IVF

Fertility Friday: A Long Story

Fertility Friday started out as a bit of a half-baked idea, but it has grown into something very, very special. When I started the series I contacted a few women who I knew had stories to tell. One of them was Viv; I contacted her with some hesitation because I knew her story would be incredibly painful for her to relive. Viv told me she would think about it, and as the weeks passed and I didn’t hear from her, I thought that she had decided – understandably – that she wasn’t able to share her story. Then, last week, out of the blue her story landed in my inbox. It is a story of incredible love and unimaginable loss, told with humour and grace. Viv, you are an amazing, courageous woman. On behalf of everyone who reads your story, thank you.

This is going to be a long story …

After meeting my Mr Right at 34, we decided to start trying for a baby after about eight months. Given my advanced age and all we thought maybe sooner would be better, just-in-case. Well, Justin proved to be a bit of a bastard. After trying for six months without success, we decided to go and get checked out. Turns out I had a fibroid the size of a grapefruit, which wasn’t exactly helping the whole process, so out it came… Once all that was over we went back to the specialist for a review to be told that if we wanted to have a baby then IVF was our only option. BUT, we should still take contraception, just-in-case.

At that point were undecided about how we felt about IVF, and in the end we just figured that a baby wasn’t in the plan for us… so I went and bought a motorcycle. It was a Triumph America, 960cc motor, and as comfy as a lounge chair, and we made a plan to ride (my husband was a veteran motorcycle rider as well) down to Melbourne for the October 2010 Moto GP at Phillip Island. We made five-star bookings at all the wineries we fancied all the way down to Victoria, and then a week before we were due to leave, it suddenly dawned on me that my period was late. So I peed on a stick, and lo and behold, it was positive. We were so shocked that we got on our bikes and took a ride to the country for breakfast. On the way home we made a pit stop at the pharmacy and bought more pregnancy tests, as you do, just-in-case (you gotta love Justin) we got it wrong the first time. Needless to say, the motorcycle was summarily parked, the winery trips were cancelled, and I flew to Melbourne as my husband rode past fields of yellow canola.

We welcomed our little Thomas on 24 May 2011 with a kiss, and whilst the obstetrician sewed me up standing on a box (he was a little on the short side), we were told that Thomas had Down Syndrome. The nuchal scan and blood tests done at the 13 week point in the pregnancy gave us a 1 in 400 chance of Down Syndrome, but nonetheless it was still a surprise.

As Thomas blossomed we started thinking about another little one because we didn’t want Thomas to be an only child. For a while I was plagued with ‘My Sister’s Keeper’ nightmares in that I was afraid that I wanted another baby for the wrong reasons (I’m a bit of an overthinker…).  Anyway, ultimately we decided to give it a go, so back for fertility advice we went, and the Clomid merry-go-round and IUI started. So did the detailed plotting of my husband’s murder, much to my angst. After a few months of the hormonal and emotional roller coaster we decided to give it a rest for the last couple of months of the year, and lo and behold, we fell pregnant in January 2013. Back to the obstetrician we trotted and, in utter surprise, he asked ‘how did that happen??’

12 weeks came and went and all was going well until our morphology scan. We found out that our baby had a diaphragmatic hernia that meant her stomach was in her chest cavity, which was causing her heart was pushed over to the right side and to not be developing properly. This in itself wasn’t a total kidney in an esky, but after an MRI at 26 weeks we learnt that there was a bigger issue with her heart than originally thought, in that there was a break in the aorta. The ‘not a kidney in an esky’ situation suddenly changed, but we needed to wait until they could do a chest ultrasound after her delivery to know for sure. Then decisions would be made as to what to do about the hernia in her diaphragm. Regardless, we remained hopeful that the situation wasn’t as dire as all that. At 32 weeks we moved two hours from our home into Ronald McDonald House at the Mater Mother’s hospital in Brisbane, and our Bailey was delivered on 22 October 2013. Immediately, Bailey was taken to the neonatal unit and I was summarily dispatched to the ward after hearing that she was doing better than expected (oh the relief…). The following day we met with the team of specialists who told us that her aorta was intact. Oh thank God… the relief… and then they told us that there was a problem with her mitral valve, and they could do nothing to fix her. And so we had to make the decision that no parent should ever have to, and we kissed her good-bye on the morning of 25 October 2013.

