What next

After a failed IVF it is typical to have a follow up meeting with your doctor, often nicknamed the "WTF meeting" in the infertility circuit. It's a chance for you and your partner to ask loads of questions, discuss what went right or wrong and what could be done differently next time. I mentioned that we have been considering getting a consultation at another clinic which is unfortunately a lot further away. We phoned them and the earliest appointment we can get there is end of August! I would also need to take time off work just to go to it which is quite awkward. In the meantime we had our follow up appointment at our local clinic and actually it went a lot better than we had been expecting. Better that is in the sense that the doctor took loads of time to discuss things with us at length and answer all our questions, not necessarily in terms of our future chances which are still hard to say.

We have a few things working against us. My one confirmed blocked fallopian tube and the other one which seems to not be working hence the need for IVF in the first place. And now it turns out I'm classed as a "poor responder" to IVF hormones. My body doesn't make as many follicles as it should. And even when they do grow, some of them are empty so that doesn't help! The doctor has a theory now that maybe some months I'm not producing an egg naturally and he thinks this is part of the reason for our not getting pregnant naturally. For all I've researched into "empty follicle syndrome" (which is what it's called when you have less eggs retrieved at the egg collection procedure than the number of available follicles) I have never come across this theory.

If it were correct I've been trying to work out what that would mean for our chances trying naturally. The first IVF round I had six follicles but only two eggs. The last round three follicles and one egg. So that would mean a one in three rate of eggs approx. So in a given year, twelve months, I would only have about four eggs, that is only four months with an actual chance. Given that one fallopian tube is definitely blocked that would half it to roughly two. So only two months out of a year when there's a chance of conceiving. Add that to missing the "fertile" window one month if our timing is off and that would leave only one month per year. So that could explain why I haven't gotten pregnant naturally before now IF his theory is true! Hubby was wondering afterwards whether we should have tried naturally for longer before pursuing fertility treatment when he heard that. But if both tubes aren't working at all then it would never happen naturally no matter how long we wait.

Anyway. The doctor says we could try the antagonist protocol next time which might work better for me. Hopefully. But he also said I don't have to rush as the few eggs I do produce are great quality and he's not worried about my age. He suggested we take about six months off. He also said it could be a good idea to do some further tests before going "blindly" into the next round. He suggested we get our chromosomes checked and to test me to see if I might have a blood clotting factor (although last round he prescribed me baby aspirin after transfer just in case).

There is also a lab where you can send your blood to for more thorough tests and they check for natural killer cells. This is a very controversial area. The idea is that some women have overly effective immune system response cells which attack the embryo thinking it's a foreign body. There are meds you can take to suppress this response. Our doctor said that some doctors don't believe in it at all and think it's just a waste of money whereas others thinks it's really great. There was a conference in Biel in Germany apparently where there was a presentation and any of the doctors who went there were convinced. He said he's also had some patients who were helped. But it's up to us whether we want to go down that avenue or not.

I figure it's worth getting the tests done their anyway. They also test your vitamin levels and any gene issues. The problem is it takes about three to four months for the testing and we also need to try to see if our health health insurance will contribute towards it first so that will take some time sorting that out. With health insurance help it might just cost a few hundred euro here but without help it would be closer to 3000€ in which case we wouldn't be able to afford it right now!

If we're going to be busy with our new house over the next few months anyway, why not get these tests done and give round three our very best shot. Especially since the third round is the last round our insurance will pay towards and what with the new house and bills, we probably wouldn't be able to afford any more rounds after this. Yes the third round will most likely be our last whether it works or not since that is what we had agreed beforehand and at some point we don't want to just keep throwing money at something if it looks like it's not going to work. If it did turn out that the next round were to fail hubby and I differ somewhat on how we would proceed. He thinks at that stage we should accept kids aren't for us and try to move on, whereas I would probably consider looking into other options like mini/natural IVF with less hormones and less costs before being ready to accept it. We've had some difficult conversations about it all. I try to think positively in general but after two failed IVF cycles I am starting to really worry more about why it isn't working and what the future holds.

