Saturday, 31 October 2009


The events of the past week have got me thinking.

This round of IVF has been incredibly hard on me, both physically and emotionally. It's also been very hard emotionally on my husband and several members of my family. I expected the emotional upheaval, but the physical side has been so much worse than I thought it would be - I think largely because of the huge rhinoceros doses I was on of all the drugs (and maybe a little bit because I'm a bit of a wimp).

And all that was for nothing. The emotional ups and downs, the physical downs and more downs, the complete breakdown on Monday, the having to tell people that we'd failed. All for nothing.

And then there's the other big news of the week. My sister didn't plan this new baby. As far as all my family is concerned, every baby is a blessing, but this one came as a bit of a surprise to her. When her husband asked what she thought they should call it, she responded, "I think we should call it a day."

Up till now, I've always been her emergency back-up, and have loved the fact that she would call on me first when she needed help. My brother-in-law works long hours and finds it hard to get away from work. So when my youngest niece had to go to A&E earlier this year, I was the one who left work and met them at the hospital to take the middle one off my sister's hands and then pick the eldest up from school.

Her children come to stay for the weekend and we each think we're being done a favour - she gets a weekend to herself, and I get to have fun with my nieces.

I often go round to help bath them and put them to bed, and whenever there's a meeting at the school, or she has to help out at playgroup, or she has to go to a work do with my brother-in-law, or any of the dozens of other things that crop up, I'm the first person she'll ask to babysit. And I almost always manage to juggle work and other commitments and say yes, because I love my nieces and am always happy to spend time with them.

If I had a baby or babies of my own, it might be harder for me to drop everything for her. And with number 4 coming along, she's likely to need help more, rather than less, often.

And then there's the other thing. We want to be in the lives of all our nephews and nieces, and with nephews in South Africa and nephews and nieces in the US, the only way we can do that is with regular travel.

We've put our lives on hold since we started TTC, and put off planning our next trip to South Africa two or three times. Our latest trip has now had to be cancelled, and I'm gutted that I won't be able to spend time with my brother and my lovely sister-in-law and get to know my nephews again. Their younger son is my godson, and he was not quite 11 months last time I saw him, so although he knows I'm his godmother, he has no real memories of me at all.

Then there's the cost. Travel is expensive, we need to provide for our retirement, and there must come a point when it becomes downright wrong to spend any more money on fruitless treatments. If we have two more cycles of IVF, we'll have spent close to £20,000 on trying to have a baby. My first house (well, flat) only cost £24,500 - that puts it in perspective.

I can remember all too well what it's like to live hand to mouth - in fact, I can remember what it's like to go hungry for three days because you miscalculated when your next money was coming in and had no food in the house and nothing with which to buy any more. And here we are now, throwing away our hard-earned savings on a dream which may never be realised.

So maybe all this is God's way of gently telling me that I should just appreciate the time I have with my nephews and nieces and forget about trying to change the status quo by putting my body and my husband through all of this again - and in all probability getting the same result at the end anyway.

Then again, maybe this is just my current state of emotional and physical exhaustion speaking, and maybe I'll be able to face the next cycle with renewed hope and vigour after a bit of a break. And as we said when all this started, maybe this IS the rainy day we've been saving for, and it'll all be worth it in the end.

Either way, I just wish I knew whether it was worth bothering to continue. Because if there isn't a baby at the end of all this, it most certainly isn't.

Friday, 30 October 2009

Official Test Day

During Insomnia Hour, I lay completely still, gazing at the ceiling. My stomach was cramping, and my temperature had dropped for the third day running. The spotting/bleeding increased yesterday to the level where I had to change the pad a couple of times, although it was still old brown blood.

In my rational mind, I knew it was all over - I've known since Monday, and confirmed it with the negative test on Wednesday. But so many people told me not to give up hope until Official Test Day.

I needed a wee, but still I lay there. As long as I hadn't got up and done the test, I could imagine that it might still go the other way. AF was like Schrodinger's cat. Until I had done the test, Rucksack and Ray-Ray were both alive and dead, but once that test box was open, there was no going back - they would be either one way or the other.

I eventually fell back into a restless sleep. I dreamt that I was talking to a little boy who was on his way home from his second day at school. We were waiting for a train, and as it pulled into the platform he said, excitedly, "You know what was on the floor of this carriage when the train came in yesterday? (Dramatic pause) BLOOD!!"

Then DH brought me a cup of tea, and it was time to get up. Reluctantly, I dragged myself into the bathroom and peed in a cup. My fingers shook as I struggled with the cellophane wrapping of the test box, and I felt sick with apprehension.

Finally, I managed to dip the test. It was a digital test, and the little egg timer began to flash. I emptied the cup and cleaned it out, then sat down and watched the egg timer as it winked at me. My mind was blank.

And then the answer came up: "Not Pregnant".

The box has been opened, and there's no more in-between stage. I never even saw my babies. They probably never got any bigger than a few cells each. But they were half my husband's DNA, and half mine, and they lived. And now they're dead.

I'll ring the clinic later to tell them and see what we do next. I haven't taken my Cyclogest, so AF should be here in full force soon. But in the meantime I'm sitting here remembering how happy we were when we heard we had three little embryos, how proud my DH was and the excitement and anticipation we both felt when we knew they were inside me where they belonged.

I couldn't keep them safe. I couldn't nurture them and help them to grow. The clinic did its job and got us as far as it could. I'm the one who let them down.

Bye-bye babies - you may have been only tiny little specks, but we'll never forget you.

Thursday, 29 October 2009

Ten things I learnt yesterday

  1. The reason the packet of Giant Chocolate Buttons is resealable is because if you eat them all in one go, you end up feeling very sick.
  2. Realising that this is going to happen when you're halfway through the packet doesn't make you stop eating if there isn't someone there physically yanking the packet out of your hand.
  3. Going on Facebook and reading half a dozen people's whinges about what time-sucking and badly-behaved parasites their children are doesn't help you to feel any better about a failed IVF cycle.
  4. I still have enough self-control not to have responded to those whinges with my own little rant, despite really really wanting to.
  5. Realising the symptoms are not caused by pregnancy doesn't make them go away.
  6. When the universe decides to crap on you, it doesn't do things by halves. The BFN was not the only crappy news I got yesterday.
  7. It's a good job my boss is so understanding, because knowing I'm not pregnant hasn't made it any easier to concentrate on my work than suspecting I wasn't pregnant did.
  8. Some people will burble on about how tragically short life is after the death of a 95-year-old, and I find it hard to sympathise with their loss simply because of the way they've expressed it.
  9. I'm not as nice a person as I'd like to be (see 8 above).
  10. And just to end on a positive note - normal tea with caffeine in it tastes considerably better than Redbush tea.

Wednesday, 28 October 2009

I cracked

I did it - I peed on a stick. Today is 12 DP2DT, or 14 DPO. I've never had a luteal phase longer than 14 days.

You've never seen anything so white and pristine as that results window. There was no point twisting and turning it, holding it closer to the window or holding it under a lamp. It was blank, empty, white as the driven snow.

I'm OK about it at the moment. I just felt numb as I sat there watching the control line get darker and the test window get whiter in comparison. I did all my crying on Monday, and in my heart of hearts I knew that the little bit of hope I had was in vain. Like I said, I know my body - even when it's pumped full of crap that gives me symptoms I've never had before.

For the record, and because I couldn't find anything like this when I was frantically googling over the last few days, here are the symptoms I've had which I can now put down to the Cyclogest and possibly also to the impending arrival of AF:

  • Night sweats starting pretty much as soon as I started the Cyclogest (that should have been a clue, I suppose)
  • Temperatures higher than I've ever had before, remaining high past my usual AF day but with occasional dips
  • Nausea, particularly when I wake up during the night
  • Unusual hunger patterns - feeling light-headed and shaky if I hadn't eaten for a few hours and needing to eat NOW
  • Smell and taste aversions - things that I usually enjoy smelling or tasting weird
  • Cramps and pulling feelings in my lower abdomen
  • Sore boobs - though the soreness diminished after about 8 DPT/10 DPO
  • Very light brown spotting from 8 DPT/10 DPO onwards (still going on this morning)
  • Delayed AF
  • Frequent urination - much more than I think was justified by the extra amount I was drinking
  • Extreme exhaustion - I can't stay up past about 9:00, and would be happy to go to bed at 7. I also have a huge energy dip in the middle of the afternoon, when all I want to do is curl up in a ball and go to sleep
  • Mood swings and crying much more easily than I usually do

So, there you have it. I'll test again on Friday so that I can call the clinic and tell them it's all over, and we'll see where we go from there.

My new hope is that the Cyclogest prevents my AF from turning up in full flow until I stop taking it. If AF shows up this weekend or later and the next cycle is at least 26 days (last month it was only 24 days, so that's not guaranteed), there's a chance I could fit in another cycle in late November/early December around my work. I just need to be able to guarantee that egg collection wouldn't be on or before the training day that I'm organising at work for 4 December, because I can't get out of that.

The positives that have come out of this cycle are that because we got as far as we did, got a decent number of eggs and had two embryos to transfer, hopefully the clinic will be willing to give us another try. It's only a couple of months since I was in the depths of despair, thinking that we wouldn't even be given the chance to start the treatment. To have got as far as we did is already a bit of a miracle.

I'm hoping we'll get an even bigger miracle next time, but I'll never forget Rucksack, Ray-Ray and little Viennetta, who gave me hope and made me believe that I might still be a mother one day.

How did we get here?

