Saturday 27 November 2010

Talking it over

Way back when all this began, we talked about what we would do if the IVF didn't work, and we agreed that the options on the table were embryo adoption and ordinary adoption. At least, I thought that was what we'd agreed. But it turned out DH hadn't considered either option at all, because he was so convinced the IVF would work. And he wasn't too sure what embryo adoption even was.

Fast forward to this week, and he's got his head round normal adoption but is still very hazy about embryo adoption. Part of the issue is that my research showed that it's pretty rare to be able to do it in the UK, due to a huge lack of donor embryos. So I was thinking we'd have to go abroad for it, and he's dead set against that, because he doesn't want me to undergo 'a medical procedure' in a foreign country. But then I discovered that although it's rare in the UK, it's not impossible, and it was back on the table again - as long as we did it here.

I'm sure we talked all those months ago about the reasons for embryo adoption rather than egg (or sperm) donation, but I underestimated DH's ability to fail to process things he doesn't want to think about. So now the whole topic is having to be rehashed, and I'm still not sure what the end result is going to be.

We've had a few discussions about embryo adoption since Monday. I've explained to him why it's my preferred option over normal adoption.

If we want to adopt, we'll have to wait a year from our last fertility treatment before they'll even start the approval process. Then we'll have to open up every aspect of our lives to a bunch of strangers who will be judging us on everything we say and do.

There's no guarantee that we'll be approved as adopters, and in fact being white, middle class, middle-aged, married and Catholic are all likely to count against us in the eyes of social services.

Even if we are approved, we then have to wait for a child to be matched with us, and since we're looking at a foster to adopt scheme, we could then end up spending the first two or three years not even knowing whether we're going to have to give the child back.

And, of course, we're unlikely to be given a baby and so we have to consider the psychological damage that the child has already suffered in its life. I admire people who adopt older children, and I'm not completely ruling it out, but right now it's not for me.

Plus, I really want the whole package - it's important to me to know what it's like to be pregnant and to give birth, and if there's any chance of that happening, I want to take that chance. And it seems shallow, but I also want to be able to name my own child - and if we're adopting an older child, or fostering with the possibility of adopting in the future, the child will have been named by its birth parents and it would be cruel to try to change the name that it's used to.

We were talking about the whole adoption vs embryo adoption thing in the car on Thursday night, and I said that with embryo adoption, the child may not be genetically ours, but because I would be growing it in my body for nine months, biologically it would be getting an awful lot from me and so I would feel that it was very much our baby.

But DH said, "Yes, but it would get nothing at all from me."

And I realised that I've been looking at this from my point of view, and what I need, and haven't really thought enough about what he needs and what he's giving up in deciding we've reached the end of the road with our own eggs and sperm.

I thought a lot about this, and then yesterday he had the day off work and we were in the car again - and I do find the car a very good place to have a discussion like this, what with him being a captive audience and everything.

So I told him I'd been thinking about what he said, and I explained that there were three reasons I'd been talking about embryo adoption rather than egg donation.

The first, and probably the most important, is that we know that there are problems with his sperm as well as my eggs. None of the embryos we've had in the first three IVFs have implanted, and we can't say for sure whether that's because of my crappy eggs or his crappy sperm, or both. If we're deciding to give ourselves a better chance by going for younger, fresher eggs, it makes sense to give ourselves the best possible chance by going for embryos which have been produced by a couple who have already become parents themselves.

The second reason is that our Church is very opposed to donor eggs and sperm, but hasn't really come down clearly on donor embryos. Plus there's a very good argument that adopting an embryo is a good thing, as these embryos have already been created and would probably be discarded if people like us didn't give them an opportunity for life. Of course, we've already gone against the Church's teaching by having IVF in the first place - I'm very conscious of that, and it was a very difficult decision to make. Going for donor eggs with DH's sperm would be a step further in opposing that teaching.

The third reason is that although the chances of success with donor embryos are much higher than with our own eggs and sperm, it's still highly likely that we wouldn't be successful first time. We can't afford to have more than one attempt with donor eggs - and can't really even afford to have that one attempt if we do get the go-ahead to have one last try with my eggs and then have to move on if it's unsuccessful. Donor embryo treatment is cheaper, and so we could probably scrape together the money for two or three attempts if necessary, and could even manage to afford one attempt after trying one last time with my own eggs.

There's another secret reason that makes me feel absolutely horrible, and I hope I never have to tell him and show him what an awful person I am. But the fact is, I can cope much more easily with the idea of having a child that's not genetically related to either of us than the idea of having a baby that's his but not mine. There's just something about the idea of his sperm fertilising another woman's egg that makes me feel betrayed. I know it's irrational, and I feel like if I loved him enough, I would want to have his child no matter what. I do want his child, but I want it to be with me - I want it to be half mine and half his, and if I have to say goodbye to that dream, I just don't think I can bear to watch a child grow up and know that genetically, it's half his and half a complete stranger's - to see a character trait or a certain expression on the child's face and think, "Does she get that from DH, or is it from the stranger who gave us her egg?"

