Day 35 - The Transfer

The whole Embryo Transfer went swimmingly. We were admitted at 8.45am, then were taken upstairs to theatre where Mr.C was given a gown, slippers and hair net. I got to keep my top on this time, stripped off waist down and popped on my surgical attire. The embryologist came to see us and told us that we had 2 beautiful embryos, and the rest just had to catch up a little bit more.

The procedure went well. The nurses were great. My husband was in the room with me. I was a little wary when they turned a monitor around for me to see, and I thought, "What on earth are they going to put on there? I don't want to see what's happening downstairs!" And then they showed us a picture of our embryo. The embryologist was right, it was beautiful! It looked perfect.

"The Spacehopper*"

Now, I did mention in my last post that I was suffering from an unwanted protrusion, which we have nicknamed "the spacehopper".  For those of you who need a bit of help with the interpretation, I've conveniently found a picture (left) for you. Thankfully it had receded, but it was still incredibly uncomfortable. When it came time to transfer the embryo, the doctor kept tapping my leg and saying "Relax! I can see you're all tensed up!" "I'm trying," I whimpered. Deep breaths.  I was trying so hard not to think about what the doctor could see down there. More deep breaths. Just look away and focus on something else... And then it was all over, and they wheeled me out to the recovery area where we watched the latest political developments of the Australian Labour Party. It was the best thing to make me sleepy and relaxed.

I rested for 30 minutes, changed back into my clothes and we were out the door by 10.30am. We decided to go out for a late breakfast while we waited for my acupuncture appointment at 12. We had a nice breakfast at the cafe in Kings Park, which was helping with the whole relaxing thing.

My acupuncturist asked how my transfer went, and I told him it was incredibly awkward, but the doctor was saying really positive things through the whole thing. I was told that acupuncture straight after transfer increases your chances from 40% to 60%. Relaxing is also key, so he was happy that I was going home to watch a movie that makes me giggly.

So we went home and watched Super Troopers, an old favourite. We also ate the endorphin kickers, my favourite, Cadbury Creme Eggs. The breakfast, the movie, the Creme Eggs and a hilarious phone call from a dear friend must have really increased the endorphin levels because we promptly fell asleep on the couch.



So, despite the Space Hopper, I actually had a very delightful day.

Our endorphin kickers

*Spacehopper image gratefully borrowed from http://www.absoluteastronomy.com/topics/Space_hopper

Day 34 - The Embryo Stage

I've called everyday since the egg pick up to check the progress of our little embryos, and they have been progressing really well for each day.

• Day 1: Yay! We have 5 eggs fertilised!
• Day 2: All 5 embies have reached 4 cell division. Good progress.
• Day 3: Some are advancing a little bit faster than others. We have different cell divisions at Grade 2, and one was breaking from the pack at an 8 cell compacting morula (stage before blastocyst stage)
• Day 4: Have a whole bunch of little compacting morulas. We won't know which one they will use or how many can be frozen until our transfer. The embryologist says that it's unusual to get 100% frozen. We can probably expect around 2 or 3 bubsicles.
• Day 5: Transfer day.
• Day 6: Call the embryologist to find out how many were actually frozen.

So my transfer is tomorrow morning. I have my acupuncture appointment an hour after the transfer. I'm feeling optimistic, but I'm also a little apprehensive too. You'll see why, keep reading.

My latest woes

This is where it gets incredibly personal. *Gross-out alert* I woke up this morning with a very sensitive rear exit. I didn't think it was too bad, but it got progressively worse throughout the day. And I realised that the bloated feeling and stomach pains from the drugs, lead to a bowel strike, which then lead to my rear entrails becoming my painful, hideously, swollen extrails. Can this get any more humiliating?

Well, of course I had to go to the chemist and discuss my southern outback problems with other pushy customers standing right behind me. No, please, I'm loving this attention, lets call in the shop owner from next door! Grrr....

I took home my miracle ointment and then realised I would have to go the double prod in both southern orifices tonight, the Crinone vaginal gel, and well, the other one...sigh...just kill me now. I'm feeling sorry for myself and very squidgy.

Dear God, please make this thing go down before tomorrow. Don't make me get on that table with unnatural protrusions. Amen.

Day 30 - Egg Pick Up

Day 30. Saturday. Egg Collection Day.

