Feedback

Dear D and A

Thank you for choosing [clinic] for your recent treatment. As Medical Director I would really appreciate your feedback and I enclose our freepost questionnaire - and a couple of tea bags to help you slow down and take time to answer it! Thank you for your time.

File note

Dear A and D

Diagnosis:
1. Third unsuccessful IVF cycle
2. Primary infertility secondary to azoospermia post vasectomy reversal
3. Hypertrophic obstructive cardiomyopathy, treated cardiac septal ablation, 1998 and 1999, second procedure complicated by vascular injury requiring double bypass graft
4. Allergy to aspirin and ibuprofen
5. Dysmenorrhoea, possibly due to endometriosis
6. Short menstrual cycle

The last review and blood test

This morning D and I had our review appointment with Dr C at the clinic. She was very kind and sympathetic, and we talked for a while about how we felt and where we might go from here. It seems that there was really nothing that anyone could have done differently. This pregnancy just was not meant to be.

Losing a pregnancy

It's been two days since we had the blood test result that showed that I am no longer pregnant. It's been a strange time - devastating of course, and there have been lots of tears shed as we think about everything we were looking forward to - but we are also grateful that we were not further along. I realise that comment may seem a bit heartless. This was a new life, even if for only a little while - but going through this after weeks or even months must be simply awful. We have been talking together a lot and there are more discussions to come about where to from here. There is no rush, though. In the meantime, we are still grieving and it will take a little time before we are ready to move on.

Bad news

So the rollercoaster takes another turn. My blood test this morning showed that I am no longer pregnant. Nurse K rang just a few minutes ago to let me know. I have to have a confirmation test on Wednesday, just in case there was a lab error, but the chances are very slim. We are, frankly, devastated. D is on his way home from work. I guess when we are ready we will talk about where to from here, but for now there is a lot of crying to be done.

Trying not to panic

As the subject line says, things aren't looking so rosy this evening. For the past day or so, I've had a bit of brownish staining, rather like the very end of a period, and for most of this afternoon my tummy has been aching a little. Nothing too severe, just a bit of discomfort as if I'd eaten too much dairy or something. But when the discomfort increased about an hour ago, I went to the toilet and found that the brownish colour was now a brownish red. Something was not right. My immediate thought was that I was miscarrying, but I managed to hold it together enough to call the clinic's on-call nurse.

Confirmation

Yesterday I went down to our local medical centre to have my blood taken for the confirmation test. It was neat telling the nurses about our positive result. They have been taking my blood for these IVF cycles for over a year now and they were full of congratulations. It's so nice to have someone to tell!

A result

Well, today was the day that A and D finally found out that they were going to have a baby.

As I write this, the news hasn't really sunk in. Even typing that first sentence seems unreal. I have imagined this day for so long. My brain seems to be allowing in only a small portion of the news at a time, as if it won't cope with the reality of such a dream coming true. There's no hurry though. It's just nice to feel this happy.

Treatment summary

Dear A and D

We are writing to provide you with a summary of your last treatment cycle.

A boy and a girl?

Yesterday started dramatically for me. I woke at about 6.20am with a slightly uncomfortable tummy. By 6.40am it was the worst abdominal pain I'd ever experienced. It was worse than period pain. It felt like my insides were on fire. I did what I usually do when I have pain: I put a wheat bag in the microwave, then held it to myself and paced up and down the hallway, willing it to stop. Eventually the pain started to come in waves, easing off for a few seconds before returning, then it faded almost completely. By then it was 7am and I was completely exhausted. I took the day off work and spent much of the morning sleeping. I wasn't so sure about eating, but for lunch I had a couple of kiwifruit and some almonds. All seemed fine until the same thing happened again about 3pm and at 9pm. Each time, a dull ache grew into excruciating pain, which lasted for only about 20 minutes before gradually fading away.

Harvest

Yesterday morning D and I went to the clinic for the egg collection. We weren't allowed to have anything to eat or drink and I was feeling the lack of coffee! We had to wait for a little while, then we were shown through to a little room where a nurse took my vital signs and I changed into a gown. She also gave me some medication to calm me.

