IVF cycle 1... here we go!

Well, my plan of getting some sun and Vitamin D on a beach in the week before starting our first IVF cycle was somewhat foiled by freak weather in Thailand! It rained... a lot... most of the time. There were a couple of hazy days with a little sun poking through, but most of the time it was miserable. I also managed to catch a cold towards the end of the week and spent a couple of days in bed ordering room service and watching TV... OK, in retrospect that doesn't sound too bad!  I guess a change is a good as a rest?!

CAUTION... if you have a fear of needles, you might want to avoid the rest of this post... and perhaps IUI/IVF, but that's another story ;)

So back to sunny China and IVF number 1. I went to the clinic on CD20 and got my downregging meds. I'm on Decapeptyl (0.1mg) which I need to inject into my upper arm once a day.  I had a choice of getting my jabs at the clinic or doing them myself. The Dr was like 'it's really easy.. you can do it yourself'. The nurse seemed to think (she speaks about as much English as I speak Chinese) that I should go there to have them.

I found out that if I do my own injections then I don't need to go back to the clinic until CD5, so I opted to do them. The nurse did the first one and showed me the procedure. The syringes come ready loaded with the correct dose (at least until CD1 when I need to halve the dose - not sure how to do that yet) so I don't need to do anything with vials which was a relief.

The only odd/confusing thing is that the nurse massaged my arm with one hand, whilst giving the injection with the other. How am I supposed to do that with only 1 hand?!

Yesterday - Option 1...do the injection without the massage.
I got the needle in on the second try (was too wimpy the first time) and it seemed to be going well except for my hand shaking a bit. It takes a long time to administer the full dose, so the hand shaking got a bit worse. I finished and noticed a big lump on my arm.. presumably where the dose had gathered around the injection site - maybe that was what the massage is for?!  Then I had a bit of a funny turn (beware TMI coming up!).. I felt really nauseous and went into a cold sweat. It was crazy! I was naked having just got out of bed and the sweat was literally dripping onto the floor. Then I had an urgent need to go to the toilet.  This all lasted just a few minutes and then I felt better, though I still went back to bed to read for a little while :)

So.. what was that about? Can't be a reaction to the drug because I was fine when the nurse did it. Maybe nerves? Maybe the sight of the lump where the drug gathered? (Which dissipated really quickly, by the way). So...

Today - Option 2... my bloke massages my arm whilst I inject.
I position his hand in the right place and demonstrate what the nurse seemed to do. I do the injection and he massages. Except, unlike when the nurse did it, the length of the needle (though not the tip) is now going in and out of my arm as the flesh moves up and down with the massage... that can't be right! This causes some discomfort which was definitely not there when the nurse did the injection. But there is no lump afterwards and I feel fine, despite my hand still shaking a bit during the jab.

So what do you think? I've looked online and it seems that most people inject in their stomach, not their arm so I haven't found any videos demonstrating how to do it 'one-handed'. All advice welcome!

On the upside.. no apparent side effects yet :)

Onwards and upwards

Thanks everyone for your lovely messages after my horrible day. It's so hard to anticipate emotional responses - they seem to be completely unpredictable from day to day. I still can't really think too much about my friend's pregnancy but I am feeling much better. Partly because...

We are now officially into our 1st IVF cycle!

Today is CD2 and I went to the clinic as instructed. I needed to:

1. get our chromosome test results
2. have my baseline ultrasound
3. find out if we'll have long or short protocol
4. have blood taken for my hormone panel
5. 'write the file'

9.15am

It was a busy day at the clinic. I try to register as a VIP patient - I've never done it before, but apparently this means I just need to pay RMB68 instead of RMB20 and I get to go to a special room and jump the queue. I would also get to see Dr J who is one of the old-hands and really knows her stuff.  Anyway, it didn't work - guy at the registration counter didn't understand 'VIP' so I was back in the normal, pleb queue. Nowhere to sit so milled about for a while until a seat came free. Used the time to people-watch...  2 other foreign couples in the clinic today - quite unusual. One lady I've seen before, but she never acknowledges me or smiles, so I've given up hope of making another fertility friend there. 

