Round 7, Day 32
I had clinical confirmation of BFN by noon.
I've been emotional today, but mostly - and I wasn't expecting this - with gratitude. This result reinforces to me what a miracle Offspring is. My disappointment in not being able to give my baby a sibling is vastly overshadowed by gratitude for what I have, which is less than some but more than so many.
And I know this is a weird perspective when we had our baby 2 rounds ago but it's like the entirety of the seven rounds was what it took. And so I feel oddly overwhelmed with gratitude.
The art of losing isn’t hard to master;
so many things seem filled with the intent
to be lost that their loss is no disaster.
Lose something every day. Accept the fluster
of lost door keys, the hour badly spent.
The art of losing isn’t hard to master.
Then practice losing farther, losing faster:
places, and names, and where it was you meant
to travel. None of these will bring disaster.
I lost my mother’s watch. And look! my last, or
next-to-last, of three loved houses went.
The art of losing isn’t hard to master.
I lost two cities, lovely ones. And, vaster,
some realms I owned, two rivers, a continent.
I miss them, but it wasn’t a disaster.
—Even losing you (the joking voice, a gesture
I love) I shan’t have lied. It’s evident
the art of losing’s not too hard to master
though it may look like (Write it!) like disaster.
- One Art, Elizabeth Bishop
Tound 7, Day 31
Final blood test tomorrow. I'm still 99% sure all I'll be left with is my battered abdomen and a giant vodka martini. Having said that I had weird double leg cramps all night last night. No other symptoms though. But it just helps stoke the fire of hope, oh maybe one day I'll be talking about how odd it was that I had hardly any symptoms for this pregnancy and I didn't even get a positive pregnancy test until the day of the blood test! *eyeroll*
Round 7, Day 30
No pregnancy symptoms over the weekend. Not even so much as a second shadow on any of the home pregnancy tests. I'm 99.9% sure this round will be a BFN. I've stopped doing my daily testing and will now only test on the final day of the round: blood test day, Thursday, just to nip any last minute hope in the bud.
I already have a vodka martini in my sights and I'm counting down the injections and pessaries.
Not long now.
Round 7, Day twenty-something
We're a week post-transfer tomorrow. Which means if I'm preggo I'll potentially start symptoms over the weekend. I've had positive pregnancy tests from about 7 days post transfer through to it not showing up until 9 days post transfer, but even then I strongly suspected I was pregnant before a home pregnancy test told me.
Lots of people who do IVF will tell you to never POAS (pee on a stick). There are a number of reasons for this, mostly I think it's because some of the drugs they give you in certain rounds (usually egg collection rounds) contain HcG which can cause a false positive. But also because it can mess with your head. Especially if you have an early loss. It doesn't mess with my head. I'm a data girl, I'd rather have the data and know. I like to take one daily from about 5 days post transfer. It gives me something to look forward to and also helps to temper my expectations. I like to stare at the pregnancy window and then pop it in the cupboard and continue to check it over 24 hours to see if there are any shadows showing up. I just wish the tests would quit being so negative. They actually look kind of sleepy and smug in this picture, like WAKE ME UP WHEN YOU'RE ACTUALLY PREGNANT...
i had a blood test on Monday which showed my progesterone levels were flagging, so they upped my pessaries to 5 a day. FIVE A DAY. 6am, 2pm, 10pm. I feel like a sub-genre porn star at this point. And I'm just apologising and saying goodbye to every piece of underwear I put on. So the $300 I spent on meds a week ago is now not going to last me through the 2WW. My bank account today was -$600 so I may just have to put a live feed on my medication regime in order to pay for it. There has to be at least one millionaire out there who's into that. Hello, Christian Grey? You listening?
I did a little research after I found out about our Very Imperfect Embryo and found this little gem of a website:
Turns out that the grading (in our case for this round, 4BB) relates to a few different parts of the embryo.
The first number (4) relates to blastocyst growth (what stage is it at?) also known as the expansion grade, and it tells you in this case that it is an expanded blastocyst, that the cavity is larger than the embryo, with thinning of the shell.
The first letter (B) relates to a grading of the inner cells of the blastocyst. Are they tightly packed (good) or more loosely packed (not so good). In this case the blastocyst has several cells, loosely grouped, so not ideal.
The last letter (B) relates to a grading of the trophectoderm cells (TE), which are the cells around the inner rim of the blastocyst that will form the placenta. A B grading here means there are few cells, not as cohesive a layer as an A grade embryo.
Different clinics may use varying methodologies to give you a grading on your embryos but it basically adds up to them looking at the same three things, which is the Gardner blastocyst grading system: 1) Blastocyst growth (expressed as a number between 1 & 6, 6 being most advanced), the cells inside the blastocyst and how tightly packed they are (expressed as a letter between A & C, with A being the best grading) and the cells on the rim of the blastocyst which will form the placenta (again, expressed as a letter between A & C, with A being the best grading).
It's important to remember that all of this grading only adds up to your chances of successful IMPLANTATION and has no bearing on the pregnancy once a successful implantation has taken place and the pregnancy is established.
Round 7, Day 21
My new post-transfer drug protocol (Bondi Protocol as it said on a letter from the clinic to my GP) is as follows:
Morning: 1 x Progesterone pessary (taken as a suppository). 2 prednisilone tabs, 2 x progynova. We have added 1 Verapamil, 1 Cardiprin baby aspirin.
Afternoon: 1 x Progesterone pessary (taken as a suppository). 2 x progynova. We have added 1 Verapamil.
Evening: 1 x Estrogen/Progesterone pessary, 2 x progynova. We have added 1 Verapamil, and an injection which I have never had to do before on an FET round: it's called Clexane, and it's an anticoagulant that comes in pre-filled syringes.
The research suggests the Clexane injections are for recurrent IVF failure or miscarriage (that fits my profile) and there are small studies that have shown high levels of efficacy, however the studies are very small and varied.