Apart from all that life has been great lately. It's very exciting that we've found new house and we'll probably be moving in just a few months; job wise things are also going great, I recently even got a small promotion! Now that I'm not currently going through fertility treatment I've had more energy for my social life and it's been fun meeting up with people more often and drinking wine again! I have also become friends with a new Irish girl living here which has been great since over the past half year several close friends have moved away. And I'm very happily married; it'll be our three year anniversary this August. So a lot of things are going really well and I'm very happy with my life...I just hope there will be a baby in our future.

Day after the result

I'm feeling a little better today. Still very sad of course but I continue to have hope for the future that one day it will work for us. I just pray it will be on the third IVF round and soon (or ideally it would just happen naturally but I've more or less given up hope now that could happen). Hubby and I had agreed before we started this whole process that we would only do three rounds max. For most people if it's going to work it would normally work by then. I hadn't thought that I would end up having two failed rounds.

I was talking to a friend today whose friend is a doctor and she said that with only one egg my chances of IVF working were really low, like only 3%. I had no idea it was that unlikely! The doctor did ask me if I wanted to keep going when it looked like I wasn't responding to the meds but he didn't mention that the chances would be so low and I thought that since I only had two eggs the last time but had gotten briefly pregnant that I would still have a chance with one.

I am wondering whether it is time to get a second opinion at another clinic. There is one that is meant to be really good but it's located over an hour away. So trying to go to appointments there before work would involve getting up at an inhumanly early hour. However I do want to give us the best chance of it working. We are thinking about trying to get a consultation appointment there to see what they might suggest.

I have also been thinking about how long I would wait before we might start the third round. I hate the idea of going through all the injections, the egg retrieval, and the horrible emotional rollercoaster again. I would say about 2-3 months maybe, possibly 4. We would also like to plan a trip to Ireland this summer though which could be awkward if it clashes with when we would start treatment so maybe it would make sense to wait until after. 

Hubby and I are planning a mini break together next weekend, a spa hotel or something. Getting away sounds really good at the moment.

Heartbroken

This morning I went in for the blood test at my clinic. They said they would phone between 12pm and 2pm with the result. I had done another pregnancy test at home which looked like a very faint positive this morning. So I thought that it meant I am pregnant but possibly the HCG level is low. I went home at lunchtime hoping I would be there for the call but they didn't ring and we couldn't get through to them. So then I went back to work knowing they had hubby's number.

Once I got in the door this evening and saw his face I knew it was bad news and I just burst into tears. He hugged me and then told me the news. Not positive. Not even a little bit. I was firstly sort of in shock as I was so sure that I was pregnant. We're heartbroken.

It's just so disappointing. We had so much hope this time and it did seem like it was going well! We had the scratch, our embryo was great quality, I wasn't stressed... The home pregnancy tests I did that showed very faint positives must have just been showing leftover HCG hormones from the shots. But then again only having one egg this round didn't give us great odds at all I guess. 

We are trying to plan a little trip next weekend, maybe a spa hotel or something, we just need to get away for a few days. In a few weeks we have an appointment with our doctor to discuss what went wrong. I'm not sure when I could face going through it all again, I just need a break for now.

False positive or reason for hope?

I couldn't wait any longer so I tested first thing yesterday morning and it was...positive! It was so exciting seeing the second line appear.

This morning however I tested again and it looked like a negative! If I held the test to the light or turned it a certain way I could make out an extremely faint second line. The fact that it has not gotten darker has made me feel really worried that this might end up being another chemical. I can't bear the thought of losing this baby too. The emotions really got to me and I was quite upset this morning as I don't think it looks good now. 

