Weeks 10 - 12 #pregnancyDiary

Week 10 thoughts

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

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

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

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

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

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

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

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

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


Week 11 thoughts

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

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

Week 12 thoughts

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

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

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

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


Week 12 - later that week

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

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

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

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

Weeks 7-9

Trigger warning: pregnancy discussed

Things have been a little up and down since our first appointment where we saw the heartbeat. Mainly great but I've also had some very anxious moments.

Dr. Peppy, the doctor at our fertility clinic gave me a plan for how to taper off Prednisolone the steroids I've been taking. It was quite a steep drop. I was to go from 15mg a day to 10mg then three days later drop again to 5mg then three days later to 2.5mg and then stop completely. I reduced the first amount from 15mg to 10mg but then I noticed my glands were slightly swollen and I wondered whether it might be a side effect. I also started to get nervous about going off the steroids so soon. I did some research online and most women who take prednisolone to reduce inflammation stay on them till the twelfth week of pregnancy before then gradually tapering off.

So I decided it best to phone the immune doctor to confirm with her. The treatment plan I had been given just said to reduce once the heartbeat was established but it was vague. When I phoned and explained the situation the lady at the practice seemed alarmed and said I shouldn't have reduced already, that it was too soon! She said that she would get the doctor to email me to tell me what to do. Obviously that phone call worried me! I decided to not reduce any further and to stay on 10mg until I heard from the doctor. It took several anxiety filled days before I got an email from the immune clinic. The email emphasised again that it had been too soon to go down without having my natural killer cell level activity rechecked. I was asked whether I wanted another treatment plan sent out to which I immediately replied in the affirmative. I was freaking out after the email though. Really worried that I might have ruined everything. My sister had also told me all about a friend of hers who had had a traumatic missed miscarriage at 10 weeks recently and I couldn't stop thinking about it which probably didn't help my worries.

Hubby thought we should trust dr. Peppy. Another friend I asked thought I should listen to the immune doc who is the expert in the area. Hubby offered to phone the practice to discuss what I should do. I thought that would be a good idea because I didn't want anything to be lost in translation (remember all the communication had been in German)! The email had come across as very harsh! But then things in German can often come across that way to non native speakers. Anyway hubby phoned and discussed my treatment with the doctor - He said that the fact that I reduced the prednisolone wasn't that bad, the issue was that I had gone down too severely, I should have only reduced by 2.5mg amounts not 5mg. The new plan was that I stay on 10mg for another two weeks (till week 10) and then in one week intervals start to go down by 2.5mg.

I am also able to reduce the Granocyte injections from every third day to every four for two weeks then every five days. I felt very relieved after that phone call! That said I was still nervous for the eight week scan. This time the appointment was done at my local gyno. It went great thank God! The baby is actually starting to look like a tiny person now, not just a dot! It was really incredible to see the head and tiny hands. Everything looked perfect. The doctor also gave me a book about pregnancy. Afterwards I got another Intralipid infusion done.

The only bad thing was that my doctor was pretty against flying at all during pregnancy. He said it increases the risk of thrombosis and miscarriage slightly so we would be taking a risk travelling to Dublin for my brother's wedding. Hubby and I did discuss whether we should cancel the trip but I really wanted to go. Also lots of people have flown pregnant and been ok so I felt like it should be fine. That doesn't mean I wasn't anxious though! I avoided the x-ray machines in the airport and even wore a "belly band" which is meant to protect against radiation which I'd ordered online! We had a great time, it was so nice seeing everyone. I even told a few friends and an aunt who had been praying for us and knew about our struggles our "news" in person, which was lovely. Everyone has been extremely happy for us. It still all feels surreal though to be honest! I wonder when it will actually feel more real. Part of me is scared at times to enjoy it too much in case I jinx it, but then the other part wants to enjoy every second!