No early pregnancy signs. You may laugh but in my early rounds I was on the lookout for them even at this stage. The earliest I have had any indication that I'm pregnant is about a week post-transfer. When I start getting up multiple times in the night to pee, and my boobs get even more sore and their consistency changes to be IDK how else to describe it, but watery. Which is ironic as those are the exact same symptoms as the hormones I am on - all I can say is that it's different, it goes to another level, and you can tell. I have never yet reached the final blood test without knowing what the outcome is going to be.
References and further reading:
The Truth about Clexane and Fertility http://www.yourivfjourney.com/the-truth-about-clexane-and-fertility/
Round 7, Day 20
After a flustercluck of a morning, we arrived at almost-noon for the transfer. My bladder wasn't yet screaming, but I knew that wouldn't last and I could tell from the pained faces of the women as soon as I entered the waiting room that the clinic was running behind. Way behind.
I managed to remember to take my Verapamil on the way to the clinic and drank my 'bladder water' at the appropriate time, so was feeling pretty pumped about how I was kicking butt despite the mornings' obstacles. It wasn't too long before we had been ushered from the shared waiting room into the "you're next, get your gear off" private waiting room where they weighed me and I reconfirmed that I really have put on about 3 - 4kgs during the prep for this round. The nurse helpfully stated that everyone puts on weight because of the hormones and steroids and I was on a double dose of those so what did I expect? I could have kissed her. Then I took off my shoes and panties per their instructions, hoisted up my skirt, put on my red cap for allergies, sky blue booties and a gorgeous navy paper gown that flapped in the breeze. Then she draped a fuzzy blanket over me, despite the warmth of the day.
The embryologist came in and said that the embryo had survived the thaw. I let out a breath I didn't realise I had been holding. She recapped what we would be doing: that we'd be using embryo glue, that she was reluctant to hatch the embryo as the shell was already very thin and looked like it was ready to hatch itself. That was fine by me. Then she said in passing that the grading of the embryo, 4BB, was the lowest they freeze. That sucked the air right out of the room. I thought it was almost perfect because Offspring was a perfect 5AA so I figured 4BB wasn't too far off. Only one letter and one number. Apparently not. My doctor/surgeon had walked in by this stage, rolled her eyes and flapped her hands at the embryologist, pooh poohing her and said they got pregnancies with that quality embryo all the time, and how were we both feeling?
"Uhhhh, I don't know. Maybe it will work?" I said honestly. The news of the Very Imperfect Embryo had just been delivered and it had taken the wind right out of my sails. She grabbed my hand and smiled. "It's a lovely looking embryo, everything will be perfect! Be positive!"
DH said that all he cared was that it was either a baby or nothing, he just didn't want me to go through another loss.
I'm not so sure. I think if I'm going to lose the baby then I can at least nurture it for as long as possible. It's a little life, but it's a life, no? And a wanted one. And I can love it for perhaps a little while. But I understand the thought and it makes total sense. All or nothing. But I do think sometimes it's harder watching someone else go through something than going through it yourself. I know I can handle it either way. I'll have to.
We were running around an hour late by the time we got into the theatre. I stood at the base of the table between the stirrups and two nurses and the embryologist checked my wrist band against my personal details.
For the seventh time in that darkened theatre room I was asked: "And what are we doing today?"
And I reply the magic words: "Transferring an embryo!"
The room smiles and they ask me to lay down and scootch my butt to the end of the table. DH sits near my head and they hand him my blanket to hold.
I asked the embryologist if they took a photo of the embryos. She looked confused. "Not usually," she said, "but I can do that now if you want?"
"Sure... that would be nice," I said. Not sure why she was looking so confused, lots of my online IVF friends have pics of their transferred embryos.
A nurse puts some gel on my stomach, rests her arm on my thigh, runs the ultrasound wand over me and ooffs a little at my swollen bladder. She points out the dark mass of my full bladder, the squashed-burger shaped womb beneath with the endometrium running horizontally through it, and points to where the embryo will be placed. The doctor puts in the speculum and I try to relax my legs to ease the discomfort. There's no pain. I concentrate on the screen. I can see the catheter enter my womb on the monitor, it's just a tiny white line, and there is no feeling at all. The doctor calls out "Ready!" and the embryologist brings in another catheter from a side room. Somehow it feels as though the room should be hushed, but everyone is carrying on at their various tasks, the embryologist team chattering away in the side room, nurses having a conversation at the top of my head. It's just another day in the clinic.
Then with a puff of white on the screen, the embryo is delivered at the fundus. The nurse points to the screen and smiles at me. "There's the baby, right there!". Not quite... but okay, I get what you're saying.
"Beautiful!" The doctor unscrews and removes the speculum, pops up from between my legs and beams at me. She says she thinks the puff on the screen looked like a boy and winks. She heads for the door. She squeezes my arm on the way out. "Best of luck to you both. You have done your best, I hope this one works in the very best way for you."
It's all over in under 10 minutes of entering the theatre. The nurse reminds me to stay on my back and DH is escorted from the room. She takes my blue paper trenchcoat thingie and hoists it between my legs as makeshift knickers and they pop my furry blanket back over me. Another nurse rolls me and pops a board under me and together they scootch me off the theatre table and onto a gurney. I'm wheeled into post-op to lay quietly for half an hour and contemplate the ceiling.
We talk about how it's weird that they call the embryo a baby. I'm slightly weirded by it, DH is very weirded by it but I can see how other people might find that helpful or comforting.
DH suggests that, given the news about the quality of the embryo, that if this pregnancy takes we may have to come up with a name with very simple spelling to match the probable IQ of Offspring #2. I giggle.
But seriously, now I'm worried. What does a low grading mean with regard to the resulting pregnancy? I suspect it's either pass/fail with the pregnancy and not scrambled. *Quick google search later* Apparently it's pass fail. It's an implantation chance thing, not an issue with the quality of the underlying materials.
