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.

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.

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!

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...

The lost art of letter writing #bookClub

I read two books a while ago for my book club which were too good not to share. With both I found myself immersed in the worlds created, I loved the characters and didn’t want the stories to end! Jojo moyes is the author of the well-known book and now movie „Me before you“. I enjoyed her writing and decided to try another one of her books, entitled “The Last Letter from your Lover”.

This novel mainly tells two stories. One set in the 1960s and centres around Jennifer Stirling, a wealthy married woman who wakes up after an accident having lost her memory and tries to put the missing pieces of her life back together when she discovers some old correspondence from a mysterious lover. In 2003 Ellie, a young journalist stumbles across these old now lost love letters and the two women’s lives intertwine. The book was well written and tells of an amazing love affair. Of course things are never simple and there were lots of clever unexpected and unpredictable twists. Overall I found it a satisfying read which I personally preferred to “Me before you”. I've since ordered another of her novels, "The Ship of Brides", which also has an interesting premise and is set in the past.

The second book I devoured in just a few days was “The Guernsey Literary and Potato Peel Pie Society” by Mary Ann Shaffer & Annie Barrows. It centres around Juliet Ashton a writer in post World War two London who begins a correspondence with someone in Guernsey which had been under German Occupation during the war. The book is told through a series of letters back and forth between various characters which initially I found quite unusual but as I got more into the story, the letter style suited it perfectly. All the characters in the book really come to life and I loved being transported back in time before the art of letter writing has mainly fallen to the wayside. Books don't often make me cry but I did shed a fear tears at a particularly sad moment. Reading some of the stories about the war, the sort of things that did actually happen, was hard. Overall an interesting and heart-warming read.

Let me know if you read either books and what you thought if you did! Or if you can recommend anything else.

We have a plan

We finally had our phone consultation with the immune specialist doctor which we had waited six weeks for to discuss our blood test results. The GerMann downloaded a recording app on his smartphone beforehand so we could record the conversation in case there is anything we might miss. I was also worried that I wouldn't understand all the medical terms in German.

The doctor was nice and explained things well. The good news is that I don't have any indicators for an autoimmune disease, just the high NK cells by themselves. I will have four different new meds to take as part of my treatment. The first is Thyroxine for my thyroid. I was surprised at this as my throiyd values were all within range. My TSH value was 2.30 (the range given is 0,34 - 2.50). However the doctor said that she would like to reduce that value and that 1 would be more optimal for pregnancy. I should be able to get a prescription for it with my general doctor and then she suggests getting the values tested again in four weeks.

The next thing is the intralipid infusion which I had been expecting due to the elevated NK cells. She suggests getting the first one between day 5-10 of the cycle before IVF, then between day 22-28 and finally after the egg retrieval before the transfer. If I get a positive pregnancy test then I would have to keep up the intralipid infusion roughly every two weeks. Possibly until the second trimester but I think I would be given another blood test to check on the NK cell levels.

Another drug she recommend is called Predisolone which is a steroid. I would start taking that after the transfer but in a very low dose which would then be gradually reduced once I get pregnant. The side effects from that are weight gain and insomnia. And the final extra medicine is called Granocyte. This is because I am lacking a few "KIR" genes which can lead to a higher risk of miscarriage and problems with the placenta development apparently and this I would take in injection form starting after the transfer. According to the website: Various studies (Würfel 2010, Scarpellini and Sbracia 2009) have shown that the pregnancy rate increases significantly and that the success rate of pregnancies in patients suffering from recurrent miscarriage shows a similar increase with treatments incorporating granocyte starting from the implantation phase.

I asked about whether it would be ok to fly to Ireland for a week around Christmas and she told me that she used to advise people not to fly at all but she has had loads of patients travel abroad for treatment and it hasn't affected their results so she thinks there is no problem with us going to Ireland, a short flight, for a week after the transfer. So that was good to hear! We will have to miss my cousin's wedding in early January which is disappointing but we will be with my family for Christmas itself and that should also help the two week wait pass quickly! We would fly back to Germany in time for the blood test result and then if I get a positive test I'd continue with the meds and treatment.

