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Posts tagged ‘ICSI’

Feb 27 / Caro

IVF, One Year On

A year ago today, I shared some really exciting news on this blog. I’d already known for a short while that our first roll of the IVF dice had worked, but today was the day I chose to share that news. Of course, it wasn’t meant to be, and I was soon un-sharing our happiness.

I look back at that day now and I can remember the pure joy of seeing that second pink line on a pregnancy test. The moment where all the disappointments of the previous 18 months faded to grey, unimportant against the technicolor headline of a positive pregnancy test. All of my hopes and dreams suddenly felt as though they were finally in reach, if I could just hold on. I can remember feeling it, but I can’t recapture the actual emotions. These days it feels as though there is a wall of glass separating me from such elation. I can see it, but I can’t imagine attaining it. All I can do when I think of those moments now is will myself not to cry, biting my lip as I push the image of the four-month old that might have been from my mind.

Last year feels, in some ways, like a dream. I almost believe that I could wake up at any moment and discover that it never happened at all. It’s only the pain in my heart that tells me otherwise.

I look back on it too, in amazement. I look at what we managed to get through. Not in simple terms of the pressures and logistics, emotions and stresses, of multiple IVF cycles, their failures and a miscarriage. I know there is much worse that happens to people. It’s more the fact that I got through it whilst also maintaining as close to a normal existence as possible. While I may have whinged about almost nothing but infertility for the last year on this blog, reality has been very different, and I suppose I want those of you who’ve seen nothing but brow-beating and woe-is-me in my words here recently to really understand that it isn’t the whole picture.

The bits you didn’t always see included me working hard in a demanding job, all too often faced with a rude and demanding public. Better yet, I furthered my career with additional study. We gave Thomas a happy year, with days out, three trips away and innumerable cuddles and kisses. I kept on top of life, keeping the house in order, clean clothes in the wardrobe and good food on the table. I kept on top of my chronic health conditions not just during treatment cycles, but every single day. Few people in “real life” knew anything about the frantic paddling that was going on under the surface. And all of those who have since found out about it in retrospect have commented that they didn’t have a clue. Because almost without exception, I managed to hold it together.

And sometimes I just want to scream “Do you know what, that was really, really tough.” It’s an achievement that I feel right to be proud of. Because infertility, and the associated treatment, is hard, even if it isn’t the worst life can throw at you.

Sure, there were moments I’m not proud of. The moments that Thomas saw me cry, especially when he thought it may be his fault. The times my temper was not entirely kept in check. The time I dissolved in to a heap on the floor when I found the “Your Pregnancy Day by Day” book – left over from my pregnancy with Thomas – under the bed, covered in dust, where we’d pushed it out of sight on the day I began to miscarry.

I didn’t always cope perfectly, and I still don’t. But one year on, with empty arms and baby-shaped hole in my heart, I’m getting on with life. I smile, laugh and joke on a daily basis. I brush aside questions of whether we’ll have more children without my composure cracking.

We came though a year of IVF with unresolved infertility and no where left to turn. We were never going to be unscathed by the experience. There are few days that pass where I don’t contemplate how different they’d be if I were on maternity leave instead of working. If I were struggling through long nights and short days with a breast fed baby. If Thomas had a sibling to dote on and dislike, all at the same time.

But I’m still moving forwards. It’s taken a lot of strength to do. And that is what I’d like people to know.

Feb 1 / Caro

Misery Loves Company

I’m pretty sure that some of the feelings I’m about to admit to in this post make me a pretty despicable person. But you know something? They’re real. I can’t help how I feel, and actually admitting it makes no difference to who I am, because whether I’m honest about it or not, this is my truth. I know that I shouldn’t waste time on such negative feelings, or concerning myself with the lot of others, but again, I just can’t help it. My blog has always been real, so here is a little more of my reality:

Something that comes as an inevitable side order, a buy-one-get-one-free of sorts, with infertility is jealousy. I know that I’ve touched on it before, but it’s completely impossible to keep the green-eyed monster entirely at bay when you desperately want a baby and it seems as though it is happening all around you. For everyone but you.

My general motto and reminder to myself is that I cannot know each person’s own, personal experience. What I frequently see are the bumps and the babies. But I recognise that these are each the product of a journey that I do not see and cannot know. Those apparent happy endings may be the result of years of heartache; Failed efforts at fertility treatment; Multiple miscarriages. I remember that and, many times in the last couple of years it has helped to soothe my sore, impatient soul, wracked with longing and envy.

