Two Cycles, Two Chances

I think we will probably proceed with IVF next cycle, all being well.

I got down 4 bag/boxes of saved baby stuff yesterday. I haven’t been through them, I’ve just put them into the cupboard in our bedroom, ready to clear out. I thought about bringing it all down, but we have a high chair, car seat, cot, and a whole load of other large items up there that will just be in the way down here. So for now, they wait.

I’ve also made a list of things to do “when we get to the end”, which includes things like going out for a commemorative meal, a trip to starbucks (no guilt, yay!), clearing out my pregnancy test stash, reading three novels I love, finding a piece of memorial jewellery, and some pampering time for this poor body that has tried so hard to do what I wanted. Also on the list is to order the baby name plates that I’ve been putting off for over three years because I wanted to make sure we got three that matched. Now, it won’t matter, so I will have my two and hang them proudly in the hall.

When I was little my parents had name plates for both of us in the kitchen. They were blue and white and contained our name, date of birth and weight. There was also a tiny picture of a clock in the background and the hands pointed to the time we were born. They were hand painted and they were so significant to me. In an emotionally empty house, they were a sign of the fact that our parents had taken note of the event of our births, despite their emotional distance from us, especially as we got older. I’ve wanted to get them for the boys for so long, but have held off, and held off, always waiting for the brother or sister to arrive so I could order them all together as a set. I can release that burden in a few weeks.

I won’t reproduce my list here, as there are some personal things on there I’m not even able to share on a blog, but it’s a meaningful set of things I need to do for me, a passage from one period of life into another.

I’m also giving myself full permission to drop out of life, and spend three days crying in bed if this doesn’t work out. It’s my right to grieve in that way and I will make sure I let that grief out at the time so that I don’t end up breaking down and crying in the middle of a random conversation in the playground, or while I’m out shopping or something, two months down the line.

I don’t know how I’m going to feel when I get out of this perspex secondary infertility prison, but I’m hoping I can carry a little bit of the feeling of relief and, in a strange way, excitement, that I feel right now, through the tears that might (very probably) be on their way. I hope I can remember, amid the awful feeling of loss for that person our family never got to meet, that moving on is the best thing to do for all of us. I’m writing this down now, so hopefully I can read it back and remember that we chose to move on. That life should be about more than just trying to conceive, and recovery from miscarriage. That each person has their limit and I don’t want the focus of our days to be on each cycle and whether or not it will work, or each pregnancy and whether or not it will hold.

A book

Over the last few days I’ve read a little book called “The Life Changing Magic of Tidying Up”, by Marie Kondo. Those of you that have been here from the beginning will know of my love of minimalism and decluttering. Well, this book is probably the best book I have ever read on the subject of letting needless possessions go. I love her quiet, considerate approach, her attention to detail, the way she talks about our possessions as being something we should care for and look after, and her tales of her own thoughts and feelings about keeping things tidy in her life. It’s just wonderful.

I have been inspired, all over again, to return to the work of paring back the things we no longer need. We’ve donated/sold/thrown away probably in the region of 1,000 items over the last few years and our house no longer has a ‘Room of Doom’, and our loft is tidy and organised. I love the feeling of space and neatness that comes from having less things.

This book has such significance and meaning in it for me, especially given our current position. Marie talks about handling each item in your house and asking yourself:

Does this item spark joy?

And letting go, with thanks, anything that doesn’t.

The thing is, aside from the stockpile of baby things that I know we need to let go of if I am to move on, there is also the mental attachment to the process of TTC. It is almost a part of my identity I have been so absorbed in it for so long. I can barely remember who I was before I started. I had a much greater sense of humour, and a much healthier outlook on life, I know that much. I also had bigger goals and bigger dreams.

So, in a way, in addition to handling our physical possessions, I have learnt something else from this book. Does this item spark joy? When it comes to trying for a baby, no it does not. It really doesn’t. There is no excitement, no anticipation, no hoping and dreaming, only plodding with heads down. And pregnancy – does that spark joy? No. It comes with endless, overwhelming fear. Fear of miscarriage. Fear of loss. Fear of bleeding after childbirth. Fear for my own safety.

So, I must remember this. I must remember, if I am devastated by the failure of this cycle AND the next, that there is an alternative. I must remember that I do not have to spend my life grieving. I must remember that I can move on and I can even say thank-you for what all these losses have taught me. Self-care, unconditional all-consuming love for my miracle children, awareness of diet and exercise, strength in my marriage, belief in myself to deal with adversity, compassion for others, and overall, an understanding of the frail, fragile line between life and death that none of us should ever take for granted.

