Prayers

I keep thinking 'what if'. What if this works. Thinking about prams and due dates and after-school activities. I'm trying not to get carried away, but my brain always does this. Every time I give myself permission to hope, it ends in disaster.

My constant prayer has been that whatever God wills, let it be done. If that means no children, then I know he has a plan for me, that I can't do with a child. Maybe I am destined to adopt? Maybe he wants to be available for some other great adventure. I don't know, but I have to trust in his infinite wisdom.

Endometrial Scratch & SA test results

This morning I had an endo (endometrial) scratch, which is essentially causing a deliberate injury (scratch) to the lining of the uterus, in the hope that the healing process will create a more receptive environment for embryos to implant in the following IVF cycle. There are some recent studies on it which are quite interesting

I took two Nurofen Plus tablets at 8.30am and then headed in for my 9am appointment with the specialist. It is very similar to getting a pap smear - you lie down with your bottom half clothes off, and they insert a speculum. My Dr also did a pap smear for me since I was due for one which was helpful.

Then came the tough bit, the scratch itself. I won't sugarcoat it - it was painful. I had to do lots of deep breathing and there was no way I could relax my body during it. People that say it is a 'mild discomfort' are lying through their teeth or else had a VERY different experience to me! In saying that, the local pain was only while it was being done (maybe 60 seconds?), then some mild cramping for a couple of minutes, and then just a little achy for an hour after that.

I had a long nap when I got home, most likely due to the effects of the codeine, and this afternoon I have felt fairly normal. The Dr said that I possibly will have a bit of spotting as their was some contact bleeding during the pap smear, but nothing to be worried about. So all in all, it was worth doing, although I can see why it isn't a first line treatment for new IVF'ers.

My specialist also gave us some really good news - Murray's DNA fragmentation test results had come in and they were only 6%!!! Considering they were once at 35%, that is a massive improvement and is now completely normal! The Dr asked what we had been doing and I explained that he had lost about 12kg since July, and has also been taking Blackmores Conceive Well for Men, which has antioxidants in it (which he hates taking but I make him take!), and she said for him to keep doing it because it is working! He is also on an alcohol ban until he gives his sample on the egg collection day, so hasn't been drinking for the last few weeks, along with me, so that we give everything our best shot. 

We are due to start IVF in about a week or so once my period arrives, which could be any time either next week or the following week. We have a big event coming up though - our tenth wedding anniversary! We are renewing our vows at a picnic ceremony in a local park on November 14, so hopefully my period doesn't arrive too soon, as I need to be able to fit into my dress!

In other good news, our 2 year adoption approval has been renewed until 2017. Even though I expected it to be all okay, it was very reassuring to get the letter in the mail this week.

All systems go

My blood test today showed that my LH levels are surging  so the doctor wants me to book in for next Friday to have my Endo scratch  done. I'm excited but also a bit nervous about it. The timing of it all also looks like our egg collection will happen just after our 10th wedding anniversary.

For our wedding anniversary we are renewing our wedding vows in front of all of our friends and family. We felt like this was a great opportunity for us to reaffirm our  commitment to our marriage  especially considering all that we have gone through with infertility and childlessness over the past 10 years.

We're having a picnic in the garden and have around 50 people coming along to celebrate with us. I can't wait!

Adoption interview complete & new house photos!

We had our adoption interview with the agency workers today and it all went really well! We had two ladies come out to interview us and they mainly wanted to know about the new house, how our health is, any changes to our extended family and support systems, our plan to do IVF next month, and of course our finances. We chatted about a couple of different things, and then did a walk around the house to tick off the inspection component. At the end, they said that we will get a letter in the mail once it is all finalised to say that we are approved for another two years! It was a really positive experience, and although we were both nervous beforehand, it was a great relief to have it go so well.

Now I promised a while back that I would post up some photos of the new house, so here they are! I promise my house isn't always this messy!

We are at the back of a triplex development so nice and private and away from the road

The kitchen before we moved in - so pretty and clean!

Lounge and dining before we moved in

The patio and garden area

Lounge area - Charlie tried to get into all of my photos! I had the lights off here which is why it is so dark

The kitchen now it is lived in! I made strawberry and vanilla jam in my thermomix tonight

Our bedroom - I love how big it is, it fits our king-sized bed comfortably with plenty of room to move.

