Sunday, 14 July 2013

Thank you

I just wanted to stop in to say thank you for all the kind words, thoughts and support.

I will be back blogging very soon.

Sunday, 23 June 2013

June ICLW and gargoyles

Today my husband and I took an impromptu trip to Oxford, just to escape our worries for a few hours. We took lots of photos as we strolled around the city. I didn't stop thinking about what might be going on inside me but it was a lovely few hours. I did realise, whilst wandering along a cobbled street, that I have done nothing for ICLW this month. This isn't good and I will attempt to rectify my error with gargoyles.



Two and a half weeks ago a doctor placed two perfect embryos into my well prepared uterus. The whole experience was spellbinding and I held out for a staggering six days before I buckled and took a pregnancy test.




Two perfect pink lines popped up. Shocked, I don't know why getting pregnant via IVF is shocking but it is, my husband and I celebrated.



Things started to go a bit wobbly when I couldn't stop myself from peeing on the dreaded sticks. 





The blasted things refused to go darker or to stop fading in and out. 




I wished, hoped and prayed. It didn't help; the darn tests refused to comply. I succumbed to the fear and begged my GP for a blood test.




The result, from a blood sample taken at 13dp5dt, was 81mIU/mL. The doctor said this was low and ordered a second test.





I duly submitted my arm to the phlebotomist fifteen days after our exquisite embryos had entered my uterus.




There was 130mIU/mL of hCG in my blood at 18dp5dt 15dp5dt. This is low, low, low. My GP warned of an ectopic pregnancy and instructed me to call my clinic. My clinic confirmed fears of an ectopic pregnancy, told me what to watch out for and said the hCG was low and slow.

My husband went on an internet rampage and found a chart that we hoped would comfort us.



If you look closely you can see our first blood test just scraped into the minimum acceptable level. However, our second blood test result has fallen off the bottom of the bloomin' scale. The doubling time for my hCG hormone level is 75 hours. Not great. Ideally the hormone should double every 48 hours but anything faster than 72 hours is considered okay.

Recently my husband and I have been doing a lot of this:




It could still all be fine and dandy but it isn't looking likely. So we are still doing this:




Friday, 21 June 2013

Second beta at 15dp5dt - Bugger

Just a quick update. There are no pictures today or silliness about chocolate lollipops.

My beta has gone from 81 on 13dp5dt (18dpo) to 130 on 15dp5dt (20dpo). Those measurements were  over 52 hours apart. My clinic isn’t too hopeful; the lovely people who help me there have gone from being chirpy to gloomy. The clinic and my GP suspect that I might be in possession of an ectopic pregnancy. Quite handily, they have given me a list of warning signs which, if any of them happen, should send me galloping on over to my local hospital. I will have another beta on Monday and, if I make it, a scan next Friday. There is a small chance that this pregnancy will work out but you'd really need a high powered microscope to see it now. I am clinging on to that small shred of hope. I want to keep my diamond, dammit.

Thursday, 20 June 2013

Pregnant? Yes, just a little bit.

It was supposed to reassure me and make it all crystal clear. A blood test would tell me if this was going to be okay. However, the universe looked at my plans, took a deep breath and laughed in my face. A huge great belly busting shriek of a laugh.


My blood test results are back. I am pregnant. No doubt about it. This is good, right? It's what I wanted, right? Achieving pregnancy is the first step on the winding, probably uphill, road to reach this:




 My beta-hCG result is 81 mIU/mL at 13dp5dt (or 18 days past ovulation).


That is not a sparkly, glittery or exhilarating number. That, my friends, is a number that is an excruciatingly low, frighteningly poor number. It is the type of number that could mean this pregnancy is going nowhere fast. My GP was kind but not thoughtful; beginning the conversation by asking if I was bleeding wasn't going to make me feel at ease or anticipate good news. In fact, it was blanket hiding time again.




How did I react to this agonising news? I scoffed my way through a bag of chocolate lollipops, a chocolate bar and a coffee, and not the decaff stuff either. I know, I know, I am wild and reckless. However, that was only stage one of post-beta meltdown.


Stage two involved trawling the internet, until my bum went numb, searching for success stories. As the pages loaded in front of me, the steaming pile of crap got higher and higher. I waded through the mountain of misery, reading about loss after loss, miscarriage after miscarriage, and then, I saw it, just poking out of the top of the mountain of soggy, stinking dung: a diamond. My eyes focused on the gleaming words. It happened, it was real. Someone out there had the same dismal number as me and won. For a while, all I could see was the sparkling gem of hope. Now, I can still see the shit but I am holding tightly onto my nugget of faith.


Stage three comprised of flicking through  the maternity wardrobe of Catherine, Duchess of Cambridge. Not literally, obviously, but courtesy of Go Fug Yourself. I don't know why I choose to punch myself in the gut quite so hard. I felt better when I remembered that she had married into the royal family and all the beautiful bump flattering clothes in the world can't make up for that.


So what have I learnt today:

  • I'm pregnant but probably possibly won't stay that way
  • Sometimes people beat the odds
  • Eating chocolate on sticks is highly enjoyable
  • Kate Middleton is a beautiful pregnant lady
  • I'm not feeling creative and am resorting to recycling pictures

I had another blood test today and, hopefully, I will get the results tomorrow.