I read a post the other day - I'm not going to link to it, because I'm not arguing with the post in itself, but would like to give another side to the picture - which said that a person in her 20s shouldn't be struggling with infertility. To me, the post said "it's understandable that people in their late 30s and early 40s go through this, because they've selfishly concentrated on other things and left it too late - whereas I don't deserve this at all, and it's not fair".

I agree with the second part of that - it is completely unfair that anybody, at any age, should struggle to do what should be the most natural thing on earth.

And the first part of it is what the media tell us pretty much every day - women are having children later because they're being selfish and putting their careers and their hedonistic lifestyles first, and some of them just leave it too late and then expect to receive help and sympathy when they suddenly decide they want children.

I have to say, that message we're constantly being fed that it's somehow our fault makes my blood boil.

I've said before that all I ever wanted in life was to be a wife and mother. I imagined myself having at least two or three children before I was 30, and going on to have six or seven.

Unfortunately, that wasn't the plan that God had for me.

I had a serious boyfriend while I was at university, but he was jealous and controlling, and I finally realised that he was not good for me.

Then there was the guy I thought for a long time (even for many years after we split up) was the love of my life. I wouldn't have sex before marriage, so he "serviced his man machine" (his words) somewhere else and ended up getting the other woman pregnant. The two consolations for me in that were first that I'd found out what he was like before we got married, and secondly that his two children were the ugliest and most unappealing babies I've ever seen (in fact, the only ugly and completely unappealing babies I can ever recall having seen).

There were a few other brief relationships which went nowhere - the sticking point was very often my Catholicism or, specifically, my refusal to sleep with the person before marriage, but I stuck to my beliefs and told myself it was their loss. As you get further into your late 20s and 30s, that becomes a bigger and bigger deal, because the people you're meeting at that age (at least in London) almost invariably have some sort of sexual experience and find it very hard to understand why you want to abstain.

It's very hard to meet new people in London, but throughout my time there (aged 25 to 36), I joined various clubs and social groups in the hope of widening my social circle and allowed various friends and family to introduce me to a succession of their single friends. As we got older and more and more of my friends married and had children, the pool of single friends they could introduce me to got smaller and smaller, and I began to believe the parting shot of my university boyfriend: "If you leave me, nobody else will have you."

My single state wasn't all bad news - because I had no other commitments (apart from work, which I've always been quite good at juggling), I was able to support one friend through a divorce, another friend through her husband's illness and subsequent death, help my newly-widowed friend to look after her toddler children, look after my sister's baby when my sister was very ill, and generally be the person a lot of my friends would turn to in a crisis.

At the age of 31, I decided that if marriage and babies weren't on the horizon, I'd better get myself a job with a decent pension, and I started to train as an accountant. Ironically, although I had never imagined myself having a professional career of any sort and still saw it as a second-best option that I hoped to leave behind for the joys of motherhood one day, I turned out to be rather good at my job. I passed all my professional exams and was rapidly promoted over the next few years.

My 35th birthday was the most miserable birthday ever, as I began to realise that my dreams were likely never to be fulfilled. I joined an internet dating agency, but never got further than the first date. Then I decided to make more radical changes in my life, and I changed jobs and moved house.

I'd almost given up hope of ever meeting the right person, but early in 2007 I signed up with another internet dating agency.

Meanwhile, my now DH was in his 40s and had never had a girlfriend. As a painfully shy teenager, his life had revolved around his brother, who had significant disabilities and died when DH was 18. He never really got off the starting blocks. Then in 2006 his best friend married a girl he had met through an internet dating agency, and persuaded DH to sign up with the same agency.

His was the first profile I saw, and he was the only person I ever contacted through the site. Six months later, we were engaged. Nine months after that, we were married. He is the kindest, most gentle and loving person, and I'm grateful every day that I found him.

We discussed children from the beginning, and I knew he was as keen to be a father as I was to be a mother. By the time we were married and able to start trying, I was 38. By the time we discovered that his sperm were never going to get us pregnant without help, I was nearly 40. I then had FSH and AMH tests which showed that I had low ovarian reserve.

And that's how we got to where we are now - I spent my life searching for my soulmate, and by the time I found him, we were both old and knackered.

So I'd love it if people would look beyond the grey hairs and suit that seem to confirm the media stereotype and see the individual behind them. The dream isn't new - it's always been there. I've done everything in my power to fulfil it, but I didn't have the great good fortune to meet my DH while my eggs were still young and fresh.

Infertility is a horrible, soul-destroying thing whatever age you are. But when you feel that people are judging you and blaming you for the suffering that you're going through, it certainly doesn't help.

Tuesday, 27 October 2009

Some good news for a change

Well, I spent pretty much the whole of yesterday in tears, except for a brief period while my sister was here with her three children. Depression not being my natural state, I now need to forget about this cycle - apart from the brief interlude on Friday when I have to POAS for form's sake and then tell the clinic I'm not pregnant - and look to the future.

And the future is ... becoming an aunt again. My poor sister, to whom I had been on the phone in tears in the morning over my failure, had to tell me that she's expecting her fourth. She was so worried about upsetting me, but wanted to make sure I heard it from her before anyone else knew and was able to let it slip. And she wanted to tell me in person, which is why she had asked if she could come and see us today.

I couldn't possibly be jealous of my sister - the baby she's having is not one of the babies I'd built my dreams on, and we're so close that I know I'll have a great relationship with this new little one. We're both sad that we won't be going through this together - but if we're successful on our second cycle, I won't be far behind and our little one will have a playmate just down the road (my sister lives about 40 minutes' drive from us).

After the devastation and tears of yesterday, it's nice that we're looking forward to welcoming a new life into the family after all, and that we have something positive to focus on.

And just to make it good news all round - Myndful got her BFP yesterday as well, and I'm chuffed to bits for her.

Monday, 26 October 2009

Total meltdown

Well, I rang the clinic and spoke to Nurse Perfect, and she was great - she didn't give me false hope, but said that the spotting was "insignificant" and meant nothing either way. She told me to carry on doing everything I have been doing and contact them again if I get full flow red blood before test day. She stressed that there's absolutely nothing I can do right now to influence the outcome one way or the other, so I should try to carry on as normal as much as possible.

Of course, the spotting was the only thing I told her about, and it's the combination of that with the drop in BBT and the total disappearance of all other positive symptoms that has me totally freaked out.

My sister and Jeannie both rang, and I had a little cry. I had a shower, and had a little cry. I checked my e-mails and read the lovely comments people have been leaving me on here, and had a little cry. Do you spot a pattern here?

Then I had a message from work - my colleague won't be able to teach his course this week, and we need to work out what to do about it. This is code for "you need to come in and teach this course" - I wrote it, so I'm the only other person who could theoretically teach it at such short notice.

It's on Thursday and Friday, and I had a total meltdown at the thought of having to be in the office teaching on official test day, the day when I have to POAS and then phone the clinic and discuss the result with them.

I called the department administrator (who is also a good friend) and she basically had to sit through my meltdown. There was everything - tears, snot, great gulping sobs, and the poor thing had to try to make sense of what I was saying through all that.

The upshot of it all is that the course has been cancelled and I've since spoken to my boss - who has clearly heard from the administrator about the earlier call, as he told me not to come into the office again until I'm feeling better, and not to worry about what's going on at work in the meantime. Of course, nobody wants a hysterical female dripping tears all over the computer equipment in an open-plan office, so I'm sure it's as much for their benefit as for mine.

And therein lies the benefit first in having the most wonderful colleagues and the most understanding boss in the world and secondly in having been upfront with them while I was still relatively sane and told them what was going on...

Rollercoaster watch - day 3

Once again, thank you all so much for your comments on the last couple of posts - I really appreciate all your support and prayers.

Well, yesterday I got the 'need to eat right now' thing again at one stage. I also had a headache all day, but my Ribena smelt and tasted fine.

I went for coffee with some other friends after Mass and realised that I really am weeing an awful lot more than usual. I had put it down to all the extra water I was drinking, but yesterday morning I hadn't had any more to drink than I would usually have done by that stage in the day. The last time I met these friends we chatted for the same length of time and had the same number of drinks, and as we were getting ready to leave I thought maybe I ought to go to the loo before heading home. This time, I had to go four times in the course of our conversation and then needed to go as soon as I got home as well.

The spotting stayed insubstantial enough not to bother me too much during the day - sometimes a bit there when I wiped, sometimes not. I also read how common spotting is, especially after IVF, and so relaxed a bit about it - until the evening, when it suddenly increased to a level where I needed to use a pad. There's just a tiny bit on the pad, though, and there was none first thing this morning.

My boobs are MUCH less sore, and my BBT went down again last night, although it's still above the cover line. And this morning I woke up with AF-type cramps.

So there you have it - I think it's way more likely that I'm not pregnant than that I am. I was very tempted to POAS this morning to see if I could put myself out of my misery, but it's not quite two weeks since my trigger shot and it's only 12 DPO, so I run the very real risk of either a false positive or a false negative. I'll be good and wait.

In the meantime, I think I've convinced DH that it's all over bar the bleeding, and we've worked out that with work commitments in November and Christmas clinic closure in December, the next time we'll be able to try will be January. I hope my old ovaries last out that long.

The consolation prize for failing this cycle will be a trip to South Africa - we've been planning it for months, but decided we wouldn't go if I was pregnant. Jeannie, it looks like we'll probably be seeing you soon - if this pans out the way I'm expecting it to, I'll be booking our tickets next Saturday.

Sunday, 25 October 2009

A degree of reassurance

You people are so great - thank you so much for your messages yesterday. I feel well and truly cyber-hugged.