The doctor also mentioned that our fertility clinic doctor, Dr. Direct, had written to her saying that he wouldn't administer the intralipids at his clinic. This confused us as he had told us at our consultation a few weeks ago that I would be able to get it done there and that he would support the treatment. So now I'm wondering whether he had written her the letter before our chat with him and changed his mind or whether he decided after talking to us that he doesn't want to administer the intralipid at his practice for some reason!

Apparently the intralipid medicine itself is difficult to procure in Germany. You either need to find an international pharmacy that will order it for you or you contact a pharmacy abroad such as in Austria yourself. The immune doctor also mentioned that medicine is cheaper in France and we'll save money if we buy some of the meds there. We need to wait until she sends us out the prescriptions and treatment plan before we can buy the meds though. She said she would send it in about two weeks. In order to go ahead with IVF in December, I would need to get the first intralipid infusion around mid November so I just hope I'll be able to get the meds in time and find a doctor willing to administer it.

So there you have it! I feel positive having a plan and happy that I should be able to get started soon. I hope things will work out timing wise, that we'll be able to get the meds required and that I can start the intralipid infusion in a few weeks. I am a little anxious about potential side effects and how I will respond to everything. However, I'm a member of a German facebook group and a lot of the women who followed the treatment plan suggested by this immune doctor had success which is promising. Let's get this show on the road!

Juggling act and living in limbo

Ask any couple going through infertility treatments and they will be able to tell you all about the many ways that it interferes with their lives. Whether it's dealing with the hormones and side effects, managing all the appointments, experiencing the emotional rollercoaster, giving up alcohol/caffeine/whatever, having to miss out on things to save money or not being able to plan much in advance, it becomes really difficult to juggle your life! I've a good friend who regrets how much her and her husband's lives were put on hold during all the time they were going through treatment. They barely went on any holidays together, certainly not flying anywhere so she didn't see her family who live abroad for years. I have always made an effort to try to still live my life as much as I can while going through all this. We postponed our second IVF cycle for instance so we could enjoy Christmas last year without the stress of it all and then later we postponed again so I could go on a family holiday and then for a wedding in Ireland at Easter. It was really nice at the time to take the break from it all and feel like myself again. Not to mention enjoying wine since I'd cut alcohol completely in the months leading up to and during IVF.

It hasn't been easy juggling it all though and I find it can be stressful trying to find a balance. Having to fit appointments around my job means sometimes having to get up crazy early followed by long waits at the doctor and then still having an eight plus hour day in the office. It meant not being able to take off as much time as I might have liked after my first IVF egg collection due to the stress of a work deadline which ended up being the same week! We have had holidays we would have liked to go on but didn't since we knew we would be going through treatment and needed to save money instead. We've had to cancel social events with friends on several occasions too. For instance a dinner and wine tasting that you had to buy tickets in advance for when I thought I might be pregnant by then. There was also a German festival event that was taking place during the IVF two week wait when according to my doctor I should avoid crowds to not risk picking up an infection so we stayed at home instead.

Other bloggers have commented that going through infertility feels like living in limbo land and I can relate to that! I don't belong with single friends who are out partying at the weekends because when you are trying to get pregnant you are supposed to quit alcohol and live super healthy. But I don't fit in with friends who are mothers either and when they all chat about their kids nonstop and plan play dates, I feel left out. Friends who are childfree by choice can be fun to hang out with, though it's still rare to find couples who don't want kids, and they generally can't relate to the lengths you are prepared to put yourself through to try to build a family. Other friends going through infertility are great as they totally get it. If they get pregnant though, of course you are delighted for them but it can leave you feeling left behind once again.

It's so difficult trying to plan anything. I mentioned that we have lots of things coming up over the next year such as weddings of family members and good friends. I would love to attend as much as possible but I'm nervous to book any flights until we know when we can begin treatment for the natural killer cells, how long it will take, and when we will be able to start IVF again. I'd love to go to Ireland over Christmas time but if I do manage to get an IVF transfer done by then, would it be crazy to fly in potentially early pregnancy? One friend said recently that me getting pregnant is the most important thing and I shouldn't think about any flights or trips. Another friend also told me if I were to fly and then had a miscarriage I would regret it! So are my priorities all wrong? Am I crazy to be trying to find some way to go ahead with IVF in November/December and still fly to Dublin at Christmas? If I were to get pregnant and I thought that it would be at risk then of course I would give up a holiday in Ireland. But I'm just wondering whether it would be possible to have both? Another option might be postponing treatment several more months but then I worry about doing that since the older I get the less likely IVF is to work!

