Tumbling Through the Rabbit Hole...
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Do I really want to know?

Posted by Haisla Thursday, 28 May 2015 2 comments

Finally after a long day of phone tag (which ended up involving M. too who was having a day off whilst I was at work) on Tuesday I managed to speak to a Dr at our clinic.

She told me that I could have another blood draw done, but also that she would be quite happy to wait until my scan on 5th June.

I was tempted, since I have now landed a place of (relative) calm and am dreading another meltdown. However, since we are flying to Finland the day after our first scan (I know, great timing) for a brief summer holiday, we kind of want to know what's going on sooner rather than later in case it does turn out to be an ectopic or that I am miscarrying.

I really don't want to blow my fallopian tube / miscarry on our holiday if I can help it. Thankfully I have just renewed my EHIC card, which means that should anything go wrong I can still get free medical insurance whilst we're in Finland.

Anyway, I got my blood drawn yesterday.

The nurse was lovely and sympathetic. She did ask me why I'd gotten my blood drawn in the first place, which made me feel like a bit of a fool (I guess they truly don't do beta blood tests here as a matter of course..) and I had to sheepishly confess to her that I'd hoped to get some reassurance from the numbers.

She reckoned that my numbers looked quite low for an ectopic in her experience and since I wasn't experiencing any bleeding or one-sided pain she considered that a positive sign.

She said this number should give us a far better picture of which way things are heading and if the numbers are going up the scan on 5th should show us whether whatever is growing in there is in the uterus or elsewhere.

This morning I've started experiencing some mild pains on my right side, but I really can't tell whether the sensations are real or purely psychological (I am such a hypochondriac). Plus with endo I get all sorts of pains all the time, so it's quite hard to distinguish those from others. Obviously if I start feeling like I'm being stabbed I'll make my way to the A&E presto.

But for now we're waiting. The nurse said it could take up to 48h to get the results, but I could try ringing them this afternoon. Yuk. Not sure if I really want to do that. I quite like this new sense of equilibrium.


Posted by Haisla Sunday, 24 May 2015 4 comments

So it turns out you can't buy peace of mind.

I received the second beta results on Friday evening but just couldn't bring myself to check them that night. M. was going to the pub with a friend, so I wanted him to have a nice night out and I certainly didn't want to be alone facing the news should they turn out to be bad. I'm so glad I didn't. Besides, I just wanted to spend one more night pregnant.

Yesterday, on the other hand, I spent crying.

We checked the results together first thing in the morning. It was a sobering moment. We both took our turns crying in the shower (there's something about running water that turns the waterworks on). It was really heartbreaking to see that M. was as devastated by the news as I.  He really wanted this to work out. He left for work (poor thing) and I proceeded with spending my day on the sofa with a box of tissues at hand.

Some of you may think that our reaction is a bit premature; my numbers aren't going down yet, I'm not spotting or bleeding, but the numbers speak volumes. Plus my peesticks are getting gradually lighter. I still have some residual pregnancy symptoms (sore boobs, tiredness, keen sense of smell), but then again, I also have some residual hCG lingering (or very slowly doubling) in my system.

According to an online hCG calculator our pregnancy looks something like this:

Doesn't look normal, does it? 

Doubling time of 132.39 hours (i.e. 5 and a bit days) and an increase of 28.6%. Not good.

Did I scour the Internet to find similar stories that ended up with healthy babies? Of course I did. And for a little while it gave me some hope. Hope against hope. But I did also have to face the facts and recognise that those stories were in the minority. They were the 1% unicorn stories.

Yesterday I was devastated and unsure how I'd ever get over this.

This morning I woke up with a greater sense of zen. I decided that the only way for me to get over the overwhelming sense of devastation was to stop dwelling on it and move on. Which wasn't to say that I didn't love our little failing embie-baby with all my heart. I just felt that unless I moved forward, I'd never get past the sadness. I thought to myself that I might revisit it again, if and when I started bleeding or my fallopian tube exploded, but for now I needed to look forward and let go. We had 7 blastocysts in ice for pete's sake and a FET to get on with.

Turns out I was a bit premature in my attempt to move on, but it did help me to get out of the house this morning. The problem is, I still feel pregnant. I cannot escape the symptoms that remind me of exactly where I am; in the no-man's land of abnormal beta results.