I continue to stare at the ceiling and worry. I pendulum swing between feeling like I want to burst into tears and feeling like I'm going to pee myself at any second. I send DH back to work because he's been "at lunch" forever.
Finally after an eternity, a nurse comes back with my new drug regime and walks me through them. I think they do it then deliberately, when the pain of your bladder is keeping you sharp and focussed. Then I'm dismissed and allowed to get up and relieve myself. I made it to the bathroom and peed for so long that I got the giggles. Then I tossed my paper outfit in the bin, yanked my skirt down, popped on my shoes and walked out into the sunshine.
It was a beautiful day.
Round 7, Day 19
The clinic called with my transfer time. Midday tomorrow. Empty your bladder at 11am, then 600 - 800mls between 11 & 12 and hold. Oh, and take two Verapamil (used off-brand as a womb muscle relaxer) at 11.30am. I've forgotten to take that medication before, pre-transfer, so I write it down very deliberately and text DH the news.
Because I'm taking my pessaries rectally I can continue to do that (if I'd been taking them vaginally I would have had to postpone my 2pm one to 5pm to as not to disturb the magic).
I researched progesterone and bladder irritation, by the way, and it's totally a thing. I called the clinic to let them know I was still experiencing "UTI-like" symptoms in case I needed to do something about it. I can tell it's not a UTI, though, just super annoying urging and swelling. And it's heaps better since I started taking the drugs rectally. They told me to clean myself half an hour after each pessary, especially the vaginal ones. Sure, I can clean my dirty, cavernous nether regions if that's what you think is doing it. Personally I think it's just the progesterone. I'm sculling water so that I at least have something to pass every time I go to the bathroom. And a heat pack directly on my vag takes the urging and pain away almost instantly. That is not clinic-sanctioned however, just something I'm doing when it all gets too much to deal with. I won't be doing it post-transfer.
Speaking of which, I wonder how the lil bubble is going with thawing? They start to defrost them about now. I'm petrified I'll arrive at the clinic, bladder-full and they will tell me it has succumbed and the transfer can't happen. I at least want to give this little guy a chance inside me, even if he doesn't make it, to live just a little while at least. Even if that's just a day.
So it comes to pass that as of tomorrow, I will have no embryos in storage for the first time in over 5 years. It's equal parts comforting and disturbing having such an intimate and precious possession both outside of your body but in cryogenic storage. Every time I drove past the clinic my heart tugged a little.
Does progesterone cause an irritable bladder? http://www.eleceng.adelaide.edu.au/personal/dabbott/publications/IUJ_cutner1993.pdf
(I know this is from 1993 but basically the abstract is that ladies with increased progesterone went to the loo more frequently).
Round 7, Day 17
I look like I'm about four or five months pregnant.
I don't know if it's because of the medications or because I splashed out and ate some carbs. By some, I mean all of the carbs. Every last one. So I'm sure that's not helping. But I'm pretty sure it's the meds.
I can't stand wearing jeans or anything that puts pressure on my abdomen because of this crazy swelling. I've put on a bunch of weight, I'm sure some of it is fluids but I am also sure some of it is not. I look like I've given up on life in my all-day activewear. In short, I'm ready for this round to be over, one way or another.
Switching the progesterone-only pessaries to being suppositories through the day has helped enormously with the weird vaginal nausea (I should trademark that as a medical term) although I'm still swollen and irritated, just not need-to-sit-on-the-loo-at-all-times irritated.
And with that said, I could smash a dirty vodka martini right now... gawd my mouth is watering just thinking about it. But it's only a few days until transfer, I should really be doing some kind of cleanse. My inner chi definitely needs cleaning, I'm just in a mental funk with this round. I just don't feel on my good game, that I'm putting my best foot forward here. At least I'm not a human hive today.
And I managed to take Offspring to the zoo like a good momma this morning after the rain cleared. We saw the "effelents" or as they started to be called by the end of the day the "elforlents".
We're working on it.
Round 7, Day 16
My vagina wants to throw up. No, really.
I guess more accurately it feels like my womb wants to throw up. It's the new pessaries I started yesterday, we added a progesterone pessary first thing in the morning and another mid-afternoon. I guess if I concentrate on what is happening down there, the feeling is like probably contractions/irritation, almost like the urging of a bladder infection. I'm not sure if it's on the basis of the medication (progesterone) or just the pessaries themselves irritating things. It's the oddest feeling. I keep going to the toilet thinking I need to poop or pee. Nope, it's just my womb trying to crawl out through my vag and push all the medication out with it.
I called the clinic sheepishly and spoke with one of the nurses. "Um, I'm not sure how to explain this feeling but it kind of feels like I have a bladder infection and need to pee or need to poop, like ALL THE TIME, and my womb wants to crawl out of my body." She covers her laugh with a half-sigh. "How far up are you pushing the pessaries?"
I'm immediately defensive. What do you mean, woman? They're pessaries. I'm pushing them up into my vagina like you told me to! I have an odd flashback. Pretty sure I might have had this conversation on a previous round.
"Well, like I'm putting them in like a tampon, like up about a fingers' worth?"
Now I'm worried. Is a fingers worth too big a vagina? Do I have a massive cave vagina and I don't know it? Maybe it just feels like a fingers' worth and it's just the first knuckle.
"You're probably hitting your cervix and it's causing irritation."
Well, no, I don't think so, but okay lady. You're the expert. Riddle me this, why didn't the oestrogen pessaries I was taking all last week irritate me if I was doing it wrong?!
Before I can formulate a response she says the magic words, "You can put them in rectally if you like." I half-knew this but like everything with IVF, there is so much to remember that you can't tuck it all safely away in your noggin. If only one could store the information in one's massive vagina, I'd be set.
So it turns out that the progesterone-only pessaries I take during the day are completely okay being inserted rectally, it's just any pessary with estrogen in it (i.e. my mixed progesterone and estrogen night-time pessaries) that need to be taken vaginally.
