Yet more things I never thought I’d have to think about

ORGALUTRON sounds like a space age kitchen appliance to me but apparently it’s what I’ll be injecting in my next cycle should I choose to accept it. It’s a short cycle drug. My doctor is suggesting we try a short cycle because, well, basically the other one didn’t work. Apparently some people who don’t get good eggs on long cycles get good eggs on shorter cycles. Between you and me I think my eggs are fried and no drug is going to change that.  Again I’m faced with the fundamental problem I have always had with IVF which is that if my eggs are not in great shape, and it seems clear that they’re not, then more drugs is just going to push out more dodgy eggs. Therefore, IVF is never going to work. If the ORGALUTRON was a time travel machine in which I could go back and retrieve some eggs from my twenties when my life purpose was to avoid getting pregnant, then that would be worth it. I mean I only have my cynicism and a dwindling bank account to guide me here, but I’m really wondering if there is any point in another cycle.

Minutes after I posted my last entry my doctor rang to talk about the failure. She was all about “next time” as I mentioned previously. She talks a lot and I’ve learned I just have to butt in if I want my questions answered. I did so, and it was clear that there’s nothing in IVF land that addresses the idea of trying to actually improve egg quality before you go in with more stimulation drugs. But she did mention DHEA. She’s a total scientist and made it very clear that she couldn’t advise me about the efficacy of the reports “coming out of the United States” about IVF successes in women with depleted egg reserves who were given high doses of DHEA prior to their cycles… But she did suggest I google it. Which I did. It’s interesting and I’ll post more on it as I find out more. I’m still swinging back and forth between “okay forget about it” and “give it another try”. In the meantime I might take on a research project about vitamin supplements.

By the way I’m still really pissed off. My cousin is about to give birth. Every woman in my family has bred like a rabbit. Why did I have to get the fucking failing ovaries?

Me and my Vagus

I thought while I was here I would address a comment from lostintranslation about the anesthetic. I found the collection pretty painful, which I kind of expected (although it was worse than I thought) but opted for a local because generals are so full on and I think to be avoided if possible.

I didn’t mention this before because it seemed kind of trivial in the scheme of things, but of course now I feel like dissecting my experience a bit – I think it helps with the grief.

While the most invasive part of the process was going on – the jiggling – where it felt like the doctor was punching repeatedly at my cervix with a sharp object – oh yeah she actually WAS doing that – I started to pass out. Not from the pain, it wasn’t that bad. I just started to get all light headed, even though I was lying down and as I’m familiar with fainting (low blood pressure) I knew I was on my way out. Big H knows that I know when it’s happening for real, so he was pretty concerned. They had to slow down and make sure I was still with it a couple of times. Then I had this weird crying reaction that felt un-emotional but unstoppable. Then I was ok. Apparently I had a Vagal Response. We have a “vagus nerve” in our cervix’s and sometimes when it’s stimulated it causes dizziness, nausea etc.

The upshot of that is that “next time” I should have a general for the egg collection.

I just thought I’d share that because I had never heard of it before. I think I’d still rather chance it with a local and some mental preparation. If I was to do this again. Which I don’t know if I will…

Lost

It’s been two weeks since my last entry. I was ignoring my blog. I was even considering erasing it and never thinking about it again.

After the disappointment of only getting two embryo’s my confidence took a bit of a knock. But they both seemed to be growing so who cares, like I’ve said before, we only need one.

So the day 5 transfer was arranged and compared to the collection it was a breeze. When the doctor arrived she had our report and before she said anything I saw that our embryos had been downgraded from “good” to “poor”. One of them had stopped moving and the other was a day behind where they would want it to be. I don’t think think I was a very easy patient to deal with for the embryologist because I got so sad at that point I could barely hold a conversation. I think I probably said what I was feeling, which was, “what’s the point?”.

When we got into the surgery my doctor said that it looked like the better embryo had started to move a little bit, which sounded hopeful. And so in it went. I made a mental note of the fact that my doctor, who is pleasant enough but tends to spew forth statistics rather than empathy, was already talking about “next time” and what they will learn from this cycle. Almost like this one was an experiment.