Since this morning I have vacillated wildly between absurd bouts of hopefulness, moments of reluctant acceptance and periods overwhelming sadness.

I emailed our clinic with the beta results and asked them for guidance, only to receive back an automated message that told me to ring up and leave a message if I wasn't reporting a day one of my cycle on the email I had sent. I was furious. So you are asking me to leave a voicemail in the midst of all my snot and tears..? Why can't they have a freaking email account for enquiries such as these (i.e. ones that aren't related to medical emergencies but are still pretty important)? I'd much rather take my time to compose a nice non-neurotic sounding email than to sob down their answering machine.

Anyway, I doubt that anyone will get back to me before Tuesday as it is a Bank Holiday weekend and all they do during weekends is scans, retrievals and transfers. It's a pared down service.

It's good though. If I can convince them to give me another blood test (free of charge this time - I can't afford any further Harley Street charges this month) at least it'll be far enough apart from the last one to hopefully give us more definite news. Surely they can't deny me that? I'm in a risk group for having an ectopic now, am I not?

So that's what's happening in Endoland. The bizarre and head-spinning journey continues.


Posted by Haisla Thursday, 21 May 2015 5 comments

Seventy seven is a great number if it for instance denotes a ripe old age you've reached from where you can look back on your life and appreciate all the great things you've accomplished.

It's not such a great number when it's your first beta result for 15dp5dt..

After numerous light pee sticks (which were darkening daily I hasten to add), I caved and booked a private hCG test at a clinic near work. I snuck out during my lunch break yesterday and received the results on my way home. I was devastated when I saw the double digit figure. I mean I knew that my pee sticks were lighter than the ones I'd seen posted online, but they had been getting gradually darker. Of course I immediately immersed myself in the world of Dr Google to find out what this number meant and the results were not good. According to Betabase for instance I am at the very tail end of the stats for pregnancies that have turned out to be viable*. Not at the very tail end, since 44 was the lowest number recorded at 20dpo, but not far behind. Although I'm aware that the doubling time of the hCG is more important than the number itself, seventy seven at this late stage in the game seemed more like 'game over'.

I felt dejected by the time I got home. I told M. that it didn't look like it was going to be good news.

He  tried to remain positive, but I could tell he was sad. We hugged and hugged.

Since yesterday I've done some more research and found slightly more encouraging information amongst all the doom and gloom. The American Pregnancy Association has this to say about hCG:

  • 85% of normal pregnancies, the hCG level will double every 48 – 72 hours. As you get further along in pregnancy and the hCG level gets higher, the time it takes to double can increase to about every 96 hours.
  • Caution must be used in making too much of hCG numbers. A normal pregnancy may have low hCG levels and result in a perfectly healthy baby. The results from an ultrasound after 5 -6 weeks gestation are much more accurate than using hCG numbers.
  • A single hCG reading is not enough information for most diagnoses. When there is a question regarding the health of the pregnancy, multiple testings of hCG done a couple of days apart give a more accurate assessment of the situation.
  • The hCG levels should not be used to date a pregnancy since these numbers can vary so widely.

    Guideline To HCG Levels During Pregnancy

    hCG levels in weeks from LMP (gestational age):
    • 3 weeks LMP: 5 – 50 mIU/ml
    • 4 weeks LMP: 5 – 426 mIU/ml
    • 5 weeks LMP: 18 – 7,340 mIU/ml
    • 6 weeks LMP: 1,080 – 56,500 mIU/ml
    • 7 – 8 weeks LMP: 7, 650 – 229,000 mIU/ml
    • 9 – 12 weeks LMP: 25,700 – 288,000 mIU/ml
    • 13 – 16 weeks LMP: 13,300 – 254,000 mIU/ml
    • 17 – 24 weeks LMP: 4,060 – 165,400 mIU/ml
    • 25 – 40 weeks LMP: 3,640 – 117,000 mIU/ml
    • Non-pregnant females: <5.0 mIU/ml
    • Postmenopausal females: <9.5 mIU/ml
    These numbers are just a GUIDELINE– every woman’s level of hCG can rise differently. It is not necessarily the level that matters but rather the  change in the level.
The article does then go on to say that low hCG levels could indicate possible miscarriage, blighted ovum or ectopic pregnancy.

So hCG of 77 could mean something or absolutely nothing. I could just be one of those women who naturally produces low levels of hCG, or I could be at the brink of a miscarriage. I'm not bleeding or spotting but that doesn't really guarantee anything.

