Miss B and Miss A are both little IVF bubbas.
As I was writing last night’s post, I realised that I have made mention of our IVF journey a couple of times, but have never given any background. So I thought I’d share our story, partly because I’m very open about our IVF journey and also because I think it’s important that my girls understand how much they were wanted despite the challenges we faced. Because despite our fairly positive experience, IVF is a challenging experience, no matter how ‘easily’ the process works.
So go and grab yourself a cuppa, coz this one is an epic. And fair warning, if you’re not a fan of TMI (too much information) then I suggest you stop reading now.
But if you’re still with me and up for a read, then here we go…
When the hubby and I had been trying to fall pregnant for six months, I had a gut feeling something wasn’t right. I had had an ovarian cyst removed when I was 19 and my gut was telling me it was all somehow connected. As it turned out, a work colleague and I were trying to fall pregnant at same time and in September 2010 we both learned that each other was actively trying. She also had a husband that was rarely home (hers worked in the mines) so we were often lamenting together that the timing of their ‘time’ at home was often not ideal.
For months we met up in the work kitchen (secretly of course) and compared notes. We even ended up downloading an app to record a whole range of fertility tracking signs (period dates and other signs of ovulation – mucous levels, temperature and of course when you did the deed with the hubby). We tried ovulation test kits (or pee sticks as we called them) and just about every morning we’d update each other sharing waaaay too much information. It worked for us and was a great support given our husbands’ chosen occupations. This little ritual went on for about 6 months and as the window for ovulation is so small, it was hit and miss with the timing for a while. However my friend eventually fell pregnant in March 2011 and we still weren’t pregnant. Whilst away on holidays (we figured we’d take a break), my gut feeling still hadn’t changed so we decided that once we got home we would go to the Dr and see what tests could be done to determine if there were any residual effects of the cyst removal I had when I was younger.
We met with our GP who ordered a series of general health blood tests and provided us with a referral to see an obstetrician. By May 2011 we had met with the OB who ordered even more tests for us. For me, it was some more blood work to check for a range of hormones that relate to pregnancy which had to be done at specific times during my cycle. For the hubby, they ordered some blood tests to check his hormone levels as well as a sperm sample to check his morphology (the shape of the sperm) and motility (how fast and well they move).
I got the results back from my tests before the hubby had even done his so we were able to find out that all my hormone levels were perfect and in theory, shouldn’t be a contributing factor to our fertility issues. So our OB ordered for me to undertake a HSG or hydrosalpingogram, which is a test where they inject dye into your fallopian tubes to check for any blockages and issues with your ovaries.
Soon June was upon us and the date 15 June 2011 is one that is etched in my memory. It was a big day. I had an interview at 3pm for a job I had been wanting ever since moving to town two years prior, plus I had my HSG appointment at 11.30am. And after anticipating what was likely to be a busy and potentially stressful day, I was looking forward to going away drinks for my friend later that night.
The day started like any other, I woke up and went to work before slipping away to the hospital to undertake the HSG test. Only the hubby and Mrs Mone knew I was doing the test and the hubby was away (of course). As a day surgery procedure, the HSG is relatively minor thing but it is a little uncomfortable (although you do get to wear the lovely bumless survey gown). Your legs go up in stirrups and they prep you much like having a pap smear before they insert a catheter as far as they can and injecting a dye. At the same time, they are moving an ultrasound wand over your abdomen so they (and you) can actually see the dye move through your tubes and across the screen.
Well, that’s what you would see if the dye was actually moving through the tubes. As soon as I saw the screen I knew. My right tube was completely blocked and the left was 95% blocked. My gut instinct was right. It turns out the surgery I had had when I was 19 had caused scar tissue to form in both of my tubes.
I don’t generally do tears, but pretty much once I got back to my car the waterworks started. After about 10 mins of self pity, I pulled myself together and then headed back to work to prep for my interview. I called my hubby on the way back to tell him what I knew (albeit without the emotion or the tears – that was a very cold and detached conversation). I went to my interview, nailed it (and got the job which is what I do now when I’m not on maternity leave) and left feeling emotionally drained. So I called a friend and asked her to meet me early so we could get the jump on the drinks that night.