I thought I would leave you all with a very special treat:



Source

Sunday, 16 June 2013

Am I? I think I am.

This week has been, as I suspected it would be, utterly crazy. Pregnancy tests suck! I hate them, I hate them, I hate them. Ahhh....that's better.  

I didn't wait until Friday to test; I didn't make it until Thursday or even Wednesday. By the time Monday turned up I was already clinging on to the last shreds of my very fragile mind. I didn't want to break but how could I resist? I needed to know. The agony of being so close to pregnancy was driving me insane, really it was climbing the walls time; it was also torturing my husband. We went back and forth. Shall we? No let's not. It won't hurt. No we can't. Eventually, on Tuesday, we flipped a coin. Heads I test, tails I don't. The coin spun in the air, landed on my hand and I peeked. Tails! Arrggghhh. Not tails, surely!?! That was it. Our will was broken.


I unwrapped that first magic stick and let the urine flow. Had I drunk too much? Not enough? Was it too early? Should I wait to use my morning wee? Too late, the stick was soaked. Placing the test face down on our dining room table, we waited. Three agonising minutes passed. We couldn't look, we held each other and then we saw this:



It wasn't the darkest line in the world but, look, there's definitely a second line.


We went to bed happy. Oh so very happy. My mind was filled with bliss, until the next morning when I decided, as you do, that one test wasn't enough to keep me going and I got slapped round the face with this little beast:

 
 
Yes, you're right, the second line has vanished. What on earth did that mean? Was I pregnant or not?
 
 
Life was not fun that day. The birds weren't singing and the sun didn't shine. I couldn't wait to get home and pee, and pee I most certainly did; this is what we saw:
 
 
 
 
 
Yipee! Oh, do pardon the pee pun. The second line returned. We could be happy again. We chatted joyfully about how it would finally be our turn for a little one. Until, of course, I lost my shit and went for another test and then, because I am a lunatic, another. I don't know how anyone stops at one. Good Lord, I admire you solo testers. To me pregnancy tests have the same allure as heroine does to the most drug addled junkie. In case you haven't guessed, and I imagine it's the same for any addict, the fix did not make me smile; we got these suckers:
 
 
 
 
The lighting is a little different but the story is the same. The final test was lighter than the previous one. What the crappity crap does that mean? Can you get pregnant, a smidgen more pregnant and then less pregnant again? Since that fateful evening there have been two more tests and they don't seem to be progressing in the way any IVF survivor would be proud of. 
 

 
 
 
I'm not an expert, not in anyone's book, but several hours of scouring the Internet makes me believe that something isn't quite right here. Tests shouldn't fade in and out, and by 11pd5dt, or sixteen days past ovulation if you prefer, the test line should be jumping right out of that oval window; it shouldn't pale into insignificance in comparison to the control line.
 
 
I am trying to remain hopeful, optimistic and bright. I mean, I've got two lines on a test so why am I even complaining? How ridiculous that I am not shouting "yay! yay! yay!" but instead I am whimpering over relative densities.
 
 
Maybe it's all okay. Maybe my embryos are just slow starters. Who knows? I heard on the pregnancy grapevine that sometimes test lines can be stubborn and refuse to pop out as quickly as you'd wish.
 
 
Tomorrow is my official test day and I will, once again, be peeing on one of those little devils but this time I can actually tell my clinic I have done so. I will also have to admit that I have been testing for some time now and that I am going berserk. I have no idea what they will say or do about my woes. Under normal circumstances - I think we have established these aren't normal circumstances - the lovely receptionist would book me an appointment for my seven week scan but, holy cow, I can't wait three more agonising weeks.
 
 
When I wake tomorrow, assuming I sleep at all tonight, I will also call my GP and beg her to do sequential blood pregnancy tests (betas) to see if the pregnancy hormone is doubling normally. My GP's practice is terrifyingly tight-fisted. The doctors there are so mean they point blank refuse to write a prescription for more than four weeks' worth of medication at a time, even if you need the meds permanently. If they cast me aside when I fall on my knees and cry for help, which is certainly possible, I am going to resort to begging the lovely doctors who took care of my first pregnancy to save me from despair. They made the foolish mistake of writing us a kind letter to let us know that nothing would be too much trouble if I ever got pregnant again.
 
 
One more thing, just before I sign off and while I have your attention: I am developing a constant pain on my right side just under my bikini line. Anyone know if that's not something to go a little bit mental about?
 
 
If you do have any answers, advice or any knowledge at all, please share. There's a handy comment box below to write out all your thoughts.
 



Friday, 7 June 2013

Good luck embryos

I have been away, not literally, just metaphorically; I needed some time to prepare myself for the upcoming crazy and I have no doubt there will be crazy.


Since I posted about my excitement of getting nine eggs, after I had thought I would be lucky to get seven, my IVF cycle has been moving forward. Like many things in life, IVF has a terrible habit of plodding on whether you are ready for it or not. You might think you are all prepared and set to get going but, quite often at the last moment, you realise you are not. Is anyone ever ready to be permanently attached to their phone whilst they go through the tightrope walking terror that is waiting for a daily embryo report?