Lately, though, my green-eyed monster seems to have morphed in to a new beast. One that is turning me in to what feels like a very nasty, bitter kind of person. One that is unleashing thoughts that I am – and should be – utterly ashamed of.

I guess my new super jealous state is defendable, if not entirely excusable. It’s been a couple of months since we smashed in to the brick wall at the end of the road. Since the light at the end of the tunnel went out. Ours is no longer a journey in motion. My hope can no longer be fuelled by tales of triumph over adversity or success after repeated failure. When I see a round, pregnant belly I can no longer tell myself that one day I too will get to rub away the kicks and thumps of a growing life inside me again. And tempering my envy with the fact that this may have been a longed for, hard won pregnancy is no longer enough.

All of a sudden, my jealousy extends even to those whose battles I know. Those women who have experienced the pain of infertility and put themselves through IVF, ICSI or other invasive, unpleasant and costly assisted reproductive techniques. Those women who’ve had to wait patiently for this, their shining moment. It shames me to say it, but I begrudge even them – the ones who truly know infertility – their happy outcomes. Whereas once upon a time anyone overcoming infertility was a cause of genuine happiness (and of course a source of hope too) now I can’t bear to hear of those who got lucky on their first round of IVF. Especially with twins! I can’t help but think we were only even allowed two embryos on round one because they were such poor quality, because we were supposed to have good odds. Yet here we are in the total failure pile, whilst for others it seems to just work. Two embryos in, two babies out. (I know that twins are no walk in the park, and have never been my desire, but it’s more the super success they seem to represent, when we could not even get a single embryo to stick.) I hate myself for thinking it, but it just doesn’t seem very fair. I cannot stop myself wondering why them, and not us?

I know it makes me sound like a terrible person, but I cannot help but roll my eyes now when I hear people describe themselves as “devastated” because their embryo transfer was cancelled due to hyper-stimulation but they’ve got six, or seven or more embryos in the freezer. I can’t take it seriously when they say they feel as though it will never work for them. Right there they already have more opportunities that I’ve ever had. They’re right there in the trenches of infertility, but I still envy them. I still want what they have.

I know it doesn’t do to compare. Fertility is so complex and so individual that one person’s story rarely has any relevance for another’s. But it’s all part of the horrible jealously I’ve succumbed to. The feeling, no matter whether right or wrong, that having a single successful cycle is nothing like trying over and over. That feeling that everybody else is achieving something that I cannot. Will not.

And it really does feel like “everyone”. When you try for a baby, pregnancies and newborns suddenly pop up everywhere and this is in no small part because you’re primed to notice them. I know that not “everyone” is really pregnant. But within infertility communities I struggle to find the people like me. The ones who’ve been forced to walk away empty handed (or more specifically with empty uteri). The ones for whom it never worked, never mind working first time, or more than once or with twins.

And yes, before anyone raises it, I’m still very aware of just how blessed I am to have one child, and these feelings do not for a moment dilute that. I understand that I too could be the object of others’ jealousy as I have a happy, healthy three year old. And I also don’t for a moment think that these women who’ve had such great outcomes should censor themselves, or that they should not be proud and happy in their success and share in any and all ways that they wish – I know I would in their shoes. But equally, I can’t force myself not to feel this way, or pretend that I don’t.

I suppose what I do want is to feel less like the only one in my situation. It’s true that misery loves company. And whilst I truly wouldn’t wish the experience of infertility on anyone else, right now I’d love to surround myself with people who not only “get” infertility, but “get” that it isn’t always able to be overcome.

There isn’t always a happy ending.

Dec 30 / Caro

2014: A Year In Blog Posts

It’s that time of year already: The closing moments of twelve calendar months that make up the year and the time when we inevitably look back and reflect, before looking forward to the new year. I’m not naive enough to believe that the turn of the calendar page, the ticking over of the clock, really makes some monumental shift to our existence. Things won’t cease to feel the way they feel now at tomorrow’s midnight chime. But years are one of the many ways we mark time, and they do offer a theoretical blank slate and fresh start. It’s natural to segment our lives by these arbitrary date divisions.

One of the ways I’ve used to reflect upon 2014 is a look back through some of my blog archives. Flipping through post titles and opening paragraphs reminded me of a review meme I’ve taken part in before. And so, prompted by its appearance  yesterday on the same blog where I very first saw it – Six Until Me – I decided to repeat the exercise.

It would appear, from these opening lines of favourite and defining posts from each month of the year, that 2014 did indeed become “The year of IVF”. Or perhaps more fittingly “The year of infertility hell”. There has been much, much more to the year as well, but I’ll let this review stand not only because I’m proud of some of this writing, but because in years to come I know that it is exactly what I will remember this year for the most.