I noticed a few more "symptoms" kicked in since week eight. If I let myself get too hungry I will start to feel quite nauseous. My sense of smell is sharper. I've also been feeling more tired and I've been more forgetful too! After the Ireland trip, I felt exhausted. Work was quite stressful too for various reasons. Then a few days later for the first time in this pregnancy I had some red spotting. It happened late at night. It reminded me of the awful miscarriage I had after our first IVF and for several seconds I just thought "Oh no, no, no..." However it was only a small amount of bleeding and it stopped soon after thankfully. I found it hard to sleep that night and kept wondering what I should do - go to the hospital, phone my gyno in the morning or do nothing and assume everything is fine. In the end I decided to call my doctor first thing. When I phoned and explained about the small amount of bleeding (but no cramps) I was told to make my way there immediately. That was quite nerve wracking as you can imagine! It was a different doctor this time but she was very nice. She checked my cervix which was closed and the right length, and she couldn't locate the source of the bleeding. She said that some spotting can be normal in the first trimester. Then she did a scan to check on the baby.

At first it just looked like a blob this time! I couldn't make out where the head was. She said the baby was in a funny position with his/her head leaning over the body looking at the feet. We both stared at the screen and there was no sign of a heartbeat at first. It seemed like it took forever while the doctor kept moving the ultrasound wand around. I was thinking something like "Oh God, oh God, please can the baby be ok". After what felt like an eternity but was probably only a minute, she found the heartbeat and everything was fine! She did comment that the baby was "small". I didn't like the sound of that. It took ages to get a measurement because of the awkward position but it looked like baby is about a week behind in growth. The doctor said not to worry though. She also wrote me off sick for several days and told me to rest at home and take magnesium. If I have any more bleeding or get cramps outside their practice opening hours then I should go straight to the hospital.

Luckily everything has been fine since then. I've just been taking it very easy. Watching lots of The Good Wife again! I go back for another scan early next week. Hopefully the baby will have grown more by then. I'm trying not to worry about the growth thing. I read on online forums that it's normal enough in the first trimester for the baby to measure a week ahead or behind. I also think that the baby's awkward position could have messed up the measurement. So that's a run down on the last few weeks! Only a few more to get through until, please God, I'll make it safely into the second trimester.

Heartbeat

Trigger warning: pregnancy mentioned.


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

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

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

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

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

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

Blissful ignorance

Right now I'm in a strange place. Our embryos may have implanted and I could be on my way to our dream of having a baby being fulfilled. Or nothing may be happening and it could end up being another heartbreaking negative call next week. Even though I would usually like the "two week wait" to be over quicker so I can just find out already, a big part of me just wants to remain in blissful ignorance a while longer. If our fourth and final IVF ends up being a negative then I'm in no rush to come crashing down. I'd just like to stay hopeful believing this could still happen for us awhile longer. So that's where I'm at now. One week down and scared for the outcome.

Hubby and I also had a discussion last night about what we would do it this fails. I said I know I would come out the other end eventually but initially I could imagine sinking into depression if it turns out all our efforts to have a family haven't come to pass. There are times when I question all my decisions in life leading up to this point. If I'd known all the challenges we would have had trying to have a baby then of course I would have started trying earlier. A few months probably wouldn't have made a big difference though. Hubby commented that even if I didn't have the issues with my fallopian tubes from previous surgeries I could still have had problems getting and staying pregnant due to the elevated natural killer cells or the missing KIR genes which were discovered during the immune blood panel.

This all sounds pretty depressing. Despite everything I was also thinking recently that we have quite an idyllic life in a lot of ways. We both love our house. That was a great decision and we are getting great joy out of spending time in our garden so far this Summer. We have a happy marriage, that's certainly not a given. Life in Germany is nice. We have a good standard of living. Coming from Ireland I really appreciate having a proper Summer here! We both have decent jobs, our health and a circle of friends, not to mention loving supportive families. So I'll remind myself that whatever happens we will find a way to be complete even if our "family" remains a family of two. In the meantime I'll stay hopeful and believe.