On Saturday, the day after the egg retrieval, I nearly threw every last shred of sanity I possessed out the window when I missed the call from the embryologist, simply because I hadn't taken my phone to the toilet with me. I haven't made that mistake again. Honestly, what a stupendous blunder! The missed call led to several minutes of sheer horror when I realised that firstly, I wasn't holding a pen to write down the embryologists number and secondly, I had no idea how to save the message into my phone. The panic reached dizzying heights when the crackly voice of the embryologist was thoughtless enough to announce that she "would like to speak" with me. Arrggghhh....far too formal and far too scary. Surely it would have been much better for her to say "please call me back I have good news for you".


After much hopping round the living room, some deep breathing and muttering "think clearly woman", I did manage to sufficiently figure out my phone, retrieve the message, although I am not sure I could do it again, and call the good embryologist lady back. I held my breath as she told me all nine eggs had fertilised. Yes, all nine! I thanked her at least ten times, if not more, and smiled solidly for, oh I don't know, an hour or maybe even longer.


Then the madness started.


Once that phone call, which contained the first update of our potential babies, was over very little has entered my brain, except thoughts of embryos. Where they are? How they are doing? Are they are still growing? Did they mind being imaged every five minutes?  


We had further embryo reports on Sunday, Monday and Tuesday. Every time there was a sigh of relief as I was told that all nine were still going strong.


Then came transfer.


The embryo transfer isn't difficult or painful, at least no more so than your average smear test, but it is odd. First you need to get used to being half naked, with your legs in stirrups, in a room full of people. Unsurprisingly, this can be awkward, not least because you are positioned directly in front of the embryology lab door. I am getting proficient at making being publicly bottomless look like the most natural thing in the world; I can now chat away happily as if we were all enjoying nibbles at particularly good Christmas do.


The best part about the transfer is you get to see the embryos; it's amazing, almost life changing and it blows my mind every time. It is life in its rawest form. Life just five days old. I look at those embryos and I can't help but gaze at my husband and marvel that they are made from a little piece of him and a little piece of me. Like I said, totally mind-blowing stuff.


This time, prior to our embryo transfer, whilst by legs were uncomfortably hoisted in the air, the doctor, Mr F, who was performing our transfer, told us that the blasts we were about to place into my uterus were of extremely high quality and asked if we really wanted to go ahead with two.

Ummmm.....arrggggh....ooohhh. Did we really? 


We thought we did. Mr F, who is Mr T's boss, cautioned about the risks of multiples and we all exchanged glances. My husband and I nodded; we were going to stick with two.


Not long after the decision was made, those two beautiful blastocysts were sliding down the catheter, all snugly wrapped in a good dose of EmbryoGlue, into my well prepared cushiony uterus and, as usual, I whispered a silent prayer.



The madness has continued. There is a constant soundtrack running through my mind: Am I pregnant yet? Will I get pregnant? When shall I test? It never stops. Sometimes my subconscious plays the "I hope I get pregnant" track over and over again. If you have suffered from any kind of fertility problems, or even if you are just trying to get pregnant a little longer than most, you may have heard the "I hope I get pregnant track" yourself.


I can't believe this is my third transfer. I struggle to comprehend that I am getting used to going through IVF. How can it be that my uterus has now been host to six different embryos and my apartment isn't over run with baby clothes, I haven't got sick in my hair and the dark circles under my eyes aren't from gently rocking a crying baby back to sleep in the early hours of the morning? I am choosing to have faith that it just hasn't happened yet. Not yet, but please God soon.  


We are now two days past the transfer and too early for a pregnancy test to be useful. I know from my first cycle that a good, and extremely expensive, test will detect a pregnancy at four days past transfer. Now, only a crazy fool would test when the embryos have only had four days to get themselves comfy and start pumping out the pregnancy hormone. Hey! Who are you calling a fool? Okay, I admit it, I am not good at the holding out part. This time, and I know I will look back at this in shame, I am planning to wait until Friday 14 July June 2013 to test. I am hoping that by writing it out so formally my subconscious will take the hint and back off a little. Hmm, only time will tell.
 


I have also been hiding because one of my friends gave birth to her baby girl almost exactly on my twin girls due date. The announcement was accompanied by an email full of photos and a trip, thankfully without said baby, to the local Mamas and Papas shop to buy the tiny girl a gift. Let's just say it wasn't easy but it's done now.


Ugghh....infertility is some mean shit.


So for those of your who haven't worked it out from my post, yes, we included the Eeva and the EmbryoGlue in our cycle. In the end, even though I don't really think it makes any difference, I couldn't say no to the Eeva. My mind was really made up by the nurse informing me, when I called to find out when we had to decide, that I may have already have left it too late and it was possible that there wouldn't be available space in the Eeva incubator. It is funny how, as soon as you think that you might not be able to have something, it suddenly becomes a whole load more attractive.


In the end Eeva rated six of embryos high (the top score) and, of those six perfect embryos, two were transferred into my uterus and three others were lucky enough to have the privilege of hanging out in liquid nitrogen for a while. The ones that got to have the first go at being babies were chosen because they made it to blast slightly faster than the others and, sadly, not because Eeva had indicated that they were any better. I hate to say it but I think I just spent £800 on slightly easing my mind for five days. 