That, and the better aspects of the year deserve their own review!

January: If I’d ever imagined a caricature of conception, then the egg would have been cool and mysterious, aloof even.

February: I’m writing this with a photograph of you in my hand.

March: Wow, what a difference a week makes. And, because this one is also important to me: Wanting another child who is biologically mine – and my husband’s – does not make me a bad person, in exactly the same way that wanting a second child at all does not make me a bad person.

April: “Do. Or do not. There is no try.”

May: At a quarter past six this morning, with pale sunlight working its way around the edges of the blinds and Thomas chattering happily to his trains in his room, my heart broke just a little bit more.

June: I’m struggling a bit with writing here at the moment.

July: If at first you don’t succeed… …should you try again?

August: This week has been a tough week on the infertility front.

September: This month marks two years of trying for our second child.

October: It’s odd how a make or break moment of my life has come down to a plastic stick and three minutes. 

November: I didn’t know how I’d got where I found myself.

December: A couple of weeks ago we returned to our fertility clinic for a “follow-up” appointment after our last failed cycle.

Who knows where 2015 will take us…

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Dec 7 / Caro

In Black and White

A couple of weeks ago we returned to our fertility clinic for a “follow-up” appointment after our last failed cycle. It’s what’s affectionately known in the infertility community as a “WTF” appointment, as in “WTF went wrong?”

The thing is, we pretty much know what went wrong. I didn’t get pregnant (obviously). And I didn’t get pregnant because my eggs are crap and because we have virtually no sperm to work with. In short, the raw materials are rubbish, and that’s a huge problem before we even get to the complicated, roll-of-the-dice chance of whether an embryo implants and continues to divide and grow. There are all kinds of solutions, proven and otherwise, that can be thrown at things like implantation issues, but without the essential ingredients of the appropriate quality to make embryos in the first place we’re… well, we’re screwed. We don’t have any options.

I knew all that before we went. And I don’t think in my heart-of-hearts that I expected to be told anything else. We went because I needed some kind of closure. Some kind of point under which I could draw a line. I needed the last time that we walked out of that clinic, and the last time we saw staff there, not to have been a limbo moment. I didn’t feel finished somehow.

From that point of view, I suppose it helped a bit. It was the final chapter in a story which, if not exactly long, was certainly intense.

But in other ways it also left me feeling worse.

There were a lot of snotty tears. A lot of wishing for a magic solution, as if I really thought they’d have been withholding something miraculous that might work for us. I’d promised myself that I wouldn’t descend to that, and I knew I sounded ridiculous and looked an idiot. But I’m so not ready for it be over. And desperation is never a particularly rational (or attractive) emotion.

And then we got the letter summarising the appointment and it really hit home. The part which stated “further treatment is very unlikely to be successful for you and it is therefore my recommendation that you do not pursue further IVF and ICSI.”

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There was something about seeing that written in black and white that reached right in to the very deepest part of my heart where I’m suppressing all the feelings about our failure to conceive another child that I don’t yet feel able to fully confront. Seeing it written like that meant it was no longer a choice that we’d made to stop. We were being told that we had to stop. That this clinic won’t treat us any more and they advise that we don’t go elsewhere either. And if it’s not a choice, then it’s out of my hands and out of my control. Somehow that just makes it hurt all that much more.

I don’t do failure.

All my life I’ve worked incredibly hard to achieve everything that I’ve set my heart on. I don’t accept being told “no” very well. It’s like a red rag to a bull, and the higher the barriers people raise to stop me getting where I want to go, the higher I’ll climb, the harder I’ll try and the further I’ll go to get past them. I’m tenacious. And I always get there in the end.

This is different. No amount of hard work or effort will change the facts. I can’t make a baby simply by trying harder. We can’t do more. And I’m finding that so hard to accept.

This time last year I had so much hope that we could be “fixed”. I still have that lingering spark deep in my heart and I think I’ll feel it flare every month for ever more. But I do have to start coming to terms with the fact that this isn’t going to happen. We have absolutely no choices to make because our bodies have made them for us. There is nothing to do.

For the first time in my life, I’ve failed.

It’s there on that piece of paper.

There, in black and white.

Oct 19 / Caro

End and Beginning

It’s odd how a make or break moment of my life has come down to a plastic stick and three minutes. That’s not something you foresee when you imagine how your life might pan out.