So now you know what a horrible human being I am. But I gritted my teeth and said that those (the first three) were the reasons why I thought embryo adoption was better . As I said at the beginning of this ridiculously long post, I thought we had discussed all this over a year ago, but at the time he might as well have been sticking his fingers in his ears and shouting "la la la" for all the good those discussions did. But I said that if he was dead set on it, we could consider egg donation as well.

So I said the right words, but even typing that last sentence made me cry just now, so we've got a lot of work to do before we're on the same page on this.

In the meantime, he said he needed to find out more about it for himself and asked me to get out my IVF books for him - and I think he's planning to spend some time today doing some reading.

I feel like we're back in that twilight zone when we first found out that we weren't going to be able to have children without help - each of us having different ideas about what we're going to do next, and struggling to understand each other's position and reach a decision about what's the best thing to do. It's not an easy place to be in, and the degree of peace that I had earlier in the week when I thought that the decision had been made has just been shattered. All I'm left with is the sadness, and a bit more confusion and uncertainty.

A couple of months ago we took our nieces to a music show. One of the songs had the following refrain:

We can't go over it.
We can't go under it.
We'll have to go through it.

And that's what's playing in my head at the moment. The only way past this uncertainty is to go through it, and I don't know what it's going to be like at the other side. But I do know it's not going to be easy to get through, and I'm kind of wishing I could just hibernate and wake up in the spring with the way forward suddenly and miraculously clear to us.

Wednesday 24 November 2010

Enough

When I got home from London on Monday evening, I had a long wallow in a hot bath. It had been a long and stressful day, and I was freaked out by being told that I wasn't having a 'proper' period. I was also concerned that yet again, it looked as though I didn't have any more than one follicle ready to grow.

I can't keep doing this month after month - I don't want to keep getting my hopes up and then having them dashed, and every month is another month closer to the inevitable time when I'm going to run out of eggs altogether.

I've also read recently in Zita West's book that fertility stops up to 10 years BEFORE your last period. As my mother had her last period when she was 51, it's likely that I'll be around that time too - and I'm now 41. So I really could be flogging a dead horse here.

When DH got home, he came into the bathroom and stood over me, still in his work suit. He said he was sorry that it had been such a disappointing day, and I told him that I thought it was time to start thinking about how long we're going to keep doing this before we move on to Plan B (actually, more like Plan D - IVF is already our Plan C). I pointed out that I wasn't getting any younger and that all indications are that it may already be too late for us to succeed with my eggs.

He immediately trotted out the usual line that I hear so often from him and from others: "But you're not old!"

These days in the West we're absolutely terrified of admitting that we're getting old. It's why botox and plastic surgery are so popular, and telling someone they look old is one of the worst insults you can throw at them. My parents, who will both be 70 in the next 18 months, think of themselves as middle-aged - despite the fact that you don't actually meet many 140-year-olds. They're horrified if I refer to them as OAPs, though they will just about admit to drawing a pension when it suits them.

So when someone says they're too old for something, the knee-jerk reaction is to tell them that of course they're not, they're only as old as they feel, or that they look way younger than their age.

The sad truth is that it doesn't matter how well I've looked after myself, or how well preserved I may look - you can't argue with the chronological age of your ovaries. I only have a few eggs left, and up to 80% of those I do have are likely to be chromosomally abnormal.

So when DH tried to reassure me by telling me I wasn't old, something inside me snapped. I lay there in the bath, with tears streaming down my face, as I threw facts at him like machine-gun fire. I pointed out how every single chart shows fertility falling off a cliff-edge after the age of 40. I told him that age was a fact of life, and acknowledging the passing of the years is not an insult but an acceptance of reality. I said that people can trot out all the stories they like about people who gave birth in their 40s, but these people become anecdotes precisely because they're so rare. I told him I was tired of being hopeful every month and then getting the same answer, month after month after month. And I said I wasn't prepared to keep wasting time and money to chase after a dream that is becoming less and less likely ever to become a reality.

Eventually, when he managed to get a word in edgeways, he said in a little, sad voice, "I suppose I do need to start facing up to reality."

Poor guy - he's seven years older than me, and thought he had a young wife. But once I was out of the bath, I showed him some more statistics and made him read what Zita West had to say about the effect of age on chances of success.

So now we've agreed - I'll go for my test next month, and probably in January as well. But if those tests don't show ideal conditions for going ahead with IVF, then we'll get in touch with clinics that do donor embryo treatment. If we have to go on a waiting list, we'll keep trying for the perfect month with my eggs in the meantime. But once a donor embryo becomes available, that's it - no more trying for the impossible dream of having a baby that's half his genes and half mine. Being parents is more important than producing a mini-me.

I'm sad, relieved and a little bit hopeful all at the same time. We still have two more months to get my hormone levels right. And if that doesn't work out, we have a plan - and one which has a greater chance of success.

I just hope when the time comes, we have the nerve to go ahead with our plan and not keep stalling any further.

Tuesday 23 November 2010

Yet another false start

So, I went into the clinic yesterday all excited and looking forward to making a start on IVF #4. I picked up my form and trotted round the corner to the lab for my blood test, then back to the clinic to wait for my scan. I was taken upstairs for a teaching session to remind me how to do my jabs, then eveeeeentually went in for the scan. And that was where it started to go a bit wrong.