Last night was a VERY disturbed night - DH thinks he might be getting a cold, which, on top of the usual snoring like a freight train, entails an awful lot of moaning, tossing and turning, rubbing his feet together in a bizarre fashion which makes the whole bed shake, clattering about to get himself drinks, and generally waking me up every half hour or so.

On a night like this, I usually end up moving to the spare room to get a chance at a decent night's sleep, but as the spare room is cooler than our bedroom, I didn't want to screw up my temperature reading, so I kicked him out instead. Then I remembered that I'd put my Cyclogest in the spare room, because it's cooler than the bathroom. Knowing I'd be needing it before he was ready to get up, I had to get up to go and get it (and then go to the loo, because my bladder is suddenly the size of a pea).

By this time, I was thoroughly wide awake, so Insomnia Hour started early, and ended up lasting a good couple of hours. My normal time for taking my temperature came when I had been lightly dozing for about an hour, so I took it and found that it was between Friday's and Saturday's temperatures - not brilliant, but not disastrous. I duly recorded it and eventually managed to get back to sleep.

The next time I woke up (I should point out that it was an extra-long night, because not only was I so tired that I went to bed at 9, but the clocks went back last night) was at 6, which is the time I used to take my temperature before Insomnia Hour set in and I started doing it earlier. I'd probably had an hour and a half of good, solid sleep, and it was about five hours since I'd got out of bed.

This time my temperature was 37.03. In all my months of charting, this is the first month it has ever exceeded 36.80 (which was very rare itself - I usually barely hit 36.65 at my peak) at that time of the morning, so either the progesterone is behaving as Sonja described, or there's still a bit of hope.

My BBT is probably the thing I trust most to tell me what's going on, and obviously I did have the spotting yesterday, but two other things happened yesterday that I've never experienced before. Since I've never taken extra progesterone before, I have no idea whether they're connected with that, or even just totally random events.

The first is that my plan was to get some lunch when I went to meet my friends for coffee. I'd had a small breakfast, then driven DH over to visit his parents and stayed an hour with them before coming home. When I got home at about 1:00, I had a splitting headache and felt shaky, and just knew I had to eat something before going out.

I had a cereal bar and a handful of dried mango, following which I felt so full that I never did have anything to eat when we got to the coffee house. The headache and shakes took a few minutes to subside, but definitely improved as soon as I'd eaten something. I know this is fairly normal for some people if they haven't eaten for a few hours, but it's never happened to me before.

The second odd thing was that DH got me one of my favourite drinks after supper - a mug of hot Ribena. I sat there with the mug next to me, watching television and noticing a foul smell like stale dishwater, and idly wondering where the foul smell came from and whether I should stir myself to track down the source and clean it up.

When I picked up the mug, I realised it was my Ribena that was smelling so bad. I was barely able to take a sip from it, and when I did, it tasted not of stale dishwater but very strongly of plastic. It was so horrible that I wasn't able to finish it.

So, who knows? I'll be upset if I get more spotting, or if it gets any heavier than it was yesterday, but the total despair of yesterday has once more given way to a little bit of hope and a whole lot of confusion.

Saturday, 24 October 2009

The writing on the wall

Thank you so much for all your comments, your support and your prayers. I appreciate all of them, but at the moment I don't feel able to answer any individual comments.

Today is 10 DPO, and it's usually around now in my cycle that I start to see spotting.

For the last three days, I've allowed myself to get increasingly hopeful, because my temperature shot up to a level it's never reached before and stayed there. This morning it dropped by 0.3 degrees, and although I told myself that a single day couldn't tell me much and that I needed to wait until tomorrow to see what it does then, my heart also sank like a stone.

This afternoon I was having a coffee with some friends. When I went to the loo, I saw the telltale signs of spotting, and instantly just wanted to get home and curl up into a little ball. I went through the motions of finishing our drinks and carrying on the conversation, all the time desperate to get away.

Now I'm home and have been to the loo again, and there is definite brown spotting going on.

The combination of the temperature drop and the brown spotting are how AF always heralds her unwanted appearance.

I'm hoping and praying that Rucksack and Ray-Ray are hanging on in there, but at the moment it's not looking good. The two week wait may be over sooner than I expected.

Listening to my subconscious

I'm starting to get some crazy, vivid dreams now, and sometimes I'm not even sure when I wake up whether they were real or not.

I haven't been able to kick the habit of charting my temperature, but since I started having a regular Insomnia Hour (or two) after waking like clockwork between 3 and 3:30am, I've started taking my temperature when I wake for the Insomnia Hour rather than when I wake for the morning (which is a little more erratic, and very seldom preceded by a full three hours' sleep).

So on Wednesday night, I reached out sleepily at about 3:15am, stuck the thermometer in my mouth, had a quick look and noted with satisfaction that my temperature was still higher than it's ever been at this stage in my cycle.

During Insomnia Hour, I worried that it might have been artificially raised because I'd been sweating profusely when I woke up and it might just have been a temporary hot flush caused by the Cyclogest. So at some point, I fell back to sleep, then woke up again a couple of hours later, took my temperature again and was crushed to see that it had fallen by 0.3 degrees C.

Except... I didn't. I worried during Insomnia Hour, then I fell back to sleep and slept peacefully (or maybe not so peacefully - certainly not dreamlessly) until morning - when I turned the thermometer back on and saw that it was still displaying the 3:15am temperature. The second reading was just a dream.

Then on Thursday night I had two separate dreams. In the first one, I had gone away somewhere for a three-day conference. I arrived there to find I'd forgotten to pack my Cyclogest, and ran up and down the corridor trying to find menopausal women on HRT who might be able to give me a bit of progesterone, all the while panicking that if I missed a single dose I would have a miscarriage. (Yeah, let's wait until we've had a positive pregnancy test before we start worrying about miscarriage - one step at a time, PLEASE!)

In the second, time had obviously marched on a bit and I was complaining to DH that with the extra laundry we were doing for the twins and the fact that the towel rail in the bathroom will only hold a maximum of four towels, I really thought it was time he got over his insistence on using two massive bath sheets after every shower - even when he hasn't washed his hair - so that we could have enough room for both the twins' towels on the towel rail.

I think my subconscious has allowed a bit of hope to creep in here somewhere between Wednesday and Friday. I'm quite excited to see what the next instalment will be - perhaps tonight the twins will be starting school, then by the time the two week wait is drawing to a close, they should at the very least be graduating from medical school, or getting a Nobel prize or something...

Friday, 23 October 2009

One week down, one to go


Killing time


Thursday, 22 October 2009

Public Service Information

This will be a long one. Sonja asked in the comments to my post on Tuesday why I was doing some of the things I'm doing, so I thought I'd do a post on the advice that my clinic gives post-transfer with some additional information that I've dredged up from the net.

Bed rest

My clinic doesn't recommend bed rest after transfer, and in fact they didn't make me lie down for more than a couple of minutes immediately afterwards. Apparently studies have been done where the position of the little bubble of fluid in which the embryos are transferred has been checked by ultrasound after women have either lain down for half an hour or so or got up straight away, and no discernable difference has been detected.

In other words, getting up straight away doesn't displace the embryos and will not cause them to fall out. There is also no statistical difference in outcome between people who have been on bed rest for a day or two after transfer and those who haven't.

My clinic advises that there is no need to rest after transfer and that you can return to your daily routine but avoid strenuous exercise.

In fact, I felt pretty battered and bruised after egg collection and embryo transfer, and apart from my trip to the acupuncturist I rested with my feet up for more than 24 hours after transfer - just because I didn't feel like doing anything else. We went to the theatre on Saturday night, but that turned out to be a mistake, as I felt absolutely dreadful by the time we were going home.

I am still taking it easy (or easier than usual) - apart from the four loads of laundry I had to do yesterday (because although I normally do 4-6 loads a week, DH seems to think that doing a single load over the weekend will keep us on top of things).


Progesterone supplementation is apparently given for two reasons. The first, and more important, is that it can help the uterus to stop contracting after transfer and thus help implantation.

The second is that after all the messing about that your hormones have had during the process so far, your body may not get the usual message to produce progesterone after ovulation and so a top-up may be necessary to support a pregnancy until HCG takes over.

My clinic prescribes enough Cyclogest to last two weeks, then renews the prescription to take you up to 12 weeks if you are pregnant.

For me, the main side effects of Cyclogest have been extreme exhaustion, sore boobs from the day after transfer and a bit of nausea. I've also been getting night sweats, to the extent that since yesterday I have a very attractive heat rash on my stomach, and when I woke up this morning the neck of my t-shirt was damp.

Taking the suppositories rectally, there is no discharge and no mess, although (TMI) my poo is a funny colour!


The clinic recommends taking 75 mg of aspirin daily from the day of transfer onwards - not earlier, as it can increase bleeding during egg collection and transfer. The reason for taking this is to prevent clotting, which can cause miscarriage.

Fluid intake

My clinic advises that you increase your fluid intake to two litres of water and half a pint of milk a day. I'm struggling with this one, as I don't usually drink that much, though as the weather gets a bit chillier I am enjoying my mug of hot milk before bedtime.

The reason for the water is partly to avoid OHSS (with only six follicles, I'm not at much risk for that, although it has been known in the unlikeliest of candidates). It also helps to flush the drugs out of the system. And finally, being well hydrated helps with blood flow, and good hydration remains important throughout pregnancy, so it's good to get into the habit.

As for milk, it can help throughout the IVF cycle - the protein it contains can help to produce better quality eggs. The calcium is useful when downregging - the induction of a mini-menopause can lead to depletion of calcium levels in your bones, increasing the risk of osteoporosis in later life.

