I.V.F

Quickly – I think I have done this before; but a quick reminder of the differences between IUI and IVF.

IUI – Intra-Uterine Insemination

With IUI, the women stimulates her ovaries (in my case I injected Gonal-F) to grow follicles (sacs which contain the eggs). Ideally no more than 3 follicles will be stimulated, or treatment will be cancelled and re-attempted the following cycle. This is because if 3 eggs mature and ovulate, and then all 3 fertilise and implant, you have yourself some non-identical triplets… If any (or all!) of those fertilised eggs then split… you got yourself a lot of babies and a potentially high risk and dangerous pregnancy for Mum and babes. A split egg (identical multiples) can happen to anyone, any pregnancy, whereas non-identical multiples are likely to be either a result of fertility treatment, or is something which genetically runs through the female side of a family. Once follicles are stimulated to the right size, a trigger is done to conduct ovulation, at which point you will then be invited back to be “inseminated” with sperm directly into your womb. The idea being the sperm will meet the egg(s) almost immediately in the womb, ready to fertilise and implant. I believe the success rates are around 16-21%. It obviously didn’t work for us, however I do follow a lady on twitter who it has worked for – so some faith is restored! IUI – I believe – is not used for couples where the “problem” is Male Factor Infertility (MFI), as its likely then that sperm have poor mobility and still won’t fertilise an egg.

IVF – In-Vitro Fertilisation

IVF is different in that, in a way, you are stimulating your ovaries with the intent to make them produce as many eggs as possible… within reason..! For us, I wanted a lot so we didn’t have to go through the stimulation part again, yet too many means discomfort, pain, potentially dangerous {OHSS} and may also mean you cannot proceed with a fresh transfer… for those going through the painstaking hell of infertility – any delay is bad! At school you are constantly told if you have sex you’ll get pregnant – & I’d have been in major trouble with my parents as a teen mum (not that I would have wanted to have potentially had children with different Fathers!). However, I have been with now husband 10 years, I wish I’d known contraception was a waste of time – I might then of been a mum already 😰 but I guess everything happens for a reason..!

After completely shutting down ( including inducing a fake menopause!) and having the IVF “take control” of your cycle, you once again stimulate your ovaries (in my case I used Menopur) and are again monitored for quantity and growth, before moving onto Egg Collection. After egg collection your eggs are then fertilised in a dish (!) and watched daily for development. Just a little side note here – if your infertility stems from MFI, then your eggs will probably be fertilised using ICSI (Intracytoplasmic Sperm Injection) where basically the sperm is injected into the egg directly, rather than them meeting together in the dish and fertilising on their own. This wasn’t used for us, as we all know my husband is Mr. Perfect and has such top quality sperm seemingly everyone loves it!! Either way, the best sperm are selected to either be injected or placed in the dish with your eggs. From what I have seen, some people have a 3 day embryo transfer, but the ideal stage is to develop your “babies” to blastocyst stage and have a 5 day blastocyst transfer. NOTE; not all collected eggs will fertilise/not all fertilised eggs will develop properly.  Now, if less than 20 eggs have been collected, and you’ve had any develop to the right stages, you will likely proceed with what is called a “Fresh” Transfer, within 5 days of egg collection. This happened for us. If more than 20 are collected, it is likely you will have a “freeze all” approach until the risks of OHSS have reduced….. I think that is enough for now.. If anyone has any questions though feel free to ask if you haven’t quite made it to the “experts” stage (by this I mean the actual trained infertility doctors/nurse/embryologists/HCA’s ETC!)…

Apparently I bruise easily!! Cannula bruise 6 days after it was removed!!

