** warning - this is soooo INCREDIBLY long!! Life story ahead!
So my history... I always used the 'withdrawal method' in 3 LT relationships between the ages 21 and 35, and had had no accidental pregnancies. Apparently that was the first sign of a problem!
I was married at 27 and separated at 33. Met my lovely toyboy soon after separation and we moved in together a couple of years ago xoxo
Then I started to experience all sorts of weird cycle changes, pain in middle of month, heavier periods. In fact my cycle had always been a bit peculiar and about a decade earlier a GP had suggested that I might have PCOS, as my period didn't come for a few months. When it recurred in 2007, an ultrasound indicated that I appeared to have endometriosis and polycystic ovaries. Although 34 years old, I felt shocked in Sept 07 during first visit with GP and then gyno, and both asked immediately: "when are you going to have children?". I was not ready to talk about that - I was not long divorced, had never been sure that I wanted kids (social / ethical reasons), and I was 16 months into a (wonderful) relationship with a much younger man who really didn't have fatherhood on his short term horizon! But these problems got me thinking.
In Feb 08, I had a lap and hysteroscopy to remove endo from pelvic side wall and to remove a number of polyps from my uterus. At this time, we started trying to fall pregnant - by this time, DP and both agreed that we should give it a try.
The first lap was OK but the public hospital experience was unpleasant and recovery was a little harder than I'd thought. Also, it appeared that my tubes were blocked. We kept trying anyway, and in Jun 08, a hycosy test showed that my tubes were clear. However, a scan found small endometromas on each ovary. Also, more worrying was that DP's semen analysis showed low count, and low normal forms. One step forward, two steps back!
We kept trying, but my cycle became increasingly erratic and lengthened. We were spending a fortune on OPK but I wasn't confident that I was actually ovulating. My gyno thought she needed to 'escalate' us to the next level.
In Jan 09 I got a referral to Dr Alison Gee at Sydney IVF. Although we had both accepted that IVF was the path we should consider, I was SO nervous before the first appointment, as I imagined that we'd be forced to sign the forms immediately and off we'd go! Of course this wasn't the case. Dr Gee was fantastic, and immediately took a detailed medical history - I actually felt like she was listening and thinking about it all, which is a rarity amongt of specialists! It became clear that we weren't going to be locked into the IVF option in any event, as Dr Gee would first try to help us conceive naturally or with minimal assistance. That was a welcome surprise.
Dr Gee was very concerned to hear about about endometriomas and my DP's poor SA results, neither of which my previous gyno had seem phased about (ie she'd just sent us off to try for another 6 months despite the results). Dr Gee, in contrast, provided referrals for a battery of tests and more detailed bloodwork. She also prescribed Metformin for me to address PCOS symptoms - I tolerated it well, got my period more regularly again (every 31 days). Best of all, although I was already a healthy weight (but a few points higher in the BMI range than I needed to be), I lost 5 kg in first month (with diet and exercise) and kept losing 1kg a month after that without particularly trying! Love the metformin!
DP's second SA results were good (no more undies at night, and men's multivitamins) but bad news on my endometriomas - multiple in right ovary, 1 small in left. Again, one step forward, and one back. Due to the speed of recurrence and size of the endometriomas, Dr Gee's diagnosis was 'agressive' endo. The pain was getting bad, it hurt when I did no. 2's and I couldn't do yoga any more. I was scared!
Dr Gee referred me to Dr Geoffrey Reid, a specialist endo surgeon, for another lap on 6 April 09. She assisted and it was at St Luke's Hopsital in Potts Point. Although the Gap cost was a killer, the entire experience was fantastic, esp after the previous Lap. I felt really positive and recovery was swift.
We met with Dr Gee for a follow up later that month and she said we
could try again for 6 -12 months, but that the endo would likely recur quickly in which case we'd be in the same boat - tests, scans, surgery. Given "my age" and the amount of stuffing around that we felt we'd already done, we voted to move toward IVF immediately. We were scheduled to start mid May... exciting!! But more worries, just as we were about to leave she was handed the biopsy from my intra-uterine biopsy during surgery - the finding was endometritis (not endometRIOSIS - endometRITIS is an inflammation of the lining of uterus, which can impact on implantation of the embryo). Dr Gee immediately prescribed a course of 3 different antibiotics, which we took prior to starting, so it was disappointing not to have 'one last month' to try naturally before IVF (because one of the antibiotics is dangerous in pregnancy I couldn't risk it). She said she 'hoped' this would work but antibiotics don't cure all cases of endometritis.
