We've Moved

The IVF Club has now moved to a new website.

The new website is cleaner, neater and will make it easier for readers to leave comments and post information directly from the site to facebook, twitter and much more!

Starting from Monday 21st September, new posts will start to appear at www.theivfclub.com

Cost of IVF

IVF Costs in Australia

I always thought of IVF as expensive and while I still think it is, it is less expensive than in other countries. For example, in the United States IVF can cost up to around US $12,000.

This is pretty expensive when compared to the cost that Australians pay for IVF. For example, at a leading clinic in Melbourne Australia, the latest cost that I paid for IVF was around $6,900 excluding hospital costs. The hospital costs were $1,900 bringing the total cost of the treatment to AUD$8,800 (US$7,700). That's a massive saving of over $4,000 for Australian IVF patients.

My upfront costs to the clinic were approximately $5,000 including medications. The difference in the cost is explained by the fact that the clinic and the health insurance fund does not charge the patient the full amount and waits to receive the rest of their payment via the government's Medicare system.

Fortunately, my private health insurance covered the hospital costs. I received $3,700 back from Medicare six weeks after egg collection as I had reached my *Medicare Safety Net* threshold. So my total out of pocket cycle cost was $1,300. Expensive yes, but not as expensive as some of my overseas readers who do not get any rebates back.

Interestingly, the Government has announced that they will be revisiting the limits on the Medicare Safety Net threshold for IVF and may cap IVF limits. Details of this are not fully known but what is clear, is that the cost of IVF will be going up.

For overseas readers who do not understand the health system in Australia, the Medicare Safety Net effectively means that I can claim money back from the government from this calendar year because I had already spent a fortune on IVF and was entitled to a rebate.

Tips for Successful Outcomes

Vitamin D Levels Could Predict IVF Outcomes

An interesting study has indicated that women have higher chances of achieving pregnancy if they have high levels of vitamin D in their serum and follicular fluid (FF) after IVF-embryo transfer.

The results of this study was published recently in the online edition of the journal, Fertility and Sterility. The study was conducted on 84 infertile women who were undergoing IVF to assess the link between IVF outcomes with vitamin D concentration.

Whilst vitamin D levels in the Follicular Fluid were inversely associated with body mass index, after adjustments, scientists observed significantly higher rates of clinical pregnancy and implantation when Vitamin D levels were higher.

This suggests that vitamin D supplements may enhance the outcome for infertile patients undergoing IVF as well as improving overall health.

Although vitamin D is known to play a key role in fetal bone growth, its exact role during fertilization and implantation is not really known. There is a need for scientists to now determine the appropriate doses of vitamin D that may help women during the preconception period and during pregnancy.

If you aren't taking supplements, it might be a good idea since it is found naturally in many foods that are not often eaten. These foods include cod liver oil, fatty fish such as salmon, mackerel, tuna, sardines, herring; Vitamin D fortified milk and cereal, eggs.

Vitamin D is also added to milk and is manufactured in the skin as a result of direct exposure to sunlight.

IVF and Your Sex Life

8 Reasons Why IVF Impacts Your Sex Life

It's a pretty delicate topic I know but IVF is not conducive a good sex life. For a start, when you are doing a full stimulated cycle, the following passion killers are likely to, and do, happen:

1. You may bleed for several days after you expect your period to end because you have been taking a contraceptive pill since the start of your period
2. You experience intermittent spotting during your cycle whilst you are taking hormonal treatment
3. Quite likely you may bleed after egg collection and will be feeling quite sore and bloated for a couple of days
4. Your breasts may become sensitive to touch so any foreplay is just out of the question
5. Because you are inserting Crinone Gel to line your uterus, you worry that a pile of it will end up on your sheets (it does!)
6. You decide to avoid intercourse for the for 24 hours after transfer (just in case the embryo falls out)
7. Both of you will continue to avoid intercourse cause you are both scared your partners penis might dislodge the embryo (As if! But as IVF is so darn expensive you both don't want to repeat the process)
8. You then get your period

I think this just about covers the two months when you are cycling. Of course, you do have breaks in between when things get back to normal - whatever that is. But after several cycles of doing this, combined with all that previous experience of trying to conceive, you sex life just diminishes. You know you need it to bring sexy back but it all becomes too hard during this time. Its pretty ironic that this is the case, given that the old testicles need to be used to produce good quality sperm. See my blog on sperm titled Keeping the River Flowing).

The good thing about not doing IVF: Bringing sexy back.

Officially Not A Paedophile

Police Record Check for Would Be Parents

It's official - my husband and I have passed our police record check and we can now start IVF.

The words on the National Police Certificate dated 4th September read "At the data of issue there are no disclosable court outcomes recorded." There are five interesting features about this report:

1. The report arrived within a week of being submitted - not the 10 week delay that I reported in a previous blog.

2. That the word "disclosable" is not even a word since it keeps coming up as an error in my spell checker.

3. That I paid $64 for two certificates that state "At the date of issue there are no disclosable court outcomes recorded." How insulting is that. The report offers the possibility that maybe in the future, I could be in court.

4. This report really it is only relevant for the past, not the future. I could go out tomorrow, commit a terrible crime and quite possibly continue undertaking IVF. No one would be any the wiser.

5. Any other couple who conceive naturally are not subject to getting checked out. Apart from this being discriminatory, it also is a breach of a normal human right which is to bear children.