Calcium is also very important in pregnancy for the development of the baby's teeth, bones, etc, and if you're not taking enough in, the foetus will take what it needs from your body, again increasing the risk of osteoporosis in the future.

Many people in the West these days have a diet which is deficient in calcium, particularly if they're trying to be careful of their weight (avoiding cheese, full-fat milk, etc) so getting those levels of consumption up is a good thing. Also, because during pregnancy you have to avoid soft cheeses, many women's calcium consumption may actually be going down and increasing consumption of milk/yogurt/hard cheese can counteract that effect.

Finally, I have read a comment from an IVF doctor who said that after he started recommending that his patients drink more milk after transfer, several who had had previous unsuccessful cycles became pregnant. This is anecdotal, but good enough for me.

Other stuff

I'm also doing the following (I've put an asterisk against the ones specifically recommended by my clinic):

  • Taking folic acid 400mg daily - OK, I've been doing this for a couple of years now, so there must be some build-up in my system by now, but I'll carry on... *
  • Eating five brazil nuts a day for the selenium
  • Listening to this hypnotherapy CD every day - there are two separate parts for pre- and post-transfer, and I do find it helpful in keeping me calm. Research (I'm not sure how scientific, as I've only read about it on hypnotherapy websites, which clearly have a vested interest) has shown that using hypnotherapy can increase the chances of success in IVF
  • Acupuncture on all the days recommended - proper scientific research has been done on this and concluded that acupuncture at the right times can significantly increase the chances of success in IVF. It's important to have a good acupuncturist, as the research has shown no increase in success (ie, no placebo effect) if pins are stuck in but the relevant points are missed.
  • Avoiding foods that you're not supposed to eat while pregnant - raw egg, pate, soft cheese, offal (who knew? Looks like DH will be eating my yummy steak and kidney casserole on his own) *
  • Healthy eating, lots of rest and generally trying to listen to my body. *

Phew, so - well done for reading this far. I'd be interested to hear any additional advice that you've been given, or anything that you have found helpful.

Wednesday, 21 October 2009


OK, so even when we were trying on our own there were months when I got so tired during the 2WW that I would end up going to bed as soon as I'd had my supper. I think that's just how my body reacts to progesterone.

Well, now that I'm on Cyclogest twice a day, I feel like I've been hit by a train! On Monday night I was in bed soon after 8. Yesterday, I was in the office, which meant leaving home at 7 am and getting back at 7 pm. I was ready to go to bed by 8, but made the mistake of falling asleep on the sofa instead, and finally woke up to drag myself upstairs at 9:30.

Oh, and that rubbery time concept? I spoke too soon - several hours passed between 11 and 12 yesterday morning and again between 4 and 5 yesterday afternoon. I'm sure two weeks have passed already since ET last Friday, and if days are going to get arbitrarily longer like that, I'm not surprised I'm so tired by the end of the day.

So if my posting, and my commenting on other people's blogs, tails off a bit, you know why. I'm sleeeeeeeping....


You know how the hormone they use in the trigger shot is HCG, and it takes a few days to clear out of your system?

And you know how HCG is the hormone that home pregnancy tests are testing for?

Has anyone else ever been tempted to POAS on or very soon after the day of embryo transfer, just so that for once in your life you're guaranteed to see that blue line appear?

Tuesday, 20 October 2009

Stretching time

On Saturday evening, DH and I went to see one of our friends performing in a production of Terry Pratchett's Wyrd Sisters. The play included the following piece of dialogue:

She never sent the castle to sleep. That's just an old wives' tale. (she glares at Nanny) She just stirred up time a little. It's not as hard as people think. Everyone does it all the time. It's like rubber, is time. You can stretch it to suit yourself.

But time is time. Every second lasts a second, that's what they're for...

How many times have weeks flown past, when afternoons seem to last for ever? How many times have minutes seemed to last for hours, when some hours have gone so quickly...?

But that's just people's perception. Isn't it?

Oh yes. Of course it is. It all is. But what difference does that make?

So, here we are at the beginning of day 4 of a 14 day wait until I'm officially allowed to POAS, and I'm wondering how rubbery time is going to be over the next 11 days. For DH, time will drag - I've kept my obsessions mostly to myself (sharing them only with Jeannie and the entire internet) over so many two week waits that for him, it's the first 2WW that he's actually been fully aware of.

I was feeling rotten on Saturday evening and as we left the theatre, I told DH how bad I felt. His immediate reaction was, "Do you think that's a good or a bad sign?" and I very firmly said that the only sign that could mean anything at all either way for the next two weeks is if I actually start bleeding.

For me, on the other hand, I think this 2WW could even be easier than some previous ones, when I've spotted symptoms like mad and absolutely firmly convinced myself that I must be pregnant, only to have my hopes dashed time and time again.

There are three main things that make it different this time.

First, I know that there is no point whatsoever in spotting symptoms. I've felt more unwell than I expected to over the last week simply because of the huge assault on my body from both the massive doses of hormones and the physical manhandling it's been subjected to. As soon as I recover from that, any symptoms I experience can be put down to the extra progesterone I'm taking, so trying to interpret them is even more pointless than usual.

Second, I have a channel for my obsessions. Normally, there's nothing to do in the 2WW but wait and obsess. This time, I have my twice-daily progesterone suppositories, my junior aspirin, my obligatory 2 litres of water and half pint of milk daily, my folic acid, my hypnotherapy CD... Rather than passively waiting as normal, I'm actively doing something to pass the time.

And third, I know that conception definitely took place and that two living embryos were placed inside me. Rather than wonder whether anything happened at all, I can visualise those two embryos and imagine the stage that they should be at every day. I feel as though I have something real to focus on rather than just hopes and dreams.

It's still going to be a long couple of weeks, and I know I'll get more anxious the closer I get to my official test date. But somehow, I don't think it's going to be my worst ever 2WW.

Monday, 19 October 2009

Laying on of hands

Today is my niece's third birthday, and yesterday we went over to my sister's for her birthday lunch. She's the middle of three children, with an older sister of five and a younger sister of 16 months.

My newly-wed youngest brother and his wife were also there. My brother is a man of few words, even fewer of them demonstrating any sort of emotion, but he hugged me harder and for longer than normal, and that hug said everything that needed to be said between us (accompanied by a gruff "keep us posted"). I know my other brothers would be the same, and seeing him actually made me feel the support from them as well (despite a rather crass and upsetting comment my brother in the US made on the phone on Friday night - Heaven help him if his bedside manner is as bad with his patients).

My sister referred to DH and me a couple of times as "the four of you", and my nieces had obviously been warned not to pull me about and jump on me too much. I felt cared for and as though Rucksack and Ray-Ray are as important to the rest of my family as they are to DH and me. I know there's still so much that can go wrong, and it actually makes me feel better to realise that if things do go wrong, other people will be almost as sad at the loss of our little embryos as we will be.

Anyway, apparently my 5-year-old niece is developing some sort of Charismatic tendencies. She sat next to me at lunch, and between the main course and pudding she suddenly leant across and kissed the front of my jumper (actually, it was my right breast, but I don't think the exact placement was important to her).

She then put her hand on my tummy and said, "Dear God, please let Aunt ___ and Uncle ___ have a little baby."

I presume my sister has been including this in their bedtime prayers, but you could have knocked me down with a feather.

During Mass earlier in the day, I silently wished my embabies peace at the sign of peace, and at the final blessing I gently traced two little crosses on my abdomen. In my prayer, I said that this was the first time I was bringing my two little ones to Mass, and asked that it should be the first of many hundreds of times.

It's so good to know that the innocent voices of my nieces are joining in this prayer for our little ones.

Sunday, 18 October 2009


I think the hardest thing about this two-week wait is going to be keeping calm and not obsessing about what's going on in there. We have a few fun things planned to keep us busy - today we're going to lunch at my sister's house to celebrate my niece's third birthday, and we have various light activities going on during the week. I'm able to work from home for all but three days of the two weeks, which in one way is good, as I won't have to spend three hours a day commuting, but it does also give me an awful lot of extra time for obsessing.

I have a hypnotherapy CD which I'll listen to at least once a day, and my next acupuncture session will concentrate mainly on helping me to relax.

I also have visible signs of how the two-week wait is progressing - having been told that I must make sure I drink at least two litres of water a day, I have a case in the kitchen which currently contains 12 bottles of water. By removing a bottle a day, I'll be keeping my fluid intake up and have a visual reminder of how the amount of time still to wait is going down. When all the bottles are gone, it'll be time to test.

But inevitably, there will be times when I start worrying and getting stressed about the whole deal. On Friday evening, I made up a little rhyme to cheer my raspberry pips on (and subtly remind them what I had to go through to get them - nothing like starting the maternal guilt trips early!) whenever I start feeling a bit anxious. Bizarrely, it does seem to help calm me down so far. It goes like this:

Gonal-F and Cetrotide
Come on little cells, divide!
Ovitrelle and Cyclogest
Come on babies, do your best!

Saturday, 17 October 2009

I think he's excited

Last night DH and I were sitting in front of the telly. As is so often the case, he was watching some obscure documentary and I was tapping away on my laptop.

We often joke about what an anorak my DH is - he has an encyclopaedic knowledge of the most ridiculously obscure facts, and is an amazing person to have on your team in a pub quiz. But every so often when he comes out with something particularly nerdy, I respond simply with a slight cough.

