It’s been a bumpy ride for the past seven days. On Friday I went in for my egg retrieval. After daily injections to stimulate my ovaries which aims to create lots of follicles (with the goal of making lots of eggs) we were ready for the procedure.
I had been experiencing tenderness and soreness around my lower abdomen in the few days leading up to the procedure. The nurse who conducted my scans told me this was because I had lots and lots of follicles which also put me at risk of ovarian hyperstimulation syndrome (OHSS). She recommended that I rest and drink plenty of water until the egg retrieval so I ended up taking the last two days off and resting in bed.
Friday came and I was feeling a little nervous but also relieved that it would soon be over as by this stage I was feeling pretty uncomfortable. The doctor performing the procedure approached me in the waiting room and introduced herself. She wasn’t sure how much I’d been told (which wasn’t much at all) and told me that while I had many follicles showing up in the scans, my oestrogen levels were relatively low which was an indication that I hadn’t grown many eggs. Based on my blood test they were predicting that they would only be able to collect six eggs that day.
I sat there feeling so deflated but smiled and nodded. I knew I only had to hold it together for a little while longer until this stage was over. I didn’t want to upset myself in front of the anaesthetist, doctor and all the nurses. After saying good bye to my husband they led me into the theatre and within a minute or two it was lights out.
When I first woke up I was feeling ok. Everything was a bit blurry and I could hear a nurse talking to me but couldn’t see her at my side. The first thing I remember asking was ‘how many eggs?’.
She told me to look at my hand where they had written the number of eggs collected. I burst into tears. Seventeen. Tears of relief. The nurse got me some tissues and the doctor phopped in to tell me how great the result was. It actually turns out we got 19.
With the IVF process the number of eggs collected is a major factor in whether it will end in a pregnancy. Although you may start with 19 eggs for example, they won’t all be mature or of good enough quality to fertilise, and once they are fertilised they won’t all survive. And the stimulation and egg retrieval can be one of the most difficult parts (physically) of the journey so I was really hoping to minimise the chance of having to do it over again.
In recovery the nurse asked me about my pain and gave my some intravenous pain relief. Once at home I’d only be able to take Panadol or Panadeine. Unfortunately codeine makes me quite sick so I was hoping to get away with just the Panadol.
I didn’t feel too bad in recovery and couldn’t wait to see my husband and go home. I was given some written instructions on pain relief, next steps for medications in the lead up to the embryo transfer which was due on Tuesday as well as warning signs for OHSS. I was told I might feel some tenderness and discomfort for a day but nothing that Panadol and a heat pack couldn’t fix.
I was feeling really positive (but still quite woozy) and went home to rest. My husband had the day off to stay with me through my recovery.
I rested for awhile but it wasn’t long before the pain worsened. It was becoming more and more unbearable. My husband had to help me to the bathroom every time I needed to go and as soon as I was up I felt faint and nauseous. Before long the pain was excruciating and I eventually broke down in tears, telling my husband I couldn’t take any more.
He rang the doctor who asked me questions, and basically said I would either need to keep taking pain relief and wait it out or to go the ER at the hospital to be checked out. Neither option sounded appealing but I had no option.
I stuck it out for the rest of the weekend. The doctor rang me each day to check on my status. The pain became bearable but I still needed help getting from my bed to the bathroom and could only lay on my back.
On Monday I was able to go see my Fertility Specialist to be assessed. I was diagnosed with moderate OHSS. I was bloated, still in pain and having trouble breathing. It turns out that my ovaries were over stimulated and what happens is they swell to several times their size and fill with fluid which then leaks into my body. That fluid was pushing on my lungs restricting my breath. I was given the week off work and under strict instructions to drink 1 litre of water and 1 litre of hydralite each day as well as taking medication called cabergoline. I was told that it could be another couple of weeks before I really feel back to normal.
My doctor sent me off to have a blood test and we went straight to the pathology at the hospital. Can I just say – after IVF, if I never have to get another blood test in my life it will be too soon. Apparently I have ‘delicate’ veins. Which sounds lovely but is really just a pain in the arse. On this day too I was particularly dehydrated due to the OHSS and the nurse had a lot of trouble finding a vein to draw blood from. She tried three different places – my left arm where she dug around with the needle and told me “I can feel it but it keeps moving away from the needle when I get close”, the right arm where she started out ok, but half way through the blood flow stopped as the vein collapsed, an finally in my hand which freakin’ hurt and was left bruised and battered.
At this stage I was struggling to hold it together. I walked straight through the waiting room where my husband and three other people were sitting and out the door as I burst into tears. I must have looked like a crazy lady with all these bandages and me bawling. My poor husband didn’t know what had happened!
