24 September 2013

Circle of Life


I’ve been planning to make you guys wait a few months for the next chapter of this story, but I thought, oh what the hell.  In my last blog I shared with you that we needed IVF and that the waiting list was long.  This is the next part of the infertility story, which follows on from The Great Sperm Race


Mr H had positive news for me that day in the hospital.  The answer to my plight of my time being now was, that if there were a medical need for someone to be expedited up the list then it would happen!  I can’t begin to tell you the relief I felt hearing that.  An appointment was made for us at the fertility clinic to discuss further and an action plan was devised that I would start treatment in six months.  I guess I was a little disappointed that it couldn’t happen straight away but this was to give me time to prepare myself physically.   I was told I would have to undergo an ultrasound of my heart to make sure it was strong enough to cope with carrying a pregnancy to term.  I would have to get fit to increase my lung capacity to the best it could possibly be and I would have a fitness test before commencing treatment.  I had that familiar carrot dangling above my nose feeling again.  It was stressful knowing I had to fulfil a criteria to get my baby and it weighed on my mind but I was focused 100%.  I wanted this and I was going to get it come hell or high water, but in the back of my mind I was thinking about those awful people out there getting pregnant without a care in the world.  You know, the ones that take drugs, drink alcohol and smoke knowingly putting their child at risk.  Where the hell was their test? 

We were invited along to an open night at the fertility centre and there were over 100 people listening to the talk on what IVF is and what the success rates were for the Aberdeen clinic.  Everybody was in that room for the same reason but I wondered what if you wanted to keep it private, but you knew somebody that was there.  I looked around the room and came to the conclusion that for many of them, they would never have a baby.  The success rate was dependent on so many factors, your age was the biggest one, women under 35 years old stood the best chance of success and I knew I would be one of them.    I discovered at that meeting that embryos don’t like perfumed soap and products that most of us use everyday.  In preparation for the IVF we both changed our washing and grooming habits for the 6 weeks of the treatment.  I felt like I’d been taking folic acid for at least two years so I had that covered.  My husband went on vitamins specifically for reproductive health.  I did what I had to do with the hoops I’d been made to jump though and treatment was due to start in January 2009 but it didn’t go ahead.  I was disappointed to learn that Mr H had planned to travel to India and was concerned that he would be away at the crucial part of my treatment, so with regret he postponed and I didn’t start until February.  He wanted to make sure that he would head the specialist team that would take me through the IVF treatment and I will be forever grateful that he made that decision.  I don’t think I fully understood what was going to happen to me and I didn’t think too much about it, nor did I look at what it involved because in the day and age of internet it would be relatively easy to find out. 

We arrived at our first appointment at the fertility clinic and I was told that I was going to have an ultrasound of my ovaries.  I thought ok, no problem I can do that.  I untucked my clothes, lifted up my top and glanced across at the ultrasound machine, it looked slightly different to the ones I’d seen previously for check ups of my liver and kidneys.  I turned my head and looked the nurse straight in the eye and said, “this is not an ultrasound of my abdomen is it”?  She said no, it’s a vaginal ultrasound.  With a lump in my throat, I gulped as that smear fear started to engulf my body but I quickly calmed myself down because lets face it, if I was going to go through IVF I was going to have to overcome this.  I just said to the nurse, look I have a vaginal examination phobia so let me relax and don’t talk to me when you are doing it or I will just tense up trying to speak back.  Then we started to laugh as the nurse got the machine ready.  The probe that was going to be inserted into me looked like a dildo, however it was more clinical looking and was cream in colour and smooth in appearance.  The nurse then opened a drawer and took out something that looked like a condom.  It was in a square wrapper just like a condom and my husband and I snorted laughing like school kids as the nurse said “it’s called a probe cover”.  We looked at each other and lip synched “probe cover”, then we winked.  I did say this fertility stuff wasn’t for the faint hearted did I.  I wasn’t sure if we were going to manage to stay calm because then the nurse put the probe cover over the probe just like those demonstrations they do in schools now with condoms and bananas.  She then picked up the ultrasound gel.  It was pure hospital porn, as the nurse squirted the gel over the probe and the probe cover.  Next she took the probe in her hand, griped the probe and started moving her hand up and down to spread the gel.  We were in absolute stitches laughing at this point and I knew if I couldn’t stop laughing there was no way she was going to manage to do the examination on me as when I laugh, I cough and muscles tense up.  Again I calmed myself down and hubby got himself on the other side of the curtain, mainly to stop eye contact between us.  However, he was also a little squeamish and needed time to adjust to the examination experience too.  It was over relatively quick, it was really to just measure my ovaries as they would be monitored over the coming months.   

