 16-20 at the earliest and then talk about all the great projects you did recently! I thought, wow, that must have come from a US site. No offense meant to any of my friends from the US. The article basically gave the underlying impression that your job is at risk if you are pregnant. I looked up some German sites and the message there was to tell your work at 12 weeks and the health of you baby has priority. There are lots of great laws here to protect pregnant women in the workplace. For instance you are not allowed to work more than 8.5 hours per day or be expected to carry heavy things or to be on your feet for more than four hours.

The doctors here have no problem giving pregnant ladies sick leave when needed. Sure, there may be women who abuse that for instance I have heard of one who got pregnant and didn't feel like working anymore and asked to be written off for all nine months, but in general that's not common and I think it's great here how the emphasis is placed on keeping you and baby healthy. Your boss is also not allowed fire you until at least four months after you've had given birth. And in Germany there is 14 months parental leave which you can share with your partner. Anyway, there are a lot of benefits to working in Germany! That's not to say that sexism in the workplace doesn't exist here, that's a topic for another day but there is good support for employees. Even when I do tell my boss and HR, I will still tell them that I would like to keep this pregnancy discreet. I would prefer to wait another month or so before other colleagues find out. I'm not sure how feasible that is since people can gossip and maybe I'll start showing at that stage. Right now I'm just really bloated but I think I have the beginning of a tiny bump too! Under all the bloat that is.

I had to phone the immune doctor to ask why my new treatment plan hadn't arrived yet. Turned out it hadn't even been sent! The receptionist sounded embarrassed and said she would remind the doctor and asked if I'd like her to scan the documents and send them by email to me first. I can see why this particular doctor gets such bad reviews, the main complaint seems to be that people are fed up with how slow everything takes! Anyway once the email arrived I had a look. Most things were clear and expected, it gave details on how to reduce the steroids and Granocyte injections. The baby aspirin tablets I'm meant to keep taking until at least week 24. This seems long to me but it's not such a big deal, just taking the tablets so whatever. Two things bothered me. Firstly it said that I have to get my blood checked again to look at the natural killer cell levels. If they are too high still then I would need to keep getting the Intralipid infusions for longer. That is such a pain. I'm so ready to be done with the intralipid infusions! Also I only have one bottle of the stuff left. They only sell it in boxes of ten and it costs about 200€ altogether then about 50€ per doctor visit to administer it not to mention the time it all takes. And the second thing was that it recommended I get a pre eclampsia test at week 13 since I am higher risk due to my missing KIR genes apparently.

I got a little upset about the email. As I was saying to hubby, I just want to have a normal pregnancy like most women and not to be so highly medicated and high risk and have all this extra stress! The thing about all the extra immune stuff is I don't know for sure if it is the reason this IVF and pregnancy is working or not. It could be the thing that made it work or maybe it would have worked anyway. I'll never know for sure. Obviously on the off chance that the Intralipids, granocyte, steroids and baby aspirin are the magic ingredients keeping the pregnancy going, then of course I'm going to keep them up! Anyway a while later I felt better. Getting the preeclampsia test shouldn't be a big deal. I'll show my doctor the letter from the immune doctor and even though preeclampsia itself sounds scary as long as the doctors catch it in time, it would be fine. And the fact that I have to send my blood off to get tested again is a pain but I'll just do it and hopefully the results will show everything is ok and I can stop the Intralipids finally.

My usual gyno is away on holidays for the month of August which was has been awkward. There are two doctors' practices that are helping out. Both aren't that handy to get to from where I live. I phoned them and neither had heard of Intralipids or wanted anything to do with them. It's not an easy thing to explain in German! So neither practice will give me the 12 week intralipid. I phoned the fertility clinic and they agreed to give me the 12 week one no problem so that's great but like I mentioned before it is really far from where I live. I'm going to have to talk a half day off work. The intralipid will be administered by dr. Peppy though, and I'm looking forward to seeing her again!