I've booked a second beta for tomorrow at the private clinic. The best thing I can do for now is just sit tight and try not to drive myself absolutely mad. If the number doubles by tomorrow, I will just try to leave it at that and wait for my first scan on June 5th. If the number looks dodgy or is shrinking, I will contact my clinic for guidance.

Oh, and I couldn't help myself, but checked the due date using an online calculator. Should this little bean turn out to be viable after all, my due date will be January 20th, 2016.

Just one more little fact to torment me.. ; )

The results are in...

Posted by Haisla Sunday, 17 May 2015 10 comments

.. and they look something like this:

Taken on Sat 11dp5dt

Yep.. it's a bit of a squinter, but undeniably there (it's much more obvious in real life than in the photo).  So my first response was utter joy - my first ever positive pregnancy test, ever!!! I showed it to M, who was over the moon.

The lightness of the second line left me feeling a bit concerned though, considering how long it's been since the transfer. It was one of those crappy freebie pee sticks that clinic provides, though, so I am partially putting it down to that. Needless to say, I spent a large amount of time yesterday visiting all sorts of shady corners of the Internet that no-one in their right mind after a faint 'BFP' should visit.. The only result was that I convinced myself that it was probably some kind of a chemical pregnancy or at least unviable in some shape or form.

I did feel a bit better when I peed on a stick again this morning and got this:

Sunday 12dp5dt

...which seems a bit more unequivocal in its pronouncement and set my mind at greater ease.

Of course I'm terribly aware that we're not out of the woods by any stretch of the imagination yet (well, by about eight and a bit months really). It still feels incredibly unreal that somehow I have managed to get pregnant.

However far this pregnancy will progress (till birth is what I hope), I will always be grateful that we managed to get pregnant at all!! That is not something to be taken for granted. After three and a half years of 'nada' I was kind of starting to wonder. Whichever way this will pan out, I now have some hope that I am not dreaming of completely impossible things.

It's a weird place to be. I am absolutely ecstatic and yet at the same time almost paralysed by fear. I now understand what people mean when they say that a positive pregnancy test is just the start of the hurdles race that makes up a full-term pregnancy. I dare not dream yet. I dare not imagine the baby or look up the due date or do any of the other stuff that blissfully ignorant 'normal' people might do.

I am trying my hardest to be happy and grateful for what I have today. I can't by worrying change the outcome of this pregnancy. It will be what it'll be.  But today I can choose to be happy.

This post will be a sort of a summary of our fertilisation report and today's transfer all mashed up into one (since I've been a lazy blogger).

We actually received our one and only fertilisation report on the morning after the retrieval.

I was making popcorn (as you do at 10am on a Friday morning; let's just say I had a hankering), M. was in the loo. So it was without a doubt the perfect moment for the embryologist to call.

I'm sure she thought I was mad with my slightly distracted tone of voice and the ferocious popping taking place in the background (I make popcorn the old-fashioned way, on a stove, in a pan). Somehow I managed to grab a Green election candidate Tony Firkins' leaflet from the kitchen counter, find a pen and take notes with one hand whilst shaking the popcorn pan with the other.

So our precious fertilisation report is scratched onto an election pamphlet. How very fitting.

Anyway, I digress. The embryologist had good news, which I was just about able to hear amidst all the popping:

- Out of the 11 eggs that were chosen for ICSI, 9 were viable and 4 fertilised.

- Out of the 11 eggs that were selected for IVF, 10 fertilised.

- So altogether we had 14 fertilised eggs!!! With this result they recommended day 5 transfer.

Great news.. However, do you notice a teeny tiny discrepancy?

Yep, on Thursday after the retrieval we were told that they obtained 18 eggs.. 11 + 11 surely = 22.. Umm.. had they somehow multiplied overnight?

Had I been less preoccupied with my popcorn during this crucial phone call I may have asked this very question of the embryologist. However, I wasn't and I didn't.

So I was left with Dr Google to figure this one out, before I drove myself crazy convinced that they'd mixed M's sperm with someone else's eggs!!