I unironically and profusely thank the nurse for being able to shove a waxy bullet into my bunghole, hang up and zip off to the bathroom. It's in quicker than you can say "Jack Robin-SON-OF-A-BITCH!". From previous cycles and panicked calls to the clinic (and because this will happen to you) I also know that it's okay to poop 20 - 30 minutes after the pessary goes to visit brown town. All of the medication you need from the pessary is absorbed within 15 - 20 minutes. There is also evidence to suggest that progesterone is actually better absorbed rectally than vaginally, and when you put it up the pooper you don't have to lie down for half an hour like you're supposed to with a vaginal pessary. You will expel the wax that the medication is delivered in when you next poop, again this is fine and don't panic. It's better than being inserted/expelled from your vag because that just happens all day long like a waxy white period instead of in neat poop parcels. Just don't trust a fart until you figure out how your body handles it.
I generally try to wear pads on the days I need to do pessaries, and it helps, but there is something about the wax that messes with the structure of a pad and the stickiness. Either way, save the lacy La Perla g-string for another time and invest in a box of Target sensibles.
In other news, have also turned into a human hive, just one giant hive. Again, it's the progesterone. My body does not like. I took both skin spray Benadryl AND Cetirizine this morning and feel slightly more human although now sleepy. Adulting is highly overrated anyway.
Round 7, Day 10
Day 10: scan day! Apparently my lining is looking "very good" at 8.2 (whatevers, mms?) so we can go ahead with the transfer as planned.
I had a very vivid Michel Gondry type dream last night that I was pregnant, they were scanning me at 10 weeks and I could clearly see the baby. I asked what the sex was and they said "a boy" which I could also clearly see, I turned to my husband and we shook hands on what the name of the baby would be (a gender neutral name which we have previously decided upon).
I've been given a new regime which includes pessaries (the joys!).
The embryologist called and reminded me that the embryo was 4BB quality, which means a 30 - 35% chance of success.
But then, I think to myself, I've added embryo glue... so that's another 23%... although I know it doesn't work like that, the numbers kind of mush together.
And then I did this calculator online and plugged in my details and it gave me a 15% chance so I'll take the embryologist over everyone else I think.
And if we look at my chance of success with FETs on implantation it's 100%.
So nanny nanny poo poo to your statistics.
Round 7, Days 7 & 8
The weekend was pretty busy but lovely. Friday night we went to our local bowls club for cheap burgers (lettuce wrapped for me) and Offspring played and scooted with all the other local children in a retired bowling green they have set aside for that purpose.
I took Offspring to a Moana singalong on Saturday morning. It was deliciously cheesy and the kids (and adults!) were all singing and dancing through the theatre. Despite a pep talk to myself on the way in, I fell off the low-carb wagon the moment I smelled the popcorn and inhaled a small box before the credits even rolled. I felt like crap in the late afternoon as a result and resolved to try and stay even-carbed for the rest of the cycle. Moana has now been on constant rotation at our house and I'm hoping Dory has a competitor.
On Sunday we were invited to visit and pat some gorgeous "police horseys" with a friend of ours who is police. Offspring fed one a carrot and sat on it's back. Big smiles. Undoubtedly pony club will loom large at some point in our future. I then left Offspring with her father and went to a hen's afternoon/evening. I stretched two glasses of red wine over the whole event. And aside from the obligatory five cheezels (one for each finger) I ate only one cupcake! So proud of myself.
So many early pregnant ladies in the group with gorgeous little bumps! Met another guest who had an IVF baby, first round (it does happen!) and with 9 spare frosties in the bank. Nice to have a related chat.
It was a lot of fun, but more hiving and flushing last night and today from the hormones. My pink cheeks were a sight to behold. It's been a little better since I took that one Zyrtec tablet. I don't feel like I'm crawling out of my own skin. I'm happy to take one if it's only every 3rd day or so. I was actually prescribed them for the hives when I was pregnant, and took them daily, and Offspring appears pretty well adjusted at this stage, so it's really during the transfer and implantation stage and early weeks (if we get that far) that I am worried about the blood flow issue. Pregnancy made the hiving worse and it's never gone back to "normal" so I worry that if this pregnancy is successful the hives will be crazy. Time will tell!
Round 7, Day 6
Last night I woke up covered in hives. Again, this is a me thing, not an IVF thing. At least, it's a "me on IVF" thing. I have a histamine disorder and the hormones really flare me up.
My skin was on fire and I couldn't seem to regulate my body temperature. I lay awake for an hour increasingly feeling trapped in my own body and panicky before I gave in and took an antihistamine. My thought process in giving in is that the research shows a potential drop in blood supply to the uterus as a side effect of antihistamine use (because it narrows blood vessels), but the only thing that's happening down there at the moment is the thickening of the lining. So I can afford for that to grow a little slower.
I figure that the more important time to not take antihistamines is after the transfer when a fetus might need the blood supply. I'm dreading the 2WW on just that basis.
Managed to not shit myself today. Yay, me! The squirts have eased up and my period has dried up pretty much completely. In other news my nipples have become super sensitive and I can smell EVERYONE and EVERYTHING. Oh, hormones!
Round 7, Day 5
Yesterday afternoon I packed up Offspring (O) and we headed to the local shopping mall to get a few essentials. Okay... it was for an electric Dory toothbrush in the hopes of bribing a better oral hygiene regimen out of O. As soon as I pulled into the car park I knew I was in trouble. On the drive over I'd started feeling hot and cold and just generally a little weird. I put it down to the wine with lunch and made a mental note to maybe stop early for the rest of the cycle. Then, I was suddenly on the verge of shitting myself. "Oh right," I thought, "I remember this now. Hormones."
"Okay, baby," I call into the back seat, "Mummy needs your help. I'm not feeling very well so we need to get into the shops really quickly, okay?"