Firstly – obviously no one ever thinks the process of infertility and all that goes with it is going to be easy, I’m sure. But never for a second did even I think it was going to be this HARD. For someone that struggles severely with mental health issues I thought I could handle this a bit better after everything else, but I couldn’t have been more wrong. The sheer anxiety is there every step of the way – they collected 15 eggs? Cool but what if none fertilise? 12 fertilised? Great! But what if none develop? 11 developed? So happy! But what if they don’t develop enough! We finished with an incredible 5 great quality blastocysts (so yes, I am *technically* a mum of 5..!) – the best of the best of which was transferred, the other 4 are frozen for future (hopefully siblings, not because we’ve failed) – but oh! It means nothing whatsoever if they don’t stick and become your healthy, happy baby! And what then if you miscarry? Or get further but then have a stillbirth? And what if, that tiny thought that you daren’t think about – but what if your baby survives everything – against seemingly all the odds – and makes it? Your dreams come true and then you keep worrying some more for the entirety of your life for every single step of the way!  I’ve been writing this blog as we’ve gone through the process, because as I said after our first IUI fail, I just couldn’t keep posting live information… despite the fact that if anyone asks me anything then I’ve provided full honest updates.. so basically all my friends and family knew exactly what is going on, when. I’m posting it now, because I do think it’s important to share. Not everyone feels they can be or even wants to be open about what they’re going through, for whatever reasons, and sometimes coming across someone else’s story can just… help… I found solace in interacting with strangers on twitter some days, and others with “old” friends who have been through IVF – “openly” (some friends I didn’t know about until they contacted me off the back of seeing one of my blogs..) or not.. IVF, infertility is NOT an easy process. It is long, and painful and hard to remain positive, and much like everything else in this world, unless you have physically experienced the heartache of something, you’ll never truly know how it feels.

15 soon became 12…

12 soon became 8…

And 8 soon ended up as 5 (hopefully dad doesn’t get eliminated too?! 😂)

It is quite a long blog, but then we were also undergoing “long process” IVF.. I hope you will stick with it and read it through…

I feel like I should add a caviat that I’m not sure my mental health was great.. November appears to be a notoriously bad month for me (3rd year running). I had not had a proper, decent, unbroken nights sleep since we had been on safari in SEPTEMBER, and even then, I didn’t get a long enough sleep. This is the longest in one go I think I have struggled with insomnia. A mix of being unable to fall asleep (in fact, the bulk beginnings of this blog, was started off the back of a 4 hour sleep night, I was exhausted but couldn’t stop writing down all the thoughts in my head – because if I didn’t, I wasn’t sleeping..!), or having entirely insane dreams/nightmares meant I was waking multiple times throughout the night. Or some nights, I’d have the joy of experiencing both in one night. Sleeping tablets don’t always work – in me if I start taking them too regularly then they stop working, so I tried to only take them on nights when I really needed to be “on form” the next day. Fortunately, as I don’t work, that wasn’t often.. at best, the ones I have only seem to knock me out for 5/6 hours at a time. Some people survive off that, but I can’t.. particularly within a long period of time of a mass lack of sleep. I was consistently exhausted and feeling run down, but I do think the medication heightened all that.

I also was convinced that it wasn’t going to work. Despite one lovely dream that I was pregnant – on the same night my best friend had the same dream – with 3(!!), healthy babies, I just could not see myself getting a positive result. I couldn’t imagine being happy or celebrating because I honestly believe it isn’t going to work – after all, the ovulation induction/IUI didn’t..

After a slight hiccup with our hospital, (as we needed to start treatment the NHS funding was removed from BCRM and in true lack of consistency in care, it looked like we were going to be transferred out elsewhere… but, very gratefully, it was sorted by one of THE BEST nurses on earth which relieved a lot of extra stress and anxiety) we were slotted in and began our IVF treatment. I started with Norithisterone tablets on day 19 of my cycle to induce a period. On day 21 I started the Buserelin nasal spray. I’d heard from others, and our nurse did state that it really affects your mood in the second week.. she did mention that as my mental health is such a disaster (NOT in those words!!) that perhaps it would have the opposite affect and make me happier… safe to say that DID NOT happen, and bang on time (although I only noticed in hindsight a day later), I became extra crazy. Easily irritable, emotional about being emotional, in tears for no reason… followed by two days where I was high as a kite, before going back to easily irritable. Up and down up and down.. not entirely dissimilar to my mood on the norm but it did feel faster and more rapid in its changes.. having said that, in an attempt to start weaning myself off citalopram at the same time, I completely lost track of when I had and hadn’t taken it and ended up doing 5 days without. I may only be on a mild dose, but I do feel me missing it so drastically all of a sudden (I had been generally managing to take it every other day, and was easing into every third) made me extra insane in my irritability..

