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.