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Oct 9 / Caro

The Roller Coaster of IVF

I’ve been absent from here for a while. First I was busy focusing on the mechanics of getting through our final cycle of IVF – the injections, the supplements, the blood glucose control, not to mention scans and appointments. Then, as the cycle progressed on, in to the agonising periods of waiting, I could hardly bear to come here. Writing too much seemed to threaten my happiness when things were going well. And when the roller coaster dipped, the idea of facing other blogs and social media that seem chock full of pregnant bellies and new babies was enough to drive me offline, in to fantasy worlds of fictional books or television. Anywhere, really, but here.

But I can’t avoid it forever. Aside from wanting to complete the story of our IVF journey, I also know that not writing about it won’t change the outcome.

The cycle started well enough. The first (baseline) scan of my last two cycles has brought bad news: Cysts on my ovaries and a uterine lining that wasn’t thin enough. We’d diminished the possibility of more bad news this time by having a scan the week before, to rule out or drain any cysts at that point. And it all paid off. The baseline scan was perfect and I kicked off that evening with three injections – two different stimulating drugs and a drug to prevent natural ovulation. It was a bit of an unusual approach, according to our consultant, but worth a try in our quest to get more good quality eggs.

Injections

For a week, I carried out my injections at the same time each evening and began feeling some tell tale bloating and twinges of pain in my ovaries. Despite the positive signs, my first scan after a week was still a bit of a shock. Having high-fived me on my “beautiful ovaries” and “gorgeous endometrium” the consultant kept scanning around for a minute, measuring the follicles as he went. He then asked casually what I was doing on Friday, because whatever it was I’d have to cancel: I was already ready for egg collection. My provisional date for egg collection had been the following Monday, but we’d thought it may even go to the Wednesday, and yet here I was being told I’d be back in two days time instead.

I had to take another couple of stim injections that afternoon to “finish things off nicely”, plus my usual ovulation prevention injection. Then, at 11pm, came the trigger shot. No fancy pens injectors this time. Instead of the usual recombinant (manufactured) hCG, I was using a combination of purified natural hCG (collected from the urine of pregnant women!) and a second hormone to force my body to release lutenising hormone – the body’s natural ovulation hormone. Once again, a change designed to increase the number of viable eggs collected. And that was it. the injection phase of our final IVF attempt was over.

Friday seemed to arrive in a flash. Egg collection went well, despite a few issues reaching all of the eggs on my left ovary. The sedation was heavy enough that I’ve already forgotten chunks of the procedure, but light enough that I came out of theatre already knowing we had ten “beautiful looking eggs”.

My anxiety all along – after the last cycle’s poor haul of eggs – had been to see how many were actually mature and able to be injected with sperm. This was soon joined by a second worry.

As usual, we’d supplied a fresh sperm sample in addition to having one remaining frozen sample. The fresh sample was the one that gave me the most hope from our last cycle. It was the one which had a “countable” number of sperm in it. Yes, it had been low, but it was the sample that made me hope that the sperm numbers were going in the right direction. I’d really hoped that this time the sample would be even better. But last time, they’d told us that there were sperm there before I’d even been sedated. This time, the egg collection was complete, and we still had no news. All they could do was tell us to wait. Then, after a while, they informed us that they were thawing out our final frozen sample.

It was an anxious wait, for the sample to thaw and then be examined. All the while I was allowed to tuck in to tea and biscuits whilst Ian remained poised for a possible procedure of his own to try and retrieve more sperm.

I can’t tell you exactly when the news came, but it felt like hours. One of the nurses stuck her head in and told Ian he was free to get a drink. I was sad, and even maybe a little surprised, that the fresh sample had contained no sperm but this feeling was overridden by the relief that we had something. I felt like we were on the climb, upwards. It was all positive. We could do this.