Our ensuite! I love having two basins! Eventually I'd love two replace the two small mirrors with one full size mirror

The spare bedroom which is set up for our nieces and nephews and friends kids when they stay over

The other view of the spare room

And finally the kids bathroom. I bought the raining cats and dogs shower curtain from Society 6 - how cute is it!

2 year renewal- adoption interview

On top of all the IVF preparations for next month, we are still progressing our two year renewal for adoption. Our Medicals must have come back fine as they emailed us to book in a time to come and interview us.

Our interview is Thursday afternoon, and one of the ladies who is coming was the very first person we spoke to at Adoptive Services many years ago. I know there will be a house inspection element to the interview so no doubt I will be busy tonight scrubbing the kitchen to make it shine!

Hopefully everything runs smoothly and we get our approval. I am trying to be positive about it- there is no reason for me not to be, but we seem to always be thrown curve balls in these situations so you never know.

IVF Appointment- All Systems Go!

We had our IVF appointment with Dr Lucy Williams on Monday. It went really well I think. She was kind and considerate of our long infertility history.  We were able to come up with a plan going forward.

Next cycle we will be doing an IVF/ICSI cycle. We are also going to try an  endometrial scratch on day 21 of this cycle to see if that helps with implantation.  Something I wasn't aware of is that the ICSI procedure is different now than what it used to be say five years ago. Now they use a special technique which helps to identify the best sperm to inject into the egg to fertilise it.  The technique helps to identify spend that does not have DNA damage which of course is the issue we have been trying to address for Murray.

 The doctor is also willing to consider replacing more than one embryo depending on embryo quality of the time of transfer. We aren't quite sure what dose of drugs I should be on so it will be trial and error at the beginning to get the right dosage but hopefully we can get to egg collection  without having the cycle cancelled. So bring on November!

Public IVF treatment

Our public IVF referral has been approved, and by a stroke of luck, we have managed to get an appointment with the specialist we wanted on October 5th! She had a cancellation that morning, otherwise there would be a 5 month wait to get an appointment. We are seeing Dr Lucy Williams who is the Scientific Director at Concept Fertility. There were two other doctors who I could have seen, but considering that we have had so much treatment in the past, we just wanted to go to the top doctor available.

Murray is currently away on school camp, in a remote indigenous community, about 19 hours drive from Perth. He is having a great time, although it has been particularly challenging in parts. They went hunting for Goanna yesterday (basically a giant lizard for non-Aus people!)

The goanna cooking on the coals

So while he has been away, I've been at home by myself. I had a lovely lunch with a girlfriend of mine, and we did a spot of shopping afterwards, and now I am cleaning up the house while I get ready for the big game - my team the West Coast Eagles are in the preliminary final of the AFL- if they win tonight, they make it to the grand final! Fingers crossed it is a good game.

On that note, better get back to house cleaning!

Regular programming

We had our public IVF appointment today and I have come out of it exhausted. After updating all our medical reports, we went back to the KEMH fertility clinic, expecting to get our referral to Concept (our regular fertility clinic) for our publicly funded IVF.

We went through some of the results briefly to bring the Dr up to speed, and then I mentioned that we had one 2 day donated embryo sitting in storage which was our 'insurance' if we didnt get fertilisation or anything to transfer. Well straight away the Dr said that we couldn't proceed onto the publicly funded IVF as part of the rules are that you cannot be undertaking any fertility treatment.

I explained the situation but apparently undertaking any fertility treatment includes having no embryos in storage, regardless of if they are your gametes or have been donated to you. I just burst into tears, and the Dr went to have a conference with a senior doctor to confirm that was correct. I pulled myself together, and the doctor came back and confirmed that was the ruling by the health department. She then took us to see the fertility counsellor to discuss what our options were.

It was good to have that chat - we had met with that counsellor many years ago when we first started IVF treatment and you had to undergo compulsory counselling prior to commencing IVF, so she vaguely knew a little of our history. We decided that we would relinquish our claim on the embryo and give it back to the clinic to potentially reallocate. The reason we were upset was because in the moment, it sounded like we had to make a decision to either use the embryo straight away, which we didn't plan to do, or make a decision to destroy it. That seems silly now that I am away from the situation, but in the heat of the moment I felt like that was the decision I had to make and my heart just broke, as we are firmly against deliberate destruction of embryos. On top of that, we have had many cycles where no embryos were available for transfer, so the loss of our back up plan in the event of that occurring was very upsetting.

