This post is late, because things have been busy so I've not got round to it, until now.
A few weeks ago we had our Consent Appointment (lots of forms), injection training and our final blood tests before commencing our treatment protocol.
The consent forms are sent out and we have to go through and fill them in. Consenting to the treatment plan agreed on (stating that we agree to be prescribed the drugs, that we agree to having our eggs and sperm used to create embryos, that we agree to have them frozen and subsequently thawed and transferred back to my uterus, that we accept that the clinic can accept no responsibility for any problems with the embryos and that we are aware that there may be no viable embryos resulting from our treatment cycle, that we agree to have ONE embryo transferred, that in the event of either of our deaths or mental incapacity, we agree that the remaining partner may use the sperm/eggs/embryos for future treatment, that we agree to our eggs/sperm/embryos which are not of usable quality for our fertility treatment being used for research, etc, etc etc.) We also signed to say we agree to the clinic storing our embryos for up to three years for us, we can use them in the interim, but if the first cycle is successful, the remaining embryos will be kept frozen for up to three years before the clinic contacts us to decide if we want to keep them frozen or if we want to dispose of them. I'm glad we don't have to make that decision yet. For one thing we don't know how many viable embryos we will have in the first place. This might not even be a decision we have to make. If we only get one embryo, that's our chance. Otherwise, we'll need to make a decision, in the future, about the remaining potential babies on ice.
We were also shown how to administer the Gonal F, the first drug I will be given. The training involves a lovely nurse showing us the pre-filled pen we will be using (very like a pre-filled insulin pen). We were shown how to screw on the needle and set the dose by twisting the pen until 112.5 is displayed in a little window. Then the nurse brought out a 'skin pad' which is a square plastic frame with a gel filled pad of pink 'skin'. She pinched the 'skin', inserted the needle and then pressed the end of the pen, held it down until the dose was delivered, released and then removed the needle. We can inject either into my thigh or my stomach, whichever is most comfortable. Ha. As if either is going to be comfortable. I'm very glad that my husband is happy to administer these injections for me. I'm not sure I could cope with doing it myself, especially as it seems you need at least three hands to do everything right. The nurse said they will teach us the technique for the next lot of drugs once we're ready to start taking them (loading syringes from ampoules). How exciting.
Final blood tests were relatively simple, just for communicable diseases like HIV and Hepatitis. We both know we're clear of these because we've had these blood tests done several times over the last 3 or so years. But the clinic has to check. So hubby's blood test is no problem at all, he has very accommodating veins. Mine are smaller and, although I'm an old pro at having blood taken by now, this one felt more uncomfortable. The pain as she took the needle back out was enough to make me wince and I could feel the bruise forming. I did get a pretty impressive bruise in my elbow which lasted nearly two weeks and went very pretty colours. Always fun and games.
The clinic also gave me a private prescription for Provera, a drug used to bring on a withdrawal bleed if my cycle has been too long. This isn't funded through the NHS funding, so it's separate and up to me to get it made up. The prescription of our fertility drugs, the Gonal F etc, are being filled by a company with the appropriately fertility based name of Stork. They contacted us the following day to arrange delivery of the two boxes of drugs and paraphernalia - syringes, sharps box etc.
I had the Provera prescription filled and when I reached cycle day 40+ we decided that taking the Provera would be a good idea. In the past when I've taken Provera, a withdrawal bleed has started within five days, this time it was eight. Just my body letting me know who's in charge.
So, tonight (Day 2 of my cycle) my lovely husband gets to administer my first stimulation injection of Gonal F. I have my first monitoring appointment on Friday at 7.45am and they will do an ultrasound and a blood test to see how the follicles are developing.
Every step from now on is one step closer to our baby.
I'm really excited.
Monday, 25 April 2016
Wednesday, 23 March 2016
IVF Consultation, Reducing Carbs and Losing my Temper
So... the IVF Consultation, deciding to reduce my carb intake and losing my temper may all be linked.
We went to the IVF consultation where I was officially diagnosed with PCOS (Poly-cystic Ovarian Syndrome) 'Normal' women produce up to 20 follicles each month, one of these then matures and is released as an egg. This egg is then either fertilised and implants in the uterine lining or is shed as part of the uterine lining as a period. PCOS can cause any or all of: irregular or absent ovulation (leading to irregular or absent periods), coarse body hair, difficulty losing weight, high AMH levels, and acne. I am fortunate enough not to have too many of the aesthetic symptoms, I don't have acne, I've got some coarse body hair but it's manageable and not on my face. I do however, have: high AMH levels, irregular periods and I find it difficult to lose weight. The ultrasound report states that I had 58 follicles on my ovaries at the scan. Pretty high. So, PCOS it is.
Hubby has a low-ish count, but not really anything to worry about. The shape and movement of the sperm is above average so it compensates.
All of this is important because it influences the type of treatment we have.
The clinic will do ICSI (inter-cytoplasmic semen injection), basically they will use a tiny needle to inject the sperm into each egg, rather than just popping them in a petri dish and letting them mingle in their own time like a microscopic cocktail party. Due to the PCOS we will do a short protocol stimulation. This means that I don't have to down regulate my cycle, and I only need to do one week of injections rather than the 16+ of a longer protocol cycle. I will also have a very low dose of stimulation. Basically because the hormones will stimulate all the follicles to grow, which means I will get lots and am at high risk of hyperstimulation. If I produce too many follicles, it can make me poorly. Each follicle is a little sack of fluid, lots of them is uncomfortable in the ovaries and, that fluid can stay in the ovaries and then enter the abdominal cavity (ovaries aren't part of a closed system) which is pretty nasty. So, they want to monitor me closely and try not to let me get hyperstimulated.
They have also advised us to do an 'elective freeze' which means that we will freeze ALL the embryos at day 3 (after fertilisation). A normal IVF cycle would be stimulation, egg collection, fertilisation, let the embryos get to a certain point in development while using progesterone suppositories (lovely thought) to prepare the uterus, implant one embryo and freeze the rest. There is a 30% success rate on this kind of cycle. With an elective freeze, all the embryos are frozen, I will be able to recover from any hyperstimulation and then, after three months, my uterus can be prepared for embryo transfer. The success rate for an elective freeze cycle increases to 70%.
Although this represents yet more waiting - which we know I am oh so good at - we talked about it and believe that the increased success rate is worth waiting for. Plus, if I got hyperstimulation we would have to abandon a fresh cycle anyway.
We are taking supplements, hubby gets a nice little vitamin tablet and I get the wonderful Inofolic. Which is designed for PCOS to help with pretty much all of the symptoms, but does also contain the advised dose of folic acid. My supplements come as a powder which you dissolve in water - although dissolve isn't really what happens, it's more like the powder being suspended in the water if you stir it fast enough and then down it like a shot. Yoghurt or banana is definitely the best thing to take the taste and gritty feeling away afterwards. I have to take two of these powder sachets each day.
The clinic would like us to take the supplements for at least a month (but ideally three). However, we have agreed that I can start stimulation if I get a natural period any time in April or I can have Provera to bring on a false period if I've not had a bleed by May.
We have to have a consents appointment, HIV tests and a session about administering the injections, so I have to phone them and book that ASAP. All go.
As a parallel to the IVF, I have a renewed determination to get my weight under control. I do not want to get gestational diabetes and I want a nice bump, not a fat woman bump. So, I researched a bit and found that, basically, carbs are EVIL. Particularly refined carbs, so I am reducing these. I do Slimming World and that diet recommends that you fill 1/3 of your plate with 'speed food' basically the really healthy veg - broccoli, green beans, cabbage etc, stuff that fills you up but has barely any calories. Then 1/3 protein - lean meat, beans and pulses and the remaining third can be free food - pasta, rice, potatoes etc or syns (up to 15 per day) including cheese, sauces etc. So, in my mission to reduce carbs, I decided to aim for at least 1/2 my plate of 'speed foods', 1/4 protein and 1/4 at most of carbs. Any carbs I have need to be as low GI (Glycemic Index) as possible i.e. wholewheat pasta, pearl barley, boiled new potatoes rather than refined carbs like white bread, white rice and so on.
This is working really well, I'm eating a wide variety of foods, as we always have, and I'm actually finding it pretty easy to do. I've lost 10lbs over the last four weeks, so I really think it is working. I also feel less sluggish and less hungry throughout the day. I do still find myself craving sugar particularly, but I am finding it much easier to limit what I have to a sensible amount. I'm also finding fruit sugars much sweeter and more satisfying than the sweet things I tend to crave, like dolly mixture, red licquorice and chocolate - the enjoyment of fruits seems to last longer whereas I now feel I get a bit of an aftertaste from sweets and chocolate. I drink a lot of water as well, so that really helps manage my hunger levels throughout the day.
I've even eaten out at a couple of restaurants within that time and have had the courage and willpower to ask for extra vegetables with my steak instead of the chips, and to ask for no cream on my fruit and meringue. Both restaurants were very obliging and I really enjoyed both meals.
