Monday, May 29, 2017

One week in

The first week has gone well. This IVF has felt a lot easier physically than the last ones so far as I've had less injections in the beginning phase. This round my doctor has me trying a relatively new shot called "Elonva". This is a slow releasing hormone so you only need to once to trigger several follicles to grow as opposed to every day like the other drugs. I had to inject it in the evening on day three of my cycle. Then starting four days later I had to start injecting "Orgalutran" to suppress ovulation. After a week I went back for my first check up at the clinic. I had been feeling pretty calm and positive up to then but the night before my scan I started to worry. I haven't felt a whole lot of symptoms so far. Bloating, and the odd stomach cramp but that's it really. I couldn't help worry that maybe I won't respond well to this drug and grow enough follicles.

Luckily the scan went well. I have seven follicles growing at the moment! This is the best number I've had yet. However only two of them are a good size, the other five are still really small and will need to catch up. The doctor wants me to inject a mixture of menogon (called Menopur in US I think and pergoveris) for two more days to try to help the follicles grow bigger and then I'll go back for another scan. At that stage the doctor should be able to tell me when the egg retrial will be, it's looking like it could be about four or five days time.

This IVF cycle we hope to let the embryos grow for five days in the lab instead of three. When you transfer embryos on day five your odds are better as the ones that have survived till then are generally good quality. Our problem is that I have only ended up with a few embryos each cycle so in that case it could be better to transfer them on day three. Dr. Peppy says that if we end up with at least four embryos then we can wait until day five, otherwise we would go with a three day transfer again. We have also chosen to transfer two embryos again.

I asked the doctor who scanned me how many eggs does she think we'll get at the retrieval. She had it's too hard to predict. So yeah I really don't know how it's going to go! The number of follicles won't correspond to the number of mature eggs unfortunately. Each cycle so far I have ended up having some empty follicles. That said I am trying to stay optimistic and just wait and see what happens. I was thinking the other day that I have been coping really well so far with this IVF, but then I remembered that I'm only a week into it and all the much harder stages are still ahead of me! The egg retrieval, the agonizing wait to see if or how many eggs fertilized, the praying that there will be at least one embryo to transfer.. not to mention the dreaded "two week wait" afterwards.

The past two weeks hubby and I have been eating very healthy and I'm really happy about that. The weather has been lovely here and I've been enjoying spending time in our garden. Lots of the herbs I planted several weeks ago have started to grow so we now have some rocket and spinach leaves. I went for a walk and said some positive affirmations in my head. Things like "I am healthy. I am strong. I am growing lots of healthy eggs.." and even "I am fertile". After three and a half years of unsuccessfully attempting to have a baby, I thought it would be good to try to replace some of the negative thoughts with more positive ones. This is a fresh new cycle and we aren't out of the race yet.

On Saturday I decided to "treat" myself to a massage. There's a Thai massage place in town and I booked myself in for an hour long massage focusing on back, shoulders and head. Anyway, I guess I had forgotten how painful Thai massages can be. Yikes! There were some nice relaxing bits but mostly lots of uncomfortable and sore parts. The occasional shoulder pain I get from sitting at a desk job all day was gone after but I also have some sore looking bruises on my arms since! I don't think I'll be going back there in a hurry. One of my colleagues at work even noticed. I told her what happened and she commented that I'm too much of a "princess" for Thai massages. That makes me sound like a bit of a diva or something, doesn't it? Anyway I think I'll stay away from Thai massages for now and go for things that are actually relaxing!

Friday, May 26, 2017

The things left unsaid

Recently I was back in Dublin for a friend's wedding. I had been hoping to see a particular aunt (on my Mum's side) again and my Dad had been messaging her to try to arrange something. This particular aunt had been battling breast cancer the past few years. The last time I had met her was during the Christmas holidays when I was back in Dublin. My brother was over from Australia at the time and saw her too and I'm so glad we all managed to spend time with her then. She has always been a very independent person (she was unmarried with no kids) and she was also quite private about her illness. Not just with us but also with other family members. I remember at Christmas she hinted that things had been hard for her lately but her attitude was that there are people going through worse things and she didn't want to be thinking "poor me". She was incredibly brave. She was really excited to see my brother and his fiance at the time and looking forward to their Irish wedding celebration this Summer.