Diet Plan Working

Weight Loss and Improving Chances of Conception

One week of solid nutritious eating on a low calorie plan and exercising has seen me lose just over 1 kilo over the past week. How exciting! I am now officially overweight not obese. Funny how a one kilo weight loss can move you from being obese to overweight according the a BMI calculator. Psychologically, being overweight sounds better than obese!

In any case, I still have a long way to go. In fact, I am aiming to get my weight back into the healthy weight range to help improve my chances of conception. By my count that means losing about 12 kilos (2 stone). With a bit of luck I should be able to get close to that goal by the end of year. I can then kick start the new year with another round of IVF. I've tried everything else so might as well try the weight loss option which according to research is one of the most significant reasons why IVF fails.

Surprisingly, I have not felt overly hungry. Well - I did for the first couple of days but my body has now adjusted to the portion sizes I am now eating. I am having 5 small meals a day rather than 3 large ones and this seems to have stopped me from thinking about snacking on lollies and chocolate in between meals.

Police Record Check IVF Anger

Police record checks for IVF patients

In an earlier blog, I highlighted that prospective parents planning to do IVF must undergo police records before commencing treatment. I mentioned that I thought the laws were very biased. It seems I am not alone in my views.

What's worse is that now that the new laws have come into effect, according to my IVF nurse there is apparently a 10 week waiting period before the people who have requested Police Record Checks will get them. Seems that while the government has made these laws they have not accounted for extra people to process higher levels of demand.

Fortunately, because of this backlog myself and other women planning to undergo will still be able to do treatment despite not having a police record check. That is a huge relief as it would mean that I would not be able to start treatment until mid November.

There has been comprehensive news coverage about this. For more information, see the article in The Age on IVF.

Still in With a Chance

IVF Conception Still Possible

A visit to my IVF specialist revealed that he still thinks my husband and I will conceive. So despite being nearly 40 and despite my husbands sperm problems, he still thinks this is a realistic goal.

It's funny how a Doctor can be so confident when after 7 failures, you are not. So after asking all the probing questions, he still feels we will get pregnant. Apparently, he has done every test possible to me so from his perspective there is no reason why I should not fall pregnant. IVF apparently helps overcome male infertility issues so theoretically, there is no reason why we shouldn't be able to become parents.

This makes things a little frustrating as it seems everything that should be working isn't. I guess it puts us in no mans land. The other annoying thing is that IVF is not cheap - not by a long shot so every failure means spending more money on another round. Whilst, you can't put a cost on what I perceive to be a joy in having a baby, it does place a financial strain on your budget.

So with this in mind we have decided to continue down this path and try again. Fortunately, we have one frozen embryo left from the cycle I did in January. So apart from giving my body a rest from the drugs it means we will use our last remaining embryo. So if this fails, another stimulated cycle is on the cards. In the meantime, I will continue to focus on having a good nutritional diet, no alcohol or coffee - basically following the suggestions in the Pregnancy Miracle ebook I purchased a few weeks ago.

A Positive Thing About IVF

No need to monitor ovulation

One delicious thing I like about IVF, is that it actually gives me a break from trying to work put when I am ovulating. Seriously! I mean the good thing is that the clinic does all checking and I don't have to monitor anything. I just have to turn up and follow instructions. Given I am a naturally lazy person, this suits me down to the ground.

It also suits me because I work in a job where I am always monitoring everything - from managing and tracking how a project is running to reviewing and analysing sales data. For me, not monitoring anything is like a dream come true! Hand holding at work is not something I enjoy.

Unfortunately when I am not doing IVF, I am back to monitoring and tracking my menstrual cycle. For some reason, I still have some glimmer of hope that I will conceive naturally even though I know that in our case it is highly unlikely. So with this in mind, I now find myself painstakingly recording the results of urine tests and fertility microscopes. The problem is that I've been monitoring my cycle for a number of days and it is now day 19 and I still haven't ovulated. Although this is not uncommon following IVF treatment, I am impatient for my cycle to get back on track.

In any case, my plan of attack has been to ambush my husband and coerce him into having sex with me more frequently. Such a task I know!! He hasn't complained yet but I suspect that he has not really appreciated the fact that he has had less sleep. Such is the joy of trying to conceive.

Crazy Lifestyle Questions

IVF Preconception Care

After several attempts at trying to get pregnant, you sometimes question yourself if there is anything you are or aren't doing right that is hampering your ability to conceive. Sometimes in doing that, you cause yourself unnecessary pain. It's called beating oneself up with negative thoughts about what you should or shouldn't have done. Thoughts like:

- Maybe if I drank a bit less alcohol
- Maybe if I quit smoking earlier than what I did
- Maybe if my diet was better
- Maybe I should have tried reflexology
- Maybe I shouldn't have drunk all those Coke Zero's
- Maybe I should drink less coffee or hot chocolate
- Maybe I am just too fat
- Maybe, I should try reflexology.

Although it's perfectly normal, all these maybes do your head in. I think I have already come a long way from where I was. For a start, I drink a lot less wine these days, I don't smoke anymore, I take folate, CoQ10, Vitamin C and fish oil tablets. I drink a lot more water these days and I rarely drink any soft drinks - diet or otherwise. I've also been exercising regularly for at least the past year or two. Seems to me that a lot of the things I used to enjoy I no longer do anymore.