So... at my therapy group last week, I lost my temper. There is a person there who I don't get along with and my feelings of frustration and annoyance at him bubbled over last week. He was overly antagonistic towards me when I was trying to offer support to another group member. I have felt isolated within the group for a while as the group seems to be split into a few different sets, there's the old gang who have been involved with this network for a long time and had been at a previous therapy group with these therapists, there's the new ones who are new to the network and know one another from the introductory group only, there's the two therapists and then there's me. I'm not part of the old group because I didn't attend the first group with them, even though I attended the introductory sessions with them, I felt like the odd one out then because they all knew each other and the only other new person at that point decided not to continue into the main group. They have a lot of history with each other, they know each other's backgrounds and have an understanding of each other which I feel excluded from. The new ones have bonded as a group in their introductory sessions and they group me in with the old gang so I don't fit in with them either. Obviously I don't fit in with the therapists, although I would place myself more at their level in terms of intellect and understanding - another group member actually said that she sometimes thinks of me as one of the therapists. I feel that there are certain members of the group, especially this one bloke, who are not really interested in improving. They just want to gripe about their lives, as far as they are concerned there is no problem with their behaviour, it's that no one else understands them. This seems like a waste of everybody's time to me. Coming into group and saying "there's no point bringing anything in because it's not going to change anything, it's them not me" isn't really the point of the group and actually wastes everyone's time. I'm not planning on going back. I did over-react, but I think it was a general bubbling up of feeling that had been there for a while. I've not been able to articulate any of my thoughts really since I tried to talk about feeling left out and didn't really feel like anyone understood what I was saying and therefore it didn't really help to have said it.
I feel that I am so much better than this time last year, and that the mentalization aspect of the therapy has really helped me, has equipped me to deal with the way I feel, the emotions I once found overwhelming are now easier to recognise and cope with and I am much more able to articulate how I'm feeling with those close to me. I don't feel like it's helpful to put myself in a situation where I feel uncomfortable and risk taking too much of other people's problems on myself. I'm well, and I want to stay well. I will continue to use the skills I've learnt from therapy, but I don't think I am going to improve further by attending group. I think there are other things I want to do which will help me to continue to get better.
Well, that was a long one!
We went to the IVF consultation where I was officially diagnosed with PCOS (Poly-cystic Ovarian Syndrome) 'Normal' women produce up to 20 follicles each month, one of these then matures and is released as an egg. This egg is then either fertilised and implants in the uterine lining or is shed as part of the uterine lining as a period. PCOS can cause any or all of: irregular or absent ovulation (leading to irregular or absent periods), coarse body hair, difficulty losing weight, high AMH levels, and acne. I am fortunate enough not to have too many of the aesthetic symptoms, I don't have acne, I've got some coarse body hair but it's manageable and not on my face. I do however, have: high AMH levels, irregular periods and I find it difficult to lose weight. The ultrasound report states that I had 58 follicles on my ovaries at the scan. Pretty high. So, PCOS it is.
Hubby has a low-ish count, but not really anything to worry about. The shape and movement of the sperm is above average so it compensates.
All of this is important because it influences the type of treatment we have.
The clinic will do ICSI (inter-cytoplasmic semen injection), basically they will use a tiny needle to inject the sperm into each egg, rather than just popping them in a petri dish and letting them mingle in their own time like a microscopic cocktail party. Due to the PCOS we will do a short protocol stimulation. This means that I don't have to down regulate my cycle, and I only need to do one week of injections rather than the 16+ of a longer protocol cycle. I will also have a very low dose of stimulation. Basically because the hormones will stimulate all the follicles to grow, which means I will get lots and am at high risk of hyperstimulation. If I produce too many follicles, it can make me poorly. Each follicle is a little sack of fluid, lots of them is uncomfortable in the ovaries and, that fluid can stay in the ovaries and then enter the abdominal cavity (ovaries aren't part of a closed system) which is pretty nasty. So, they want to monitor me closely and try not to let me get hyperstimulated.
They have also advised us to do an 'elective freeze' which means that we will freeze ALL the embryos at day 3 (after fertilisation). A normal IVF cycle would be stimulation, egg collection, fertilisation, let the embryos get to a certain point in development while using progesterone suppositories (lovely thought) to prepare the uterus, implant one embryo and freeze the rest. There is a 30% success rate on this kind of cycle. With an elective freeze, all the embryos are frozen, I will be able to recover from any hyperstimulation and then, after three months, my uterus can be prepared for embryo transfer. The success rate for an elective freeze cycle increases to 70%.
Although this represents yet more waiting - which we know I am oh so good at - we talked about it and believe that the increased success rate is worth waiting for. Plus, if I got hyperstimulation we would have to abandon a fresh cycle anyway.
We are taking supplements, hubby gets a nice little vitamin tablet and I get the wonderful Inofolic. Which is designed for PCOS to help with pretty much all of the symptoms, but does also contain the advised dose of folic acid. My supplements come as a powder which you dissolve in water - although dissolve isn't really what happens, it's more like the powder being suspended in the water if you stir it fast enough and then down it like a shot. Yoghurt or banana is definitely the best thing to take the taste and gritty feeling away afterwards. I have to take two of these powder sachets each day.
The clinic would like us to take the supplements for at least a month (but ideally three). However, we have agreed that I can start stimulation if I get a natural period any time in April or I can have Provera to bring on a false period if I've not had a bleed by May.
We have to have a consents appointment, HIV tests and a session about administering the injections, so I have to phone them and book that ASAP. All go.
As a parallel to the IVF, I have a renewed determination to get my weight under control. I do not want to get gestational diabetes and I want a nice bump, not a fat woman bump. So, I researched a bit and found that, basically, carbs are EVIL. Particularly refined carbs, so I am reducing these. I do Slimming World and that diet recommends that you fill 1/3 of your plate with 'speed food' basically the really healthy veg - broccoli, green beans, cabbage etc, stuff that fills you up but has barely any calories. Then 1/3 protein - lean meat, beans and pulses and the remaining third can be free food - pasta, rice, potatoes etc or syns (up to 15 per day) including cheese, sauces etc. So, in my mission to reduce carbs, I decided to aim for at least 1/2 my plate of 'speed foods', 1/4 protein and 1/4 at most of carbs. Any carbs I have need to be as low GI (Glycemic Index) as possible i.e. wholewheat pasta, pearl barley, boiled new potatoes rather than refined carbs like white bread, white rice and so on.
This is working really well, I'm eating a wide variety of foods, as we always have, and I'm actually finding it pretty easy to do. I've lost 10lbs over the last four weeks, so I really think it is working. I also feel less sluggish and less hungry throughout the day. I do still find myself craving sugar particularly, but I am finding it much easier to limit what I have to a sensible amount. I'm also finding fruit sugars much sweeter and more satisfying than the sweet things I tend to crave, like dolly mixture, red licquorice and chocolate - the enjoyment of fruits seems to last longer whereas I now feel I get a bit of an aftertaste from sweets and chocolate. I drink a lot of water as well, so that really helps manage my hunger levels throughout the day.
I've even eaten out at a couple of restaurants within that time and have had the courage and willpower to ask for extra vegetables with my steak instead of the chips, and to ask for no cream on my fruit and meringue. Both restaurants were very obliging and I really enjoyed both meals.
So... at my therapy group last week, I lost my temper. There is a person there who I don't get along with and my feelings of frustration and annoyance at him bubbled over last week. He was overly antagonistic towards me when I was trying to offer support to another group member. I have felt isolated within the group for a while as the group seems to be split into a few different sets, there's the old gang who have been involved with this network for a long time and had been at a previous therapy group with these therapists, there's the new ones who are new to the network and know one another from the introductory group only, there's the two therapists and then there's me. I'm not part of the old group because I didn't attend the first group with them, even though I attended the introductory sessions with them, I felt like the odd one out then because they all knew each other and the only other new person at that point decided not to continue into the main group. They have a lot of history with each other, they know each other's backgrounds and have an understanding of each other which I feel excluded from. The new ones have bonded as a group in their introductory sessions and they group me in with the old gang so I don't fit in with them either. Obviously I don't fit in with the therapists, although I would place myself more at their level in terms of intellect and understanding - another group member actually said that she sometimes thinks of me as one of the therapists. I feel that there are certain members of the group, especially this one bloke, who are not really interested in improving. They just want to gripe about their lives, as far as they are concerned there is no problem with their behaviour, it's that no one else understands them. This seems like a waste of everybody's time to me. Coming into group and saying "there's no point bringing anything in because it's not going to change anything, it's them not me" isn't really the point of the group and actually wastes everyone's time. I'm not planning on going back. I did over-react, but I think it was a general bubbling up of feeling that had been there for a while. I've not been able to articulate any of my thoughts really since I tried to talk about feeling left out and didn't really feel like anyone understood what I was saying and therefore it didn't really help to have said it.
I feel that I am so much better than this time last year, and that the mentalization aspect of the therapy has really helped me, has equipped me to deal with the way I feel, the emotions I once found overwhelming are now easier to recognise and cope with and I am much more able to articulate how I'm feeling with those close to me. I don't feel like it's helpful to put myself in a situation where I feel uncomfortable and risk taking too much of other people's problems on myself. I'm well, and I want to stay well. I will continue to use the skills I've learnt from therapy, but I don't think I am going to improve further by attending group. I think there are other things I want to do which will help me to continue to get better.
Well, that was a long one!
Tuesday, 1 March 2016
Miniature Breakdowns
I am currently having a series of miniature breakdowns, mainly about the IVF. These 'episodes' come on very quickly, like a punch to the gut and then play on my mind until I distract myself thoroughly enough. I generally distract myself by either eating something, making something or getting angry about something. Two of three of those strategies are not healthy, but they are healthier than totally losing my mind. The mini breakdowns generally involve the many different (some more realistic than others) scenarios and outcomes of the IVF consultation appointment next week.
Scenario #1: This is my best case scenario (but I really don't know how likely it is to be the correct one). We will go to the appointment where they will discuss the different treatment options and tell us which is the best protocol for us (what dosage of medication, etc) and what we can expect from the next steps. We will have some blood tests done (HIV, Hepatitis etc) and, when those come back clear, we will then be starting treatment imminently
Scenario #2: This would be frustrating as it represents more delays, but is not the worst my brain can come up with. At this appointment, we will discuss the treatment options, the clinic will then make us attend one of their monthly information evenings (likely to push us back to April), ask us to see one of their counselling team and then look to begin treatment in a few months.