As for the EmbryoGlue, well that decision turned out to be a little easier. There is real clinic evidence presented in a meta-analysis performed as part of a Cochrane Review that EmbryoGlue, or any transfer medium that contains hyaluronan, will significantly increase clinical pregnancy rates. That was good enough for me. There have been conflicting studies since the review was published but, overall, it seems like the EmbryoGlue really does work.


Well, this post is very me, me, me, isn't is? There is another person going through all this too. My lovely husband, or Mr H as I just decided to call him, has also been struck down with the crazy fever. Today he has asked me: Are you pregnant? Can you feel anything? Do you want to take a test today? Are sure you are taking your progesterone? and, my favourite: When will you know if you are pregnant? Poor, dear Mr H. He certainly wasn't like this during out first IVF cycle; I suspect the crazy is contagious or, maybe, it just gets a harder each time we haul our miserable selves through it.


Sorry this post is a bit scrappy but I hope I can redeem myself by leaving you with a picture of our miraculous, and I do think development of IVF has been a miracle, embryos.





They are both sitting in a bubble of EmbryoGlue; the top one has begun hatching out of its shell and the bottom one is almost ready to start hatching.


Good luck little embryos.

Wednesday, 5 June 2013

Oh My God - I won something!



Hello lovely readers,

I expect you are hoping for an update on my IVF cycle; it's coming tomorrow I promise.

Now onto to really important matters, I have been nominated for my first ever blog award. Yes, you are right, it is just too exciting for words.

The most lovely and wonderful Aislinn from Baby Making and the stupendously super Jenni at Unconceivably Blessed have nominated me for the Super Sweet Blogging Award. Yikes! Thank you so much ladies, I am not sure I can handle the responsibility but I'll give it a go. 

As with most great things in life there are some rules. Right, here we go....



 Thank the blogger(s) who nominated you.
Oh ladies, thank you so much. It is so lovely to know that you thought my blog worthy of sharing it with others.
 
 
 
 Answer 5 super sweet questions. I have done this below.
 
 
 Include the Super Sweet Blogging award image in the blog post .
 If you look very closely you will find the image towards the top of this blog. It's a bit like Where's Wally but hopefully a little easier.
 
 
 Nominate 12 other bloggers
Okay I know I am going to struggle with this. I am really just finding my blogging feet but I hope I can manage a few.
 
Now for the Super Sweet Questions:
1. Cookies or cake? Gosh, what a question! For those of you in the UK, this is very much like the Daddy or chips question. For those of you who don't know what I am talking about, a clip that will explain all is below. It's great. Even though it's a tough one, I am going to go with cake.



2. Chocolate or vanilla? Has anyone ever gone for vanilla? This is definitely not a Daddy or chips dilemma: chocolate all the way.

3. Favourite sweet treat? Ummm...hmmm...ahhh...tough. I have just gone through an eclair phase, so I guess that would be it right now. I am hoping the eclair phase was Gonal-F related because I can tell you an eclair a day does no favours to your waistline.

4. When do you crave sweet things the most? I am not sure I do crave them. I just really like them and don't have the will power to say no to myself. Having given up cigarrettes and caffeine I can say cravings can be mean. With sweet things I quite often think "hmmm, that would be nice" and that thought it quickly followed by "ohhh, go on then, I am sure you deserve it".

5. Sweet nickname? Okay, I couldn't think of any. So, I asked my husband and his response, and I am quoting, was "oh, I don't bloody know". Huh, charming. Hmmm....I am feeling pretty boring without a sweet nickname. Maybe I could make one up now? I am feeling a bit old for a new glucose-laden title but lets see......hmmm....still nothing. Okay, back to the husband.

Me: hypothetical question dear, if you were going to give me a nickname what would it be?

Him: Chook

So there we have it. Chook. In case you don't know what that means the Urban Dictionary tells me it is an Australian slang word for chicken. In case you are wondering, there was no explanation - just chook.


Right, that's the questions done. Now for the nominations. I can tell you know I won't make 12 but I am going to go for as many as possible.


  • Sadie at My Invincible Spring is just amazing. She writes so beautifully. She was the first person I came into contact with who had a similar loss to my own. I am so thankful that she found my blog and so grateful that her posts are full of optimism, hope and love for her son.

  • The Infertile Chemist writes an excellent blog. Ever want to know how pregnancy tests work or what all the meds do? Check out her blog, her explanations of the science stuff are great!

  • Lauren at On Fecund Thought is another truly lovely writer. I love her blog. She writes with such insight about the really tough stuff. She also helped me figure out how to fix my comments for which I will be forever grateful. We have so many random connections it is strange but lovely too.

  • MrsDJRass at Baby Baby...Please is a new blog to me and I am really enjoying it. She has just gone through a frozen embryo transfer so I expect she is going through crazy hellish mind games right now. Go now quickly and congratulate her on getting this far.

  • Cindy at My journey through infertility, pregnancy & loss has been a great support. She is starting a cycle to do a frozen embryo transfer and also suffered the loss of her daughter Olivia. Her posts are often a testament to the love she feels for the girl she lost.

  • Lisa at The Pursuit of Pregnancy left the first ever comment on my blog and has been like a blogging mentor to me. She introduced me to ICLW and to some great blogs, but, best of all, her blog is beautiful. I love reading about her pregnancy and it is so inspirational to see someone make it to the other side infertility.

