By early December last year (2017), I’d moved through the motions and I was ready for round 2. I had read about treating the first IVF cycle as a “trial and error” round and that you shouldn’t be too disheartened (if you can ever say that to a woman desperate for a child).
The consultant made adjustments to my drug cocktail recipe (we upped the dose to 450iu Menopur) and the protocol (we needed ICSI – see lessons from my first IVF cycle here). The clinic was closing over Christmas for a few days, so we would only be able to start the second round if my period arrived by 3 December – and lo and behold, it arrived on that very day. Aunt Flo had never been this compliant. This had to be a sign that it was our turn, surely…
The timing was perfect, we were staying in London over Christmas, I was off work for two weeks so I would have plenty of time to relax after transfer. Not that I’m religious, but this had to be our very own baby Jesus?! Another sign, surely…
Almost exactly a year ago, in early September 2017, H and I were super egg-cited [sorry bad yoke 😂] to start our first IVF cycle. After a traumatic 11 months of the miscarriage (read my letter to my angel here), the discovery that I had Asherman’s Syndrome (more here), the uterus surgeries and the various hormone therapy treatments (HRTs), we were ready. It had to be our turn now, surely…
I’d received the drug delivery a week earlier. Not knowing what to expect, I ordered it to work. My office used to be located in one of London’s largest shopping centres, so the delivery guy got lost. He called me (from a withheld number) in the middle of the afternoon and asked that I meet him down a dark alley outside Zara Kids. (Shady AF, if you ask me.) I rushed out of the office, not knowing what he looked like. As it turned out, he wasn’t hard to spot – there was one guy standing next to a HUGE box (see picture on my Instagram). Et voilà, my first drug exchange was completed.
Today is day 11 of stimulation and I had an ultrasound scan this morning. There are seven follicles on the right ovary measuring between 15-22mm in diameter and four follicles on the right measuring between 19-26mm in diameter. There is also one more on the right ovary which is measuring 13mm in diameter and could possibly have a growth-spurt and reach 15mm by egg collection.
That’s a dozen in total, so I’m singing [in my head] my own version of The Pointer Sisters: “I’m so eggcited, I just can’t hide it…”
The blood work came back showing that the estrogen levels are up too, so we’re ready to go: double-trigger LH shots (Gonasi 5000 IU and Suprecur 1 mg) this evening – bam! – and collection scheduled for Wednesday, 8.30am. In my previous three rounds, I triggered with a single shot of Ovitrelle 250 mcg but in this round our consultant wants to try a double LH trigger in the hope that more eggs mature. Lucky egg collection is not on Friday because: “what’s the eggs worst day?”….. “fry-day”. (I just realised that I had egg collection on a Friday in The Disaster Round. That explains a lot.)
I had an ultrasound scan this morning to check how the follicles are developing. On Friday at the baseline scan, the nurse could see 15 follicles in total (six on the right and nine on the left ovary). As with previous cycles I respond quickly to the meds. My eggs grow quickly, but they aren’t all growing at the same speed. We had 15 at the marathon starting line. Out of those, it looks like we have ten that are still contenders and out of those we have a group of six front runners and a second group of four stragglers. The group of six are running side-by-side at great speed. The worry is that the four slower ones might not catch up, and then we would need to do egg collection “early” to avoid having over-ripe eggs*. We don’t want exhausted runners to crash out of the race before the finish line. So, we need the group of four to pick up the pace and the group of six to go steady. And, we certainly don’t want any injuries along the way…. C’mon you four!!
I don’t have any comparable stats from my first three egg races because I never had a day 5 scan on the NHS. On the NHS, they scan you for the first time on day 10. In my second
round race, I asked for a day 8 scan because I respond quickly to the stimulation drugs. Because the biggies are running full steam ahead, I have to start my Cetrotide today, a day earlier than expected. I forgot to bring one with me, but luckily the lovelyy nurse gave me one soI didn’t have to dash home…. Phew, and thank you.
Today is the start of new beginnings: the start of my fourth egg collection. I have spent a lot of time over the last couple of months mentally resetting. Right now, I feel positive, hopeful and excited. I saw the lovely nurse at the clinic this morning for an ultrasound scan and the lining looks thin enough (1.7mm) to start . For an Asherman’s survivor having a thin lining fills you with FEAR, but today I’ll take it. Current IVF score after three rounds is: IVF 3 – Me 0. BRING ON ROUND 4.
I began stimulating this evening. For my first three rounds, I took Menopur (300iu in the first round and 450iu in the second and third rounds). This time we are going for the Rolls Royce of stimulation drugs: Bemfola. I will be taking the max dose: 450iu.
I am not squeamish and I’ve never had an issue with needles, so I don’t mind the injection phase – hats off to those of you who have fear of needles and still do this!! I was just thinking about all the odd places in which I have been “shooting up” throughout this process: work loo, random office medical room, a Pilates studio, a wedding (mid-speeches), hotels on work trips and the classiest place must have been the public toilet at Natural Kitchen (somehow it felt more virtuous than doing “it” at Gourmet Burger Kitchen). Sometimes I wonder if I could add to the “Other” section of my CV (or perhaps the dreaded “Interests” section): Highly skilled at self-administering subcutaneous injections in a calm, motivated and efficacious manner.
Asherman’s Syndrome, also referred to as intrauterine adhesions (IUA), is a condition that occurs when scar tissue forms on the lining of the uterus, often resulting in infertility. There isn’t any one cause of Asherman’s Syndrome, but it is expected that 90% of the cases are caused by a surgical procedure, and especially D&Cs. The main reasons for having a D&C are:
- after a miscarriage to reduce the risk of a serious infection;
- after childbirth to remove a retained placenta;
- to stop excessive bleeding at birth; and
- after termination of a pregnancy.
Thinking about this, it seems odd that a surgical procedure, which is supposed to help you, causes you further trouble… So, why is this?
Fast-forward six weeks to mid-November 2016. I was feeling a little better following the miscarriage. We had had a lovely week in Dubai to load up on vitamin D ahead of the winter, so things seemed brighter. My period had returned (somewhat normal – I can’t remember to be honest) at the right time, so I felt hopeful. My body was back to normal!
I went for an ultrasound scan with the guy I had been to see previously on Harley Street to track my ovulation (I wanted to make sure I was ovulating regularly again). The good news was that I was ovlulating, but the bad news was that the scan showed that part of the foetus was still in my uterus. WTF?!!
It turned out that the little foetus, my bean, was more stubborn than its mother (what comes around…) and would not give in. Sobbing loudly I walked back to the Early Pregnancy Unit (EPU) (again) at the London Hospital and asked to be seen. The lady at the desk asked if I had had my period. Yes, I replied, but I KNOW there is still a piece of the foetus inside me. She didn’t believe me until I managed to get the private ultrasound report sent over.