Thursday, December 29, 2016

When IVF fails

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

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

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

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

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

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

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

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

Thursday, December 15, 2016

Eating for three

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

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

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

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

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

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

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

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

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

Tuesday, December 13, 2016

Finding it all hard going

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

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

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

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

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

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

Saturday, December 10, 2016

So far so good

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

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

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

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

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

Sunday, December 4, 2016

A new month and a new start

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

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

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

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

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

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

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.