Category Archives: Reprofit

Early days & first visit to the midwife

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I was dreading the first visit to the midwife. I knew my GP was comfortable with me getting pregnant at my age but I was worried about the rest of the NHS staff. My first appointment was less than a week after I had tested positive but by the time it came round I was officially 5 weeks and 1 day pregnant – very odd. It’s strange the things you don’t know when you’re pregnant for the first time, I had no idea you are technically pregnant from the date of your Last Menstrual Period (LMP) – which was about 3 years ago in my case!

I went along with a small notebook which has become my pregnancy bible. On the front page, I have all the key dates ie fertilisation date, embryo transfer and from these I worked out my estimated due date (EDD) & the donor’s LMP. I also noted down the medication I was taking and key phone numbers. I used this online ivf calculator to work out the LMP and EDD. I had questions for the midwife written down and I was feeling a little bit of pressure to get some results.

Reprofit wanted my HCG levels monitored via blood tests done at regular intervals to check the hormone is increasing at the expected rate. Most people get these done at a local fertility clinic but I didn’t have links with any and was struggling to find a private provider locally. Reprofit also wanted an early scan, at around the 6-7 week mark when a heartbeat should be detectable. I understood the importance of this as heartbeat is a key measure of their success. In 2014, 70.3% of donor egg cycles at Reprofit resulted in a positive pregnancy test and 56.2% resulted in a heartbeat detected (blame those awful chemical pregnancies/early miscarriages for the difference). I also wanted to see a heartbeat as soon as possible as I was still worried at the prospect of a chemical.

Much to my relief my first appointment went surprisingly well. The midwife took my contact details and date of birth and explained the basics eg. which foods to avoid in pregnancy. She explained that, because of my age, they would want to take extra care with me so there would be an automatic referral for consultant led care. I would be sent a pack of information in the post, including my maternity notes, along with an appointment to go along for a longer meeting with a midwife called the “booking appointment”, during which they would also take some basic blood tests.

She explained that the NHS does not offer HCG testing but she understood why I would want an early scan. She gave me the number of the EPAU (Early Pregnancy Assessment Unit), based at the hospital, and said to give them a call and see if they would consider an early scan on the grounds of my age and it being an IVF pregnancy.

I sat in the car park of the GP surgery and phoned the EPAU and was hugely relieved when they agreed to scan my and gave me an appointment for a couple of weeks time. Reprofit would just have to do without their HCG levels.

Now I just had to sit and wait and hope that everything continued to go well.

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…..