I am writing this a week after finding out the outcome of this cycle which was negative. This has been the first day I could even contemplate looking at my blog as I took this particular failure very badly. However, to get things up to date I will summarise the cycle and my feelings on it as best I can. I nicknamed it the kitchen sink cycle as we really threw everything at it both in terms of our own preparation, alternative therapies etc which were the subject of earlier blog posts, and the clinic’s programme which included medications for immunes issues, thyroid and potential PCOS tendencies. We thought we had all bases covered in as far as was possible.
This part of the cycle was largely uneventful. I felt rather tired and moody on Buserelin nasal spray but hot flushes were minor. Unlike my previous clinic, I had been put on birth control for this cycle and had to stop it for a withdrawal bleed. I found this part the worst as I had incredibly bad PMS and really felt in irritable form. I took the Buserlin spray three times daily. In addition I also took my thyroid medication (Eltroxin) and the Metformin drug.
My baseline scan after 12 days indicated that I was ready to proceed to the next stage. For stimulation I had a combination of 3 nightly injections. Puregon (Follitropin beta) the FSH agent at 150 dose, Luveris at 75 dose- this is a touch of luteinising hormone which is meant to help egg quality I was told. I also had a nightly shot of Clexane which is a blood thinner. I don’t have blood issues but it was given as a precautionary measure. I had used Puregon before so I was comfortable enough with that. The Clexane was in a pre-filled syringe and was straightforward also except that it made me bruise, the advice was not to rub the area after injecting as this would make any bruises worse. The Luveris required mixing of a vial of powder with a vial of solution which made me a little nervous as there were mixing needles and injecting needles supplied. However, the clinic nurse had gone through everything in detail and I looked up videos on You Tube as well. I got used to it as the days went by. I felt reasonably ok on stims just a little bruised and bloated and a bit tired from the heavy regime of medications and trying to fit them all around my life. I went for a scan after about 6 days and it showed 3 follicles on the left and 5 on the right. This was a little disappointing as I had been told at my last clinic that my antral follicle count was now 12 (6+6) and as my AMH was quite high last year, it was hoped I would respond well again now. The Puregon dose was increased to 225, with the rest remaining the same.
During the stims stage I also attended the clinic for an intralipid infusion. This is a treatment given to quieten the immune system and especially Natural Killer cells. Mine were only found to be very slightly elevated in tests but the clinic decided to treat me anyway. The infusion involved me sitting in a comfy leather recliner chair, having a drip inserted into my arm and a white liquid fed in. It took about an hour and 2 other girls were also being treated at the same time. We had magazines to read and a TV to watch and various nurses came in and out to check on us. It wasn’t uncomfortable at all though I was a little tired afterwards. I just went to work for the afternoon as normal.
At my second stims scan the follicles had grown but the overall number had not increased. I felt that I was not responding as well as I should have. The Puregon dose was kept at 225. At my final scan the overall number remained at 8 and I nicknamed them the 8-Team. It was decided to delay my retrieval by a day to give extra growing time. My retrieval was scheduled for the following Tuesday. I had to take my trigger shot at quarter past midnight on Sunday. The trigger shot I was to use, Pregnyl, made me nervous as it was in little glass phials and required the mixing of 2 powders with one saline solution. I looked up You Tube videos again and remembered the clinic nurse stressing the importance of breaking off the caps at the black dot marked on them as they would snap off cleanly (they did). I assembled everything in plenty of time, put the phials in my lipstick holder tray to stop them falling over and managed it all.
I had to start antibiotics for the period from EC to ET and my husband had to take them for the duration of my stims. I also had to start steroid tablets, 25mg Prednisolone.
I arrived as requested an hour before the time, fasting from the previous midnight. I was brought to a cubicle and given a paper gown to wear and was instructed to take two Solpadol tablets (painkillers with codeine). These made me feel a little lightheaded on an empty stomach. I handed over the Flagyl pessary to the nurse- that would be inserted while I was under sedation. One of the doctors came in to see me to go through everything and to sign consents. A nurse also called in to go through the printed sheet of aftercare instructions. I was brought down to the theatre and my husband presumably was dispatched off to fulfil his part of proceedings. In theatre there was some further confirmation of identity and a canula was inserted into my arm. After this I remembered nothing further though I did wake while still in theatre and could see the doctor still working, but I felt nothing and drifted out again. I found out later that a mock transfer had been done on this occasion as I had mentioned past difficulties with transfer. It seems they opted to do it on retrieval day rather than transfer day. I think I might have woken when they were doing this.
