Pre-operation assessment - and a change of plan

This morning I drove to the hospital in the city for my pre-operation assessment. First up was an ECG at the cardiology department. It went very smoothly. I am familiar with ECGs but I haven't had one in a while. The results showed nothing unexpected.

A call from the hospital

Yesterday morning a lady from the booking department at the hospital rang me to let me know the date of my laparoscopy - 23 December - yes, two days before Christmas! I'm glad it will happen so soon, but I hope I can still eat my Christmas dinner with my family rather than spend the day in hospital. It is planned that I will be in for only one night, though. The surgery will be at a hospital near our home. I asked for more information, like what time I would need to report to the hospital, but I was told I would find that out later.

Letter from Dr Mc

Dear A and D

It was really nice to see you both again today. We went through your most recent IVF cycle. Unfortunately we did not have success with the fresh embryo but we have one further remaining in the laboratory which is a good result.

Review appointment

This morning we drove into the city for our review appointment with Dr Mc. He was 20 minutes late, which annoyed D a bit, but I think he had been held up unexpectedly.

Letter from Dr Mc

Dear A and D

I am just following up having come back from the school holidays. I am sorry that you have not conceived but happy there is a frozen embryo and fingers crossed, touch wood, we will get some success there.

Checking in

Yesterday Nurse S from the clinic rang to see how we were doing. I didn't have much to report. We're okay, really. I think we're putting all our hope into our last frozen embryo. We're looking forward to our review appointment in three weeks.

The result

First thing this morning I went down to the lab and had my blood taken for the pregnancy test. It all went very smoothly and I was in and out within a few minutes.

Uh-oh

On Friday afternoon I started spotting. Just pink loo paper, nothing too much to worry about, but by last night it had turned into light bleeding. This morning I was sure something was wrong. I've had post-implantation bleeding before but this was bright red and more like a period.

Checking in

This morning I got a call from S at the clinic's lab, just to see how everything is going and to wish us luck for Tuesday's test. I had no questions but it was nice of her to do that!

Letter from the lab

Dear A and D

Thank you for having IVF treatment at [clinic]. I'm writing on behalf of the laboratory team with a brief summary of the embryology from this cycle.

We've got a frostie!

We just had a call from C at the clinic's lab. She told us that of our remaining embryos, one had developed into a blastocyst and has been frozen. This is great news. It gives us some backup in case yesterday's transfer isn't successful. Of the others, one had developed into a blast but its outer walls didn't look too good and the rest had not progressed well. We are happy with this news!

Transfer complete

This morning we went to the clinic for the embryo transfer. I had to drink a lot of water beforehand so that my bladder was full for the procedure and I was absolutely busting by the time we'd finished!

Day three numbers

This morning S from the clinic's lab gave me a call. We have four eight-cell embryos and one four-cell embryo. I'm happy with that.

More numbers

I have just had a call from A at the clinic's lab. She told me that of the six fertilised eggs, two have grown to four-cell embryos, two have grown to two-cell and one has grown to three-cell. The sixth more immature one isn't doing as well and should probably be discounted. One of the two-cell embryos has multinucleation (one of the cells has two nuclei), but this almost always resolves itself.

Numbers

This morning I woke up feeling exhausted. I hadn't slept very well, and then my gut decided to play up. I've had this happen before, perhaps half a dozen times over the years. I'll go to the loo early in the morning, then over the following few minutes a small twinge will turn into a fiery cramp and I'll start to sweat buckets. It's awful. All that can be done is to take off all my clothes, clutch a hot wheat bag to my tummy and wait it out. After 20 minutes or so, the pain starts to come and go. Each time it eases off I get a huge feeling of relief and eventually it stops completely, leaving me drained. It happens in exactly the same pattern each time, but because it happens so rarely, I've been unable to pin it down to anything. I should probably get it looked into! However, I went back to sleep for a few hours and now I feel much better.

Egg collection

This morning bright and early we showed up at the clinic for egg collection. We were met by Nurse L who took my vital signs and started to go through some details with us. Then she left the room and a few minutes later Nurse K came in and started to go through the same things! Then we talked to A, the laboratory technician, and we discussed what was going to happen with the eggs. We decided to do transfer two embryos and to try for a transfer on day five, assuming all goes well. A will call me in the morning to let me know.

Instructions and a final jab

Yesterday morning I went to the lab to have a blood test. Of course, it wasn't quite that simple. The lab did not have the form required, so I had to call the clinic and ask about it. They said they would send it through electronically right away, so I went and ran some errands for 20 minutes or so and then went back.