Watched the 'craziness' that is the Chinese lack of privacy.. particular examples:

• Lady having her dildocam* scan behind the curtain (remember, door to consultation room always open). Cleaner walks into room and behind curtain to brush some tissue from between the Dr's feet as she probes. Clearly didn't occur to her to wait until the patient had put her knickers back on.
• 4 ladies peering through consultation room window to get best view of another patient being given her update (imagine old ladies resting their elbows over a picket fence to stand and gossip with their neighbours... similar scene). Clearly not good news as she burst into tears. Observers looked sad on her behalf, but didn't move to give her any privacy.
• Patients are called into the room to get ready for scans whilst previous patient is still in the stirrups. This is a peculiar dance which involves walking past the curtain opening where you could clearly get a 'between the legs' view if you turn your head 20 degrees to the right. So you keep your head straight ahead, take off your shoes and wait for the 1st patient to come over to put their shoes on. Then it's your turn to go behind the curtain and whip your pants off. I choose the one-leg option - only remove trousers and pants from right leg and tuck them up around left leg for faster redressing.

11.15am

Called into the consultation room to see Dr N - I like her even though she was a bit rough on my last IUI. Explain why I'm there. Get sent to nurse desk to collect chromosome test results. Dr N looks at them for 2 seconds and puts them in my file - guess that means they're OK. Job 1... done! Have dildocam scan - Dr N doesn't say anything - Job 2... done!

Dr N wants us to do long protocol! She doesn't say why and I'm strangely too excited to ask. Apparently she doesn't want to wait for the hormone panel before they decide, which is what I was told. Oh well - Job 3... done!

Get sent to 'write the file' and have blood taken. Blood and injection desk is closed until 12.30.  I go home to collect our passports and marriage certificate needed for writing the file (which I'd forgotten). Unlike the pages and pages of legal documents that I hear you ladies talking about, this basically involves me signing 1 piece of paper written all in Chinese. My bloke will have to come on Saturday to sign. I imagined more of a discussion of legal rights, risks and dangers etc, but no! They didn't even want to see my passport and marriage certificate. Job 5... done!

12.40pm

Blood desk opens. I'm 2nd in queue so in and out quickly.

Job 4... done!

12.55pm

Back home :)

Feeling pretty good. Basically I just need to go back now on CD20 to check that I've ovulated before I get my downregging meds. They didn't give me the pill which I thought they might and apparently we're still allowed to have sex - that's a plus considering we'll be in Thailand next week (though bloke is working).

So that's it. We're doing IVF. So far, so good!

* I didn't come up with this name and now can't remember on whose blog I read it. But loved it so please consider my theft an homage!

Growing old is mandatory; growing up is optional.

So I popped into the clinic this week and, after getting over the shock & confusion of the Dr's poor choice of words,  the rest of the 'appointment' was fairly productive.

Good news: I won't need to have the mock transfer/uterus measuring test because of already having 3 IUIs. It seems that they got the data needed during those procedures. I literally raised my arms and cheered in an 'over the line' celebratory gesture when Dr told me this!  I know the test is just one part of the whole IVF process and not that big a deal, but it was just a relief to know it's one less thing to have shoved where the sun don't shine (oh, I'm such a lady...)

Good news: Dr seemed quite understanding and flexible about me wanting to schedule IVF around my holiday at the end of the month. I can pretty much call the shots on when I want to start, which I know is not the case everywhere.

Good news: Dr said it was a good idea for me to have a holiday and 'rest my organs'. I've been resting my ovaries for a couple of months, now it seems my other organs want a break!

Bad news: It's official.. I'm not young :(

Just before this appointment, I had lunch with 2 fertility challenged friends (look out for future post about this) who've both had IVF here. I was picking their brains and asking about their protocols. Although neither of them were that familiar with the different options (Really?! Isn't everyone as anal as me about reading all available info before drilling the clinic with questions?!), it became clear that they'd both had short protocols. We got to talking about long vs. short and how the clinic picks one or the other. I was pretty sure it was related to your FSH level and the number of antral follicles, but my friend said those results were fine for her and it was more to do with her age. Now my friends are 33 (my age) and 35. Young, right? Apparently not. I asked my Dr about my protocol and  he seemed to automatically assume that I'd be on a short protocol, even though my FSH is 'good' and apparently my antral follicle numbers are OK too (would welcome more info on this, if anyone has any). I asked why and he said my age.