The scan was done by Mr Greek God, and the first thing I did was make an idiot of myself by putting my bottom where my head was meant to go. OK, I know, I'm hardly a beginner at all this - you'd think I'd know. In my defence, it was in a different room with a different set-up, and I got a bit confused.

Once I'd got myself in the right position, he got started. My lining was looking as it should, beginning to come away. One ovary was showing no signs of activity whatsoever - not a potential follicle in sight. The other had one or two around 4 mm, and another which measured 9x10 mm. Mr Greek God said that their cut-off is 10 mm, which interested me, as I had a 10 mm follicle last time we got started and they never mentioned it to me as a potential problem. Anyway, he said it would be Mr Miracle Worker's call whether he was willing to go ahead.

I then wandered off to a coffee shop to wait for the results. I met DH for lunch (and he irritated me by turning up 10 minutes late, so that I was left hanging around in the cold for 15 minutes, because, as he should know by now, when I make an arrangement with someone to meet at a certain time, I always try to turn up a few minutes early), and then wandered around the shops, clutching an information pack from the clinic in one hand and my phone in the other.

Eventually, one of the nurses called, and said that they weren't happy with today's results, but if I wanted to I could go back again today for yet another blood test and scan to see whether they had improved. She said the blood test indicated that this wasn't a proper period yet - well, that really freaked me out, because it came at the right time and had been as heavy as usual since Saturday afternoon.

I said if this wasn't a good month, I didn't want to waste time and money going back for more blood tests and scans for nothing, and tried to ascertain what she meant by 'not a proper period'. All she could tell me was that my progesterone was still high, and it should have dropped after my period started.

In the morning, I had asked Mr Greek God what I should do about the DHEA if Mr Miracle Worker decided I shouldn't go ahead this month. He said it was fine to be on DHEA for up to six months, and since it was Mr Wonderful who prescribed it last time, I should talk to him about getting a repeat prescription. I mentioned this to the nurse who called, and she said she would talk to Mr Wonderful and call me back.

So it was back to wandering the streets while I waited for another call, and eventually I settled in another coffee shop with a book until the phone rang.

It was Mr Wonderful who called me back. He asked if I was still taking the DHEA, and when I said I was, he said I should stop it immediately and then come back next month. He said that the high progesterone could be caused by the DHEA - and sure enough, when I consulted Dr Google when I got home, I discovered a few articles that said DHEA supplementation could cause increased progesterone levels. The only warning I'd had beforehand was that it could increase testosterone levels, so I wasn't prepared for this at all.

Although they didn't tell me what the level was, both the nurse and Mr Wonderful also said that my oestradiol was elevated yesterday, so I presume that must have risen since Sunday - maybe no surprise, if I already had a dominant follicle.

So the upshot of all that is that I wasted a day hanging around waiting for calls, wasted more money on blood tests and scans, and don't get to go ahead with IVF this month after all.

The good news? Well, my FSH was lower this month than it was last month, but still borderline at best, so another four weeks should hopefully give it a chance to come down a bit further. My cycle has returned to its normal length at last, following several short cycles after IVF #3. We get another month of healthy eating and taking the Foresight supplements, which did seem to help last time. And if we had gone ahead this month, we might have ended up with just the one dominant follicle again.

But does all of this make me any more confident about next month's results? Well, after one dominant follicle cycle and then seeing that the same thing seems to be happening again the very next time you get a scan, would you be confident of ever again getting more than one egg?

Sunday 21 November 2010

Starting blocks

Sorry I've been a bit absent the last few days - life suddenly got very busy. It's calming down again now - in one way. I have no more work bookings for the next couple of weeks, and can do as much or as little marketing as I choose to get myself busier or less busy over the coming months.

And that calm is a great thing, because the next couple of weeks could be rather busy.

I was quietly pleased in the last couple of days to see that for the first time since we went through IVF #3, my cycle appears to have returned to normal and AF showed up when it was supposed to, late yesterday afternoon. For the last three months, it's been arriving one or two days early, and I'm pleased to be back in my regular cycle (which at 26 days is short enough as it is).

This morning DH accompanied me into town for my day 1 blood test.

I just got the call back from the clinic. My FSH is 11.6, which is still borderline but much lower than last month. And the great news is that my oestradiol, which has been a problem since we first signed up with this clinic, is only 116. That's the lowest it's ever been by a very long way, and means that my FSH level is a true level and not artificially reduced by higher oestradiol levels.

So the clinic want me to go in tomorrow morning for another blood test and a scan, and then hopefully tomorrow afternoon I'll be getting started on IVF #4.

I'm hoping the low oestradiol level this month means that I won't be starting with a dominant follicle this month, as I did last time, and that this might help me to end up with more than one egg.

I feel mentally and physically ready for this in a way that I didn't for either IVF #2 or IVF #3. I have no major commitments while this cycle is going on - even DH is taking a couple of days off work so that we get a long weekend together next weekend - and I'm actually looking forward to being able to put everything else second and concentrate fully on following Mr Miracle Worker's instructions.

It's crazy, but I actually feel quite excited!