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.

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!

New doctor, new hope?

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

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


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


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


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





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


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


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


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


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


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


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


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


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

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

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

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

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

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

What next?

Well I still can't really believe that we have three failed IVFs behind us now. How did I end up here? I just really thought that it would be third time lucky for us and I had already planned it all out in my head - how far along in the pregnancy I would be by which month and even when I would be due. It all seems a bit stupid now of course. If it had worked I would have had my first scan last Thursday. Wouldn't that have been something? The odd thing is that our first IVF was actually the most successful in that I was properly pregnant and for the longest, even though it only lasted five weeks. These past several months between the immune testing and treatments not to mention the IVF itself was just so all consuming. Now that it's over I've been feeling at a loss. Sort of aimless and unsure of myself. The support from all of you has helped me a lot. It really means a lot to me, so thank you so much!

While I was googling IVF failure, I came across this article which I found very helpful. There are few resources available for when infertility treatments don't work so it can be a hard and lonely time. It's been difficult as you can imagine but I think I am handling it well all things considering. I was grateful that I had a few days off before I had to go back to the office. I'm still feeling quite fragile. It seems like every time I log onto facebook there's a new pregnancy or baby announcement! How I wish that were us. Yesterday hubby told me that friends of ours had their twins on Christmas day. I am embarrassed to admit this but I burst into tears when I heard. They also went through infertility and had a long journey. Actually when I did my second round of IVF, they did their first and for them it was successful. I am delighted for them, just disappointed for us.

I would have been due this month if the second round had worked. I probably wouldn't have been able to travel to Ireland in that case if I was so far along, and I would have missed out on a lovely Christmas with my family though. I liked the suggestion in that article to take up a new hobby or write a list of things you'd like to do. So I've decided to jot down lots of simple things like restaurants we've been meaning to try out, places I'd like to visit and so on. I've also thought about possible hobbies like doing a dance class, writing a book or taking up painting so maybe I will try something new. It would be good to focus on something else for awhile.

We've gotten an appointment at the other clinic I mentioned for early March. It's actually nearly an hour and a half away but I have heard great stories from people who have gone there. I'm really happy we have this appointment and keen to hear what they tell us. We'll have a long list of questions for them! I've read about some women having success with certain supplements such as DHEA and royal jelly but I'd prefer to get a doctor's advice before taking them. They offer natural IVF at the other clinic and I'm planning to discuss whether that might be something we should try. I'm also wondering whether it would be a good idea to get the scratch done (again) to increase our chances and whether it would make sense to check my tubes to see if one is still unblocked. In the meantime we have to fill out a three page questionnaire and send them all our medical records etc. I'll have to go back to my gyno to get a referral.

Hubby and I watched a few Netflix documentaries recently that revolved around food and health that made an impact on us. The documentaries were basically about how there is way too much processed and fast food these days. And also that people should cut back on animal products and dairy. So we decided to make an effort to eat healthier this month. We have been trying out some new recipes and cooking together more which has been fun! Just trying to incorporate lots more vegetables in our diet, more home made stuff, less sugar. I've also decided to try cutting out gluten. I've been having some digestion issues on and off for awhile now and I've noticed on days I avoid gluten it tends to be better so I'm going to give it a go. I also came across some research indicating that a gluten intolerance could lead to overactive natural killer cells in some women so I've been wondering if that might be what's happening to me. If I can improve my digestion, be healthier and improve the NK cells over the next few months that would be great!

I'm also hoping to get my thyroid values back under control. The day after our transfer I got my blood tested and found out my TSH value had gone up not down (it went from 2.30 to 2.46)! This is despite taking meds to reduce it the previous six weeks. I freaked out, worrying that it would affect the embryos implanting (and maybe it did...) I went to my doctor and she prescribed me stronger thyroid meds as the ideal value for pregnancy is around 1 and definitely under 2. Not sure why mine went up not down though I've read that IVF hormones can affect it. A higher TSH value means underactive thyroid. So my plan is to keep taking the meds and hopefully get my thyroid under control over the next few months.