Anyhow, it seems to be all sorted now, but I need to contact the public clinic to let them know about the reallocation of the donated embryo, and then they will send the referral through. I have no idea how long that will all take, and to be honest I don't care right now. I am just trying to get all of our adoption paperwork under control for our two year renewal, and that is taking all of my focus.

I spoke with the adoption agency last week, and they have said there are no children at the moment looking to be placed in the near future. There are a couple of babies in care but they are some distance from being placed, if indeed the birth parents don't choose to parent. I just wish we would get that call.

We had a great weekend babysitting my best friends 6 year old this past Saturday. We played board games, coloured in and drew, baked biscuits, watched basketball and went out for breakfast and to a park. I am eternally grateful to friends and family who have allowed us to be part of their children's lives, even though we may not get the opportunity to be parents ourselves. We love children so much, that weekends like that make my heart sing, even if there are bitter-sweet moments when they leave.

Enough blathering, that's pretty much where we are at. Oh and our new house is fantastic - one of the best things we have ever done. Photos to come - promise!

Photos from the past few months

Celebrating my 29th birthday with my nieces and nephews

Taking Charlie and Daisy to a dog park close to where we live

Daisy getting some cuddles on the couch

Indoor rock climbing for my birthday. Unfortunately I hurt my back after this and was on bed rest for a week :-(

Our IVF history - a recap

As part of the preparation to meet with the fertility clinic and proceed with IVF, I have updated our fertility treatment history for the new specialist. I don't expect that the specialist is going to have read every item in our files, after all we have been trying to conceive for nine years now - that would be a lot of paperwork! Instead I have created a treatment cheat sheet with all the key bits of information, and if there is something interesting then the doctor can look in my file for the specifics.


FERTILITY TREATMENT HISTORY
1. September 2007 – IVF #1 (Dr Doreen Yeap)
Understimulated, cancelled before egg collection
Synarel from day 21, FSH 75iu x2, 112.5iu x2

2. January 2008 – IVM #1
13 eggs retrieved, 8 matured, 7 fertilised, 1 blastocyst transferred, Negative result
FSH 150iu x 3 days

3. March 2008 – IVM #2
Ten eggs retrieved, 8 matured, 7 fertilised, no embryos to transfer
FSH 150iu x 9 days

4. May 2008 – IVF #2
20 eggs retrieved (17 mature, 3 immature), 14 embryos fertilized, 4 blastocysts frozen
OHSS – 3 nights in hospital, Freeze all cycle
FSH 150iu x 5 days, 225iu x 11 days, Orgalutran x 7 days. CD 12 E2 1800, CD 14 3000, CD 16 5500

5. August 2008 – FET #1
1 blastocyst transferred, Negative result

6. October 2008 – FET #2
1 blastocyst transferred, Negative result

7. November 2008 – FET #3
1 blastocyst transferred, HCG level of 21, 44, 0

8. April 2009 – FET #4
1 blastocyst transferred, HCG level of 35, 110, 388, 1700, 4280.
D&C conducted after ultrasound – no heartbeat at 9 weeks. No reason for miscarriage found

9. August 2009 – IVF #3 (Dr Mike Aitken)
33 eggs retrieved (24 mature, 9 immature), 17 eggs fertilized, 13 embryos at day 3, no blastocysts
TESA – 5 samples frozen. FSH 225iu x 12 days, Orgalutran x 4 day. CD 11 E2 2959

10. October 2009 – IVF #4
20 eggs retrieved (12 mature, 8 immature), 5 eggs fertilized, 2 embryos transferred at day 3 (6 & 9 cell). Negative result
Used fresh semen sample. FSH 225iu x 9 days, Orgalutran x 3 days

11. May 2010 - IVF #5 (Dr Graeme Thompson)
Cancelled due to potential for OHSS
200iu Puregon. CD 9 E2 5000, CD 10 E2 10,000, largest follicle 14mm

12. September 2010 - IVF #6
Cancelled cycle, estrogen dropping, 1400, 1300, 1300, 1200, 950
112.5iu Puregon, Orgalutran

February 2011 - Ovarian Drilling, laparoscopy and dye-test completed

13. June 2011 - IVF #7
Cancelled due to potential OHSS
100iu Puregon, dropped down to 50iu.
CD 12 E2 5100, 22 follicles, LH 15