Monday 15 November 2010

Little good feeling

One of my favourite books when I was growing up was 'The Little Brute Family' by Russell Hoban. It's the story of a fairly miserable family of creatures who eat sand and gravel for breakfast, stick and stone stew for dinner, and are rude and unpleasant to each other.

Then one day, Baby Brute comes across a "little wandering lost good feeling" in a field of daisies. He takes it home in his pocket, and by the end of the book everyone is nice to each other and their lives have been transformed.

Well, on the way back from the Fertility Show the other day, I came across my own little wandering lost good feeling.

I can't explain it, and I have no real reason for it, but I suddenly got this really calm, peaceful feeling that everything's going to be all right.

And I still have that good feeling now. I'm actually allowing myself to be cautiously optimistic - even though I know it's still more likely than not that our next IVF will fail, and I know our chances of conceiving naturally are vanishingly small.

Maybe I'm finally learning the difference between hope and expectation - separating out my understanding of the odds from my hope that it might work for us, rather than being plunged into despair at the thought of how low the odds are and talking myself into expecting to fail.

Maybe it's also because I feel more in control of my life. A lot of things spiralled out of control over the last year, and are just beginning now to come right.

I've always been strong and healthy, and I was terrified by how unable I was to function when I put my back out earlier this year, and how long it took before I was able to do simple things like put my own socks on or turn over in bed. For the last couple of months, I've been seeing a personal trainer, and she's been concentrating on exercises to strengthen my back. As a result, I feel stronger, fitter, and more confident in my body's ability to do what it's meant to do.

Then there was my job situation. When I was made redundant, the programme that I had researched, written and run from its first conception was abolished - my employers were effectively saying that they didn't value the product that I had devoted five years of my life to creating, developing and improving. And the product was so much my creation that it felt that they were saying they didn't value me as a person - my skills, my ability, my knowledge and the personal qualities that I brought to the job.

When I was then also turned down for a job which I had been told was being created especially for me, I hit a real low point in confidence. I couldn't have a baby, I couldn't rely on my body to do what I wanted it to do, and now I couldn't even get a job.

Around the time of the Fertility Show, I was just reaching the end of my first commissioned piece of work. I had also had a call the previous day offering me four days' work for the next fortnight, and so I knew that for the first time since August, I was going to be earning some money this month. Both of these jobs were what I think of as bread-and-butter work - connected with my previous job and so something I know I should be able to do to make money when I need it, but not something I'm hugely enthusiastic about continuing in the long term if I can make a go of what I really want to do.

But that morning I had also got my first bit of serious interest in the work that I really want to do - something I've done on an amateur basis for years now but have now decided to try to do professionally. It's something I'm passionate about, and although I'm increasingly realising that I still have a lot to learn, I have had some pretty good results when doing it for friends and family. Anyway, I subsequently got the booking, and I did my first professional job for a total stranger this last Friday. There are more commissions in the pipeline, and I have lots of marketing ideas and am excited about making this work.

As for the fertility business - I know I'm doing all I can. I'm not giving up without a fight, and if nothing else, everything that I'm doing at the moment will make me mentally and physically stronger and ready, if need be, to take that strength into whatever the next round of the fight might be.

You've all been very patient with me through all my whinging, and no doubt there'll be more dips and troughs to come, but for today, what's not to feel good about?

Sunday 14 November 2010

Reflexology

I said I would tell you about my first reflexology session, last Monday. This was an extra-long session, to allow her to take a full history before she started playing with my feet. I answered all her questions, then lay back as she went to work, kneading away at various parts of my foot as I occasionally winced in pain and she looked interested, nodded wisely and made little notes on the clipboard next to her.

I didn't really know what to expect. At one point, she murmured that she could tell I was calm on the outside but crying on the inside. I wasn't all that impressed with this, as you can say that to pretty much anyone who's having fertility issues and it's likely to be true. I also found it a bit irritating the way every time I winced, she encouraged me to breathe through the pain - I know what real pain is, and I don't need to start puffing like a woman in labour to soothe myself after a little twinge when someone presses a sore place in my foot.

I was impressed, though, when just from playing with my feet she was able to identify two major health problems that I've had in my life, neither of which I had alluded to at all when she was taking my history.

She said she felt some vitality in my reproductive system, which meant that there certainly wasn't any reason I shouldn't produce some good eggs. But she detected sluggishness in my pituitary gland, which plays a major part in hormone production, and also in my thyroid. She said if my thyroid was borderline underactive, it wouldn't be picked up as a problem in testing (the test I had earlier this year said it was in the normal range), but could still be causing problems.

These are areas that she said she could work on, as well as helping me to destress and be a bit more relaxed. First, she wanted to see if we could get rid of my sinus infection. Since I'm not a big fan of antibiotics, and couldn't get an appointment with the doctor anyway, I was all for her having a go at treating it just by rubbing my feet. She also gave me some 'homework', showing me points that I could press on my hands to try to clear the congestion.

After the treatment was over, she warned me that I would probably feel very tired and a bit fluey and achey over the next day or so, as a result of what she had been doing. Sure enough, on Tuesday I dragged myself out of bed feeling like death warmed up, and spent the day feeling very sorry for myself.

By Thursday, though, my head was still stuffy, but the rather yucky signs of infection were already clearing up and I was feeling quite human again.