Shortly after, we heard about a legendary fertility specialist by the name of Dr Warren de Ambrosis… so I called in November 2013 and burst into tears on the phone when they told me that they couldn’t fit me in until July 2014. I’m not sure whether it was out of ‘Ohmigod there’sahystericalwomanonthephone’ pity or what, but they managed to squeeze me in around March. And so the IVF journey commenced… After two egg collections, a few failed cycles and countless self-administered injections of blood thinners, growth hormones, cycle suppressants, ovulation stimulants, blood circulation pads, pills etc, we still weren’t fortunate to have any viable embryos after PGD (pre-implantation genetic testing) was carried out.

After the last round of disappointing news, sitting at the dining table with my step-niece, I told her that I thought that the most challenging thing in life was having to accept that there are some things that you just can’t change, no matter how determined you are and how much you try, and I told her what had happened. With tears pouring down both our faces she offered to donate her eggs to help us given that she didn’t want kids herself. Well, that was Thursday morning, and needless to say, we didn’t need much convincing. By lunch time Thursday I had an appointment for her to see Warren de Ambrosis on the Friday (thank you G20 summit for freeing up all the appointments!) at which time he tried to convince my niece to get her mates together for an egg donation party. We then had an appointment with Queensland Fertility Group and a counsellor the following Monday. She then flew to Melbourne on Tuesday to start a new job with a bag full of IVF drugs. Her new employer was, incidentally, a fertility endocrinologist. After a few months she decided to move back to Queensland and got a job in Brisbane, about 5km from Warren’s offices, so things became a little easier for us.

At the end of February 2015 she had her first egg collection, and we ended up with two viable embryos after another round of PGD, and managed to finally arrange a transfer of the embryo. Well, needless to say I was howling after that, all the way through the shot of drambui I had been instructed to bring along to the procedure. A week later we got the news… the embryo had taken. Wow… Warren’s referral to my obstetrician of choice was a one liner – ‘She beat the odds’.

The pregnancy progressed but was fraught with tension and concern, and a lot of bleeding in the first trimester. Second trimester I lost two-thirds of my hair, so much so that I was convinced it was all going to fall out! The morphology scan was fine, but the worry was still persisting, even though we had a scan every month.

On the morning of 17 November 2015 we dropped Thomas at kindy. My parents in-law were kind enough to come and stay in our home with our son so that we could make our way to Brisbane’s Mater Mothers’ Hospital (the Fetal Medicine Unit had been caring for us through the pregnancy and we were fortunate to have the head of FMU as our obstetrician). I cried all the way to Brisbane, I’m not sure if it was because I was leaving Thomas or if I was terrified…

By mid-afternoon on 17 November 2015 we were crying lots, and kissing and cuddling our little Shelby, which we have continued to do for nearly 11 months, along with a few ‘OMG what’s in your mouth’ statements lately. She loves her bother to distraction, along with his trucks, legos and his glasses (much to his pain and grief), and I’m pretty sure he loves her too. But the gift in the middle will always be missed, and will never be forgotten…

Fertility Friday: Unplanned

It’s Fertility Friday once again. I cannot tell you how much I am loving reading and sharing these amazing stories. I really do have the privilege of knowing some truly amazing women. This post is by Heather, who I met through my online cancer support group. We share a dry sense of humour and a love of animals and our kids (not necessarily in that order). I am so grateful to Heather for opening herself up to share this post – she has been so honest and I think her words will resonate with many of us.

Have you ever felt your heart break?  I always thought it would make a cracking sound, like the snap of a dried twig underfoot or the sound a palm leaf makes when it falls from the tree.  It doesn’t.  It happens with a thud.  The same kind of thud you hear when a kangaroo bounces of your speeding car.  That kind of thud that you can not only hear, but feel, in every nerve ending, every hair follicle.  It makes you shiver.

My husband and I have a wonderful life together.  We are both incredibly in tune with one another.  We like the same things, laugh at the same things and generally think the same thoughts.  When we married 21 years ago we didn’t really think about children, ever.  The only time the topic came up was when well-meaning friends and family would enquire as to when we would be expanding our family.  There is some unwritten law that opens the most intimate details of your relationship to general discussion once you sign a marriage certificate.  The other thing we didn’t realise was that with each year of ownership of said certificate, the pressure to actually undertake the expansion would increase beyond bearable limits.  Children were not on our agenda.  We were happy in each other’s company and the only family planning we did was to add a couple of dogs and a cat to our household.  And besides, we were really bad planners.  Preferring to saunter along and allow life to decide where it would take us next.  We liked this relaxed way of life, the randomness seemed to make sense, seemed to work for us.

