IVF3

27 Mar

Bet you thought you had heard the last of me! This is a post that I wrote a few weeks ago, but only uploading it now.
IVF 3:

You may remember IVF 1, and there was an IVF 2 in October this year that didn’t work. IVF 2 didn’t fail in the normal way, as there are still 3 little embryos that were created, but the cycle was cancelled after egg collection as they couldn’t find a way to return them into the uterus. This was despite a recent operation to dilate the opening. So we now have a dozen frozen embryos living in the Lister hospital!

I referred to these operations and IVF 2 in this post, but the operations were both for fixing the problem I had with my monthly cycle as well as getting access for IVF.

IVF number three really started early in December. I had another dilatation operation with Professor Shepherd on December 3, and he stitched in part of a small catheter to try to keep the cervical canal open. All went well (I’m used to that operation now!) but just a few days later, while we were out on a Santa pub crawl, I suddenly felt something strange, and the catheter basically had fallen out. It was like a punch in the stomach. Made harder by being out having fun, when I just wanted to go home and have a good cry. I was also a bit lost as to what to do. I knew insurance wouldn’t pay for another operation, but if the clinic couldn’t get access then they just wouldn’t try again. Anyway, we had an appointment back at the Lister Clinic a few days later and had a chat to the IVF doctor. She was disappointed to hear it had fallen out, but said we could think about a frozen emrbyo transfer in Janary anyway. But, since very little had really changed, I didn’t really see the point! We left feeling pretty deflated without much hope.


 What is the problem? A little bit of info about IVF will help.

IVF is a three step process. 

  1. The woman injects a combination of drugs for somewhere between 2-6 weeks, depending on whether you are doing a long or short protocol. These drugs force the ovaries to produce lots of follicles, each hopefully containing a developing egg. They do this to give you the best chance of one sucessful embryo. Normally you just have one single egg a month. You are monitored by regular scans, usually every 2-3 days towards the end. Then you are given a ‘trigger shot’ which pushes the final development. 36 hours later the eggs are surgically removed via a giant needle through the side of the vagina. They drain the fluid from each follice, and hope they catch the egg. This is done under anaesthetic, sometimes a general and other times ‘sedation’ where you sort of drift away but are awake. 
  2. The eggs are taken to meet sperm ‘in vitro’ (in glass). Either just by putting them together and letting them get jiggy with it, or via ICSI where an embryologist picks a specific sperm and injects it into the egg. That is known as day zero. On day 1 you find out how many fertilised to create embryos, then wait for 3-5 days biting your nails and going insane. 
  3. The best embryo(s) is chosen and put back into the womb. This procedure is similar to a smear test. They gently push a catheter through the cervix, and place the embryo in the right place.

My problem is step 3. The cervix is easy to find normally, but since my surgery it seems the normal markers are gone, and for a while there was scar tissue that had actually blocked it. The small operations were to try to open it up further, to clear out scar tissue, and try a few options to hold it open so that scar tissue will form around the istmus (cervical canal) instead of closing it up. Until they doctors can get access to do step 3 they refused to start the IVf. Then in November they said they could get access, did step 1 and 2, but by step 3 said it had blocked up again! Frustrating…


Back to the story! Co-incidentally, at the same time I actually had a long awaited appointment for IVF on the NHS. I met then on 13 Dec, and came back on  20 Dec for another dummy embryo transfer, which is when the doctors try to get access to the womb as per step 3 above, but without the embryo. The doctor there was on a mission to prove he could do what the Lister clinic could not! The process took about two hours, and ended up with me taking a fair bit of gas and air as it got more and more painful. BUT – it worked! They suddenly found the access, and the doctor virtually high-fived the nurse!! An odd experience if I’m honest… They then tried to talk to me, but I was pretty out of it by that stage, but very pleased. I saw later on my notes that there is a little map with an x marking the spot!

XmarksthespotSo, after so many months with the Lister, we decided to give this new clinic a go. I liked the strong optimism and hope they managed to re-create, which had been beaten out of us for a while. Plus this was a fully funded cycle, meaning we decided to do one more fresh cycle. Starting on 1 January I did a short protocol, using a very high dose of Menopur, and Centrotide. I think it was 2 shots each day, and things went as normal. 2 weeks of stimulation, trigger shot and EC took place on the 15th of January. EC wasn’t under general anaesthetic which was a new experience. They sedated me, which makes you very hazy, but I do remember the process. Not too bad, although I was pretty nervous about it.