So should I continue trying to find a way to still live, travel, enjoy my life around treatments, or is it now time to focus 100% on making having a baby our number one goal? At this stage we're only a few months off from having been trying for three whole years. It's a long time! I suppose all we can do is wait for the phone call with the doctor and then we'll be better able to decide whether we would be able to do the treatment and still fit in a trip to Ireland at Christmas. According to what I've read online the intralipid infusion therapy against natural killer cells would start the month before you do IVF and involves an IV infusion for about two hours. It should be done every two weeks up until the 12th or 24th pregnancy week. I'm already wondering how I would be able to juggle the extra doctor's appointments with my job. Finding a balance between fertility treatment and my life isn't going to be so easy the next few weeks and months but I'm leaning towards doing the treatment for high NK cells in case it's the answer, giving IVF round three our best shot as much we we can and everything else will just have to take second place.

September recap

Thought I'd join a what's new with you in September blog link up and share what's been going on with me recently.

• We are living in our new house about two months now and we love it! There is still lots to do, we have quite a lot of boxes to unpack and some more furniture to buy but it's not urgent and we are getting there. Hopefully by Christmas everything will be done. Though from talking to other house owners, it sounds like the work is never truly finished, there are always new projects and improvements to be done! We had some friends over for our first dinner party in the new place a few weeks ago and it went really well. We served Irish stew with mushroom risotto and walnut and banana cake for dessert.


• We joined car sharing last month. Basically you pay a deposit and monthly fee then you can rent a car from one of the stations near you and just pay for it by hour. The GerMann has been the one driving but I tried last weekend. It was quite difficult actually! Since we don't have a car (the public transport is so good you don't need one here), I've only ever driven when I'm back in Ireland a few times a year at most. Not to mention I'd never driven on the right hand side before, which felt strange! Also I kept reaching out my left hand to change the gears and hitting the side door as you change gears on your right hand side, not left like in Irish cars. Hopefully it will get easier with practice because I felt like a learner driver all over again!


• We are still waiting on our telephone consultation with the immune specialist doctor to explain our blood test results and treatment plan for NK cells. We did have an appointment with our fertility clinic doctor. He said he isn't able to interpret our results though, we need to wait to talk to the other doctor but he did say he would support us doing the treatment. For instance I could get the intralipid infusions at my local clinic and not have to travel. He did mention that if you get the infusion too quickly there is a risk of a stroke! He commented that he wouldn't want to read about that happening to a patient at his clinic. Hubby said to me afterwards that it sounded like he is more worried about avoiding bad press than actually caring about my health! Hearing about the stroke risk has made me very nervous, there is certainly a limit to what risks I am prepared to take in order to have a baby. I am praying that any serious risks are minor!
  The "good" news is that since our first IVF ended in an early miscarriage, my health insurance might pay towards a fourth attempt and not just three. It's good to have that backup plan. I feel like four rounds of IVF is my limit physically and emotionally. I just really hope it works by then!
  


• Our next book club book will probably be "The light between oceans" by M. L. Stedman. From what I understand the book deals with infertility with the couple going through several miscarriages, so I can imagine reading it could be very sad and feel too real. But I've heard it's very well written. And I would like to see the film adaptation afterwards with Michael Fassbender.





• I went shopping yesterday. Normally the shops are closed Sundays in Germany but every so often they have a special Sunday shopping day. I couldn't decide on anything so in the end I bought myself some new pyjamas. I already have plenty but they looked so compfy and I bought cosy slipper boots too in matching burgundy which is my favourite colour at the moment.