Me: So I'm considered old?

Dr: Well, you're not young.


I know some of you will be shaking your heads at my stupidity/naivety here.. 'How can she think she's young at 33?!' But it really came as a bit of a shock.. not really that 33 (nearly 34) is not young as far as IVF and childbearing goes, but more a shock that I am actually nearly 34! I couldn't sleep the other night and I suddenly had this moment of panic... I'm nearly 34! What happened to my 30's?!

I was happy to reach 30... I'd just got married, I was enjoying life, I was looking forward to starting a family and I felt like a grown-up. So where did those 4 years go? Although I have achieved quite a bit professionally in that time (and I am proud of and happy about that), we have achieved so little in terms of moving forward in our family goals.

So, this confirmation from the Dr that I am fast approaching that scary 'Advanced Maternal Age' was a bit of a kick in the teeth.  Anyway, I know that it's not the end of the world and I still feel very young at heart - hence the title of this post.

And what does this mean for our IVF? Well, the Dr conceded that, depending on my hormone profile on CD2, it might not be a clear decision whether to have long or short protocol. It might be more of a choice. So, although I like the idea of a short protocol because, well, it's shorter and you get a result (or not) faster, I've got it into my head that short protocols are the 'poor man's choice' (otherwise known as the old woman's choice) and might not be as likely to work. The Dr sidestepped my question about the relative success rates of the protocols several times, so I'd welcome any information you can offer on this. Is long protocol the 'ideal' and short is used when that isn't possible/feasible? Is one more likely to work than the other?

And, just to finish, a quote I found which seemed to sum things up so well:

Thirty-five is when you finally get your head together and your body starts falling apart.
  

Lost in Translation

Today I had one of those real 'China' moments (all expats.. please feel free to substitute China for any other country where you're not communicating in the same first language as your doctors). I had decided to go back to the clinic and make sure that we are all set for starting IVF at the end of this month. Last visit we had our chromosome blood tests and I was hoping the results would be back - they take about 4 weeks here. I see them as a box to tick and didn't expect any problems. The main reason for my visit was that I'm hoping to be away on a beach for a week at the end of March (semi-free holiday as my bloke is on a business trip) and wanted to know whether we could fit IVF around this or would we need to postpone until April.

The only male doctor was on duty and I've questioned his judgement a bit in the past - mostly because he says things I don't want to hear. But I thought I'd bite my tongue and get the visit out of the way, rather than going back another day.  I got in to see him within about 30 minutes.. I know the quiet times of the clinic now and time my visits accordingly to avoid potential 3 hour waits. He remembered me.. I might have shouted at him a bit last time when he suggested that they should scrape my endometrium, but he didn't seem to be taking it personally and was pretty friendly.  He went off to get the chromosome test results and came back clutching a piece of paper that looked like test results, all in Chinese of course, which he put on the desk between us.

Dr: The test results are not right.

Me: Not right?

Dr: No, not right. I've called another Doctor and I'm waiting for him to call me back.

Me: What do you mean 'Not right'? *(please add high-pitched, slightly maniacal voice here) Can you tell me what the problem is? (as I point at the ominous piece of paper)

Dr: Oh no.. these aren't your results! (as he moves the paper onto his in-tray) They're someone else's. Yours aren't back yet!


Cue huge sigh of relief on my part! It turns out that our results weren't in the computer system yet and he was calling the lab to check on the status of the results. Now I know that this doesn't mean that our test results will be OK, but the relief in finding out that they're NOT not right was immense :)  It seems that our results should be back in a week or so and I'm keeping my fingers crossed.

Another post coming later on the rest of the appointment... off to get shouted out by my Boot Camp trainer :)