Since then I’ve slowly improved each day. My transfer was meant to be on Tuesday. Meaning I could have been sitting here in the early stages of pregnancy. But the risk of getting worse was too big. OHSS can be fatal so it’s not to be taken lightly. My FS still had asked me to return for my transfer appointment on Tuesday but was very apologetic about the fact that it was unlikely we could go ahead. On the day she assessed me again and we decided that it was safest to wait, recover and do a frozen transfer when the time was right. I wasn’t too disappointed. I was feeling so rubbish that all I could focus on was feeling better.
I believe that what is meant to be will be. I actually feel positive about having a break from all the drugs and blood tests to completely recover physically and mentally before we take the next step forward. I feel like I need time to emotionally recharge.
And there’s always a silver lining – it will be nice to relax and have a champagne with my family over Christmas!
The good news from all of this is that out of the 19 eggs they collected, 13 fertilised normally (after being injected with my husband’s sperm – that sounds romantic doesn’t it). Of those embryos 5 were of good enough quality to be frozen for future transfer! I’m told this is pretty good numbers.
So right now I’m a mummy to five very frosty babies! I am feeling really positive about 2015 and everything I have in my life in this very moment. Especially my husband who has waited on my hand and foot for the past week! Even if he did force me to drink the hydralite whenever I opposed.
Another positive to come from it all is that I decided to tell my close family and friends about what was happening. There’s nothing like serious illness to make you want your mother! It was nice to share with some of my nearest and dearest what we’d been going through – they were very sympathetic but also so excited for us in going forward. It’s so nice to have the support of loved ones, it really makes all the difference.
It’s been a bumpy ride but I really believe in the end it will all be worth it.
The IVF Process and Gratitude
Coming to the end of my first week of our IVF ‘stim cycle’…
My understanding of it all is pretty basic and perhaps lacking medical accuracy in parts, but I’ll try to explain what (I believe) it’s all about very briefly…
After my first blood test which confirmed my hormones levels were fine to start, I began on Sunday night with one injection a day – Puregon – which aims to stimulate my ovaries into making lots of good sized follicles.
On Wednesday I had another blood test which confirmed that we were ok to begin with suppressant injections (while continuing with the Puregon – so now onto two injections a day). This one is called Oragulatan – and it stops me from ovulating, so we don’t lose all the eggs I’m growing as they need to stay in ‘there’ to be collected.
I’ll continue with both of these and have another blood test as well as an ultrasound on Wednesday. This should confirm that my hormones levels are ok and that I have plenty of follicles that are a good size in order to continue.
If that goes well, I will then be told to administer the “Trigger” injection at some point. I believe the “Trigger” injection is HcG (also the hormone which you produce when you’re pregnant) and that it’s purpose is to trigger the maturation of the follicles so they’re ready to collect.
If that is all going well my EPU should be on Friday next week. I’m already counting down. The outcome of the EPU will play a huge part in determining the success of our IVF – as the number and quality of eggs they collect is so important.
After they collect the eggs I believe they grade them and if there are any of high enough quality they inject them with the sperm to create embryos and hope that enough survive and are of good enough quality to transfer back into me (one at a time – no octomom here).
So I’ve been told that although you might get 10 eggs (for example), this number decreases at each stage. The goal is obviously to be left with at least one (preferably more) of good enough quality to be transferred. The embryos that aren’t transferred are frozen for future transfer. Then I have to wait around for two weeks for a blood test to see if I’m up the duff! Just like trying the natural way nothing is guaranteed.
So far I haven’t had any serious side effects from the medication. I’ve had a bit of a headache hanging around and have been pretty fatigued. The needles haven’t been too bad at all. The Puregon was far easier than I expected. The Oragulatan stung a little bit more and left a red rash which had a burning sensation but it was all cleared by the morning. I have a bit of mild pain and tenderness in my lower abdomen but I’m hoping that’s just a sign that my body is working to do what it’s meant to.
I’m definitely over needles but it just has to be done.
I imagine it would be easy to get down about the whole process but I’m still feeling quite positive. I’ve been thinking that it’s a good time to take stock of everything I’m grateful for – while I’m still feeling good about it all. If I start to feel down, or overwhelmed or crazy hormonal it might help to have something positive to read back on (or not, but I’ll do it anyway)…
- I’m so lucky to have two friends who I can talk to about everything I’m going through – both who understand, who relate, who have some knowledge of the whole process and who check in on me to see how I’m going and offer to help me in any way they can.
- I’m really grateful to have a husband who has been there every step of the way and gives me my injections every night calmly even when I’m nagging him about whether he’s doing it right. I know a lot of women have to give themselves the injections because their husbands are too squeamish (or they’re going through it solo) and I can’t even imagine how much harder that would be.
