Category Archives: IVF treatment

When should you do a home pregnancy test? My experiences….

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While running the gauntlet of the Two Week Wait, you’ll need to decide whether to test before the official test date (OTD) given to you by your clinic, or not, & it’s a toughie. Of course, if you’re pregnant you want to know asap but are you ready to handle yet another negative pregnancy test? And, if it’s a no, is it a real no, or have you just tested too soon? Home pregnancy tests only work when there is enough of the pregnancy hormone HCG in your urine and, if your embryo was a late implanter, then you may take a little longer than the next woman to reach the required level so testing early may give you a false negative. But just remember if you test early “It Ain’t Over till OTD.”

In my case, I had a blastocyst (usually a 5 day old embryo that has developed normally) transferred and was asked to test 12 days after transfer. The online forums may refer to this as 12dp5dt (12 days past a 5 day transfer). I made a mistake and tested impulsively 10dp5dt and got a negative but I had multiplied the mistake by testing in the afternoon and using a poor quality test. I also had a full bladder so, if there were any hormones in there, they were no doubt well diluted! As I had a complex transfer and no definite symptoms during the two week wait then the result was no surprise to me. I was convinced it hadn’t worked anyway. So I decided to wait a couple of days until my OTD to confirm it hadn’t worked and focussed instead on the two frozen embryos I had waiting for me.

My OTD was a Sunday morning. I woke up quite early and snuck off to the bathroom. I’d bought a supermarket own brand test as I figured all I was doing was confirming a negative. I honestly could not believe my eyes when the second line started appearing almost immediately and it was a definite strong line – take a look at the picture! After staring at it for a few seconds and looking at the instructions again to check the result actually meant positive, I wandered in to a drowsy Mike and mumbled “I think it might have worked”. He, of course, had no idea what I was going on about. I managed to burble out enough sense to get him to come into the bathroom to check the test himself. A definite positive result.

I suspect all couples act differently when faced with a positive pregnancy test. Mike and I reacted with utter shock, no tears, no elation, no jumping up and down, just pure shock. I think we had each convinced ourselves we couldn’t be so lucky for this to work first time and my lack of symptoms had reinforced our belief. We just hugged, stared at each other, stared at the test again and honestly the fact that I was pregnant just would not sink in. I spent the morning going back and looking at the test every 10 minutes or so. But it would not sink in.

But I was, I really was pregnant. OMG…….I am going to have my first child at 50yrs…..

Two Week Wait

 

 

There’s no doubt the two week wait before you can do a pregnancy test  is a challenging time. There’s so much advice out there on what to do and not to do, and, as always, it’s inconsistent.  The key messages I took were as follows:

  • Don’t take to your bed for two weeks, gentle exercise is a better idea. I did yoga and gardening through my two week wait as I think getting the blood flowing is a good idea.
  • Keep hydrated
  • No heavy lifting
  • No baths, swimming and no sex to avoid infection
  • Keep taking your prescribed medications at the same dose
  • No sporting activities
  • No alcohol
  • Avoid the foods they tell you not to eat when pregnant
  • No caffeine
  • Some people swear by brazil nuts or pineapple to aid implantation. I did occasionally eat these but I was intermittent at best.
  • And, finally, TRY to relax….so much easier said then done when you will undoubtedly have a  running dialogue going on for the whole time…

Has it worked? Is that a symptom? Should I exercise? Thank goodness I have frosties to fall back on, we can always go back for another go. Should I test early? How soon can a pregnancy test detect HCG? Perhaps going to yoga this week will help get the blood flowing around. Are my boobs any bigger? Is that just the progesterone? Why do other women find it so easy to get pregnant? Does my stomach feel harder than yesterday? Is that a sign? Why are the days taking so long to pass? Can we have sex? And how can Mike stay so calm? Oh, I just fell asleep in the passenger seat, that’s unusual, does that mean I’m pregnant?

Seriously, the two week wait is just hard work so I think the easiest thing to do is accept that as the case and get through it as best you can. Go back to work, stay busy, find anything you can to distract yourself, stay away from Google.

If you really want to symptom spot then these are the most popular symptoms reported on Fertility Friends from people who went on to have a positive pregnancy test, in order of most reported. But I think you’ll agree, many of these are also common pre-period symptoms and/or side effects of IVF medication so I suspect this is a list that only works in hindsight!

  • Period pains
  • Tummy cramps (not AF type)
  • Painful boobs
  • Frequent peeing
  • Large boobs
  • Backache
  • Extreme tiredness
  • Emotions change
  • Increased appetite
  • Nausea
  • Dizziness (room spinning)
  • Night sweats
  • Strong sense of smell
  • Veiny boobs
  • Spotting
  • Funny taste in mouth
  • Itchy nipples
  • Loss of appetite
  • No symptoms
  • Other
  • Vomiting

And GOOD LUCK !! As Mike said, what’s done is done and if it’s worked it’s worked and most probably nothing I do is likely to change the outcome.