About a year into our marriage we found out we were pregnant.  We hadn’t planned this, we don’t plan.  In fact we had invested quite a bit of time and money ensuring that this didn’t happen.  It took us by surprise as we had never talked about children and really hadn’t thought too hard about the whole issue.   I had recently taken a redundancy package from work and was procrastinating over my future, self employment versus regular employment.  The pregnancy made me ill, violently ill.  I could barely drag myself out of bed and spent the best part of my days becoming intimately connected with the bath room.  We talked about what we should do.  My husband had never really shown any interest in children and I had just assumed that he wasn’t interested in procreating.  I had thought about it, perhaps too much, and I was terrified of the responsibilities associated with parenthood.  I didn’t want to be responsible for someone else’s physical and psychological development and I was certain that any child of mine would grow up to be a very proficient serial killer, or worse, due to my bad parenting skills. That scared me.

I was kind of surprised when my husband suggested that we could do this, we could become parents.  I immediately stocked up on baby books and in my usual fashion, began researching the topic.  I felt disconnected from the information in the books.  I didn’t have the warm, nurturing feelings that the books suggested I should have.  I wasn’t overjoyed by the miracle of birth.   I was now even more scared.  Scared and sick.  I don’t know if I was just incredibly selfish, but I didn’t want to share my home and my husband with anyone else.  I didn’t want an intruder introducing chaos into my perfect little world.  We decided to terminate the pregnancy.  I felt relief that this problem would be solved and we could move on with our life, together.  I booked into a clinic, and went to my appointment alone.  It didn’t seem important enough to insist that my husband miss work, just another doctor’s appointment.  Minutes after the procedure, I stopped feeling sick.  A great wave of relief came over me.  I was happy again.  The clinic counsellor wanted to talk, I didn’t.  I felt like a great weight had lifted and I practically skipped out of the clinic.

Of course, the questions about children continued to come up.  When people asked when we were having children we started replying with “we can’t”.  This seemed an effective manner of ending the questioning in the longer term.  The irony of this is not lost on me now.

We decided to move to warmer climes.  Again, we didn’t really plan.  My husband applied for a couple of jobs at various locations on the Queensland coast and secured a job in Central Queensland.  We had two weeks to give notice to our present employers, pack up the house and put it on the market, farewell our families and travel, with our two sizeable dogs, the 1700kms to our new home.  A little planning might have saved a bit of angst but people who don’t plan are remarkably adaptable and we got there in time for my husband to begin work.

We established a new life, made new friends, bought a new house, I found a new job.  The country lifestyle took a bit of getting used to but the informality of our new environs suited us to a tee.  We resumed our cruise through life.

I don’t know when it happened but we started talking more and more about adding to our family.  I rescued a poor, forlorn kitten from a pet shop, but the conversations continued.  Perhaps country life was just too relaxed and we were looking to shake things up a bit, anyway, we decided that we should have a child.  We stopped using birth control and waited for our baby to join us.  No ovulation tracking or temperature charts for us, we had done this before, without even trying, so we just had to sit back and wait for the waves of nausea to arrive.

I don’t know when we recognised that something might be wrong.  People who don’t plan don’t keep timelines.  I remember that I was approaching my 38th birthday and thought that maybe it was about time we sought a professional opinion.  I rang the local Fertility Clinic and was provided with enough information to get started.  I forgot about it for a few months and eventually set about obtaining the mandatory referral from my GP.  Having had the referral for about 5 months I finally telephoned and made an appointment with the Fertility Specialist.  I dropped the referral into the clinic only to be told that my GP, a rather eccentric old gent, had made the referral out to a non existent clinic, hadn’t included my husband and the sole content of the letter read “please help my patient to get pregnant”.  I laughed.  The clinic receptionist, not so much.  At least I had an appointment with the specialist and a deadline to produce a new referral.  I can work with deadlines.  People who don’t plan need deadlines, it helps to get things done.

I had never really felt a sense of urgency about the whole baby thing.  I am not sure if it is because people who don’t plan really don’t get those feelings or if I didn’t foresee any problems.  That was until I met my fertility specialist.  It was December.  I was basking in the glory of summer, the holidays were nearly upon us, life was good.  The specialist organised some immediate tests for us both and told me to come in for some further testing at the beginning of my next cycle.  It didn’t matter to him that this was likely to be during the holidays, it just needed to be done.  I was surprised by this and marvelled at his dedication to his craft.  I hadn’t caught on.  I undertook the required tests over the holidays and he scheduled some exploratory surgery that week.  Again, I failed to catch the urgency and praised the hospital for their standard of customer service and their speed in being able to organise this so quickly.  The surgery and the tests determined that we had unexplained infertility.  Nothing obvious was preventing us from getting pregnant.  We celebrated our victory and determined that we would only require some minor assistance from our specialist.  Our specialist had other ideas, due to my advanced years and my quickly declining fertility, we would begin our first IVF treatment in three weeks.  Now I began to panic.