So there we were last night, and I was concentrating on my computer and completely oblivious to what was going on on the telly. DH suddenly came out with some obscure comment in response to something that was said in the documentary, and when I looked at him I could tell from his face that he knew he had just said something very esoteric and - well - nerdy.

I didn't instantly respond, as I had been deep into whatever I was reading, and he smiled at me and said, "Was that a little cough I just heard...? Or was it three little coughs?"

Poor chap - he's obviously expecting Rucksack and Ray-Ray to join me in ganging up on him. I just hope they stick around - I won't even mind if they're busy knitting themselves tiny little anoraks in there and come out spouting obscure trivia like their father.

Raspberry pips

I need to try to get over the feeling that too much gravity will cause my little chaps to fall out of their cosy little nest.

That feeling is, of course, not helped by the typical diagram of the female reproductive organs, which shows the uterus as a great empty cavity. I imagine Rucksack and Ray-Ray floating round this great empty space, occasionally hitting a side and trying desperately to grab hold and cling on, while being sucked inexorably downwards in ever-decreasing circles until they start circling the bottom and fall out of the Cervix of Doom.

The most helpful thing I've found to counteract that mental image is an article which pointed out that the uterus doesn't look like that at all, and the space we see in the diagrams is actually just a potential space. When you see it on an ultrasound, there's no great gaping space - just two lines with a greater or lesser amount of grey stuff between them, depending on where you are in your cycle and how thick your lining is.

This article describes the two sides of the uterus as being more like two slices of bread stuck together to form a sandwich. The lining is the jam in the middle, and the embryos are like little raspberry pips in the jam.

I'm clinging onto that image, because all I can think is that these little chaps really are awfully tiny, and it wouldn't take much of a gap at all for them to slip through it.

Friday, 16 October 2009


Well, that's another step successfully completed, and I'm now pregnant until proven otherwise.

Little Viennetta didn't make it, so Rucksack and Ray-Ray, who according to the embryologist take after their parents in being beautiful little chaps (I'm paraphrasing slightly, but she said they were looking good), are now snuggling down into what will hopefully be their home for the next nine months or so, and we have nobody in the freezer.

Transfer wasn't nearly as bad as I was expecting. Mr No Nonsense likes to do it in (almost) total silence, so there were no reassuring little murmurs or anything, but Nurse First Time gave me encouraging looks as she ran the ultrasound scanner over my stomach.

The bed was raised right up so that I was vagina-to-eyeball with Mr No Nonsense, and as he shoved the speculum in and cranked it open I felt a little as though he was trying to crack me in two with a nutcracker or something. The ultrasound screen was turned away from me, and I had nothing to look at but the ceiling as Mr No Nonsense and Nurse First Time concentrated on the screen.

Mr No Nonsense muttered something about waiting a couple of minutes while the embryos were brought through. I shut my eyes and took deep breaths, trying to focus on the relaxation techniques I've been learning from my hypnotherapy CDs. The pain eased a little, and when I heard the door open and close I prepared myself for the discomfort to go up a notch when Mr No Nonsense started fiddling around again.

Within seconds, he pulled out the speculum, said, "Good luck, then" and left the room.

I looked at Nurse First Time in astonishment and said, "Was that it?" and she assured me that I now had two embryos in just the right place.

She then ran through a sheet of instructions with me and sent me off to pick up my Cyclogest - pessaries to be taken rectally twice a day for the next two weeks, and then longer if I get a BFP. After reading about other people's experiences with PIO injections, I'm perfectly happy to take my progesterone in this form, and had no problem inserting the first one as soon as I got home, as instructed.

Nurse Perfect wished me luck as I was leaving, and then I walked out into the beautiful autumn sunshine to phone DH and tell him the good news.

The morning of the day

Thank you so much to everyone who's left me comments - it means so much to me to have the support of so many people that I've never even met.

Something else that means the world to me is that I sent an e-mail round my family yesterday to tell them about our three little embabies, and I had loving and supportive messages back from all five of my brothers and sisters (or their spouses, which is just as good). So I've gone from feeling a little bit unsupported to knowing that they all care and are all rooting for us - which I really knew all along, but lost sight of when I was feeling a bit hormonal and hadn't actually heard it from some of them spelt out in black and white.

When DH got home from work last night, I greeted him as he came in through the door with "Is that the Daddy?", and his whole face lit up. I then got a bit superstitious, though, and didn't like it when he called me "Mummy-to-be". I explained to him that the way I saw it, we were already parents to these little embabies, but I couldn't be comfortable in calling ourselves parents-to-be until we have at the very least a positive pregnancy test, because there's still so much that can go wrong.

Yesterday didn't go quite according to plan workwise. Although my normal speaking voice was fine, my 'teaching' voice when I tried to project it a bit was very hoarse after having a tube stuck down my throat. I also felt very sore by the time I'd taken the train into London and arrived at work, so my colleague very kindly agreed to do the full two days' teaching for me (she'd already agreed to do my share of today's). I just hung around to set everything up for her and introduce her to the class, then came home and spent the rest of the day relaxing on the sofa with a hot water bottle on my stomach, and really enjoyed the relaxation.

Last night was the best night's sleep I've had in a while, so I feel much better rested, and the cramps have subsided. I had lots of CM last night and this morning, which was streaked with brown blood - I'm hoping I'll get all that out of my system by this afternoon so I don't have to worry about it once the babies are on board.

My job for this morning is to have a poo - my bowels were quite loose while I was on all the injections, but I haven't been since I had my egg collection, and I really don't want to be doing any sort of straining after transfer. So I'm eating lots of fibre and drinking warm drinks in the hope that they'll do the trick in the next couple of hours.

I've read that research has shown that acupuncture can improve IVF outcomes. According to my acupuncturist, the optimal treatment times are the day you start stimming (done), then within a few hours each side of embryo transfer. So today's timetable is acupuncture at 11:30, embryo transfer at 3, then acupuncture again at 6:30.

When I told DH on Monday (which seems sooooo long ago now!) that egg collection was scheduled for Wednesday, he e-mailed to tell me he had booked the day off. I said I was planning to go into work on Thursday, and he suggested that I should take it easy on Thursday and book Friday off.

Biting back the urge to remind him how many times he'd been told that embryo transfer would be two days after egg collection, I mildly mentioned that I hoped to be busy on Friday.

He responded with an e-mail saying, "Oh dear, do you need me there on Friday? I've just rearranged a meeting from Wednesday to Friday."

I wrote back, "No, I don't need you there - as long as you don't mind that another man will hopefully be getting me pregnant while you're at work."

So I'm on my own today, but I'm happy with that - I know he's with me in spirit. I'm very nervous about the actual transfer procedure. It's no consolation at all to me to hear that it's "no more uncomfortable than a smear test", because I find smear tests almost unbearably uncomfortable, but I'll just have to grit my teeth and think of why I'm doing this.

I'll just finish off (gosh, this is another long one - well done if you've read this far) with the story of the big needle that Jeannie referred to yesterday.

DH sometimes has a bit of difficulty releasing his swimmers, and when Nurse Perfect was telling me on Monday about what would happen on Wednesday, I asked her what would happen if he was unable to perform on the day. She replied, "Oh, don't worry - if he really isn't able to do it, we can put a big needle in and get what we need." When I told Jeannie about this, she laughed like a drain - but my brother, and my DH when I told him about it AFTER he'd managed to produce his little potful, somehow didn't find it quite so funny.

I'm just glad we didn't have to use the needle - when he spent so long in there carefully checking the porn file, I was beginning to think I might have to call for it...

Update: I just had a call from the hospital to say that Rucksack and Ray-Ray are dividing nicely, but Viennetta is lagging a bit behind and may not make it. I won't know for sure what's happening to her until I get there and have a chat with Mr No Nonsense and the embryologist, as there's still a bit of time for her to catch up.

Transfer time has been brought forward from 3:00 to 2:30 - I hope that doesn't mean someone else's embabies haven't made it.

Oh, and my other job for the morning has now been accomplished...!

Thursday, 15 October 2009

Fertilisation report

Well, it turns out DH's boys are quite the smooth talkers. Of the six eggs, five were suitable for injection, and as of just now we have three beautiful embryos.

There are statutory limits on how many embryos can be transferred at a time in the UK, and under the age of 40, except in exceptional circumstances, you can only have a maximum of two. Over 40, that increases to three, due to the greater likelihood of one or more failing to implant. As I recently turned 40, that means I could have all three transferred tomorrow (assuming they all survive till then - I know nothing is guaranteed). But I don't think I'm prepared for the risks to my health and, more importantly, to theirs, if all three did implant.

DH and I had jokey names for our first two children long before we even got engaged, and there's now a clear name choice for the third. So, again assuming they all survive until tomorrow, I think we're going to see if we can transfer Rucksack and Ray-Ray and send little Viennetta to the freezer. If they won't let us freeze just the one, maybe we'll go with the risk and transfer all three, but I'll need to discuss that with DH tonight.

It was one of the best moments ever to call DH and tell him he's now a father of three. I then called my parents and told them they have three tiny new grandchildren in a petri dish.

One of the things that I feel cheated of by this whole IVF process is the ability to plan to surprise people with the announcement of our pregnancy. I had various different plans about how I was going to tell DH, our parents, our brothers and sisters, and some close friends. I know this is one of the major reasons why some people keep the fact that they're going through IVF a secret, because they don't want to miss out on those moments.

But whatever happens, and however this whole process turns out, I'll never forget the joy of being able to announce to some of my favourite people in the world that we have those three little babies. With DH's disastrous sperm count and my low ovarian reserve, there was huge doubt about whether we'd ever even be allowed to start this process, and now we have proof that our aging chaps between them are not so duff that they're unable to get together and have a party.