  • Maria from Gutter to Stars has a very interesting blog. She is currently completing her PhD and loves science too.

  • Ariel at Journey of a New IVF Mum is another information led blogger and she has come through IVF and has achieved the holy grail. Yes, she has a baby!

Okay, I know that is no where near twelve but it's late and I am tired (it's been a long exciting day). I hope the Award Police don't come and take my award away. Also, I am curious, who starts these awards?


Friday, 31 May 2013

Nine




Nine. That's how many eggs we have. For those who are excited by numbers I can tell you that nine is two more than seven. As I am still in a drug induced haze, this won't be an overly flowery or descriptive post, I  don't want to scare you all off by going all Dali on you.

If I wasn't so addled I might tell you about the charming hotel we found just behind Baker Street or how staying in London the night before added an flavour of holiday excitement. I would mention the lovely Spanish receptionist who checked us in and my attempts to impress her with my rusty Spanish. I am certain that I would write that she was still on duty when we checked out and that she was too sweet when she told us she thought we were a very kind couple and much nicer than her average guests. I am pretty sure that, if I wasn't lazing in front of trash telly, you would hear about how smoothly everything flowed at the clinic; the kind elderly anaesthetist who explained how he got real joy from working within in NHS; the friendly embryologist who detailed how he uses Eeva and when it can be helpful. I would tell you about the simple lunch we had in a cafe on the way home but, most of all, I would shout out that I am so happy, overjoyed, excited and thrilled. Happy we got this far, overjoyed that we got nine not seven, excited that tomorrow I will know if we have created new beings and thrilled that we are one step closer to parenthood.

Wednesday, 29 May 2013

Counting my chickens

"You can get dressed, come through and we'll discuss the findings."
 
Once those words are spoken I exhale and wonder why my doctor always says "the findings". Am I his lab rat? It's just so, umm, experimental, I suppose. I brood over it as I hop down onto the lino flooring. Leaning forward I separate the jumble of clothes left dumped on the metal chair, promising myself that next time I'll fold. The phrase flips over and over in my mind; I decide that I am okay with it. At least, I muse, it sounds as though he is taking this baby making extremely seriously. Pulling my jeans over my cold knees I try to imagine what I am going to hear. My mind flips back to a few minutes earlier, I think of the click-click-clicking of the button as Mr T flipped through the dark spaces that represent my follicles. Just moments earlier, I was staring hard at black follicular spots on the screen, my neck ached from the strain as I tried to count them all. But, as always, the doctor was too fast for me to memorise the numbers that flashed past or to note all the little white lines that marked the spots. Click, click, click, click, click and we were done.


I close the examination room door behind me, attempt a confident smile and place myself on the seat opposite the doctor. Clattering from his keyboard fills the tiny room as he inputs the findings from my ovaries into an electronic file. I breathe slowly, notice the expensive watch skimmed by an expensive shirt and use the spare seconds to silently speculate about what car he might drive. I am just deciding on Mercedes when my train of thought is broken by his eyes flicking from the screen and directly toward me; my mind whispers "stay calm, look confident, relax". I wonder why I so desperately feel the need to maintain my composure in front of this man. He starts to speak and I nod mechanically.


"Your current cycle is quite different from your last."

I continue nodding, "Oh."

"Your last cycle was very good, you had plenty of follicles and we retrieved 16 eggs."

I'm still nodding and force a smile, "Oh."

I wonder if I am nodding too much, shift my position in the chair and brace myself for bad news.

"This time you have 7, maybe 9, follicles and we would expect to get approximately 7 eggs."

I am not nodding anymore, "Oh."

I blink through his explanation that every cycle is unique, that it doesn't mean there is anything wrong with me and that if we did another cycle it may all be wonderful again.

My mind screams: Another cycle, doctor?


Mr T continues to rattle off the plan from here on in: one more day of stimulating my ovaries, two more days of suppressing the egg release and then, finally, the trigger. Yup, we are at the big one. The trigger shot will help the few eggs to mature and get ready for collection on Friday. Yes, on Friday!


As my ovaries no longer seem to be enjoying the IVF game, the considerable meds I bought from the dodgy perfectly respectable Internet pharmacy were not nearly enough. Mr T takes me down to the nurses' station and arranges for more drugs to be sold. I make a mental note that I will have some updating to do on my IVF cost tally.  


I thank every one in the clinic, including the receptionist and the doorman from the apartments opposite, at least ten times each and head back to the underground station in the rain, hoping for a miracle on Friday.


Monday, 27 May 2013

Uncovering revolutions in IVF treatment

Firstly, I want to say thank you to all the people who commented on my previous post regarding the extra treatments my IVF clinic offers. There was some confusion between Google+ and me; unfortunately Google+ responded to my attempts to understand it by removing most of the comments from my blog. So if you need to know where your comment went, you'll have to ask Google because I'm not exactly sure. On the upside, I think I have managed to stop restricting my comments to Google+ only. Thankfully, all your lovely comments are still stored in my account but I have no idea how to link them back to my blog, sorry. I did read them all and they were very helpful; I appreciate that people made the effort to respond to my request for advice.