Scenario #3: My nightmare. We go to the clinic and they tell us they can't help us and we will never have a child.
There are also other scenarios very similar to the three above, but with slight variations in detail. One involves a Scenario #3 with the added comment from the Dr to husband "you should get a fertile wife next time". Thank you brain.
Additional to this, there are stories of miracle women who, having been told they will never conceive naturally, on being referred for IVF become so relaxed while waiting for their treatment that they actually, amazingly fall pregnant. Obviously this is possible, but not very likely. However, being the pathetic optimist I am, having been told that I had a lovely sized follicle possibly ready to ovulate at the scan appointment I thought: wow, I could be one of those miracle women! However... I am now on cycle day 56, it's two weeks since the scan so if I had ovulated I would either be starting a period within the next couple of days or I'd get a positive pregnancy test. Now, being the experienced TTCer (Trying To Concieve) I have plenty of early detection tests, which claim to give a positive result four days before your period is due. Negative test yesterday. But obviously I'm symptom watching and luckily for me and all the other anxious TTCers out there the symptoms of early pregnancy and the syptoms of PMT are basically the same thing. So... I will try not to do a test until at least Saturday.
There is also a ton of other stuff happening at the moment which is causing tension/stress/worry for us. There's a lovely virus going around so hubby has a lovely bout of flu-like symptoms. There's a promotion which I think my other half should apply for at work but he's uncertain so has left the application to the last minute - now he's ill... so it's even more difficult to motivate him. My dad and my husband are also working on our bathroom, which they wanted to have finished two weeks ago but it got more complicated than they were expecting so it's still ongoing. Then there's complicated family stuff.
The issue really, is that I have very limited control over ANY of this. I don't like not being in control.
Scenario #1: This is my best case scenario (but I really don't know how likely it is to be the correct one). We will go to the appointment where they will discuss the different treatment options and tell us which is the best protocol for us (what dosage of medication, etc) and what we can expect from the next steps. We will have some blood tests done (HIV, Hepatitis etc) and, when those come back clear, we will then be starting treatment imminently
Scenario #2: This would be frustrating as it represents more delays, but is not the worst my brain can come up with. At this appointment, we will discuss the treatment options, the clinic will then make us attend one of their monthly information evenings (likely to push us back to April), ask us to see one of their counselling team and then look to begin treatment in a few months.
Scenario #3: My nightmare. We go to the clinic and they tell us they can't help us and we will never have a child.
There are also other scenarios very similar to the three above, but with slight variations in detail. One involves a Scenario #3 with the added comment from the Dr to husband "you should get a fertile wife next time". Thank you brain.
Additional to this, there are stories of miracle women who, having been told they will never conceive naturally, on being referred for IVF become so relaxed while waiting for their treatment that they actually, amazingly fall pregnant. Obviously this is possible, but not very likely. However, being the pathetic optimist I am, having been told that I had a lovely sized follicle possibly ready to ovulate at the scan appointment I thought: wow, I could be one of those miracle women! However... I am now on cycle day 56, it's two weeks since the scan so if I had ovulated I would either be starting a period within the next couple of days or I'd get a positive pregnancy test. Now, being the experienced TTCer (Trying To Concieve) I have plenty of early detection tests, which claim to give a positive result four days before your period is due. Negative test yesterday. But obviously I'm symptom watching and luckily for me and all the other anxious TTCers out there the symptoms of early pregnancy and the syptoms of PMT are basically the same thing. So... I will try not to do a test until at least Saturday.
There is also a ton of other stuff happening at the moment which is causing tension/stress/worry for us. There's a lovely virus going around so hubby has a lovely bout of flu-like symptoms. There's a promotion which I think my other half should apply for at work but he's uncertain so has left the application to the last minute - now he's ill... so it's even more difficult to motivate him. My dad and my husband are also working on our bathroom, which they wanted to have finished two weeks ago but it got more complicated than they were expecting so it's still ongoing. Then there's complicated family stuff.
The issue really, is that I have very limited control over ANY of this. I don't like not being in control.
Friday, 26 February 2016
Pre-treatment Scan and Blood Test
Before starting IVF treatment, we were asked to attend a pre-treatment appointment. I had to have an ultrasound scan on my uterus and ovaries as well as a couple of blood tests and hubby had to *ahem* produce a sample for analysis. After this appointment, a report is put together for us with our results and medical history. We have a consultation in March to discuss a treatment plan.
I had researched the place, planned our route and everything so I knew it should take us just under an hour to get there. I factored in 'getting lost' time and 'hubby faffing before we'd left the house' time and decided that leaving at 11 would give us plenty of time to arrive for my 12.30 appointment. When I searched for information about parking availability and charges, I came across a lot of people saying parking was really difficult because of the clinic being based on the same site as a big hospital - however, when I looked at the clinic's Facebook page (which I can't publicly 'like' because that would be a bit more out there than I want) they had information about their new site (the address on the letters) which is on a business estate just off the motorway with ample, free parking. One less thing to worry about. We had got ourselves a little wound up that morning. When stressed, I like to try and control everything, my other half gets very quiet and wound up and then stresses me out. It didn't help that he hadn't slept well the night before (apparently I'd been kicking him in the night and had woken him up, he had then woken the cat up, the cat had then kept him awake... somehow ALL my fault). So we had a mini argument but I kinda had to decide to put a cork in it and not wind him (or myself) up more than needed, especially as my role at the appointment was quite passive whereas he had a task to complete. It was sort of important for him not to be too stressed, otherwise he might not be able to... get the job done.
On the way, I tried to get him to talk about anything, to keep him distracted and chilled. We talked about oil refining... how petrol engines work... how diesel engines work... what red diesel is... how wind turbines work. Pretty safe topics because they have nothing to do with politics, economics, THE FUTURE, nagging, or anything that could be seen as fussing. Also, these are all subjects he is very knowledgeable on and I am not, so I am genuinely interested in his explanations.
The journey was very straight-forward, straight down the motorway and the clinic is about three turns after the motorway slip-road so we didn't get lost at all. Parking was great, and the building is big, well sign posted and easy to recognise - big logo on the windows.
The clinic itself is like a combination of a hotel, a spa and a posh office block. Not really like a hospital at all. Apart from the staff who appear occasionally in scrubs. It's very clean, the receptionist at the front desk is friendly and approachable but not in-your-face over cheerful. She checks us in and explains that my appointment is upstairs and his is downstairs, we can wait together upstairs as my appointment is first. Presumably wanting some peace and quiet, my loving husband chooses to wait downstairs in the 'men's waiting room' while I go upstairs on my own. Probably because he was tired, but I felt a bit like I would have liked him to wait with me upstairs. But never mind.
I went upstairs into the very spacious waiting room, still a lot more like a hotel than a hospital. Very spread out, different areas to wait in with white swivelly chairs, green comfy chairs and white coffee tables with orchids and lush green plants on. There is an area to make tea and coffee with proper branded tea bags and real cups! There are a selection of carefully curated magazines on the tables: health and fitness, gardens, home and decorating magazines. There are no gossip magazines or magazines with pregnant women or newborns on the front. This is deliberate. There are women in this waiting room who have lost babies, women who may be about to be told that there's no point continuing with the pursuit of a pregnancy. The women in this clinic waiting room do not need to see other women's swollen bellies or tiny children. There is a radio on, quietly in the corner, more as a background hum than anything, the staff chatter as they pass each other.
Every member of staff smiled warmly when they caught my eye.
It's a big waiting room, but there weren't many people there. This means that, unlike at the hospital where we struggled to get seats together in the waiting room, there is space between you and the other people, you could almost have your own area in there, you wouldn't have to interact with anyone if you didn't want to. When I came into the waiting room there was an older woman with her adult daughter and two other couples, one of whom had a toddler with them. The couple with the toddler went into one of the rooms to see someone and, when they came out, the little boy was playing on a chair in the waiting room. He was very cute, but it was heartbreaking. When his parents left with him, my eyes met those of the other couple in the waiting room and we both sighed. The woman's eyes looked so sad. I looked away from her and glanced at the older lady who was waiting for her daughter to come out from her appointment and she smiled at me with the tight lipped sad smile that people use when they know what you're feeling. She must have had the same conversations with her daughter that my mum and I have had. She must know how I feel, or at least she understands what I am likely to have been through because of what her daughter has been through.
A nice nurse came and called me through into a small, calmly lit ultrasound room, she went through a few details about me, name, date of birth, what day of my cycle am I on, have I had an internal scan before? I took my leggings and underwear off and assumed the position, on the tilted chair with my ankles in the stirrups. I kept my socks on. Top tip: KEEP YOUR SOCKS ON. Your feet get really cold dangling around in the air, these exams take a little while and it's hard to relax with chilly toes.
When ladies who are pregnant have an ultrasound scan, the technician uses that little handheld scanner on their belly. This is because they have a full bladder and the womb filled with fluid and baby is pushed up out of the pelvic cavity. When you are not pregnant, the angle doesn't work to use the external ultrasound, so I get to experience the wand.
The wand is literally a probe, and they put a condom on it. Nice. But to be honest, very little about this baby making process is romantic anymore. It's pretty clinical from here on in.
