Oh My God - I won something!

Hello lovely readers,

I expect you are hoping for an update on my IVF cycle; it's coming tomorrow I promise.

Now onto to really important matters, I have been nominated for my first ever blog award. Yes, you are right, it is just too exciting for words.

The most lovely and wonderful Aislinn from Baby Making and the stupendously super Jenni at Unconceivably Blessed have nominated me for the Super Sweet Blogging Award. Yikes! Thank you so much ladies, I am not sure I can handle the responsibility but I'll give it a go. 

As with most great things in life there are some rules. Right, here we go....



 Thank the blogger(s) who nominated you.
Oh ladies, thank you so much. It is so lovely to know that you thought my blog worthy of sharing it with others.

 

 

 

 Answer 5 super sweet questions. I have done this below.

 

 

 Include the Super Sweet Blogging award image in the blog post .

 If you look very closely you will find the image towards the top of this blog. It's a bit like Where's Wally but hopefully a little easier.

 

 

 Nominate 12 other bloggers

Okay I know I am going to struggle with this. I am really just finding my blogging feet but I hope I can manage a few.

 

Now for the Super Sweet Questions:
1. Cookies or cake? Gosh, what a question! For those of you in the UK, this is very much like the Daddy or chips question. For those of you who don't know what I am talking about, a clip that will explain all is below. It's great. Even though it's a tough one, I am going to go with cake.



2. Chocolate or vanilla? Has anyone ever gone for vanilla? This is definitely not a Daddy or chips dilemma: chocolate all the way.

3. Favourite sweet treat? Ummm...hmmm...ahhh...tough. I have just gone through an eclair phase, so I guess that would be it right now. I am hoping the eclair phase was Gonal-F related because I can tell you an eclair a day does no favours to your waistline.

4. When do you crave sweet things the most? I am not sure I do crave them. I just really like them and don't have the will power to say no to myself. Having given up cigarrettes and caffeine I can say cravings can be mean. With sweet things I quite often think "hmmm, that would be nice" and that thought it quickly followed by "ohhh, go on then, I am sure you deserve it".

5. Sweet nickname? Okay, I couldn't think of any. So, I asked my husband and his response, and I am quoting, was "oh, I don't bloody know". Huh, charming. Hmmm....I am feeling pretty boring without a sweet nickname. Maybe I could make one up now? I am feeling a bit old for a new glucose-laden title but lets see......hmmm....still nothing. Okay, back to the husband.

Me: hypothetical question dear, if you were going to give me a nickname what would it be?

Him: Chook

So there we have it. Chook. In case you don't know what that means the Urban Dictionary tells me it is an Australian slang word for chicken. In case you are wondering, there was no explanation - just chook.


Right, that's the questions done. Now for the nominations. I can tell you know I won't make 12 but I am going to go for as many as possible.

• Sadie at My Invincible Spring is just amazing. She writes so beautifully. She was the first person I came into contact with who had a similar loss to my own. I am so thankful that she found my blog and so grateful that her posts are full of optimism, hope and love for her son.

• The Infertile Chemist writes an excellent blog. Ever want to know how pregnancy tests work or what all the meds do? Check out her blog, her explanations of the science stuff are great!

• Lauren at On Fecund Thought is another truly lovely writer. I love her blog. She writes with such insight about the really tough stuff. She also helped me figure out how to fix my comments for which I will be forever grateful. We have so many random connections it is strange but lovely too.

• MrsDJRass at Baby Baby...Please is a new blog to me and I am really enjoying it. She has just gone through a frozen embryo transfer so I expect she is going through crazy hellish mind games right now. Go now quickly and congratulate her on getting this far.

• Cindy at My journey through infertility, pregnancy & loss has been a great support. She is starting a cycle to do a frozen embryo transfer and also suffered the loss of her daughter Olivia. Her posts are often a testament to the love she feels for the girl she lost.

• Lisa at The Pursuit of Pregnancy left the first ever comment on my blog and has been like a blogging mentor to me. She introduced me to ICLW and to some great blogs, but, best of all, her blog is beautiful. I love reading about her pregnancy and it is so inspirational to see someone make it to the other side infertility.

• Maria from Gutter to Stars has a very interesting blog. She is currently completing her PhD and loves science too.

• Ariel at Journey of a New IVF Mum is another information led blogger and she has come through IVF and has achieved the holy grail. Yes, she has a baby!

Okay, I know that is no where near twelve but it's late and I am tired (it's been a long exciting day). I hope the Award Police don't come and take my award away. Also, I am curious, who starts these awards?