Second scan

This morning we went to have a blood test and then to the clinic to have my second scan. Dr P was in his usual form, chatting about an amazing new ultrasound machine he'd read about, but I'm used to it by now! Unfortunately some of the follicles that we saw on Thursday haven't grown very much, but I have four mature follicles, three on one side and one on the other. So rather than leave them for much longer, Dr P would like to do the egg collection on Monday. That means a day off for both of us and only one more injection for me.

First scan

This morning D and I went to the clinic to have the first scan for this cycle. We have been on the Gonal-F injections for a week now, so it is time to see how many follicles have developed and when they will be ready for harvest. But first we went to the testing centre near the clinic to have a blood test done.

Contact

This afternoon Nurse K rang with the results of yesterday's blood test. We are to start the Gonal F injections on Friday night. We will continue with the Buserelin, but we'll cut the dose by half. Another step ahead...

Day one again

Yesterday afternoon I rang the clinic and left a message to let them know that my period had arrived overnight. This morning I went to the medical centre to have a blood test. This test will let us know when to start the Gonal F injections. I will be contacted tomorrow with the results.

The old dog and bone

I have just had a call from Nurse R at the clinic with the results of yesterday's blood test. She would like us to start the Buserelin injections tomorrow morning. (I don't mind the morning injections too much. D wakes me with a cup of coffee and a syringe and it's all done before I'm properly awake. But I digress.) We will continue with those for about ten days, but I am to call the clinic when I get my period, which will be during that time. I also need to have another blood test on 3 September. I wrote all of that down as we spoke so I didn't forget anything!

Ring ring

Nurse J from the clinic rang this afternoon to let me know about the blood test I had yesterday. She said that it looked like I had already ovulated, a little earlier than they expected, but she wants me to have another blood test tomorrow to get another reading. I have made an appointment with the local doctors surgery for 9.20am.

Drug education appointment

Today we both took the day off work and did some shopping and had lunch in the city before our 2pm appointment at the clinic. As usual, we had to wait a little bit, but the waiting room is pleasant enough and there are always good magazines. Often we are by ourselves, but if there is another couple there I find myself wondering how far along the process they are. I like to think that the ones who are still looking bright and enthusiastic are just beginning. On our first few visits I remember assuming that everyone else was more experienced and knowledgeable than us, but now I know that it always feels strange and daunting no matter what stage you're at! I definitely feel much less excited and full of hope than I did before. I am tired of coming to this waiting room.

Ka-ching

Last evening I went to our bank's online facility and transferred $11,000 from our savings account to our current account, and then I went to the clinic's website and paid our invoice for $10,255. (The invoice for our medications will come later.) Paying such a large bill reinforces the monochromatic nature of this situation. It is no wonder that "you can't be half pregnant" has become a cliche. If we fail, the total cost of something over $13,000 will feel like such a waste. But if we succeed, having the chance to be parents will be priceless. For us, it feels worth it to have one more chance.

Appointment made

This afternoon a nurse from the clinic rang me to let me know the result of the blood test I had on Wednesday. It indicated that 20 August is a good day to start the series of blood tests required to pinpoint ovulation, so we have arranged a drug education appointment at the clinic on the same day. At this appointment we will be given all the medication we need for the various injections.

Letter

Dear A and D

You have now booked on for an IVF cycle. The actual week you commence stimulation injections will depend on the regularity of your menstrual cycle and our nursing team will advise you when you need to pick up your medications or for out of town patients, the date the medications will be couriered.

Here we go again...

Last week I called the clinic as instructed to arrange our next IVF cycle and spoke to Nurse R. She posted me some new consent forms to sign, a lab test form for a chlamydia swab (a new requirement) and a note asking me to call on day one of my period.