So she 'gently' inserted the wand - fyi I don't think medical staff understand the idea of 'gentle' - and an image appeared on the screen. Which is kind of fascinating, I've never seen an ultrasound of my insides. The technician talked me through the image on the screen, showing me the outline of my uterus, the lining that's in there. She said the lining is pretty thick which could mean I was due to have a period (since I was on day 40 something at that point, it could well have been), she took a couple of measurements of the lining and then moved on to the ovaries. She moved the wand to look at my ovaries in a way that I can only describe as 'trying to find reverse gear in an unfamiliar car'. Not painful but... a definite pulling sensation. So, right ovary appeared on the screen and there were lots of little bubbles. She explained that these are cysts and there are a lot of them. That may mean I have polycystic ovaries. I asked if this would be a problem and she said not really, it might just mean that they will give me a lower dose of stimulation drugs so as to not over-stimulate my ovaries. Hyper-stimulation can be painful and cause problems. She took several images of my right ovary and said she'd count up the cysts later. Side-note it seems that cysts, follicles and eggs are very similar things. Eggs are microscopic and are inside follicles. Cysts can be follicles or cysts can just be little sacks of water. And they are little, each of these cysts were less than half a centimetre. So, changing gear again, she found my left ovary. On the screen, there appeared a clear picture of one massive follicle - about two and a half centimetres, this egg looks ready to drop. Apparently this is a good thing. The size of that follicle looked like I might expect to ovulate shortly.
The confusing part of that is that: ovulation should occur two weeks before a period, on a random scan (at a point outside of a normal 28 day cycle where there's no way of knowing what stage of the cycle you're in) you should see either a maturing follicle or a thick uterine lining. Not both. So thanks for that body.
Anyway, the technician finished the scan, removed the probe at the perfect angle not to generate a fanny fart (they really have that down now, it is so stressful to worry about, but it never happens anymore, because they must teach the technique now). The technician left the room and I got dressed.
Then, I had to have a blood test and a chlamydia screening. The chlamydia screening involved peeing in a tiny bottle: pretty challenging to be honest.
So, I have scars from years of self-harming which was my - granted, unhealthy - coping mechanism for mental health issues. It has been a long time since I have self-harmed and there are a lot of people supporting me, one contributing reason to me stopping was that I wanted to have a baby, I knew I shouldn't even try to get pregnant while I was still having trouble with hurting myself. Although it has been a long time, and self-harm is something I have under control now, I do have lasting scars, particularly on my arms. I have very pale skin, hubby calls it thin skin, and scars appear very red and don't heal well. This is the same for accidental cat scratches, grazes and scrapes as it is for my self-harming scars. I still have visible red scarring from childhood injuries. But, I do understand that it probably looks pretty recent on my arms. The nurse saw some of the scars when she was taking blood. I don't try to hide them, I just don't show them off either. I wear long sleeves around all but my husband and occasional VERY close friends. In a blood test, you do have to roll up your sleeve, so she saw it and asked about them. She asked what they were, I said I used to self-harm. She said that they look quite fresh, I explained that I scar badly, and that it's been years since I self-harmed. She asked if it is still a problem, had I had any counselling or support. I explained that I have a very supportive GP, a psychiatrist who knows about the fertility stuff and who has already assured me that I will get psychiatric support during pregnancy and after the baby is born, a very supportive husband and family. I am actually in a better position than many women at risk of Post-Natal Depression, because I will be given pre-emptive support.
I did feel judged. I felt frustrated with myself. I'm angry with me from thirteen years ago who decided it was a good idea to start hurting myself. I'm worried that this will represent a barrier to me being able to have a child. It upsets me that if I could get pregnant without medical assistance, this wouldn't even be an issue, but because I can't, every decision I've ever made is being weighed up to decide whether I should be allowed to have a child.
Looking back at it, and having discussed it at therapy, I don't think she was trying to find reasons to block me from treatment. I think she cared, and wanted to understand what was going on for me. They offer counselling at the clinic. I think we may take them up on that.
After I was done being probed, stabbed and peeing in a bottle, I was allowed to go downstairs to see my husband. He was still waiting for his appointment, in the men's waiting room. This area was a lot smaller, with more men focused magazines like FHM. He was taken down to the 'comfortable, private room' to produce his sample by a friendly, and pretty, nurse. He came back about ten minutes later looking as if the weight of the world had been lifted from his shoulders.
Then we were done and could go home. On the way home, I coaxed him to tell me about the 'room'. He said there's a porn audition style couch and posters of bikini clad women on the walls and proper dirty magazines. As in, the ones where you can see EVERYTHING. He said in a way it was kind of sleazy, but maybe that's what some men need to help them... perform in unfamiliar surroundings. I guess that's why it is out of the way, where it is, and the nice bit of the clinic is upstairs, open clean and comfortable. Also, the labs are down the corridor from the 'room' so they can wiz the jizz straight into the lab - time is of the essence you know.
We went out for lunch on our way back home. We don't eat out together very often. It seems like we mostly have lunch or dinner out as a debrief session after fertility appointments and I cry at him across the table. I did get upset. As I said, I hold things in so that I can get through the hard bit, then I have a bit of an emotional purge. He was totally fine, really great in supporting me and making me feel better. It's just the emotional exhaustion of so much hope and expectation and worry and then it's all just over. Until the next appointment. So now I can build up to that.
I had researched the place, planned our route and everything so I knew it should take us just under an hour to get there. I factored in 'getting lost' time and 'hubby faffing before we'd left the house' time and decided that leaving at 11 would give us plenty of time to arrive for my 12.30 appointment. When I searched for information about parking availability and charges, I came across a lot of people saying parking was really difficult because of the clinic being based on the same site as a big hospital - however, when I looked at the clinic's Facebook page (which I can't publicly 'like' because that would be a bit more out there than I want) they had information about their new site (the address on the letters) which is on a business estate just off the motorway with ample, free parking. One less thing to worry about. We had got ourselves a little wound up that morning. When stressed, I like to try and control everything, my other half gets very quiet and wound up and then stresses me out. It didn't help that he hadn't slept well the night before (apparently I'd been kicking him in the night and had woken him up, he had then woken the cat up, the cat had then kept him awake... somehow ALL my fault). So we had a mini argument but I kinda had to decide to put a cork in it and not wind him (or myself) up more than needed, especially as my role at the appointment was quite passive whereas he had a task to complete. It was sort of important for him not to be too stressed, otherwise he might not be able to... get the job done.
On the way, I tried to get him to talk about anything, to keep him distracted and chilled. We talked about oil refining... how petrol engines work... how diesel engines work... what red diesel is... how wind turbines work. Pretty safe topics because they have nothing to do with politics, economics, THE FUTURE, nagging, or anything that could be seen as fussing. Also, these are all subjects he is very knowledgeable on and I am not, so I am genuinely interested in his explanations.
The journey was very straight-forward, straight down the motorway and the clinic is about three turns after the motorway slip-road so we didn't get lost at all. Parking was great, and the building is big, well sign posted and easy to recognise - big logo on the windows.
The clinic itself is like a combination of a hotel, a spa and a posh office block. Not really like a hospital at all. Apart from the staff who appear occasionally in scrubs. It's very clean, the receptionist at the front desk is friendly and approachable but not in-your-face over cheerful. She checks us in and explains that my appointment is upstairs and his is downstairs, we can wait together upstairs as my appointment is first. Presumably wanting some peace and quiet, my loving husband chooses to wait downstairs in the 'men's waiting room' while I go upstairs on my own. Probably because he was tired, but I felt a bit like I would have liked him to wait with me upstairs. But never mind.
I went upstairs into the very spacious waiting room, still a lot more like a hotel than a hospital. Very spread out, different areas to wait in with white swivelly chairs, green comfy chairs and white coffee tables with orchids and lush green plants on. There is an area to make tea and coffee with proper branded tea bags and real cups! There are a selection of carefully curated magazines on the tables: health and fitness, gardens, home and decorating magazines. There are no gossip magazines or magazines with pregnant women or newborns on the front. This is deliberate. There are women in this waiting room who have lost babies, women who may be about to be told that there's no point continuing with the pursuit of a pregnancy. The women in this clinic waiting room do not need to see other women's swollen bellies or tiny children. There is a radio on, quietly in the corner, more as a background hum than anything, the staff chatter as they pass each other.
Every member of staff smiled warmly when they caught my eye.
It's a big waiting room, but there weren't many people there. This means that, unlike at the hospital where we struggled to get seats together in the waiting room, there is space between you and the other people, you could almost have your own area in there, you wouldn't have to interact with anyone if you didn't want to. When I came into the waiting room there was an older woman with her adult daughter and two other couples, one of whom had a toddler with them. The couple with the toddler went into one of the rooms to see someone and, when they came out, the little boy was playing on a chair in the waiting room. He was very cute, but it was heartbreaking. When his parents left with him, my eyes met those of the other couple in the waiting room and we both sighed. The woman's eyes looked so sad. I looked away from her and glanced at the older lady who was waiting for her daughter to come out from her appointment and she smiled at me with the tight lipped sad smile that people use when they know what you're feeling. She must have had the same conversations with her daughter that my mum and I have had. She must know how I feel, or at least she understands what I am likely to have been through because of what her daughter has been through.
A nice nurse came and called me through into a small, calmly lit ultrasound room, she went through a few details about me, name, date of birth, what day of my cycle am I on, have I had an internal scan before? I took my leggings and underwear off and assumed the position, on the tilted chair with my ankles in the stirrups. I kept my socks on. Top tip: KEEP YOUR SOCKS ON. Your feet get really cold dangling around in the air, these exams take a little while and it's hard to relax with chilly toes.
When ladies who are pregnant have an ultrasound scan, the technician uses that little handheld scanner on their belly. This is because they have a full bladder and the womb filled with fluid and baby is pushed up out of the pelvic cavity. When you are not pregnant, the angle doesn't work to use the external ultrasound, so I get to experience the wand.
The wand is literally a probe, and they put a condom on it. Nice. But to be honest, very little about this baby making process is romantic anymore. It's pretty clinical from here on in.