On the 20th of February after attending the clinic for over a year, we were finally due to start treatment.  After another routine vaginal ultrasound I was shown how to inject the hormones into me.  I felt my eyes rolling being shown how to put a needle onto a syringe and how to break open the glass bottles of medication.  I’ve dealt with needles and medication for many years but I’ve never actually had to stick a needle in my skin and that was a bit weird.  IVF is not without risk and it’s possible that your ovaries can react to the medication causing Ovarian Hyperstimulation Syndrome, which can serious.  In the initial stages of IVF treatment, the drugs being injected first are to tell the Pituitary gland in the brain, which controls the reproductive system, to stop what it’s doing.  Then after about six days I had to inject another drug, which fired things up again.  This is so the doctors know exactly what stage in my cycle I am at so they could control it.  I had to inject into the stomach or thigh and the drug must be given at the same time everyday.  I let my husband have a go at being the nurse, it was nice to involve him in the process and with the injections being stingy I felt I was resisting and dragging it out doing it myself.  While all this is going on at home, the clinic will be monitoring the ovaries by vaginal ultrasound every two days and was taking blood samples every week to measure hormone levels.  This whole process with the injections takes about 5 weeks.  The drugs stimulate the growth of eggs and the follicles in which they grow are measured.  Once they are at the required size another drug is given to mature them, and get the body to release them into the follicle but this is a carefully timed injection because if given to early or too late the eggs may not be right.  You also don’t know how many eggs will be retrieved.  It really is an emotional rollercoaster. 

During my treatment my Grandfather had become sick and was in hospital.  It was an unwritten rule in our family that I did not visit him if he was in hospital because he had a lung condition and that it would be risky for me having contact with him.  Especially as I was going through the IVF it was even more important for me to stay well.  However about a week before the egg recovery I did become unwell and I needed antibiotics, but I held off until the eggs were out so they had the best chance of being healthy and not take the risk of damaging them with antibiotics.  On the 26th March 2009 we went into hospital for the egg retrieval.  I drove us down to the hospital in my dinky pink car and I was nervous but excited.  I put on my lucky diving t-shirt, the same one I wore for my fitness test a few weeks earlier. Normally the egg retrieval would be carried out by two doctors in the fertility centre treatment room, but I had a team of four doctors and one nurse down in the Maternity Hospital Operating Theatre.  This was a safety precaution so that if anything went wrong with my lungs, we had the right people on hand to deal with it.   Mr H did a quick check with labour ward to make sure all was well and there were no signs of any women needing an emergency c-section anytime soon.  When labour ward gave the all clear we were able to start.   I was sedated but conscious throughout the procedure and I remember getting up onto the bed wearing my hospital gown and no pants almost trying to do it without flashing anyone.  But hey, that’s what they were there to look at so no point being all shy.  My husband sat beside me and was kitted out in his very own surgical wear and he thought he looked like a doctor.  He even told me he thought people in the waiting room must have been thinking he’s a real trendy doctor with all his tattoos on his arms.  I don’t remember too much about the procedure, but what they do is use a transvaginal ultrasound to guide a needle through the back wall of your vagina, up to your ovaries.  The needle is then used to aspirate the follicle, or gently suck the fluid and oocyte from the follicle and they are placed in a test tube.  This is where the “test tube baby” phrase originates.  There is one oocyte per follicle and these oocytes will be transferred to the embryology lab for fertilisation.  As the procedure was drawing to an end the anesthetist woke me up by gradually withdrawing the sedation drug and I glanced across to my husband who was holding my hands.  I was taken back up to the fertility clinic for monitoring before I was allowed to go home.  Once we got back to the fertility clinic the embryologists got to work to see how many eggs they retrieved and we had FIVE.  My husband was then required to do his bit and provide the semen for the next stage.  Only this time he had to hand it over himself, but by now he was fully involved and it didn’t bother him.  The embryologist washes the sperm in the lab and selects the “best looking” sperm to be introduced to the egg in the culture dish and round 10,000 sperm will be battling it out to get inside the egg.  The culture dishes are then incubated and after 12-24 hours they are inspected for signs of fertilisation.  We were allowed to go home after an hour or so but I was told that I couldn’t drive.  Knowing instantly what this meant for my husband, I glanced across and sniggered laughing as he was trying to take in what the nurse was saying.  I think he must have been saying to himself “OMFG I have to drive a frigging baby pink smartcar fortwo home in broad daylight”.  And he did!

