Future plans

Yesterday we went to the clinic (new location, ultra posh place, was almost expecting a room named after me LOL!) and we met with the Fav Doctor. The medical part of the chat was very quick, the policy is "don't change what works" and so we'll do the same protocol the next time. We are looking at September with no pill (whoohoooo!!!), as my cycles are very regular already, I just have to give her a call when my period start in September (probably it'll be late August), she'll get my prescription ready and we are good to go! She suggested to start with a lower dose, she'll monitor me more often (the new place is walking distance from work) and we can increase if necessary. Two out of the three fresh cycles I have done, I risked OHSS and this resulted in half the trigger dose the last time which yielded 6 eggs out of 18 follicles which then became 3 blasts. We'll try and aim for 10 eggs without OHSS. We still think we'll freeze which means I won't be on steroids or clexane this time. The idea is to go to blast anyway and freeze then (Oliver was a frozen blast). But we'll see how it goes and the Fab Doctor seems to be quite flexible with us, which is great.

We also got a tour of the new facility and I can only say WOW. They even bought a new 3d ultrasound machine. Cool!

Yesterday was also my CD3 so I got my bloods done at the GP to see how I'm getting on on the hormones side of things. I'll have the results back next week.

Finally, I'm deeply saddened by the many losses happing in blogland. Some of them are just unreal they are so so cruel. I still get a profound sense of fear reading those stories, as if they trigger my memories around Oliver's birth so though you girls are in my thoughts and prayers I am not able to comment too much.

21 weeks (tomorrow!)

It's a day early but given that I'll be flying to the Azores very early in the morning I'm not sure I'll have the time to update.

So this week really flew by. With all that happened it feels like the days were on top of each other. Yesterday there was the funeral of the girl who passed away and I decided not to go. I get so upset and emotional at funerals I don't think I could cope with the devastation of her parents and friends. I hope everyone understands.

I'm feeling well overall, I've changed the prenatal medicine since yesterday and my tummy has taken a turn! I hope it'll settle soon.

I feel more regular movements, definitely every day now and it's really reassuring. I can feel them as high as my belly button at times and if Mike has his hand in the right spot at the right time he can feel the kicks too! He loves it and makes so so real.

I'll bring the laptop to the conference so I hope I can stay tuned with what my cyber friends are up to, otherwise I'll catch up with you all when I'm back next weekend. Actually the plan at the moment is that as I touch down in Dublin on friday (my birthday wohoo!) we'll bring the cats to the cattery and we head off to the countryside for the weekend visiting our dear friends in their fairy tale cottage! So lot's of travelling ahead, I'll make sure I'll rest as much as I can any time I can.

8 weeks...or is it next Wednesday?

Ah well, I don't know, I go that it's 8 weeks today anyway! What a milestone, is it really me writing this? It seems so!

Yesterday I had one of those "let's freak out a bit more" day so I started searching the internet for "small gestational sac, normal foetus" and oh my, did I get myself frightened? Finally, I found a board somewhere where the girls were showing some pics of their scan where they were told the sac was small, and it was really small, like no black area at all around the baby, but eventually, it caught up and everything went well (of course this is not always the case). They said drinking plenty of water helped. So I'm drinking like a camel at the moment and peeing almost every hour. Then I found a medical presentation according to which the sac should be at least 5mm bigger than the baby and I think then mine is ok...isn't it? The doc didn't say how big it measured, only that it wasn't accurate.

