Cycle plan with dates

Ok, so here is the specific plan for this cycle:

22/9 Started the pill
23/9 Blood test to confirm hcg level at 0 - all clear
24/9 Start Synarel (nasal spray) 12 hourly
6/10 Stop pill
7/10 Appointment to pay for cycle and pick up meds
8/10 Blood test to confirm down regulation has worked
9/10 Start Puregon (injections) daily
16/10 Internal scan to check progress of follicle growth
20/10 Rough estimate of egg pick up

So I started the Synarel today...that taste brought back so many memories. I really hate that stuff. At least I only need to do one spray twice a day - last time it was always two sprays twice a day. (For those who haven't had it before, it makes you sneeze/feel like sneezing for around 30 minutes after doing it, and has an absoutely awful taste that runs down the back of your throat - words can't describe...yuck!).

I also found out the cost for the cycle which isn't too bad - pretty much what I expected. Although with the new safety net changes starting in January next year, I don't know whether IVF will really be affordable for us. The clinic's paperwork estimates an average 80% less in safety net rebate, this would add an additional $3,000 to each cycle! So one cycle would likely cost around $4.5K! To give you a slightly better chance than a natural conception. It is absolutely ridiculous - all that will happen is that IVF will only be for the rich, and it will make the multiple birth rate skyrocket due to people wanting to put multiple embryos back to give themselves the best chance because they can only afford one or two cycles. So basically heading towards the American system. It baffles me why they have come up with this system - the money that they save on safety net costs, will end up being spent on hospital costs relating to multiple births/pregnancy complications and the like. It is difficult enough for those of us who don't have the ability to conceive naturally without adding so much financial burden on top...and for a lot of us, taking that opportunity to have a baby away from us. And not only that, but the people who can easily conceive naturally are also given extra money for nothing in the form of the baby bonus! Now where the hell is the logic in THAT??

Anyway, ranting over, sorry about that. It's just really difficult when we are looking at the possibility of IVF being taken away from us. I'm sure those of you in the same sort of position as me understand. But, enough of the things I can't control...onwards and upwards!

Blood test...all clear

So the blood test result came back in this afternoon to say that my hcg has dropped down to 0, meaning that it should be all systems go tomorrow. Will update after the appointment when I have more information...

All systems go!

That's right, we have decided that we will be jumping straight back in to another cycle this week. It makes much more financial sense to get another cycle in while we are over the safety net this year so we are just going to do it! So the pill starts tomorrow, blood test the next day, then the appointment to pick up the meds on Thursday.

I'm feeling ok and as prepared as I can be at the moment. I am really loving being off the meds though, so I may change my mind from next week!

The new plan

Well, the scan today revealed as suspected - the embryo did implant, but has not continued to grow successfully. The specialist showed me where the sac was and told me that by the look of the scan, he is expecting me to miscarry naturally once I stop the meds so I shouldn't need a D&C which is great news. I'm actually feeling ok about it having had all this time to prepare. He assured me that there was nothing that I did wrong, the embryo was just not capable of becoming a baby. In about 20% of cases, there is something chromosonally wrong with the embryo and it doesn't continue to develop into a viable pregnancy.

So...the plan for the next cycle. It will indeed be a stim cycle, he definately agreed with me that it would be the best way to go with only one frozen embryo. We discussed the cycle and have decided on a down reg cycle with 125iU of Puregon and blast transfer. I have the option of starting straight away - as it was a HRT cycle, the miscarriage won't have any affect on the next cycle, providing that there is no hcg left before I start (as it can affect egg quality)

So, I stop all existing meds today, go onto the pill on Tuesday next week, blood test on Wednesday to check if the hcg level has gone back to 0, then an appointment on Thursday to pick up the meds, starting Synarel (a nasal spray) that day. (Although he is also talking about using another drug in place of Synarel which is a once only injection...to be decided at the appointment next week.) Next step is the Puregon (a form of Follicle Stimulating Hormone, given as a daily injection). As mentioned, he is putting me on 125iU - it is a reasonably small dose, but I haven't been on a dose that high before, last time I was on 100iU. But, I trust his judgement.

After that comes the egg pick up (EPU). I have talked to him about the possibility of a local anaesthetic instead of a general (which it is normally done under). I get very nervous about generals and find the recovery a bit difficult. Especially now that I have my son to look after, and my husband leaves for work at around midnight. After a general, you are supposed to have someone with you for 24 hours - not only do I not have that, but I am also responsible for my son in that time. He has suggested that it may be possible and we can discuss that as the time gets closer. As mentioned, he is also planning a blastocyst transfer which means that the embryos are grown to day 5 before transfer.