14. August 2011 - IVF #8
Known sperm donor used
10 eggs retrieved, 2 immature, 8 fertilised, no further cell division. No transfer
Lucrin, Gonal F 37.5 > 75
CD 8 E2 510, CD 12 E2 1200, CD 14 E2 3300, CD 15 E2 4400, CD 16 E2 4700,
CD 17 E2 3300, CD 18 E2 2200 ~20 follicles, CD 19 E2 3400, CD 20 E2 3700, 8 follicles >14mm

15. October 2011 - DIUI #1
Known donor used. Negative Result
Clomid, CD 12 E2 1600, trigger injection, 2 straws used, slight spasm when sample inserted

16. November 2011 - DIUI #2
Known donor used. Negative Result
Clomid, CD 11 E2 1400, trigger injection

17. May 2012 - Donor FET #1
Donor embryo, Day 2 3 cell embryo. Negative Result
Clomid, CD 13 E2 4000, Pregnyl trigger injection

18. June 2012 - Donor FET #2
Donor embryo, Blastocyst. HCG level of 7, then 4.
Clomid, CD 12 E2 2700, Pregnyl trigger injection

19. August 2014 - Donor FET #3
Donor Embryo, Day 2 4 cell embryo. Negative Result
Clomid, CD 14 E2 1836, Natural Ovulation


So that brings us up to date (I think). Please let me know if I have missed anything - sometimes it's hard to keep up with it all!

Getting started again - IVF

We got a letter back in May from the public health reproductive clinic stating that they were restarting the publicly funded IVF program. Of course the program has changed significantly from what it originally was when we were referred to the clinic. It wont cover anyone who requires sperm donation, which is a bit of an issue as that is what we were pursuing. Also, it now only covers one IVF cycle and the replacement of any embryos generated.

It does state that certain patients may proceed to a second IVF cycle at the discretion of the KEMH clinic if they meet relevant clinical criteria. I'm not sure what the criteria is but I'm hoping it's a fail-safe so that if the first cycle is a total bust (no embryos to transfer) that they will let us do a second cycle.

To be referred to the private fertility clinic for our funded cycle, we had to re-do all of the tests that we have done many times beforehand. At first I felt it was a waste but realise it is a necessary evil to at least check where we are up to.

Firstly I still have PCOS - my ovaries still have the usual 'string of pearls' appearance, and my AMH (Anti Mullerian Hormone) level is 48.6 pmol/L which indicates PCOS and the higher risk of OHSS in a stimulated cycle. I had hoped that my sustained weight loss would have helped but apparently not. Also apparently my B12 is quite low, and iron is borderline - both good things to know.

Murray had to do a new semen analysis of course, but we got a huge surprise when the results came back nowhere near as poorly as they have previously! The count and morphology came back normal when they are usually on the low side, but most importantly the motility came back at 30%, 20% of with progressive motility! Considering the cut off is 40% and 32% respectively, it is still low but so much better then the 0-6% he has had every other time! That result has meant that he feels much more comfortable with doing IVF again. It would be good to repeat the DNA fragmentation test as well to see if that has changed at all.

So we are off to our GP on Thursday afternoon to get an updated referral to the fertility clinic, and then we just wait and see when we can get started again. The fertility clinic actually called me today as we still have one embryo in storage that was donated to us - they ring to see if we still want it. I explained that we were keeping it as a back up in case our fresh cycle doesn't work, and she said that was a good idea, and that even if that one didn't survive the thaw, she could probably find one on the day if worst came to worst, which made me feel more confident also.

I don't really want to go down the IVF path again - in fact nothing would make me happier than for the adoption agency to call up and say we have a child, but 20 months in the approved applicant pool  has made me realise that nothing can be taken for granted.

Healing wounds

Time doesn't heal all wounds. It can definitely help to provide perspective, and ease the hurts, but scars are left behind.

Pregnancy announcements shouldn't be able to affect me the way they do. For the most part they (almost) don't. Facebook is the demon of all announcement platforms because people write their one line Congratulations message, along with whatever other pithy message they can think of, and inevitably someone says 'you deserve this'.

And I'm like *whiplash* What now! Back up there, we do not get what we deserve in life. If that was the case, there would be a whole lot of people in the world in very different situations than what they are currently in. And even though I know it is just a platitude, it hurts. Even though I know that it's not about who deserves to have a child, there is still that tiny part of me that says what have I done wrong to deserve childlessness.

I'm fine. It's just one of those days.