The other big achievement is that I found an OB to go to. In Ireland the business of finding an OB is like a quest. They get booked up pretty much as soon as you find out you are pregnant. First you have to select the hospital you want to go to for the delivery, then you find an OB that works there and hope he/she will take you on. I had a couple of names suggested and as I called, the secretary asked me the due date (January 25th) and she almost laughed! "No love, Dr. S is booked until the beginning of February!" I mean really? Someone must have called her as the HPT was still developing! They were very nice though and suggested other doctors. I checked them out, I tried another one, same story. Eventually I called the OB recommended by my colleague who also went through IVF 2 years ago. The conversation with the secretary started with the same "Sorry, Dr. L is very full at the moment, he's not taking on other patients" "Oh...right, can you suggest someone? I had a really tough time getting pregnant, I'm and IF patient since 2008 with Dr. W, I had two ectopic pregnancies following IVF and several failed transfers before getting to this stage, so I need someone who will look after me very well as I am a bit nervous...." and she said "In that case....we'll take you on" WOW!! So I have my first appointment and scan booked with Dr. L for the 14th of July at 12 weeks!! We are going private, what the hell...with all we have been through we need some pampering! Then I called the clinic to have them writing a referral letter to Dr. L and to book a scan in between now and the 14th of July, so I'm going in on the 24th of June and I think I will then be officially released from the clinic.

Let's hope everything will be well, Misfit Mrs. wrote a fantastic post the other day which was really illuminating for me (and I know for others too) and I am committed to enjoy this pregnancy to the fullest and to think it will go well until the end, and if it doesn't I will deal with that then.

Wrapping up ICLW

This week really flew away! For me it has been a week filled with things to do and novelties. To wrap them all up here goes the list:

1) I had the WTF review on tuesday which went well, the plan is to have a hysteroscopy to make sure I have nothing that impedes the implantation in the uterus and then schedule the FET with the single penguin we had in this cycle. I will be on a modified protocol this time which will involve Viagra to maximise the blood flow to the uterus. I look forward to the experience :o)

2) Patches and the Dude came home also on tuesday, they quickly got to know each other and now are inseparable! They sleep together, play together, and even lick each other, so we are delighted with that. Patches was very affectionate from the very beginning, the Dude on the contrary was quite shy and would hiss at you if you were getting too close or try to pet him. Well, yesterday both Mike and I were able to pet him for quite a while (from under the table)! We are hopeful that he will relax a bit more but we know it may take some time.

3) My second PhD student submitted his thesis on friday! What a milestone for him (and for me!) I am really happy with the way his project turned out so hopefully the external examiner will be of the same opinion. The viva will be some time in April.

4) Mum and Dad have finally booked a flight to come visiting after Easter. It took two kittens to get them over here! They will love them and this is now the main topic of conversation when we chat on skype "how are the kittens?" "What do they do?" "Can you show them to us?" and so on. Bless them.

5) I have booked a weekend in London with my best friend, we are going to go to an amazing Spa (check it out here) in March! We went there for my 30th birthday 5 and a half years ago, it was about time we were going back!

6) Last but not least, I found new blogs to follow and I look forward to get to know better my cyber-frineds.

The kitties and the WTF review

Please welcome....the newest members of the family....

Patches O'Houlihan and The Dude Lebowski!

I can't believe we have kittens in the house! Well you may wonder about the names, I know, not the most classic cat names, but we had seen Dodgeball recently and Patches O'Houlihan really cracked Mike up (apparently the surname is typically Irish but no way the name is!) and we decided no matter what the cat looked like, if it was male or female, we would have have had a Patches! So Patches is the stripy-patchy one on the left, he's probably 3 months old and very affectionate. You pick it up and he starts purring in no time. The Dude is actually very shy, and walks really low on the ground, but he has eaten already and although Patches hisses at him a bit he's really cool about it! So Patches and The Dude are now adopted, they have found a cosy place under a trolley in the kitchen where the photo was taken and they don't seem to mind sharing it (allright, Patches is not too pleased...) we are very happy and I'll keep you posted on how they settle in.

And what do you know, while I was at the shelter I got the WTF phone call! Dr. W (the Super Doctor, the one who did the transfer) started with "Oh, Fran, I'm so frustrated it didn't work, you must be too!" oh yeah...you got that right doc! Anyway, he thinks that maybe this cycle the quality of the blasts wasn't as high as the last time, nothing to be read into it really, it just happens. He also said that we should go ahead with the penguin, you never know, it's a nice blast, likely to survive the thaw, we'll be changing a bit the protocol so that I won't be on so much estrogen and we add a bit of Viagra to the mix. Seriously. I said right so, how about we make sure we have nothing to worry with my uterus? Can I have a hysteroscopy? He said sure! I would have suggested it myself if this FET failed, might as well get it done beforehand! And so he's contacting the doctor in one of the Hospitals (very near home) and we'll get that sorted out and then here we'll schedule the FET. He was really positive about us, he said that I always got pregnant on fresh cycles, it's just in the odds that sometime it doesn't work or they would have stats of 100% success per transfer!