• Some friends from Ireland will be visiting in a few weeks. Now we have the house and space, more people are coming over which we are delighted about. A few weeks ago my Dad and his partner visited and we had a fun time. We took them to the wine festival in Heilbronn which they loved! Schwarzriesling Rose was our favourite. Though Muskateller is a very nice white. We got pretty tipsy trying all the wines! I love showing people around where we live and having friends and family from home is always nice.

What's new with you?

Natural killer cells - friend or foe?

The first time I heard the term "natural killer cells" in relation to miscarriages and failed IVF cycles, I thought it sounded awful. As if certain women have these toxic cells in their bodies destroying any potential babies! However, I have since learned that everyone has natural killer cells and they are generally a good thing. They help your body fight off infections and diseases (including cancer) and indicate a strong immune system. The theory, which is quite new in the infertility industry, is that some women (I read somewhere it's around 10-15%) have elevated levels which could then interfere with pregnancies. Initially when an embryo arrives into the womb, it will appear as a something foreign since it will have different DNA, and her body will need to decide that this is something good and should be protected and not fought off. It is a complex process so I guess it's easy to imagine that something might go wrong along the way.

While researching NK cells (which has left me more confused than ever to be honest!) I came across a blog saying that if you have elevated levels then you should figure out why, and not just take medicine to reduce them. That makes sense but I don't think it's so easy. I went to a gastrologist recently to discuss some occasionaly digestive issues I've been having and am now getting tested for celiac, just to rule out any other food intolerances. I hope I don't have any more as living with lactose intolerance is already difficult enough! I'm not sure what else I could be tested for. The gastrologist I went to was actually really uncaring and abrupt. He agreed to do some testing but when I tried to show him the blood tests results, he basically just told me to discuss them with my gyno. I had mentioned my miscarriage following IVF to him to explain why we had done the further blood testing and he looked like he couldn't care less. He certainly didn't show any sympathy. Clearly he doesn't believe that stomach issues may have any connection with infertility. I felt quite upset actually after the encounter. On my way home I was sad thinking about those three IVF potential babies that were transferred into me during the first and second round and what could have been...

These days a lot of people have food allergies and intolerances. It's probably due to the western diet, too many processed foods, plus we eat too much dairy in general. A cow's milk is designed for calves not humans. I still eat dairy with lactase enzyme tablets. Completely cutting it out is just too difficult since I love yoghurts and cheese but I have been trying to reduce the amount. I tried osteopathy two years ago when I was attempting natural fertility options (such as acupuncture) and the lady told me that she has had several women who couldn't get pregnant who she advised to quit dairy for three months and they then fell pregnant shortly after! She had the theory that a lot of people probably have undiagnosed food intolerances that they don't know about but could be causing stomach inflammation. It could be the case that your body then says, oh something is wrong, and the natural killer cells get elevated. One of the women on an IVF forum I frequent was able to substantially reduce her elevated NK cells naturally when she followed the so-called AIP diet (Autoimmune Protocol) which is an even stricter version of the paleo diet. It is great to hear there may be some other ways to treat the NK cells, and I also read something about omega3 helping (I'm taking supplements now), but I don't think I would be able to follow such a restrictive diet for that long!

During my research I came across a website saying how great natural killer cells are, that they fight off cancer and some tips on how to elevate them which seemed ironic since I am trying to do the opposite! In general I rarely get the flu and don't come down with many colds so maybe I do have a strong immune system. The treatment for elevated NK cells can leave you more prone to infections so it's important to be aware of that. I came across IVIG & Intralipid Therapy in IVF: Interpreting Natural Killer Cell Activity for Diagnosis and Treatment which mentions the importance of testing for NK cells in relation to fertility and wishes more reproductive doctors would take it seriously.

However then I also found Fertility Fraud: Natural Killer (NK) Cell Testing which says there are too many false positives and no need for the unnecessary treatments. Another negative article: Natural killer (NK) cells – fertility fraud? which suggests the idea of the human uterus attacking an embroyo it is designed to nurture is "preposterous". And from another post on the same site:
Anxious IVF patients are soft targets for hard marketers. In consulting rooms and online, they’re told their bodies may be sabotaging their pregnancies because their embryos are perceived as infections. This ‘NK’ scare may be completely unfounded. Natural killer cells: you have to hand it to the person who coined that phrase. It’s a mortifying description for vulnerable IVF patients willing to try anything to improve their chances. The truth is, intralipids might help. Might. Not will

The next article I read, Reproductive Immunology – What is the truth about Natural Killer cells? sums it up such;
Studies looking into these cells have produced conflicting results, but the majority of leading scientists in this area dispute that Natural Killer cells are a problem in fertility treatment and pregnancy. Given the potential side effects accompanying Natural Killer cell treatments, there does not seem to be enough justification for undergoing this testing and treatment.