And boy did I get on it! I didn’t tell anyone what had happened with my HSG but within half an hour at the pub I had drunk a bottle of wine and was settling into bottle number two. Nobody had suspected why I was drinking, they thought I was celebrating my interview and letting off some steam. I had called another friend to enlist her in my drinking efforts and when she arrived (sober), she quickly tried to catch up. Keep in mind this was only about 5/6pm. By 10pm, many people had gone home and there were probably only about half a dozen of us left. By this stage I was pretty tanked and was sitting quietly, reflecting on what I now knew about my HSG results. My friend (who was the reason for the party) came up and asked my why I looked so sad and then the floodgates opened. I remember sobbing that I’d never get to have kids and about the HSG results. My friends (and the couple of very new acquaintances still there) were shocked, not so much at the news, but because this was a side they’d never seen of me – they only knew me as being very independent, confident and strong so they didn’t know what to do.
So when I went to the bathroom to freshen up (and drunk text my BFF as it turns out), the friend who I had enlisted earlier called my hubby who was on the road in his truck. Not the best move! She was drunk too and wasn’t making any sense, telling him he had to come home (he was 2 days away from home!) and that I was upset and devastated. Needless to say he panics and was trying to call me but I didn’t hear my phone or notice any of his missed calls. Plus my BFF had called him to see what was going on and as I learnt the next day, we pretty much just completely freaked him out! And there wasn’t a damned thing he could do about it being so far away!
By 11pm, the pub was closing, so we decided to head to another one which was still open. It was a Wednesday night so there wasn’t a huge crowd. We walked into the next pub and I went up to the bar and ordered tequila shots. I apparently drank one and threw one over my shoulder. And by this stage, (thankfully) another friend had the foresight to get us into a cab and take me home.
Ok, it’s time for:
**** INTERVAL ****
Grab a fresh brew, or take five to relieve yourself, or simply rest your eyes from all the text by looking at a picture I took the next morning, before I got out of bed and headed into work an hour late!
Ok, you back with me? Let’s continue shall we.
Aside from a killer hangover, I had blown all the cobwebs out and it was time to regroup. By the time we got back to the OB the next week I was over my self pity and ready to work through the options. Plus, the results for my hubby were also back and didn’t look good. Turns out both of us had fertility issues. His issue was around his morphology (shape of the sperm and therefore their ability to penetrate an egg) and motility levels (their ability to swim fast and survive) which were both very poor. This meant that even if my tubes weren’t blocked, the chances of us conceiving were minimal. Turns out, this kind of result is quite common for truck drivers, or farmers or anyone who sits over a hot engine bouncing up and down on their bits day in and day out.
Our OB said that ordinarily the would have tried us on an IUI protocol (intrauterine insemination) which is basically artificial insemination of the sperm into the uterus (AKA turkey baster method) however with my hubby’s low counts and poor shape of his swimmers, it would not be likely to success. So we were referred to an IVF clinic to go straight into IVF. We are nearly 500km away from our nearest IVF clinic. But thankfully, our OB’s clinic supports the pre and post surgery component of the process – ie the provision of the fertility drugs and the ultrasounds etc, however the surgery to harvest the eggs and then the transfer of the embryos had to be done in Adelaide.
In September 2011, we headed over there for our initial consultation. Mountains of paperwork was filled out and whilst I was giving some history to one of the nurses, my hubby had to go and spend some romantic one-on-one time in ‘Room B’ to provide the clinic with a sample. We then both met with our Dr (who looked and sounded exactly like Borat) and who told us that rather than just do IVF, they would split our eggs between IVF and a process called ICSI to see which method worked best. IVF is in-vitro fertilisation – although I like to call it the Shake and Bake method. Basically the eggs are harvested and put into a petrie dish with the sperm and they then fertilise naturally as though they would if meeting in the uterus. ICSI on the other hand is Intracycloplasmic Sperm Injection – this is where the sperm is injected into the egg. It’s a specialised area of IVF but is often the image people know of when they hear about IVF (you know, the classic picture of the needle going into an egg). It’s also the more expensive option.