So she 'gently' inserted the wand - fyi I don't think medical staff understand the idea of 'gentle' - and an image appeared on the screen. Which is kind of fascinating, I've never seen an ultrasound of my insides. The technician talked me through the image on the screen, showing me the outline of my uterus, the lining that's in there. She said the lining is pretty thick which could mean I was due to have a period (since I was on day 40 something at that point, it could well have been), she took a couple of measurements of the lining and then moved on to the ovaries. She moved the wand to look at my ovaries in a way that I can only describe as 'trying to find reverse gear in an unfamiliar car'. Not painful but... a definite pulling sensation. So, right ovary appeared on the screen and there were lots of little bubbles. She explained that these are cysts and there are a lot of them. That may mean I have polycystic ovaries. I asked if this would be a problem and she said not really, it might just mean that they will give me a lower dose of stimulation drugs so as to not over-stimulate my ovaries. Hyper-stimulation can be painful and cause problems. She took several images of my right ovary and said she'd count up the cysts later. Side-note it seems that cysts, follicles and eggs are very similar things. Eggs are microscopic and are inside follicles. Cysts can be follicles or cysts can just be little sacks of water. And they are little, each of these cysts were less than half a centimetre. So, changing gear again, she found my left ovary. On the screen, there appeared a clear picture of one massive follicle - about two and a half centimetres, this egg looks ready to drop. Apparently this is a good thing. The size of that follicle looked like I might expect to ovulate shortly.
The confusing part of that is that: ovulation should occur two weeks before a period, on a random scan (at a point outside of a normal 28 day cycle where there's no way of knowing what stage of the cycle you're in) you should see either a maturing follicle or a thick uterine lining. Not both. So thanks for that body.
Anyway, the technician finished the scan, removed the probe at the perfect angle not to generate a fanny fart (they really have that down now, it is so stressful to worry about, but it never happens anymore, because they must teach the technique now). The technician left the room and I got dressed.
Then, I had to have a blood test and a chlamydia screening. The chlamydia screening involved peeing in a tiny bottle: pretty challenging to be honest.
So, I have scars from years of self-harming which was my - granted, unhealthy - coping mechanism for mental health issues. It has been a long time since I have self-harmed and there are a lot of people supporting me, one contributing reason to me stopping was that I wanted to have a baby, I knew I shouldn't even try to get pregnant while I was still having trouble with hurting myself. Although it has been a long time, and self-harm is something I have under control now, I do have lasting scars, particularly on my arms. I have very pale skin, hubby calls it thin skin, and scars appear very red and don't heal well. This is the same for accidental cat scratches, grazes and scrapes as it is for my self-harming scars. I still have visible red scarring from childhood injuries. But, I do understand that it probably looks pretty recent on my arms. The nurse saw some of the scars when she was taking blood. I don't try to hide them, I just don't show them off either. I wear long sleeves around all but my husband and occasional VERY close friends. In a blood test, you do have to roll up your sleeve, so she saw it and asked about them. She asked what they were, I said I used to self-harm. She said that they look quite fresh, I explained that I scar badly, and that it's been years since I self-harmed. She asked if it is still a problem, had I had any counselling or support. I explained that I have a very supportive GP, a psychiatrist who knows about the fertility stuff and who has already assured me that I will get psychiatric support during pregnancy and after the baby is born, a very supportive husband and family. I am actually in a better position than many women at risk of Post-Natal Depression, because I will be given pre-emptive support.
I did feel judged. I felt frustrated with myself. I'm angry with me from thirteen years ago who decided it was a good idea to start hurting myself. I'm worried that this will represent a barrier to me being able to have a child. It upsets me that if I could get pregnant without medical assistance, this wouldn't even be an issue, but because I can't, every decision I've ever made is being weighed up to decide whether I should be allowed to have a child.
Looking back at it, and having discussed it at therapy, I don't think she was trying to find reasons to block me from treatment. I think she cared, and wanted to understand what was going on for me. They offer counselling at the clinic. I think we may take them up on that.
After I was done being probed, stabbed and peeing in a bottle, I was allowed to go downstairs to see my husband. He was still waiting for his appointment, in the men's waiting room. This area was a lot smaller, with more men focused magazines like FHM. He was taken down to the 'comfortable, private room' to produce his sample by a friendly, and pretty, nurse. He came back about ten minutes later looking as if the weight of the world had been lifted from his shoulders.
Then we were done and could go home. On the way home, I coaxed him to tell me about the 'room'. He said there's a porn audition style couch and posters of bikini clad women on the walls and proper dirty magazines. As in, the ones where you can see EVERYTHING. He said in a way it was kind of sleazy, but maybe that's what some men need to help them... perform in unfamiliar surroundings. I guess that's why it is out of the way, where it is, and the nice bit of the clinic is upstairs, open clean and comfortable. Also, the labs are down the corridor from the 'room' so they can wiz the jizz straight into the lab - time is of the essence you know.
We went out for lunch on our way back home. We don't eat out together very often. It seems like we mostly have lunch or dinner out as a debrief session after fertility appointments and I cry at him across the table. I did get upset. As I said, I hold things in so that I can get through the hard bit, then I have a bit of an emotional purge. He was totally fine, really great in supporting me and making me feel better. It's just the emotional exhaustion of so much hope and expectation and worry and then it's all just over. Until the next appointment. So now I can build up to that.
Friday, 19 February 2016
Contact from the IVF Clinic
The IVF Clinic have been in touch. They sent us a letter asking me to phone on the first day of my period to book a pre-treatment scan and blood test which needs to be performed between days 2 and 7 of my cycle. They also sent a whole pile of forms for us both to fill in.
Phone on the first day of my period... oooookkkaaaaaaay. I have irregular cycles. On the day I received the letter, I was on day 30 something of my cycle. I may not have a day 1 until July. Cue: panic. Obviously, the solution to this problem is to phone the clinic and talk to them about it. I can't be the only woman referred for IVF to have irregular cycles, they must have dealt with this before. Calm. Except of course, the letter arrives on a Friday so I have an entire weekend of stressing about it before I can call them on the Monday.
The forms. Wow. I understand they need a lot of information but it really is pretty overwhelming. We've already filled in the forms with the GP to get referred. There's a file on us at the hospital with all our medical history and our test results. The IVF clinic now need to build a file on us themselves.
The forms include:
Patient History Forms (info on both of us)
Child Welfare Forms (one each)
Information Sharing and research consent forms (one each)
Pre-treatment scan questionnaire (for me)
Semen Analysis Form (for my lucky husband).
The Patient History Forms include all the standard: name, date of birth, height, weight, bmi, medical conditions, medication etc etc etc. They also include some questions which catch you off guard a bit, questions which make you stop and consider why they need to ask that. Questions about childhood illnesses and whether the male partner's testicles were descended at birth:
me: "were your testicles descended at birth?"
him: "I don't remember"
me: "can you ask your mum?"
him: "ask my aunt, she'll know"
send a message to his aunt. The response is: 'yes and no. one was, one wasn't.'
The bizarre conversations you have to have.
As a side note, we're very close with his aunt, she went through IVF for her second child and so is someone I find it useful to talk to.
Of course, it makes sense that they need to know everything, but when we already know our infertility isn't male factor, his testicles are kind of irrelevant.
The Information Sharing forms are consent forms about what information you're happy to share: personalised data, anonymised data, no data, data just about yourself, data about any resulting child. We had a long talk about this. Husband is a little over protective when it comes to personal information. I knew he wouldn't want to share anything. I'd share anonymous data about myself but I don't feel comfortable making decisions about the data of our as yet hypothetical child. We decided to opt out of information sharing on the basis that we can opt in at a later date if we want to.
Pre-treatment scan questionnaire: what day of the cycle are you on (43), any of: excessive hair growth (yes), acne or oily skin (no), cramps during period (yes), cramps at other points of cycle (no), and so on.
Semen analysis form: Name, Date of birth, how long have you abstained from sexual activity before the analysis (4 days), was the sample produced at the clinic (yes), any illnesses or medication in the last three months (no).
Child Welfare Forms. I've left these until last to talk about because, although these are very simple for us to fill in, it's difficult to have to complete them. The form asks if you have ever been convicted for a crime against children, whether you have any physical or psychological condition which could prevent you from being able to support the child.
I was very honest. I explained that I do have mental health issues, that I am under the care of a psychiatrist who is supportive of my pursuit of a pregnancy and who will monitor me throughout, referring me to ante-natal psychiatry from 4 months pregnant through until the baby is a year old. I will be well supported.
It kinda sucks to have to fill these forms in. If we could do this unassisted, we wouldn't have to prove we aren't going to abuse or neglect our child. There are people out there who are terrible parents but, because they can get pregnant without medical intervention, they don't have to fill in these forms, jump through these hoops. As if anyone would go through all of this, simply to have a child who they wouldn't treasure. However, I understand why they have to do these checks. The clinic themselves have a duty of care to us and to any resulting child. They can't, in good conscience, create a life which may then be treated badly. I know they have to do this; it's sad that they have to though.
About 20 signatures later and the forms are complete.
Monday came, I phoned the clinic and got through to a nice receptionist. I explained my predicament and she said that she would need to speak to a nurse and would I mind holding on. No problem. She comes back on the phone and says that she's sorry but there is no nurse available at the moment but she can ask someone to phone me back.
A little later in the afternoon, a nurse calls me and we have a chat. She explains not to worry too much about the days, it's more that if I did have a regular cycle, they would need to see me on those days, with no regular cycle she says we can come in whenever and would I like to book the appointment now. Appointment booked for me to have an ultrasound on my uterus and ovaries and a hormonal blood test and an appointment for my husband to do his semen analysis on the same day. The nurse also asked if I'd like to book our consultation appointment as there is about a 4 week waiting list on that one. So I booked our initial consultation appointment as well.