Team IVF Stronger Together 💕

Then I started Menopur. I have only ever heard or read bad things about Menopur, and that, coupled with it feeling like absolutely ages since I had last injected myself (negative IUI was early September, started injecting Menopur late November) left me super anxious and dreading it. I had heard it bloated you, was painful and burned when you injected and left small bruises all over your tummy at the injection sight, but I was lucky to have no bruising or bloating (in fact, I actually felt like my stomach was slimmer and flatter, which for someone who constantly feels fat is saying something!). Our lovely nurse had made it look super easy in our personal planning meeting to open the glass vial of liquid, but we seemed to struggle every night. For the first three nights we shattered the lid into the liquid which only added to my anxiety of potentially a tiny bit of glass also being sucked up into the syringe and then injected into me (yes, I am that paranoid/mental/anxious to essentially imagine absurd scenarios). On the fourth night, I managed to get the lid clean off after much force… only to shred 3.5 of my fingers on my left hand when the force of my right arm pushed the raw glass edge of the lid right across them.. it wasn’t pretty, and was very painful.. and meant the entire vial was wasted spilt all over myself..

However, as at day 5 of injecting, it wasn’t anywhere near as bad as I’d heard. I had no needle entry-site bruises on my tummy, and had found the injecting itself quite similar to Cetrotide or Gonal-f (but without it being a pre-filled pen). I felt a slight light burn at the injection site once the needle is pulled out and I start moving around, but it soon passes.

It’s hard to say what is what, especially as my mental health is quite erratic anyway, but I’d say I had only a few mild side effects. I noticed I had a light headache that wouldn’t properly shift and kept returning for a few days, and I felt like when I washed my hair a lot more was coming out than “normal”. At one point I felt like I had diahrrea – but again, is it the meds or did I just eat something funny? My head insists that I have an intolerance to some foods which make me feel uncomfortable, bloated and have diahrrea so who knows if it was just that?! I also noticed both arms felt like I had done some serious weightlifting (I really should!!) for a couple of days, which I later read aching muscles can be a side effect – but again, I’m unsure if that was from doing a bit of painting of a unit, or because I’d had blood taken from both arms after the first refused to give any out on my day 21 bloods, or if it was truly a side effect.. I did also notice I was having to “stretch” and contort my limbs/body a fair bit trying to get comfy in bed, and I found myself with a fair few bruises on my thighs and no clue where they’ve come from (which isn’t unlike me to forget but there seemed to be a lot?!)

The last, but biggest side effect is the additional knock on to my mental health. I have read somewhere before that those with anxiety and depression have a tendency to really feel – more so than those that don’t suffer, and I’d say that was entirely true for me. The simplest of things can overwhelm me and have me in tears – tiny bits of kindness from strangers (I recall an incident when I was signed off sick when still working where a couple gave me the extra 25p I needed to park to walk Rufus, and it both sliced through me and made my day). On the flip side something – that I even acknowledge as being fickle – as an unfollow or unfriend from someone I considered a friend or just generally felt a connection with, also hit me hard – harder I would say, whilst on the meds. There were days when age-old suicidal thoughts returned, alongside some self harm, and I questioned if I even wanted to bring a child into this hideous world with an absolutely insane mother who frequently, literally lost the will to live.. I finally recognised that the restriction and tightness in my chest I had noticed a couple of weeks previously, was indeed the return of panic attacks and nothing to do with my asthma.