So we head back home, brains swimming with all this information and in November 2011 we prepare ourselves for our first cycle which involved injecting myself with FSH (follicle stimulating hormone) over the course of about 2 weeks during my cycle to stimulate the eggs to grow in my ovaries. The injections are administered using a pen which you ‘dial up’ the dose of FSH you need to take (similar to an epipen). We had been given all the drugs, and the pen as well as the verbal instruction from our nurse at our OBs office on how to administer the needle in my stomach.
I don’t like needles (not sure who does) however I had psyched myself out a little bit about the needles and on day one I had to youtube how to give myself the needle again – just to be sure. Bad idea! The first video the woman gave herself the needle and was screaming down the house…. Gulp, move on please! The second video turned out to be a Thai transsexual who was giving herself hormone injections but finally I found a how to video by the manufacturer of the hormone brand I was using – much better. Surprisingly the needle was nowhere near as bad as I thought it’d be and for the next few days I gave myself the needle in the stomach (trying to avoid the bruises which each needle left).
I was giving myself needles every day and then every second day I would have to go and have an ultrasound to see how big the follicles were growing as well as blood tests to see what levels my hormones were at. The ultrasound is done transvaginally or as I liked to call it via Dildo-cam. After about two weeks (and multiple Dildo-cam sessions), the follicles and my hormones finally reached their optimum levels for harvest and I was able to give myself the ‘trigger’ shot. The trigger shot is the last needle in this process and contains a hormone that tells my body to release the eggs from my ovaries into my tubes and towards my uterus. It’s also a proper needle and syringe which is bigger than the pen needle and hurts a lot more!!! Once this needle is given I had about 24 hours to have the eggs harvested which meant getting up at 2am to administer the trigger shot and then heading over to Adelaide for surgery the following afternoon.
The harvesting surgery is again a day surgery but it’s a lot more invasive and requires a general anaesthetic. I remember getting changed into my hospital gown whilst my hubby was off for some more romantic one-on-one time in Room A or Room B. I walked into the theatre in my gown and was faced with a room full of about 12 people, half of whom were male and I remember thinking great, I have to try and get up onto a table and into stirrups with an audience. Thankfully, they got me onto the table and started with the anaesthetic so I was just about zonked out before they even moved my legs into the stirrups.
The procedure for the harvest is basically to insert a long needle into the vagina and push through the vaginal wall into the ovaries and suck out the eggs. I’d been given the heads up that they would write the number of eggs they got out on your hand so you could see it when you woke up from surgery. Normally you can expect somewhere between 8-10. I had the number 15 written on my hand. I was excited (and a little bit proud of myself if I was honest!). After I recovered for a few hours in the recovery room, we drove home and the next day, the clinic called to confirm that I actually had 14 eggs (one was a speck of dust apparently) and that 8 were put through the shake and bake method (IVF) and 6 were done using ICSI. Of these she told me that all the IVF eggs had died (ie not fertilised) and that 4 of the ICSI had successfully fertilised. So of the 14 eggs we harvested we only had 4 embryos. But, that was 4 chances! One was going to be transferred 5 days after the surgery as a fresh embryo, the others would be frozen once they hit the 5 day blastocyst stage.
The method that my IVF clinic use is a 5 day transfer method meaning that they transferring the embryo around day 5 when the cell structure had split into a blastocyst (other clinics use a 3 day method where they transfer at 3 days not 5). This meant that I had to return back to Adelaide for the embryo transfer in 5 days (a tough gig when you’re trying to keep it secret from work but thankfully as our harvest was on the Monday and there was a 4WD expo on that weekend prior so I used that as an excuse for being away on the Monday. As it turned out, I actually legitimately had tickets to see Dolly Parton in Adelaide for the following Saturday so I had already taken the Friday off to head over there for the concert. My transfer on Friday was in the late PM so the story was an easy one to concoct.