In the end I tried to remind myself that the last test could have been affected by leftover hormones in my system from the HCG shot last Monday. It's still too early to know for sure either way. I guess I will probably test again in two days and then if it's negative then I'll know it hasn't worked. If it's positive but very faint then it could end up being another chemical. The only good sign would be if it were a strong positive. The thought of this round failing makes me so worried. I don't know whether I would be emotionally strong enough to go through IVF again. I mean I guess I would be if I thought it had a decent chance of working but otherwise I just don't know. 

I have to try to put it out of my mind and just wait the next few days. I hate this emotional rollercoaster. Sorry this post is so negative, just having a bad day.

To test or not to test

Last time I went through IVF I choose not to take any home pregnancy tests but rather wait until I had the blood test at my clinic and got the official result. This time I have been thinking about testing earlier. The reasoning is that it would be nice to prepare myself a little, especially if the result were to be negative. The problem with home testing is that it can be difficult to figure out exactly when to test. If I look at this which shows the day to day of what should be happening with the embryo, it suggests you can start testing on day eleven already if not sooner as your levels of HCG the pregnancy hormone should be high enough by then.

However some clinics like mine get you to give yourself injections of the HCG hormone during the two weeks after transfer which could then cause you to have a positive test even if you aren't really pregnant! I read that it takes roughly one day for each 1000 IU amount of HCG hormone to leave your body. So since I had a 2500 IU injection on Monday then I wouldn't want to test before Friday to be totally sure. However I found another link that said it can take up to a week for a 2500 injection to leave your body! So getting a false positive may not be so unlikely.

And what if it's negative? Well it's possible it's still too early and you should wait and see what the blood test says to know for sure. Even if the test were to give a faint positive, then testing a few days later should show the line getting darker if the HCG level in your body is increasing which is a good sign. A very faint line could possibly indicate a chemical pregnancy. Despite all that I am still considering testing, but taking the result with a pinch of salt. I will try to wait until the blood test but it's starting to feel like time is passing at a snail's pace. On the other hand I am beginning to feel more nervous as the deadline gets closer. I just really hope that it works this time. I hate the thought of having to go through the whole IVF process again.

One week down #MicroblogMonday

I'm nearly one week into the two week wait now. Since the rough last few days I've been feeling fine again and pretty much normal. Now and then I thought I felt the odd twinge or pinching feeling in my uterus which could possibly mean some implantation is happening but who knows! Hopefully work will be a distraction and the time will pass quickly until my blood test next week. 

I already had a friend texting me today asking about whether I have any baby news yet, even though it's only one week past transfer and WAY too early to know anything! This is one of the reasons why I was hesitant to tell people that we would be doing IVF as I didn't want to get asked if it had worked or not. I would like to decide on my own terms when I am ready to share, no matter what happens. If it's positive then I would ideally want to wait a few weeks and see if I stay pregnant unlike last time when I sadly ended up having an early miscarriage and if the result is negative then I also might not feel ready to talk about it so soon. 

Painful cyst after transfer

As you can see from this post title it's been an eventful few days and not in a good way unfortunately! The first two days after transfer I was feeling great! I had to give myself another shot of the HCG hormone which also went fine. Then Friday morning I was awoken at 6.30am with severe stomach cramps. At first I wondered if it could be implantation cramps already although it would be too early for that. It was very unpleasant as I couldn't use a hot water bottle or take a painkiller (both unadvised during pregnancy) so I had to just grin and bear it. I couldn't seem to get comfortable or go back to sleep so I got up and had a glass of water and tried to relax on the couch but I also started feeling really nauseous at that stage. I even wondered if it could be morning sickness but again unlikely this early! Awhile later it got really bad and I had to throw up. I also felt weak and dizzy and the pain which seemed to be centered around my right ovary was not getting any better. 