When I woke again I was back in the cubicle feeling slightly sore but not too bad. I was told they had retrieved 8 eggs. After a while I drank some hot chocolate and ate a couple of plain biscuits. After a rest period I was allowed home with instructions regarding starting progesterone. Once home I went to bed to rest and took some more Solpadol.
I did feel a bit uncomfortable for a few days after, some bloating and a feeling of pressure on my stomach and under my chest. It did ease off though after about 3 days.
I had been told that it could be 4pm next day before I got a call about fertilisation but thankfully the call came though around 11. Of the 8 eggs, 7 were suitable for injection and 6 fertilised using IMSI, a highly magnified form of ICSI. My husband’s sperm count was 6 million (his best yet) with 1 million usable post-wash. My consultant wanted to go for a 5 day transfer using EEVA so the embryologist explained this and the risks involved. I would not get a call again until day 4, Saturday. This was the longest wait as every day I feared the embryos would be lost. This fear was especially bad on day 3. It seems day 4 is a critical stage as the embryo works off egg energy up to then but then switches to its own combined energy and often the embryo can fail at this point. Day 4 arrived and I got the call to say that 3 embryos had reached compact morula stage and the others were at 4, 5, and 9 cell. The smallest two were not expected to progress. Egg transfer was scheduled for the next day, Sunday. I was the 4th transfer of 4 that morning for midday but had to arrive 2 hours before as there are no reception staff on duty on Sundays, so everyone has to be admitted together.
I had a pre transfer acupuncture session that morning and then we went to the clinic. I was admitted to a cubicle and given a paper gown to put on though I was allowed leave my upper clothing on. I also wore knee high socks. I had a very full bladder and a long wait. In hindsight I am sorry I did not empty and refill it but it was hard to judge the timing. As it was by the time I got to transfer I was quite uncomfortable and found the transfer a bit uncomfortable. My consultant did the transfer at my request and there seemed to be no issue as such with it. I could not see it happening on screen because of where the nurse had to stand but she showed me the images afterwards. My husband could see it though. Two of the embryos had reached blastocyst and both of these were transferred. I nicknamed them the Roses as we had two in bloom in our garden. Two others were at compact morula stage and were being grown another day to see if suitable for freezing. The smallest two had not grown any further. After the transfer I was wheeled back to the cubicle and allowed rest. I held out for 15-20 minutes and then emptied the bladder. Soon after we got ready to leave and I went for a post-transfer acupuncture session. Following that I went home and went to bed for a couple of hours. Drank some pineapple juice and had a light fish dinner.
I took the first week of the 2ww off work and rested at home though not in bed. I watched lots of films and box sets including Harry Potter, Mad Men and various others. I listened to a Circle and Bloom recording daily (as I had done throughout the cycle) to help me meditate and relax. I was feeling relatively ok for the first couple of days though not hugely optimistic as I just felt it had not been a great cycle. By day 4 the worries and doubts set in. I felt nothing, no bloating, no cramps of any significance, no spotting. I felt the pressure of having 2 embryos on board with none having made it to freeze, unlike last year. I felt the pressure of my age. I went for an acupuncture session and also a hypnotherapy session and I attended for a second intralipid infusion. By week 2 I went back to work, convinced it was not working out. As the week went on I slept less and less at night. Our 2nd anniversary came and went on the 17th and we decided to go for dinner at the weekend. Test day was Friday 20th September and I was awake that morning at 5. I took a cheap internet test and a First Response, both negative. Although I was expecting it to some degree, it really felt like the biggest kick. My husband and I had taken the day off work as he wanted to attend with me for my beta at the clinic, I had not had these at my previous clinic. I didn’t have the heart to wake him, I left the tests on the toilet and he came to find me downstairs an hour or so later. We cried. We went to the clinic and a nurse took the blood test. I told her about my negative test. A very nice nurse rang back with the result later that afternoon and unsurprisingly it was negative. She advised me to stop all medications except Metformin and Eltroxin and reduce the steroid gradually. A counsellor also rang me. I left a message to make a review appointment which is scheduled for 30th September. We spent the day a bit shell shocked but managed to dress up and go out for our belated anniversary dinner. We had the nicest steak and a good bottle of wine and a musician in the restaurant sang songs that appealed. If nothing else we figured we should celebrate our 2 years of marriage and surviving all the heartache and loss we had been through. That night we sat up with more wine until 3am, each picking 5 songs from our ipods in turn, songs that had some meaning for us. We usually turn to music for all the good and bad things in our lives.