The one thing I haven't changed is my diet. Actually I tell a lie - it has gotten worse. Since starting IVF, I have been getting progressively fatter and fatter - in fact my BMI has moved from the overweight category and just edged into the obese category!!! Whilst I don't think the hormone treatments have helped my cause, I've noticed that my food portion sizes have increased since I got married. My coffee intake has also increased significantly.

Given that the human body is a complex and finely tuned machine, I have decided to take up the challenge to improve my diet. I will continue to maintain the positive changes I have made in regards to quitting smoking and exercising regularly, but as of today no coffee, only herbal teas and healthy good food choices. I've been reading up on the topic and I think there is a lot of merit in alternative therapies and I think these can be highly successful for some people. Acupuncture is back on the agenda and I might even have a go at reflexology. Now I am not expecting change overnight. I know good preconception care starts about 3-4 months before trying to conceive but if I don't get pregnant within the next year, at least I'll know I have done everything in my power to get pregnant. And that my friends is the only thing that I can do.

What Biological Clock at 40

Back on Board for IVF at 40

Call me ignorant but after months of worrying about not being about to get pregnant before the age of 40, I am not worried anymore.

A sure sign of this is that after months of procastinating with the Police Record Check forms so I can start IVF, I have finally sent my form in complete with cheque. Somehow I don't think I will be getting it back in time for the 1st September deadline when the new laws take effect.

Apart from the fact that my husband's form has not been sent in yet, I imagine there will be a backlog of applications from the late rush of couples who have also submitted their forms. Obviously, holding off like me in the hope that they won't have to do another round of IVF. In any case, I guess it means we might start the next round a little later.

It's strange but I am less perturbed by the later start this time. In the past, I have pushed my body so hard, doing IVF with only a month break in between cycles. Once, I did a cycle back to back with no break. Now that was hard. All of my attempts, of course, have been done in my futile attempt to racie against my biological clock.

But the truth is, I will be turning 40 at the end of September. I am already in the statistically significant, lower end of the IVF success bracket. A delay of one month is hardly going to make a big difference. I think my body also needs a break to get back to its natural rhythm. The scary thing is that I've been doing this so frequently that I don't even know what my natural rhythm is.

Apart, from that IVF is hard - I am in no rush to start again only to get another negative result. I need emotional space to come to terms with the last seven failed attempts. Maybe my birthday this year will not be about trying to conceive - maybe it will be about relaxing and enjoying myself. Now that would be a nice change.

Discriminatory IVF Laws

Police Record Checks for Parents Undergoing IVF

From September 2009, any couple wishing to undergo IVF treatment in Victoria Australia will now need to obtain a Police Record Check and a Child Protection Certificate.

As I sit here contemplating when I will be doing my next round of treatment, I am suddenly faced with the possibility that I need to apply for these various certificates before I can undergo treatment. Given I would like to start treatment again soon, I've decided I'd better get my butt into gear even if I disagree with this repulsive law.

What freaks me out the most however, is that legally, we now have to prove that we are going to be suitable parents. Amazing! I hope that careless driving charge I got when I had a car accident a few years ago ain't going to be held against me.

Actually, I think the aim of the law is stop potential pedophiles from having children. But seriously, putting preventative measures in place for the small minority of couples who undergo IVF ain't really going to solve the problem. Seriously, does anyone truly think that people who spend thousands of dollars on IVF and who experience the rollercoaster of emotions that comes with IVF are pedophiles.

Imagine the public uproar if laws throughout the world were changed so that all couples contemplating parenthood would have to prove that they were going to be suitable parents. Surely, this goes against natural human nature and civil liberty. I for one am opposed to these ridiculous laws that target a small minority of people rather than tackle the actual problem.

Keeping the River Flowing

Tips to Improve Male Infertility

At a recent human reproduction and embryology conference in Europe (http://www.eshre.com), some interesting findings on Male Factor Infertility were uncovered.

One of the studies titled "Keep the River Flowing" was an exploratory study investigating the effect of daily ejaculation for 7 days and sperm DNA damage. Anyway, the study uncovered that 3 days of abstinence followed by 7 days consecutive days of ejaculation, resulted in reduced sperm DNA fragmentation (down from 33% to 21.8%), increased motility and improved morphology.

It was concluded that sex / ejaculation for 7 days leading up to and including ovulation during a normal female reproductive cycle may then increase chances of conception. The implication being that if the same thing was applied leading up to a sperm collection for IVF/IUI/ICSI then the chances of conception may also be improved. There is the usual caveat that more studies are needed to look at this furthr but I don't need any convincing. We've tried many things - might as well give this a go and keep the river flowing as well. My poor husband is going to be exhausted (he works full time and studies part-time)!

Questioning Your IVF Specialist

Questions to Ask After Repeated IVF Failures

After seven failed attempts at IVF, there comes a time when you have to ask some pretty hard questions to your Doctor.

I've been too frightened too ask - maybe I am not going to like what I might hear. But my visit with the Counsellor today did help in exploring what our options and questions we might ask our Doctor.

The questions are:
- Given our history and 7 failed attempts, what is the likelihood of us conceiving?
- Why do you think we lose so many embryos between day 3 and day 5?
- Do you think it has something to do with my egg quality or my husbands sperm?
- Should we try giving Day 3 embryos a go instead? (or Day 5 if relevant)
- Is there any kind of genetic testing that you think we should do?
- Are there any other tests that you think we should explore?
- Should my husband see an Andrologist?
- Should we have his sperm tested again?
- Are there any other alternatives that we should explore?