Very promptly, we get a letter confirming the date and time of both appointments. All very friendly, approachable, professional and exciting.
Phone on the first day of my period... oooookkkaaaaaaay. I have irregular cycles. On the day I received the letter, I was on day 30 something of my cycle. I may not have a day 1 until July. Cue: panic. Obviously, the solution to this problem is to phone the clinic and talk to them about it. I can't be the only woman referred for IVF to have irregular cycles, they must have dealt with this before. Calm. Except of course, the letter arrives on a Friday so I have an entire weekend of stressing about it before I can call them on the Monday.
The forms. Wow. I understand they need a lot of information but it really is pretty overwhelming. We've already filled in the forms with the GP to get referred. There's a file on us at the hospital with all our medical history and our test results. The IVF clinic now need to build a file on us themselves.
The forms include:
Patient History Forms (info on both of us)
Child Welfare Forms (one each)
Information Sharing and research consent forms (one each)
Pre-treatment scan questionnaire (for me)
Semen Analysis Form (for my lucky husband).
The Patient History Forms include all the standard: name, date of birth, height, weight, bmi, medical conditions, medication etc etc etc. They also include some questions which catch you off guard a bit, questions which make you stop and consider why they need to ask that. Questions about childhood illnesses and whether the male partner's testicles were descended at birth:
me: "were your testicles descended at birth?"
him: "I don't remember"
me: "can you ask your mum?"
him: "ask my aunt, she'll know"
send a message to his aunt. The response is: 'yes and no. one was, one wasn't.'
The bizarre conversations you have to have.
As a side note, we're very close with his aunt, she went through IVF for her second child and so is someone I find it useful to talk to.
Of course, it makes sense that they need to know everything, but when we already know our infertility isn't male factor, his testicles are kind of irrelevant.
The Information Sharing forms are consent forms about what information you're happy to share: personalised data, anonymised data, no data, data just about yourself, data about any resulting child. We had a long talk about this. Husband is a little over protective when it comes to personal information. I knew he wouldn't want to share anything. I'd share anonymous data about myself but I don't feel comfortable making decisions about the data of our as yet hypothetical child. We decided to opt out of information sharing on the basis that we can opt in at a later date if we want to.
Pre-treatment scan questionnaire: what day of the cycle are you on (43), any of: excessive hair growth (yes), acne or oily skin (no), cramps during period (yes), cramps at other points of cycle (no), and so on.
Semen analysis form: Name, Date of birth, how long have you abstained from sexual activity before the analysis (4 days), was the sample produced at the clinic (yes), any illnesses or medication in the last three months (no).
Child Welfare Forms. I've left these until last to talk about because, although these are very simple for us to fill in, it's difficult to have to complete them. The form asks if you have ever been convicted for a crime against children, whether you have any physical or psychological condition which could prevent you from being able to support the child.
I was very honest. I explained that I do have mental health issues, that I am under the care of a psychiatrist who is supportive of my pursuit of a pregnancy and who will monitor me throughout, referring me to ante-natal psychiatry from 4 months pregnant through until the baby is a year old. I will be well supported.
It kinda sucks to have to fill these forms in. If we could do this unassisted, we wouldn't have to prove we aren't going to abuse or neglect our child. There are people out there who are terrible parents but, because they can get pregnant without medical intervention, they don't have to fill in these forms, jump through these hoops. As if anyone would go through all of this, simply to have a child who they wouldn't treasure. However, I understand why they have to do these checks. The clinic themselves have a duty of care to us and to any resulting child. They can't, in good conscience, create a life which may then be treated badly. I know they have to do this; it's sad that they have to though.
About 20 signatures later and the forms are complete.
Monday came, I phoned the clinic and got through to a nice receptionist. I explained my predicament and she said that she would need to speak to a nurse and would I mind holding on. No problem. She comes back on the phone and says that she's sorry but there is no nurse available at the moment but she can ask someone to phone me back.
A little later in the afternoon, a nurse calls me and we have a chat. She explains not to worry too much about the days, it's more that if I did have a regular cycle, they would need to see me on those days, with no regular cycle she says we can come in whenever and would I like to book the appointment now. Appointment booked for me to have an ultrasound on my uterus and ovaries and a hormonal blood test and an appointment for my husband to do his semen analysis on the same day. The nurse also asked if I'd like to book our consultation appointment as there is about a 4 week waiting list on that one. So I booked our initial consultation appointment as well.
Very promptly, we get a letter confirming the date and time of both appointments. All very friendly, approachable, professional and exciting.
Friday, 12 February 2016
How I coped when my best friend told me she was pregnant
Wanting to have a child and not being able to is really hard. It is traumatic. Trying to conceive month after month is an emotional rollercoaster. Every. Single. Time.
I swing from having total conviction that I will get pregnant to feeling like a failure as a woman.
The failure part hits me particularly when someone I know announces that they are pregnant. There are a lot of feelings which surround this. When it is someone I don't know very well, it's just outright jealousy and a feeling of unfairness. Why does she get a baby and I don't? When I don't know them very well, I can manage to not take it too personally. However, when it is a close friend, particularly one who knows we are having trouble conceiving, that is awful.
Over the last few years, I've had many people in my life become pregnant. Some closer friends than others. I've dealt with some of them badly, have distanced myself from them and have cried - a lot - over their 'easy' fertility journey. The experience which has hit me hardest was my best friend becoming pregnant.
I want to make it very clear: I do not hate people who can get pregnant easily. I am jealous, it hurts me, but those negative feelings are about me feeling sad for me. I don't dislike them because they are pregnant or have children. I am so happy that they have got pregnant and have children and I'm really glad they haven't had to go through the pain of infertility.
My best friend and I have been close since we were 3 years old. We've been through a lot together, from playing games as children where we would be 'pregnant' (jumper stuffed up the t-shirt) and look after our babies (sometimes a cat, but more usually a doll), to being bridesmaids for each other. She knows as much about me as pretty much anyone in the world does. She remembers stories from primary school which I had forgotten. She's always been there for me. I can tell her anything.
Except how I really felt about her being pregnant.
Not long before she fell pregnant, we had a girly day watching movies and talking. I told her about our infertility journey so far. About the tests and treatments. About how I felt about other people in my life with children. I told her she was one of the last of my friends in a relationship who didn't have children. I asked her to please tell me if/when she and her husband started trying, so that I could adjust myself to the idea. I wasn't in a great place at this point. I was pretty low mood-wise, we hadn't been able to start the clomifene yet and I was finding things quite complex and challenging. Looking back on it, it was totally unreasonable of me to put that kind of pressure on her. Just because I am willing to open myself up and tell people private things about my reproductive health doesn't mean anyone else should be.
A few weeks later, I got an email from her telling me, in a very sensitive and considered way, that she was pregnant.
"The reason I am emailing you this is because I want you to be able to react in whatever way you need to. I've thought a lot about how to tell you this and, knowing you as I do, I thought that a phonecall would be unfair given your issues with telephone calls, and to tell you to your face could really put you on the spot.
You have probably worked out what it is I want to tell you; I am having a baby and I'm currently just over 9 weeks pregnant.
I know this is going to be really difficult for you and I sincerely hope that you are not too upset. I know you asked me to tell you when we were trying but it was something so personal to us that we agreed not to tell anyone.
You have been my best friend for as long as I can remember and knowing that I am going to upset you really breaks my heart. I want you to take whatever time you need and I will leave it up to you when we next see/speak to each other, I can't imagine what you are going through, but I do understand if you are not ready to see me.
We have only told our immediate families so far and I would be immensely grateful if you could keep it between yourselves (and your parents if you need their support). My grandparents, our aunties, uncles and other close friends aren't aware yet. We plan to tell them after 12 weeks but I wanted you to know early so you had a bit of time.
Please know that I keep everything crossed that this will happen for you too, I know you would both be fantastic parents and have so much to offer a child."
This is one of the many reasons I am proud to say that she is one of my best friends. She is the kindest and most generous people I have ever met.
My first reaction was (brutally honestly) absolute misery. I thought it was so unfair. How could she? Why would she do this to me? She knew it would hurt me - how could she get pregnant? I cried. A lot.
After I'd realised how much of a b*tch I was being, I felt a different kind of misery. I felt deeply sad that I had made my friend, my best friend, think of me during what was surely a joyful time in her life. The fact that she had obviously put a lot of thought into how to tell me news which she must have been delighted about but knew would make me sad. I felt like I'd betrayed her. I felt like I had stolen some of her joy. I felt horrible. I was pleased, I was delighted that she had got pregnant. That she and her husband would be having a baby. I felt awful that she had worried about me and my reaction, but I also felt a huge surge of love for her and for her baby. I became aware of just how special this friendship was.
Receiving this email also enabled me to deal with it in my own way. She didn't do it face to face, where I would have had to pretend to be instantly delighted while fighting back tears (trust me, I've done it). I wouldn't have to ask all the questions you are expected to ask - she'd told me everything I needed to know and she had done it in such a kind, careful and considered way. She had left the ball in my court, she recognised that she couldn't understand what I would be feeling but that she was there for me when I wanted. This actually made it easier for me to contact her. If she had wanted to see me immediately, I probably would have distanced myself from her. Because she had been so sensitive, I was able to see that I needed to be a grown up about it.
I made some ginger biscuits and a card and sent them to her. In the card I said congratulations, and thanked her for how kind she'd been. How I would never want to miss out on it and that I love her. Since then, we've been fine. We texted a lot through her pregnancy, I went to her parties and her baby shower. I visited her lots while she was pregnant and visited her lovely baby boy.