At that stage we phoned the clinic's emergency number and were told to come in and get checked out. I felt very nervous going there wondering what could be wrong with me. I also worried that it could be OHSS but that seemed unlikely since I only had one egg extracted and it rarely happens for poor responders. After waiting for over an hour on the uncomfortable waiting room chair I got to see a doctor. She examined me and said that I don't have any leaking fluid in my stomach which would indicate OHSS but I had an enlarged ovary from the hormones and a ruptured cyst on my right hand side which is causing all the pain. It should go away by itself but if the symptoms get worse over the weekend I shouldn't hesitate to go to hospital and she recommended I come in for another scan Monday. I was relieved it was not even more serious and also glad when she commented that my womb lining looks nice and thick! 

For the rest of the day I still had a dull pain but I seemed to be feeling a lot better and the nausea was also gone by the afternoon. The doctor said I can take paracetamol but I decided to not risk it if I can avoid it just on the off chance it might affect the growing embryo. I also hope all the stress of the past few days won't stop the embryo from implanting! Over the weekend I felt gradually better and was back at work today. This morning my scan also looked fine so thankfully the cyst does seem to be going away by itself.

I can say from experience that having a ruptured cyst is extremely painful and horrible. I also can't help wondering whether it might have been avoided, like whether my clinic could have noticed it growing and drained it or warned me about it at least. Another thought I have been having is that if this IVF round ends up with our miracle baby I doubt I would want to do it again in the future. Despite the fact I would love more kids, I don't think I would want to keep putting my body through it. Right now a healthy baby and not having to do IVF anymore is my wish!

Transfer day is the best day

This morning I went to my clinic for my appointment still not knowing if I would actually have something to transfer or not. When I arrived and the lab guy asked my name he seemed to be confused or something which made me worry that my name wasn't on the list and then he went to get the doctor's assistant. So then I was worried that he might be getting someone to talk to me and tell me the sad news that my embryo hadn't made it. Thankfully that wasn't what happened! The assistant arrived and took me to the quiet area to relax and drink some water while I waited to be called. I think the lab guy was just in a bad mood that day.

The circle and bloom relaxation tapes have one specifically for transfer day so I listened to it and tried to calm my mind. When I went in for the appointment the doctor firstly got me to confirm my name and birthdate and then informed me that we have a really great looking embryo; 8 cell with some "construction". I was so happy and relieved as you can probably imagine! The transfer itself also went without problems and afterwards I relaxed for awhile and the nurse gave me some instructions for the next two weeks, No sport, baths, or hot water bottles on my stomach and I should drink lots of fluids and try to avoid stress.

When I googled 8 cell day three embryos with compaction I came across a positive study which says they have a higher chance of leading to pregnancy than ones without. I feel like I have good reason to feel positive that this just might work this time!

I've been feeling so happy, ecstatic basically that we have a chance at all this month. So today has been a really good day!

Awaiting the call

Last night it took me ages to fall asleep and I also woke up early, at 7am which isn't like me on a Saturday. I think it was the nerves. Last time around the clinic had phoned me around 11am with the fertilization results so I was expecting the call around the same time. However they phoned while I was in the shower and my phone was on vibrate so hubby also didn't hear it. I tried to call back but it was displayed as "private number" therefore I wasn't able to and since it is outside of the clinic's opening hours I haven't been able to get through to them since. 

I can't believe that they didn't phone me again or leave a message! It would be nice to know for sure whether we have an embryo growing at the moment so I can at least relax this weekend and not be worried, but I just don't know now. I am hoping that if the egg did not fertilize that they would make an effort to get through to us on the phone because that would be beyond awful if I ended up showing up there bright and early Tuesday morning (Monday is a holiday here) only to find there is nothing to transfer. 

Since we would only have one embryo unlike two like last time our chances of it working have decreased. They say it's only about a 13 percent chance with one, whereas it can be 33 percent with two. It's possible that getting the endometrial scratch several weeks ago increased my odds, let's be optimistic and say it doubled them, but that would still only bring the odds to 26% which doesn't sound that good. That's the thing with IVF though, the chances of a round working are never great but we try anyway.