I am sure there are some that I have missed but these are the questions that seemed most relevant after repeated IVF failures.

Feel free to post any other questions you might have. We can all learn from other peoples questions.

Embryo Debate Continues

Day 3 Versus Day 5 Embryos

The debate between Day 3 or Day 5 embryos continues. I have always done Day 5 blastocyst transfers. The theory being that scientists can monitor the embryo for longer so that they can assess which ones are most healthy. This allows them to process and screen out those embryos that are unlikely to survive and are the most healthier. Although, it is not that they are screened out - they just don't survive.

The risk is that you can lose most if not all of them. Certainly this is something we have experienced. From 19 eggs and 15 fertilised, we were left with only 1 Day 5 blastocyst. The implication being that if this failed to implant we would need to go through the whole process again.

We have now had 7 transfers in total (9 blastocysts) and every one of the them has failed to implant. They say that the definition of insanity is doing the same thing over again. Maybe we are insane. It led me to ask the question of my nurse, should we do day 3 transfers instead. Apart from the fact that she suggested I discuss this with my Doctor, her answer was interesting. She said some women have had no luck with Day 5 blastocysts and have tried Day 3 and got successfully pregnant. Others have had had the same result as Day 5. My guess is that there is no easy answer but I am going to give the Day 3 ones a go. Maybe there are better off in my body than some cultured medium.

Getting Support Doing IVF

A Matter Of Counselling

Yesterday my nurse rang me to tell me the bad news that I already knew. My 5th IVF attempt was unsuccessful. I bombarded her with questions. Should I change Doctors, should I try Day 3 embryos instead of Day 5? Should I do this? Should I do that? In the process of asking questions, I burst into tears.

She was very understanding and asked me if I felt I needed to see a counsellor. I didn't know. I had mixed feelings about it when she asked. I am a strong person. I think I am coping fine but the last time and this time have hit me harder than the other times. Maybe I do need to see a counsellor. The thing is that I am grieving for someone that hasn't happened. No one has died. I know this makes it difficult for people to understand. But maybe I am grieving for the loss of hope or my dream of becoming a parent. Each failure brings this growing realisation that maybe my plans for parenthood are never to be. No - I am not giving up on IVF. I will persevere although I don't know for how long. What I do know is that each failure pushes you in this direction.

With some doubts, I agree to speak to a counsellor and I expect to hear from them next week. However, the Counsellor rang late Friday afternoon to arrange a time. This is happening too quickly but as it turns out, it is not. All Saturday appointments are booked out and the next available weekday appointment is Friday week in the afternoon. I check my work diary and there is a meeting organised. I decide there and then that I don't need to be there. I think I should accept the appointment. I think it is also in the interests of my employer that they have happy people working for them so will discuss this with my Manager when I return to work on Monday.

Oh and what were the answers to my questions. Now that's a long story and I am going to save that one for another day. Stay tuned.

How to Give Support

What Not to Say to Someone Undergoing IVF Treatment

IVF is unpredictable. My Doctor thinks I should be pregnant by now. This makes me feel a whole lot better. Not! The problem with IVF is that the more times you do it, the harder it gets. I am not exactly sure why but I think that statistically the majority of women get pregnant from IVF after 6-7 stimulated cycles. I have now done 5 stimulated cycles and two transfers and I've had no luck. This weight of expectation does not help.

The more you go on, the more there is an expectation that your turn is due. But IVF is never that simple. It makes it hard also for friends and family to understand what we are going through. Often people will say, don't give up. Keep trying. This is probably one of the worse things people can say.

They need to understand that when you get to the point of doing IVF you have already exhausted all other options - there is already a history of failed natural attempts. IVF gets harder the more times you do it. Apart from the money invested with nothing to show, there is also the physical demands on your body and living a life that has become less social and centred around your menstrual cycle and when and what drugs you are going to take. Life to some extent is on hold. You stay in a job with a manager who is critical and treats you badly because you need stability, you need your job to pay for IVF and you want to be eligible for maternity leave in the event you actually get pregnant.

There is also the fact that you are starting to reach a point where you feel you have no control over your body. It feels like your uterus is destined to become a graveyard.

The fact is that there is nothing anyone can say to their friend. Make it clear you are there for them if they need you but don't push it. All they can be is a friendly ear and a shoulder to cry on. Because as time goes on, that shoulder is most definitely needed.

Bring Out the Bottle Again

Confirming IVF Failure

Just as I suspected. I am not pregnant. Another failed IVF cycle. Get me a drink now. A bottle of red or 3 will do nicely thanks.

Whilst my tell-tale breasts gave it all away, my sneaky suspicion was reinforced last night when giving myself a dose of Crinone gel. That suspicion was also confirmed at a visit to ladies room around lunch time today.

It's hard to believe that one could inspect toilet paper so thoroughly!!! Scouring through the folds to see if a flash of red has started to appear. Creepy I know but something any woman I know who hopes to get pregnant has done.

Another failed round of IVF. The last cycle was much more upsetting. After so many failures the expectation of pregnancy diminishes but the hope somehow gets stronger. Surely my turn will come. IVF is a numbers game - hopefully the more times you throw one in, eventually your odds come up. To add insult to the wound, I also have to sit through yet another blood test tomorrow to tell me what I already know. BFN (Big Fat Negative - for the uninitiated).