Week 11 thoughts

It feels like a long wait till the twelve week scan. I've been trying to think positively though and not let myself get too carried away with worries. At ten weeks I realised I am already one quarter of the way through the pregnancy which is a crazy idea! I have also been thinking recently about how lucky we are. I came across some statistics for IVF and the odds of it leading to a take home baby are really surprisingly low in general. It's still early for me and I don't want to count my chickens before they have hatched, but I am so grateful to have gotten this far. This was our 7th embryo. Six other perfectly good embryos were placed inside me over the past two years. One took for a few weeks but sadly wasn't to be and the rest just didn't implant at all for whatever reason. What made the 7th embryo implant and keep growing into a tiny human I have no idea! I wish IVF would work for everyone though. This is most likely going to be my last pregnancy too. Provided it works. I have no idea what we would do if the worst happens. Hubby and I both agreed we wouldn't want to go through IVF again. For many reasons. We have both accepted the fact that we will most likely just end up with one child and we have come to terms with that. Only children are very loved and I have no doubts that our single boy or girl will be happy!

I have a pregnancy app on my phone. It was fun to read today that the baby is the size of a fig now! On my gyno's advice I went for a teeth cleaning at the dentist. I actually always dread it a bit. I was scared of going to the dentist when I was a kid. It's gotten a lot better as I've gotten older but I still don't particularly like the experience. I hate all the noises in the dentist office, like the drill, ah! Anyway the teeth cleaning is normally not too bad just mainly uncomfortable and long. I have sensitive teeth too so some bits like when cold air is blasted on my gums is very unpleasant. But anyway it went fine. And I reminded myself that I'm doing it for a baby. Thinking about the little one moving around in there and growing is a really nice thought. This morning I also feel fine, not nauseous at all! Of course then I started to worry that it could be a bad sign but I googled it a bit and some women's pregnancy symptoms can start to ease off in week 11, so it's probably just that. A lot of women on the forums mentioned their nausea came and went a bit too. Like they'd have a good few days and bad few days again. According to my pregnancy app, you don't look pregnant at this stage just bloated and as if "you've had too much to eat" haha! If I pull in my bloated tummy I think I can still see a tiny bump. Otherwise I haven't noticed any other body changes really. Instead of my hair getting glossier, it's gotten frizzier. I think I'll need to use the de-frizz serum more often!

Week 12 thoughts

Before my appointment I felt a little nervous but not too bad, I had a good feeling that things would be ok. This time we went to a different doctor as my usual one is on holidays and this one was standing in for his patients. I had to do a pee test, have my blood pressure checked and get weighed. Then we went into the room to wait for the doctor. Once he arrived he asked what he can do for us today. I said, well I'm here for my 12 week scan! He looked at my Mutter pass and asked some questions about the pregnancy. I got another prescription for my thyroid meds. I asked about the pre eclampsia test which the immune doctor recommends. He said it's too soon and I can get it done at my next appointment.

He asked about whether we had done the first trimester screening (where they check for gene defects). We said we had done a blood test but then our doctor went on holidays and we hadn't gotten the results. He explained that the blood test alone doesn't mean anything without measuring the baby's neck which hadn't done as far as I'm aware. So that was annoying. The substitute doctor said he would take measurements today. We'll have to wait two weeks till our doctor is back from holidays to ask about the blood test results though. We asked this doctor his thoughts on flying to Ireland around six months and he said it's absolutely fine so that was nice to hear since my usual gyno is against flying altogether. We are still considering whether we might go to Ireland for a week around November.

Anyway then I had the scan. This doctor was a lot more thorough which was great! He showed us the baby, commenting on how great everything looked then proceeded to point out things like the spine and brain. At one stage he said something like "do you see that black dot there?" in a serious voice and in my head I thought, "oh God, is it a heart defect?" but then he said, "it's the baby stomach"! Then he showed the kidneys. He made a joke at one stage about the baby being a girl because she's so "sensitive" (eye roll) but then he said you can't actually tell yet, it's too soon. We'd like to find out the gender but I'm not in a huge rush, I can wait until the next scan. He measured the neck and said it was 1.5mm which is good, they want anything under 3.5mm. That shows a 70% odds of the baby not having down syndrome. You need to look at the blood test results too in order to say with 90% certainty. At one stage he commented that the neck was a little schrag which means crooked or bent! That made me worry as you can imagine. He said that the baby was in an awkward position and sleeping and he would try to wake the baby up to get a better look at the neck. He then proceeded to tap on my stomach! Then we all saw the baby start to move around! It was incredible. He said at that age they sleep every half hour. I felt protective of the baby already and didn't like him disturbing him or her. But I also wanted to get the measurements to make sure everything is ok.

