I started my Prague cycle in April and this cycle was co-ordinated between my new local satellite clinic and a clinic in Prague. I had registered with the satellite clinic but as it turned out I communicated mostly by email with a co-ordinator in Prague. I also had a phone consultation with the head doctor there which was very helpful. I was put on a flare protocol with no prior down regulation. Instead I took a Suprefact (buserelin) injection at the same time as the stimulation medications. I was on 300 Menopur reducing to 225 after 3 days. I was also on the delightful bruise-inducing Clexane. So 1 morning jab and 2 night-time ones. This allowed 7 follicles to wake up. My lining was 7.3mm at the final scan in my local clinic. I was put on Cyclogest as the progesterone supplement. This was a vaginal suppository but solid unlike the gel of Crinone. Still quite leaky all the same with panty liners again my new best friend. Each time I had a scan the results were emailed to Prague and they emailed back an updated treatment plan. Although I had paid the local clinic for the basic cost of the cycle, I opted for IMSI, PICSI and embryo glue in Prague which meant I had to bank transfer an additional amount to them directly. This had to be done quite late soon before departure to Prague. I also opted to have immunology treatment (steroids and intralipids). These were not provided by my local clinic or particularly favoured by the clinic in Prague. However, my local clinic wrote the prescriptions for me to get the intralipids privately (as it happened in a venue 5 minutes from the clinic) and they also prescribed the steroids. Both clinics accepted my use of these. I had one intralipid infusion about a week before transfer and another one around a week after. I was on 25mg prednisolone steroid from before transfer. The hardest part of this cycle was not knowing when exactly I would need to travel to Prague and not being able to book flights or accommodation until quite late. Once my follicles were deemed ready I was instructed to take the trigger shot Ovitrelle which was in a pre-filled pen. Thankfully this was at 9pm rather than the post-midnight experience with fiddly bottles I had on an earlier cycle.
It was on a Tuesday afternoon that I was instructed to be in Prague for retrieval at 9am on Friday morning. I was mid intralipid when I got the call and managed to book my hotel on the iPhone with my non-dominant hand! I detoured by the office on my way home from that and booked the flight there. I felt a little relieved once that was done. I left the logistics of getting to the airport and parking to my husband. I arranged taxi pickups through the clinic as they used a firm with a cheaper rate than the general taxi firms. There were no problems bringing my medications including Clexane through the airport security, it was useful having the explanatory letter from my clinic even though it was barely glanced at. Travel was uneventful thankfully and we were met by our taxi driver on arrival. He helped us get change at the reception desk as our Czech currency had been given to us in rather large notes. The hotel was simple enough but comfortable and we had a nice view of the city from the 8th floor and more English language TV channels than I was expecting. The room had a mini bar fridge too so I stored all my little extras I had brought to assist my attempts to stay gluten and dairy free as much as possible- dairy free milk, some gf protein bars and some dark chocolate. We found a local restaurant nearby which had plenty of menu options and I chose a chicken and vegetable dish which was very tasty. Once midnight came I could not eat or drink any more in preparation for retrieval.
The following morning we were up early and I made my husband go and eat a good breakfast as I knew we would be away for some hours. I sat with him but could have nothing but I took some fruit to have later and packed a protein bar in my bag. The taxi was early so off we went. We had spotted the clinic en route from the airport the previous night so recognised it immediately after the 25 minute drive. The taxi driver brought us right in and we filled out some forms in English and took a seat. We met with a doctor and were brought by a very friendly nurse to a private cubicle where I was given a lovely paper gown with pockets to dress in. I was brought into theatre and my husband led away to do his part. In theatre, there was a little bit of difficulty getting a vein for the canula but they got there in the end. Everyone spoke to me in English except for one person who spoke to me in Czech anyway in a very friendly tone. Once the sedation was given I remembered no more. I woke up back in the cubicle in a bed, covered by a blanket and with my underwear back on (it had been in the pocket of the gown on their instructions). A nurse came in every so often to check my blood pressure monitor and my husband was brought in. After an hour or two I was allowed get up and dressed and we were brought back to the waiting room to await the doctor. After a time we were brought into his office and he explained that they had retrieved 7 eggs and 5 of those were suitable for injection. He told us we would get the fertilisation report call in the morning. He said also not to eat a heavy meal for a few hours including the infamous Czech dumplings!! The retrieval went smoothly from their perspective. We got a taxi back to the hotel and I spent the afternoon resting in bed and eating various snacks. Later on that evening and for convenience we went back to the same restaurant as the previous night and I tried a different dish.