- I’m so grateful that we don’t suffer unexplained infertility or have spent years trying to get pregnant and going through various treatments and surgeries. I know this process is so much harder for many people as there is so much uncertainty. Although we tried the vasectomy reversal first, I’ve always known it wouldn’t be as simple as nature intended, so nothing came as a surprise and we were able to pretty much get straight into it when we were ready.
- I’m lucky to have a boss who is understanding when I’ve needed to take time off work (even when I haven’t disclosed the reason), and to have flexible work hours so that I can take time to attend appointments and make up for it later if I need to. I don’t know how people manage this process with the endless appointments in jobs that aren’t flexible, it would add so much stress!
- I’m so, so, so grateful to live in a time when IVF is available and accessible and I’m so very blessed to have the financial ability to afford it. I don’t think I’ll ever complain about having to go down this route to have a baby because I am so lucky I can!
- I’m incredibly fortunate to have a wonderful husband and three great step-children who treat me with so much kindness and respect. And I hope that I can grow this family with a new baby who will only increase all the fun and love we have into the future.
Beginning IVF – Google research, needles and more needles
On Friday night we were in bed by 9 pm. My husband had been working out bush all week so he had a pretty solid excuse. I on the other hand only had wine to blame. I’d had one glass at lunch for a friend’s birthday. These days whenever I have a wine at lunch in the middle of a work day I always regret it. I crash in the afternoon and by the time I get home I’m already sleepy, often suffering a dull headache and ready to crawl into bed.
I must have slept too early because at about 4 am I woke and couldn’t get back to sleep, so I decided to pick up the iPad.
Somehow I got to reading an article about the risk factors associated with ICSI (the type of IVF procedure we are undergoing which involves the sperm being directly inserted into the egg)… before I knew it I was Googling studies and finding a whole host of things to worry about. It seems that everything comes with its own risks… IVF, ICSI, paternal age, maternal age, caffeine consumption, that cheeky glass of wine – every factor you can think of has been found in some research study or another to be correlated to some sort of less than ideal condition for baby or mother.
Congenital defects, autism, learning disorders, lower IQ, low birth rate, miscarriage, pre-eclampsia… there are so many things to worry about!
After an hour and a half of Googling various risks and outcomes I had read more research articles than I did in my honours year of uni and I was becoming rather panicked.
Now to put this in perspective – I’m not even pregnant yet.
At 5.30 am, my eyes blurry and my mind racing, I had to snap myself out of it. “Put the iPad DOWN”.
As is usually the case with problems that haunt us in the middle of the night, everything seemed much less dire when I woke at 8 am. I had a laugh to my husband about my early morning loss of sanity.
My rational mind returned as I remembered my fertility specialist pointing out that while ICSI ‘doubles the risk of congenital birth defects’ what this equates to is the risk increasing from 62 cases out of 100,000 to 93 cases out of 100,000. It’s still a very small risk overall.
And the thing is this… statistics are one thing, but the only way for me to avoid any risk associated with pregnancy and mothering would be to remain childless.
Anything worthwhile involves risks.
And as we all know, worry is never going to reduce the risk of anything.
That morning we went for my scheduled blood test to check whether my baseline hormone levels were ok to start FSH (which I believe stands for ‘follicle stimulating hormone’) injections… I’m still learning.
There was already a big wait at the medical centre by 8.45 and I wished I’d gotten there when they first opened fifteen minutes earlier. My husband didn’t help my nerves by telling me that the people leaving after coming from that ‘back room’ didn’t look happy. I’m not a big fan of needles (who is) but I may as well start getting used to them now as they become a regular ritual at this stage in our IVF journey.
We finally got called in and it was all pretty standard. On the way out as we passed through the busy waiting room my husband asked me “Did that hurt?! I can’t believe that needle was so big, it was like she was sticking a sword in your arm!” I noticed a couple of panicked faces as I made a quick exit.
That afternoon I was drifting off for a nap (who doesn’t love an afternoon nap?) when I received a text message from my fertility clinic, notifying me that our ‘Bookon Instructions’ had been emailed to us. I was suddenly wide awake and I eagerly opened the email. It said that we were ready to start injections Sunday evening, and it detailed upcoming my upcoming blood tests and ultrasound.
After what feels like such a long wait we were finally ready to start!
Last night was the first injection and it had to be given between 7 pm – 10 pm. I pushed it until 9.30 pm. With each passing hour I was getting more and more nervous. They tell you the needles are so small you hardly feel them, but I figured that’s just what they tell you.