***
For those not familiar with the IVF process, here is a very simple summary:

Sequence of Steps for an IVF Treatment Cycle
Suppression of own hormones using nasal spray ( & contraceptive pill)
Follicle growth (stimulation by injections)
Ovulation timing (based on ultrasound scans)
Trigger of follicles (one off injection)
Collecting the eggs from the follicles
Collection and preparation of sperm
Insemination of eggs with sperm
Progesterone support (twice daily pessaries)
Assessment of fertilisation
Embryo division & growth
Embryo transfer to the uterus
Embryo freezing (if any surplus embryos)
Pregnancy blood test (approx 2 weeks later)
***

I'm feeling quite good about this plan, very nervous about going back to a full stim cycle, but still feeling ok about it. Until the appointment, I really didn't think that I would be able to continue with IVF right now, but it has inspired me to want to keep going. I feel so much better after having a really good talk with my specialist today. I talked to him about the quantitive blood tests - he still strongly disagrees with doing them. His belief is that they can't tell you anything so they shouldn't be used. He is very involved in the industry and has quite strong opinions about the way that things are done in the medical profession. He is very well respected though and apparently has the best success rates in QLD, so I do have to consider that. But, he was still happy to discuss it with me (and I think if I pushed, he would give me the blood tests). He did joke that he should form a support group for me and the other patients who are very 'involved' in their treatment process, but he also assured me that it was a good thing and that he is more than happy for me to remain as involved as I like, asking as many questions as I like and contributing to the decisions along the way. After our talk today, I am back to feeling very confident with my choice of clinic/specialist.

So, onwards and upwards I guess. I have the next week to decide if I am happy to jump straight back in, if not all I need to do is phone to cancel the appointment, stay on the pill, then make another appointment for whenever I want and I can start straight away from then. At this stage I am leaning towards just jumping straight back in, but I will make my final decision over the weekend after consulting with my hubby a bit more and looking into our finances.

Ruling from the clinic

I heard back from the nurse after she spoke to the specialist. He gave me the option to stop the medication, or to continue and wait for the scan. He has admitted that there is very little hope for this cycle, but his style is to not give up until the scan. Probably why they don't do quantitive blood tests.

I have managed to find a compromise and brought the scan forward by a week to next Thursday. Not that I believe there is any chance of a pregnancy from this cycle, but I want to do the right thing by the clinic and follow my specialist's recommendations. This way, I still get to come off the meds a week earlier than if I had not got the quantitive blood tests. And I am much better prepared.

Needless to say, next time I will be demanding the quantitive blood tests from the start, regardless of their standard policy.

Another one bites the dust

I don't come bearing good news unfortunately...hcg level from yesterday came back at 50. I spoke to the clinic and confessed to them about the blood tests. A hard thing to do actually as the nurse was quite upset about it. I do feel bad, but I still maintain that they should have offered me the tests when I asked about it. And after all, all I did was follow my instinct, which turned out to be correct.

Anyway, I have asked whether or not I need to stay on the meds for the next 2 weeks. Recluctantly, she is checking with the specialist and getting back to me. With the level being so low and in particular, dropping, I really don't see the need for me to have to keep putting myself through all these drugs. A side effect of failing the cycle should be to allow me to have a part of my life back.

More news

pending tomorrow. Just got a phone call from the GP clinic, results are in. They don't give results over the phone so I have made an appointment with the GP for tomorrow morning at 9:15am to get the results. Holding my breath until then...

Blood test results

I managed to get my blood test results this morning. Had to make another appointment to see the GP to get them, but I got them. Not great news unfortunately...level was 85. At the same stage with Jake's pregnancy my level was 1,786. Now I definately wasn't expecting anywhere near that, but at 19DPO I would have expected at least 300, not 85.

As the GP didn't know my circumstances, he kept telling me that it was a positive result and wanted to refer me to an OB. Even though I commented on how low the level was. He probably thought I just ovulated later than usual. But I managed to convince him to allow me to do another blood test to check the doubling time. He was going to make me wait another week to do the test, and was going to charge me for it, but I managed to get it bulk billed and done today, 2 days exactly after the last test was done. Again, I have been told I will have to wait 2-3 days for the results. I'm really hoping that I get them by Friday.

Needless to say, I am quite upset today. I realise that, especially on a frozen cycle, the embryo could have just implanted later than normal. But with a level as low as 85, it's hard to have much hope left.

Waiting

I managed to get my quantitive blood test request from the GP yesterday and had the blood test done, but have been told it will be a 2-3 day wait to get the results which was pretty disappointing. I may even have to have another appointment with the GP to get them! Makes me appreciate specialist care more!