During my recent trip home my Dad invited her over for dinner on the Friday to see my sister and I. My aunt said she didn't want to commit to it as she wasn't sure how she would feel. We said we would keep it free for her. She then told us that she was actually in hospital but hoping to be released soon. We offered to visit but she said she was feeling too tired. I remember wondering whether we should insist and just show up but we decided that if she said she wasn't up for visitors we should respect that. I was busy Saturday with my friend's wedding so we left it that we would try to meet for lunch on Sunday before I'd travel to the airport. That never happened. We got a call from the hospital Sunday morning to go in as soon as possible. I remember thinking in my head about all the things I wanted to say to her and praying for strength to be able to say them without crying too much!

However once we got into the hospital we found out it was already too late. The nurse told us she had passed an hour earlier. She had taken a bad turn during the night. We were all in shock! Like I mentioned earlier, we had no idea how bad her illness had gotten. We were also really sad that she hadn't let us in as we would have loved to have supported her more through it. It's always the way that after someone is gone, you have regrets about things you wish you had said said and done. I wish I had stayed in touch with her more. It's so easy to get caught up in your own life. It's been hard recently as you can imagine. It has also brought back a lot of sad memories of my own Mum's death. Both her and my aunt had been fighting the cancer for as long as they could.

Living away from home is also more difficult when things like this are going on. I'm glad I was there to pay my respects. We said some prayers with the hospital priest. However I wish I'd gotten to see her alive one more time. And then Mother's day was this month and I remember feeling really sad that there is no such thing as 'aunt's day'. There are so many people who mean a lot and I'm sorry they don't get more recognition. I came across this post recently on the importance of childfree people in children's lives and it mentions aunts in particular. It really does take a village.

On my wedding day I remember how happy and supportive my aunt was for us. She didn't go into the church but wanted to wait to see me arrive in the car! And then she even photobombed some of our wedding photos as she was there beside me fixing my veil. So sweet. During our first dance there are pictures of her watching us and looking so happy. I hadn't spoken to her directly about our struggles to have a family but my sister had and so I knew she was aware and hopeful for us. It still hasn't really sunk in that she's gone. She won't get to be there for my brother's Irish wedding this Summer.

F*ck cancer for taking so many great people away from us too soon.

Monday, May 22, 2017

From a bag of nerves to feeling zen

The last few days my emotions have been all over the place. I was all set to start IVF round four, then I got a blood test which showed an elevated thyroid (TSH) value which threw a spanner into the works. The GerMann started saying that maybe, what with the cyst that was noticed at my ultrasound, our flights to Ireland for my brother's Irish wedding celebrations in July and now the thyroid issue, we should postpone a few months. My doctor also wants to do the short protocol again instead of the long protocol so I was also freaking out a bit as I thought we'd still have another month of really healthy eating before the egg retrieval but now it'll only be about two weeks!

It's really overwhelming as well knowing this is our final try at this. The guy at my health insurance office had mistakenly told me that I would have 50% coverage for three more IVF rounds and had gotten my hopes up a little... Not that I particularly want to do three more, just nice to have a safety net... Anyway he had filled out the form wrong as I am only entitled to one more round that will be partially covered. Hubby has also reminded me a few times that this is our final try. We have discussed it at length many times and we are both in agreement; there are lots of reasons why we feel like we can't keep going after this, but I guess I'm finding it scary thinking that we might reach the end of this journey without a baby.

It feels overwhelming now that the final round is upon us and I'm terrified to be honest! Part of me is screaming, "I'm not ready yet!", "maybe we should wait another month or two so I can try to eat better as I haven't been as good as I wanted to be the past few weeks". Another voice is saying, "let's not keep postponing and letting my eggs get older, you're as ready as you'll ever be, let's do this! " Basically, I was freaking out a little!

I wouldn't say I'm a very religious person these days. I was brought up catholic and there used to be a time I'd go to mass every week but these days I rarely go and my faith has definitely been questioned over the years. Sometimes I'm not sure what I believe anymore but other times I still feel spiritual and I still pray often. Anyway so I prayed for guidance to help me decide whether to move forward now or wait. The next day I felt oddly remarkably calm. I just had this feeling like this is the right time. (Of course I know this may have all been in my head, but the main thing is I didn't feel as stressed so I'm happy!). I also made the decision that I would trust our doctor at our new clinic.