As my husband was sorting through the huge bag of drugs, finding the right one and preparing the needle, I kept bothering him with questions. “Have you got the right one?” “Yes” “Are you sure?” “Yes” “The right dose?” “Yes, 125” “No it’s meant to be 150! Oh my god, now I’m so worried”. “I think you’re not meant to click the pen around to the right dose AFTER you put the vial in it” “No you’re not, it doesn’t matter which order you do it”… and finally “Just let me do it!”
Well you get the idea.
I lay on the bed and put a pillow over my eyes so I couldn’t see anything and braced for the searing pain which was surely going to follow.
I hardly even felt it. It was such a relief. Now that I know what to expect I am so much more relaxed.
Finally it feels like it’s all really happening. I am still a little nervous – there is no guarantee that I will come of all this with a baby – it is all in the hands of the universe.
I’ll be focusing on looking after myself for the next couple of weeks in the lead up to the EPU (Egg Pick Up) procedure – to give my body the best chance of success, and so that I’m in the best possible condition before going under the necessary general anaesthetic. Healthy meals, lots of water, no alcohol and early nights are in order.
And I’ll brace myself for the needles – the daily injections, regular blood tests and since I can’t just get enough of it all there is also the weekly acupuncture.
I would love to hear from anyone else who has been through IVF or is undergoing it at the moment or planning to in the future… please take the time to comment and share your experience with me below!
Preparing for IVF
Years ago when I first started dating my husband, he came with a disclaimer – he told me he had three children to a previous marriage but he would consider having more with the right person. At that stage in my life, to be honest I was just focused on having a good time and was not about planning for the future.
I was in my mid-20’s and enjoying life. I had never been in a rush to ‘settle down and marry’ and I hadn’t even considered a desire to have children.
I thanked him for letting me know, and just to cover my bases I gave him a heads up that maybe one day I would want children….maybe.
That was almost five years ago and since then I have fallen madly in love, moved in with this man and his children, experienced a crash course in step parenting, became engaged and gotten married.
The last few years I’ve grown more and more fond of the idea of becoming a mother. Life is fun with children in it. I love my family and my three stepchildren (who live with us every second week) and over time I have contemplated and thought very carefully about all the responsibility that comes with being a mother.
To be honest, coming to this decision was a gradual process. My husband on the other hand knew he wanted to have children with me from very early in our relationship. He loves being a father (he’s damn good at it) and he tells me how much he loves the idea of being parents together.
Having three children, it’s no surprise my husband had a vasectomy, so I knew well in advance that this would not be as simple as it’s ‘meant’ to be.
We first tried the vasectomy reversal route. We probably did it all the wrong way around, as that was a couple of years ago when we weren’t serious about trying – prior to our wedding. The results were really positive to begin with but over time it became clear that it wasn’t 100% successful so a couple of months ago we decided to go and get a second opinion from a fertility specialist with a referral from my GP.
Well that first appointment was a complete whirlwind! I went in with the expectation that we were going to have a nice casual chat about our options. Within the first five minutes – no exaggeration – the Doctor told us we would be doing IVF and was rattling off all the things we needed to do to prepare.
At this stage both my husband and I were already taking pre-conception vitamins (I take Elevit and he’s on Menevit). The FS told him “keep taking them because in a couple of months – she’s going to be undergoing IVF – and we need you to have Ferrari’s ready to go”. Wait. What?
I walked out of that office with hands full of test referrals, brochures, invoices and a spinning head. In the next few weeks I had to undergo a blood test and an ultrasound – all timed precisely to my ‘cycle’. Well I have since learnt you really plan anything because it turns out your body ends up doing the opposite of what you want it to do when it comes to these things.
I missed out on my tests that month because we were holidaying in Bali exactly when my tests were due.
It was probably a blessing because that gave us extra time to consider the process. By the time we got back from our holiday we were both sure that we wanted to go through with it and so we headed off to get all our tests done and I also started acupuncture.
The results confirmed that IVF – specifically ICSI – was the way to go and we were booked in, given more information and pamphlets and don’t forget the invoices….
So here we are about to start our first cycle. Yesterday we had our appointment with the nurse to learn about the injections. My husband will be administering them to me, and these are due to start next week as long as my next blood test results are fine.
What we’re about to embark on hasn’t completely sunk in yet. I don’t let myself think about the injections or procedures because I become nervous and I know there is no point worrying about it. It has to happen and worrying won’t help anything. So we’ll just deal with it step by step.
I have only told two friends (other than my husband) that we are about to start this month. Other close friends and family know we will be doing IVF but I have told them we’ll start ‘maybe next year’. I guess I don’t want the pressure and questions, and disappointment if it’s not successful.
And now we wait…
good things small 