Monthly Archives: September 2015

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?

 

Brno

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One of the pleasures of having treatment overseas is you get to have a holiday at the same time, and Brno turned out to be a lovely place to spend a relaxing few days.

Brno is the Czech Republic’s 2nd city, situated in Moravia in the South East of the country. It’s surprisingly easy to get to from the UK. It has its own airport with direct flights from Stansted or Luton and it’s only a couple of hours away from Prague, Vienna and Bratislava (Slovakia) so you can fly into any of these airports and use the excellent local trains or buses. There’s a wide selection of hotels and apartments to suit all budgets and tastes. We used booking.com due to the favourable cancellation policy for most places.

It’s a university town with three large universities and a number of smaller ones. Interestingly, one of the major universities is Mendel University named after the “father of genetics” who lived here. Not surprisingly many of the egg donors at Reprofit are from the 89,000 students who study in the city.

Brno is a beautiful city, we were so impressed by all the old buildings and lovely parks, especially Luzanky Park (visit Park Lane Cafe whilst you’re there for a delicious hot chocolate). It feels safe to walk around and we had no problems with language, many of the coffee shops and restaurants had English menus. And it’s just so cheap to eat out and, of course, for anyone not alcohol free, Czech beer is superb. Lots of things to do aswell….the zoo, Spilberk castle, cathedral, technology museum, botanic gardens, the rather gloomy ossuary (collection of human bones – we gave it a miss as it didn’t seem to fit with the purpose of our visit!), Villa Tugendhat (book well in advance of your visit) plus various museums and galleries. There are lakes and caves nearby as well as various events…local festivals, a fireworks competition and the annual MotoGP at Masaryk Circuit. Oh, and shops, how could I forget?! Time to stock up on clothes and shoes as the prices are very favourable compared with the UK.  And with Prague, Vienna and Bratislava within easy reach you really shouldn’t be bored.

It’s a beautiful place, blessed with a relatively mild climate and we had a really relaxing, sunny few days.

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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…..