Okay, back to my normal blogging self:


The days following my fertility specialist announcing that I could improve my chances of achieving pregnancy by intently studying the embryos and/or by gluing them to my uterus, I was a little confused. I asked for your advice and you didn't disappoint, thank you. I was advised to find out more about the procedures before I committed, so that's exactly what I did.



Currently, there are two companies that are offering systems in the UK that analyse the earliest characteristics of developing embryos: Embryoscope and Early embryo viability assessment (Eeva); both technologies monitor early cell division events using time-lapse imaging.


Time-lapse imaging of embryos was first developed in the mid-1990s. Initially it was used as a tool to study embryo movement and development. In those early days, scientists hooked up videocassette recorders to culture incubators and captured the exact sequence of events after sperm met egg. As the research advanced, scientists investigated how early cell division characteristics, captured by time-lapse imaging, could predict the embryos destiny. After beavering away in their laboratories for many days, possibly months, the scientists made a breakthrough discovery: the timing of the first developmental events after fertilisation correlated well with blastocyst formation. Embryos whose fate it was to develop into beautiful blastocysts had a very defined schedule for each of the critical mitosis events. Building on these early observations, investigators have developed software systems, which incorporate fancy mathematical algorithms, that accurately predict which embryos will arrest and which will survive. Amazing, right?





Not only it is now possible to predict blastocyst formation but studies have shown that, using these advancements, embryos likely to yield pregnancies can be identified prior to transfer. Remarkably, transferring embryos that were rated as high, using an imaging system, led to a 66% pregnancy rate. In contrast, when embryos were transferred that were rated low only 8% of women became pregnant.  


For me, the most fascinating element of these new technologies is the apparent correlation between embryos that are predicted to be poor and the presence of chromosomal abnormalities. Two studies (here and here) have demonstrated the cell cycle and fragmentation patterns, identified using time-lapse imaging, are diagnostic of faulty chromosomes.


The results from these studies sound wonderful and they are certainly extremely promising; it would be difficult to deny that this really is astonishing science time. However, no one has published any studies or clinical trials which demonstrate these imaging systems are better than an embryologist at predicting which embryos will make it to blast; my clinic is super confident that their embryologists are excellent at choosing embryos for transfer. The truth is that there have been absolutely no clinical trials published assessing whether these technologies increase pregnancy rates when compared with current methods.  



A review of the use of time-lapse imaging for embryo assessment, published in March this year, concluded "before time-lapse markers are to be implemented in the clinic, additional clinical validation of their safety and efficacy and their measurement/quantification technologies is urgently required".



The FDA also seems to be under the impression that treatments should demonstrate efficacy prior to routine implementation and, not surprisingly, has decided to wait to evaluate clinical trial data before licensing the technology in the United States.


So why are these systems already in use in European clinics? I asked my fertility specialist that very question; he argued that couples should have access to all opportunities to increase their chances of success. I am unconvinced that, usually pretty desperate, couples should be expected to pay for unproven treatments. Sure, if the clinic wants to boost their success rates and offer it to their patients for free then I'm all for it. Now that I am there, I know that, even though the science is shaky, I want to do everything, even irrational things, to increase my chance of pregnancy.

I think Dr Sue Avery, from the British Fertility Society, sums it up perfectly (play the clip to find out what she says):


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Source

I guess I am struggling with the ethics of it all. I am also worried that these scenarios will become more common in the British health system as an increasing number of services are privatised. Good ethical policies in medicine and science are so important and I fear that sometimes the desire for money triumphs over reason. This weekend an argument over the patent granted for this technology has erupted in a British newspaper. The United States Patent Office has recently granted a patent whose claims include the monitoring of embryo division. How can that be? Is it ever okay to patent the measurement of naturally occurring biological processes? I am extremely keen on the idea that innovation and invention is protected by patents, and I would applaud a patent that covered the use of the mathematical algorithms or the imaging software, but the processes that underlie life itself? Should they really be able to be covered by patents?

I don't know the answer. Maybe you have some ideas and opinions about what is and isn't acceptable? If so, do share.


My doctor also suggested we try EmbryoGlue and I have done some research on that too. However, this post is getting quite long now so I am signing off and will cover EmbryoGlue in a separate post.


Side note: I did read the patent and I am not sure that the claims are as extreme as the newspaper article would have us believe.





Thursday, 23 May 2013

Mo' money, mo' problems

Last year, when I took my slightly battered car for its annual service, the mechanic cheerfully informed me that I needed four new tyres. He kindly explained that standard tyres would be acceptable but extra special non-slip tyres would be so much better. He thought that regular tyres were okay, of course, but, if it was his car, the better tyres would be fitted without a doubt. Towards the end of our discussion, just as I was leaning towards the fancy tyres, he dropped in that the better tyres also had a mightily spectacular price. Hum, decision made, I was pretty sure my little car will be alright with the basic tyres. 

Haven't we all enjoyed similar conversations with garages, or car salesmen, or even kitchen fitters? However, I was knocked-off-my-feet surprised when I had the same experience with my IVF clinic. Yes, I am not joking, it really did happen.