Leave it in the lap of the Gods, and just hope for the best

Embryo Transfer

I was pretty nervous about embryo transfer, although excited too. This could be the day I get pregnant for the first time in my life! Mega busy morning as we had to pack and leave the apartment, store suitcases at the station and then make our way to Reprofit for our lunchtime appointment.

I’d watched a load of YouTube videos to try and get an idea what to expect but nearly all of them were American and they seem to routinely prescribe valium so were not surprisingly pain free. Reprofit say embryo transfer is painless so don’t offer any pain relief but I was a little concerned. I contemplated taking some paracetamol but then realised if the treatment didn’t work, I would undoubtedly blame myself. So I turned up painkiller free and free of any body cream or perfume. Let nothing get in the way of my success!

We had a meeting with our Doctor who updated us on the condition of our embryos. We were delighted to hear that three were good quality blastocysts so he suggested we pop one back and freeze two. Then, if we needed to come back, we could put two back in next time. We readily agreed.

A nurse took us to another room, asked me to strip off to the waist in a small cubicle, to not use the toilet (full bladder required), to wrap an apron around me and then get on the bed. My husband was sat alongside me. She placed my feet on the raised foot rests and prepared me for the doctor.

The first part of the procedure is similar to a smear test when the speculum is put in place. Then the doctor puts a tiny catheter through the cervix into the uterus using ultrasound for guidance. The embryo is brought in by the embryologist who double checks your name (can’t fault Reprofit’s procedures!) and the embryo is passed through the catheter into the uterus by the doctor and can be seen as a small blob on the screen. In most cases this whole procedure takes no more than 10 minutes.

Typically I had to have the longer version. No matter how hard the doctor tried and how many catheters the nurse passed him, they would not go through into my uterus. The embryologist appeared and was sent back to the lab and in the end the doctor went and found a colleague to have a go. We were at least 20 minutes and by now I was getting period pains which at times were quite strong. Mike was quiet as a mouse holding my hand tightly while I shut my eyes and focussed on taking deep breaths and staying calm. The nurse was wonderful. Thankfully in the end we got there and I could see that lovely little blob on the screen and the cramps immediately stopped. I’d read somewhere that laughter following transfer can increase success, in fact the more relaxed you can be the better, so we watched some stand up comedy routines on our iPad (free wifi at Reprofit) while we rested for 10 minutes.

And then the mega busy day continued. Straight onto the tram back into town, a quick coffee and muffin at McDonalds in Brno then onto the train out of the country and we flew later that evening eventually getting home around 12 hours after our transfer.

And so began the dreaded Two Week Wait until we could do a pregnancy test.

The dreaded phone calls

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IVF feels like one set of obstacles after the other but one of the things I hated the most was phoning the clinic on days 1 and 3 to see how our embryos were doing. You have to phone a dedicated phone line between 1pm and 2pm…..and your stomach will be in knots. We tried to be busy on the mornings to take our minds of it as those calls are just so stressful.

The first time I was sat outdoors at a restaurant in Vienna and had to go indoors so I could hear. I had a bit of a nightmare as first of all I’d forgotten to take the number with me (doh!) so was then trying to connect to the internet to get a number. I could only get the main number for Reprofit so had to dial that to be given the correct number. I had struggled with dialling as it was international and then really struggled to hear what the person from Reprofit was saying…as if this wasn’t nerve wracking enough! Thankfully, we found out that 8 of the 10 eggs were mature and 6 had fertilised so we were doing OK. Over to the embryologists at Reprofit now to work their magic while we tried to distract ourselves for the next day and a half. It didn’t work, I spent that evening Googling to try and find out if 6 was good and what our chances were of them making it to blastocyst stage. Didn’t really get anywhere, I’d have liked a greater number for reassurance but kept reminding myself that we had pretty much decided only to transfer one so I only really needed one of those embies to make it (but I desperately wanted to have some to freeze too). IVF turns you into an over-thinker – all that time, money, emotional energy will it just be wasted or will we be one of the lucky ones?

We were due to be in Prague for the Day 3 phone call but I wanted to be more local second time round so we were the Technical Museum and managed to find a quiet corner away from everyone. It was good news. All 6 embryos were hanging on in there and 4 had made it to the 8 cell stage so were looking particularly good to make it to blastocysts. Our embryo transfer was set for lunchtime on day 5 and we both breathed a huge sigh of relief. Although I knew there was a chance things could still go wrong, in my heart of hearts I felt that all would be well and we would be transferring on Friday.

So now, I started to get nervous about the transfer process….will this worrying ever end?

 

My Treatment – Brno

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So we arrived in Brno early afternoon on a Wednesday and settled into our apartment before heading out for a little wander around and to find something to eat. We stayed in the centre and were immediately impressed with this lovely old city.