Thankfully I found this very helpful blogpost from an actual scientist (the Infertility Lab Insider) who has worked in a number of fertility labs over the years. To summarise (very badly) the initial counting of eggs after retrieval can be obscured by a cloud of cumulus cells that surround the egg inside the ovarian follicle and sometimes immature eggs (which are at the brink of maturation) mature naturally in the next 24h in vitro which may account for a change in the number of mature eggs. So there appear to be very good, scientifically based reasons why the egg count after the day of retrieval may go up as well as down. Whoever knew? Anyway, I am not complaining. But if you're interested in fertilisation and everything that happens to an egg before it becomes an embryo, may I recommend that you visit the above blog - it's fascinating.

So we had 22 eggs out of which 14 fertilised, which leaves us with a 63% fertilisation rate. According to Fertility Lab Insider this is below average, from memory I think she states that 75% is normal. But again, I'm not complaining. I am 36, my eggs are bound to be heading south in quality.

But the good news is that on some level we obviously are really quite fertile - I can produce a fairly decent amount of eggs; M's sperm can find their way to those eggs and actually get in and get things going.

This was as much as we knew until today, day 5. Our clinic does not appear to be big on providing information for their patients. It could be that the reason why they don't provide detailed daily reports is because they want to keep the developing embryos as undisturbed as possible. Apparently this is a thing with some clinics.

So today we approached the clinic with trepidation.

We were there at 11.35am for our 11.50am appointment. I was busting for a wee (as is the norm, I had been asked to arrive "with a full bladder").

At 12.20pm, I was in absolute in agony. Did I mention that progesterone makes my bladder hyper-sensitive to the need to wee? At this point I alerted a nurse to my dilemma and we were without further ado whisked to the transfer lab. I got to don the hairnet again with a fetching white disposable gown (as did M - we got the cutest photo taken), the doctor asked me to sit down whilst she gave us the final fertilisation report - I couldn't I was literally in pain with the need to wee at this point. She kindly allowed me to go to the toilet and empty my bladder somewhat. What a sweet relief! I was again able to take in and retain information.

The doc resumed sharing the Day 5 fertilisation report with us. Out of our 4 ICSI embryos all had turned into blastocysts and were hatching (yay!).

Out of our 10 IVF embryos 2 had turned into blastocysts (but were not yet hatching) the rest were still developing but at a far slower rate than the others. The doc said they'd keep an eye on them for the next couple of days.

But the bottom line is that we got 6 blasts!!!

They asked if we were happy with transferring one, to which we said yes. So I've got one healthy (looking), beautiful (the doc's words, not mine), hatching embryo nuzzling inside of me as I am writing this and we've got 5 in ice for future FETs!!!! I am so, so very grateful; this has all gone so very smoothly and without a hitch.

The transfer itself was fairly uneventful. The doctor cranked me open with the speculum as they do (that was mildly uncomfortable, as she wasn't able to use any lube), then her assistant got the embryo from the lab in a catheter, the doctor placed the catheter inside of me (we saw a little light flash on the ultrasound screen as it happened) and then her assistant checked the catheter to ensure that the embie had indeed been decanted inside of me, which it was. Not two minutes later I was back up on my feet and dressing up. We sadly didn't get to see a picture of the blast, which was a bit of a shame and all in all the whole transfer experience was a bit a of an anti-climax.

But, and this is a big but, at this very moment I am officially PUPO and am planning on enjoying every single moment of this experience.

The progesterone pessaries have already given me massively sore boobs, a heightened sense of smell and slight nausea, so I'm aware that symptom spotting will be futile. I'm back to work tomorrow and my plan is to stay busy (in a very relaxed sort of way) and try to stay away from Dr Google as much as I can. Wish me luck. Eeeep!!!xx


Posted by Haisla Friday, 1 May 2015 6 comments

Ok, so the good news is that we got 18 eggs retrieved yesterday!!!

I'll tell the slightly longer story, just in case one day I'll get to repeat it to our children and need a reminder of the full facts:

We left home at 7.30am supposedly in good time to reach Central London by 9.30am.

Everything went well until we hit traffic around Battersea. We'd had such a nice drive up until then, the sun was shining, we had good music on the playlist and were feeling fine. From Battersea on the journey was wracked by nerves and unannounced roadworks (M. had planned the journey meticulously to avoid as many traffic jams and roadworks as was humanly possible). The problem with Central London is that once you hit traffic, there is no way to back out and you just have to grin and bear it. My jaw was clenched so tight by the time we arrived at the hospital that I could have done with a crowbar to unclench it.