Long story short I got another ultrasound at my appointment today and it did show two small cysts. However the doctor said that since they are tiny it's not a problem and I can still go ahead. I asked about the thyroid, explaining that this is our final IVF round and we would postpone a month if need be. We were told that even though my TSH value certainly isn't optimal, it is being treated now. I'll get my blood checked again next appointment and we should still go ahead. So long story short, IVF number 4 is a go!

First injection is tomorrow. I'll go back to clinic in a week for a scan and then be told how many more days of injections will be needed and when the egg collection will take place. I have decided that I am going to just take everything one day at a time and try my best to stay calm. Thinking about the future makes me stressed and anxious, so focusing on getting through this step by step seems to be the approach that works best for me! Hubby and I have started eating as healthy as possible for the next two weeks. No alcohol for either of us, lots of fruit and veg, gluten and dairy free for me. I'm off caffeine and he's reducing his two cups of coffee a day to one.

Thanks so much for all the support the past few days by the way!

Friday, May 19, 2017

Pesky thyroid

Last week I'd gone for a so called "check up 35" at my doctor's practice. It's basically a general health check up covered by your insurance here once you turn 35. Anyway I asked to get my thyroid tested during it. When I phoned to ask the results a few days later they said everything was fine. I then asked what exactly my TSH value was. The nurse answered "3.11". I think my reaction was just shock! That is not a good value when you are trying to get pregnant. You really want between 1 and 2, under 2.5 at any rate.

Seriously, what the hell is going on with my thyroid? Last year when I got the extensive blood panel done it had been 2.3 so then I was put on meds for six weeks. It went up a little during IVF last year, which I read is quite common due to the IVF hormones so then my does of Levothyroxine was then increased (from 50mg to 75mg). By the end of February the packet of meds ran out and Dr. Peppy at the fertility clinic gave me another blood test after our appointment early march. She didn't tell me the exact numbers just that my thyroid was perfect so at that stage I went off the meds. Or rather, I wasn't prescribed anymore. I thought my thyroid was fixed but it seems like it has been gradually increasing since then!

I emailed Dr. Peppy about the latest blood test results. I think she may be regretting giving me her email now, haha! Actually she's been very good at emailing me back and really helpful which is nice. I've been trying to not abuse that fact and keeping questions and emails to a minimum.

She said that I should take the thyroid meds again and she would test my blood at my next appointment. So during my lunch break ch break I went to the pharmacy to buy Levothyroxine only to be told that I need a prescription. As soon as I could I emailed the doctor again asking if she could possibly scan the prescription and send it by email. She hadn't replied by the end of that day so then the following morning before work I spoke to the receptionist at the clinic to explain the dilemma. We came up with a solution. I would be sent the prescription by post. In the meantime, she would fax it to my local pharmacy so I could start taking the meds sooner. Perfect! However when I got to the pharmacy no fax had arrived. They tried phoning the clinic several times but couldn't get through. I waited around for awhile then eventually went to work.

Luckily when I went back on my lunch break I was able to collect the thyroid meds so I'm back on 75mg of thyroxine again the past few days. Let's hope my thyroid will be back within the normal range before I get to the IVF transfer stage.

Thursday, May 18, 2017

Gearing up for round 4

It was touch and go whether my uterine biopsy results would arrive in time for me to start our next round of IVF. I provisionally made an appointment for early this week and we had left it that I would call that morning to see if the results had arrived in time and presumably if they hadn't I'd need to postpone treatment for another month or two. Although if they showed that I had an infection (Endometritis) then I'd need antibiotics for several weeks and have to postpone anyway.

Both the GerMann and my sister were thinking it would be good if I had Endometritis since it would mean something to treat and a reason IVF hasn't worked until now. Personally I was hoping I wouldn't have it, as I don't particularly want to find another issue potentially wrong. It's already a hassle having all the immune problems.