"Okay, mummy." O has no idea what I mean but is always so accommodating. In theory.
I pull into the Parents with Prams area which is full of cars that do not have baby seats in them - they should just rename the area from "Parents with Prams" to "Assholes with Attitude". So... I am forced to park some distance from the front door. I carefully get out of the drivers' seat (a firm buttcheek clench is the only thing maintaining my dignity), grab a shopping cart and pull Octopus Arms from the car seat.
"Dummy! B-bear! Barbara!" Offspring is demanding various items from around the car before we can leave.
"Quick, quick, darling, mummy is in a hurry!" I try not to bend as I gather in an odd sideways limbo. Into the cart and off we go. I know I'm walking funnily and I can only hope that people think I'm disabled. Why must they put toilets so far away? Sweet Frankincense, a hill inside the mall, how did I not remember this is here? Oh god oh god oh god, it's going to happen isn't it?!
It's school holidays and the mall is mobbed. Every child and slow-walker gets in my way. I'm half-expecting some men carrying a sheet of glass to step in front of me or a wheelbarrow full of watermelons to tip over at our feet. Things are getting more precarious with every step. My face is starting to flush. The toilet sign looms ahead like an oasis in the desert and I can feel my butt clench start to slip.
The disabled stall is open, thank god, and I scootch us in and lock the door. The poor baby is smooshed up to me in the seat of the cart, given the size of the stall, and pats my head as I shudder into the bowl.
"Yes, mummy's ok," I say as another wave of liquid fire shoots out of me. Oh gawd, I want to die.
I have a flashback to Round Two, well over five years ago, when I had OHSS and was extremely sick. It took me a long time to recover but after a while I thought I was in the clear. One of the side effects was very loud gas which was extremely inconvenient to me but DH found hilarious. Glad one of us was enjoying it.
"Hey, listen to this," I said one evening romantically to DH, as I pottered around in the kitchen in a cute summer frock. He was in the adjoining room watching TV. I lifted my leg to emphasise the resonance of the upcoming fart. SPLAT. I sharted so hard that it shot past my panties and splattered on the tile. DH looked over with a smile and gave me the thumbs up. My bottom half was hidden by the kitchen island so he had assumed it was just a regular ole chunky fart.
I panicked. "DON'T COME IN HERE!" I yelled and in response, of course, he stood up and grinned and started walking toward me. "Why?"
"STOP!!! Just go... get me an old towel or something, throw it to me, and walk away."
"Did you drop something?" Still smiling but he's stopped at least.
"I..." there was no getting around it, "I shat myself."
"NO! You didn't?!" he laughed. He still thought I was joking.
"It's on the ground. Just go get me the towel." His face dropped and I could see him filing this incident on the "Cons" side of the "Should I divorce her now?" checklist he undoubtedly keeps in his head.
I remember a time when I would hear comedians talking about shitting themselves and found it funny but really couldn't relate, like 'WHO SHITS THEMSELVES?! That never happens!'.
Those were the days.
Round 7, Day 4
My period, which is usually viagra falls (lol autocorrect and I'm leaving it, more like VIAGRA FAILS AMIRITE?) has tapered off due to the progynova. Small mercies.
I managed to have a hot shower before Offspring awoke and the hormones combined with heat of the shower gave me hives (don't worry this is just a ME thing not an IVF thing) and so I spritzed a little topical Benadryl antihistamine on them - instant relief.
Then of course I wondered about antihistamines and conception. I'm not big on medicine if I can avoid it but I do take a fair amount of them, a Zyrtec every few days when the hives get too much, as well as topical antihistamines when my skin is on fire.
Well of course the internet has a lot to say about antihistamines and conception, not a lot of it good. Stuff like it has been shown to reduce blood flow to the uterus and impact implantation. Oh lawd I'm going to just have to be a hivey miserable mess this cycle aren't I? I can do it. Honest I can.
Glass of wine (and some soft stinky cheese) with lunch while I still can, and sat out in the winter sun for a while during nap time. Glorious.
http://www.lanefertilityinstitute.com/blog/antihistamines (note references at bottom of article):
Round 7, Day 3
Progynova is okay but prednisilone tastes like bitter vomit.
I'm terrible at remembering to take medicine so I have a system figured out now: I bought a bunch of old lady day-of-the-week pill boxes and I dole everything out in advance for breakfast, lunch, dinner and evening pills. It's then very apparent when I've forgotten my pills, or already taken them and forgotten, which starts becoming a thing when you have so much on your mind. I wish I'd had this system figured out from round one. The added bonus is that I get to also dole out vitamins and other meds I'm supposed to be taking so you get to be really on your game in that regard.
Breakfast box: 2 x progynova, 2 x prednisilone, 1 x metformin (for my PCOS) 1 x Megafol folate, 1 x triple strength fish oil, 1 x uterine-centric shelf-stable probiotic [not pictured as I've run out]
Lunch box: 2 x progynova, 1 x metformin, 1 x Vitamin D & calcium, 1 x Elevit pregnancy multivitamin, 1 x Bioceuticals Mag Forte magnesium mix supplement
Dinner box: 2 x progynova, 2 x prednisilone, 1 x metformin 1 x uterine-centric probiotic
Evening box: 75mg + 50mg Thyroid medications (I have Hashimoto's Thyroiditis)
So it sounds like I'm a walking pharmacists wet dream with all of those autoimmune conditions, but I'm really quite healthy and functional. And sexy as hell. Aside from fertility, weight struggles and lip waxing frequency, it really doesn't impact my day to day life.
One of the clinic receptionists called and immediately said, "I'm just calling to process your payment over the phone... how did you want to pay for that?". Honestly I could almost hear nunchucks swinging and knuckles crackling in the background. I told her I was was driving and shouldn't have even picked up (true!) but that I'd call her back after I'd checked the accounts.
The truth is that I already know the state of the accounts, it's a horrorscape, and DH isn't getting paid for another week.