Expecting a week of intermittent tears. Interested friends - happy for you to make comments on this blog but please don't ask any questions or offer any condolences if seeing me in a public venue - it brings up too much emotion. Me thinks I deserve a red.

Perhaps this is an idea for tomorrow's blog - how friends can handle their fragile friends who are undergoing IVF. Now - where was that red. One glass will do fine given I have not had a drink in ages!!!!

Day 12 Breast Alert

A Sure Sign You Are Not Pregnant

Bad news. Constant breast groping has revealed my breasts are back to normal. They are no longer sore and tender and pumped with hormones. The pimples on my face have gone down only to leave my nose with ugly flashes of red (thank God for make-up).

I take the breast thing as potentially bad news - it seems unlikely that I am pregnant. However, I remain in hope that this is not the case. That hopefully, the lack of tenderness I am experiencing is just a sign that my body has worked hard to remove all those excess hormones that developed as a result of the injections.

I really don't want to think about the consequences of spending another $5,000 on yet another treatment. I am in denial and I am still weeks away from receiving any reimbursement from Medicare for yet another IVF attempt. Next year, some sweeping changes to Medicare will mean that IVF will not get as much favourable treatment so the out of pocket costs will definitely rise. The implications of this are yet unknown.

I contemplate the research I have been doing on IVF and count my fortunes that I do not live in the USA where IVF is more than double the cost of doing it in Australia. I guess there are small blessings in everything. The best blessing though, would be a pregnancy. Who I am kidding!

Day 11 Countdown

IVF, Acupuncture and Male Fertility

I spoke to our Chinese herbalist today. She has been a great source of support to both me and my husband. My husband sees her to help his sperm. His sperm count and motility have improved quite dramatically. However, his sperm morphology and the antibodies in his sperm are still a problem.

I have also been seeing her and have had acupuncture on a regular basis but this is the first time during treatment that I haven't had it. There were a number of reasons for this.

The first was that I have developed an aversion to needles. I am so sick of needles, blood tests and injections that I just couldn't face seeing any more. Whilst acupuncture does not hurt, I just couldn't do it.

The second reason was that my transfer happened on Wednesday. Having acupuncture would mean that I would have to commute for a couple of hours after work in peak hour traffic three times in that week for treatment. I decided, probably selfishly, that my time was better spent relaxing at home rather than stressing out in traffic. Maybe I am trying to make myself feel better about not going, but it sure feels like all her good work is undone when I get back into the car and stress out in the traffic.

On a positive note, my lovely IVF nurse has arranged for me to have my pregnancy blood test on Friday which will be Day 14. So with a bit of luck or misfortune, I will get to find out if I am pregnant... or not.

Normally, the clinic asks you to have a blood test on Day 16 but that happens to fall on a Sunday but the clinic is closed on Sundays. I also think my nurse is feeling sorry for me and does not want to keep me in suspense. Mind you, my period is as regular as they come so I don't think I will waiting the whole weekend to have an answer any way.

How IVF Impacts My Body

Five Side Effects of IVF Treatment

While I am in in the official two week waiting zone, I thought I would share some of the side effects I have encountered during full blown IVF treatment:

1. Acne
2. Bloating
3. Constipation
4. Spotting
5. Sore Breasts

Without fail, my nose has become victim to acne. Apart from the lumps on my face, I get to look like Rudolph before Christmas time.

Immediately after egg collection, my stomach bloats. The bloating usually subsides after a few days but I have been known to bloat for up to 1 week afterwards. Annoying if you are planning on going out to any fancy outing.

This time around I managed to avoid the dreaded constipation. It can however be a problem. My advice - drink plenty of water because it helps in overcoming this problem.

Light bleeding is common after egg collection. Most times it goes away within 24 hours although this time it lasted for about 4 days. My advice is to have some panty liners on hand.

I touched on the topic of sore breasts a few days ago. All those hormones definitely have side effects. The bad news is that if you aren't pregnant it subsides just before you get your period. The good news is that maybe you might actually be pregnant. Just wait the full 14 days before pulling out your test strips.

Breast Groping

Things You Do During The Two Week Wait

I am officially living in the zone of the the "2 week wait." Although, it is actually a 9 day wait it still seems like 2 weeks. If my embryo has survived, it will be 8 days old and hopefully starting the process of implanting itself to my uterus.

I wonder if this means that my breast will start to become sore. Yesterday and today I have found myself groping my breasts to determine if my breasts are more tender than what they were the day before.

Of course my boobs don't feel any different. After every IVF cycle my breasts are always tender. They are not however mind-droppingly sore like when you are pregnant.

I know I will be groping my breasts for quite a few days more. I have become attuned to my body. I know I will checking them, testing them and groping them to analyse if they are more sore or less sore than before. If my breasts, stop being sore I will know before my period comes that I am not pregnant. If they continue to be sore then there is still hope.

IVF On A Rollercoaster

Unpredictable Nature of IVF

A positive situation from yesterday has turned out to be not so positive today. Of the 13 embryos that we had yesterday, none survived!!! None. Not even the one that made it to early blastocyst stage. It is terrible. No fall backs. Nothing. Such is the unpredictable nature of IVF.

All our hopes are pinned on the one that was transferred yesterday. It is not a good situation to be in. If this one fails, then we know we are potentially going to face yet another cycle of IVF. I am not sure when a stopping point comes but sooner or later it has got to happen.

Embryo Transfer Moments

An Embarrassing Incident At The IVF Clinic

Wow. What a day. One expanding blastocyst transferred. One early blastocyst in the making. And drumroll please .... hopefully at least one more blastocyst to come.