Reading all those of course makes me wonder if the tests and treatments could just be a complete waste of money, unjustified and potentially put my health or that of my future unborn baby at risk. Going through IVF, I am already prepared to take certain risks with my own health but I definitely would not want to negatively affect any children! Then again I also read lots of sites which were on the other side of the controversy, for instance: Miscarriages can be Prevented, and this study which concludes:
The results of present study demonstrated that the level of NK cells as a risk factor is associated with pregnancy loss in women with IVF failure.

There was also this interesting article: Natural Killer Cells & Fertility:Cutting Through the Controversy which summarizes;
Studies are beginning to surface that demonstrate IntraLipid therapy does in fact improve the odds of pregnancy for those with recurrent implantation failure. In fact, well-reputed journals (Human Reproduction (2016) 31 (1): 217–218; “The absence of evidence is not the evidence of absence” and (2015) 30 (7): 1526-1531 “Enough! Stop the arguments and get on with the science of natural killer cell testing”) are publishing articles outlining both the pro’s and con’s of testing natural killer cells. Unfortunately, many people opposed to the testing only cite the publication that argues against it. That being said, not everyone requires testing for natural killer cell activation – it should be reserved for certain patients that have already demonstrated an implantation issue. And treatment of these individuals, should their test be positive, has been successful in thousands of anecdotal cases.

I asked around a bit. Two doctor friends think that having high natural killer cells does not cause fertility issues and the numbers can just be raised due to other factors such as stress and to be wary of any "treatment". I heard from someone else who has a doctor friend in Hannover that specializes in fertility that she has had eight patients helped by the NK treatment, even a few of them who got pregnant naturally after failed IVF! I've also read loads of stories on forums from women who had several miscarriages and then got the treatment which worked for them. It doesn't work for everyone though, I know that. Hearing the positive stories makes me hopeful and I think it could be worth trying in our case. That said, I do feel somewhat uncomfortable about it and will definitely be asking my doctor a lot about the risks and side effects.

Would you pursue the natural killer cell treatment if you were me?

Trying to make sense of it all

Well we have just received our blood test results by post. Unfortunately the earliest appointment we could get for a phone consultation with the doctor is in six weeks so for now we just have to try to interpret what we can ourselves. The results are several pages that list items tested next to the ideal range. If something is above or below that then there is a little arrow beside the value and sometimes a paragraph with some info from the doctor.

The main result is that I tested positive for natural killer cells. My initial reaction was to curse to be honest! I had really been hoping that our results would show that everything is fine and that we could just go ahead with IVF round three. I know some people might see this as a good thing that now we have something to treat but at the moment it just raises loads more questions for me. For instance, have I always had this? Could this also be preventing us from getting pregnant naturally? Does that mean my body basically killed the three little embryos that were transferred during round 1 and 2 IVF (as opposed to it being a chromosome issue with a pregnancy that would not have continued anyway). The thought of that makes me sad... And I also have questions about the treatment for NK cells. The whole area is still very controversial like I mentioned before and because of that treatment wouldn't be covered by my health insurance so could be expensive.

And I am wondering if there might be some other underlying issue causing it. My T4/T8 index was also elevated which according to the info below means either an auto immune disease (!!) or an allergy. So maybe I have some undiagnosed allergy which is causing an inflammation and then the natural killer cells get activated. In which case maybe I need to do more allergy tests to see if I could find the issue. Maybe I will need to change my diet too. I already try to avoid dairy when I can and I haven't found that easy (since I was diagnosed with lactose intolerance early this year). The idea of having to try to restrict what I eat even more doesn't sound fun!