Desperate times call for desperate measures. I transfer $2,700 out of our home loan onto our credit card. Or I should say currently the money is floating in The Nothing between banks for a few business days while someone, somewhere collects interest on it.
Then I emailed her the receipt so she knew I wasn't lying because I feel like she thinks I'm lying. I briefly wonder if I have some sort of red alert on my account that says "Even though she has a trustworthy face, this lady is, in fact, dodgy AF. Squeeze her early and hard for the cash."
One of our fears when we first started doing IVF is that it would turn into a mainly clinical/transactional thing where the clinic was more of a baby factory: money in/baby out. That's not how it works at all. It's more like money in, money in, money in, money in, money in, baby out[?]. We shouldn't have worried about it... because of course it's clinical and transactional. Amazing scientists who need money to do amazing things work in these places. And amazing business people who drive sports cars. It's not a natural process at all. You are a bit of a walking science experiment. But you're also a walking goddamn miracle. How many of our sisters and aunts through the millennia would give anything to have the chances we have, to even have hope? And how lucky am I that I am privileged enough to even afford one round, let alone 7?
Round 7, Day 2
There are so few benefits to IVF pregnancies, but one of them is that you know when you're NOT pregnant. So I enjoyed a glass of Cab Shiraz last night despite being Schrodingers pregnant and a lovely hot cup of caffeinated coffee this morning, then slipped out to the clinic while Offspring was distracted by the everyeth viewing of Dory. DH has a rare day off.
The traffic was unusually light and I got a parking spot right out the front door. I can't tell you how unusual that is. An omen of course. ;) The receptionists know me by name now so I don't need to announce myself when I walk in, but I do it anyway, just in case.
I've barely taken a seat when my name is called for the scan. I sign my consent form, she lowers the light to get me in the mood and I take off my shoes, jeans and knickers. I lay down on the paper covered table, put my legs in the stirrups and scootch all the way down until I feel like I'm almost falling off. I've learned that if I don't do that and just lay comfortably she'll just get me to wriggle further down anyway, may as well get it over with. We make small talk about the weather.
It's day 2 so messier than a bashed punnet of raspberries down there and I warn her but they're used to it and the internal exam was over in no time. I've had the same technician for every scan over the years, and she's great. It's not uncomfortable until she changes direction to point at my left ovary and bumps across my bowel.
"Oh wow, you have a good number of follicles, you should get a lot of eggs this round."
"I'm not doing an egg collection. I'm done with surgery. This is my last round and it's a frozen one."
What did that "ah" mean - does she think I should be doing another collection? Is this like a miracle egg crop I should be taking advantage of?
STOP. ENOUGH. NO MORE COLLECTIONS. YOUR TIME IS UP.
She points the wand in the other direction. Oof.
As she scans, she rattles off a bunch of numbers to her assistant who writes them down. I heard "anteverted" (my uterus is doing backflips again), my left ovary is apparently bigger than my right, my endometrial lining is 4.... millimetres I guess!? and she measured all of my beautiful but useless follicles anyway. Protocol, I guess
Now I'm in the almost-empty waiting room awaiting the doctor. Thank Beyoncé it's not a Monday, Mondays are crazy at IVF clinics and the wait times are atrocious. I used to dread day 1 falling on a weekend for precisely that reason. I look around. There's a lady here who looks like she's in her late 40s or early 50s. She's carrying a cooler bag. Lunch or gametes? I chuckle to myself. I wonder about her story and hope with all of my heart that she gets everything she wants. I hope she feels my support and love from across the room. I want to tell her it worked for me but I know that wouldn't help.
I have a flashback of driving to the clinic for Round 5 blood tests and gripping the steering wheel while "Please, Please, Please, Let Me Get What I Want" by The Smiths came on the radio. I couldn't breathe.
I snap back into the present and I'm trying to remember if I had to do any injections or anything with a frozen round. It really hasn't been that long but it's amazing how you forget. There's too much to remember. It all merges. I've learned to just follow the immediate instructions they give you until they give you the next lot of instructions. It's easier that way.
The doctor calls my name. I love her. It's a quick visit.
"Ah, the last round." She smiles and looks down at her notes.
"Would you like embryo glue?"
"Would you like hatching?"
Does that increase the chances?
"By about 23%."
"Well, in studies on a 38 year old with 4 failed transfers showed a 23% increase."
Ok yes, lets do that.
"And you're automatically on the miscarriage protocol due to your losses."
Pessaries. Ugh. But yes, good.
"Any more questions?" She looks up.
I have a million stupid questions that I already know the answers to but I shake my head. Should I ask her about the weird lump on my vulva? I decide no. I know there is something important I'm forgetting.
She comes over and hugs me. "This is going to work," she says, and smiles, and I want to believe her.
She directs me into an office where a nurse gives me my medical instructions.
The nurse points at a printed sheet with a mini calendar of my cycle.
8mg progynova, three times a day.
10mg prednisolone, two times a day.
Just keep doing that for the next 10 days, she says. Very important to keep a steady stream of the hormones. Don't miss a dose. Come back in on Day 10 early morning for a blood test, scan and embryologist appointment. The transfer will likely happen on Day 20.
Yes. I mean no.
"Do you need to see the accounts manager?" She asks, like I have a choice in the matter. He's hovering outside the door.
She ushers the accounts manager comes in. I steel my wallet. I know him well. It's a love/hate relationship. I love to hate him. He looks haggard and has grown a beard since the last time I saw him. Maybe I should lay off the negative vibes. He's just doing his job.
"I see you want hatching," he says. "They will only do that if it is necessary, so you may not have to pay, but that's $400 out of pocket with no rebate."
My eyebrows shoot up but I say nothing. He notices. 'What price 23%?' I think to myself. My husband would have something to say about that. Money's very tight right now.
He carries on. "The embryo glue is another $300 out of pocket." I think about Offspring and how we used embryo glue for Round 5, our successful round. I nod slightly.