After that I didn’t know what to say. I was lurking on other blogs but wasn’t really able to connect with what was happening for me. Except that after a week a sense of excitement had started to develop, along with a realisation that I really wanted this to work. That probably seems strange but if you’ve read some of my earlier posts, I’ve had trouble working out whether having children is the choice I really want to make. Well, maybe biology took over because my body seemed to think it was a good idea. I loved having sore breasts (and bigger than usual too, which if you’re an A cup, I’m sure you’ll sympathise with!)  and I found myself fantasing about family outings and all the wonderful things Big H and I would do with this beautiful child born of our love and devotion to eachother.

Blood test day was the 24th. On the 23rd I woke up and knew it was all over. I was bleeding and sobbing on the toilet within half an hour. The clinic said I still really had to come in for the blood test to confirm it. I noticed that the nursing staff made no mention of where I was at in my cycle. I don’t think they would have known that it was already clearly a negative, I think it must be policy not to mention it in case people are in exactly my position. It felt weird and cold, but I guess it’s a sensible way to approach it. Definitely my least favourite clinic visit.

I’m exhausted from bleeding and crying. I don’t know what we will do. I want to thank you for posting comments – it’s why I am writing now. I opened my inbox and you were there. After a good sob I decided to put this down.

I’m sorry I have no words of hope right now. And I know I’m not the only one going through this, it’s only my second cycle. I don’t know if there will be any more. I’m back to not knowing how I feel.

Life in a petri dish

It’s day 3. We have two embryo’s in a petri dish. Actually I don’t know if they keep them in petri dishes at this stage. I suspect they probably do. Anyway, there are two of them. This morning they were 8 cells each, which is apparently on track.

My desire to blog had siezed up until Coach Louise sent me a message. I don’t know what to say – because I don’t know what to feel. I am excited. When I got the call this morning I melted on the inside and didn’t know what to do with myself because I was at work and there was no-one to tell. So I rang Big H and we shared a moment, but he was driving so that didn’t last long.

Every time I get a rush of happiness I also feel the warning shiver; don’t get too excited. On the one hand I feel like we’re home and hosed. What could possibly go wrong? We’ve had successful fertilisation and that was the biggest worry – I genuinely thought we might not get that far. But it worked, so that’s it. Give me my baby. On the other hand – plenty could go wrong. And if it does, I have a sense that I’ll go into shock and lose it completely. So I’m hovering in “I don’t know how to react” land.

We did the Pregnyl injection this morning and it really hurt. I haven’t had a problem with the other injections but this one made me yell – very carefully of course and only once Big H had safely secured the pointy bit – but I had to express my pain. I have tomorrow “off” and all being well I’m booked in for transfer at 10:15am on Saturday.

16 cells and counting…

Egg collection

I figure if this blog is to be of any interest or use to anyone I might as well describe exactly what the IVF experience has been like for me. That is not to say that my experience is definitive, but in hindsight I would have liked to talk to someone about what to expect. I’ve gone into this thing with only the basic, official information.

So I’m back sitting at my computer with a pretty bloated belly and a slightly dizzy feeling. It’s 1:30pm. I got to the clinic at 9:00am. I had my details double checked, signed some forms, put on a gown, took off my undies, and had visits from a couple of nurses and the scientist who explained the procedure.  My doctor arrived at about 9:25 and I was in stirrups at 9:30. She doesn’t mess around.

My partner was there the whole time which was really good for me – I wouldn’t have wanted to do this by myself, but I know some people do, for various reasons. He was the only boy in the room. It was me, the doctor, a nurse and a scientist.

I had the sedative in my hand and it made me feel numb and dizzy. To my left was the ultrasound monitor and Big H was sitting to my right. All up I was in there for about half an hour. At first there was a lot of putting-in-of-things, which was uncomfortable – like a pap smear, but not terrible. Once the collection was happening, the doctor did a lot of wiggling and jiggling with the needle as she was sucking out the fluid, which was a bit odd. At times this was pretty painful – I’ll be honest. If you have any experience with meditation or deep breathing techniques, I strongly suggest you prepare to utilise them. I found once I let go and focused on my breathing, it got easier.  It also hurt when the needle went through the cervix, but not for long.