The following morning I got the fertilisation report while we were at breakfast. It was good news as of the 5 eggs collected, all 5 had fertilised. There would be no more communication now until transfer day in 4 days time. At this point there was nothing to do but go out and about and enjoy Prague. That is exactly what we did, making the most of a beautiful city, nice weather and decent food. We fitted in a three hour WW2 history tour as well. I recovered quickly from the retrieval. I guess a 7 egg haul was not too taxing on the body, unlike the 17 I got in my very first cycle in 2012. However, I did have to take little rests from all the walking every so often. We found a large shopping centre too and over the course of the 7 nights we spent in Prague I managed to get myself both a scarf and a handbag as mementos. There have to be some little treats!! I listened to my Circle and Bloom cds nightly. I actually found these few days quite relaxing and didn’t fret too much about the progress of my embryos.
On the night before transfer as we relaxed in our room, the tv options seemed to be a choice of rather bad disaster movies! Transfer day was a Wednesday and we again got a taxi to the clinic, this time for midday. As I have had some difficult transfers in the past, I was allowed take a Czech version of Valium half an hour beforehand to relax me. A female doctor met us and explained that we had 2 early blastocysts for transfer but there were none suitable to freeze. Although I was grateful to have anything for transfer I was sad that there were none to freeze. It reminded me all too much of my previous cycle which ended in tears and which distressed me greatly afterwards. I was brought into a room outside the transfer room and given a paper gown again. My husband was allowed in this time. I got into place and in the moments that my husband and I were left alone, I couldn’t help but shed a tear as I found it hard to believe what could be different this time. We were shown the 2 embryos magnified onto a screen and the transfer itself went smoothly. I had to lay still for 30 minutes and then I was able to leave and use the bathroom. We got a taxi back to the hotel and I spent the afternoon relaxing in bed. Later that evening we went to the hotel’s own restaurant for dinner so that I would not have to walk very far.
The following morning was our last day in Prague, we had a relaxing breakfast, checked out, left the luggage and spent the morning looking around the modern art gallery beside our hotel. It was quite a relaxing thing to do. I had to take an injection (decapetryl?) that the clinic had given me at 1pm so managed to find a Ladies in the gallery to do this. We went for lunch in the same local restaurant and got out taxi to the airport. I let poor hubby lift all the cases.
I had taken a few days off work so took it pretty easy after I got home. As usual I was fine for the first few days and then the doubt started to set in. I attended for my second intralipid appointment just over a week after transfer. The following weekend I was visiting my father some hours away by car. On the Sunday I started spotting. This was 3 days before my official test date. I had brought some tests with me and took one which was negative. The hardest part was that as my father did not know I had even done the cycle I could not let on. I was devastated as was my husband, and he had to return home that night whereas I had to stay on for a work meeting the next day in the area. I visited my sister in law who did know, and she was very kind without saying too much. I was terrified I would crash in the same way as I did after my last cycle. I put it aside for that evening and had a rare quiet evening with Dad on my own. The next day I went to my work meeting and stayed calm although I did get fined by speed camera on my way home- I didn’t know this until about a week later mind you. In my approximately 18 years of driving I have never got a speed ticket. Lesson learned.
I continued with the meds and increased Cyclogest on the clinic instructions but the spotting turned in to bleeding. By the time test day came it was still a negative and I reported it to both clinics. My local clinic also did a beta HCG which was also negative. I stopped all the medications and weaned off the steroid. At the start of the cycle I had decided that this was my last attempt with my own eggs. Part of me had hoped that somewhere an embie would pull though. But after 32 eggs, 9 blastocysts transferred over 5 transfers, I think there is no point trying again with my own, especially as I am now 42. Most clinics would run a mile!
So deflated doesn’t even begin to describe it. I took a week or two off my diet regime to eat and drink all round me and set up a phone consultation with Prague and an in-person consultation with my local clinic for early June to decide on next options. I know now that donor egg will definitely be involved. I just feel so bruised by this process that I am not confident that even donor eggs will work for me. Perhaps 5 cycles in under 2 years have taken their toll. I need to find my hope again and my will to go on. I will find it somehow with a little time. I’m THAT stubborn!