I feel quite maternal towards them already, and hope they're keeping safe and warm, behaving themselves and being nice to each other over there in their petri dish. And transfer is tomorrow afternoon, so I'll be able to keep a closer eye on them and give them proper motherly instructions after tomorrow.


I did NOT have a good night's sleep, and was awake from just before 3 until just before 6. The last time I remember looking at my watch was about 5:50, following which I fell into a nice deep sleep - just in time to be woken by the alarm at 6:15.

Anyway, to reassure Jeannie in particular, I have to say that apart from not sleeping, I'm absolutely fine. I have a bit of a rough throat from the tube, but my calf muscle is no longer sore, my temperature is more or less back to normal, and I'm still only in moderate pain from my stomach.

One of the problems with sleeping (it took me ages to get to sleep in the first place as well, so I probably ended up with less than four hours' sleep in total) is that I always involuntarily turn onto my left side as I'm drifting off. Last night my right ovary had apparently turned into a cannonball, and turning onto my left side left it hanging in the air feeling as though it was about to break loose from its moorings (sorry, mixed metaphor there) and either crash down through my insides, crushing all my other organs in its wake, or force its way out Alien-style through my front. I would then turn back onto my back and be totally awake again.

A couple of other random things about yesterday - DH was an absolute star, and the afternoon I spent with him at the hospital melted away the irritations of the last week or so and totally reminded me why I love him so much.

I woke up in recovery with a heat pad on my stomach, and it was the Best Feeling Ever. Unfortunately, they took it off when they sent me back up to my room, and although I could possibly have done with a hot water bottle when I went to bed, my body was still feeling a bit like a furnace and I couldn't face having any extra warmth in the bed with me. I may well use one tonight, though.

I know the description of DH's boys chatting up my girls was a bit unrealistic - ICSI is more of an arranged (some might say forced) marriage. But despite the nature of their introduction, I hope his boys are now charming the pants off my girls and building the foundation of a long and happy relationship.

And now it's time DH was out of the bathroom so I can go in, so the story of the big needle that made Jeannie laugh and my brother wince and cross his legs is going to have to wait...

Wednesday, 14 October 2009

Home again

Well, we're just back from the hospital, so where was I? At the last scan, there were four nicely growing follicles, and apart from a little bit of concern about early ovulation, I was quietly hopeful that I might get two or three eggs out of that.

I had a few more concerns this morning (possibly contributing to my weepy, hormonal state) when I had a streak of blood in my CM, which is often a sign of ovulation for me. I didn't mention it when I got to the hospital, but it did make me just a little bit pessimistic.

Anyway, first we went down to the fertility suite for DH to do his stuff. He checked the porn file to see if they'd updated it since his last visit, but reported back to me that it appeared to be the same stuff (since July - shocking!). Meanwhile, as he was in there for rather a long time (clearly a thorough inspection), I was outside worrying about whether he was having trouble marshalling his troops.

His work was eventually done, the file checked to his satisfaction, and we were taken up to the ward. I've never gone private before, and was quite impressed that we had our own room with proper walls and everything (no flimsy curtains in a private hospital!) and our own en suite bathroom.

There were then a couple of minor dramas (Jeannie, please don't mention this to anyone else - as far as the rest of the family are concerned, everything was perfect).

First, they took my temperature when admitting me and it was 38 (which meant nothing to me, as apart from my BBT charting I work in Fahrenheit - now that I'm back home with Google I know that translates to 100.4). This could have been a deal-breaker, as it counts as a high enough fever to cause concern. Of course, I couldn't drink anything to bring it down, but I kept splashing my face with cold water and when they retested I'd managed to get it down under 100, so they agreed to go ahead.

Once I'd put my gown on, then taken it off and put it back on the right way round after the nurse had turned up and seen me, a nurse walked me down to theatre. (For the record, it goes on backwards.)

When we got to theatre, I realised why it has that name - there was a substantial audience waiting for me. I was pleased to see Nurse Perfect standing in the background with her reassuring smile, but there was a cast of thousands between us - I felt like quite the celebrity. Mr No Nonsense got me to sign yet another consent form, then the anaesthetist stepped forward. We'll call him Dr Butcher.

Dr Butcher stuck a needle in my hand, fiddled around a bit, muttered that he hadn't got the vein and took it out again. This happened three times before he gave up on my hand and decided to go for the inside of my elbow instead. He rather accusingly said, "You've got very small, delicate veins, haven't you?", to which I responded, "Well, some part of me had to be."

They eventually found a vein and put me to sleep, and apparently another minor drama happened while I was asleep, as when they woke me up I was told they had intended just to give me sedation but had trouble maintaining my airway and had to give me a full general anaesthetic and stick a tube down my throat. It doesn't seem to have had any negative effect whatsoever, and they weren't worried, so nor am I.

I vaguely remember waking up and saying to the person who was looming over me, "I can see two of you." Then I drifted off again, and the next time I woke up the first thing I did was to look at my hand. So here's the news we've been waiting for (drumroll please).... I got a whole boxful!!!!

That's right - count them out. I got one - two - three - four - five - SIX. S-I-X eggs! Out of my four follicles. How amazing are my ovaries?!

When we got back up to the ward my temperature was still up, so they gave me paracetamol to bring it down. By the time we left the hospital it was 37.5 (99.5) - no idea what caused that, but I feel fine.

I had something to eat and drink, did my statutory wee (yes, apparently it's illegal in this country to let people go after a general anaesthetic before the two hour recovery period is over and they've had something to eat and drink and produced a wee) and then texted my friend to pick us up.

Some of the post-op stuff was done by a student nurse. All I'll say about her is that clearly the drip removal and post-op observation lessons at her college precede the bedside manner lessons - not that she was rude, but her communication skills weren't the best.

I don't know what they've done to me, but I have a great counter-irritant in the form of a very sore left calf. The nurses didn't seem worried about it, so again, I'm not. And my stomach is no more sore than it has been for the past few days, so all in all, I'm pretty pleased with how well it's all gone so far. Just as well, as I have to go into the office tomorrow and do a bit of teaching.

Now my prayers turn to fertilisation - I'm hoping DH's boys are sweet-talking my girls, getting them drunk and wheedling their way into their affections.

Saying something

I wasn't sure whether to write about this, especially as I know other people have it so much worse, but if this is going to be a warts-and-all account, I think I have to. And I have to say first of all that I know how lucky I am to have incredibly supportive parents (my dad just phoned to say he was on his way to Mass to pray for everything to go smoothly today for us) and a wonderful sister-in-law in Jeannie (who has also phoned this morning, and who I appreciate hugely).

But... I have a brother I've always been very close to. Despite being very close to me in age, he was always a very protective older brother, and I was delighted when he married someone who also became one of my best friends. They now live in the US and have several children.

I haven't spoken to them as much in the last year or so as I used to. This is partly because of Skype - funnily enough, we find it harder to have a good chat on Skype than on the ordinary phone, partly due to the quality of the connection and partly because my sister-in-law doesn't have time to sit and chat for hours in front of the computer. When we're on the normal phone, she wanders around the house getting jobs done while we chat. And yet, because Skype is free and is available, we tend not to call each other as much on the normal phone either.

When we see each other, it's like we've never been apart, and we can talk about anything and everything, and even when we're not chatting on the phone we e-mail regularly and my brother often sends text messages from his mobile when he's out and about.

So let's count this up. The ways that we have to keep in touch are telephone, Skype, e-mail (I have a work and a home address and my brother and sister-in-law each have an address) and mobile phone (my brother and sister-in-law have one each, and my brother regularly texts from his, though I don't think my sister-in-law does).

And yet I was deeply hurt on my 40th birthday not to hear from either of them or any of their children all day by any of these methods. In fact, it was so extraordinary not to hear from them that I got worried that something major must have happened to prevent them getting in touch, and I e-mailed them at the end of the day to ask if they were all right. My brother responded the next day to say they'd been very busy. It takes ten seconds to send a text message to say 'happy birthday'. A few days later, I did receive (and appreciate - please don't think I'm ungrateful) something in the post that my sister-in-law had sent, but not a word on the day to say they were thinking of me.

(And by the way, I flew out to the US for his 40th birthday, because I knew it was a big deal and I wanted to share his special day with him. I have never missed any of their children's birthdays, and always phone AND e-mail as well as sending parcels to all of them.)

When we had our first appointment at the clinic, I sent a brief e-mail round my family to say that we had issues and that we were going to have to have some sort of fertility treatment. Neither of them ever responded, by e-mail, phone or any other method.

Last month I did have a chat with my sister-in-law and told her about the IVF. It was a really good chat, and she was totally supportive, but the call was cut short because she had to go and fetch the children from school. I haven't heard anything from her since then, other than the normal e-mails which get sent round the family group and have never alluded to this issue.

My brother never acknowledged any of this in any way. I sent him an e-mail a month or so ago which alluded to the fact that we were having a hard time dealing with all of this, and he never even acknowledged the e-mail (though I know he got it, because he alluded to something else I'd said in it in a general e-mail to the family).

Last Friday I sent another e-mail around the family, telling them that I'd started my injections and was hopefully going to have egg collection at the end of this week or beginning of next. Again, not a single acknowledgement from either of them - until Monday evening, when my brother e-mailed me about something else and then said, "Oh, by the way, Clomid - which I presume you're taking..." and giving me some obscure medical fact about it (he's a doctor).