Of course, they were three minutes that felt like a complete eternity, sitting together in the darkness of our bedroom at 6am, unable to prolong the agony by waiting for the sun to rise.

When the clock had ticked its full three revolutions, we made our way, hand-in-hand, back to the bathroom. And there one life – or it’s promise at least – ended, and another began.

Negative.

Failure.

There will be no second baby for us. No sibling for our son.

No happy ending here. Just the beginning of an acceptance that you can’t always get what you want. That dreams don’t always come true.

But then I always knew that and perhaps I was greedy to expect anything else.

We clung to each other in the pitch darkness for a long time. Long enough for salty tears to make my eyes to puff up and stick together. Long enough for my neck and head to begin to ache from crying, until I realised that the strange, animal-like sound I could hear was my own sobs.

Grief is completely real even when what you’ve lost is something that you never even had, at least not outside your dreams. I know that now.

But life goes on.

Thomas stirred, and rose from his bed wanting to play trains.

And so there we began a new life. It’s one where hope is gone, but replaced at least with some degree of certainty. The certainty that we are, and always will, be a family of three.

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I know it could be a lot worse. But it still hurts like hell.

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.

Sep 22 / Caro

Drugs! (Or, Here We Go Again!)

So this week I took delivery of two giant boxes of drugs. The drugs for our third, and final, round of IVF.

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I’ve been a bit hesitant, over the past couple of months, about sharing the exact details of this round of treatment. I wasn’t sure if blogging it “live” in previously cycles had been more of a help, or an extra source of stress – particularly when things went so badly in cycle two. Certainly I wanted the option to keep it all under wraps until the fat lady (hopefully me, with a big pregnant belly!) sang. But gradually, as the weeks have gone by, I’ve found myself letting information slip out, and actually, I’m comfortable with that. I value the support it brings. (So if you feel able to cheer me on, then please, please do!)

So here we are. Two huge boxes of drugs and tomorrow is a date with the dildo-cam for my baseline scan. After six weeks on the pill, in order to precisely time this cycle to coincide with time off work for me and the availability of our consultant to personally perform all my scans, and assuming that all is well with the scan, tomorrow the cycle kicks off properly.

People keep asking if I’m excited. I’m not sure excited is the word. Of course I’d still much rather be falling pregnant in the way nature intended. I don’t want to have to be doing this at all. Injecting all the drugs and dealing with the side effects, having a painful egg collection procedure and an undignified transfer of the resulting embryos back in to their natural home. And after two failures I’m nervous and apprehensive. Especially knowing that this really is the final roll of the dice. But then, in a month’s time, I COULD BE PREGNANT. This is a chance. Yes, it’s our final one, but no matter how small it’s still a chance. And yeah, that bit is exciting.

It’s fair to say that we’re throwing everything we can at this round. The drugs bill this time started out considerably more than for previous rounds, although with some successful shopping around I managed to shave over £700 off. It’s still a huge chunk of money, and even I was a bit shocked at the sheer amount of stuff. In addition to higher doses, we’ve also added two new drugs, and for most of the cycle I’ll taking three injections a day. I’ll be mixing human (natural) and recombinant (engineered) goandotrophins to stimulate my ovaries, and I’ll be using a mixture of natural hCG and a drug to force my body to release natural lutenising hormone – the ovulation hormone – as my trigger shot. This contrasts sharply against the recombinant hCG I’ve used in the last two cycles and that I strongly suspect may be behind my high numbers of immature eggs.

Our consultant has also agreed to do the entire cycle personally, from baseline to transfer (assuming we get there!). It’s normal for scans to be performed by different nurses, but obviously this introduces inter-operator error. The consistency of having one person who now knows me really well for the whole cycle was the deciding factor in staying with the same clinic. I’ll admit after two failures we did look elsewhere, but none of the other clinics could offer us much different and had the massive disadvantages of being further from home (more difficult and stressful to get to) and of not knowing, or understanding our case, or me as a person.

My consultant, on the other hand, gets me. He fully accepts that my insomnia cure of choice is searching Medline and attempting to learn to do his job. He and I work well together, and far from being offended by me making suggestions, or responding with the arrogant air of one who believes the professional always knows best, he seems to like the fact that I question, and challenge him. Many of the changes we’ve made this cycle have been as a direct result of studies I’ve read and suggested we adapt to our circumstances.

I’m feeling positive about the changes we’ve made, and the fact that we’re not simply trying the same thing again and hoping for a different outcome.

But only time will tell. The next four weeks of time, to be specific.

The roller coaster starts here. Wish us luck.

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