Once we got going, the nurse was putting all the fluid into test-tubes and the scientist was collecting them as we went. Directly opposite me on the wall was a large monitor which showed exactly what the scientist was seeing. Lots of bits and pieces, bloody, membraney looking stuff… and in the end, four eggs.

Not a lot, four… but better than nothing. The scientist was shouting out the count as we went so I knew what we were heading for. They wheeled me into recovery before she had quite finished but she came in soon after to let us know that was it. I was fine until I read on her face that she was disappointed. Then I felt flat.

Big H did his thing and after a cup of tea and some raisin toast, some antibiotics and some codeine pain killers – thank you, lovely, attentive nurses – I slowly and carefully got out of my reclining chair and went to the change room.

By the time we got to the car park I was feeling kind of tired, a bit crampy but ok. I did however cancel an appointment for this afternoon, as I’m not sure I can concentrate the way I would need to.

Maybe the drugs haven’t worn off yet, but I’m feeling ok. As about 5 people said at various times during the morning; “you only need one!”.

So now we wait for the fertilisation report tomorrow morning. I don’t know how I’ll get through the week. They were talking about a day 5 transfer. Saturday seems a long way off.

17 hours to egg collection

I’m worried there won’t be any eggs.

I’m worried there won’t be any sperm.

I’m worried we won’t make it blastocyst stage.

I’m worried if I do get get pregnant that something will go wrong.

I’m worried I won’t be a good mother.

I’m worried the environment can’t sustain any more humans.

I’m worried about whether I should shave my fanny before the procedure.

Trigger Happy

I have to enjoy the good news when I get it. God knows I will not have any trouble getting depressed should there be reason to do so. It would seem there is reason to be cautiously optimistic at this stage. I have probably five potential eggs; based on follicle size and estrogen levels. So we are triggering tonight at 9:30pm. Egg pick up on Monday. I know many people get many more eggs than that, but I was starting to wonder if I was going to get any at all (last time in the cycle that got cancelled there was only one follicle).

So as Coach Louise suggested in her last comment, some pampering is in order. This will mostly consist of not waking up at 6:00am to either inject myself or drive to the clinic tomorrow. Apart from that I’ll probably just try to get some studying done. And to not think constantly about whether-this-is-going-to-work… Now that something’s happening it all seems very fast. Years of waiting and trying and hoping and suddenly-we’re on! Of course it may all be over just as quickly but right now I’m going to focus on keeping my eggs warm.

12 Follicles

I have 12 follicles. One of them is too big. A few of them are too small. A few might be just right.

I had bloods and an ultrasound this morning. I spoke to the clinic a couple of hours ago and they want me back in there tomorrow for the same. They say it’s looking like an egg pick-up Monday or Tuesday. I’m afraid something will happen and it won’t work again. I’m afraid it will work too.

I’m bloated and kind of achey, as if my period were coming. And I’m fairly emotional. I had to keep it together while I was talking to the nurse. Monday is only a few days away. This thing is happening. Maybe.

Speaking of nurses; I’ve noticed on some blogs people have names for the nice ones and the irritating ones. I’m having trouble thinking of a name for the one I encountered this morning. But when I do, it won’t be very flattering. She’s as big as a house but somehow manages to look like a muppet. And she really enjoys the power of the probe.