Once baby was in a better position he measured the neck again and it was fine so that was a relief. He/She was also measuring perfectly for 12 weeks. Then baby fell asleep again. So precious! The doctor commented that while 95% of the placenta is in the right position, 5% is a little low so I might experience some bleeding again. He said if that happens, get it checked out of course but not to immediately panic about a miscarriage. He probably noticed I was still a little anxious because at the end of our appointment he told us that the odds of something going wrong are only 3% at this stage which was nice to hear. I then got the confirmation letter for work to say I'm pregnant. It continues to feel surreal that that there's a little baby growing inside me. Still a dream come true! Despite having some nausea bouts and the anxiety, I do love being pregnant and I am trying to enjoy this whole experience. My next appointment isn't for four weeks, crazy! but I guess at this stage everything is ok. Next week I'll get my 12 week intralipid done and then send my blood off to check the natural killer cells again.


Week 12 - later that week

It was strange making my way to my fertility clinic. It's only been six weeks since I had been there last but it felt like so much has happened since then. As I sat in the waiting room, I looked around at all the other couples and really hoped that things would work out for them. My fertility doctor, Dr Peppy set up the intralipid for me. It was really nice seeing her again. She said that the previous intralipid I had gotten at 10 weeks would have taken me to week 12 and I didn't really need to get another one (but I could). I told her that the immune doctor wants me to send my blood again to re-check the NK levels and she said that there is no need to get any more Intralipids done after 12 weeks. By this stage the placenta has already formed. As usual different doctors saying different things! I trust her though and it made me think that unless the NK cells have gotten really bad again that maybe I would choose not to get any more intralipids done.

A few days later I went to my GP to get my blood taken in the vials provided by the immune practice. Then I hurried to the post office and sent it all by express post. A few days later I asked hubby to phone to check my blood vials had arrived at the immune practice and to ask how soon I would get the results. The results were already there! My NK levels have gone down from 18.4%to 14.7%. They are still "borderline" but ok. I can stick with the current treatment plan, meaning I don't need to get any more intralipids. That's a relief! I was a little disappointed that my NK cells haven't gone down even more than that but anyway I'm not going to let it bother me. Some paperwork was missing, I was meant to send a referral in order for my health insurance to cover the blood test costs. I wasn't sure which doctor would give me one since my gyno is on holidays and the substitute doctor had mentioned he doesn't believe in all the immune stuff. Hubby phoned his practice and explained the situation and he sent the referral no problem though so that was a relief. It's nice the blood test is covered 100% by my health insurance this time.

A friend of mine lent me her fetal doppler. That's a device you can use to pick up the heartbeat at home. For some women they can get it to work as early as about nine weeks though others take longer. In my case I finally got to hear baby's heartbeat at 12wks2 days. That was amazing to hear and reassuring. I tried again a few days later. It took longer and I was only able to hear it for a few seconds but it was there. Then at the beginning of week 13 I had been feeling anxious and I tried that night and this time I couldn't find it at all! Hubby tried too but no luck. I started getting anxious but he said baby was probably in an awkward position and not to worry. I tried again the next morning before and after breakfast and still nothing! I found a heartbeat which was probably my own as it didn't sound fast enough to be the baby's. I was sorry then for using the fetal doppler at all. When it works it is very reassuring but when it doesn't it can be scary! Anyway, I tried again that night and finally I was able to find the baby's heartbeat for a few seconds. This time it was on the right hand side instead of the left, so many the baby has been moving around! I put the doppler away and I have decided I won't use it again for at least a week.