Five-a-side

Bright and early this morning we went to the clinic for my first scan. We saw a different doctor this time, Dr M. There was no mucking around! We were ushered into a room and I undressed in an alcove and then the doctor performed the scan. Dr M was on his own with no nurse, so D had to write down the measurements

How hard does it have to be?

Yesterday I left a message on the clinic's answerphone to say that we didn't have enough Gonal F to last us until my first scan on Thursday. Nurse D rang back and agreed that we didn't have enough. D went to the clinic this morning to pick up some more, as well as some alcohol wipes. This is the third time we have had to visit the clinic to pick up medication. It would have been much more convenient if they'd made sure we had everything we needed the first time!

Oops

This morning we did a bit of maths and realised that we don't have enough Gonal F to last us until my scan on Thursday morning. We have a 900mg pen and a 450mg pen and we need six doses of 250mg. I rang the clinic this morning to explain the situation and hopefully they'll call back and we can go and pick up some more.

Catching up

Oops - I haven't been very good at updating lately. Last Tuesday we went to the clinic for our drug education. There was nothing new, but it was good to have the reminder. We left clutching our green cooler bag full of interesting stuff and then I went to the pharmacy with a prescription for even more medication.

Letter from the lab

Dear D

This letter is a record of your long term storage semen freezing procedure performed at our clinic.

Procedures for everyone

This morning I drove into the city and picked D up from work to get to the clinic by 10.30am. D had taken his painkillers and had had nothing to eat all morning. Before our procedures, we met with one of the finance administrators at the clinic to talk about a funding scheme that would give us $1,000 off the cost of our IVF cycle. We're eligible because we've already done two privately funded cycles and I fit the age criteria. If we're accepted, it will make things a lot easier!

Itchy and scratchy

Nurse L called me this morning to talk about D's appointment tomorrow for his sperm biopsy. He is going to be in meetings all day today, so she gave me the information to pass on to him. Apparently he needs to shave - and I don't mean his beard - which he hasn't done before, so there might be an interesting spectacle in the bathroom tonight!

After meeting Dr Mc

Dear A and D

It was a pleasure to see you both today. You have had a lot of treatment previously and had at least five good quality embryos replaced. You achieved a biochemical pregnancy once but unfortunately have not had success otherwise.

The new clinic

On Friday we had our first appointment at the clinic in our new city. I picked D up from work and we drove there. I was very nervous driving in the central business area, both because of the traffic and because of the tall buildings (I don't like earthquakes). But we made it in plenty of time and there was lots of easy parking available. I also felt nervous about starting treatment again. I really don't want to go through it all again, but there is enough hope for a different outcome that I am willing to try again. It seems that D has never given up and really doesn't want to stop trying yet.

Letter

On 28 May we moved to a different city. Our clinic has many branches throughout the country, so we can continue our treatment with the same provider.

Test results

Dear A and D

Further to your appointment and subsequently the blood tests done for you both to look for immunological coagulation and genetic factors that may predispose to lack of success for IVF, I now have the details. The chromosome analyses for you both were normal, with no obvious major chromosome anomalies evident that could lead to miscarriage or failure of IVF embryos to implant.

SIS scan

Yesterday at noon we went to a private radiology clinic for my saline infusion sonohysterography (SIS) scan. It was fairly similar to any other pelvic scan to start with. We met two radiographers and they left the room while I undressed my bottom half and got up onto a table. Then a doctor came in and performed the scan while the radiographers assisted.

SIS fact sheet

This is a procedure to assess your uterine cavity and the patency of your fallopian tubes. It uses ultrasound and sterile saline rather than ionizing radiation (x-rays) and x-ray dye.

The procedure is usually performed days 5 to 10 of your cycle, immediately after your last menstrual period, or as advised by your specialist. Please allow an hour for the procedure.

File note

I reviewed A and D on 12 March. Unfortunately, the most recent IVF cycle resulted in the transfer of two embryos without pregnancy occurring. I have reviewed the details of their history since D's vasectomy in 1995 and reversal in 2005. On the four occasions they proceeded to IVF the first three resulted in satisfactory fertilisation (3:5, 5:6 and 2:3 oocytes fertilised). On the most recent occasion only 3:9 oocytes fertilised. There have been good quality embryos transferred now on five occasions, with one early pregnancy achieved but unfortunately early miscarriage.

Seeing Dr P

Today we visited the clinic after a long break to see Dr P. We wanted to talk with him about our various options and to gather more information before we make the final decision about whether to try another IVF cycle.