On Wednesday she shoved it in so fast it took my breath away, and funnily enough I had a little trouble relaxing after that. Then she proceeded to give me a lecture about how I was too tense and that I should insert the probes myself for the ultrasounds. This did not appeal to me at all. Mostly because I find the whole experience deeply awful and I’d rather be in denial than interact with that god-awful phallus with a greasy glove on, and also because if I’m sitting up trying to insert it myself, I’m tensing my stomach muscles which makes it even harder than it already is. Anyway today, fate being what it is, I get her again. “I remember you!” she booms. “Likewise” I say. So I’m sitting on the chair naked between my cardigan and my long woolly socks and I say “If you could just take it slow, I’ll be fine”. Personally I don’t believe people with her job should have to be asked to respect the pace of the patient. But apparently this was unacceptable to her; “Oh no, I’ve been doing this for twenty years and I know about patients like you. You’re doing it yourself”! Big H was in the room. He wasn’t much help at this point. In hindsight I think he may have found it fairly entertaining. Although he did wince and tried to look the other way while the enormous nurse stood there -hands on hips – and I pointed the cold stick in the general direction of my vagina. Eventually it went in enough for me to take my hands off and then I lay back, hands free; “I need to lie back now, you can do the rest”. She didn’t have much choice. I noticed that it didn’t seem to be nearly as far in today as it was on Wednesday. Afterwards she congratulated me for being better behaved. I could have pinched her on the arm.

The meaning of it all

I was interested to see that yesterday someone found this blog by searching on “ivf existential crisis”. I have used this phrase before but haven’t posted lately on the subject. And yet amid all the blood tests and the multi-vitamins this is very much what this experience comes down to for me. I am in a constant state of confusion about how I feel. And while I appreciate that no two people ever feel exactly the same, I suspect I am not the only one who struggles with the weight of not just the grief, anger, resentment and frustration that can come with the IVF territory, but also with the strangeness of what it means to be put in this position in the first place . When I think about this, combined with the fuzzy headed-ness brought on by the drugs, I want to congratulate us all for ever managing to leave the house.

If you read some of the professional literature around treating IVF patients, you will find our condition referred to as “a hidden disability”. I had realised for myself that my identity was uncertain in the face of infertility; it is still shocking to me that I can’t conceive. It still doesn’t seem to fit the image I have of myself. As many times it has been proven to me over the last few years, I still don’t feel like it’s real. Sometimes I still find myself baffled that I’m doing IVF. Me.

So I think the term “hidden” is important here. My infertility is hidden – through my choice – from most people in my life. I protect it from the curiosity and assumptions of people I don’t trust to understand. I also think society keeps the reality of infertility hidden from itself because, like me, it doesn’t know how to integrate it into the realms of normal experience. What could be less normal than the inability to reproduce? Our very existence depends on the fact that we can do so. On a very deep level, I think most people don’t know what to make of the reality of infertility.

So no wonder some of us feel existential angst. Our experience doesn’t make any sense. One of the most important parts of grieving is thought to be that ultimately some sort of meaning is made from what you go through. In some way, the traumatic event will come to make some kind of sense in your life. You will relinquish suffering and find acceptance. I haven’t found that place.

As I’ve mentioned before; I don’t feel like I can’t survive if I don’t have kids. On the contrary; part of my struggle has been to choose to even try. I’m caught between wondering if it’s really not meant to be – there’s something else I’m meant to be doing – and feeling like I have been deemed by some greater power to be unworthy, faulty. That my infertility is natural selection, because there is something fundamentally wrong with me that doesn’t belong in the gene pool.

Existential angst is borne of the struggle to find meaning in a meaningless world. I don’t feel I need children to discover the meaning of my life, but I do need to find the meaning of being required to think so carefully about the idea of having them at all.

First bloods; So far so good

Had the first blood tests of this second cycle today. I had a conversation with the doctor too, in which she said that basically what the approach this time is, is to up the dose of Puregon. That’s it. I don’t know what I expected. I guess that’s what it all comes down to. Growing eggs. She did explain that there are three options in the follicle stimulating approach; the standard one – that I’m having, the aggressive one where you start the stimulation earlier and the flare; where you start the Lucrin and the Puregon on the same day. I don’t remember the details; I can barely keep what’s going on with me in my head. I try to make sure Big H is present for the important conversations because I get out to the car and say “So, what are we doing?”

My Estrogen is at 1000 apparently. Which is better than it was this time, last cycle. It might mean that this time I have a good number of follicles, or it might mean that there is only one or two that have taken off quickly, but won’t come to much. I know I’m being a bit pessimistic. Her words were “I’m sure we’ll get to egg harvesting this time”. So there you go. I say, one day at time.