Now that I have reached the 12 week mark we are gradually starting to share our news with more people. Telling people makes me a little nervous. I guess it's difficult to feel totally at ease with this pregnancy after the long journey to get to this point. I still have a fear of it all being taken away. However, I have also been making an effort to enjoy each day instead of anxiously awaiting the next scan. I have been trying to stay as calm as possible and I keep telling the baby how loved he/she is! When I told the HR manager at work she gave me a big hug and was delighted for us. That was really sweet. Hubby has also been really happy about this pregnancy and it has been a sweet time. We were joking since the last scan that our baby loves sleeping just like his/her parents! I'll ask hubby "what do you think baby is doing now?" and he jokes back "probably sleeping!". I have also been sharing with him some of the facts from my pregnancy app. Like, I read that starting from week 13 the baby can start to hear things outside the womb! And they can also differentiate between light and dark. I am so amazed that from a bunch of cells a tiny person is now forming and growing. I pray that in six months time we'll get to meet our little one! In the meantime baby can stay put and keep growing and being loved.

Heartbeat

Trigger warning: pregnancy mentioned.


Firstly I wanted to say thanks so much for all the lovely comments and messages from everyone! It really means a lot to us.

Well I finally the day I've been waiting years for arrived. It was my first pregnancy ultrasound ever! The appointment wasn't till 5pm and it felt like such a long day waiting for it. On the way to the clinic, hubby and I both felt pretty nervous. I couldn't help thinking that either it was going to be an amazing moment or an awful one! Once we were called in to Dr. Peppy we spoke for a few minutes and then she suggested we do the ultrasound. I jumped up, pretty eager to finally see what's going on in there!

She started having a look and pretty immediately found something - the gestational sac with a tiny fetus..and a heartbeat too! I literally burst into tears at that stage! Mostly from relief to be honest. Just all the anxiety had been building up and I was so relieved and happy to know that everything is ok! The doctor also confirmed that there is only one baby in there. I did feel a little sad thinking about the other embryo that didn't make it but we are still absolutely delighted with one. A multiple pregnancy would have had more risks. We would be so grateful for one healthy baby! Once I pulled myself together and stopped crying I was able to ask some questions. It was so amazing seeing the little heartbeat! You can't really see much at this early stage (six weeks), just that something is there. The baby is only the size of a pomegranate seed!

Then Dr. Peppy discussed all my meds. I am to continue taking something for my thyroid plus baby aspirin. The Granocyte injections will be kept up every three days until I reach the 2nd trimester. I will need to continue getting the intralipid infusions every two weeks until then too. Progesterone tablets and steroids I can gradually start reducing now. And then she said that that would be my last appointment there, the next one would be at my local gyno! Wow, gradation from the fertility clinic already. We thanked the doctor profusely for all her help. She could see how happy and overwhelmed we were!

Afterwards I got another Intralipid done. That took almost two hours. The clinic had really bad reception so it was ages before I was able to message my family to let them know how the appointment went! Everyone was delighted. To be honest this whole experience still feels completely surreal. Sort of like I've woken up in a parallel world where our dream is actually coming true. This morning I phoned my gyno and arranged an appointment for two weeks time. I'll be eight weeks pregnant by then, please God.

I don't think either of us will be able to fully relax until the second trimester to be honest. I still have a fair bit of anxiety. That said, I am absolutely loving the thought that there is a tiny baby growing in there right now. I'm praying so hard that it will be a viable pregnancy and the little one will stick around. So far my only symptoms have been increased appetite, sore boobs, tiredness and lots of heartburn! Hubby is excited too. He's even been thinking about how many months he'd like to take as parental leave (In Germany, you get 14 months to share among the parents). It's so amazing to dream and imagine.

New doctor, new hope?