The results also mentioned that I will need to get a second test to find out if the natural killer cells are just in my blood or also in my womb. I've made an appointment with the doctor at our fertility clinic to see if I can get that done there and just to talk about the results and what it means for us going forward. My vitamin D level is also too low so I'll need to take supplements. My AMH value was in the normal range but only just about. It looks like it has gone down from when I had it measured last time, which also concerns me!

Right now we just feel confused and overwhelmed. The one thing we know for sure is that we need to put our plans for the the third IVF round on hold until we can figure it all out. 

The green room #MicroblogMonday

There's a room in our new house that we painted green. I thought that would be a nice neutral colour for our future kid's bedroom. Right now we have some book shelves in there and might use it as a guest room in the meantime. Is it just wishful thinking and possibly a little delusional even that we both still feel so hopeful that we will be able to have a baby despite the low IVF odds?

Since we've bought our house, questions from people asking if and when we are going to have kids have been more frequent. And some of the comments can actually be a little hurtful to someone who is trying to have a baby and struggling. We generally just say yes that we would like children since that's the truth but just wanting them isn't enough unfortunately!

We recently had some relations over to show them the house and they commented that it's too big a place for just us but ideal for a family of four. That stung. I know they meant it in a nice way as they assume having kids is just something you choose to do when you are ready.

The actual choice we face is how many rounds of IVF to go through before giving up. And how will we save enough to afford our mortgage AND a fourth round if this one doesn't work out. However, I have decided that it's ok to still be hopeful. Our "maybe baby" journey isn't over yet. We are not out of options so we will keep going, hoping the green room won't remain empty for too much longer.

Maybe Baby update

Well I gave an update on our new house a few weeks ago, maybe it's time to give an update on project "maybe baby" which is what I've nicknamed our journey to hopefully start a family on this blog. Several weeks ago after our second IVF cycle failed we decided to do extensive blood testing to see if there might be a reason for the two early miscarriages after a suggestion from our doctor. It took a few weeks to get things clarified with our health insurances but they agreed to contribute towards the costs (so we will only be charged a few hundred euros as opposed to a few thousand!). It ended up being about twelve vials of blood from me and about eight from the hubby. Timing wise since I knew we would be busy with the house, I liked the idea of getting the blood testing done since it can take about two months anyway.

So far we have only gotten some partial results back. Both our chromosome blood tests came back fine and it also showed that I don't have a blood clotting disorder. It's nice to be able to rule those issues out. The rest of the results will probably take another few weeks. I'll be tested for the MTHFR gene mutation which is where your body doesn't absorb folic acid properly unless it's in folate form and has been linked to miscarriages. And natural killer cells which your body produces to get rid off any foreign bodies like diseases but the theory is that in some women the antibodies work too well and can kill a growing fetus. There is treatment you can get apparently to help fight this problem. Hubby and I will also be checked for some vitamin and mineral levels. For instance I've read if you have a B12 deficiency it can cause infertility and miscarriages! Since I'm lactose intolerant and don't eat so much dairy and I'm also not a big meat eater then it is possible that my values are low.

Once we find out our test results we will be able to plan plan when to do IVF again, ideally before the end of this year. It's not that easy to plan though as over the next several months there'll be Christmas and several weddings of family and close friends that we would ideally like to travel back to Ireland for. During IVF I wouldn't be able to fly and afterwards if I get pregnant I would also be too nervous to fly in the first trimester. I suppose I should cross that bridge and figure that out *if* I manage to get pregnant. If that were to happen I would be so happy. I love travelling though and I already often feel like I miss out on so many big moments back in Ireland by living here in Germany so I would love to go back for the weddings, especially my brother's next Summer. It's less than a two hour flight to Ireland but apaprently IVF pregnancies are considered high risk.

We'll know more in a few weeks. If the blood tests come back with no issues then we could plan round three IVF quite soon but if there are any problems discovered then we would have to wait several months anyway probably to get treatment. So it's all quite up in the air still. I feel ready enough for the physical side of it all, the injections, egg retrieval etc, but I do worry about the emotional side which I always find really hard going. Especially if it were to fail again.