The transfer itself went smoothly. The only hiccup was when I went to go to the toilet to empty my bladder and found that someone was already in the toilet.

That's right. The occupant forgot to lock the door. I don't know who was more surprised, the occupant for being sprung or me for finding this woman standing up over the toilet facing the door. The mind boggles. Not how I would use the toilet anyway.

Now my only perplexing thing is that the embryologist told me that there were still 13 embryos going along. You may recall that yesterday my nurse told me that there was 11 with 3 not looking so good. I sure hope they get their stories straight when I ring up tomorrow afternoon to find out the final outcome.

Some other random thoughts about the day and why you know you have done IVF too many times:

- When the admission nurses all greet you by your first name without looking at your file.
- When the Doctor asks you if you would mind if a student watches your transfer and you ungratefully say that's ok but with an attitude that sounds like an imposition.
- You vow to say no to the student next time because news flash! It is an imposition. You don't want any more people looking at your girlie bits even if it means annoying the doctor who is helping put the embryo inside you.
- You start becoming less amazed with the science of it all and more impatient for a result
- You start telling people not to ask you any more questions about how your IVF is going because you know if there is a failed result this time, you will be devastated and "tear up" at the drop of the hat

Day 4 - Fertilization Update

IVF Fertilization Success Rates

There are now 11 surviving embryos. Of these, 8 look good and 3 don't look so good. If we get 8 blastocysts tomorrow that would be fantastic but maybe it's a touch unrealistic.

Today is the first day since egg collection that I feel remotely normal. My tummy is still a bit bloated but the pain has gone. I can walk normally instead of being bent over like an old woman.

In any case, I am booked into admission at the clinic for 7.45am. Bugger - no sleep in. The big transfer happens at 8.30am and then I am off to work. Lucky work is only 15 minutes away from the clinic so I reckon I will only be half an hour late.

I've told my manager and she has been pretty good about it, even offering for me to work from home if I want to. I am not sure if it will help, I work in an office so nothing I do at work is ever strenuous on my body (maybe my mind but that is another story).

It is hard to know what to do. Believe it or not, there is a meeting at work I want to go to. Besides, I've tried taking time off to rest and I have also tried working after a transfer. Neither options have worked. I guess there is no right or wrong thing to do. I think it can happen either way - just depends on the quality of the embryo.

A lady at work got pregnant at 43 on IVF and she had her transfer when she was in the middle of some high level negotiations with a leading retailer. So it just goes to show that it doesn't necessarily matter.

Anyway, the woman in question has now gone on maternity leave and I arrived at work today to find out that she had a little baby boy. I am very happy for her.

Day 3 Fertilisation Update

Embryo Survival Rate At Day 3

The news of the day is that I have lost two of my 15 embryos. We are now down to 13 embryos at Day 3 with four of them a little slow on the uptake. Of course, there will be less by Day 5.

I find myself disappointed by the news. Yes. I know we still have 13 embryos but a lot can happen in the next two days and I really want this one to work. I am praying that we will get more than 1 blastocyst this time since 3 out of 4 cycles have only produced one. Surely all this effort has to produce more than one. Fingers crossed. One day at a time.

Sore Tummy and Ovaries

What to Expect After Egg Collection

Well so much for thinking that I was feeling better from egg collection. The rest and relaxation has been good but it has ruined my weekend in terms of achieving anything. I am still feeling out of sorts with a bloated stomach and sore ovaries.

This is one of the not so pleasant aspects of IVF. I assume it is worse when there is a higher number of eggs collected but given I produce lots of eggs I have not way of comparing.

Usually it takes a couple of days to recover but this recovery is actually taking longer than normal. The key here is to keep drinking water (plenty of it) and panadol (less of it).

Maybe that Panadol I took when I wrote my earlier blog gave me false hope. In any case, I am hoping I am better tomorrow as I am back to work!

Cycle 7 - Fertilization Report

Fertilization Post Egg Collection

Of the 19 eggs collected, 18 were suitable to be fertilised. If those 18 eggs, 15 fertilised. I think that is a good result but last time something like this happened we only had 1 egg left for a Day 5 transfer. Still we were lucky to have 1.

This means I will need to start crinone gel on Monday night before I go to bed. The transfer will at some stage on Wednesday - I will get the phone call the day prior so I know my admission time. Fingers crossed more than 1 embryo will make it to day 5.

A Haul of Eggs

Egg Collection Results

Despite having an objective of achieving less eggs of better quality, we ended up getting what I would consider a large collection of eggs - 19 in total. This makes this collection the second highest ever with the previous stimulated cycles achieving:

- #4: 22 eggs;
- #3: 12 eggs;
- #2: 18 eggs;
- #1: 15 eggs.

Given we had 19 today, I am not sure what this actually means in terms of quality. Maybe this is not a good sign. IVF is essentially a numbers game where hopefully you throw enough embryos out there one of them will stick.

In any case, I feel better today than what I have done in previous collections. I put this down to having lots of rest before and after the egg collection. The big test will come tomorrow. The big questions are:

- How many will actually fertilise?
- How many will make it to a day 5 blastocyst?