In the meantime, I am going to continue to POAS every second day, hoping to see that line get darker. 15 days until scan day and counting!

Testing, testing

Yes, that's right. On top of going to the GP this morning, I have also started to POAS every morning as a matter of routine! I was nervous all over again when it was hard to see a change between Saturday & Sunday's test, but felt better this morning when the line was noticibly darker. Still no where near as dark as my tests from my last pregnancy (which may be part of what is making me a bit nervous), but dark enough that it has changed from yesterday morning's test.

Now for some bizzare reason, blogger keeps rotating the picture, so I'm sorry about having to tilt your head! The one on the top was done yesterday morning, the bottom one is from this morning...

Booked

Ok, so with a little extra encouragment (thanks guys!), I have now booked an appointment with a GP to request a quantitive blood test (or two). Have had to book in with a different GP than my usual one - he was the one who referred me to my IVF speacialist so I thought it would be a bit harder to explain! But have found a medical centre in my local area and managed to get an appointment with a GP there for 9:15am tomorrow morning. I'm hoping that I will be able to get the blood test done early enough to get the results tomorrow afternoon, but I may have to wait the extra day.

I just feel like I need this. Another HPT this morning was still only a very faint positive, I feel like I can't really accept this until I know more about what is happening inside me.

Shock

Umm...yes...I am in shock. My blood tests results came in yesterday afternoon....and apparently I am PREGNANT!!! :O

More than happy to eat my words on this occasion, still seems so weird though after I had myself convinced that this cycle had failed. A HPT yesterday afternoon was still negative which I think made it even harder to accept. But one done this morning is finally showing a faint positive.

Unfortunately though, my clinic only does qualitive blood tests, so I have no idea what my hcg level is. This is also making it hard for me to accept this. I have a scan booked in for Wednesday the 23rd...I don't know how I am going to get through the next 2 and a half weeks without going insane.

I am debating going to a GP to get a quantitive blood test request to help me, but may yet just settle for becoming a POAS addict waiting for the line to get darker.

I really just can't believe it...I am one of those people! First cycle back, and a FET cycle at that! A chance at a baby, without having to do any injections!

Another one bites the dust

Yep, that's right...I caved. I ended up doing a HPT at 12DPO and again at 13DPO...both negative. I'm remaining on the tablets and pessaries until the blood test on Friday, but this obviously means a negative result for us this time. With 20mIU tests, something would have shown up by then otherwise. I also started getting cramps this morning at 14DPO so I would not be surprised to see my period turn up very soon.

I'm feeling ok about it considering. I really didn't have a big expectation for this cycle anyway, being our first one and being a FET cycle. Still disappointed though obviously - it would have been nice to be one of those couples who only need to do one IVF cycle for a baby.

The really disappointing thing for me is that it looks like we have to delay IVF for a short while... there are a few financial issues we need to get sorted as well as some business goals that could affect our ability to continue with IVF right now. It's very unfortunate timing for me, if I had of known earlier, I would have done a stim cycle rather than a FET for our last cycle. Can't be helped now though, I'm hoping that the break will only be for a couple of months - now that we have paid our safety net and hospital excess, it would be a bit silly to not take advantage of that by getting in another cycle this year.

After some consideration, I have pretty much decided to do a full stim cycle next time, rather than try another FET with our last frostie. It's not great odds to try and thaw a single embryo, and even then, much less chance of a sucessful pregnancy. Considering that I need to do HRT FET cycles, it really isn't that much more to do a full stim cycle. At this stage, I would rather twice daily injections instead of 8 hourly tablets - they would have less effect on my life...I could re-gain control of my bedtime and wake up time! The main big difference for me would be EPU (egg pick up) which is normally done under general anaesthetic - but I believe my specialist offers the option of a local anaesthetic instead which I am very interested in finding out more about. (I hate GA, and the 24 hour recovery time).

I am still going to keep my appointment on Monday to talk to the specialist about the next cycle. That way, when we are ready to go again, we can get straight back into it. I'm pretty sure that he will recommend a stim cycle as well. The odds are more like 50-60% (well he reckons he is getting 80% at the moment but I think that's a bit crazy!), instead of 15-20% with a FET cycle. So a big difference and one I think is worth doing it for.

So now we wait...some more. I thought this whole process would be easier than it has been...maybe it would be if nearly all the mothers I know didn't already have second/third children or were pregnant again. While I am still incredibly grateful to have my son in my life, that urge for another baby, a sibling for my son, is just getting stronger.