Options

Mo commented below about something I have been thinking about for a while. Trying to get out of the box - what are the other options we can pursue? I've thought of nearly everything (I think), from the possible to the ridiculous.

- Try one more time at IVF at concept with Dr Thompson (already doing)
- Change Drs at Concept (possible)
- Move clinics to do IVM (Weight limit and cost)
- Try a completely different clinic and protocol (again - really?)
- Progress our local adoption application (already doing)
- Apply for fostering in WA (issues with working fulltime, possible)
- Apply for international adoption as well as local adoption which we have already started ($$$$)
- Having an embryo transfer of donated embryos while we are in Europe in October (unlikely)
- Flying to Colorado or Montreal to see the world leaders in IVF for a last-ditch effort ($$$$$$$)
- Having someone be a surrogate 'off-books' (illegal)
- Have someone be a surrogate legally (but that's not the problem, and we would have to use donor eggs anyway)
- Get an egg donor (I cant put someone else through IVF for my sake, and my eggs themselves are fine damn it)
- Moving to another country to be eligible for free IVF (some UK counties, part of Italy etc - a serious consideration at this point)

- Give up. (And die)

I'm not sure what the right answer is anymore

déjà vu

Yesterday was our review appointment with our specialist. He didn't have good news for us. He says he doesn't think IVF will work for us as I am constantly fighting ovarian hyperstimulation syndrome each time I use Gonal F or Puregon. The past three cycles have all been cancelled due to my high estrogen levels, and he said he just isn't willing to take the risk of OHSS and take me through to egg collection, even with all the other control measures like cabergoline and albium in place. He openly stated that he is conservative, and when I pushed him to go ahead with an egg collection even if I was at risk of OHSS, he said he would not do that, and that, while he hates to do it to a patient, he will have to relinquish me as a patient.

I think I was in a fair bit of shock at that point. He wasn't rude or abrupt about it, it was just very matter of fact. After absorbing what he was saying, we talked about what other options we have. He is happy for us to have one more attempt at IVF (at our request), on the lowest possible dose of FSH, along with Lupron rather than Orgalutran. He doesn't think it will help as my body is so temperamental it will either not respond at all on that dose, or still go crazy with the OHSS risk - both resulting in a cancelled cycle. But we have nothing to lose trying it. Cancelled cycles cost very little, only a couple of hundred dollars out of pocket, and although there is a physical and emotional cost associated with it, I still believe that if we can just get to egg collection, we will fall pregnant.

There is another option which we discussed. Dr Thompson has suggested that I return to my old clinic, Fertility Specialists WA, and go through In Vitro Maturation there. It is the only clinic (that I know of) in Australia that is using the method, and I have been through it twice before. It will basically guarantee us to get to egg collection, which has been the issue. The reason we were unsuccessful in the past with IVM is due to Murray's poor sperm quality etc, and now we have a donor, that is not an issue. But there are still other road blocks. FSWA charge more than my current clinic. It is further away, and not generally open on weekends like Concept is.

But the biggest sticking point is that they have a BMI limit of 35. If your weight is over a certain limit, then the clinic will not treat you. It’s déjà vu. Back when we first started treatment at FSWA, I was told I was too fat for treatment, and so I went all out and did everything within my power to lose weight to meet the BMI limit. And I did it. I know it can be done because I did it then. But it was freaking hard - beyond hard. I am over the threshold. Thanks to a lack of exercise, and comfort eating, and fertility treatments, my weight has ballooned and I have hit a BMI of 41. The thought of having to do all of this to then go through all of the fertility treatment again… I don't even know where to start.

I am in the too-hard basket. I don't know what to do.

Wordless Wednesday - 13 weeks to go

The most famous painting in the world

Wordless Wednesday - 14 weeks to go

The palace of Versailles fascinates me - I can't wait to see it!

The Plan

So this is The Plan. Capital Letters indicate this is a Very Important Plan.
The Plan is actually a three-pronged attack.

PART ONE
I am going to see my GP on Saturday morning to update my medical report to submit to the adoption panel so we can start the assessment process. Now that Murray's medical report issue is finally sorted out, mine is out of dte. But by next week we will have submitted everything and make the $750 registration/assessment fee, and start the process to determine whether we are fit to be adopted parents.

PART TWO
I have an appointment on June 28th to see my fertility specialist. I'm clearly not happy with the situation that we have ened up in. There has to be something we can do to get me to egg collection successfully. I believe that if we can get our embryos, we will fall pregnant from a frozen transfer. But three cancelled cycles has meant that I don't trust my body anymore. I am researching different protocols as much as I can to bring ideas to my doctor for him to consider.

I did call my old clinic to discuss the possibility of doing IVM there. They were very positive about it, and it would be my preferred option, but they have a strict BMI limit of 35 which I am nowhere near at the moment. Which leads me to the next part.

PART THREE
I know my weight is a factor in all of this, I don't have my head in the sand. I have previously done a LOT to address this, losing over 20 kilos in 07/08 to get my BMI to 35. But it was hard. And I mean HARD. I essentially have to control every meal and exercise five times a week to get any results. That might seem extreme but between the PCOS, insulin resistance and metabolism, it is hard to get my body to do what I want it to. And even when I did all of that, guess what. It didn't make an iota of difference to IVF success or restoring ovulation. Fertility treatment, being busy, attending uni at nights, and laziness has meant eating habits have slipped and the weight is back plus some.

But I am going to give it a shot. I am hoping to get involved in some team sport, and start jogging to get my fitness up, with the aim of losing seven kilos before our trip in October. Seven kilos is big enough to notice a difference, yet small enough to not be too intimidating. Four months also allows me time to do things properly and not crash-diet.