Dr. Peppy (my nickname for her) had emailed me a few days before my appointment saying that my results arrived and they were "unauffällig" (unremarkable) so nothing stands in my our way now. She sounded excited in her email which was sweet! I was also happy as initially the clinic had phoned hubby to say the results were there but they wouldn't discuss them on the phone which led me to start worrying that maybe they were bad and the doctor wanted to tell me in person!

Several things happened at my appointment this week.

  • The ultrasound showed a cyst (urgh), so I'll need another ultrasound once my period starts to make sure that's gone before I can begin

  • There was a problem with my health insurance (the eejit at my health insurance office had filled out the form wrong. He also had mistakenly told me I'd be covered for three more IVF cycles when actually I should only be covered for one more). so that's a bit disappointing. It all rests on IVF number 4..

  • My womb lining apparently looked nice and thick

  • Dr. Peppy has decided that instead of me doing the long protocol like we had agreed before, she wants me to do the short protocol again but try a new drug called Elonva. You inject it once and it gradually releases the hormone over several days. She has seen promising results from women in her clinic who have taken it

  • The plan is that first we need to get things sorted with my health insurance. Then once my period arrives I need to get checked either at my local doctor or at the clinic to make sure it's gone then I can start with the injections on the third day of my cycle

  • She would like me to start taking a low dose of Prednisolone before transfer this time. They also only administer one round of Intralipids in the weeks before you start IVF. The next one would be after the egg collection. I was able to get my first Intralipid done while I was there. Of course this all assumes that I'll be able to start next week...

So that's where I'm at. I feel a little overwhelmed about going through it all again. Scared too. The only part I'm actually looking forward to is the transfer. I like my doctor though and trust her. I'll know more in a week whether I'm starting or not.

Monday, May 8, 2017

The art of doing nothing #MicroblogMonday

I remember a joke someone shared a few years ago along the lines of, "Adulthood - if you're not tired, you're not doing it right!". These days everyone is so busy. People on trains rarely just look out the window to watch the world go by, but rather stare at their screens. There are always so many obligations and chores it can feel never ending at times. This week I came across; "The psychological importance of wasting time" which is worth a read and has a good message.

It states; The problem comes when we spend so long frantically chasing productivity, we refuse to take real breaks. We put off sleeping in, or going for a long walk, or reading by the window—and, even if we do manage time away from the grind, it comes with a looming awareness of the things we should be doing, and so the experience is weighed down by guilt.

I'm sure most of us to relate to that! I know that I have weekends where I want nothing more than to just relax with a good book but then end up feeling guilty that I'm not tackling one of the things on my to do list or catching up on housework. However having downtime is crucial to all of us. So if you don't manage to do anything productive today, don't worry, you are still doing something right!

Tuesday, May 2, 2017

How I've been preparing for my 4th IVF

It's a strange feeling knowing I could be beginning our fourth IVF in just a few weeks, Or I might not be starting for a several months. Would you believe we're still waiting for the results of my uterine biopsy? We emailed our doctor while we were in Australia and she said that it takes about six weeks. So initially we had been told one week by the doctor who performed it, then three to four by the receptionist and now six. The not knowing is frustrating but since there is nothing we can do I'm trying not to think about it too much! Anyway, these are the way I have been preparing for our 4th IVF;

  • Step one - uterine biopsy to rule out any infection such as endometriosis

  • The uterine biopsy and scratch was suggested by Dr. Peppy at our new clinic as it's the one test I haven't had done yet. It was uncomfortable but luckily not painful and only took a few minutes. The long part was getting to and from the clinic, as it's in a different city to where we live. If it turns out that I have an infection such as endometriosis then I'll need to take antibiotics for a month and probably test again so it would definitely affect how soon we can start our next IVF cycle.

  • Step two - go on holidays

  • We went to Australia in April for my brother's wedding and had an amazing time. It was so nice to spend time with family, have a holiday with hubby and just relax and not think about infertility treatments! It was really good for us to take some time off from everything. Traveling is one of my favourite things to do. I'll try to do a separate post on that and share even more photos. I'm really glad we decided to go on the trip in the end. Initially we had been considering staying here to save money and not have to postpone IVF too long, but a family wedding is such a special event and I'm glad to have been a part of it.