The journey to Reprofit was so easy the next morning. The ticket machine for the trams was in English as well as Czech and the electronic display in the trams shows the stops. Reprofit is close to the Exhibition Centre and, thanks to Google street view, I recognised the building immediately.

We were impressed with the clinic from the moment we stepped out of the lift. Friendly, efficient, clean, light, professional. Somehow even walking into the clinic raises your hopes that this might actually work. We needed to show our passports and fill in some paperwork  so sat at one of the little café style tables in reception. Then one of the coordinators took us to a small room and talked us through the treatment, took the copies of our blood test results, gave us a chance to ask any questions and left us with various leaflets with key information, phone numbers etc on them. All leaflets are professionally printed in English, include pictures of how embryos develop and what we should expect on each day after fertilisation. I sat and read them word for word when we returned to our apartment later on.

We were then returned to reception before Mike was asked to go with one of the nurses to give his sperm sample. Thankfully, he doesn’t get stressed easily but I know from online forums that lots of men really worry about their ability to “perform” on the day. Mike was hugely impressed by the thought that Reprofit have put into this, they have clearly tried to make everything as relaxed as possible. Mike went to a completely separate “men only” part of the clinic, totally cut off from anyone wandering past and very private. He was shown to a small room and given written instructions in English to follow and then asked to make his way back to reception in his own time. He was then left alone. The room will only open from the inside so no danger of anyone walking in and was apparently spotlessly clean and simply furnished. As you would expect there are magazines and a dvd player to help the men along if needed. After the deed is done (😉), there is small hatch in the wall and the instructions told Mike to open his side of the hatch, place his sample inside, slide the door shut and ring a bell. The andrologists can then open their side of the hatch and retrieve the sample. Very civilised!

Mike returned to reception and was then picked up again by a nurse to give a blood sample, it seems Reprofit are meticulous when checking for STDs – at this stage this level of professionalism was no surprise to us.

So, back to reception and then it’s the turn of both of us to meet our doctor so we are taken together to another consulting room. Once again, everything friendly and professional. We were informed the egg collection from our donor had gone well that morning and that 10 eggs were collected (yay!), we discussed again the procedure for us to contact the clinic for updates on our embryos and also had an initial discussion about how many embryos to put back on day 5. The doctor then performed a scan on me himself and he was obviously delighted with the results – the additional oestrogen had done the job and my lining had improved to 9.6 with the holy grail of the triple stripe which even I could see on the screen (although this means I had an optimal lining, I know people are also successful without the triple stripe). I had also started taking the progesterone that morning which, all being well, I would take until my 12th week of pregnancy.

We were so excited when we left the clinic. We felt we were in very good hands and, so far, everything was looking good for us. We made the most of a lovely sunny day in Brno and strolled back to the city centre hand in hand daring to believe that, maybe, just maybe, our future might include a child.

 

My Treatment – UK

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I was lucky enough to be able to fit my treatment in before the age of 50 years so, on the basis of great reviews, results, price and the ability to fit me in, I went to the Czech Republic for treatment at Reprofit in Brno. I used an intermediary service, Your IVF Journey , as they have pre-booked slots so I could maximise my chances before my 50th birthday. If I had had the time, I’d have gone direct as the feedback on the forums is that the co-ordinators and doctors at the clinic are really good at getting back to you. But time was not on my side.

Initial tests and investigations

All clinics will want some initial tests so they can prepare your “protocol” or treatment plan.  Reprofit asked for a scan of my uterus, ovaries and the lining of my womb, sperm analysis for Mike and blood tests for us both (standard STD tests including HIV). These can be done privately but Mike and I have very supportive GPs so we were able to get the blood tests and his sperm analysis done on the NHS. For my scan, I came across a company called Babybond which operates nationwide and does a family planning pelvic scan which covers everything Reprofit need. Babybond gave me my results on a CD and I emailed the images and scans of the blood test results back to Becky at YourIVFjourney to pass on to the clinic.

Medical questionnaire

We completed a comprehensive questionnaire prior to treatment. The questionnaire included information on both myself and Mike including previous pregnancies/IVF treatments and their outcomes, detailed medical information and lifestyle information. We were also asked about our donor preferences; height, weight, eye colour, hair colour, interests, education and any other preferences that were important to us.

Our protocol

This is an individualised protocol which in our case was wonderfully simplistic. Mike’s sperm analysis was fine so there was nothing for him to do other than turn up on the day. My infertility was down to early menopause so I had no monthly cycle to work round which also makes life easier. If you’re still having a monthly cycle you will need to be synchronised with your donor. I was prescribed a programme of oestrogen and progesterone, essentially HRT drugs in high doses.