Then we entered the unchartered territory of letting the embryos grow. I had 9 eggs, 8 of which were mature. They were all ICSI’d, and one didn’t survive the process. Of the remaining 7, 2 didn’t fertilize properly, so we were down to 5 by day 2. It’s so stressful!

By day 3 there were still 5, but only 3 looked ‘right’. Normally with only three they would put a couple of them back there and then, but I am only allowed a single transfer (long story), so we took the scary decision to give them 2 more days to get to Blastocyst. You can’t transfer on day 4, not sure why.

On the 20th we didn’t get a call and I was convinced they had all died. When we arrived they told us we had 1 little embryo which had made it to Blastocyst. It was a surreal experience really. The embryologist talked us through where the embryo was at, and showed us some general images, but not our own embryo. I was convinced they were all quite poor, but they decided to put one back anyway just to give something a chance. Then next thing I’m signing a form agreeing to allow the remaining 4 to ‘perish’. Its sounds so silly, but it felt sad to say goodbye so soon!

5 Day blastocyst

5 Day blastocyst

The actual transfer was a non-event after all that prep! The map clearly worked, although I was encouraged to take some nitrox anyway just in case it was painful.

Then you are sent home to relax for a day, then go back to normal. Normal?!!?? Let me tell you that there is no ‘normal’ in the 2 week wait. The first week I was ok, lots of strange cramps, but that can be caused by your body just recovering a bit from the IVF process. The cervix has to relax back and close, and your womb is dealing with something going on… hopefully…

The second week I was a wreak. I was taking progesterone, which is the hormone that causes all the normal pre period symptoms (bloating, breast changes, headaches, moodiness) and also all the normal early pregnancy symptoms (bloating, breast changes, headaches, moodiness) so it’s very hard to know if any symptoms are pregnancy or period!! And I was analysing every twinge, every feeling, every minor change going on in my body. It drives you slowly insane!

The day before I’d decided to test I was also on a strange work course all about maximising your potential, where we were expected to talk about what personally motivated us, what crisis we have faced and how we recovered. I can tell you with certainty that is the LAST thing you should do when charged up on hormones, stress and fear! There may, ahem, have been a very embarrassing moment of near tears in front of my colleagues… followed by a proper cry on the tube. I realised I had to test to sort out my sanity if nothing else.

My official test day was meant to be 2 weeks after the transfer, but I knew that I should get a result one way or the other a few days earlier. Plus the OTD was a Monday, and I couldn’t face a negative test and then going to work. So, 1 Feb, I woke up at 6am and worried for a while. Then worried a bit more, and procrastinated. Finally I had to get up (largely driven by an impatient bladder), had another little cry, and then pee’d on a stick. And I watched nothing happen… I watched that stupid control line appear that I had seen many times before, and then… and then… amazingly, miraculously, wonderfully, a second line slowly began to appear. Pale, but definatly there.

FRER

Shock

With shaking hands (not a cliche in this case) I got out the posh digital test, and tested again.

Digi

OH MY GOD! This is an everyday, perfectly normal event that the vast majority of women will experience in their lives, but still a wonderful overwhelming magical moment. After almost 4 years of heartbreak, 3 IVF’s, a little bit of cancer – there was that elusive second line. I didn’t quite believe it, so a checked a few extra times. 😉

Tests

Baby brain already kicked in by the last tests. Date should be 6/3/14, and the last one who knows!

So here we are! I’m 10 weeks pregnant now, and just had another look at my little resident. I’ve had a few scans, a bit of a scare with some bleeding, but now he or she seems to be settled in (its definitely only one). There is still lots going on medically, and I will blog about the upcoming next steps, which are unconventional to say the least, but right now I’m just an everyday normal pregnant woman and we are both so happy to have this chance. It’s just so amazing and wonderful (and scary, and stressful and terrifying) but mainly wonderful!

Update: Actually I’m now 12 weeks, I couldn’t bring myself to post this until this latest round of tests were completed. I still can’t really believe it. But the baby passed all tests today with flying colours, and operation ‘lock that baby in to cook for 6 more months’ starts tomorrow. Literally an operation… which I will post about soon.

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