So far we have had pretty good fertilisation rates. Whilst there has been a few fragmented embryos, the majority have survived up to Day 3. However, the statistics are more telling by Day 5. Essentially, in all but one cycle we ended up with only 1 little blastocyst for transfer to my uterus. The last cycle was by far the most successful with 6 little blastocysts in total. So whilst I am anticipating fairly good fertilisation rates tomorrow, the big test will be 5 days from now and of course 11 days after that. Hopefully my number is up and it will be my turn to get pregnant.

The Final Jab

Triggering Ovulation

Tonight heralds the night where I will inject the final needle that will trigger ovulation. I got the call from my nurse and was instructed to use Ovidrel at 9.30pm (EST) tonight. Of course, this means I will be checking in at "Hotel M" (my affectionate term for the world famous IVF clinic) at 10.30am Friday for my egg collection at 11am.

Hubby will also need to produce some sperm when we check in at the "Hotel." It's funny but I never really thought about how he produced his sample but I now have it on good advice that the cubicle where he is to "produce" is well equipped with visual stimuli including videos and magazines. I assume the content is soft porn. Who knows - it remains unspoken as I am sure my husband will not want to divulge this information.

In any case, after an intense couple of days of multiple needles, I find myself strangely looking forward to this last jab. On a personal note, I am feeling fine and not overly bloated which is good. I recall that our objective was to have less eggs of better quality (not 22 of poor quality like last time).

I find myself wondering how many eggs they will retrieve, will they fertilise and will they survive to a day 5 blastocyst. But most importantly I wonder if all these conditions are met - will the little embryo finally implant. This is place where IVF has failed in my last 6 attempts. At yes, time to keep playing the waiting game.

Another Test, Another Dollar

IVF Tests, Scans and Costs

Today marks the third scan and blood test that I have had in less than a week. The good news is that my follicles are coming along nicely and there are now 10 reasonably large follicles (hopefully with some eggs inside of them).

It seems that at certain point, the ultrasound team don't measure the small follicles - just the larger ones. What I'd like to know is what happened to the other 20 plus follicles that were detected only a few days earlier!! I suppose they are still there in hiding.

In any case, that question goes unanswered as I learn that I am scheduled for egg collection this Friday 31st July. This means taking the day off on sick leave and not working at my part-time job on Saturday.

It also means two more injections tonight and two more tomorrow night and then a final one on Wednesday night to trigger ovulation. All good fun. My aversion to needles is back with a vengence. The veins in my arms have gone into hiding. My stomach is looking pretty bruised from all the needles. I am starting to feel bloated and uncomfortable again from my swollen ovaries. My purse is $166 lighter after paying for two more antagonist injections. Is it worth it? Definately if we get a positive result and a healthy baby at the end of it all.

Losing My Medicine

Losing IVF Medication

Oh dear! I am using a new injectable medicine called Orgalutran. This is an antagonist medication that prevents ovulation.

The medication comes in the form of a syringe rather than a nasal spray. The syringe is not adjustable like some of the pen style syringes where you can adjust the dosage. This little baby is all ready to go. In most cases, you are supposed to depress the syringe until the air comes out and there is a little droplet of the medicine at the end of the syringe.

The only trouble is that I pushed it too far and it seemed to me like a gush of medicine came out. At $83 per injection and the risk of ovaluating this is not good news.

Fortunately on closer inspection, it does not seem like I lost more than a third of the medication so I injected it anyway. What else could I do. Its the weekend. I rationalise that it is early days and I only had my scan today and only 2 follicles were 14mm while the other 28 were still pretty small. Since its the weekend and the clinic is closed on Sunday, I will tell me nurse tomorrow.

Annual Leave or Sick Leave

IVF and Managing Work

One of the difficulties in regularly undertaking IVF whilst working full-time is explaining why you are taking time off on sick leave. You know you are going to be in hospital - you just don't know when. This simple fact, can create a myriad of problems. Like for example when I was expected to fly to another state to oversee a TV commercial shoot when I might potentially be in a hospital bed having my eggs collected.

As it happened in that example, I told my manager about my dilemma. I think this may have been around IVF cycle #2. Naively, I thought this may make life a little easier. Bad assumption! Since I told her about my plight, she asked me if I was taking sick leave or annual leave. I told her I had intended on taking sick leave.

My manager's response was most interesting. I was questioned whether I should be taking annual leave or sick leave. The rationale being that she considered the treatment I was having as being "elective." She then proceeded to tell me about another staff member who had to take annual leave (not IVF) when having elective surgery.

Ignoring the ethics of her disclosure, I contemplated her comment for a while. To say I was speechless would be an understatement. I was totally amazed that she had the gall to ask me this. Especially since I know that she herself wants to have children one day. In any case, it highlights to me that we are all really very ignorant of our ability to get pregnant. We take it for granted that it will just happen. I know I did.

But back to my story on annual leave versus sick leave. It was bad enough being asked this the once. But I was seriously offended when this was thrown up in my face on no less than 3 occassions over the course of six months. In end, I had to tell my Manager that I was offended by her comments. I thought they indicated a complete lack of regard for my situation. I hoped that she would never have to face the situation I was in.

On reflection, I strongly believe that IVF treatment should be considered sick leave and not annual leave for the following reasons:

1. Most people I know don't choose to be infertile
2. Like any other illness, a person chooses to have treatment or not.
3. The condition may not be life threatening, but it is highly emotional and it is not uncommon for complications to occur as a result (e.g. Ovarian Hypostimulation, Depression)
4. A doctor issues a certificate for the procedure (I assume this is not issued when undertaking cosmetic surgery.
5. In Australia, the treatment is partially medicare refundable

In any case, I would love to hear the views of other people navigating their way through IVF and infertility. You all know my views but I am interested to hear other peoples opinions on the matter.