If you've been following our 'maybe baby' journey you might recall that I'd nicknamed our old doctor "Dr. Direct" due to his straight talking attitude. "Dr. Gentle" is the second doctor at the clinic who we only occasionally saw but seemed to have more empathy and was softly spoken. The first nickname that came to me about our doctor at the new fertility center was "Dr. Peppy"! She just seemed full of energy. Hubby commented afterwards she's probably a type A personality. She was nice and made a good impression. I think it will be easier if I use bullet points to sum up some of the main things from our appointment;

• She said we have done and tried everything already by now apart from me getting a uterine biopsy done. This is where they take a sample of your tissue and then you can have it tested for natural killer cells and/or plasma cells. If I have NK cells in my womb then the only way to treat it is to get the Intralipids infusions which I'm getting anyway for high NK cells in my blood so the doctor said there is no need to check for that. However if I were to have plasma cells, which seems to be some kind of infection then I'd need to take antibiotics for four weeks to get rid of it! She said it is unlikely that I have it but it would make sense to rule it out. The decision is up to us though. According to an information sheet she gave us, among couples with several failed IVFs/miscarriages behind them, between 10-20% of women in that group are found to have this issue. The whole thing would cost around 300€ out of pocket.


• She wouldn't suggest natural or mini IVF in our case. The follicles can be empty or contain immature eggs and it is often a wasted cycle. Since my health insurance will partially (50%) cover one more IVF it makes sense to do another full round. She discussed two possible stimulation protocols I could try. Her preferred one for me would be the long protocol. Around day 20 of my cycle I'd go there for a scan to make sure there are no cysts, then I'd use a special nose spray morning and night for about two weeks to down-regulate. Then your period comes and she said at this stage your hormones are at null and you then start to build them up from scratch with the injections. I'd have to go for two ultrasounds during the injection phase and then the egg retrieval would be around two weeks later. She recommends that protocol since I haven't tried it before and it *might* lead to them getting more eggs from me at the collection (no guarantees of course). She's seen it help some poor responders in the past.


• She recommended I should do the whole immune therapy stuff again. When I'd go in on day 20 for the ultrasound I would get the first Intralipid infusion done there, then the second one at egg retrieval stage and then third would be if I get a positive pregnancy test then every two weeks in first trimester. I'd also take the low dose steroids again after transfer plus the extra Granocyte injections. She acknowledged that those are a pain as they are expensive and not covered by health insurance (none of the immune therapy is). Last time we had to order the Granocyte meds from France since they are about 200€ cheaper there. Think it cost about 400€ for just five of those injections nonetheless! However if the Granocyte reduces my miscarriage risk of course I've no problem with it.


• She discussed some "extras" we could consider. For instance there is something called Assisted Hatching. This is where they use a laser to cut a tiny opening in the shell of the embryo to help it to get out better. We never went for it before as we just thought it sounded too artificial and that the embryo should be able to get out by itself! Hubby still thinks it's a waste of money but I'm conflicted about it now. I have read that when several IVFs have failed that it *could* help. It's so hard to know with these things. At some point when going through IVF you do end up thinking what's another 200-300€ in the long run since we've already spent so much on this and I want to give it our best shot. On the other hand I don't want us to waste our money on these unproven things. For our first round we paid extra for a thing called Embryo Glue. That isn't even offered at this clinic making me think it can't be so good after all!





• She talked about whether we'd want to let the embryos grow to day 5 this time. It would be a good idea if we were to have at least four but otherwise it could be a bit risky if we only have a few embryos. There is a theory that some embryos that don't survive in the lab might have lasted longer had they been transferred into the womb sooner.


• I'll mention here that PGS testing (genetic pre testing of embryos) isn't allowed in Germany unfortunately. ERA receptive testing which ecofeminist talks a lot about the importance of isn't available here either! You'd have to go to Spain for it we were told.


• The doctor wanted to take a blood sample in order to test my AMH and thyroid levels. When she phones me in two weeks with the results, then I can tell her if I have decided to do the uterine biopsy and if so make an appointment for it. She also wanted me to get a booster vaccine for polio & typhoid etc which I was also able to get there and then which was handy though it did give me a sore upper arm for days after!


• She said that yes some women do need to get their fallopian tube removed when it is blocked as sometimes the liquid inside it can drip down and cause a hostile environment. That was something I was worrying about recently. She gave me an ultrasound there and then to have a look but luckily my right tube, the blocked one, though slightly bumpy/bigger than it should be is not bad enough to require surgery to remove it


• We asked about our chances of trying naturally. Her answer was a little vague, along the lines of never say never but chances are very low. When there has been surgery or infection around the fallopian tubes then the tiny little hairs inside them can become stiffer making it very difficult for sperm/eggs to travel through them.