She stated very clearly that she's not setting herself up as a doctor and she can't claim to be able to 'cure' anything, but she said it felt as though everything was still there and ready to work, but it was almost as if I'd just shut down shop in reaction to something traumatic, and that if we could just coax my body into the state it was in just before everything shut down, it should be able to do the rest on its own.

That makes sense to me - I've never got millions of eggs, and that doesn't really bother me. But on IVF #1 I got six, of which four were mature and three fertilised, and on IVF #2 I got four, of which two were mature and one fertilised. Those two treatments were very (too?) close together and involved huge doses of hormones and lots of messy emotions.

Then there was a longish wait, during which I improved my diet, took supplements and tried to get in as good a condition as possible, followed by a third IVF in which I got two eggs, only one of which was mature. I also had my worst ever back problems (and interestingly, the reflexologist said that the precise area where I had my slipped disc is strongly connected to the reproductive system) and lost my job, so it was a pretty stressful few months.

So after the assaults on my body and my emotional well-being over the last year, despite the healthy eating regime, is it really any wonder that my ovaries decided the time wasn't right to start pumping out eggs as if there was no tomorrow?

In any case, something was definitely going on in my body after the first session last Monday, so I look forward with interest to seeing what effect, if any, this treatment has on my hormone levels in the next couple of months.

Thursday 11 November 2010

Control

One of the things that's so difficult about this whole IF business is the feeling of loss of control. Many of us have no, or very little, control over when we'll be cycling. We have no real control over whether the treatment will be successful or not. We spend month after month being unable to make plans, or having to make tentative plans in the knowledge that they may have to be cancelled in favour of a trip to our favourite clinic.

This is why we so often fall prey to superstition and mumbo jumbo - because they give us something that we can actively do and in a way give us back some sense of control. Saluting a magpie may not get me pregnant, but it's a positive action that some say can help ward off bad luck.

One of the things that I think my coach is trying to do is to give me back a real sense of control (rather than the false one you get from superstition). Before last week's session, she asked me to think about things I'd like to change to help me feel more positive about this next cycle, communicate my needs and feelings more effectively, and/or improve my chances of conception.

I decided that the first and third of those aims would be fulfilled by losing weight, eating more healthily and sleeping better, and I thought about things that I could do to achieve each of those aims.

In the session, we concentrated on the weight loss. We drew up an action plan with a specific, concrete goal (how much I want to lose, when I want to lose it by and how I will reward myself if I achieve that aim) and specific actions setting out how I plan to do this.

Suddenly, my focus has shifted slightly from something I have no control over ("I must reduce my FSH, then produce plenty of good quality eggs, then get pregnant") to something that is much more within my control and will ultimately be good for both my general health and my chances of conception.

I know that I'm also doing everything that I can in other ways - I'm listening to Circle + Bloom and going to a reflexologist for relaxation, I'm back on the supplements that I'm convinced helped us last time, I'm taking DHEA and wheatgrass, and I'm getting regular exercise.

Despite feeling so grotty over the last week (thanks for putting up with my whinges, by the way), I have maintained that sense of control over what I'm doing, and so far I'm seeing results - in the first week, I've lost 3 lbs.

Just as importantly - perhaps even more so - I'm beginning to feel as though I'm back in control of my life. It's been a crappy little-over-a-year, with three failed IVF treatments, a slipped disc, a redundancy, a couple of months of no work, dealing with feelings of jealousy over my SIL's pregnancy - all things over which I had little or no control. And now I'm making progress with my work (tiny steps, but it means I'll be earning money this month for the first time since August, and since what I want to do relies quite heavily on word of mouth, the first few jobs were always going to be the hardest to set up) and have taken as much control as I can over the whole baby-making process.

All of this makes a control freak like me feel an awful lot better.

Tuesday 9 November 2010

Bleurgh

I've got loads of stuff I could be blogging about - my last coaching session and the homework I've got from it, my first reflexology session yesterday, the job bookings I have which mean that I'm now officially self-employed rather than unemployed, the funny thing that happened on the way home from the Fertility Show on Friday...

But you're going to have to wait for all of that, because today I'm just too busy feeling sorry for myself.

I only ever call for a doctor's appointment if Dr Google tells me he thinks I should. So when I have all the symptoms of a humdinging sinus infection which I just can't seem to shake off, and after being sick for nearly three weeks I finally give in and decide to ring the useless surgery, I do find it irritating to be told on Monday that the earliest appointment they can give me is on Friday.

So excuse me if I just curl up in a corner with a hot drink and a healthy dose of self-pity for company - in the absence of antibiotics, the self-pity is the only thing I can dose myself with at the moment.

Saturday 6 November 2010

Fertility Show - Part 2

That was getting a bit long...

The seminars cost £1 each, and I hadn't booked tickets for any of them. However, when I got there I discovered that they were not being held in rooms, but in roped-off areas. This meant that passers-by could stop and hear the seminars - the only extra you were getting for your £1 was the chance to sit down in a chair for 45 minutes. If I'd paid my £1, I might have been a bit miffed to realise that other people were getting to hear the seminars for nothing - especially when the barriers were lifted at the beginning of one talk and people without tickets were invited to fill the spare seats.