It all boils down to one

This morning was the egg retrieval procedure. It went fairly standard without complications and afterwards I rested for several hours with a drip and then had an appointment with the doctor to make sure everything looked ok and finally get a chance to find out how many eggs were collected.

A very disappointing one. One measly egg, after almost two weeks of injections and close to one grand spent on meds. Not to mention so much hope for good numbers and potential extras to freeze. Don't get me wrong I am absolutely grateful and delighted to at least have the one but it is disappointing.

Tomorrow the clinic will phone me to let me know whether it fertilized and I am feeling very nervous about that. Last time we had a 100% fertilization rate, both embryos fertilized and were top quality so I am really hoping that this one might also be good.

I realise that our chances are not as great as they would have been had we gotten say ten eggs in which case the doctor could have chosen the best two embryos to put in. I have already started to think that maybe I need to stay somewhat neutral and prepare myself that it might not work. I read a few articles the past few days about women who are poor responders to the meds. It said we face a greater challenge than others. Nonetheless it reported that mini IVF can be effective which is where you have a cycle with minimum meds but still end up with good quality eggs and embryos, but it can take several more rounds to work and a lot of clinics don't offer it as it makes their statistics look worse. No harm having a plan B in the back of my mind just in case.

I am trying to stay positive for the call tomorrow. All our hopes rest on this single egg!

Day 12 Trigger time

Yesterday morning doing the injections I felt very unmotivated and dejected. I was wondering what is the point of me doing this if the meds aren't working for me?  Once I reminded myself that I only have one more day to get through and then I'll have a break from needles I felt somewhat better. Yesterday evening I also felt particularly run down and had stomach cramps so I just relaxed with a hot water bottle on the couch. I've started feeling more bloated and uncomfortable now, hopefully that's a good sign.

This evening at 10pm exactly I'll give myself the trigger shot. This is the hcg hormone will tells your body to ovulate in 36 hours. My egg retrieval operation will be Friday morning and the idea is to catch the eggs when they have finished their final preparation process in the follicles but just before they are released for ovulation. Therefore the timing is crucial.

Yesterday I went to the shops and stocked up on avocados. There was a study that showed that women who ate a lot of them during IVF had better odds of it working. So I'm doing what I can! Apart from that I will keep doing my meditation in the evenings and try to not be too anxious even though this is obviously a very stressful thing to be going through!

Ultrasound disappointment

I'm in shock, that appointment did not go how I was expecting at all. I had been feeling so hopeful that maybe all ten follicles would be growing this time and that we might have the option of as many as ten eggs this time with the possibility of extra embryos to freeze.

During the ultrasound the doctor was being very quiet and just taking some photos of the screen. I eventually asked "wie sieht's aus?" which translates to "how's it looking?" and the answer was not what I was hoping to hear. Apparently my body is just not responding well to the meds, like I had feared the other day. Only two follicles are growing. The rest haven't changed at all! 

The doctor even asked whether I would still like to go ahead with the egg retrieval this Friday, since I will most likely only end up with one or two eggs. I am so disappointed. It feels like my body is failing me again, firstly by not being able to get pregnant naturally and now by not responding to the IVF meds. Certainly having less eggs doesn't help our odds of this working.

I decided that I still want to go ahead with the egg retrieval procedure though because I've come this far already and since I had the endometrial scratch done the womb lining should be more fertile this month. I am hoping and praying that we will get at least one egg at the retrieval and that it will be mature enough, of good quality and then fertilize. The transfer would be a couple of days later if we even have something then to transfer!

The whole IVF process is so unpredictable and hard. I am trying to still stay hopeful but part of me is really worried after the bad news today. 

One week down

Two days ago I felt exhausted and I think I might have had a few occasionally cramps, though it was difficult to say whether it was from the meds or just something I ate! Yesterday I felt great though, full of energy! And today I also feel really good so far. No symptoms whatsoever. I'm not even bloated at all which is surprising. 