Having the house has been a great distraction for sure. We love the new place and are settling in well. We still have loads of boxes to unpack and lots of stuff to get done but we've been able to enjoy German Summer in our new garden now and then which has been great.

Shortlisted #LWIBloggies2016

Today I had a happy surprise when I found out my blog made the shortlist in the Irish blog awards in the Diaspora category. It's always nice getting some positive feedback! There are lots of great blogs linked on the site worth checking out and you can vote for your favourites here.

I started this blog six years ago when I decided to move to Germany. It was quite an adjustment for me at the beginning dealing with culture shock and life as an expat, learning German and making friends but I really like living here now. The south of Germany is a great base for travelling and I love all the various festivals and traditions. And now since we have recently bought a house, I guess it looks like I'm here to stay!

House Update #MicroblogMonday

Things with the house have all been moving very fast. We signed the contract and then got the keys just six weeks later. They say buying a house is one of the most stressful things you can do and the last few weeks have certainly been extremely busy!

First there was all the paperwork and sorting things out with our mortgage. Then all the bills started coming in (taxes, realtor, insurances...) which wasn’t fun! The next thing we had to do was get in touch with various people to get quotes for renovation work. Of course August is prime holiday season so it’s been difficult with limited availability. We also had to decide which work on the house we would consider urgent before we move in and what we can put off for now. Not to mention the huge task of all the boxes to pack.

This past week we got the keys and the renovations have started. Pretty much any spare moment we have spent at the house and we have also started bringing things over from our rental apartment so as to not leave everything for the moving day. We have even been able to eat meals in our new kitchen already and enjoy the garden.

It's all been quite overwhelming at times! It t feels a little surreal still that this will be our home. There's always so much to get done and becoming house owners is a major responsibility. But it is also exciting. And even though there is a lot of work involved, there is something very rewarding when you know you are helping improve your future home. I am really looking forward to the end of this month once we will have all our furniture moved over and can really start to settle in to the new place!

Girl on the train #bookClub

The last novel we read for my book club was „Girl on the train“ by Paula Hawkins. I would describe it as a thriller. The story centres around Rachel who takes the train every day to work in London and while doing so looks at one suburban house in particular and imagines stories about the couple who live there and their “perfect lives”. She then witnesses something strange one day. Shortly after she finds out that the women, Meghan, has gone missing. She soon finds herself getting more and more involved in the case as she tries to help solve it.

The main character, Rachel, is an unreliable narrator. We find out she is an alcoholic and dealing with the breakdown of her marriage. She experiences blackouts caused by her drinking. The book also has sections written from Meghan’s point of view in the time leading up to when she goes missing. Another woman’s point of view in some chapters is that of Anna, the new partner of Rachel’s ex Tom. The book deals with some upsetting themes such as violence and abuse. It certainly doesn’t show alcoholism in a rose tinted light but rather the harsh reality. So I could well imagine that some people might find it difficult to read.

One of the criticisms in my book club was that none of the female characters were likable and that they were also very weak. Take Rachel for instance whose life revolved around her husband and falls apart after their marriage ends. She treats some people badly and generally her life is mess. Anna, her ex’s new wife, had no problem breaking up a marriage. Personally I still felt sympathetic towards Rachel and was rooting for her. The reason given for her turning to alcohol was that she and her ex husband had dealt with infertility issues and had an unsuccessful round of IVF which I know is very difficult for anyone to go through.

The book gets compared to “Gone girl” a fair bit and there are certainly many similarities. Both are action-thrillers, involve a mystery around a woman going missing and have twists and turns. So if you liked Gone Girl you probably would also enjoy the Girl on the Train, although overall I would say I didn't find it quite as good as the former. One of the things I enjoyed about the book was the fact that I suspected every single character at some point of being involved and there were also some clever twists. Once I got further into the story I found I was really eager to find out what going to happen next and I devoured it quickly.

Overall I liked the book, though as I mentioned it might not be to everyone’s taste. I’m looking forward to watching the film which stars Emily Blunt who I've always found to be a really good actress. The trailer is out already. I do think it’s a shame that the location has been moved to New York instead of London though.

Have you read Girl on the Train? Will you go to the film?