Talk Talk

DH and I talked through all the IVF stuff yesterday. It was nice to have a proper heart-to-heart about how we’re both feeling. We’ve lived with this for so long that a lot of the time we never mention it. A failed month is just a passing comment and a few tears. A pregnancy announcement is just an eye-roll from both of us.

I struggle to share my feelings (in real life), so tend to keep everything bottled up, even from DH. It was nice to talk about it all.

So, we’re still not sure what to do. DH has reservations about IVF (albeit different from mine), but he says he is truly on the fence about it, as I am. It’s a crazy place to be, but I think we’re both just so tired of this big thing being in our lives that we don’t want to really deal with it at all anymore. We’re not committed to the ‘fight’ like we used to be.

Interestingly, DH shared a theory he has about why it hasn’t worked for us. He thinks that because I had quite a traumatic time with DS1 at the birth (I lost almost 3 litres of blood), and then when we started trying for no.3 I got pregnant immediately but ended up almost dying from blood loss during the miscarriage at 13.5 weeks, that my body somehow recognises a pregnancy from him as a threat to my wellbeing and won’t support it. He thinks that if I were to sleep with another man, I would probably get pregnant and carry to term immediately. As odd as this might sound, our bodies do have a memory of sorts, because that is how antibodies work after we have had an infection such as chicken pox or measles. And it’s how vaccines work too.

DH says he knows a doctor would laugh this idea off, but that it just might be in 50 or 100 years time when the whole process is better understood that there is something in what he is saying. We agreed that if that really was the case, then so be it. We can live with that as an explanation – especially because nothing else has turned up anything, and all people seem to do is tell us how healthy we both are. And we’ve gone from magically being able to have kids to having three years of loss, loss, loss.

Anyway, we have until next Wednesday to decide – that’s the day before my setup appointment and probably the latest I can cancel it. On the day I have to pay the cycle fee (over £3,500), and that’s pretty much the green light.

I spoke to the clinic this morning and my AMH won’t be back until Monday, which for some reason I’m desperate to know the result of.

Sigh.

I think we’ll probably do this, just so we know we tried everything. The only issue we have is if we are lucky enough to get extra eggs – do we freeze them? If it doesn’t work, would we try a transfer? We both want this to be OVER. We’re worried about getting sucked into trying longer and longer and longer.

We’re both in agreement that we’re done with the trying. We want to move on.

I think whatever happens now, it’s time for me to get all the pregnancy and baby stuff out of the loft, collect all my various bits and bobs up and get them ready to use or donate/sell. We both want a clean break and we need to mark that clearly in our lives.

This Cycle – Bust or Not??

There was one more piece of information from yesterday’s consultation that I’ve been obsessing over.

They checked my ovaries to see if my cyst was gone and everything looked okay. It wasn’t a thorough scan, it was a swish around look, and a quick follicle count. They took no measurements or photos.

When we were chatting afterwards and I said I was expecting my period in two weeks (I’m on CD15), the consultant said:

I think you’ve got a little longer than that to go, you don’t have a dominant follicle, so it might be longer than two weeks.

I don’t have a dominant follicle.

A dominant follicle usually emerges about day 9 (as far as I can tell), and then grows some more and releases the egg a few days later.

According to fertility friend’s crosshairs (and my own observations correlate), I ovulated 3 days ago, on CD12.

Now, they should have seen the corpus luteum, but they didn’t (although they weren’t specifically looking for it). They didn’t see a dominant follicle either.

So, no corpus luteum and no dominant follicle means an anovulatory cycle.

Here’s my chart:

febchart

So… for me, it’s not the clearest chart I’ve ever had. My temps are usually 80-90% below 97.9 in the follicular phase, and this month I’ve had a lot of weird highs. I am attributing that to the cyst that has “resolved” possibly interfering with my hormones.

However, I got definite egg white cervical mucus on days 11 and 12, along with three days of ovulation pain (primarily on the right, but I could feel the tenderness in both). I also got a very dark, positive opk on CD12 (I usually ovulate early after miscarriage, so that it normal too).

My cervical mucus has dried up completely, and my ovulation pain has all gone. I’ve got that mild, low backache I always get after O and I feel 99% certain that I’ve ovulated – I wouldn’t even have questioned it if I hadn’t had the ultrasound done.