So I managed to catch the second half of a seminar on coping strategies before, during and after treatment, which had already started when I arrived. Then I lurked at the side of seminars on complementary and alternative medicine, fertility treatment for older women and one called 'Why should I give it another go?'. All were interesting, and it was good to learn more about reflexology in the seminar on complementary and alternative medicine, since I have my first refloxology session coming up on Monday.

In no particular order, here are a few of the little titbits that I noted down from these sessions.
  • There's plenty of suffering in life, and you will suffer at times - you don't need to practise for it by putting yourself through needless suffering.
  • We find it hard to live with uncertainty, so when things are uncertain, we try to make them certain. Often, we do this by predicting a negative outcome. We need to learn to live with uncertainty and allow ourselves to accept that positive and negative outcomes are both possible.
  • "Everyone is a house with four rooms, a physical, a mental, an emotional and a spiritual. Most of us tend to live in one room most of the time but unless we go into every room every day, even if only to keep it aired, we are not a complete person". (This is a quote from Rumer Godden, based on an Indian proverb.)
  • There was an acupuncturist there who said that the people who are successful following his treatment are the ones who feel a change in themselves and then make a change in the rest of their lives as a result - as opposed to those who keep coming for treatment week after week after week, but continue to do everything else exactly the same. He said if you're not willing to change, don't expect results.
  • In the talk on fertility treatment for older women, the guy talked about tests of ovarian reserve. He said it's a truism in medicine that where there are many alternatives, none is perfect - and this is the case with the various methods of testing ovarian reserve. So a poor result on one of the tests (FSH, AMH, antral follicle count) doesn't necessarily mean disaster.
  • He also said that a major issue has been identified with the quality of DHEA supplements. Some brands have been found to contain no DHEA at all, while others contain more than the stated amount. This gave me pause for thought, as I was thinking that if we still hadn't started IVF #4 by the time my prescription runs out, I would order some cheaper DHEA off the internet. I'll now look more carefully at the brand and do a bit more research before I buy it.
  • Of all creatures on the planet, humans have the worst reproductive potential. Up to 70% of all embryos are non-viable. Playing the numbers game now, I've had 5 embryos which were clearly not viable. Perhaps the 30% will turn up in my next batch.
  • Low AMH doesn't mean you're menopausal - having no periods for a year does. This reassured me, as my AMH is low, but my periods are still regular.

I'm still assimilating a lot of what I heard yesterday, but it was all useful, and I'm very glad I went.

Fertility Show - Part 1

I had wondered whether there was any point in going to the Fertility Show yesterday. Most of the seminars I was interested in were sold out, and I wasn't sure how much I would learn that was new, given how long we've already been on the IF train. Then on Thursday, my 4-year-old niece phoned and said she was going to be in a play at playgroup on Friday morning, and asked if I would go. Being incapable of saying no to a 4-year-old, of course I agreed.

So yesterday morning I did a bit of work on an article I'm writing which is due in on Monday, checked the material I'd been sent for another assignment which has just come in (yes, for the first time since August, I'm actually going to earn some money this month, and I'm quite relieved about it!), went and had coffee with a friend (a long-standing arrangement that I wanted to fit in, even though it had to be cut short because of the play), then rushed over to watch my niece's play. I did a bit of useful networking afterwards and picked up a couple of potential customers for the other bit of my new business (the bit I'm more excited about).

Finally, at about 1:30, I was ready to set off. The article wasn't finished, and we're busy all weekend, so I wondered if I should just go home and work.

But I remembered what my coach had said about priorities - if I want this IVF to work, it must be my number one priority, and I mustn't let other stuff get in the way. The Fertility Show is once a year, and you never know what useful titbits you might pick up at something like that. And I'll be able to make time over the weekend to finish my article.

I arrived at the show at about 2:45, and started by doing a quick tour of the hall to see what was there. I then had to go back out to the ticket office, having realised that there was way too much change in my pocket and they must have undercharged me. I think the woman was a bit surprised when I complained about having been given too much change and insisted on giving £10 back to her, but it felt good to do the right thing, and I like to think it made up for what happened with the seminars...

There were a few interesting stands about. Most of them had big bowls of various sorts of free chocolate and sweets in front of them, and I was very good and avoided taking any, despite the exorbitant prices in the cafe (£1.80 for half a litre of water, and I didn't even dare ask what the food cost).

One of the things I appreciated was the chance to browse through some books - our local bookshop isn't very big on infertility, IVF, etc, and with such a bewildering array of books out there, I didn't want to order from Amazon without getting a chance to flick through them first. I ended up buying the Foresight recipe book, which also contains a lot of advice and information about nutrition and menu planning, and Zita West's latest book.

A lot of clinics, both in the UK and overseas, were represented, including the other two that I considered when we were looking at switching clinics at the beginning of this year. One, which is known for its success with people with high FSH, didn't impress me much when I went to its stand towards the end of the day and all the representatives who had come from there stood chatting to each other and completely ignored me, but I took one of their brochures anyway.