Treatment cycle – UK

My treatment cycle started a couple of weeks before egg collection from the donor. I had to take 3 tablets of oestrogen a day and then arrange a scan with Babybond on day 11 to see how my lining was progressing. That was a stressful day.

It was a bank holiday weekend and when I arrived for my scan, the equipment had broken. I was offered an alternative day – no good for me, the timing of the scans is really important – or I could wait until the afternoon and have a scan an hours drive away. No discount was offered for the additional inconvenience and cost (I live 45 minutes away from the original scan site so that extra hour’s drive each way meant my scan took pretty much the entire day) and then they also mentioned it was a man doing the scan which, given it needs to be an internal scan, I was totally unprepared for. (When I’d got my head round it, I was fine with a man doing the scan, it just hadn’t occurred to me it wouldn’t be a woman and I was thrown for a while). Plus the new scan site was my hometown and in a popular shopping street so I had the extra stress of worrying someone might see my going into the premises and we had told no-one about our treatment. When I did eventually get my scan it wasn’t great news either, my lining was only 5.4mm – too thin.

So then the drive home, a phone call to YourIVFJourney who asked me to phone the clinic. Thankfully the clinic has a phone number you can contact even at 6pm at the weekend and the advice was to up the dose of the oestrogen from 3 to 4 a day. I was reassured this wasn’t unusual and not to worry. I was just glad to be at home with a cup of (herbal) tea.

So onto stage 2…..our trip to Brno…..

How to choose an IVF clinic – part III

 

Donors

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Let’s face it, if you’re having a baby in your 50’s then you’ll be using an egg donor at the very least, you may also need sperm or embryo donation. So before you choose your clinic you need a do a bit of research on how they find their donors, how old they are and the tests the clinic asks them to complete.  Age is particularly important for the egg donor as it’s maternal age that is the main risk factor for Down’s Syndrome so the younger the better. UK guidelines say all egg donors should be aged 35yrs or younger. Overseas clinics will vary and some have lower age restrictions. Although the UK has many generous women who are altruistic donors (they can only claim up to £750 in expenses), a growing number of egg donors are women undergoing fertility treatment themselves. These may decide to share their eggs with another woman to offset the costs of their own treatment. Women overseas are more likely to be paid for their egg donation, although some countries limit the amount. Although I can’t find any research to back this up, my feeling is that egg donors overseas tend to be younger than those in the UK as they are less likely to be donating eggs to offset the cost of their treatment. This was one of the reasons I went overseas and my donor was 23yrs old. The other advantage, of course, is that with an exclusive donor, you should get more eggs.

Confidentiality

In the UK, all donors are placed on a register managed by HFEA and must agree that identifiable information will be available to any children once they reach 18yrs. I couldn’t find any other country that offers this so if you go overseas the donor will remain anonymous. This is a key reason some people choose to go overseas. You may wish to keep the fact you used a  donor secret and perhaps you would prefer for your child to have no way of contacting their donor. Personally, I preferred the UK option and this was the only reason I seriously considered the UK for my treatment. In the end, however, knowing I would probably need three rounds of treatment and the higher cost and lower success rate in the UK compared with overseas meant I reluctantly decided that overseas was a better option for me. Perhaps European legislation will change in the future and my child may have access to their donor if they wish.

For me, making this decision was the hardest of all and I agonised over it for some time.

Guarantee

Some clinics offer guarantees around treatment which I felt showed confidence in their abilities and some degree of peace of mind for me. But, as always, the guarantees differ so look around. My clinic, for example, guaranteed two embryos of the highest quality available on the day of embryo transfer for people using donor eggs. But another clinic I looked at guarantees a minimum of four eggs from the donor. Well, there’s a big difference from four eggs (do they guarantee maturity?) and two embryos. And there may be other guarantees depending on the treatment you choose, for example, reductions off the third cycle or the third cycle free of charge. The guarantees can be very important. Someone going through treatment at the same time as me received no eggs from her donor so was not charged at all for the treatment. Check out that small print!

 Online Reviews

I used online forums extensively when looking for a clinic. I felt the best source of information was the fertility friends forum, although as I started to narrow down my list of clinics I Googled each of them to see what other women were saying.  Fertility Friends is a UK based forum with members from all over the world. The forum has a thread specifically for women over 50yrs as well as boards for most of the well used clinics in the UK and overseas. There’s tons of information on there and I found this the best source of information on recent treatment successes. Yes, it’s purely anecdotal but it’s up-to-date and I found it the best place to get specific questions answered and get a real feel for what the clinic is like. I can’t recommend it highly enough.

Gut Instinct

I started out trying not to let anything other than logic and the results of my research influence my choice of clinic but, after reading other women’s opinions, I came to the conclusion that you must let your instincts lead the way and you will eventually find yourself drawn to a clinic which will be right for you. Perhaps there really is something in female intuition after all so we might as well use it!