I was quite surprised that he assumed I was on Clomid, as surely a doctor would have got from what I wrote last week that we were doing IVF, and I haven't heard of it being an IVF drug. But I wrote back saying that I wasn't on Clomid. I told him exactly what drugs I'm taking, and said that egg collection would be today. And since then I've heard.... nothing.

So yes, it's a funny thing, this infertility. You learn that some people (Jeannie - who offers amazing support from South Africa, my parents, some of my friends) can be incredibly supportive, and others, however close you think you are to them, take no interest whatsoever. Could it be that they just don't know what to say?

Well, if you've stumbled across this post and are looking for the right words to say to someone who's in the same position as me, let me give you a couple of pointers. Saying nothing is NOT an option - it will make the infertile person feel disregarded, ignored and devalued as a person. It will make them feel that you're belittling their pain and that you don't care about them and the struggles that they're going through.

If you don't know what to say, try something like "I'm sorry you're having to go through this, but I'm thinking of you". On days when you know they're going through procedures, just drop them a quick line to say you're thinking of them and hope it all goes well. It takes seconds, but you can't underestimate just how much it means to that person.

Otherwise, you may find that they end up sitting at their computer on egg collection day feeling sad and bloated, writing about how uncared for you make them feel as they angrily brush away the silly hormonal tears.

Update: Thanks for all your comments, and your support - which does mean a great deal to me. Now that I'm feeling slightly less anxious, bloated and hormonal, I'm feeling a bit guilty about this post. I won't take it down, because it expresses how I felt at the time I wrote it. But I just had an e-mail from my sister-in-law in which she said they were particularly praying for me today, so obviously they are thinking of me - as I always really knew they were, but just wished they would express it a bit more.

Tuesday, 13 October 2009


Well, I finally got back to sleep some time after 5 and managed another couple of hours' sleep. In the cold light of day, I was a bit less worried about the ovulating-before-egg-collection business, but it still niggled, so I just rang the clinic and spoke to Nurse Perfect.

I was concerned that when she gave me the Cetrotide on Friday she said it would prevent me ovulating and would last until Tuesday morning, so I asked what was now preventing me ovulating between this morning and tomorrow afternoon when they do the egg collection.

She said because the HCG shot was given before the Cetrotide ran out, the Cetrotide would have prevented me ovulating up to now, and the HCG will now take 36 hours to make the eggs mature before they pop out. There is nothing that should make me ovulate before 5:00 tomorrow afternoon, and she said, "You don't need to do any worrying. I'll do the worrying, and I can tell you I'm totally laid back about this."

She also said that my oestradiol level yesterday was exactly where she expected it to be and was "absolutely beautiful for someone with only four follicles" (does 4,500 sound about right? In my excitement at having a beautiful level I've forgotten the exact number already!).

So I feel better now - and so far I've had no reaction to the trigger shot, so let the day begin!

Oh, and today's crazy internet statistic? I just happened to idly put my egg collection date into an IVF due date calculator, and it told me I'm already 1 week and 6 days pregnant. Yay me!!!

Guess who can't sleep...

Could 4:45 am be the worst time ever to have to give yourself an injection you're a bit nervous about? I've been awake since about 3, and gave up trying to get back to sleep at 4:15. I've been lying there worrying about whether I'll ovulate before they manage to get in there to take my egg, whether the follicles will have anything in them, whether the eggs will be any good if they do, whether any of them will fertilise...

Better get the stuff out of the fridge and get myself ready for the jab now.

Monday, 12 October 2009

All systems go!

Well, this morning Nurse Perfect says I have a very nice little bed for any embryos to snuggle into (she measured the lining, but didn't tell me how thick it was - just that it looked great). I still have four follicles - two are now over 20mm, the one on the left is 14mm and the other is 13mm.

I have one more Gonal-F injection to do this evening, then at 4:45 tomorrow morning I have to do my trigger injection, and I go in for egg collection on Wednesday afternoon. Provided we get an embryo or two out of that, transfer is on Friday afternoon - so by the weekend I should be into the two week wait!

I'm excited, nervous, emotional (I just had a chat with a friend, and in a ten minute conversation she had a good laugh about how unusually moody and irrational I was, which bizarrely made me feel a lot better, even though I was crying when she said it - so I suppose moody and irrational is a pretty good description) and veering between optimism and terror.

There's so much that can still go wrong - but for the moment, it's all going well.

Full freezer

Thank you for your reassurance yesterday. My temperature's back down this morning, so hopefully I was worrying about nothing - my scan is in three hours, so I'll update again when I get back from that.

I spent most of Saturday shopping and then cooking for the freezer, while DH went to see his parents. We have lots of little plastic pots that are just the right size for two decent servings, and the freezer now contains two pots of leek and potato soup, three of boeuf bourgignon and three of steak and kidney casserole.

Yesterday we had to go shopping for my niece's birthday present and I was too tired to do any more cooking when we got home, so I still have a big pack of minced beef to deal with. I'm trying to decide between cottage pie, bolognaise sauce and cabbage lasagna. Cabbage lasagna is one of my favourite meals - like normal lasagna, but with layers of white cabbage instead of pasta, which makes it a bit lighter - but is quite labour-intensive, so if I'm feeling tired again tonight (which I definitely will be), I'll probably stick to using half the mince for cottage pie and half for bolognaise sauce. I also have a pork joint which I'll cook for tonight's supper, and the leftovers should see us through a couple of days at least.

If we end up having to go through this again, one thing that I'll definitely do differently is to fill the freezer before we start. I've taught DH to make three basic recipes, but they all use leftovers, so he doesn't really know how to make anything from scratch* - and now that I've made the mistake of telling him the cooker is officially a piece of dangerous machinery, he says he's even more reluctant to learn to cook. As a general rule, I'm quite happy with this situation, as I enjoy cooking and he does all the washing-up, which is NOT my favourite chore.

So, with a freezer full of yummy things, I'm ready for whatever they throw at me at the clinic today - I hope...

*Seriously - a few weeks ago when I wasn't feeling well he said he'd make the supper, and I asked him to reheat some leftovers in the microwave and put a fried egg on top. He came wandering back into the room shortly afterwards to ask me how to fry an egg - so I ended up doing it myself anyway, but made sure he was watching. Did I mention that he's nearly 47?

Sunday, 11 October 2009

Bit concerned

Look what my temperature did this morning:

I usually take my temperature between 4 and 5, as I seem to wake up naturally around that time. This morning DH wildly flailed his arm and knocked his alarm clock on the floor at about 3:15, and once I'd been woken up I had to get up for a quick bathroom visit.

So when I took my temperature I'd only been asleep for about an hour. Could that be why it's higher this morning?

I'm really worried that the increased temperature means I've accidentally ovulated and that this entire cycle will have been a waste of time. I can't find anything on Google that suggests anything different - does anyone have any experience of this?

Saturday, 10 October 2009


So, we currently have four people offering to be our 'responsible adult' - or at least to do the driving on egg collection day. I mentioned it to DH this morning and pointed out that while they're hanging around at the hospital, I'll mostly be asleep and he and whoever it is who's driving us will be hanging out together - so I asked him who he would prefer to hang out with.

His response of "Why don't we just get a taxi there and back?" did NOT go down well with this hormonal and slightly-apprehensive-about-having-surgery-however-minor-it-is wife.

We've actually discussed the taxi option before, and I explained that when I've just woken up from an anaesthetic and am feeling a bit sore and delicate, I don't want to have to wait around for a cab, then get into a strange vehicle which will probably smell of one of those dangly air fresheners they all seem to have in there and make polite conversation with a stranger, who will neither know nor care how I'm feeling and is likely to bounce over every pothole in the area and screech round corners at uncomfortably high speeds.

Having explained that AGAIN (and pointed out that we've already had this conversation), I hit him below the belt with, "Of course, the best option would be if you could drive us, but you can't, so the next best thing is at least to have someone I know driving."

He's now gone out for the day to visit his parents, leaving me feeling guilty about throwing that in his face - but I don't think I'm the only one being unreasonable here. It is, after all, two years now since I first mentioned to him that he might find it useful to be able to drive. And it's three months since we found out we would need IVF and I pointed out that there were likely to be days during the treatment when I would be unable to drive and it would be REALLY useful if he could. And it's two months since I told him all I wanted for my birthday was for him to learn to drive. So it's not like I'm throwing something new in his face that he couldn't have done anything about by now.

Another thing he doesn't do is cook, and the pre-op sheet that I had to sign said I shouldn't operate any dangerous machinery "such as cookers" for the 24 hours after egg collection. So I'm now going to spend most of the weekend cooking for the freezer, for all those occasions when I'm going to be unable or unwilling to slave over a hot stove.

I made the mistake of mentioning the "dangerous machinery" clause to DH, and he has picked up on this and said he definitely won't be learning to cook now he's got official confirmation that cookers are dangerous. I THINK he was joking.

I feel a little aggrieved this morning, but also a little guilty for upsetting DH by showing him that I'm a little aggrieved. I think I'd like to go to sleep now, and wake up when all this is over and I've got a little bun in my oven.

Friday, 9 October 2009

And just so you know...

... when they say you may have a little local reaction to Cetrotide, they're not kidding. This is what my stomach looks like an hour and a half later (sorry, not a pretty sight!). You can see the size of the swelling from the little plaster that I have where the needle actually went in.

I should assure anyone who's going to go through this, though, that it wasn't painful at all. I didn't really feel the injection, and although it's a bit itchy now, it's not really uncomfortable. That doesn't mean I won't be expecting lots of sympathy from DH tonight, of course...


... things are moving pretty quickly.