The other is the place where a good friend of mine conceived her twins on her second IVF cycle. I had read that they did donor embryo treatment, and I got a chance to sit down and talk to their donation co-ordinator. She said they have three lots of embryos available for donation at the moment, but are not able to predict from month to month whether they will have any available. These three will be there until they are taken, which could be a couple of weeks or a few months. This is definitely something I'd like to explore with DH if IVF #4 doesn't work, and he showed some interest when I told him last night about the conversation.

I also met and chatted to the woman from Foresight, a couple of other nutritional experts and someone from Infertility Network UK.

I probably shouldn't have been, but I was surprised at the number of men who were there, especially as it was a normal working day and most would have had to take the day off work for it. I commented on this to DH, and he said, "Well, yes - we're involved too."

I explained that my surprise stemmed from the fact that the people I've met IRL and online who do all the research and are active in finding out how to improve their chances of success tend to be women, and he said, "That's just the natural way of things."

"It seems to be the natural way for us," I responded. And maybe he did finally realise that it doesn't have to be that way. I've left the Zita West book out on the coffee table and mentioned a couple of chapters that he might be interested in reading - you never know...

Friday 5 November 2010

A timely exercise

Well, that exercise I did where I thought about my support network couldn't have come at a better time.

Yesterday, I was on the phone to my BFF and she asked what we were up to this weekend. I told her I was thinking of going to the Fertility Show.

She immediately began to giggle, and said, "Those are two words that really shouldn't go together, aren't they?"

It wasn't the most sensitive response ever, but then my effortlessly fertile friend still thinks that the way you get pregnant is by having sex. I suppose that image doesn't really go with the idea of a show - or at least, not the sort of show that people like us would be going to.

I'm sure a few weeks ago I would have got quite upset at the way she responded. Yesterday I was able to laugh it off - I love her dearly, she will always be my best friend, but there are some things she just doesn't get. And since I'm not relying on her for support in this particular area, that doesn't matter. I know who I can rely on, and they won't make mistakes like that. So we can just be good friends, without the pressure of me expecting her to understand something that she never can understand and constantly being disappointed when she doesn't live up to my unrealistic expectations.

(Incidentally, I told Jeannie, who IS in my support network, about this conversation, and she said she was worried now that she might say the wrong thing. Let me just say again, Jeannie - the reason you're such a major part of my support network is because you NEVER say the wrong thing. Even if it's ever not what I wanted to hear, it's the right thing because of where it comes from and the understanding and desire to give me emotional support that I know is behind it.)

Wednesday 3 November 2010

Support network

The homework that my coach gave me this week was to think about who's in my support network - not just who my friends and family are, but who I can really rely on and turn to for help and support, both emotional and practical, in this whole business.

One of the ideas behind this is that if someone I have identified as not being in my support network disappoints me, or says the wrong thing, or upsets me in some way, the sting will be taken out of it somewhat by the realisation that they're not one of the people I'm relying on.

I've been thinking a LOT about this all week, identifying people in my mind and mulling over whether they're one of the four or five key people who will help me to get through this. And it's surprising how many people, regardless of how much I love them and know they love me, I've realised are not in this network.

One of the limitations for me in identifying people who can truly offer emotional support when I need it most is that there are very few people in the world that I'm prepared to cry in front of. And if I can't cry in front of someone, there's a point at which, when I'm at my lowest and most vulnerable, I have to stay away from them, or back off from the thing which is hurting me the most.

There are also those whose feelings I try to protect by not talking to them about how low I'm actually feeling, or how difficult I'm finding things. Or perhaps I worry that they'll think less of me if I admit to some of my uglier feelings.

A combination of those three factors means that my mother and sisters are not part of my support network. They know what's going on, they're very supportive, and I have told my mother some of what I've been feeling. My sister is wonderfully understanding about some things, and I know how much she wants this to happen for us. But there's always a big part of me that holds back, to protect them and to protect myself.

DH is going through this with me, and has the dubious honour of being someone I'm not afraid to cry in front of, or get impatient with, or show any other ugly and unpleasant feelings to. And he's patient and loving and tries hard to understand, but a lot of the time he's too close to the problem. And sometimes I get frustrated with the different way he chooses to deal with our situation.

I have a couple of friends who live locally and are always willing to offer practical support - the one who drove us to the clinic and picked us up when I was having my egg collection on IVF #1 and #2, the one who drops round with flowers and chocolates when I'm feeling low and offers to do my shopping for me when my back's bad. But although they'll ask how it's going when we're in the thick of treatment, neither of them wants to have children and they don't really understand how I feel.

And my BFF has demonstrated in the past that she's willing to drop everything and come to me whenever I need her. But she has three children and a lot of commitments, and I don't want to abuse that willingness by making her drop everything when she doesn't need to.

There are two or three close friends that I know I could call at any time to talk about things if I needed to. One went through IVF twice herself - the second attempt resulted in her now 9-year-old twins. Another had her own fertility struggles and really gets the sort of decisions I've had to make over the last couple of years. But I always hold something back - I don't want to cry, I don't want to upset them, I don't want to overburden them.

Most of all, I don't want to become that whiney friend who never talks about anything else and never moves on - I have personal experience of the compassion fatigue that can result when someone you've propped up through a difficult time in her life is still making the dramatic 2 am phone calls about the same issue several years later.