Anyway, it may have been that I had Patches and the Dude ready to go home, but I was very happy about the conversation, again the clinic is really hands-on and I'm sure they really want to get me pregnant!

So what now

Thanks to each and everyone of you. I just have no words. Thanks for all the tips on having a pet, I think Mike is nearly convinced!!! We may go for a small dog, there are many places around where we are that will take it if we go out of the Country, so it's doable!! I'll keep you posted of course.

I read a lot yesterday if it's really possible that my uterus is "unsuitable" for pregnancies like I feared. I found a clinic in Chicago that deals with failed implantation and that has a very informative website on all the known causes of pre-implantation loss, peri-implantation loss and of course post-implantation loss. I'll post it here because it was really helpful

http://www.illinoisivf.com/recurrent-pregnancy-loss/index-rpl.html

I would be in the category of either pre- or peri-implantation loss. I don't have hormonal issues (ie I do respond to estrogen and progesterone and my lining thickens), I don't seem to have a physical uterine issues (polyps, submucous fybroids or scarring) and I'm dealing with the mild immuno issues with the intralipids. So it could in fact have been the embryos.

"Data from preimplantation genetic diagnosis suggest that 30% to 90% of in vitro fertilized eggs depending on maternal age are chromosomally abnormal. Furthermore, it has been estimated that 75% of karyotypically normal pre-implantation embryos fail to implant."

That's sound like there is a chance that maybe next time we'll be ok! We still got two pregnancies out of 5 transfers (plus one chemical at the second FET), so really we are well within the stats (still it sucks that it didn't work!).

The other thing is the position of the transfer. It's a very fine line and I think given that I don't have tubes any more we may risk a higher transfer next time.

My WTF phone-appointment is scheduled for next tuesday, I'll ask if it's worth my while having a third laparoscopy, to tidy properly the left over stumps of the tubes, remove the external fybroid and perhaps having a look to see if I do have any scarring from my exploratory lap&dye and D&C back in December 07. I'll ask also about surrogacy in Ireland, a friend yesterday said she'll be our carrier...can you believe that? Although I was moved by her gesture I don't think she thought it through and I'm not sure if she would even be suitable (she's 3 years older than me, had hormonal issues in past etc.). Still it was so generous for her to offer.

No calls from the adoption board of course, not sure what to do, if you are seen as an impatient harasser it doesn't really work in your favour!

Overall I feel well, my scientific thirst for knowledge is satisfied for now and I feel more relaxed about our future chances. I went to yoga yesterday and it was great, gong again this evening for a "Goddess gathering" of meditation and positive energy! Just what the doctor ordered!

Here I go again

...on my own...
Goin' down the only road I've ever known....
Like a drifter I was born to walk alone...
An' I've made up my mind..
I ain't wasting no more time...


Perfect lyrics actually! I got the dates sorted out with the clinic!!! A little dance please...
So I'll start the pill with the December cycle (around Christmas), until the 17th of January. Scan dates: 21st of Jan, 27th of Jan, 29th of Jan and 1st of Feb for EC on the 3rd or 4th of February!!!

I'm very happy with this, they had offered an ealry date (EC on the 20th of January) but that was too similar to the date of a FET I did this year and I think I prefer a different month this time for transfer! Same protocol as the last time (short with antagonists) and a bucket of fingers crossed!

For hose of you who don't know the song I'm talking about at the beginning of this post, please have a look at this link, it's an ad for Twix and I think it's brilliant, the old lady singing in the rain bringing tea somewhere far! Let's hope there is a warm shelter at the end of the road!