Nine

Nine. That's how many eggs we have. For those who are excited by numbers I can tell you that nine is two more than seven. As I am still in a drug induced haze, this won't be an overly flowery or descriptive post, I  don't want to scare you all off by going all Dali on you.

If I wasn't so addled I might tell you about the charming hotel we found just behind Baker Street or how staying in London the night before added an flavour of holiday excitement. I would mention the lovely Spanish receptionist who checked us in and my attempts to impress her with my rusty Spanish. I am certain that I would write that she was still on duty when we checked out and that she was too sweet when she told us she thought we were a very kind couple and much nicer than her average guests. I am pretty sure that, if I wasn't lazing in front of trash telly, you would hear about how smoothly everything flowed at the clinic; the kind elderly anaesthetist who explained how he got real joy from working within in NHS; the friendly embryologist who detailed how he uses Eeva and when it can be helpful. I would tell you about the simple lunch we had in a cafe on the way home but, most of all, I would shout out that I am so happy, overjoyed, excited and thrilled. Happy we got this far, overjoyed that we got nine not seven, excited that tomorrow I will know if we have created new beings and thrilled that we are one step closer to parenthood.

Counting my chickens

"You can get dressed, come through and we'll discuss the findings."
 
Once those words are spoken I exhale and wonder why my doctor always says "the findings". Am I his lab rat? It's just so, umm, experimental, I suppose. I brood over it as I hop down onto the lino flooring. Leaning forward I separate the jumble of clothes left dumped on the metal chair, promising myself that next time I'll fold. The phrase flips over and over in my mind; I decide that I am okay with it. At least, I muse, it sounds as though he is taking this baby making extremely seriously. Pulling my jeans over my cold knees I try to imagine what I am going to hear. My mind flips back to a few minutes earlier, I think of the click-click-clicking of the button as Mr T flipped through the dark spaces that represent my follicles. Just moments earlier, I was staring hard at black follicular spots on the screen, my neck ached from the strain as I tried to count them all. But, as always, the doctor was too fast for me to memorise the numbers that flashed past or to note all the little white lines that marked the spots. Click, click, click, click, click and we were done.


I close the examination room door behind me, attempt a confident smile and place myself on the seat opposite the doctor. Clattering from his keyboard fills the tiny room as he inputs the findings from my ovaries into an electronic file. I breathe slowly, notice the expensive watch skimmed by an expensive shirt and use the spare seconds to silently speculate about what car he might drive. I am just deciding on Mercedes when my train of thought is broken by his eyes flicking from the screen and directly toward me; my mind whispers "stay calm, look confident, relax". I wonder why I so desperately feel the need to maintain my composure in front of this man. He starts to speak and I nod mechanically.


"Your current cycle is quite different from your last."

I continue nodding, "Oh."

"Your last cycle was very good, you had plenty of follicles and we retrieved 16 eggs."

I'm still nodding and force a smile, "Oh."

I wonder if I am nodding too much, shift my position in the chair and brace myself for bad news.

"This time you have 7, maybe 9, follicles and we would expect to get approximately 7 eggs."

I am not nodding anymore, "Oh."

I blink through his explanation that every cycle is unique, that it doesn't mean there is anything wrong with me and that if we did another cycle it may all be wonderful again.

My mind screams: Another cycle, doctor?


Mr T continues to rattle off the plan from here on in: one more day of stimulating my ovaries, two more days of suppressing the egg release and then, finally, the trigger. Yup, we are at the big one. The trigger shot will help the few eggs to mature and get ready for collection on Friday. Yes, on Friday!


As my ovaries no longer seem to be enjoying the IVF game, the considerable meds I bought from the dodgy perfectly respectable Internet pharmacy were not nearly enough. Mr T takes me down to the nurses' station and arranges for more drugs to be sold. I make a mental note that I will have some updating to do on my IVF cost tally.  


I thank every one in the clinic, including the receptionist and the doorman from the apartments opposite, at least ten times each and head back to the underground station in the rain, hoping for a miracle on Friday.

Uncovering revolutions in IVF treatment

Firstly, I want to say thank you to all the people who commented on my previous post regarding the extra treatments my IVF clinic offers. There was some confusion between Google+ and me; unfortunately Google+ responded to my attempts to understand it by removing most of the comments from my blog. So if you need to know where your comment went, you'll have to ask Google because I'm not exactly sure. On the upside, I think I have managed to stop restricting my comments to Google+ only. Thankfully, all your lovely comments are still stored in my account but I have no idea how to link them back to my blog, sorry. I did read them all and they were very helpful; I appreciate that people made the effort to respond to my request for advice.