Several people have asked us recently about adoption. It saddens me a bit as it sounds like they don't think we'll be able to have kids ourselves whereas we haven't moved on from that hope yet. Years ago when we started having problems hubby and I had a chat about what things we would consider and he said he doesn't want to go down the adoption route. I remember feeling sad at the time thinking that if IVF doesn't work then we would end up totally childless but when I thought about it more a few days later I realised that I also don't feel particularly drawn to adoption myself. It's a great thing for loads of people, don't get me wrong, I just don't feel like it's right for us. I can't imagine having the energy to start down that long road either if our other treatment attempts fail. Also for me the biological connection is very important. My Mum died when I was younger and I love the idea of a part of her living on.

People have told me about friends who adopted and then got pregnant naturally implying it might work in our case but that's not a good reason to pursue adoption! We also don't feel comfortable with the idea of donor eggs or sperm. Both are illegal in Germany actually (However it is actually legal to "adopt" already created embryos from another couple here). Update: only donor eggs are illegal here. Basically if it doesn't work with our own DNA we would stop. Hubby didn't even want to try IVF initially but luckily came around to the idea. And at the beginning we had agreed on 3 (or max 4) rounds. I have been starting to wonder about what I would consider depending on what we are told at our next doctor's appointment. Going through infertility means you end up having to think about all sorts of things. One friend even suggested we go to India to find a surrogate! I can't imagine ever doing that and thankfully I haven't been told that I can't carry my own child so we don't need to consider options like that. Our doctor has never said there are any issues with our own eggs or sperm either. Both are good quality. I think the main problem is that I don't respond well to the IVF hormones and we don't end up with many embryos. Maybe our thoughts on donor eggs or adoption might change in the future but for now we are still hopeful that we might be able to have a biological child. I hope that doesn't come across the wrong way. Each couple has to decide what is right for them.

Our plan is to see what they say at the other clinic and then decide our next steps. I am open to doing a fourth round at some point. Hubby isn't so keen on the idea, like I mentioned before, he's already ready to stop and try to move on. However he's open to finding out what the new doctors have to say. He just hates seeing how hard IVF is on me. I have heard of women who take five or six rounds to be successful but I don't know how much more I can take. I tell myself it will be worth it in the end when we have our baby but I do worry about the long term effects. The emotional rollercoaster isn't good for my mental health either. Each failure just feels worse than the last! The hardest thing at the moment is deciding where to draw the line. If IVF is never going to work for me then I would obviously rather stop now than keep putting myself through it (and spending more money)! Our health insurance will pay towards a fourth round and it's great to have that option.

So that's where we are at now. I hope my post didn't sound too sad. It has been an incredibly disappointing time. I'm doing ok though. Feeling a little better each day and I am hopeful that maybe something will still work this year. I would love to be pregnant by the summer. Oh man, we would love that baby (or babies) so much! I would be the happiest woman in the world if it worked out. But I also want the doctors to tell it to us straight. If our chances are slim, I will try to accept that. In which case I will also start moving on. Hubby and I have also discussed what that might mean for us. We could consider getting a pet. Or we could plan some amazing holidays. Hubby has never been to Thailand. We would both love to go to the States together. It would also be such a relief to be done with all the doctor's appointments and injections. I hope by this summer we will have our answer either way. Please God we'll be able to have a healthy baby one day.

We are hoping to fly to Australia for my brother's wedding in April. It would be something to look forward to! Initially I had been thinking about staying here so that any potential treatments wouldn't have to be postponed but then I realised that I would regret missing out on seeing my brother get married and a month or two delay shouldn't make a big difference. My life has revolved around infertility treatments so much the past while and I'd like to focus on other things and try to enjoy life again!

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.

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.