"Your medications could be $700 or more, and I can't guarantee what you'll get back from Medicare or your health care insurance." I know with the additional meds for the miscarriage protocol that I'll automatically be going above that. I'm bad at math but this seems pretty exxy so far. Like "no holiday next year" exxy. Maybe even "no food next week" exxy.
"Then the actual transfer and round management costs $3,400." Blood rushes to my head. For some reason I had $2,000 in my mind.
"Has that gone up recently?" I ask
Not for a few years, he says. You'll get some of that back from Medicare, but you need to pay it in whole, up front.
My mouth is dry.
I look at the paperwork, a little embarrassed. I think we can shuffle some money around maybe and fit it on the credit card. Just. Maybe.
But this time the cost is really bothering me. For most people conception is free with a side of orgasm. I've paid the same amount every frozen cycle and then well over $12k for each of my four collection cycles to this clinic. Plus endometriosis surgeries that I had through them. At the same time, I understand and appreciate the professional effort and technology and labour of love that goes into running an IVF clinic, it's not cheap, but if this were me buying a fridge at even half the price I'd be haggling, and likely successfully. Why should this be any different? If this were a cafe I'd be approaching my free coffee punch by this point.
I WANT MY FREE COFFEE GODDAMMIT.
"Any chance of a Round 7 discount?" I hear myself saying.
To my surprise he says he'll see what he can do and will call me later after he's spoken with management. Maybe he's not so bad after all. I hope everything is okay at home for him.
I try to play it off coolly... like of course they should give me a discount... then I'm not sure if that's the right move to reinforce the discount, so I also I tell him I've been out of work for the last year (kinda true, even though I have a casual day gig every here and there when I can).
A receptionist I didn't recognise tried to ping me for the full amount on my way out. Like I have $4k tucked into my bra or something. He's only just told me how much it is! Surely everyone needs to shuffle money around accounts, remove spending limits on their bank or sell a family heirloom between the "how much" and the "please pay" discussion.
It always feels like a shake down when they ask. I've paid every bill they've ever given me - thousands upon thousands - and yet they still seem to have this weird energy when they ask for payment. Like I'm going to somehow dupe them out of getting paid.
I said in a low voice that the account manager and I were coming to an alternative arrangement and he'd be calling me this afternoon and she still went to verify with him like I was lying or something. I get it. But doesn't longevity of a relationship help any here?
My IVF friends tell me this is NOT normal clinic behaviour and plenty of clinics post-bill and don't make you feel weird about payment. We wanted to change clinics earlier on for that and other reasons, but by then our eggs were literally in one basket. Seemed easier to just suck it up. Plus, I love my doctor.
I'm in the clinic by 8.30 and out by 9.47am. I timed my street parking ticket perfectly. YES. Those inspectors have pinged me more than once outside the clinic when appointments have gone long. I give them a mental middle finger.
I head home, grab Offspring and we head out for a babycino and breakfast while DH chills out. I pick up my meds at the chemist and down them with my coffee.
The account manager calls back in the afternoon.
"I have some, hopefully, good news." Oh wow, didn't expect him to actually give me any kind of discount, but yay! Oh great, thank you! I say in anticipation.
"Due to the amount of money you've spent and rounds you've done with us over the years I've spoken with management and we've decided to discount this round by $1,000."
Holy fecking spitballs. I'm momentarily silent... and then I start to cry. I blame the new hormones that I'm now on and splutter out another sincere but thick-voiced thank you through my tears and assure him I'll get into payment ASAP.
So glad I at least asked the question! There's a lesson for you. Always say when they give you the grand total, "Is that the best you can do in terms of price?". Who knows where it will get you?
And now I'm thinking I should have asked for a Round 6 discount, haha.
Round 7, Day 1
Day One in IVF-speak is just a fancy way of saying you got your period. It marks the start (Day One) of your round. And if you're really lucky, it also marks day one of your pregnancy, even though (for a frozen round) your little embryo is on ice in a vat somewhere. Isn't that weird? The first month of a round of IVF is a veritable Schrodinger's pregnancy, where you're kind of half-pregnant until they transfer the embryo and then three-quarters-pregnant until the final blood test. Even then you can't get really excited until they tell you your "numbers" are doubling nicely. I'm still confused as to when you're allowed to say you're all the way pregnant. It can really mess with your mind.
Anyway, so Day One: what you do is you call your fertility clinic, tell them Aunt Flo has rocked up, and they say something like, "That's lovely, Mrs. MoneyTree. Exactly what time did you notice you'd ruined your favourite underwear? Mmm hmmm. So why don't you come into the clinic so we can push an internal wand into your privates, shove a needle in your arm, dole you out some pretty blue pills, make you sign away your right to sue us and give us our first chance at emptying your bank account?" and you say, "Oh yes that would be lovely, thank you so much for the kind offer. Does tomorrow work for you?". Technically even though my period started last night, they tell me that TODAY is day one because of the timing. Whatevs - mine is not to question why.
And so I clear my schedule for tomorrow morning for a date with a condom-sheathed light sabre wielded by a kindly middle-aged technician, check the balance on my credit card and throw down some ibuprofen for the wicked cramps. Hashtag endometriosis.
Takeaways and a hot water bottle tonight. The most action I've had in weeks tomorrow. I might even wear my fancy undies.
Let's talk about endometrial biopsies. Otherwise known as a "scratch".
Let's talk first about WHY we get an endometrial biopsy when having fertility treatments. It's certainly not a necessary procedure for any given IVF/ART round but there are studies that show having an endometrial biopsy prior to transfer increases the chances of embryo implantation in some people. It's arguable as to how much it increases the chances, and for which patients it has the most impact, but there are some really promising studies out there that I will reference below. For some people it is likely to have minimal or no impact. For others (like me), every time I had an endometrial biopsy (or uterine surgery, which mimics the "roughing up" of the endometrial lining) it did actually work and I fell pregnant that round (spoiler alert: they weren't all successful pregnancies). It's a cheap addition to the list of tools that increase the chance of implantation, so personally I would recommend asking your doctor about it.