Okay, back to my normal blogging self:


The days following my fertility specialist announcing that I could improve my chances of achieving pregnancy by intently studying the embryos and/or by gluing them to my uterus, I was a little confused. I asked for your advice and you didn't disappoint, thank you. I was advised to find out more about the procedures before I committed, so that's exactly what I did.



Currently, there are two companies that are offering systems in the UK that analyse the earliest characteristics of developing embryos: Embryoscope and Early embryo viability assessment (Eeva); both technologies monitor early cell division events using time-lapse imaging.


Time-lapse imaging of embryos was first developed in the mid-1990s. Initially it was used as a tool to study embryo movement and development. In those early days, scientists hooked up videocassette recorders to culture incubators and captured the exact sequence of events after sperm met egg. As the research advanced, scientists investigated how early cell division characteristics, captured by time-lapse imaging, could predict the embryos destiny. After beavering away in their laboratories for many days, possibly months, the scientists made a breakthrough discovery: the timing of the first developmental events after fertilisation correlated well with blastocyst formation. Embryos whose fate it was to develop into beautiful blastocysts had a very defined schedule for each of the critical mitosis events. Building on these early observations, investigators have developed software systems, which incorporate fancy mathematical algorithms, that accurately predict which embryos will arrest and which will survive. Amazing, right?

Not only it is now possible to predict blastocyst formation but studies have shown that, using these advancements, embryos likely to yield pregnancies can be identified prior to transfer. Remarkably, transferring embryos that were rated as high, using an imaging system, led to a 66% pregnancy rate. In contrast, when embryos were transferred that were rated low only 8% of women became pregnant.  


For me, the most fascinating element of these new technologies is the apparent correlation between embryos that are predicted to be poor and the presence of chromosomal abnormalities. Two studies (here and here) have demonstrated the cell cycle and fragmentation patterns, identified using time-lapse imaging, are diagnostic of faulty chromosomes.


The results from these studies sound wonderful and they are certainly extremely promising; it would be difficult to deny that this really is astonishing science time. However, no one has published any studies or clinical trials which demonstrate these imaging systems are better than an embryologist at predicting which embryos will make it to blast; my clinic is super confident that their embryologists are excellent at choosing embryos for transfer. The truth is that there have been absolutely no clinical trials published assessing whether these technologies increase pregnancy rates when compared with current methods.  



A review of the use of time-lapse imaging for embryo assessment, published in March this year, concluded "before time-lapse markers are to be implemented in the clinic, additional clinical validation of their safety and efficacy and their measurement/quantification technologies is urgently required".



The FDA also seems to be under the impression that treatments should demonstrate efficacy prior to routine implementation and, not surprisingly, has decided to wait to evaluate clinical trial data before licensing the technology in the United States.


So why are these systems already in use in European clinics? I asked my fertility specialist that very question; he argued that couples should have access to all opportunities to increase their chances of success. I am unconvinced that, usually pretty desperate, couples should be expected to pay for unproven treatments. Sure, if the clinic wants to boost their success rates and offer it to their patients for free then I'm all for it. Now that I am there, I know that, even though the science is shaky, I want to do everything, even irrational things, to increase my chance of pregnancy.

I think Dr Sue Avery, from the British Fertility Society, sums it up perfectly (play the clip to find out what she says):




Source

I guess I am struggling with the ethics of it all. I am also worried that these scenarios will become more common in the British health system as an increasing number of services are privatised. Good ethical policies in medicine and science are so important and I fear that sometimes the desire for money triumphs over reason. This weekend an argument over the patent granted for this technology has erupted in a British newspaper. The United States Patent Office has recently granted a patent whose claims include the monitoring of embryo division. How can that be? Is it ever okay to patent the measurement of naturally occurring biological processes? I am extremely keen on the idea that innovation and invention is protected by patents, and I would applaud a patent that covered the use of the mathematical algorithms or the imaging software, but the processes that underlie life itself? Should they really be able to be covered by patents?

I don't know the answer. Maybe you have some ideas and opinions about what is and isn't acceptable? If so, do share.


My doctor also suggested we try EmbryoGlue and I have done some research on that too. However, this post is getting quite long now so I am signing off and will cover EmbryoGlue in a separate post.


Side note: I did read the patent and I am not sure that the claims are as extreme as the newspaper article would have us believe.