It worked out beautifully that it wasn't on a work day as I was dreading the whole "what convincing lie can I come up with to have a sick day". Plus my husband was able to come to the appointment without any fuss.

We arrived at 8.35am and we met the nurse where I filled out more forms and collected my Crinone gel. Crinone helps to prepare the uterus lining and is applied vaginally. I was hoping I wouldn't have to be prodding or jabbing myself anymore, but there you go. I was starving from having to fast and skip breakfast, and my stomach growled the whole way upstairs to theatre. Here's an interesting side note, I was told not wear perfume, deodorant or any smelly stuff, so I didn't even wash my hair. But I've since discovered that aerosol perfumes are not embryo friendly.

 Hubby waited for me while I went into my little change room to change into my gown, hairnet and booties. As I had a "rear-ventilated" gown, I was also given a modesty blanket, which was massive, and you could hear me giggling as I struggled to drape the blanket like a toga, dragging it down the corridor with my giant handbag and belongings in the other hand. Very dignified.

I sat in the chair next my husband and the embryologist came to see us. She briefly explained the process, how she would check for the eggs during the procedure, and we would know how many fertilised by the next day. Hubby was called away for the sample. And then the anaesthetist came to talk to me and I answered all the medical questions. Then at around 9.40am, I was whisked away to theatre where my Fertility Specialist was waiting.

I walked in and two nurses were there to help me with my gown. They asked me if I'd done this before and I said, "No, this is my first time." "Well, you're a virgin then!" And I said,"Yes, please be in gentle."  My Fertility Specialist commented on my difficult follicles, but I reassured him that I gave them a good pep talk and told them not to be scared of him. He he, good for a giggle.

There were about 5 people in theatre, and they were all bustling around me while I lay on the table. The Anaesthetist put the needle in my hand and I was off to sleepyland. I woke up in the recovery room at around 10.40am with an oxygen mask on my face, very drowsy, just wanted to sleep. They rang my husband to come and get me and then they wheeled me into a little cubicle with a TV. Now, when my husband arrived, I remember him clearly coming into the cubicle and we chatted about what he did for the last hour or two and what was on TV. My husbands version of events went a bit differently, apparently I stared blankly at him a lot and had trouble stringing words together. The nurses brought in a toasted sandwich and a cup of tea, and I was allowed to leave at around 11.40am. So we were probably there for 3 hours in total. The nurses told me that they collected 5 eggs.

I felt okay in the hospital laying down. Once I stood up, I started to feel a bit woozy, but still okay. But during the 45 minute car ride home, I felt like absolute rubbish. I felt terribly hung over, the car was too hot, then it was too cold. I got cold sweats and I could feel the toastie wanting to come back up again. At one point I grabbed my husband's hat and said I was going to throw up in it, but "Don't stop the car! I just want to get home!"

I put myself straight to bed when I got home and couldn't really bring myself to eat anything else. I slept most of the afternoon. Had a light tea, my antibiotic and then the Crinone before bed. I felt very crampy and sensitive around my abdomen and had two hot packs, but luckily was able to sleep it off.

The day after...
I woke up feeling quite good. I was less crampy but still sensitive. I still felt a little drowsy. I couldn't do much, I found that I had to rest after doing 30 minutes of housework. I had a few naps. 

I called the embryologist in the afternoon and found out all 5 eggs were fertilised. Woo hoo! Hubby was strutting around the house, so proud. That was a big relief. 

So now we wait for news on the Transfer Day. 

Day 28 - The Trigger Shot

Today I went in for my blood test and ultrasound to check how my follicles were going. I was expecting egg collection to be happening some time soon, so I was thought I best see the nurse for my trigger shot (Ovidrel) as well, just in case.

I didn't get to see the Ovary Whisperer this time, and I really noticed the difference. This guy was a lot more gentle than the first doctor, but he didn't spend much time explaining anything, he just rattled off the numbers to the nurse. But I heard him say there were a couple of follicles at 22mm and a few from 16 - 18mm, so things were looking good. The left side was hard for him to see as well. I mean I know these things are small...but where could they be hiding?