File note

Dear A and D

Diagnosis:
1. Second unsuccessful IVF cycle
2. Primary infertility secondary to azoospermia post vasectomy reversal
3. Hypertrophic obstructive cardiomyopathy, treated cardiac septal ablation, 1998 and 1999, second procedure complicated by vascular injury requiring double bypass graft
4. Allergy to aspirin and ibuprofen
5. Dysmenorrhoea, possibly due to endometriosis
6. Short menstrual cycle

The winter's tuning up...

This morning we had our follow-up appointment at the clinic with Dr C. She was very considerate and sympathetic and spent a lot of time with us discussing our questions about the future. Our first question was whether the reason we hadn't had a successful outcome was because of a problem or simply because of seemingly random factors outside anyone's control.

Gutted

Having exhausted my patience, I rang the clinic back a few minutes ago to chase up the blood test result. Unfortunately it was negative. I am gutted. My hopes were so high. We have a follow-up appointment later this month at which we will discuss whether we try again. Of course I want to try again - but it is beginning to seem very pointless.

Being patient

First thing this morning I went to my local medical centre for a blood test to see whether I am pregnant. The test form was marked "urgent" and the result was supposed to be available this afternoon.

Letter

Dear A and D

We are writing to provide you with a summary of your last treatment cycle.

Transfer

I have just arrived home from the clinic after having our first (and hopefully only) transfer for this IVF cycle. It all went very smoothly and was far less complicated than the pick-up. First I had to undress from the waist down and put on a green gown, just like the one I wore last week, and then we went into a small room with a monitor high on the wall and a large chair with stirrups. D was able to sit next to me and hold my hand throughout. First we were brought up to date with our embryos. Five had been successfully fertilised last week but unfortunately two of them had since stopped growing. Of the remaining three, two were growing well but one looked better, so that was chosen for today's transfer. The rest will be frozen in case we need them.

Almost half a cricket team!

This morning a technician from the clinic rang me to let me know how things had gone in the laboratory overnight. She said that of the nine eggs that had been picked up, six were mature and five of those had been fertilised with D's sperm. That's a good number - certainly better than the two we had last time!

Egg pick-up day

This morning we were up bright and early to get to the clinic by 9.15am for our pick-up appointment. I wasn't allowed anything to eat, but I did sneak in a mug of chamomile tea at 6.00am - the closest I could get to coffee! I was feeling very hormonal and grouchy and my breasts were especially sore. I chose a comfortable bra!

Trigger

This morning I went to the medical centre for a blood test, just to confirm where my hormones were at. In the afternoon Nurse K rang me from the clinic to run through what happens over the next couple of days. Tonight at exactly 10pm I will have an injection of Ovidrel, the "trigger", which will prompt the follicles to begin releasing the eggs. Our pickup appointment is scheduled for 10am on Wednesday, exactly 36 hours later. D and I will need to take the whole day off work. I won't be allowed to drive and D will need to keep an eye on me while I recuperate during the afternoon. It's a bit tough on the body, but at least there are lots of healthy-looking follicles, so hopefully we should get plenty of eggs and I won't need to go through this again. Still feeling positive!

Saturday scan

This morning we were up bright and early to go into town for another ultrasound scan. It showed that the three follicles on the right side and seven on the left had all grown larger, though not quite large enough, so we have scheduled the egg pick-up for Wednesday rather than Monday. We were also given another preloaded needle of Gonal F to last us until Sunday night.

How many?

Today we went into the clinic to see Dr C for our first ultrasound scan for this cycle. I have been having the Gonal F injections for five days now and the blood test I had yesterday showed that my estrogen levels were "nice and high", so it was time to see what my ovaries have been up to.

Two jabs

Yesterday the nurse from the clinic rang me with my blood test results. They showed that my hormones were very low, so it's time to start the Gonal F injections tonight. We will keep going with the Buserelin every morning as well. I have to have another blood test next Wednesday and then on Thursday I'll go in for an ultrasound scan. The Gonal F will stimulate my ovaries to create lots of eggs - the more the better - and we will be able to see the follicles at the scan.