So what does the scan mean?

Could they have missed the corpus luteum?

If I haven’t ovulated, why has my temp gone back up?

I feel really sad that this cycle – this one I had planned, with all our efforts at eating better, the juice fast, the diligence, the constant attention to everything that might impact my chances – might be a total no-goer.

Especially as it’s the last cycle before IVF, if we go ahead.

Pfff.

Oh well. We’ll find out soon enough.

Information Overwhelm

We had our IVF consultation yesterday and I am just overwhelmed with everything about it.

DHs SA was excellent
He has some great swimmers. He has way above average for count, motility and morphology.  Great news, although makes me feel a bit rubbish about my eggs clearly being the issue.

My 5cm post-miscarriage cyst has gone
Hurrah! Dr Bird was really pleased about that. She said: It was a big one too!

My follicle count was great
I have tons of them. At least 14 in total on a very quick eyeball of both ovaries when they checked my cyst. They were nodding with big smiles as they totted them all up. They said my lining looks great and my ovaries look great, and everything looks “very healthy” in there. (Why is all this proving so bloody difficult then??)

We have a 20-25% chance of success with IVF
This seems higher than average to me, but it’s what the consultant said, so I’ll take that.

If we opt for 2 embryos to put back (if we get 2), we stand a 1 in 4 chance of twins.
I’d take twins any day, and DH agrees, so that’s no problem.

We have a set-up appointment booked for next Thursday
This will cover how to use the meds.

We are ready to go on day 1 of my cycle, which is about 12 days away.
Dr Bird was super-accommodating in getting us all ready to go for my next cycle because she knows how much we want to move forward. She really was amazing about it all.

She has recommended Progesterone and Prednisone (steroid for immune system) should I fall pregnant.
I’m okay-ish with this. Okay-ish. I hate taking drugs. Hmm.

She recommended an endometrial scratch in the cycle proceeding as it increases implantation rates.
I’m booked in for this next Thursday, but I can change my mind. This is a bit of an issue for me, because obviously, I am hoping to be pregnant. Also, I think they give antibiotics as a “precaution” afterwards to prevent infection, but a) I never take antibiotics and b) if it could cause infection, is it really worth the risk? It’s a good procedure for those with recurrent implantation failure, but I think my body tends to implant okay, and reject eggs that are no good. I kind of feel that I don’t want to mess with something that isn’t broken, and I think extensive walking is a great way to increase circulation and blood flow to the uterus, but she is keen to throw everything at this one cycle if we proceed. So… I’m still deciding if I’m going to have this or not…

She recommended EmbryoGlue
Yuh. Really. It’s a culture that mimics a chemical produced in the implantation window. It costs an extra £100 and again she said we should throw everything at this cycle to make it work. I’ve done some research and am not convinced about it. Meta studies seem to show only a mild increase in live birth rate… Still deciding on this one too.

She said it’s highly unlikely we will need ICSI, given our history, but that we needed to decide if we might want to use it if something goes wrong ‘on the day’ and fertilisation doesn’t occur.
We said a definite ‘no’. Aside from the correlation with birth defects shown in studies, I just don’t want to go down that road. If none of my eggs fertilise, that’s not something I think ICSI will fix. We clearly fertilise eggs all the time, so if they fail outside the body, then I can accept that it just wasn’t meant to be, for whatever reason.

We’re not even considering PGD
It will double the price (which we can’t afford), but also there is a chance of a false positive (i.e. an egg identified as abnormal that isn’t), due to mosaicism in older women’s eggs. Given that the only test I’ve had done on a lost baby was chromosomally normal, it’s just not something we want to consider.

They’ll raise a script for my drugs at my set-up appointment, so I just have to order them.
That’s almost £1,000 worth of meds… They will be delivered and ready to use for day 3 of my next cycle.

All in all, I came home so overwhelmed with information that I pretty much ignored it all and instead had a glass of wine and binge-watched Walking Dead.

This is suddenly very real, very imminent, and very expensive.

I’m waiting on my AMH result, which will come in on Friday hopefully. That, plus my official follicle count next week will determine the level of meds I need to take, but Dr Bird said she anticipated the highest dose (fear of OHSS runs through me).

So, today, I only have facts, no thoughts. Add to that the fact that I am overrun with other stuff at the moment and the housework and laundry are a mountain the size of K2, I’m not quite sure when I’m going to sit down and think about it all.

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