Tick Tock, Tick Tock – My TTC, Asherman’s and IVF Timeline

Tick Tock, Tick Tock – My TTC, Asherman’s and IVF Timeline

Hello,

I started this blog back in January shortly after our second IVF-round had failed.  As I’m sure you know if you’re reading this, the infertility journey has its ups and downs and some days, weeks, months are harder than others.  After the second round, my heart was shattered and I couldn’t muster up the energy to write.  Quite a lot has happened since January: I have had a few more tests done and completed our third IVF-round (a fresh cycle) in March and it was brutal for many reasons.  That too failed and, truth be told, my heart was heavier than ever before.  We are doing a second ERA now in May and a fourth egg collection round in June.  I have no idea how that will go, but I’m ready to write again.  So, here we go…

I’ll be writing about the various events of my infertility journey over time, but I thought it might be helpful for you to get an idea of the steps of my journey.  I’m a facts and dates junkie (full disclosure: I’m a lawyer by day).  I’m the kid who remembered all the other kids’ birthdays and the kid who read the phone book (true fact — my brothers still tease me about this).  So if you’re a facts junkie like me, you’ll appreciate a timeline.  I’ll be updating this blog post as anything new happens.

2015

November:  stopped taking the pill – time to start peeing on ovulation sticks and trying to conceive (TTC)

2016

April/May:

  • the sticks confirmed that I ovulated every month, but no positive pregnancy tests since we started trying to conceive December
  • I had ovulation follicle tracking ultrasound done privately – the scans confirmed that I ovulate each month

June:

  • Hysterosalpingography (tubes fine, hooray!)
  • Tested H’s sperm (within normal range)
  • Private fertility consultant put me on Clomid (found out later this wasn’t necessary)

July:

  • Took Clomid
  • First IUI (done privately)

August

  • PREGNANT!!!!

September

  • Walking on clouds

October

  • Missed miscarriage at 11 weeks
  • First ERPC (D&C) with junior doctor

November

  • Period returned on time (hallelujah!), but something felt not quite right (NQR)
  • Arranged a private ultrasound scan, which showed remains of the foetus in uterus
  • Stressful few weeks trying to get second ERPC to remove remains on the NHS
  • Fertility blood tests done through my GP – confirmed all normal

December

  • Second ERPC (D&C) with senior consultant to remove remains (on the day I would have been 20 weeks pregnant)
  • Check-up with senior consultant just before Christmas – confirmed all looked “fine”

2017

February

  • Second IUI privately – no pregnancy
  • Period was very, very light this month
  • Appointment with fertility consultant on the NHS – booked in for hysteroscopy (“just to check all is fine”)

March

  • Period was almost non-existent; just brown, scanty drops (TMI – sorry)

April/May

  • First hysteroscopy (on the NHS) – confirmed Asherman’s Syndrome (40-50% of uterus cavity covered in scars).  My uterus was punctured, accidentally, during the hysteroscopy, so I had a laparoscopy to repair the hole in my uterus wall
  • Seven weeks of hormone replacement therapy followed the traumatic surgery
  • Received NHS funding for IVF (three rounds on the NHS – felt very lucky!)

June/July

  • Second hysteroscopy with an Asherman’s expert (an “A-lister”) to clear scars in uterus – confirmed uterus was no longer scarred, but endometrium lining was very thin in places
  • Second round of hormone replacement therapy and waited a few months in the hope that scar tissue does not reform

August

  • Uterus looked free of scar tissue, so cleared by the A-lister and NHS fertility consultant to move forward with IVF – finally!!

September

  • First round of IVF (NHS):
    • short protocol: 300 iu Menopur
    • 7 eggs retrieved
    • sperm sample looked great, so embryologist wanted us to try IVF (as opposed to ICSI which we were originally down for) – we agreed
    • only one egg fertilized over night (clearly, we would have needed ICSI)
    • transfer on day 2

October

  • BFN – gutted.
  • Appointment with senior consultant – we decide to go again in December if we make the Christmas cut-off

November

  • Wait, wait, wait, wait, wait

December

  • Period arrives on 2 December – start second round of IVF:  (We made the Christmas cut-off date – it felt like a sign of a Christmas miracle!!)
    • short protocol (higher dose this time – 450 iu Menopur)
    • ultrasound scan on day 8 showed eggs were maturing nicely and quickly; triple layer lining measured at 7.49 mm (post-Asherman’s this is the best it had EVER been, hurrah!!)
    • 10 eggs retrieved
    • ICSI:  9 eggs mature enough to inject sperm into; 7 fertilised (above average, yihaa!)
    • Day 5:  3 embryos had deteriorated; 2 embryos had reached early blastocyst stage and 2 were still developing; transferred the 2 early blastocyst embryos
    • Day 6 – the 2 embryos that were still developing had reached blastocyst stage, but deteriorated afterwards so not suitable for freezing and were discarded
    • BFN over the Christmas period – felt utterly crushed

2018

January

  • Saw private Asherman’s expert (who is also a fertility consultant) for a second opinion after the two failed cycles – he recommended we do an endometrium receptivity array (ERA) and a thrombophilia screen (to check if I had any blood clotting disorders)
  • Blood test results came back showing that I have a blood clotting disorder – I am a carrier of two gene mutations, which means that I have a 20-fold increased risk of developing venous thromboembolism.  No more long-haul flights without compression socks and low-dose heparin injections!
  • Blood test also showed that I am a carrier of the MTHFR gene

February

  • Did a mock frozen cycle – back on the oestrogen again – and did the ERA, which showed that I’m “post-receptive” (i.e. my uterus wouldn’t be ready for transfer for day 5, ideally the transfer should take place on day 6)

March

  • Third IVF-round (NHS):
    • short protocol (same dose as the second round, 450 iu Menopur)
    • lining was terrible on day of egg collection: no trilaminar pattern and around 6mm
    • only 5 eggs retrieved
    • ICSI:  only 3 mature eggs, one popped while they were trying to inject but the fifth one fertilised
    • Day 5:  the one embryo was a fully hatched blastocyst (c’mon this must be the little miracle!) and was transferred on day 5
    • BFN – completely heartbroken (nope, not third time lucky…)

April

  • Took the whole month off — breathing, rebuilding and trying to smile again

May

  • Second ERA to test to see if I’m receptive on day 6.  Results showed I am pre-receptive (i.e. not receptive on day 6 either – a Sherlock Holmes-style conundrum… TBD)

June

  • Fourth round (private):
    • short protocol (this time, Bemfola 450 iu)
    • 9 eggs retrieved
    • ICSI:  8 mature eggs were injected and 6 fertilised
    • Day 5:  two were fully hatched blastocysts, which were frozen and sent off for PGS testing; three stragglers (was hoping 1-2 would make it)
    • Day 6: all three embryos were fully hatches blastocysts and sent off for PGS testing
    • All five embryos are currently chilling in the freezer (yes, another bad pun – sorry, not sorry…)

July

  • PGS test results expected early July — eeeeeek

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