And we're off

I had another blood test yesterday and the nurse at the clinic rang me this morning with the results. It showed that I have ovulated and that it's time to start the first of the injected medications, Buserelin. I was surprised to hear that I need to start it this morning and, since D has gone to work already, I had to inject it myself. It was a bit fiddly drawing the right amount into the syringe from the bottle and I was slightly nervous doing the actual injection, but it seems I am a good nurse and it didn't hurt a bit (though the site is slightly itchy now). So the pattern for the next ten days or so will be a Buserelin injection first thing in the morning before D leaves for work, then I'll have a blood test on 5 April, and then we'll add an evening injection of Gonal F to the regimen. It feels very much like we're at the beginning of another journey but we don't know yet what we'll find at the end.

Blood test result

The nurse from the clinic called me yesterday afternoon to give me the result of the blood test I had on Monday. She said that the test showed that I had "surged" (i.e. ovulation had occurred) and that I need to have another blood test next Monday morning. At this stage it looks like we'll start the injections sometime next week.

Blood test

This morning I popped into the doctor's surgery to have yet another blood test. This one is to help pinpoint the time of ovulation. It was expected around day 11 and today is day 13. The nurse at the clinic will call me tomorrow when they get the results to let me know when we can start the injections.

Education appointment

I have been so crazy busy that it's taken me a few days to write about our education appointment last Wednesday.

File note

Dear A and D

Diagnosis:
1. Primary infertility secondary to azoospermia post vasectomy reversal
2. Unsuccessful first IVF cycle
3. Hypertrophic obstructive cardiomyopathy, treated cardiac septal ablation, 1998 and 1999, second procedure complicated by vascular injury requiring double bypass graft
4. Allergy to aspirin and ibuprofen
5. Dysmenorrhoea, possibly due to endometriosis
6. Short menstrual cycle

Day one again

My period arrived yesterday, which meant codeine and a hot water bottle but the pain wasn't too bad this month, and which also meant a phone call to the clinic to let them know. I left a message on their voicemail and a nurse rang me back later in the afternoon. I need to have a blood test around ovulation and we have pencilled that in for 20 March. D and I also need to attend another education appointment next Tuesday. The injections that he needs to give me during this cycle are similar to last time but not completely the same, so we'll run through it again to make sure we get it right. So it seems we're back on the treadmill again, even though it'll be a while before we see any results this time.

Review appointment

Yesterday we attended our review appointment with Dr C. This is the first step in our second cycle of IVF. Dr C was, as usual, very empathetic and took time to see how we were feeling. We both felt that we would like to try again as soon as possible. This time she would like us to try an agonist cycle (as opposed to an antagonist cycle which we tried last time). It involves slightly different drugs and more injections, and it takes place over two menstrual cycles so the results will be a little further away, but apparently it is worth trying. My next period is due next week so I will call the clinic when it arrives to let them know, and then we will have an appointment scheduled.

Letter

Dear A and D

Further to our recent conversation I write to confirm that I have made you an appointment for a medical review. This will be held on Tuesday 28th of February 2012 at 3.10pm at [clinic] with Dr C. Please note that both of you are to attend this appointment. Your treatment will be discussed and planned at this appointment.

As discussed we require the following tests to be updated:
Full screening blood tests (female) - We require A to have these blood tests updated and it is important that these tests are undertaken at a Medlab laboratory. We need the female bloods to be done on day 3 of your next cycle.

Please note that funding is allocated in advance, therefore there can be up to a four month delay before you can book on for your actual treatment cycle. Your specialist will advise you when you will commence your cycle at the appointment above.

Please call the clinic to confirm that you can attend this appointment or if you have any questions regarding the programme.

Yours sincerely ...

A new appointment

The waiting list co-ordinator at the clinic rang me this morning and we have arranged a review appointment with Dr C for 28 February. That will allow time for me to have another set of day three blood tests (probably about the end of next week). Dr C has already told me that she wants to increase the stimulation medication that she will prescribe, which will help me to produce more eggs for fertilisation. Remember all those injections? So we're back to square one and hoping for better results this time.