    Usually I try to quit alcohol in the months leading up to IVF but I haven't been doing that this time. I haven't been drinking much though, just the odd glass or two of wine at the weekends, but then in Australia I ended up consuming a fair bit, as you do on holidays! For instance, we went on a Swan Valley wine tour one of the days and my sister and I got very tipsy. I hadn't laughed so hard in a long time! I've decided to not let myself feel bad about it as I needed the break after everything. Once I start with the IVF injections I'll cut out alcohol completely.

  • Step three - supplements to prepare ourselves

  • We are both planning to take his and her preconception supplements once we start our IVF cycle. I've also got hubby on Coq10 which has been shown to improve DNA fragmentation. He hasn't been shown to have any issues with his swimmers, but no harm doing whatever we can to improve things. Hubby and I have both been taking vitamin D as our blood tests showed we were low.
    My doctor agreed that I can try DHEA before this cycle which can help women who respond poorly to the IVF hormones. Of course, I'm also on folic acid. For egg quality I'm taking 600mg of coq10 each day and I'm planning to start 3mg of melatonin once I begin the IVF injections stage until the egg retrieval as I've read good things about it. I had taken thyroid meds for several months after my blood tests showed my levels were slightly off but my most recent blood test showed my thyroid is ok now. Let's hope it stays that way!

  • Step four - general health and diet

  • Since January, I decided to go gluten free and eat low dairy and less sugar. Apparently that could help reduce elevated natural killer cells. Hubby and I have also been trying to avoid processed foods as much as possible and generally eat lots of vegetables and legumes. We've both cut down on the amount of animal products in our diet. It has been fun trying out new recipes together and we've both been feeling great. I decided to try going gluten free after reading this study which concluded;

    Patients of childbearing age having fertility problems may have subclinical NCGS and they should be informed that the treatment of NCGS by a gluten free diet might improve their fertility. Based on the case we are presenting, the possible prevention or treatment of reproductive effects may be achieved through a strict gluten free diet.

    NCGS stands for 'non-coeliac gluten sensitivity' by the way. In some people your body apparently mistakenly thinks it is something bad and there can be an autoimmune response. I figure I could try it for a few months, what have I got to lose? Since going gluten free my general digestion has also improved which is a plus. It can be quite challenging following a gluten free low dairy diet living in Germany though, particularly when eating out! Here's a picture of a delicious breakfast I ate in Perth. Vegan buckwheat pancakes with fruit and cashew cream.

  • Step five - general self care

  • I haven't started this yet but I'm planning to try to make more time to do nice relaxing things for myself. I'd like to book a massage for instance, read more as I love reading, take long baths, listen to music and so on. And make sure we also do nice things like go on dates. It's very easy to get into the habit of staying in and binge watching tv shows and as much fun as that is, it's good to get some variety and go out for walks, dinner, cinema etc.

Won't it be nice once all this is over and I can eat, drink and do what I feel like without worrying about affecting my egg quality! Also it will be great once I'm done taking so many tablets each day. But it's ok, I'm happy now as I know that I am doing it all for an important reason. I've also noticed that the Australia trip has done me a world of good! I feel like I got to be myself again. My brother's wedding was so much fun! I was hanging out with a lot of his friends who are about three years younger than me. The handy thing was that none of them were at the kid stage yet (it's quite typical to not get married in Ireland until your 30s) so hubby and I weren't constantly being reminded of our lack of children like we might be when we meet up with friends our age. It was interesting to get to know my brother's friends and his life on the other side of the world. I had fun dancing like crazy on the dancefloor! Myself and some of the other girls from Dublin even attempted to do some Irish dancing, haha!

I would even go so far to say that I feel stronger emotionally after the Australia trip too. For instance on the flight there I refrained from watching "Bad Moms" or "Storks" on the plane as I was still feeling too fragile and worried that they would upset me too much with too many triggers. However on the flight back I watched them both! Bad Moms had some moments about how great it is being a mom and so on but otherwise it was mainly silly and funny and perfect for wasting a few hours on a long flight! During Storks I did cry a bit at the end but everyone did!

Hopefully I'll hear from Dr.Peppy soon so we can finally start planning when our 4th round will start. In the meantime we have another wedding to go to this month, so there will probably be more drinking and hitting the dancefloor!