Yesterday I went for scan number two of my current IVF cycle. There were the usual dilemmas: Is it acceptable to make small talk whilst the doctor is lubing up a condom? Can I shriek "Youch" when he presses too hard on my left ovary? Is it okay to ask why my doctor decided on a career where he spends most of the time looking into ladies' private parts? You know, the usual stuff. But on this occasion, during our familiar wind down pleasantries, Mr T looked down at his hands and started to mumble. There was clearly something on his very thoughtful mind. Huh, he's got something awkward to say, I thought, wonder what it is? I hope I haven't got a large growth hiding in my uterus. The doctor shuffled in his chair, frantically tapped away at his keyboard and finally brought up the subject of two "optional" treatments. What?! There's more stuff they can do to me? Well, as it transpired, not me exactly.


The first addition up for discussion was Early Embryo Viability Assessment (Eeva). If you think it sounds fancy, that's because it seriously is. Eeva is a method of continuously monitoring embryos during their first moments and days of development. The very scientific theory goes that by scrupulously watching their every move and division you can tell which embryos are the good ones. And, based on a complicated mathematical algorithm the embryologist can, potentially, choose that elusive embryo capable of yielding a golden pregnancy. Good, huh?




Source


The second super-dooper IVF improvement is called EmbryoGlue. Yes, the marketing bods really have named the "optional" treatment EmbryoGlue. Who is going to turn down the opportunity to glue their embryo to their uterus? The science is a bit, but not much, more complicated than just gluing one thing to another; it involves adhesion molecules and carbohydrates but, in a biological sense, sticking things together is exactly what it does. A-ma-zing! Just look at the title of their movie clip. Who wouldn't want that?



Source


What's the catch? Well, there really isn't a lot of evidence that either of these things will definitely make me a pregnant lady. And, not surprisingly, they come with some pretty yikes-inducing price tags.
 

As I listened to Mr T enthusing over the benefits of these two IVF advancements, I couldn't hide my scepticism; I was the same with the mechanic. As my eyes grew wider and wider, my lovely fertility specialist finally cracked and said "Well, it certainly won't hurt". Losing control of myself for a moment, I let out an involuntary snort - always attractive - and Mr T conceded that it would most definitely hurt my pocket.


So it has come to this. I am forced to make decisions about whether I take the gamble and pay the money for experimental treatments that might - Mr T says probably - improve my chance of a pregnancy. I can't help feeling that this shouldn't be my decision. Surely this is either the best treatment, in which case sign me up, or no-one really knows, in which case, do the bloody trials.


The cost for both treatments would be £1200 (approximately $1800 USD) and, if I choose both, could increase my pregnancy rate from 50% up to a staggering 80% (possibly).


If I turn it down and I don't get pregnant will I beat myself up and think I should have done more, spent more, tried harder? Of course, the lovely fertility specialist was very careful to say my current plan, without the bells and whistles, is perfectly good - nothing wrong with it - but, in his opinion, the extras would make it better.


I don't know, I really don't. Any advice? What would you do?


Wednesday, 22 May 2013

ICLW - May

Oh dear, I am late. ICLW started yesterday and I'm only just getting my post together. Oh dear, I hope all you lovely ICLW visitors didn't arrive en masse at some point during the last twenty four hours and I have missed you all. Let's believe that isn't the case and carry on as if I'm right on time.


WELCOME TO MY BLOG


First a very brief introduction: My wonderful, supportive and courageous husband and I are currently going through our second fresh IVF cycle; there was an unsuccessful frozen cycle in between. During my first IVF cycle, which was magical and terrifying in equal measure, I became pregnant with identical twin girls. The babies shared the same sack; it was a complication that almost certainly led their foetal demise at sixteen weeks and 5 days. I miss those girls every single day.


Now dear ICLW visitors, and for anyone who wants a quick refresher, here is a run down of what you might like on my blog:


  • If you have ever experienced a pregnancy loss you might relate to the post "Good days and bad days". And, as an added bonus, it includes a picture of me on my wedding day. Click here to read.

  • Those of you going through the dreaded two week wait will nod your heads and smile at my "Could I be pregnant?" musings. Click here to read.

  • Anyone who is organisationally challenged, you know who you are, may blush in recognition when the read "Down to the wire".  Click here to read.

  • Some people love science, don't they? Are you one of those people who tingles with excitement when you find a new fact of figure? Yes? Well, then get yourself on over to my Operation Big Belly posts. Operation Big Belly is my research mission to uncover what will really impact your IVF cycle. So far we have covered food, alcohol, caffeine and smoking. Some of the discoveries have been predictable but many quite surprising. There is still more to come and I am hoping to cover stress, acunpuncture, hypnotherapy and a few more topics before I'm done.

  • Thinking about going through an IVF cycle and want to know what's in store? Then you might like to check out my posts on my first step (although, be warned, my husband thought that one was a bit too surreal), my WTF appointment, the day the meds arrived and, lastly, the post where I think about what we're all thinking right before we hop onto the lovely scan bed.


Go clicking crazy, people. It is my dearest desire, and not so secret wish, that you read one other post after this one. I know it's a lot to ask and I am sure you are really busy. After all you have six comments a day to complete. But please, oh please, oh please do it. Your compliance would make me so happy and it would feel so delightful to find your comments scattered throughout my blog. And, if you leave a comment and your url, I promise to go back and read not only your ICLW post but at least one other as well. I can't say fairer than that, can I?