Moving on

Thank you so much for the comments on my last post. We were away last weekend and I had the opportunity of talking to a good friend of mine who's a clinical psycologist (and I think she's pregnant!! see later) about my student and she agreed with you all that she needs to see a doctor very soon. So I talked to my student this morning again, she feels much better, appears to be the usual lovely girl I got to appreciated so much during the years and although she has not gone to the doctor yet I made her promise that as soon as she feels things are changing again she'll go. And I'll have her under very strict surveillance!

So as I was saying we went to visit friends in the countryside last weekend. We have two couples of very close friends who are even closer among themselves. T is Mike's best friend and A, his wife, is a fantastic girl and a very good friend of ours. They know all about our IF and have been amazingly supportive (during my FET last April we went at their wedding carrying the penguins!). C and D are the other couple, they have a baby who's 18 months or so and absolutely adorable. A and C are both clinical psycologists and they have been great help during the dark days. C is pregnant again and I so much appreciated that she called and told me very early on (she is 10 weeks), she said it was difficult but also she knew it would have been disrespectful of me actually not telling me. And I was truly happy for them. This was last week news.
And then we went to T and A for the weekend. I had the immediate impression she was pregnant too. They didn't say though, so it may be just very early, but I knew. You know the classic things like she's not even tasting the wine (and he's not even offering it to her, very unusual!!) and being a bit more tired than usual. Yet we went for a nice walk up the hills and did a lot of gardening. So Mike doesn't think she is. I bet we'll get the official news in a month or so.

We'll be the only childless couple left. I admit, this had an impact on me that I probably understimated a bit. I felt sad at the idea, out of the circle so to speak. I'm afraid they won't call us anymore, maybe just out of consideration that it may hurt us being around their children, their happiness. Which we don't have.
And I got my period on friday night, right on time which was great, but somehow brought back the feelings of fear that I had when I was bleeding due to the ectopic. God....I'll be absolutely terrified if I'll get pregnant again. Not sure what to do about it.
I called the clinic today and I'm waiting for a call back. Ideally I don't want anyone IRL to know about this, I know everyone is just trying to be supportive, but the stress of keeping real people up-to-date for me is a lot right now. We'll see. Hopefully they can schedule us for January/February, I want to be on the pill for as short as possible.

And I know I haven't updated on the attic conversion yet, but i promise it's on my list of things to do!

Are we there yet?

Ladies and Gentlemen, please welcome the one and only stable HCG person on the planet!

Yes, that would be me. This morning we went to the hospital, got the blood done and the midwife was once again brilliant! She contacted Dr. A before I left so that we can have a plan given that is, once again, friday. Dr. A would have called me with the results and talk to me directly after lunch.
And so she did, she asked how I was (I'm well, but I think I ate something wrong yesterday...) and if I had any bleeding (no, I don't think so, but maybe a slightly slightly coloured mucus?). Anyway the HCG on sunday was 964 and today was 1007. She definitely calls this a plateau. Really no difference. Actually I think we may have reached a turning point! From 885 to 964 in two days and now after five more we are to 1007. I'd say we've gone around the corner. Could it be that it's actually slowley going down?
So what do we do now? She said she's really trying to hold off on the methotrexate because she said "You really cannot start IVF again for two month if you get the shot" I said "No worries! I don't think we'll try again for at least 4 months" but still the values are not going to increase now I think and we can wait a little longer to make a decision. I'm going in on wednesday for yet another blood test and a scan (given that I had two embryos transferred back and that she's very confident they removed the pregnancy with the laparoscopy, could I have picked the lucky ticket for two ectopics for the price of one within the same IVF?) and we decide that day how we progress. If the values haven't dropped I'll definitely insist on the injection. She said the side effect are actually minimal and yes of course I can feel a bit sick with it but it's more likely I won't.

Today a year ago I found out our first ICSI had worked. Can you celebrate a BFP anniversary even if it turned out to be an ectopic? Still I feel in the last year a lot had happened, I got pregnant twice and maybe a third time wasn't far off! This is out of four transfers! Ok I have no babies yet, but I know ladies who never got a second line on those damn sticks, and even though the happiness for us was short lived, it still was one of the happiest moment in my life.