Maybe I should be feeling happy that I'm not experiencing any side effects but now I'm starting to get worried. If the meds are working as they should then my ovaries would be really big right now with lots of follicles growing which is why it would be normal to be feeling bloated. The lack of symptoms is making me wonder whether I am responding to the meds at all! 

I have read stories from women on some of the IVF boards who had to have their cycle cancelled mid way due to poor response! I can only imagine how disappointing and frustrating that would be after doing all the injections to not even get to the egg retrieval stage. I already had the disappointing outcome last time of only getting two eggs but at least I still had a tiny chance of pregnancy. 

I am also feeling annoyed that my clinic won't let me come back for my first ultrasound until day ten so I have to wait until then to find out how I am responding the meds which are different to the ones I had last time. Well I did some googling and read online that lots of women don't experience many symptoms yet go on to have lots of eggs, so I'm feeling more hopeful now. Still, I'm looking forward to my ultrasound on Monday to find out how it's all looking. I'm going to have to try to not let myself get too stressed about in the meantime. 

A few days in

I've got four lots of injections behind me now and I have to say I'm feeling fine so far! The first day I was quite hormonal but since then the only symptom I've noticed is maybe being a little more tired than usual. I'm happy that I'm not experiencing any bad symptoms such as cramps or headaches but I also hope that it still means that everything is going well - I hope that lots of follicles with good quality eggs in them are growing.

It seems quite strange to me that I'm not scheduled to go back for an ultrasound until day ten so I gave the clinic a call to ask if maybe I could go in on day seven as well. However they more or less said that Dr. Direct knows what he's doing and has been doing it for years and if he says I don't need an ultrasound until day ten of meds then that's what I'll get! So that means I will have a full ten days of injecting the hormones without knowing how well they are working.

Lately I've been watching episodes of Call the Midwife on Netflix. It's a good show but I'm also hoping seeing all the babies will subconsciously make my body be fertile this month, haha! The meditation mp3s I'm listening to are also about positive thinking and healing your body with your mind. I don't believe it can heal everything that's wrong with a person, that would be ridiculous but I do think that the mind is nonetheless very powerful and no harm trying.

I've been feeling so great today I was even considering going for a jog this evening but then I googled exercise during IVF and moderate working out can negatively affect success rates plus there's the risk of something called ovarian torso where your ovaries can get twisted which sounds nasty! So maybe I'd better stay on the safe side and just stick with gentle walks now and then. 

Day one

We're off to a good start. The first day's injections went well, probably all the practice from the last round of IVF helped. Altogether it took a good half hour though and I have to do them in the mornings so I'll need to set my alarm clock for thirty minutes earlier each day until I get the hang of it again and get faster.

What helps is I created a motivational playlist on spotify of songs I love to take my mind of the injection process. At night I'll also be listening to a special IVF/IUI meditation series called Circle and Bloom. Each one takes around fifteen minutes and involves taking deep breaths, calming your mind and lots positive thinking and healing. I am hoping it will be good against stress. So far so good.

Here we go again

I had my baseline today which is what the initial IVF appointment is known as. Everything looks good, and I've no cysts so I'm ready to start. Tomorrow I'll begin with the injections. Similar to last time, two each day alternating sides. I have the "decapeptyl" again but this time also "Menogon". The latter will be the trickier one as it involves mixing four vials of powder and two liquid.

I went to the pharmacy after my appointment with Dr. Direct and collected all the boxes. Wow, it's a lot! Also it cost nearly a grand altogether. And that's not even everything, I'll be getting a separate prescription for the progesterone at a later stage. It will all be worth it if it works of course!

I am feeling a mixture of excitement and apprehension. Excitement that I am giving myself the best possible odds at getting pregnant in several weeks time, all goes well, which would be amazing! However apprehension and nervousness mainly about just having to go through the whole emotional rollercoaster again with no guarantee of a happy ending.