I have to know within myself that I have done everything within my power to get us our child. And losing weight is part of that.

So that is The Plan.

I don't know if it will work. I am still fragile. Raw. Wounded. But I have to hope. What do you have left if you have no hope?

Giving up.

It was the end yesterday. It was the first time I have honestly thought that I couldn't go any further and that we wouldn't have a child. In the past I believed that even though now wasn't the time, that it would still happen sometime. And yesterday that disappeared. I don't know if we will ever have children. It kills me.

But today, something happened. I held my friends little baby today and soothed her until she went to sleep. And I realised I can't give up. Not on this.

Over and over again

E2 - 5100 uP from 1300 on Saturday. LH at 15. Many follicles on both sides, the biggest at 10 and 15mm. And another cancelled cycle.

Body fail

Hormones are currently at 750 up from 150 on Monday but my follicles haven't grown much at
all, still nothing bigger than 8mm on both sides. AND my doctor wants me to drop my puregon down to 50iu because of the fear of ohss. Fantastic. Not. Back to the clinic for another blood test in the morning. Just the kind of news I need before my uni exam tonight.

I am starting to get stressed. The fear that this cycle will be cancelled is always with me.

Wordless Wednesday - 16 weeks to go

We will pay our respects at Anne Frank's house in Amsterdam

Day 6 - OHSS Prevention

Injections, blood test and ultrasound were done this morning, of course making me an hour late to work. Somehow, even with only 5 people on the ultrasound list in front of me, there was still an hour wait to be seen. My annoyance faded though once I was in the sonography room, as the nurse spent a lot of time completing my request to count and measure every follicle (usually at day six at this clinic they just do an estimate of how many follicles there are and only measure the lead follicle). As of this morning I have 12 follicles on my right side around 6-7mm and 10 follicles on my left side measuring 6-8mm. I'm assuming I will be coming back in on Thursday for another set of bloods and a scan. Just hoping that my E2 levels aren't too high at this early stage!

Speaking of high levels, for all my bravado about risking hyper-stimulation, I should clarify that I really don't want to end up with OHSS. It sucks. Really badly. Although the memory has faded, I remember feeling so out of control and hating how sick I felt. So I don't want to be reckless about any of this - no extra drugs, making sure I do exactly what the doctor says. But when it comes down to a choice between the chance of a baby and zero chance of a baby, I have to take the former, no matter the short term pain and discomfort. I just hope I am able to stick to that decision later on- or that I am even given the choice to continue.
I'm starting to trawl through different journals and look at studies that focus on OHSS to try and come up with a game plan for how I can get through to the egg collection successfully. Even if we end up with a freeze-all situation, I will be ecstatic, and happy to allow my body to calm down before proceeding with a frozen embryo transfer. Any advice or experience in this area would be greatly appreciated!

Day 2

Thank goodness for long weekends! I've had such a busy morning today, I am so glad I decided to take the day off! I went into the clinic this morning to pick up my drugs and do my annual HIV/HEP blood screen done (apparently you need to repeat them each year). I had a grumble to the nurse as once again I am not happy with the dosage I am on - only 100iu Puregon each day. I have asked the nurse to speak to my dr to up it to 150, hopefully I win that battle.

I am willing to do whatever it takes this cycle. I know fertility clinics are conservative by nature but they have to understand that I am at the point where it is time to take risks. I am willing to risk one week of physical pain (potential OHSS) against the months and possibly years of depression and emotional anguish of having a cancelled cycle, or not having any embryos to transfer. Some people get it, some people don't. But that is the point I am at. I don't say it lightly - I remember what OHSS was like and I don't want to get it. But I am willing to take the risk, and that is my decision to make.

While I was waiting to do my blood test, the scientific director of the clinic popped in and introduced himself to me, offering his assistance where he can, and also asked if I was interested in participating in a study during my treatment. I am all for research, so I am now participating in a study that examines the link between infertility, infertility treatment, stress

And in other related news, we got a letter from Adoption Services stating that they have determined Murray to be 'fit to adopt'! So a year after we initially had our medical reports done, they have worked all the mess out and we can proceed to assessment when we are ready. Well except the slight hiccup that because it has been over 12 months since I did my medical report, it is out of date and they want me to do another one. We have decided to just hold off for the moment until we know the outcome of this IVF cycle, and then I will do the medical and we will decide whether we are ready to start the assessment process.

All in all, a productive day! Murray and I are headed down south for the weekend, not for a romantic getaway, but for a weekend packed with sport! It's State Youth Games which is where a bunch of young people from churches across the state get together to play sport, mingle and worship! I went for the first time last year and this year I am the church organiser which has been nuts but lots of fun as well. My itinerary this year involves ultimate frisbee, touch rugby, bocce and mixed netball - a rather eclectic mix I admit. My only concern is how COLD it is going to be. I guess winter well and truly has arrived!

And so it begins

I got my period about an hour ago, so we are all systems go for IVF round 13. I will call the clinic tomorrow to let them know, and go in for a blood test and to pick up my meds on Friday morning, which luckily I have off work. Then I am spending all of the long weekend down in Bunbury, helping out with our church's State Youth Games team. Hopefully I don't scare anyone with all my injections!

I am scared. The moment I realised my period had arrived, I just got this overwhelming feeling of 'oh my goodness, I don't know if I want to do this anymore'. It's the fear that we might get to the end of this and have nothing. But you know, the payoff if it works is going to be incredible. So it's a game of risk and odds. The risk of success = around 40%. Scale from 1 to 10 of how awesome it would be = 20 gazillion. So let's play. We are all in.