And so then began the overnight wait for the fertilisation report. Thankfully it did not take long for the call to come on Saturday morning and the embryologist immediately told me, whilst I held my breath, that it was good news. In contrast to my zero mature eggs last cycle, this time ALL TEN were mature. And even better than that, EIGHT had fertilised. You can’t argue with an 80% fertilisation rate. It’s fair to say I was elated. Still so far to go, but I felt like my biggest personal hurdle was over. All the experimentation and changing the protocol had worked. All the supplements I’d been religiously taking had been worthwhile. The pay off was ten viable eggs. I was at the very peak of the hill.

If I’d written this post on Saturday or Sunday, it would have been full of happiness and hope. Yes, I dared to hope that this could be it. I thought we’d lose a few, but I figured we might have five embryos by day three and a good chance of several going all the way to blastocyst. I thought we’d have two to transfer for sure. I even dared to hope that we might achieve the holy grail: a frozen embryo.

What I fool I am, to dare to dream.

I should know by now that I don’t deserve hope or dreams. That somewhere along the line I must have done something to anull my right to those things. I should know that happy endings are not assured, least of all for me.

The phone call came early on Monday, whilst I was walking back from the pre-school drop off. I made the walk in a daze, on autopilot, because I’d just been told that seven of our embryos had arrested. They never made it beyond two cells.

I’m not sentimental enough to believe them to be my children at the stage of cells in a laboratory. But they COULD have been my children. They were my hopes. My dreams. My chances. My possibilities.

And just like that we’d lost them.

The one remaining embryo was not exactly top grade either. It was six cells – expected for day three – but its behaviour had been odd with early rapid division, then a long delay. They were waiting for it to divide again to ensure that it, too, had not arrested.

Our choices were to transfer back in to me that day, or to wait it out until day five to see if it continued to divide well and made it to blastocyst stage. The risk in the latter option was that it wouldn’t make it and we’d reach Wednesday with nothing to show for the cycle. Of course, the risk was the same with transferring it, but I simply wouldn’t know about until a negative pregnancy test two weeks later.

In our last cycle, we faced a similar scenario. A single, poor quality embryo.Then, after much discussion and soul searching, we opted to leave it in the lab until day five. I felt, and still do I suppose, that if it doesn’t make it in the lab, it wouldn’t make it inside me either. Transferring it at day three would hence just prolong the agonised waiting to find out. But in that cycle, I always knew, in my heart of hearts, that we’d probably try again. We’d have another chance to get things right. This time, if I didn’t transfer and it didn’t make blastocyst, I would always wonder if it might have been different. And I think I’d have regretted finishing our final cycle in that way forever.

So back it went, despite its odd behaviour. Probably not the embryo anyone would have picked had there been a choice. But there was no choice.

So this is it.

Two weeks of waiting to find out if its stuck.

I have to be honest: I’m all out of hope. If seven of our embryos were so genetically flawed that they couldn’t even progress past two cells, what is the likelihood that the other one will go on to grow in to a baby. It doesn’t just seem improbable; it seems impossible. That call on Monday morning was like the death drop on a roller coaster, and I honestly see no way up.

It’s difficult to get my head around the fact that this is almost all over. We have nowhere to go from here. With my rubbish eggs and the absolute lack of sperm, there will be no “surprise natural pregnancy” following IVF for us. Everything rests on that one tiny embryo.

All along I’ve had an unwavering, deep seated positive belief that we would get there eventually. Even when I miscarried following our first cycle, and even in the moments of despair during our disastrous second cycle, I felt like it was all going somewhere. Our only issue was supposed to be the supply of sperm. I was supposed to have a good chance. I’m only 34 – still considered “young” where assisted reproduction is concerned. I’ve been pregnant before, so we knew it had to be possible. The reason for the acceptance and the composure which have for the most part overridden my sadness and baby-envy in the last year is my private belief that it would happen for us. Yes, it was foolish of me, arrogant even, to assume that the statistics would bend in my favour. Perhaps deep down I realised that all along, otherwise I may have stated it more openly. But imagining, each day, the day where I would hold another child of my own in my arms – seeing it as a real and solid event, not a dream – kept me going.

Now that just seems so unlikely.