Crash and Burn
After the negative result, as the days went on I started to feel worse and worse, I could not sleep more than 3 hours a night, I was constantly on a hyper nervous edge, unable to relax, snappy and prone to crying fits at any moment. My heart felt like it was racing and I felt panicked. The weight on my chest was unbearable, it felt like physical pain. I could get no rest or relief, asleep or awake. I had to attend a family event that weekend and as the night wore on I found myself unable to interact properly and kept having to go outside for air. I saw a photo of myself at this event and I looked how I felt, sad, tired and stricken. After all the hopes (and money) invested into this new clinic and treatment, for it not to work was devastating. I won’t be pregnant by my EDD for my lost baby as I had secretly hoped. Another season has turned, another wedding anniversary (our 2nd) has passed in the shadow of another BFN like last year. Christmas looms. It was an exact repeat of last year. Even my county team lost their final match just as they did last year, except this year it was to my husband’s county team. I railed bitterly against life, fate, God, nature, for dealing us this miserable hand. Why us? Why are we always left behind? What have we done wrong? I wondered what awful thing I had done in a past life to deserve this. Had I not suffered enough having had other major bereavements in my life? I felt sorry for my husband, he had tried so hard, diet, acupuncture, everything. He deserved better.
By Monday I went into work but was unable to contemplate it. I managed to get an early doctor’s appointment with my GP. I explained the situation and she signed me off work for the rest of the week, gave me a short course of low dose sleeping tablets and Xanax to help re-establish my sleep pattern. I went straight home and took 3 Xanax throughout the day and napped. I took a sleeping tablet and got 7 hours that night. I took one Xanax and one sleeping tablet over the next 2 days. As of yesterday I stopped the Xanax but am still taking the sleeping tablet for another few days. I rested as much as I could, watched gentle TV, read, went for walks, cried.
I attended a counselling session on Thursday at my clinic which was helpful as the counsellor made me feel normal for how I was feeling based on all that has happened. She said that it was ok to feel as sad/angry/bitter/hopeless as I did in view of what my experiences had been but that I was carrying around a lot of unwarranted guilt and self-blame that I needed to let go of. She said I needed to be compassionate to myself and give myself a big hug and also to find a part of me that existed before IVF. Losing my faith was understandable and not to pressure myself about it, it may return later. Failed cycles are like bereavements but less tangible in a sense as there isn’t an actual death (unless you consider it embryo death) that can be processed in the mind, it is more the loss of the assumption that I can have a child. Also the process doesn’t have an end unless I call an end to it, or my biology does. She said that this will resolve itself in time and I won’t always feel this way. The nature of the resolution will depend of course, I may end up with or without a child, but a reconciliation to whatever the resolution will be will come eventually. I have survived major bereavement and a miscarriage before and I have the resources to survive this. She suggested to let the feelings flow but perhaps set a time limit on them daily and then find something, anything that can lift me a little. Also she said to acknowledge negative thoughts if they happen but just let them happen, don’t add another 20 negative thoughts to plump out the original one. I have another session next week but it is a joint one with my husband and with a different counsellor. I was distressed that I could not come up with a plan of what to do next and she said not to fret about that now, the plan will come when I am ready.
So now I have to find the road to recovery. This has been a really difficult week, there have been many tears, many moments of wondering is it all over for me and will I never be a mother and should I stop. I am trying to find a little of the old me again, I started back my yoga and zumba classes this week and it felt good. I have more classes next week. Starting to sleep better is helping. Today I decided I would bake, and I made blondies (white chocolate brownies with pecan nuts) and vanilla cupcakes. I put on uplifting 80s music while I baked and let the delicious smells soothe me. A friend phoned and a group of us plan to attend a college reunion in a couple of weeks’ time. I think I am even looking forward to it although may need a ‘fit in a dress’ crash diet between now and then. I am staying with another friend on Tuesday, we will drink wine and complain about our useless reproductive organs and life in general and then eat chocolate. I am not sure of my next plan. I will attend the review on Monday, I may research donor egg, I may send in my adoption application papers. Right now, I just don’t know. The bruises on my stomach from the injections are nearly healed now. I just need the bruises in my mind to heal the same way.
Wish me luck my friends. I really need it.