I'd had nightmare visions of having to ditch M. and the car to make their own way to the hospital and hopping on public transport to beat the traffic. The obvious problem with this plan was that we were both needed at at the hospital; me leaving M. behind wouldn't have really accomplished anything.

To cut a very long story short, we arrived at the hospital at 9.40am.

Another reason for feeling some pressure to arrive at the hospital in good time, was that I'd been advised to insert a rectal Diclofenac pessary approx. 1h before the retrieval. Obviously with the long drive, I couldn't do this in the privacy of my own home and no way was it doable in the car (I mean there are crazy things I would do to beat infertility, but there are also lines I will not cross!). So as soon as we arrived to the hospital (sweating, panting and slightly shaken), I slipped into the toilet and got the thing in. Not pleasant. If you have to do this thing in a public toilet, I recommend a pair of disposable latex gloves and nerves of steel. I know, I know, perhaps this borders on TMI, but listen, I'm glad I thought of the gloves before I left home. This is really just to prepare any IVF first-timers out there on what might lay ahead.

Once at the ACU itself, there was a bit of waiting around to do. I was offered a fetching gown,  a hairnet and the ugliest pair of slippers I have ever seen (see exhibit A) to wear:

Mmm ... sexy

I got to confirm my name and date of birth umpteen times, but I'm obviously grateful that they take such care in identifying each couple in order to match the right eggs with the right sperm. M. was led into a private room to do his thing, but generally we didn't really know what was going on, or what the schedule was going to be like.

I emptied my bladder a million times, since I'd accidentally drank some water in the morning just before leaving the house (somehow I hadn't managed to take in that the 'no food or drink 6 hours prior to procedure' advice included water *doh!*). I was terrified that it would wreck the retrieval (that somehow they'd 'know' and cancel the procedure) or that I'd end up choking on my own vomit whilst unconscious. Thank goodness it had been enough time for the water to travel through my system and thanks to my nervous bladder I managed to squeeze out every single drop before I was led into the theatre at approx. 11am.

The operating theatre was much more 'medicalised' than I'd thought with scary looking stirrup bed placed in the middle of the room. I climbed up on the stirrup bed, got the IV-drip attached to my hand by the dead nice anaesthetist (he had to dig around a little and it was probably the most painful part of the procedure that I can remember). He then placed the oxygen mask on my face, said something about it being time for the 'gin and tonic' (I think, although I can't be sure), I started feeling a bit woozy and then went out like a light bulb.

The next thing I remember is waking up back at the recovery room where M. was waiting for me. I woke up from what felt like a really nice deep sleep; apparently I'd been completely out of it (and snoring lightly) when they'd wheeled me in.

As I woke up a bit more, I discovered I was in quite a bit of pain (me and pain don't get along), so I asked for some extra painkillers and was given some together with my tea and gluten free crackers.

After a while, the embryologist came in to have a chat with us and confirmed that they'd managed to retrieve 18 embryos.


As M's sperm sample had been fairly cracking, too, they proposed a 50% IVF and 50% ICSI plan for scientific purposes, so they could learn a bit more about our fertility issues. We were both overjoyed by this. I'd always felt that by doing ICSI alone we might miss out on learning something valuable about why we're not getting pregnant. I'm all for gathering data. So this was like having the best of both worlds.

Around an hour later I was feeling steady enough on my feet to get changed and leave the ACU. I was still feeling a bit wobbly so allowed M. to go fetch our car from the car park whilst I waited in the lobby. By the time he got back (which did take a good 20 minutes) I was feeling decidedly odd. With hindsight, I don't think the gluten free crackers did much to hike up my blood sugar levels and I was positively crashing in the car on our way home. I just kept my eyes closed, leaned my head against the opened window and did my best not to throw up all the 90 minutes that it took us to get home.

When we got home, M. made me some cheese on toast and I drunk a large glass of water and went straight to bed. After a couple of hours' sleep I was feeling much better and spent the rest of the day on the sofa part napping, part watching crappy telly and drinking as much water as I could.

Today I am feeling much better with hardly any pain. There is still some discomfort and bloating in the pelvic / belly region (which worsens after I eat), but I haven't needed to take any pain medication since leaving the ACU. I also spotted a little yesterday, but that appears to have cleared up today.

So all in all, not too shabby at all. Now we just wait for the fertilisation report, on which I shall report later.