• I commented about how our embryos were great quality last time, plus I had done all the immune stuff and it still didn't work! She replied that even if everything is perfect, IVF still only has a 30-40% chance of working each time.


• In terms of supplements which I asked about, she said I could try taking 25mg of DHEA until IVF starts or I could take melatonin since both do more or less the same thing in terms of improving egg quality.


• We have a fair bit of paperwork to get sorted first if we want to change clinics. My health insurance approval is tied to the other place so we would have to reapply for approval. There is a requirement for couples doing IVF to get tested for HIV and hepatitis which we've already done so we'll need to ask our clinic for a printout of results. Also a different doctor not associated with a fertility clinic has to talk to any couple in Germany considering IVF about their options and tell them about the risks associated with IVF. We already had that talk ages ago but need to find the signed form otherwise we'll need to do it again.


• My gynecologist in the town where I live had offered that he could do some ultrasounds for me so that I wouldn't need to travel back and forth to the new clinic. However Dr. Peppy said that's not possible as they'd want to scan me themselves. Since I'm still not comfortable driving in Germany (haven't had enough experience here yet), I'll have to get public transport to reach the new clinic. It takes about 75 mins each way. It's not ideal obviously but I could catch up on my reading and try to get appointments that are either very early or late to work around my job or even take some half days off. It should be manageable.

Overall the appointment went well. That said, I left feeling very overwhelmed about it all and needed a day to get my thoughts straight. Hubby was a bit cynical saying of course they say we should do another round with them as they want the money and didn't feel convinced that anyone in the industry gives you unbiased advice. We had some differences of opinion on how to proceed but we are on the same page now. We've both agreed that we'll go for a fourth (and final IVF) at this new clinic.

I spent a few hours reading up about DHEA supplements and ended up totally confused about whether they would help me or not! On the one hand some studies have shown very positive effects for poor responders who take them. However I've also read studies disputing that. Some women on message boards talk about how they had much better IVF results after taking DHEA but then I read others saying it messed up their IVF and it was a wasted cycle! On top of that it can affect your thyroid and immune system apparently which concerns me since I already have immune and thyroid issues. I'm still on the fence. Melatonin has shown some promising results.

Something I did decide to order is Serrapetase. It's an enzyme found in silkworms and it's meant to dissolve old tissue in your body so it has even helped some women unblock their fallopian tubes and get rid of adhesions apparently! The doctor hadn't heard of it and it hasn't been clinically proven but I read through hundreds of reviews from people who bought the tablets and the majority were very positive. A few did mention it caused stomach upset so hopefully I won't be one of the unlucky ones with bad side effects. I've figured it's worth a try.

I an feeling quite overwhelmed at the thought of going through IVF again. I'm painfully well aware that just because we are trying a new protocol there is no guarantee that my body will respond better to it and grow more eggs so that's a concern! During the second round of IVF the doctor tried me on new meds and I only ended up getting one egg at the retrieval, my worst round. It was incredibly disappointing really. I've read online that poor responders generally have worse success rates than average. Even if I do get pregnant I'm anxious about having a another miscarriage. Hubby also commented that we could go through so much only to find out that something is wrong with the baby. It probably sounds like these are all very negative thoughts but I think we are just being realistic at this stage. We could be one of those couples that IVF just doesn't work for.

All that said, I am still hopeful. Sometimes I allow myself to fantasize about what it would be like to go to the doctor for a pregnancy ultrasound with my husband and see our baby moving around on screen, or how wonderful it would be to have our baby or babies growing inside me for nine months. I also imagine how amazing it would be having our child actually here with us! I'd love to bring him/her to trips to Ireland with me and there are so many people among our family and friends who would also have so much love for our potential offspring. I still hope and pray that this is something we will get to experience. However if it doesn't work out this Summer with our fourth IVF attempt, at least we'll know we gave it our best shot and be able to move forward without regrets.