I went in to see the nurse to ask her about my trigger shot. She gave me the pack and my information sheet. I couldn't remember if I had taken my morning Synarel dose, so I asked her if it was okay if I missed it. She told me I should probably go home and take it, because I wouldn't want to risk my eggs escaping in ovulation before they could get collected by the doctor. Aargh! So my panic levels go up a little. I said to her, "I live an hour away and I only work five minutes down the road." She looked at me blankly as if to say"...and? How is that my problem?" Grrrrr! Anger levels rising. Just give me an emergency dose or something lady!!!! And then she said,"We don't want you to lose your eggs before we have a chance to get to them first." Sigh. She was right. I was already investing enough time and money into this whole process, what's an extra 2 hours out of my day. I would hate it if the whole thing went to crap because I didn't want to drive home and back to the city again.

So I got in my car, I was already a bit annoyed and stressed that I would have to fight all that traffic again. I had to take a few deep breaths and just accept that's what I had to do. I got home, put the Ovidrel in the fridge, sprayed up my nose, grabbed a banana and was out the door again.

The nurse called me just before 3pm and she said, "You're ready for theatre." I was so excited to hear that! Things were progressing. Good news. She ran through the instructions for me. I take my trigger shot (Ovidrel) at precisely 9.45pm tonight, exactly 36 hours before egg collection. Ovidrel is used to trigger the release of the egg from the follicle (ovulation). I also start taking my antibiotic twice a day with food. I start fasting tomorrow night and need to be at the clinic at 8.45am for egg collection on Saturday morning. It's the first time I've ever had to go into hospital for any procedure. It's a bit scary, not sure what to expect, but I'm feeling positive! We're actually doing this!

And then I had my acupuncture appointment this afternoon. (My acupuncturists are absolute legends. More about them later) This would be my last appointment before egg collection. My next appointment would be right after they transfer the embryo (if they fertilise) back in. And then he told me that after my appointment I was to go home and put on my favourite funny movie. That's the best thing that's been prescribed so far! But the reason was because when a baby is conceived naturally (that means sex, people) you've usually had a great time and a whole bunch of endorphins are released afterwards. So going home to watch a topless Ryan Gosling recreating a dirty dancing moment will essentially have the same effect. Sigh. Can't wait! I'll make sure to take home my fave chocolate bar as well...just to kick start those endorphins.

Day 26 - The Ovary Whisperer

Today I met the Ovary Whisperer. She...is...a...gem.

After my dismal results from the ultrasound yesterday, I wasn't feeling terribly optimistic this morning. I was told that my left side could have been difficult to see for whatever reason, so I wasn't looking forward to the ultrasound wand getting rammed around in there.

But the Ovary Whisperer came in smiling and instantly put me at ease. She showed me the screen and explained what she was looking for. And she was ever so gentle. She really romanced me before getting to third base. And everything she said was positive. She would rattle off some numbers to the other nurse and then quickly interpret them to me. So, my lining was good at 12mm. She said anything over 8mm is good. I had a number of follicles on my left and my right sides, and she was happy with their sizes. She told me to go home and tell my ovaries it was a job well done. She was an awesome ultrasound lady! I don't want to see anyone else for an ultrasound :)

I also met with a nurse coordinator today, who was equally helpful. I had the opportunity to ask her a few questions and get another Gonal-f kit. Questions are below.

How are Oestrogen levels related to the size of the follicle?
She explained to me that a smaller follicle will have a lower level of Estradiol (E2) and a larger follicle will have a higher level. So you want to aim for a level of at least 550 to get one nicely sized follicle. When my levels came back in my first blood test at 750, they were aiming to get it to around 1000. My second test results at 2900 were good, showing I was responsive to the drugs and that I had numerous follicles at a decent size. For a really good explanation of follicle sizes and Oestrogen levels click here (there is a good discussion on follicle sizes and E2 levels). The dangerously high levels of Oestrogen are when it approaches 12000, that's when you're at risk of Over HyperStimulation Syndrome (OHSS).

How many follicles should I be aiming for in an IVF cycle?
If you were to have only 1 or 2 good follicles, your cycle may be cancelled because  you may be wasting a lot of money for a low chance of success. They will usually aim for 5 or 6 follicles in a cycle, any more than that is a bonus. But the more follicles you have, the more chances of fertilisation, and the more embryos for further cycles.

What do I do with my used Gonal-f Kits?

Throw the empty Gonal-f Kits (including unused needles) in the bin. Take the sharps disposal container to any chemist or back to the fertility centre for disposal.