I met a couple of people through one of the internet forums - we were having treatment at the same place, and all three of us had failed IVFs around the same time. We propped each other up through it all, experienced it all together, and shared our impressions of the clinic, the buttoned-up consultant, the lovely nurses, the side-effects of the drugs and our hopes and fears for the future. One of them had her baby three weeks ago, after a successful third IVF treatment. The other is now about 18 weeks pregnant. They're not in the same place as me any more.

The last time I saw the latter of those two was when she told me she was pregnant. She sat there saying, "The thing is, I never gave up. I prayed really hard, and my DH and I have a really strong relationship. I think those two things are what made it happen." That made me feel as though if it didn't happen for me, it would be because I hadn't prayed enough, or because my relationship with DH wasn't good enough.

She also kept saying, "I know it's going to happen for you. I know you're going to get pregnant too."

And I kept thinking, "No, you don't. We can both hope as much as we like, but nobody knows."

I felt worse after seeing her than I did before, and although I'm sure we'll remain friends, she's certainly no longer on my list of people I could turn to for understanding.

So my support network, in the end, boils down to two 'people'.

One real-life person who I can talk to about anything, I can even cry in front of without feeling too uncomfortable, and who is always at the end of the phone when I need her. She sends me little notes and text messages that let me know she's thinking of me, and she's the only member of my family that I would ever want to read my blog. She gives practical advice as well as emotional support, and is a wonderful sounding-board. I just wish she didn't live quite so far away...

And the other 'person' is the blog itself, all the anonymous people who read it without leaving comments but who make me realise that there are people listening to my ramblings, and the wonderful people who leave comments to let me know they understand and send me virtual hugs when I most need them.

So I'd just like to say thank you for all your support - and let you know how important you all are to me.

Monday 1 November 2010

Sticking at it

I'm feeling a bit run down at the moment - my insomnia has been pretty bad the last month or two, and I've got a nasty cold which is showing no signs of abating after a little over a week. So it's time to reassess what I'm doing and try to get myself (and DH) back into peak physical and emotional fitness ready for our final IVF attempt.

One of the things my coach pointed out in our last session is that I keep trying new things for a relatively short period of time and then abandoning them when they don't work straight away and moving on to the next miracle cure I've found on the internet. I need to give things time to work, and stop chopping and changing so much - it's not a wonder my body is a bit confused.

Well, I tried acupuncture for over six months, and eventually came to the conclusion that it had done me more harm than good, so I won't be going back to that.

The Foresight regime had a lot of positive benefits. DH stopped snoring, his sperm improved hugely, we both lost weight, and we both felt healthier, picked up fewer bugs and recovered more quickly when we did pick anything up. My FSH was lower for the months that we were on the regime, although I did have a corresponding rise in my oestradiol.

So why did we stop? Well, it's not so much that we consciously decided not to do it any more - it was a three month programme, following which we were supposed to get another hair analysis to see how we were doing. When we reached the end of all our supplements, we were a few days off the end of a cycle and although we did actually cut our hair and have it ready to send off, we decided to wait and see whether we were able to start in that next cycle - and sure enough, we were, and we got a much better embryo than on the previous two attempts (though I did only produce the one mature egg).

And then after our BFN, we never did send those hair samples off, and then they got too old and we would have had to cut new samples, and then DH got a really short haircut, and we just never got round to it. It takes a couple of weeks to send the hair off and get the results back and then order the supplements, and we just kept putting off deciding to do it.

My coach made a revolutionary suggestion last week. She said it was so long now since we stopped taking the supplements, we were likely to be back to square one, so why not just reorder the same supplements we took last time? Well, that had never occurred to me, but today I'll be searching out the order forms from last time and phoning up the supplier to see if I can do that.

We'll then stay on those supplements until the final IVF attempt has been and gone, however long that is.

I'm also going to stay on DHEA, and I've started taking wheatgrass again - I stopped after a month because I'd read that it could affect immune results, but I definitely felt healthier while I was taking it, so I decided to reorder it and we'll deal with the immune issue if and when it comes up.

During IVF #1 and #2, I listened to a self hypnosis CD. The woman's voice and some of the language that she used annoyed me from the start, but I persevered with it until we got our second BFN, and those CDs are now gathering dust in the spare room. I do like the idea of tapping into the mind-body connection and listening to something to help me relax, though, so I'm now using the Circle + Bloom series.

Coaching is currently helping me to identify and address the sources of stress in my life. Coaching is not meant to be an open-ended thing, as the idea is that it gives you the tools to deal with things yourself, but I am finding it very instructive and in each of the three sessions I've had so far, something has come up which has given me a new perspective and made me see something in a different way, so if there's work still to be done at the end of the 8-week course that I've already booked, I'll carry on with that for as long as necessary.

And the final piece in the jigsaw at the moment is that I finally got hold of the reflexologist who had been recommended to me (it turns out she was on holiday last week), and I have my first appointment with her next week.

So there we have it - a whole raft of extra measures which will hopefully help me to get ready for our final attempt at IVF. And once they're all in place, I'm going to stick at it until those pesky FSH and E2 levels are under control and we get to go ahead on our final IVF attempt.