Antagonizing Cycle

IVF Antagonist Cycle

I am now commencing IVF cycle #7. This should be interesting. My Doctor has changed the treatment protocol and I will now be having an antagonist cycle???

An antagonist cycle essentially means that at a certain point of the cycle I will need to inject twice daily - the first injection being a follicle stimulating hormone (FSH) and the second being a injection that apparently stops you from ovulating. For those familiar with IVF, the second injection is a substitute for the nasal spray.

The antagonist cycle is more intense but the benefit of this cycle is that it is quicker than a normal IVF cycle. I have been told that generally the aim is for less eggs but more quality. Given I produce a lot of eggs, this should be interesting.

In any case, I had an appointment at the IVF clinic to test my hormone levels and also how many follicles I had. My expectations weren't that high given it is only Day 6 of my cycle and I have been injecting FSH for the last 3 days (although tonight's dose makes it 4).

Fortunately I don't have to have the second injection just yet as the follicles are too small and immature. However, during my ultrasound visit I learnt that I had 18 follicles in one ovary and 9 in the other. Amazing! I only counted 5 of the 18 and expected a lot less at this early stage.

I am now hoping that they don't all mature because there will be hell to pay as I get nearer to egg collection. That many eggs = bloating and sore tummy. My highest number of eggs collected was 22 so with a bit of luck there won't be any more than that.

So my next visit to the clinic will be in two days time. Lucky me - I get to get up early on Saturday morning for an 8am appointment.

Lurking in Toilets

The Inconveniences of IVF

One of the most annoying aspects of IVF is organising your social life around the daily process of needles and injections.

This brings me to the events of last night which were just plain weird. For a start, I was in a library. Now this is not a place I would normally frequent. However, I happened to be at the library because I was attending an Internet marketing meeting on blogging! Yep - and this blog is the result.

In any case, I came to the library prepared with mini esky (ice box), ice pack, antiseptic swabs and syringe in tow. My plan was to escape my meeting at 8pm so I could duck off to the toilet and treat myself to another dose of Follicle Stimulating Hormone (FSH). Just want everyone wants to do. Not!

What was weird about the whole episode was that I felt like some druggie escaping off to get my next fix - especially since I have never been a user of illegal substances.

The location of the library certainly added to my overall feeling. For a start, the library was located in Fitzroy which is an inner city suburb of Melbourne. Fitzroy is quite eclectic and fashionable but I would also say it would probably have a higher than average proportion of druggies in the area. So it would be fair to say that this contributed to the overall weirdness of what I was doing.

It also felt strange injecting in such a public place away from the privacy of home. Fortunately, by the time I went to the toilet the library was closed to the public but I think that just added to the weirdness of my act.

In the back of my mind was the thought of being caught out in the random act of giving myself an injection. How would I handle it? What would I say? How would the person react? Would they think I was a user? I don't think I had a readily available answer.

And fortunately, my act was done undetected with no unwelcome intruders. Phew!!!

Frustrations of IVF

The Challenges of IVF

After 6 attempts at IVF, I have learnt that again I was not successful in getting pregnant. I was devastated and have had random moments of tears since that discovery.

I never thought that this week would be so hard. I am starting to learn that the the more you go down the IVF path, the harder it actually gets. I have now done 4 IVF stimulated cycles and 2 Frozen Embryo Transfers.

For my part, the disappointment stems from an unbelievable sense of loss. It feels like my dreams of becoming a parent will never materialize. My biological clock is ticking and my body is against me.

The difference with IVF compared to natural attempts at conception is the knowledge that an embryo has been implanted. What I mean is that you know an embryo is there and fertilisation has taken place. With this knowledge comes the hope that this time might be the lucky time. The disappointing thing, is that I now know that it isn't. I now have a history of two years of infertility and am contemplating doing another stimulated IVF cycle.

I am also surprised to learn new things about myself and depth of my emotions on the topic. I never thought this possible, but I am am surprised to learn that I would be a person who has been:

• Happy but angry that a friend would conceive after 1 IVF stimulated cycle and 1 Frozen Embryo Transfer.
• Reduced to tears when shopping for baby clothes at Target for a friend who recently gave birth because I am wondering if I will ever shop for clothes for my own baby.
• Cynical (funny cause I've always been thought of as naive).

These are feelings that I would not normally have. I am even more devastated as we have going for top of the range blastocysts which according to my fertility specialist apparently has a better success rate than Day 3 embryos. I don't know how true this is - just look at what happened to my friend. What I do think however is that Day 5 embryos have a better chance of lining his pocket. Maybe that is the new "cynical' side of me coming out.

I hope that by writing this blog, I will then be able to help people understand more about IVF and the pressure that they or someone close to might go through if they go down this path. Whilst most IVF clinics explain about IVF from a technical viewpoint I believe that improvement could be made in helping couples understand the full ramifications of IVF. IVF is not the be all and end all. At best it offers people more hope and the potential to have children but it is by no means guaranteed.

In the meantime, my hats and commendations are for the women who have gone through far more cycles that I and who have had the courage to continue on. My commendations are also for the men who stood with them, all the while knowing how interfering IVF can be with your sex life and emotions.

In future blogs I intend to cover off what it is like going through a stimulated IVF cycle.