Mo' money, mo' problems

Last year, when I took my slightly battered car for its annual service, the mechanic cheerfully informed me that I needed four new tyres. He kindly explained that standard tyres would be acceptable but extra special non-slip tyres would be so much better. He thought that regular tyres were okay, of course, but, if it was his car, the better tyres would be fitted without a doubt. Towards the end of our discussion, just as I was leaning towards the fancy tyres, he dropped in that the better tyres also had a mightily spectacular price. Hum, decision made, I was pretty sure my little car will be alright with the basic tyres. 

Haven't we all enjoyed similar conversations with garages, or car salesmen, or even kitchen fitters? However, I was knocked-off-my-feet surprised when I had the same experience with my IVF clinic. Yes, I am not joking, it really did happen.


Yesterday I went for scan number two of my current IVF cycle. There were the usual dilemmas: Is it acceptable to make small talk whilst the doctor is lubing up a condom? Can I shriek "Youch" when he presses too hard on my left ovary? Is it okay to ask why my doctor decided on a career where he spends most of the time looking into ladies' private parts? You know, the usual stuff. But on this occasion, during our familiar wind down pleasantries, Mr T looked down at his hands and started to mumble. There was clearly something on his very thoughtful mind. Huh, he's got something awkward to say, I thought, wonder what it is? I hope I haven't got a large growth hiding in my uterus. The doctor shuffled in his chair, frantically tapped away at his keyboard and finally brought up the subject of two "optional" treatments. What?! There's more stuff they can do to me? Well, as it transpired, not me exactly.


The first addition up for discussion was Early Embryo Viability Assessment (Eeva). If you think it sounds fancy, that's because it seriously is. Eeva is a method of continuously monitoring embryos during their first moments and days of development. The very scientific theory goes that by scrupulously watching their every move and division you can tell which embryos are the good ones. And, based on a complicated mathematical algorithm the embryologist can, potentially, choose that elusive embryo capable of yielding a golden pregnancy. Good, huh?




Source


The second super-dooper IVF improvement is called EmbryoGlue. Yes, the marketing bods really have named the "optional" treatment EmbryoGlue. Who is going to turn down the opportunity to glue their embryo to their uterus? The science is a bit, but not much, more complicated than just gluing one thing to another; it involves adhesion molecules and carbohydrates but, in a biological sense, sticking things together is exactly what it does. A-ma-zing! Just look at the title of their movie clip. Who wouldn't want that?



Source


What's the catch? Well, there really isn't a lot of evidence that either of these things will definitely make me a pregnant lady. And, not surprisingly, they come with some pretty yikes-inducing price tags.
 

As I listened to Mr T enthusing over the benefits of these two IVF advancements, I couldn't hide my scepticism; I was the same with the mechanic. As my eyes grew wider and wider, my lovely fertility specialist finally cracked and said "Well, it certainly won't hurt". Losing control of myself for a moment, I let out an involuntary snort - always attractive - and Mr T conceded that it would most definitely hurt my pocket.


So it has come to this. I am forced to make decisions about whether I take the gamble and pay the money for experimental treatments that might - Mr T says probably - improve my chance of a pregnancy. I can't help feeling that this shouldn't be my decision. Surely this is either the best treatment, in which case sign me up, or no-one really knows, in which case, do the bloody trials.


The cost for both treatments would be £1200 (approximately $1800 USD) and, if I choose both, could increase my pregnancy rate from 50% up to a staggering 80% (possibly).


If I turn it down and I don't get pregnant will I beat myself up and think I should have done more, spent more, tried harder? Of course, the lovely fertility specialist was very careful to say my current plan, without the bells and whistles, is perfectly good - nothing wrong with it - but, in his opinion, the extras would make it better.


I don't know, I really don't. Any advice? What would you do?

ICLW - May

Oh dear, I am late. ICLW started yesterday and I'm only just getting my post together. Oh dear, I hope all you lovely ICLW visitors didn't arrive en masse at some point during the last twenty four hours and I have missed you all. Let's believe that isn't the case and carry on as if I'm right on time.

WELCOME TO MY BLOG

First a very brief introduction: My wonderful, supportive and courageous husband and I are currently going through our second fresh IVF cycle; there was an unsuccessful frozen cycle in between. During my first IVF cycle, which was magical and terrifying in equal measure, I became pregnant with identical twin girls. The babies shared the same sack; it was a complication that almost certainly led their foetal demise at sixteen weeks and 5 days. I miss those girls every single day.