We embarked on the first cycle full of hope and excitement.  The clinic gave me a schedule.  I liked this.  They did all the planning, I just had to follow it.  Nasal spray of one hormone, injections of another, scans, blood tests and finally we were ready to harvest the eggs we had been nurturing.  With step one over we just had to wait to see if my husband’s contribution would get us to step two, fertilisation.  While waiting for the clinic to telephone the results through I realised, to my surprise, how emotionally involved I was in the whole process and that the results really mattered to me.  I don’t think I was trying to protect myself from likely disappointment, I guess I just hadn’t thought too much about it.  I hadn’t planned.  The eggs became embryos, started growing like mad and were returned to their place of origin a couple of days later.  Life returned to normal and in two weeks’ time we would find out if all our hard work had had produced the desired result, a pregnancy.  It didn’t.  We were disappointed but recognising early that IVF rarely works first time, we were able to quickly move on.

We couldn’t wait to start round two.  More schedules, more hormones and this time our response was too good and we lost the best eggs before the surgery.  We only had one, very poor quality embryo to put back and as expected a negative result.

When we started on the IVF journey we decided that we would complete three cycles only.  If that didn’t work out, at least we could say we gave it our best shot.  The figure was quite random, not based on statistics or anything scientific.  Not that well planned.  It just seemed like a good number.  Approaching round three we realised how important having a child had become to us.

The third cycle was a dream.  We had record numbers of eggs collected.  We began to hope.  Not so great fertilisation rate but hey, we still had plenty of eggs to work with.  Our scientist told us we had two great looking embryos to put back and we even managed some leftovers to pop in the freezer for use at a later date.  Hope became a part of our day, our dream of parenthood a very real possibility.

I remember the exact moment that my heart broke.  I was standing on the verandah, soaking up the sunshine when I felt the all too familiar cramping sensation in my gut.  Our hope disintegrated like the rusted machinery littering the farms on the outskirts of town.

Our three cycle limit quickly became four cycles. We said adios to our regional clinic and organised an appointment with a clinic in Sydney. The clinic had the best labs in the country and very high success rates. It was going to break us financially but we had to try. IVF had become a way of life, an obsession.

The fertility specialist wasn’t nearly as enthusiastic as we were and explained that for a woman my age, the success rate was less than two percent. The specialist decided to monitor my FSH levels and if there was a month where they were low, we would push ahead. He agreed to one cycle only as I guess he had stats to maintain that wouldn’t benefit from hopeless cases undertaking repeated cycles. Month after month, my FSH levels were high. Our sense of urgency was not felt by my specialist. Finally, after realising that my FSH levels were only going to continue to rise and that I wasn’t going to go away, he agreed to proceed with our one cycle.

The experience was completely different to my experience with a regional IVF clinic. I was heavily monitored, blood tests and ultrasounds every few days until finally I found myself in Sydney with ten perfect eggs. These miraculously turned into seven perfect embryos and then five perfect blastocysts. Not bad for an old chick. The specialist was stunned, I was smug.

I returned to country Queensland with two embryos on board. Just over a week later, a home pregnancy test delivered the news we had dreamed about for what seemed like an eternity. We were pregnant. Many months of angst finally saw us with a healthy baby boy who was so, so wanted and so incredibly loved. Life was finally perfect and we both felt complete.

My obstetrician, at my post birth follow up appointment, ask me what type of contraception I would like. I snorted while reminding him of the lengths we had gone to to make our family. He apologised for asking.

I remember standing in a queue at the checkout in Target, my gorgeous 7 month old baby in the pram beside me taking in the surrounds. Someone tried to push in front of me and the checkout operator shoo’d her away and proceeded to serve me. I burst into tears, hurriedly completed my purchase and retreated home all the while pondering this weird emotional outburst. A pregnancy test revealed that I was a hormonal mess and that I was, in fact, 5 weeks pregnant. Our lack of planning in this instance turned out to be a wonderful surprise in the form of a gorgeous baby girl.

I have many regrets about our lack of planning. About our seemingly appalling decision making capabilities. About the length of time we waited to form a family. I do however feel extremely grateful for the people and the science that helped us get here. These days, my heart may feel a little weary but it is whole again, it is full. I feel extremely lucky.

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