We do have a plan!

Work is crazy at the moment, the academic year has started and I hardly have time to eat! So I didn't manage to update on our meeting with the Super Doctor.

It went very well, of course he said we just have to try again and hopefully our embryos will stick to the right place. We dicussed a lot the stats of another ectopic pregnancy, but he said that if it happens again we'll make a publication out of it! And to basically stay positive and hopefully things will be fine. When we'll be ready to go again I'll be on the same short protocol which worked really well for me. Of course I told him about the HCG being still high and the "wait and see" attitude of Dr. A. He also thinks it's probably good too see if it'll decrease on its own and that there is no real reason to panic as the increase was so minimal. In fact he said that if some cells have in fact been left behind, it may be to my advantage as some scarring of the stump may take place blocking the access even more. I asked him about more surgery before going again (remember? to remove the stumps and the fybroid) but in his opinion could be a bit excessive. So we'll see. Overall it was a great meeting and we came out quite reassured. Then we bumped into the Favourite Doctor and she wanted to know all about how I was, so she brought us into one of the scan rooms and we had a great chat. She thinks this HCG value is high but you never know, she said with me she woudn't be surprised if there was in fact a second ectopic! But obviously I'm feeling well so she's not worried and on friday we'll know in any case. Her husband happens to be an oncologyst and we found out we live very near! I asked her about the methotrexate shot and she said it's very effective but that I can be sick for a few days if I have to get it done. I may loose some hair (hopefully from the legs!) but the dose is so mild I may not even notice. She wants me to stay in touch and le her know how things work out.
Tomorrow it'll be a very early start as I'm teaching at 10 and I have to drive into town beforehand for the blood test! Better going to bed early tonight...

Do we have a plan?

Last night I mange to talk to the doctor again. She was very apologetic for the delay in getting back to me, apparently there were only two doctors on call and it was just crazy. She was very nice over the phone of course, and very reassuring. She said she checked with the other doctor as well and they both felt that the best thing woudl be to talk this morning with the consultant who oversees my case. She said she was going to be on duty all night and that she would call me tomorrow with a plan. She was very sympathetic and knew I just couldn't be left in limbo, and she aslo said that they had received the offial pathology report and that the pregnancy was normal, no sign of trophoblasts (that was my fear, particular cells from the pregnancy that starts replicating out of control) and that although my HCG is a little high, it's no where near the values of a trophoblastic tumor. The fact that I feel well is of course an other indication that this is no emergency to them. She said probably with my knowledge and background I have "been reading a bit too much into the numbers" and I think it's "probably true".

So this morning then I was called twice, once by one of the midwives who deals with all the consultant's cases (we'll call the consultant Dr. A) and she said Dr. A was aware of my results, and that she'll call me tomorrow in person but that she doesn't think there is the need to be worried and that it could be a physiological plateau (basically between 885 and 967 there isn't much of a difference in medical term) and that the best thing is to recheck the HCG ths coming friday and have a better idea which way they are going.
Then the lovely doctor from last night called me (it must have been around 10 am this morning, she must have had some shift!), again she confirmed what the midwife said, she had spoken with Dr. A who thinks this could be completely normal and that given my high HCG before surgery, two weeks was just too early to check. Of course we'll repeat the HCG and that if the value is truly creeping up on friday we'll have a plan in place.

I do feel less worried, I still think these numbers are going in the wrong direction, but hey, can I be wrong for once in this pregnancy please??? Friday is only three days away so it's not a long wait and if they are creeping up this slow it's not going to make a major difference acting today or in a few days time.

And I also got a text from the Favourite Doctor, she had received the report from the clinic and wondered how my HCG was at the last count. So I told her and she said to let her know what the plan was. Today I also have the appointment with the Super Doctor, so many things have happened meanwhile that I'm not ready with all my questions! Maybe I can just listen this time.