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!

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.