It's been a manic week at work, and yesterday I spent the day babysitting my nieces. The biggest side effect of these drugs (bigger even than the irritability - which I can confirm only seems to affect me around adults, as I was fine with a 1-year-old, nearly 3-year-old and 5-year-old yesterday) seems to be total exhaustion, so I've been dragging myself home and to bed as soon as possible in the evenings.

So, today is day 5 of the rhinoceros doses (450 IU) of Gonal-F, and I've just been for my first scan. I have a 10mm follicle on the left ovary and another 10mm and two 14mms on the right. Nurse Perfect is satisfied that this is enough to proceed, and reckons egg collection could be as early as next Wednesday. It seems a bit pathetic against the huge numbers that some people get, but at least we're assured that we won't have a problem with what to do about any spare embryos.

Nurse Perfect gave me a Cetrotide injection to prevent me ovulating too early and took an armful of blood, and I picked up my Ovitrelle for the trigger injection, then she went through the pre-op questions with me. I had to sign a form promising not to operate any dangerous machinery such as cookers (there were other specific items listed, but that was the one that caught my eye) for 24 hours after egg collection.

I also need someone to drive me home afterwards. Although various friends have offered, this is actually a little bit of an issue - DH can't drive, despite me asking, encouraging, cajoling and eventually begging him to learn in case of emergencies. I said all I wanted for my birthday was for him to learn to drive, and he promised he would. Five weeks after my birthday, he hasn't booked any lessons yet, or even looked into it - and probably never will unless I do all the legwork for him. I'm Very Not Happy about the situation, as I am the official chauffeur not only for him but also for his parents, and it puts a lot of strain on me at times.

And finally, I'm required to have a responsible adult to take care of me for 24 hours after the event. Does anybody know one of those...?

Thursday, 8 October 2009

How cool!

Lin at Our Someday Family has given me my first award - thanks Lin!

There are rules attached:


1. You Can Only Use One Word!
2. Pass this along to 6 of your favorite bloggers
3. Alert them that you have given them this award!
4. Have Fun!

The Fun Part

1. Where is your cell phone? Pocket
2. Your hair? Brown
3. Your mother? Friend
4. Your father? Lovely
5. Your favorite food? Chocolate
6. Your dream last night? Confusing
7. Your favorite drink? Tea
8. Your dream/goal? Motherhood
9. What room are you in? Bedroom
10. Your hobby? Blogging!
11. Your fear? Fire
12. Where do you want to be in 6 years? Here
13. Where were you last night? Pub
14. Something that you aren’t? Thin
15. Muffins? Starbuck's
16. Wish list item? Holiday
17. Where did you grow up? Europe
18. Last thing you did? Wake up
19. What are you wearing? Pyjamas
20. Your TV? Off
21. Your pets? None
22. Friends? Amazing
23. Your life? Happy
24. Your mood? Hormonal
25. Missing someone? Jeannie
26. Vehicle? Fusion
27. Something you’re not wearing? Socks
28. Your favorite store? Electrical
29. Your favorite color? Red
30. When was the last time you laughed? Yesterday
31. Last time you cried? Tuesday
32. Your best friend? Anna
33. One place that I go to over and over? Watford
34. One person who emails me regularly? Charlotte
35. Favorite place to eat? Home


1. Sonja at On (In)fertile Ground, whose supportive comments I really appreciate
2. Myndful at Tenaciously TTC, who is 2 days ahead of me on the stimming and has put up several posts recently that have spoken what I was thinking - I wish I could work out how to leave comments on her blog without having a Wordpress account, but if she keeps being so eerily in tune with me I may have to just sign up for Wordpress
3. Barrenblog, who has a brilliant way with words and who recently wrote one of the best descriptions I've seen of the whole IVF process

Most of the other bloggers I considered giving this to already have it, so I'll have to stop at three for now.

Phew, that was tricky - you may have noticed that I'm not usually one to use a single word where a few dozen would do.

Tuesday, 6 October 2009

Side effect or convenient excuse?

OK, it's only a couple of hours since I did my second jab, so perhaps I'm being a bit feeble here. All I can say in my defence is, it's a HUMUNGOUS dose I'm on - the maximum recommended dose right from the start. It takes most people 3-6 days to take as much of this stuff as I get in a single dose.

Anyway, here, in no particular order, is a list of all the people, places and inanimate objects that have irritated me today:

  • the woman who sat next to me on the course I went on, by asking lots of fatuous and inappropriate questions;
  • one of my colleagues, by failing to understand the point I was trying to make;
  • another colleague, by failing to answer his phone when I needed to talk to him;
  • my husband, by waking me up this morning with his snoring;
  • my brother, by forgetting to mention in the dream I had last night that he and his wife had had another baby (yes, I know it was only a dream, but I was still irritated with him when I woke up);
  • the supermarket, by failing to stock the thing I went in for this evening;
  • every chemist in town, by being closed when I wanted to nip in and pick something up;
  • the woman next to me on the train this evening, by playing with her hair in an annoying way;
  • my MP3 player, by failing to pick up a radio station on the train this morning;
  • the woman on my hypnotherapy relaxation CD, by using the made-up non-word "feel-imagine" three times in quick succession;
  • and I'm sure there were a few others.

Perhaps irritation is my natural state and I usually work a bit harder at suppressing it. I reckon a rhinoceros' dose of hormones swirling round my already decrepit body should be enough to allow me to get mildly testy from time to time, though...

Monday, 5 October 2009

The journey of a thousand miles

The Chinese have a saying, "The journey of a thousand miles must begin with a single step".

This saying has a particular relevance for me, because when I finished my PhD I dedicated it to my parents with the words, "This truly has been a journey of a thousand miles, and my parents have been with me every step of the way." I gave them a copy with a bookmark in it which bore the original words of the saying.

Anyway, today I took a single step on my latest journey of a thousand miles. It certainly wasn't the first step, but I hope it was a significant one leading me closer to my goal.

I had my scan, and Nurse Perfect proclaimed herself satisfied that although my cyst hadn't disappeared altogether, it had shrunk to a mere 10mm. She then sent me off to the pharmacy to pick up my Gonal-F and bring it back for a quick lesson in how to give myself an injection.

The pharmacy only had one box left, and I needed five - on a daily dosage of 450 IU (the maximum recommended dose), a phial of 600 IU doesn't last long. I took the one box and went back to the consulting room, where Nurse Perfect lived up to her history of going the extra mile by offering to drop the remaining four boxes off at my house tomorrow on her way home from work. Fortunately, she won't have to do that, as a new delivery of drugs arrived at the hospital while I was doing my first injection, and I was able to leave with my prescription properly filled.

The box contains a little phial with a sort of white powder in the bottom of it, a syringe filled with some sort of solvent and six empty syringes. Nurse Perfect demonstrated how to mix the solution and fill the syringe, then handed it to me and invited me to pinch an inch of flesh and sink the needle into it. After a slight hesitation, I heroically stabbed myself and sank the plunger down - and let me tell you, 450 IU of Gonal-F is a LOT of fluid!

I now feel very proud of myself that I've got past the first hurdle, and very relieved that the injection turned out to be so easy and painless. I've been thinking of these injections as being on a par with ripping off your own plaster - easy enough to do to someone else, but not so easy to do to yourself, because you know it's going to hurt and have a natural tendency to protect yourself from pain.

I now know that the two things are not at all on a par - I may occasionally in the future hit a tricky angle or get a blunt needle or something, but I know for a fact that it's absolutely possible for me to give myself an injection without feeling a thing, and that's going to make it a lot easier to face over the next few days.

So all in all, I'm excited and looking forward to the next few steps on this journey.

Dramatis personae

I think I need a shorthand to refer to the different people at the clinic, so here goes.

The consultant is a man of few words, who tells it like it is and doesn't beat about the bush - at our first appointment, he asked us a few questions and then introduced the results of DH's sperm analysis with the words, "Well, you wouldn't have been successful whatever you did, because your sperm count is so bad. Your only hope of conceiving is IVF with ICSI." He's very thorough, very well respected in his field and very good at his job, but he doesn't do small talk. So we'll call him Mr No Nonsense.*

The head nurse is my favourite nurse. I've seen her a few times, and she's very friendly and knowledgeable - apparently she's been working there for donkey's years - and always makes time to answer questions and reassure me. She's the one who turned round and went back to the office when she remembered she hadn't phoned me that time. We'll call her Nurse Perfect.

Then there's the nurse I've only seen once so far, so don't know her well enough to have formed an opinion - though she seemed very nice when I did see her, and she was the human being I spoke to on Saturday who set up this afternoon's appointment for me. The only time I've actually met her was at our very first appointment at the clinic, so we'll call her Nurse First Time.

And then there's the one who stuck needles into both my arms and still failed to get enough blood for a blood test, who booked me in for a scan on day 3 last cycle without asking if I was free on day 2, despite day 2 being the optimal day to start treatment, and who I spoke to on Friday. She's very friendly and pleasant, but I don't trust her as much, and I'm going to call her Nurse Not Quite.

And there we are - the happy team that I'm hopefully going to be seeing more of over the next couple of weeks.

* Note for American readers - in the UK, when you first qualify as a doctor, you're addressed as "Dr So-and-So". When you then qualify in a surgical speciality as a consultant, which is the peak of the profession, you're conventionally addressed as "Mr So-and-So". Apparently it stems back to the days when surgeons were trained in barber shops and weren't actual medical doctors - but even today, if you call a surgical/obstetric consultant "Dr" rather than "Mr", he is likely to be quite offended.