I got home and took it easy; it was going to be a tense 24hrs.  Tomorrow we would be called to tell us if any of the eggs had fertilised.  I got up the next day, still a bit on edge because if this didn’t work it would all end today.  All the hopes and dreams would come crashing down.  I looked out the window and saw my Grandma’s car pull up outside our house, but my mum got out of the car.  My Gran was nowhere to be seen and I instantly knew something was wrong.  I opened the door and my Mum was clearly upset.  There on the doorstep, she struggled to get the words out, but I knew what she said.  Your Granda has died.  I fought back the tears as I was more shocked, because I didn’t realise he was that unwell.  I had also not seen him for over two weeks.  I cried for a few minutes but I couldn’t let my body get upset, I had to stay focused because if those little eggs fertilised they were going back into me the following day, regardless.  About an hour after my mum arrived with that devastating news the lab called to say that 4 of the 5 eggs had fertilised and now they were being monitored.  We were booked in for implantation the following day.  Some people may think it silly but I’ve often thought, did he die so I could have my baby.  It seems really spooky that he died during the night, the same night as those eggs and sperm were being incubated in the lab.  The next day we were told that of the 4 eggs that did fertilise only 3 of those were good enough to be implanted.  One embryo in particular stood out in the lab and that was the one that was going to be transferred to my womb.  In embryology terms, it was the best it could possibly be, we had a Grade 5 on a 3-day embryo.  The lab was absolutely delighted!  The embryo transfer was the final part of the treatment; today it was make or break.  We arrived at the clinic on Saturday morning, the day after my grandfather passed away and the clinic atmosphere was serene.  This time I had my treatment in the fertility centre treatment room.  I got changed into my hospital gown and Mikey was back into his surgical scrubs, yeah pretending he was a doctor again (we did have photos and I wish I could find them for you guys) After years and years of the same jokes, I kinda had a “whatever” attitude to his sense of humour and I’m sure he thought I was negative a lot of the time but I didn’t mean it like that.  That was just my sense of humour.  I got up onto the bed and put my legs in the stirrups, I had become a pro with all this poking about down in my lady bits.  I really didn’t care anymore, but the instruments table looked like they could have been used in medieval torture.  My husband up until now had the luxury of being at the head end of business but now he had a full view.  There was a doctor in the treatment room and the lab could be seen through a glass room divider.  The doctor inserted the clamp into me just like you would get in a smear test.  She swabbed and cleaned my insides so that the embryo had the best chance of being accepted by my body.   When the doctor was ready the embryologist came out of the lab and passed the doctor a syringe with a long catheter attached.   This then gets passed up through the vagina and into the uterus.  It was popped in and that was it, legs were closed and I went back through to the recovery suite to lie down.  My husbands face was a picture.  I wondered how this man who had picked up body parts in the 1998 Omagh boming could be squeamish.  I wondered how the hell he managed in the Army being one of the battalion first aiders.  He just said quietly, “it’s different when it’s someone you love”.  That’s one thing I did know about him, if we ended up with a baby in our arms after all this I knew that baby was WANTED, was really WANTED and there was no question about that whatsoever.  After about an hour we left with the pregnancy test I had to do in two weeks and drove home, we took our campervan this time so he didn’t have to drive the pink car.  I wasn’t told I had to go to bed, but I just decided that’s what I was doing and I wasn’t going to move.  We were home by 11am and I stayed in bed until 7pm.  He adopted the role of nursemaid and I was waited on hand and foot.  He was pretty good like that.

I think the hardest part of the IVF treatment is, surviving the TWO WEEK WAIT.  This is how long you have to wait before carrying out a pregnancy test.  I guess I had other things to think about, as we had to bury my Grandfather.  All the family met up for lunch the following day, it was the first time we’d all been together since the news of Granda.   I’m not a big fan of funerals and I generally as a rule don’t go to them.  Some I’ve regretted not going to but my own mortality is usually right at the forefront of my mind and that’s what stops me going.  I felt my Grandma needed this pregnancy just as much as me as it would be a reason for her to carry on living.  I’d managed to avoid countless funerals for over three years but I had a responsibility this time to not let sadness consume me.  After all, I was due to take a pregnancy test in a few days.  Something that would change my life forever.



Elton John - Circle of Life