Now, let's talk about the procedure. The first time I had it done, I was facing round three and rounds one and two were completely unsuccessful for me. The doctor explained that an endometrial biopsy increased the chances, and she said it was about as uncomfortable as a pap smear and didn't add any cost. She was willing to do it then and there (the round would start at my next period) so I popped up on her table and she began.
Now I hear from many other people that for the most part that this is a painless (or at the most mildly uncomfortable) procedure as she stated. It started out normal, like a pap smear, speculum thingie to open things up, not exactly pleasant but not painful, then when the biopsy started the pain was very high for me. 8 out of 10. Luckily it only lasted maybe 2 minutes maximum and it resulted in a pregnancy for me that unfortunately ended at 10 weeks.
The next "scratch" I had was for round 5, I asked to be medicated for it. When I got into the theatre they explained that it would take longer and probably be more uncomfortable to administer the medication than to just go ahead and do the biopsy. They said that the last round was probably a one-off and that this biopsy wouldn't hurt, so I gave consent to go ahead. It was just as painful. That round resulted in a successful pregnancy for me.
Round 6, I decided not to do it again. I did fall pregnant that round, but lost it quite early.
Cut to round 7, the final round. This round. It's the final round. I've got to give it everything, right? So back for another biopsy I go. This time I'm making sure I'm medicated. They book me in and they offer me Valium and Nurofen Plus. I make sure to repeat it to every staff member I see on the way in. The drug lady comes and asks me if I REALLY want the drugs. "YES, THANKS LADY! WHAT ELSE YOU GOT IN THAT CUPBOARD?"
Here's a cute shot of my toes waiting for the valium to kick in which I'm not sure it ever did, it felt more like two glasses of wine than a hit of LSD - I was really hoping for unicorns and rainbows so I felt slightly ripped off.
Long story short, it was about as uncomfortable as a pap smear. :) One of the nurses said she thought it was because I had given birth - that lots of women's experience of a biopsy changed after childbirth and were no longer painful.
The drug lady popped back afterwards, squeezed my hand and winked at me. I think I love her.
Endometrial Biopsy Studies:
https://www.ncbi.nlm.nih.gov/pubmed/25561347 "it may improve live birth in women with two or more previous IVF failures."
https://www.sciencedaily.com/releases/2016/07/160704082720.htm "Endometrial scratch appears beneficial in couples trying to conceive"
I know the end may seem like an odd place to begin. Well it's not quite the end yet, but this will be our seventh and final round of IVF... and the weird thing is, perhaps you already know this particular ending - the internet has a strange way of bending time like that. How marvellous to think that you, dear internet time traveller extraordinaire, already hold the knowledge of the outcome of this most intimate detail of my life that currently teeters in front of me. Oh please, let it be a happy ending! Wouldn't that be nice?
I meant to start this process earlier. The writing, I mean. I couldn't find anything online that I could even remotely relate to when I started IVF all those years ago. It was either too sciencey and confusing and cold or too dramatic and sad. I meant to reach out to you and hold your hand. Or perhaps to reach out to you so we could hold each other's hands through this. And now here I am at the end of the journey, looking back, and wondering at the twists and turns, the highs and lows, and the losses. And not having written a smidge down for you. I'm sorry. I'll try to make it up to you.
Each IVF or ART (assisted reproductive technology) journey starts with loss. No-one wants to conceive by having a team of people to prod, poke and otherwise invade you while simultaneously raiding your wallet (although maybe you're into that... no judgement!). And yet we are really so lucky when you think about it. Lucky to be living in a time when we can even contemplate becoming parents thanks to some really cool and ground-breaking scientists... when even a few short decades ago you would have been lucky to get a shrug and pat from the doctor and have been told to throw yourself into your knitting or something.
So this will be our final round of IVF. It's our last frozen embryo and I'm 42 so the door has to close at some point. Spoiler alert: I'm luckier than most - we have a miracle offspring from Round 5 (more on that later). I'm sure I'd feel differently and a lot less comfortable about closing that door if we didn't have a child, but there is still an undercurrent of terror for this round that I haven't had in any other rounds, because we always had another chance behind it.
Here's to lucky number 7!
Just some of the terms you may come across when doing IVF or reading message boards. Let me know if there are any missing you'd like to know about.
2WW- Two week wait
7dp5dt - 7 days post 5 day transfer
AF - Aunt Flo (period arrival)
AH - Assisted Hatching
AHR - Assisted Human Reproduction
ANA - Antinuclear Antibodies
ART - Assisted Reproductive Technologies
BBT - Basal Body Temperature
BCP - Birth Control Pill
Beta - hCG level (pregnancy) blood test
BFP - Big Fat Positive
BFN – Big Fat Negative
CD - Cycle Day
DH - Dear Husband
Dx - Diagnosis
EDD - Estimated Due Date
ER- Embryo Retrieval
ET - Embryo Transfer
FSH - Follical Stimulating Hormone
FET - Frozen Embryo Transfer
hCG - Human Chorionic Gonadfotropin
HPT - Home Pregnancy Test
IUI - Intra-Uterine Insemination
IVF - In Vitro Fertilization
IVIg - Intra-venous immunoglobulin therapy
LAP - Laproscopy
LMP - Last Menstrual Period
LH - Luteinizing Hormone
LP - Luteal Phase
MF - Male Factor
OHSS: Ovarian HyperStimulation Syndrome
PCOS - Polycystic Ovarian Syndrome
POAS - Pee on a stick - home pregnancy test
POF - Premature Ovarian Failure
PUPO - Pregnant Until Proven Otherwise
RE - Reproductive Endocrinologist
Rx - Prescription
TSH - Thyroid Stimulating Hormone
TTC - Trying To Conceive