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8 Comments

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  1. Carie / Oct 9 2014

    I’m sort of deliberating over whether to comment or not because the last thing I want to do is rub salt in a wound (and please delete this if that is the case), but I wanted to say that I’m thinking of you and that I’ll keep hoping for you, even while I completely understand that hope feels like setting yourself up right now. Take care of yourself – I think roller coaster may be an understatement!!

    • Caro / Oct 10 2014

      Of course you are welcome to comment! I always appreciate your support, and the unending supply of it. Yes, if I’m honest I’m jealous of your fertility, but your family is gorgeous and I’d never wish that you didn’t have or share them. It’s a hazard of social media that people share all their “best bits” and so it has to be for me to avoid what I can’t handle. The onus should never be on others not to share in appropriate places! I really do appreciate your hoping.

  2. Jo / Oct 11 2014

    Oh lovely, I’m so sorry. I know there is absolutely nothing I can say to stop the hurt right now but just to let you know I’m thinking of you and saying a little prayer that you have a miracle come your way. xxx

    • Caro / Oct 15 2014

      Thanks Jo. I so hope things go more smoothly for you. xx

  3. Jen / Oct 14 2014

    I’m still hoping for you too. The way you write sounds like we are a lot alike. I’m not as far into my journey for a second as you are, but I’m going through the same sorts of emotions and frustrations. I really hope this works for you!
    Do you wonder if having your first somehow changed everything that makes it possible to concieve your second? I hear of women who were previously infertile and after going through IVF and having a child suddenly unexpectedly become pregnant. I wonder if the opposite is true. While nearly everyone in my life wants to tell me that its my own stress causing my issues I just don’t agree. Everything with my cycle changed since having my daughter. My doctor agrees enough to run some tests this months. Its crazy that I’m actually hoping she finds an issue so that we can correct it. I will be following you for an update. Email me any time if you need support from someone who gets it.

    • Caro / Oct 15 2014

      Thanks Jen. I know what you mean about wondering if the first pregnancy changed things. I certainly felt that when we were first struggling – I was pretty sure for a while that my much unwanted c-section delivery had something to do with it. For some women I certainly think it’s a possibility. For us, we have a reason for the infertility, but few reasons for the reason. My husband now produces virtually no sperm, and my eggs are the quality of a woman’s ten years my senior. The biggest question for us is just how we did manage to conceive the first time! Like you, I wanted a cause, and was glad we found one. It’s just hard that there is so little we can do to correct it.

      Secondary infertility is certainly becoming a bigger and bigger problem though. Some of it is age related, but I’m not sure what else is causing it. Stress could be another factor, but I wish people would understand that them telling me not to stress is one of my biggest sources of stress!

      I hope you get some answers, and it’s all easily fixed for you.

  4. I’ve been trying to think of what I wanted to say after you wrote this post. I know there probably isn’t a ‘right’ thing to say, but I hope what I do say isn’t completely the wrong thing. Above all, I just wanted tell you my genuine thoughts.

    Every time I write something, say something or even think something about my boys, my thoughts go immediately to you. And how completely unfair it is. I am here to listen to your frustration, your sadness, and your venting, and of course everything else you write about too. I think all of your regular blog readers are just really routing for happiness for you and your family, whichever way you find it.

    • Caro / Oct 17 2014

      Thank you Chloe. This genuinely made me a bit teary, but that may be all the hormones 🙂

      There isn’t a single “right” thing to say, but to know that people are thinking about me, and care, is really lovely and means a lot. And this definitely isn’t a “wrong” thing – they’re more along the lines of “at least you have a child” or “everything happens for a reason” (really? Wtf is the reason?) or “I know someone who tried loads of cycles of IVF and then had a natural miracle so it might happen”. These things just aren’t helpful!

      I’ve been finding it difficult to concentrate enough to assemble my thoughts in to coherent writing lately, but I know that whichever way things work out, there will be a lot more venting – of the sadness or the fear variety. I’m grateful to have this space and people to share it with.

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