Oh, just a note: Please leave your url, your ICLW number or your blog name. I really do want to find your blog and, unfortunately, I don't seem to be able to easily find people from their comments.

And finally.....


ENJOY

Saturday, 18 May 2013

Back on the big dipper

Why do people voluntarily ride roller coasters? Perhaps if the aliens land tomorrow they will think that, if they base their assessment on the roller coaster riding alone, the people who inhabit this planet are bonkers. The creatures from Mars will see that, before the earthlings climb into the buckets, they are trembling and, once seated, they will scream, nausea will rise from their guts and, if it's a good one, even cry. However, once it's over, you will hear the riders say how thrilling it was, oh it was such an adventure, they'll say; get right back in line and hop on again for one more go. In short, the exciting, thrilling, exhilarating, wonderful feelings outweigh the fear, vomit and scream-inducing gut-wrenching stuff. Maybe that is why couples keep on putting themselves through one IVF cycle after another: the hope that, one day, after all the rain they'll get a turn at dancing in the sunshine.


This week I had the first scan of my current, it's my third if your counting, IVF cycle. I tried to remember how many scans I have had throughout my infertility journey  but I can't, there have been just too many. After the first scan of my last frozen cycle I wrote down my thoughts on the scan process and, lucky reader, you can read all about it below:

 
"On the train back home from my clinic I couldn’t help thinking about how odd these scan sessions are. Maybe it is just me but they are weird, aren’t they? I find it all so awkward and slightly hysterical at the same time. I spend a good ten minutes in the morning checking everything downstairs looks okay, like anyone cares, and the thought that it isn’t pops into my head many times during the day. Then, once I get to the clinic, I spend several moments debating whether it should be socks on or socks off, wondering if it matters, and trying to remember if my nail varnish would be suitable if I do dare to go socks off. Finally, I make a socks on decision, clamber onto the chair, or maybe it’s a bed – I am not sure what it is – and I attempt to maintain some semblance of dignity whilst desperately trying to balance in the stirrups. Once I think I’m safely in, I have to call out “I’m ready” at which point I panic wildly, think Mr T won’t hear me so call out two more times with increasing volume and desperation. The whole humiliating process culminates with, what can only be described as, an eye-wateringly large dildo like probe which, to add insult to injury, gets lubricated and covered with a condom! Then the lights go down, I half expect Barry White to start playing, and we get to spend several minutes examining my inadequate innards. Like I say – odd!"


I had the exact same feelings again this week - nothing changes. Except this time, instead of excited anticipation, I am nervous and a little bit scared. The scan went well, I have 8 resting follicles (that's okay, apparently) and none of my internal organs had left the building - I wouldn't blame them if they had, I think they've had enough. But this time I have prior knowledge of what lies ahead; I know that IVF is hard and it makes me feel like this:




Oh before I forget, the financial round up:

1. IVF meds:    £1092
2. IVF cycle:   £3275
3. HEFA fee:    £75
4. Train fares: £28
   Total:       £4470

Wednesday, 15 May 2013

I am an IVF junkie

It turns out that having a text speak name, being very cheap and only existing on the Internet doesn't mean that you are an untrustworthy outfit run by a gang of Internet fraudsters, living off great piles of cash sent to you by desperate infertile couples. It also seems that my inability to get things done any quicker than your average snail, or get things done at all, hasn't brought our IVF cycle to a grinding halt. No idea what I'm talking about? Then see here. For the rest of you:

We have drugs and lots of them too. Look at them all. 





It is mind-boggling to think that in four weeks time, if everything goes according to plan, all those little beauties will be inside me - they shouldn't be in me all at once, some of them have better be metabolised or else I am one odd fish. Those drugs you see right there will, oh so hopefully, have made a baby or two or three or four or more. Yes, I know embryos aren't the same as babies but, please, work with me, I am writing out my dreams here. The great and good Mr T, our fertility specialist, seems to think he has got me all figured out this cycle. No need for guess work or buying our fertiltiy meds one syringe at a time. So, we've only gone and bought them all at once. Yikes! Oh Lord, I hope that doctor is worth the megabucks. In case you are wondering what the plan actually is, and it seems obvious to me that you must be, I have handily prepared a flowchart, not including scans which are randomly placed throughout:






In other news, my period kindly arrived. I apologise if you were still hanging on the edge of seat after my "could I be pregnant?" post. Hope can be a terrible thing. Maybe I should have cushioned the blow for you? Next time, although I'm hoping next time I will be screaming from the roof tops "I'm bloody pregnant!", I will gently sit you down, offer to make you a cup of tea and say "I have some bad news, you know that baby you wished I was making? I am afraid it's not going to be this month, dear". More importantly, the arrival means that I can take a trip to London tomorrow to see the magnificent Mr T in person. I get to spend some quality time with him and his magic stick (always enjoyable); then, assuming my uterus hasn't jumped ship when I wasn't paying attention, I will have the joy-inducing opportunity to hand over a ton of money.


For those who are financially minded, and so it reminds me to behave responsibly and not book a random weekend break, I will be tallying up the credit card bill as we go along. Here comes the first total:

   IVF meds: £1092
      Total: £1092