Now dear ICLW visitors, and for anyone who wants a quick refresher, here is a run down of what you might like on my blog:

• If you have ever experienced a pregnancy loss you might relate to the post "Good days and bad days". And, as an added bonus, it includes a picture of me on my wedding day. Click here to read.

• Those of you going through the dreaded two week wait will nod your heads and smile at my "Could I be pregnant?" musings. Click here to read.

• Anyone who is organisationally challenged, you know who you are, may blush in recognition when the read "Down to the wire".  Click here to read.

• Some people love science, don't they? Are you one of those people who tingles with excitement when you find a new fact of figure? Yes? Well, then get yourself on over to my Operation Big Belly posts. Operation Big Belly is my research mission to uncover what will really impact your IVF cycle. So far we have covered food, alcohol, caffeine and smoking. Some of the discoveries have been predictable but many quite surprising. There is still more to come and I am hoping to cover stress, acunpuncture, hypnotherapy and a few more topics before I'm done.

• Thinking about going through an IVF cycle and want to know what's in store? Then you might like to check out my posts on my first step (although, be warned, my husband thought that one was a bit too surreal), my WTF appointment, the day the meds arrived and, lastly, the post where I think about what we're all thinking right before we hop onto the lovely scan bed.

Go clicking crazy, people. It is my dearest desire, and not so secret wish, that you read one other post after this one. I know it's a lot to ask and I am sure you are really busy. After all you have six comments a day to complete. But please, oh please, oh please do it. Your compliance would make me so happy and it would feel so delightful to find your comments scattered throughout my blog. And, if you leave a comment and your url, I promise to go back and read not only your ICLW post but at least one other as well. I can't say fairer than that, can I?


Oh, just a note: Please leave your url, your ICLW number or your blog name. I really do want to find your blog and, unfortunately, I don't seem to be able to easily find people from their comments.

And finally.....

ENJOY

Back on the big dipper

Why do people voluntarily ride roller coasters? Perhaps if the aliens land tomorrow they will think that, if they base their assessment on the roller coaster riding alone, the people who inhabit this planet are bonkers. The creatures from Mars will see that, before the earthlings climb into the buckets, they are trembling and, once seated, they will scream, nausea will rise from their guts and, if it's a good one, even cry. However, once it's over, you will hear the riders say how thrilling it was, oh it was such an adventure, they'll say; get right back in line and hop on again for one more go. In short, the exciting, thrilling, exhilarating, wonderful feelings outweigh the fear, vomit and scream-inducing gut-wrenching stuff. Maybe that is why couples keep on putting themselves through one IVF cycle after another: the hope that, one day, after all the rain they'll get a turn at dancing in the sunshine.


This week I had the first scan of my current, it's my third if your counting, IVF cycle. I tried to remember how many scans I have had throughout my infertility journey  but I can't, there have been just too many. After the first scan of my last frozen cycle I wrote down my thoughts on the scan process and, lucky reader, you can read all about it below:

 
"On the train back home from my clinic I couldn’t help thinking about how odd these scan sessions are. Maybe it is just me but they are weird, aren’t they? I find it all so awkward and slightly hysterical at the same time. I spend a good ten minutes in the morning checking everything downstairs looks okay, like anyone cares, and the thought that it isn’t pops into my head many times during the day. Then, once I get to the clinic, I spend several moments debating whether it should be socks on or socks off, wondering if it matters, and trying to remember if my nail varnish would be suitable if I do dare to go socks off. Finally, I make a socks on decision, clamber onto the chair, or maybe it’s a bed – I am not sure what it is – and I attempt to maintain some semblance of dignity whilst desperately trying to balance in the stirrups. Once I think I’m safely in, I have to call out “I’m ready” at which point I panic wildly, think Mr T won’t hear me so call out two more times with increasing volume and desperation. The whole humiliating process culminates with, what can only be described as, an eye-wateringly large dildo like probe which, to add insult to injury, gets lubricated and covered with a condom! Then the lights go down, I half expect Barry White to start playing, and we get to spend several minutes examining my inadequate innards. Like I say – odd!"


I had the exact same feelings again this week - nothing changes. Except this time, instead of excited anticipation, I am nervous and a little bit scared. The scan went well, I have 8 resting follicles (that's okay, apparently) and none of my internal organs had left the building - I wouldn't blame them if they had, I think they've had enough. But this time I have prior knowledge of what lies ahead; I know that IVF is hard and it makes me feel like this:

Oh before I forget, the financial round up:

1. IVF meds:    £1092
2. IVF cycle:   £3275
3. HEFA fee:    £75
4. Train fares: £28
   Total:       £4470