Anyway... we were ready to kick off with Sydney IVF. We met the nurse coordinator and account manager in May 09, they were all incredibly friendly and helpful. Got
AF right on time (thanks Metformin!). Dr Gee choose the antagonist short protocol as most appropriate for me - blood test first day of period, then following day start FSH injections (Puregon) so that becomes Day 1.
I
felt like I was completely organised - I even typed up a spreadsheet for my cycle so I could keep track - but I still got in a flap! Eg the instructions were, "if bleeding before midday, telephone that day and come in for bloodtest, if after midday, call ASAP and blood test the following day". Well my period actually arrived - but I was so excited/terrified, I did nothing. Fortunately, one of the marvelous nurses rang to see how I was going as their records showed that I should be starting my period very soon. Ooops, I'd completely forgotten that the very first step of my protocol was "call the clinic as soon as your period arrives". Thank goodness they'd called!
The injections were all good, DP did them for me each morning. I had puregon for 10 days, Orgalutran from days 5-10 (ie for 6 days), and the trigger on day 10. I went in several times for blood test and/or scan, DP came with me to later appts so he could see the expanding follies! One crazy morning - Monday - waited for 1 hour for BT and 1hr 45min for ultrasound - other than that pretty quick. I tolerated the drugs incredibly well, Dr Gee had done a brilliant job of getting dose right to avoid hyperstimulation - a significant risk for polycystic ovaries. Felt some bloating toward the last few days, and after egg collection, and some headaches. I drank loads of water every day - well over 3L, but found that my head started pounding if I had any less! Also had a couple of brief periods of feeling a bit breathless but the water took care of that.
We were told to do the trigger at 8.30pm on a sat night, unfortunately my DP had planned a boys night before we knew this... so he did the trigger with a group of boys downstairs yelling and drinking! Funny. They were all fascinated and looked at me very strangely when I came back downstairs. I felt a bit overcome afterwards and had an early night.
Egg collection was Monday morning 25 May so I arranged a day off work for "more women's stuff" (they were used to it by now thanks to all my issues!). I found it a bit painful particularly on the right ovary (due to pressure on cervix) but fortunately there was only 2-3 decent follicles on that side so it was quick! (The poor little right ovary had a couple of large endometriomas removed from it in April, I guess that's why it was a bit slow to respond).
Out of the 12 or so follicles counted during the scans Dr Gee retrieved 6 eggs, all were mature. The following day the lab rang to say that 5 had fertilised normally through IVF (ICSI not required which is good). By Day 3, we had 1 at 10 cells, 1 at 9 cells, 2 at 8 cells and 1 at 6 cells, so 4 of the 5 looking good. Day 5 - Saturday - was embryo transfer, which was very quick and easy - oh, except that we started half an hour later than we were supposed to and I was soooo busting for the loo when they pressed that abdom ultrasound on my tummy!! There was a Grade 1 hatching blastie which was transferred, it looked so cute on the screen! At that time the other 4 embies were classed as 2 expanding blasties, 1 early blastie, and 1 at "only 3.5 day stage". The following day they telephoned to say that 2 were frozen and the other two not suitable.
I was not terribly optimistic of immediate implantation success (uterus lining "too thick" and polypoid, and may have endometritis which is inflammation of the lining) ...OH and a higher risk of miscarriage, as I have a blood clotting factor issue too (low positive anticardiolipin antibodies) - my poor sis lost 4 angel babies before 7 weeks before she was prescribed Heparin therapy and she just had her first baby in June.
Anyway the TWW was, as we all know, sheer agony. As I got to the end of it, the list of symptoms were growing hard to ignore, and I knew that the hormone injectable effect had worn off by then. But I kept convincing myself that it was nothing as I didn't want to get my hopes up. When I got 'the call' from Dr Gee after the blood test, I was completely and utterly shocked! She immediately asked who my obstetrician would be, my mind was racing "Oh do I need one of those??!"... I'm sure I was the first long term TTC and IVF patient who hadn't given any serious thought to actually getting pregnant! I just couldn't let myself believe it would happen, as you may understand from reading about my range of issues.
Anyway of course it was a steep learning curve from that moment, and so far so good. 15 weeks, feeling great and so happy to have little Scooby on the way!
If you read all of that WOW, it is good to assemble various notes I've made through the process and have this record.
Good luck to all of those facing the minefield of health issues and TTC troubles. Babydust to you and hope you have the success I've had SOON!! I also heartily recommend the Dr's I mentioned and SIVF.