So now I wait for the FS to review all my results and tell me what my next step is.

UPDATE!

I got the phone call from the nurse today. My results were good. Four smaller ones on the left and seven bigger ones on the right. Thank the heavens!!

I have 2x16mm, 2x14mm, 2x12mm and 1x8mm on the right. The 4  follicles on the left range from 5 - 15mm. Apparently follicles grow 1-2mm per day, so I'll be going back in for another blood test and ultrasound in 2 days. Then more finger crossing.

Happy Valentines Day everybody!

Day 25 - Second Blood Test, First Ultra Sound

This morning I had my follow up blood test and my ultra sound to check how my little follicles were going. I was feeling pretty optimistic. I was sure my levels would have increased like they should have. Just had to wait and see.

My Fertility Specialist (FS) performed the ultra sound today and I can't say he was too gentle. It made me very squirmy and uncomfortable. The ultra sound didn't sound very promising. The FS asked me about my previous blood test results and said it didn't look very good as he could only find one follicle on my right ovary. There were none on my left. You would normally expect at least 4 or 5 good follicles in order to proceed with IVF, but this lonely little follicle wasn't really going to cut it. He started talking about cancelling the cycle and making another appointment to work out what the next course of action would be. But first he would wait for my second blood test results that afternoon before he made up his mind.

I was very brave when he first told me, but it quickly disappeared when I got in my car. I couldn't call my husband to tell him, I had to send him a text, and it still got the tears flowing. I had to make a detour to the coffee shop on the way to work, just to buy myself some time to collect myself. That was it. Over. Cancelled. Try again next month. I was gutted. I was facing another failure.

I really didn't want to answer the nurse's phone call during work that afternoon. But she wasn't delivering the bad news I was expecting. She told me my Estrogen levels had increased to 2900, which is definitely a good sign. I ducked into the empty meeting room so I could ask her a few more questions. Yes, 750 from last Friday was low, but those 750 alone still indicates that there could be at least 2 follicles there. And levels of 2900 indicates that there could be 2 or 3 decent sized follicles, or there could be 6 smaller follicles. That's why they need to do a scan, to check how many there are and how big they are. My husband and I joked that I must have one gigantic follicle growing on my right ovary. Not so funny if it actually turned out to be true though!

So I went from coasting along on optimism, plummeted down to the depths of despair and then shot up again to the dizzying heights of hope again. It's an exhausting ride.

Hopefully my ultrasound just works out OK tomorrow.

Day 22 - First Blood Test

The nurse range me with my result for my first blood test. My (Estrogen? E2?) levels are at 750, which apparently isn't as high as the Fertility Specialist would like. The doctor has increased my Gonal-f dosage to 187.5 and I need to go in on Monday for my next blood test and ultra sound. I'm annoyed at myself for not asking the nurse what my levels should be. I'll have to remember to ask on Monday.

I'm a bit worried about this cycle now. Are my levels too low? Will this cycle be cancelled? My husband tells me to stop stressing and trust that the doctor knows what he's doing. Well, did he know what he was doing in my last cancelled IUI cycle? Could he even explain why my body responded to Femara like that? No.

I had a quick look on the forums at Essential Baby, and read a few other posts about slow rising E2 levels, which sounded similar to mine. Their levels were much lower because their cycles were a bit longer, which means it takes a longer time for the levels to rise before it reached the ovulation stage. So, now I'm thinking that 750 might be normal for me, as I have a 30-31 day cycle.

I can't be sure, but it makes me feel better :)

Day 20 - How easy it is to use Gonal-f

This is my 5th day of Gonal-f injections, and I think I'm getting pretty good at it! My hand does get a bit shaky to begin with, but once it's in, it's all good. So far, no skin irritations, no bleeding. I did have a bit of a mishap this morning where I couldn't remove the needle from the pen, but otherwise no dramas.

Today I've added some pictures of my prepared shoot-up area, with a description of the whole procedure below.

Preparing the injection site

My nurse recommended that I inject after I have a shower, because I'm already nice and clean, otherwise I would have to swab my stomach etc. But I just wash any lotions from my hands, throw on my bath robe and I head out to the Shoot-Up Area.

Preparing the Shoot-Up Area

I've chosen the bench next to the kitchen to be my Shoot-Up Area. It's close to the fridge where you should be keeping your injection pen. I keep my roll of paper towel and sharps disposal unit on there, and give the bench a quick spray and wipe down before I start. I lay down some paper towel and grab the kit from the fridge.