My hubby was back at work by this stage and technically speaking, you don’t need the male around for the embryo transfer (it’s nice for them to be there but in a medical sense they don’t need to be – he wasn’t for our second daughter as he was at home hosting a AFL grand final party at our house, but that’s a whole other story!!), however by coincidence he was actually in Adelaide in the truck when I needed to be there so I picked him up from a service station and we went and had the embryo transfer done. The transfer is no worse than a pap smear but unlike a pap smear you get to experience the chair o’ fun with an embryo transfer. Imagine if you will a dentist chair that has most of the seat cut away so that there’s just a tiny little ledge to perch your bum on. The chair lifts up high and then tilts right back so you are nearly laying flat. Picture your feet up in stirrups, spreading your legs so that your girly bits are at eye level to the doctor who is about to insert a catheter into your vagina and implant a tiny little embryo into your uterus. Via ultrasound you see the tiniest ‘flash’ as the force of a little air pump puffs the embryo out into the uterus. They even gave us a picture of our little 5 day old blastocyst and I remember thinking how special it was that our kids first photo is of them as a cell under a microscope.
Fast forward through the dreaded 2 week window which was the time we wait before I could have a blood test to see if I was pregnant. I think I used about 10 pregnancy tests during that time which was torture in itself. Two days before I got the call confirming the blood results I had a positive result on the pregnancy test (and the other 3 or 4 I did just to check). Then as I was walking back to my car with Mrs Mone after having a coffee, I got the call to say I was pregnant. Again, I burst into tears at the news. I’d cried more in the past few months than I ever had… but this time it was happy tears. Our IVF had worked and we were going to have a baby.
Our first daughter, Miss B was born from that first fresh embryo transfer in August 2012 and our second daughter, Miss A was born via frozen embryo transfer from the same batch in June 2014. In fact, we actually put two embryos in during Miss A’s transfer. Both were viable embryos but one was graded higher than the other so we took the risk. Given the process for using frozen embryos doesn’t involve the hormone support and therefore no needles we used my natural cycle, blood tests to monitor hormone levels and then waited for the call to go over to Adelaide to have the embryo implanted. As timing would have it, we got the call to come in for Miss A’s frozen embryo transfer on the same date as the AFL Grand Final… something we only found out AFTER we’d planned a big party as our household is a Hawthorn one! So Mrs Mone and I hightailed it over to Adelaide, telling people that Mrs Mone’s husband couldn’t make it to an appointment with her, so I was going instead. Mrs Mone was present for the transfer (at the head end of course), and the fact that she was ‘present when Miss A was conceived’ is something she loves to tease her kids about!
We have no more frozen embryos and if we want to go back for a third baby (which we always said we would), we will have to go through a whole new cycle again although we would do a pure ICSI cycle, we wouldn’t bother with shake and bake again.
We were very lucky and our experience was a very positive one. We had what I call a ‘logistical’ issue as opposed to a ‘chemical or biological’ issue. As I tried to explain to my hubby in the early days, our situation is like a truck travelling along a highway when all of a sudden he comes to a road block and has to take a detour, we’re still using the same truck and the destination is still the same destination, we just had to find a different route to get there.
I am so completely aware of the fact that all of the gods were on our side through our IVF journey. I actually know a lot of people, including two very good friends, who have been through a much more turbulent IVF journey, not only emotionally, but financially as well. I’d like to think though that we would have retained our positivity and sense of humour throughout the process, even if it had’ve taken us a bit longer. Because it’s really a remarkable thing. Science has given those of us who would have otherwise been denied the chance at parenthood the most amazing gift. And there aren’t too many bubbas out there who can claim these as the first pictures:
Oh, and the last thing. There is no humility left after IVF – any mum would know what it’s like with just the regular OB appointments… well multiply that by 10 and you’re starting to get the idea of what IVF is like. You are poked and prodded within an inch of your life. You become a pin cushion between the blood tests and the actual IVF process and every man and his donkey has seen your bits!!! On the plus side it sure does make breastfeeding in public a cakewalk.
Did you make it to the end of this epic post? Do you have an interesting conception story of your own?