I find myself quite often struggling to distinguish between dream and reality, but there seemed to be many more times whilst on meds that this seemed to be happening. With the buserelin nasal spray, you have to take it every four hours (twice at bedtime), one morning, 40 minutes after I *think* I took it, I had no recollection whatsoever if I had or hadn’t.. in part I blame the extra exhaustion. I figured it was better to potentially take too much and took the dose at 8.40, rather than have missed that dosage entirely..

It is safe to say the meds made me crazy. Crazier. I lay awake one night unable to sleep thinking about everything and nothing, in tears, then not in tears, feeling fat and disgusting and telling myself I was not to eat any longer, to find my mind telling me I needed to run. At midnight, after I’d taken a sleeping tablet [which failed to work]. It had been a long time since I felt the need to run like that, at that time of the night/early morning.. nevertheless, by 1am I gave up and found myself outside in the pitch dark of the night, under clear skies and not quite feeling as cold as the 6 degrees it was, running 5 miles. It was so peaceful, so oddly calming and beautiful, that eventually it cleared my head, and I found myself back home at 2am stripping my running gear off, throwing my pjs back on, and falling straight to sleep… I guess I need to listen more to what my body is telling me, because although I doubt anyone wants me running at that time of day, it worked. I’m 30 and I still can’t just trust myself.. I may have got an extra hours sleep if I’d just got up and gone at midnight rather than 1am!!

Everyone says to be kind to yourself, but no one thinks running is being kind to me and would rather I didn’t, but at the end of the day, you need to listen to your own body. Running when I needed to was – is – being kind to me. There is no evidence either way to say running is good or bad when trying to conceive, although I do agree too much (for me at least) isn’t conducive, and I had continually said I would stop in the two week wait (tww), but up until then if I needed to, I needed to. I think it is important to remember that being kind to yourself isn’t atypical and “same size fits all”, it isn’t just spa days and sleeping in and watching all the TV and films and eating everything and anything you fancy – being kind is listening to yourself and what you need. Sometimes I needed a lie in, sometimes I needed a (ok all!) the doughnuts, and sometimes I needed to run at 1am. Although, I will say that I didn’t realise *quite* how dangerous that could have been running with mild OHSS, AFTER egg collection – I stopped when I felt serious pain, but essentially ran right up to our transfer day…!

And what about James, I hear you ask?! I can’t even begin to describe how much of a rock he was throughout all of this.. give or take the odd fuck-up-morning alarm situations/inability to have a clue what was going on despite being at the same meetings as me (#men 🙄😂) – I am the “expert patient” after all…!! I know I am lucky to have him, and he is a true gent always, but throughout all of this he was incredible. He worked so hard to try and “keep the peace” – to keep me calm and sane. He cooked, he cleaned, he worked, he shopped. He was quite consistently in touch with me and checking in. He prepped meds or injected me when I couldn’t. He walked Rufus, and literally held my hand all the way, figuratively as well as literally. He made me laugh, and cracked me up with coining terms (alongside an IVF friend) like “Dildo Cam”/”Fanny Vision”/Uterus-tube/Womb-with-a-view for the transvaginal ultrasound you are subjected to as a woman throughout fertility treatment. I think this stolen image best sums up his part in it all (& quite literally how I am with him after!!) – seriously these illustrations are a perfect sum up of it all!

And so, we did indeed go through with a 5 day transfer with a top quality blastocyst…. there is another blog to come on the outcome (this one is already long enough!) but what I will say, is that, IVF, just like any other fertility treatment we have tried, I felt had failed straight away. As soon as I trigger ovulation my boobs get sore, literally straight away, like they do about 2 weeks before I have a period. The evening of our transfer I had some cramping, and the following day I had some huge cramping just trying to walk the dog and I was constantly light headed. About 4 days after transfer I awoke in the early hours to horrible agonising lightening bolt like cramps flashing across my tummy. Was this implantation cramping? I hadn’t expected as much pain for that – and who knows even now what it was!

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