Our five snowflakes that weren't

Over the course of the last year and a half we've had three IVF cycles and I've had a total of five embryos transferred into me. Five little snowflakes which had the potential to grow into babies but sadly didn't. I can't help wondering what kind of people they might have one day become. How many of them were boys, how many girls? Would they have had my eyes? My husband's smile? Or even our bad eye sight (haha)? Even though they were only growing and alive for such a small amount of time, I loved them wholeheartedly.

Last week we had the follow up appointment at our clinic ( also nicknamed the "WTF meeting!"). It turns out the two embryos that were transferred during our last failed IVF were rated 1 (which is the best possible mark here!) and 2 (which is also very good). Since hearing that, I have felt mixed feelings. Sad to think of our perfect embryos that weren't to be and wondering what went wrong, why even one of the two didn't take. The doctor put it down to bad luck. Everything looked great he said. It should have worked...

I've felt happy though that my partner and I are still able to create such good quality embryos despite the fact that I'm classed a poor responder to IVF hormones and don't have that many eggs grow each time. The doctor said that our egg and sperm quality are great which means we *should* be able to have a biological child. However, there are no guarantees with IVF, I've learnt that lesson time and time again. Sometimes you can have everything go right, transfer a perfect embryo and for whatever reason it just doesn't implant.

The good news is that the doctor says he's not worried about me running out of time and my fertility decreasing if I want to take several months break. That's a relief and I feel justified now in our decision to book our flights to Oz. I asked if it would be ok to wait until this summer and he said absolutely. I actually hate the thought of going through it all again; the Intralipid infusions, the injections, the feeling crappy, the egg retrieval procedure, the emotional upheaval. So I will need several months just to be able to gather my strength before I can try again anyway.

On Wednesday I went to my gyno. I told him about our plan to try the other clinic. He doesn't think they are any better than our local one, in fact he says their results are generally slightly worse. That was disappointing to hear! But he understands our wish for a second opinion after three failed IVFs at one place. He kindly offered that if we decide to go ahead with treatment at the other clinic, he could do some of the ultrasounds for me here and send them the results so that I wouldn't need to travel 60 kilometers there and back each time. That was a nice offer! I'll ask at the new clinic whether that would be feasible. He said he'll try to support me whatever way he can. For instance if I want to get the intralipids done again. He's a good doctor, I like him a lot.

He's not too impressed with natural IVF though when I asked him his thoughts on that because it still includes the egg retrieval procedure but has only low chances of success with one egg. He said it only makes sense for older women or poor responders. I explained that I AM a poor responder since he might not have realised. I only had 2 eggs during IVF#1, 1 during IVF#2 and four during IVF#3. He agreed it might make sense in my case then. Our fertility doctor isn't a big fan of natural IVF either. They don't even offer it here. But he encouraged us to go for a consultation at the other clinic to decide if it could be right for us. He said many women do a low dose / mini IVF with the drug Clomid which is much cheaper than the other meds once they run out of IVF rounds covered by their insurance. I couldn't help feeling a little sorry for them (and us). It's no fun reaching this stage!

That said, overall the appointments went well. It's great to have the support from my gyno in terms of getting intralipids or ultrasounds done so I wouldn't need to travel to the other clinic every time if we decide to get treatment with them (I'll just need to find out how much extra that might cost). And I'm happy to hear that we are still able to create great embryos together and that having a few months off shouldn't affect things negatively (that was one of my worries particularly after turning 35 last month). I've decided I do want to go for a fourth IVF, whether it will be normal / natural or mini, probably sometime this Summer because I feel (hopefully not naively) like there is still a little hope that it might work for us.. And my husband has also agreed to us trying one more time. At that stage we will both feel like we have given it our best shot and can then move on with our lives one way or the other!

After our appointment at the clinic I went shopping and bought myself some new Summery clothes for our trip to Perth in a few months time. A bit of retail therapy can be good sometimes! I am so over this freezing cold never ending winter here. It even reached minus 10 degrees this week. I hope the weather is a bit nicer wherever you are!

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 two..no 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!

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.

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.

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.

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!

Hope

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.

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...