Honestly, I got through a lot of it by forcing myself to be interested, forcing myself to show how happy for her I was and then dealing with the negative emotions on my own time. I knew there was no need for me to be nasty, or to make her feel bad for something which is so positive for her. It was hard some of the time. But I NEVER hated her. I NEVER wished she wasn't pregnant. I was happy for her. I was sad that it wasn't happening for me.
It still sometimes makes me sad. It sometimes overwhelms me with this deep feeling of longing.
But mostly, it makes me feel so so proud of her. And so grateful to have a friend like her.
I swing from having total conviction that I will get pregnant to feeling like a failure as a woman.
The failure part hits me particularly when someone I know announces that they are pregnant. There are a lot of feelings which surround this. When it is someone I don't know very well, it's just outright jealousy and a feeling of unfairness. Why does she get a baby and I don't? When I don't know them very well, I can manage to not take it too personally. However, when it is a close friend, particularly one who knows we are having trouble conceiving, that is awful.
Over the last few years, I've had many people in my life become pregnant. Some closer friends than others. I've dealt with some of them badly, have distanced myself from them and have cried - a lot - over their 'easy' fertility journey. The experience which has hit me hardest was my best friend becoming pregnant.
I want to make it very clear: I do not hate people who can get pregnant easily. I am jealous, it hurts me, but those negative feelings are about me feeling sad for me. I don't dislike them because they are pregnant or have children. I am so happy that they have got pregnant and have children and I'm really glad they haven't had to go through the pain of infertility.
My best friend and I have been close since we were 3 years old. We've been through a lot together, from playing games as children where we would be 'pregnant' (jumper stuffed up the t-shirt) and look after our babies (sometimes a cat, but more usually a doll), to being bridesmaids for each other. She knows as much about me as pretty much anyone in the world does. She remembers stories from primary school which I had forgotten. She's always been there for me. I can tell her anything.
Except how I really felt about her being pregnant.
Not long before she fell pregnant, we had a girly day watching movies and talking. I told her about our infertility journey so far. About the tests and treatments. About how I felt about other people in my life with children. I told her she was one of the last of my friends in a relationship who didn't have children. I asked her to please tell me if/when she and her husband started trying, so that I could adjust myself to the idea. I wasn't in a great place at this point. I was pretty low mood-wise, we hadn't been able to start the clomifene yet and I was finding things quite complex and challenging. Looking back on it, it was totally unreasonable of me to put that kind of pressure on her. Just because I am willing to open myself up and tell people private things about my reproductive health doesn't mean anyone else should be.
A few weeks later, I got an email from her telling me, in a very sensitive and considered way, that she was pregnant.
"The reason I am emailing you this is because I want you to be able to react in whatever way you need to. I've thought a lot about how to tell you this and, knowing you as I do, I thought that a phonecall would be unfair given your issues with telephone calls, and to tell you to your face could really put you on the spot.
You have probably worked out what it is I want to tell you; I am having a baby and I'm currently just over 9 weeks pregnant.
I know this is going to be really difficult for you and I sincerely hope that you are not too upset. I know you asked me to tell you when we were trying but it was something so personal to us that we agreed not to tell anyone.
You have been my best friend for as long as I can remember and knowing that I am going to upset you really breaks my heart. I want you to take whatever time you need and I will leave it up to you when we next see/speak to each other, I can't imagine what you are going through, but I do understand if you are not ready to see me.
We have only told our immediate families so far and I would be immensely grateful if you could keep it between yourselves (and your parents if you need their support). My grandparents, our aunties, uncles and other close friends aren't aware yet. We plan to tell them after 12 weeks but I wanted you to know early so you had a bit of time.
Please know that I keep everything crossed that this will happen for you too, I know you would both be fantastic parents and have so much to offer a child."
This is one of the many reasons I am proud to say that she is one of my best friends. She is the kindest and most generous people I have ever met.
My first reaction was (brutally honestly) absolute misery. I thought it was so unfair. How could she? Why would she do this to me? She knew it would hurt me - how could she get pregnant? I cried. A lot.
After I'd realised how much of a b*tch I was being, I felt a different kind of misery. I felt deeply sad that I had made my friend, my best friend, think of me during what was surely a joyful time in her life. The fact that she had obviously put a lot of thought into how to tell me news which she must have been delighted about but knew would make me sad. I felt like I'd betrayed her. I felt like I had stolen some of her joy. I felt horrible. I was pleased, I was delighted that she had got pregnant. That she and her husband would be having a baby. I felt awful that she had worried about me and my reaction, but I also felt a huge surge of love for her and for her baby. I became aware of just how special this friendship was.
Receiving this email also enabled me to deal with it in my own way. She didn't do it face to face, where I would have had to pretend to be instantly delighted while fighting back tears (trust me, I've done it). I wouldn't have to ask all the questions you are expected to ask - she'd told me everything I needed to know and she had done it in such a kind, careful and considered way. She had left the ball in my court, she recognised that she couldn't understand what I would be feeling but that she was there for me when I wanted. This actually made it easier for me to contact her. If she had wanted to see me immediately, I probably would have distanced myself from her. Because she had been so sensitive, I was able to see that I needed to be a grown up about it.
I made some ginger biscuits and a card and sent them to her. In the card I said congratulations, and thanked her for how kind she'd been. How I would never want to miss out on it and that I love her. Since then, we've been fine. We texted a lot through her pregnancy, I went to her parties and her baby shower. I visited her lots while she was pregnant and visited her lovely baby boy.
Honestly, I got through a lot of it by forcing myself to be interested, forcing myself to show how happy for her I was and then dealing with the negative emotions on my own time. I knew there was no need for me to be nasty, or to make her feel bad for something which is so positive for her. It was hard some of the time. But I NEVER hated her. I NEVER wished she wasn't pregnant. I was happy for her. I was sad that it wasn't happening for me.
It still sometimes makes me sad. It sometimes overwhelms me with this deep feeling of longing.
But mostly, it makes me feel so so proud of her. And so grateful to have a friend like her.
Sunday, 7 February 2016
Clomifene
Clomifene (or Clomid) is a fertility drug given to stimulate the release of an egg (or eggs) in women with suspected ovulatory problems. It is a relatively early intervention and is used because it's pretty useful in a lot of cases where you have irregular cycles. If it works (makes you ovulate) it's easier to predict your fertile days, time intercourse to match those days and increase the chances of sperm meeting egg in the right place at the right time.
As far as I understand (and I have done *quite* a lot of reading on the subject) the best time to have sex is in the four days coming up to ovulation, although regular intercourse is important as well. The reason that having sex just on the day you think you ovulate isn't the recommendation is that a) you might have miscalculated your dates, b) your cycle might be a couple of days out in this particular month and c) sperm can take a while to get to where they need to meet the egg.
a) It's very easy to miscalculate dates. Firstly, day one of the cycle is generally accepted to be the first day of your period. This is not the first day you get a little bit of spotting. Day one is the first day you see red blood. If your period starts in the evening, day one is calculated as the first full day of bleeding (i.e. the first morning when you have bleeding). Secondly, with a complicated and busy life, it is actually really easy to forget exactly which day your period started. A lot of women who are trying to have a baby will track their cycles using a fertility app, this does all the calculations for you as long as you input your day 1.
b) Your cycle starts on the first day of your period, i.e the shedding of the previous month's unfertilised egg. This means that you know how long last month's cycle was. You can look back and calculate when you ovulated within that cycle, because in most cases you ovulated about 14 days before the start of your period. However, you can't see into the future, so you might ovulate on day 14 of your cycle this month, or on day 16, or on day 12. Therefore it is best to have 'baby-making' sex regularly, beginning a few days before the predicted middle of your cycle and for a few days after. You're more likely to catch ovulation that way.
c) I didn't know this at all! Sperm takes time. An ejaculation takes (as I'm sure most people know) a matter of moments. When the sperm is in there... well surely it's in the right place? Remember, sperm is microscopic, as in seriously teeeeeeny tiny. For sperm, the journey to meet the egg is a really long way. Also, the egg and the sperm need to meet up in the fallopian tubes ideally, to fertilise, start multiplying cells and then to travel down into the womb and implant. So timing is pretty important. If the egg has descended through the tubes and into the womb: it's too late. If the sperm runs out of energy before it has reached the tubes: it's too late. Also, you have no idea when any of this is happening, some women say that they can feel ovulation, that's fine, but it's not like your body sends you a text message to say 'just so you know, I'm planning on releasing an egg from the left ovary on Tuesday at 4.51pm' and even if it did, you can't instruct the sperm to head left.
But all of that is totally irrelevant if you are not ovulating in any kind of predictable manner. It's really emotionally wearing to take pregnancy tests every two weeks *just in case*. There's always a shred of hope, even when I know my cycles could be anywhere from five weeks to five months. But because the egg comes first, then the period, there's always a tiny chance I *might* have ovulated and fallen pregnant. Of course, it never happened. Not for me anyway. That's why we are where we are.
So, clomifene. After the blood tests and the HSG, the semen analysis and the Provera, we were given the go ahead to try clomifene. I honestly thought this would be our magic bullet. I thought, great, obviously I'm not ovulating, clomifene will make me ovulate and then I will get pregnant. There's nothing wrong with the mechanics of my reproductive system, just for some reason, my body neglects to mature and release an egg. So, the solution seems pretty obvious: chemically encourage my ovaries to mature and release one or more eggs.
I had to take provera to kickstart my cycle and get a day one. I took clomifene (50mgs) from day 2 to day 6 of my cycle. The clomifene is designed to trick your body into producing the hormones to stimulate follicle growth and then release the matured egg.