Sometimes you don't want to be right

This morning I drove into the city to have another blood test to see if I am pregnant - and the result has come back negative. I am disappointed. It would have been great if it had worked this time. But I was very much in a "expect the worst, hope for the best" head-space ever since my period arrived earlier this week. And although we are getting really tired of negative results, we are keen to try again. Hopefully next time things will run more smoothly since we know the process. Tonight we will go out for dinner - as has become our habit on "results days" - and then we'll take it easy this weekend.

One thing I hadn't realised - and which I feel kind of stupid about now - is just how many women have what seems to be a period before a positive pregnancy test, especially if they are being given extra hormones. Apparently it is not unusual. I am glad I didn't know this before!

Still on the treadmill

Day one has rolled around again, so I guess I'm not pregnant. I rang the clinic this morning and the nurse told me that I still need to do a blood test on Friday because "often people report their period has arrived but it can be something else". However I don't think she's right in this case. Yesterday like the first day of a normal period to me - sore and grouchy! But I will trust the experts and do the test as I have been told. I tried very hard not to get my hopes up this time and I think that has helped. I did feel pretty sad when I realised but I want to go on and try again. In the meantime, I will wait to see if Friday's test brings a surprise.

Letter

Dear A and D

I am writing to provide you with a record of the outcome of your frozen embryos held in storage at [clinic].

A visual aid

Perhaps it's not so wise to post a picture, especially since this little dude has only a one in four chance of making it, but who can fail to be amazed at the technology? This is our three-day-old embryo - human life in its very earliest stages - and the scientist at the clinic took its picture and sent it to me via email. Cor.

Up and away

After a very long week of daily blood tests, I have finally ovulated! An appointment has been made for 11.15am tomorrow when the second embryo will be implanted (or "transferred", as the clinic likes to say). This embryo was conceived at the same time as the first one but has been frozen since then. It may not survive the thawing process, so there is less chance that this attempt will be successful. However, we'll give it a shot and see what happens. We will have time to pack the car before we leave for the clinic, so straight afterwards we will be able to head out of town to a lovely bay an hour or two away. I wait all year for my holiday under canvas and I'm especially looking forward to this trip! It'll make the two-week wait until my pregnancy test just that little easier.

On it goes

The clinic has made its daily telephone call and the longed-for surge has not yet been detected, so there will be more blood tests for me over the weekend. Our local doctors surgery will be closed so we will have to drive into the city to have them done there. That's not a problem - we have a bit of shopping to do anyway. We were hoping to go away on our camping holiday next week and it looks like it will have to be put off for a few days. I am longing for a break but no one could predict how the timing of this next attempt would work out. I will be all the more grateful when we do get there though!

Testing, testing ...

This morning I had my fifth blood test. I biked to the doctors surgery again, which is a great thing to do. It's probably four or five kilometres from one side of our little town to the other. I always have to wait 20 minutes or so beyond my scheduled appointment time but that's all right. I'm usually not in any hurry and there's plenty going on.

Miscommunication

This morning I went down to the local doctors surgery and had my second blood test taken, from the left arm this time! Soon after I arrived home I received a phone call from the clinic to let me know the results of yesterday's test. It seems that my hormone levels are increasing slightly, which is good. I need to keep having blood tests until the hormone surge that signals ovulation is detected. We assume that will be sometime this week.

Day one ... again

This morning I rang the clinic to let them know that yesterday was day one of my cycle again. It feels like we've jumped back on the carousel. I have to have a blood test tomomrrow and another one on Monday. Then, depending on the results and how long this cycle is, we'll be back at the clinic sometime in the last week of January to try again with our frozen embryo. I'm still not feeling so positive - the chances are much lower this time because the thawing process is risky - but we'll just have to see. The good news is that for the first time in what feels like forever, perhaps a couple of years, I've not had any menstrual pain this month. A good sign, maybe.