The prepared Shoot-Up Area with all the necessary bits

Preparing the Gonal-f Pen

My kit has a whole bunch of screw-on needles that come in little sealed packs. Once I remove the lid on the pen, I peel off the seal on the needle pack and screw it on to the end of the pen. There's a small window that indicates the dosage amount. I dial the end of the pen and stop when it reaches 150. Check there's no air bubbles. Then I'm good to go!

The prepared Gonal-f Pen with needle

Get down to business

OK, usually I inject below my belly button and to the side, where there's plenty of fat. And I will alternate sides every day. I grab a nice chunk of fat between my thumb and forefinger and insert the needle at a 90° angle. Once it's in, I let go of the fat, let it rest in there for a little bit, and then press down on the button at the end of the pen. Hold it down for 10 seconds, then remove the needle. Easy!

Needle Disposal

I screw the outer cap back on to lock it on to needle, then unscrew the whole thing and toss it into the yellow sharps container. Done! Then I pack everything up ready for the next day.

I've found the whole "injecting myself" thing deceptively easy. Almost too easy. Thank God SOMEONE put a lot of thought into it, because you can't really screw it up. I hope the close up of the needle doesn't freak you out, but it really isn't as scary as I thought it would be. I can hardly feel it.

Good luck if you're trying this for the first time!

Day 17 - Sniffing and injecting drugs

I conquered the Gonal-F injection yesterday! I have to say that this is the part (or ONE of the parts) that I was dreading about this whole cycle. The thought of having to inject myself in the stomach…(shudder).

Thankfully it all comes in a very convenient little pen, with very easy to follow instructions and accompanying DVD. Needless to say, I was incredibly nervous about my first injection. I read the instruction booklet, and then watched the DVD (which wasn't any more enlightening). I prepared my "drug administration bench". This is where I keep the nasal spray and it's right next to the fridge where I keep the Gonal-F. I had my cotton wool, tissues, syringe disposal unit, Gonal-F pack and I lay it all out on paper towel.

When I took the cap off the needle, I immediately thought I would puncture my internal organs - it was that long! Luckily I enough layer of fat to protect my precious innards. But it honestly did not hurt! I was expecting it to be something similar to getting a needle in my arm, or even getting a blood test. But it's much less painful than that.

So, look at me now! Confident needle user and drug sniffer. Now that's something to write home about.

Day 15 - Enter the next phase

Okay. So let's recap. It has been 15 days since I met with the Nurse Coordinator and started taking Synarel.

LMP - Last Menstrual Period

Usually a normal person would start Synarel and they would get their period within the first 10 days. I only just got mine today! My acupuncturist  reassured me that it was normal for Synarel to delay your period. And as I ovulated so late in my normal cycle, it was normal for me to have delayed for 5 days.

I started spotting last night, and I noticed my period is a little different than usual. It's definitely a lot lighter in colour and flow. Cramping is a lot worse. That may not mean the same thing for you though, because I rarely experience PMS symptoms at all. So a little bit of cramping is quite a new thing for me.

Hot Flushes

So one of the side effects of Synarel is hot flushes. I was told that you experience menopausal symptoms when taking Synarel. So I was picturing a red, sweaty face and a thin, blouse clinging to my sweaty bosoms. That's what happens in the movies isn't it? The reality is, your core body temperature increases. And the best way to tell is when you still feel hot in a cold room.

Now, I live in Perth and it's the middle of summer with 38°C days, so it was a little difficult for me to tell the difference. However, since starting Synarel 15 days ago, there have been a few nights where I woke up because I had over heated. I was so physically hot, that I had to sleep like a starfish. I couldn't sleep on my side, because I got too hot with my legs together. I also noticed that (Gross-out Alert!) when I went to wipe myself on the toilet, my nether regions were...hot...I know, WTF? My lady giblets were radiating heat. I'm pretty confident that's not normal, even for 38°C days.

The Next Phase

So what next? As today is Day 1 in my menstrual cycle, I start giving myself Gonal F injections tomorrow. Scary! Hubby starts taking anti-biotics today. I've booked in for my next blood test in 8 days.
I think this is the phase that pumps up those eggs, ready for harvesting!