Side note: Follicles are the sacs where the eggs grow. Eggs are microscopic however, follicles can be around 2 centimetres big)
The first cycle on clomifene was eventful. Clomifene stimulates your body in a way that (especially with irregular cycles) you are just not used to. There are hormones flying around that I just don't know how to deal with because I haven't had to do it on a regular basis, ever. The most disruptive side effects were:
the hot flushes: at night waking up feeling red hot and absolutely drenched in sweat is really not fun.
the swinging emotions: One minute, I would feel optimistic and like I was walking on air, the next moment I would be crying for no reason. It was hard for us, my husband never knew what to say to me as I would either cry or scream at him. Thankfully, he has plenty of experience dealing with me as an irrational being and has developed coping mechanisms. Many coping mechanisms involve chocolate.
(partly leading on from the coping mechanisms mentioned above) the weight gain. I gained weight. It is very easy for me to gain weight, however, I could gain upwards of 3lbs in a week at certain points of taking the clomifene. I'm trying very hard to lose weight, as being at a healthy weight helps you get pregnant and can make pregnancy more comfortable.
thrush: changes in hormones can lead to all sorts of lovely imbalances, which can seriously upset the foof. My nether regions reacted badly to this and thrush is uncomfortable at the best of times. With the clomifene induced thrush and hot sweats, I was not sleeping well which then makes the mood swings worse.
It really was such fun.
I didn't even ovulate on cycle 1! That was a massive blow. I thought, having been so strongly affected by the drug, I must have ovulated. How could I get these side effects if it hadn't even worked?! So, I had to wait another two weeks after my cycle day 28 *just in case* I was pregnant. Testing obsessively every other day (Ok, pretty much every day) and getting negatives every time is really disheartening, but I just couldn't risk taking provera and inducing a bleed if there was any chance, no matter how tiny, that there might actually be a little fertilised egg nestling in there. By the time you get to cycle day 40+ and you're still getting negative tests, it's a pretty definite no. So I got to take Provera again.
Lather, Rinse, Repeat. Side effects again. Not as strong as on the first cycle, which is a plus but also made me feel that the drugs must not be working. In Cycle 2, I had a day 21 blood test, which shows the hormone level and indicates whether or not ovulation has taken place. I don't know what the blood test showed, but bang on day 28, I got my period. This means that I DID ovulate- Hooray! It also means that, even though I ovulated, I am NOT pregnant - boo. But, it means, I have eggs, they are able to be released from my ovaries. When I ovulate, my body is able to do what it is supposed to do and shed the lining of my uterus when that egg is not fertilised. This is, actually quite reassuring.
Cycle 3 is the same as cycle 2, blood test at day 21 and a period. The period was day 32 though, not day 28. From day 28 I was cautiously optimistic one moment (it made me ovulate last time, my period is late...) and down in the dumps the next (why would it work one month and not the next?) Testing pretty much every day from day 28 and getting negatives is really disheartening. There are no answers as to why it's not working or what's even happening. But obviously, day 32 arrived and so did my period.
Cycle 4: same again.
Clomifene made me ovulate in three consecutive cycles. If it was going to help me get pregnant I should have got pregnant within those three cycles. There's no point carrying on or increasing the dose. It appears it's not purely an ovulation issue; there's something else going on.
At this point, IVF is our next step.
As far as I understand (and I have done *quite* a lot of reading on the subject) the best time to have sex is in the four days coming up to ovulation, although regular intercourse is important as well. The reason that having sex just on the day you think you ovulate isn't the recommendation is that a) you might have miscalculated your dates, b) your cycle might be a couple of days out in this particular month and c) sperm can take a while to get to where they need to meet the egg.
a) It's very easy to miscalculate dates. Firstly, day one of the cycle is generally accepted to be the first day of your period. This is not the first day you get a little bit of spotting. Day one is the first day you see red blood. If your period starts in the evening, day one is calculated as the first full day of bleeding (i.e. the first morning when you have bleeding). Secondly, with a complicated and busy life, it is actually really easy to forget exactly which day your period started. A lot of women who are trying to have a baby will track their cycles using a fertility app, this does all the calculations for you as long as you input your day 1.
b) Your cycle starts on the first day of your period, i.e the shedding of the previous month's unfertilised egg. This means that you know how long last month's cycle was. You can look back and calculate when you ovulated within that cycle, because in most cases you ovulated about 14 days before the start of your period. However, you can't see into the future, so you might ovulate on day 14 of your cycle this month, or on day 16, or on day 12. Therefore it is best to have 'baby-making' sex regularly, beginning a few days before the predicted middle of your cycle and for a few days after. You're more likely to catch ovulation that way.
c) I didn't know this at all! Sperm takes time. An ejaculation takes (as I'm sure most people know) a matter of moments. When the sperm is in there... well surely it's in the right place? Remember, sperm is microscopic, as in seriously teeeeeeny tiny. For sperm, the journey to meet the egg is a really long way. Also, the egg and the sperm need to meet up in the fallopian tubes ideally, to fertilise, start multiplying cells and then to travel down into the womb and implant. So timing is pretty important. If the egg has descended through the tubes and into the womb: it's too late. If the sperm runs out of energy before it has reached the tubes: it's too late. Also, you have no idea when any of this is happening, some women say that they can feel ovulation, that's fine, but it's not like your body sends you a text message to say 'just so you know, I'm planning on releasing an egg from the left ovary on Tuesday at 4.51pm' and even if it did, you can't instruct the sperm to head left.
But all of that is totally irrelevant if you are not ovulating in any kind of predictable manner. It's really emotionally wearing to take pregnancy tests every two weeks *just in case*. There's always a shred of hope, even when I know my cycles could be anywhere from five weeks to five months. But because the egg comes first, then the period, there's always a tiny chance I *might* have ovulated and fallen pregnant. Of course, it never happened. Not for me anyway. That's why we are where we are.
So, clomifene. After the blood tests and the HSG, the semen analysis and the Provera, we were given the go ahead to try clomifene. I honestly thought this would be our magic bullet. I thought, great, obviously I'm not ovulating, clomifene will make me ovulate and then I will get pregnant. There's nothing wrong with the mechanics of my reproductive system, just for some reason, my body neglects to mature and release an egg. So, the solution seems pretty obvious: chemically encourage my ovaries to mature and release one or more eggs.
I had to take provera to kickstart my cycle and get a day one. I took clomifene (50mgs) from day 2 to day 6 of my cycle. The clomifene is designed to trick your body into producing the hormones to stimulate follicle growth and then release the matured egg.
Side note: Follicles are the sacs where the eggs grow. Eggs are microscopic however, follicles can be around 2 centimetres big)
The first cycle on clomifene was eventful. Clomifene stimulates your body in a way that (especially with irregular cycles) you are just not used to. There are hormones flying around that I just don't know how to deal with because I haven't had to do it on a regular basis, ever. The most disruptive side effects were:
the hot flushes: at night waking up feeling red hot and absolutely drenched in sweat is really not fun.
the swinging emotions: One minute, I would feel optimistic and like I was walking on air, the next moment I would be crying for no reason. It was hard for us, my husband never knew what to say to me as I would either cry or scream at him. Thankfully, he has plenty of experience dealing with me as an irrational being and has developed coping mechanisms. Many coping mechanisms involve chocolate.
(partly leading on from the coping mechanisms mentioned above) the weight gain. I gained weight. It is very easy for me to gain weight, however, I could gain upwards of 3lbs in a week at certain points of taking the clomifene. I'm trying very hard to lose weight, as being at a healthy weight helps you get pregnant and can make pregnancy more comfortable.
thrush: changes in hormones can lead to all sorts of lovely imbalances, which can seriously upset the foof. My nether regions reacted badly to this and thrush is uncomfortable at the best of times. With the clomifene induced thrush and hot sweats, I was not sleeping well which then makes the mood swings worse.
It really was such fun.
I didn't even ovulate on cycle 1! That was a massive blow. I thought, having been so strongly affected by the drug, I must have ovulated. How could I get these side effects if it hadn't even worked?! So, I had to wait another two weeks after my cycle day 28 *just in case* I was pregnant. Testing obsessively every other day (Ok, pretty much every day) and getting negatives every time is really disheartening, but I just couldn't risk taking provera and inducing a bleed if there was any chance, no matter how tiny, that there might actually be a little fertilised egg nestling in there. By the time you get to cycle day 40+ and you're still getting negative tests, it's a pretty definite no. So I got to take Provera again.
Lather, Rinse, Repeat. Side effects again. Not as strong as on the first cycle, which is a plus but also made me feel that the drugs must not be working. In Cycle 2, I had a day 21 blood test, which shows the hormone level and indicates whether or not ovulation has taken place. I don't know what the blood test showed, but bang on day 28, I got my period. This means that I DID ovulate- Hooray! It also means that, even though I ovulated, I am NOT pregnant - boo. But, it means, I have eggs, they are able to be released from my ovaries. When I ovulate, my body is able to do what it is supposed to do and shed the lining of my uterus when that egg is not fertilised. This is, actually quite reassuring.
Cycle 3 is the same as cycle 2, blood test at day 21 and a period. The period was day 32 though, not day 28. From day 28 I was cautiously optimistic one moment (it made me ovulate last time, my period is late...) and down in the dumps the next (why would it work one month and not the next?) Testing pretty much every day from day 28 and getting negatives is really disheartening. There are no answers as to why it's not working or what's even happening. But obviously, day 32 arrived and so did my period.
Cycle 4: same again.
Clomifene made me ovulate in three consecutive cycles. If it was going to help me get pregnant I should have got pregnant within those three cycles. There's no point carrying on or increasing the dose. It appears it's not purely an ovulation issue; there's something else going on.
At this point, IVF is our next step.
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