Third time lucky

Embarking into my 3rd IVF cycle. Dr Lynn B. had placed me on a different protocol, increased my FSH injection by 50%. That resulted in a more successful scan. The sonographer saw 11 follicles on my right ovary and 8 on the left side. But the egg pick up yesterday revealed 9 follicles. That's ok because I learnt my lesson.

It is not about how many eggs or how many ended up fertilised, or how many survived and grew up to day 5 blastocyst. It is how many managed to survived all those stages and manage to stay implanted in my uterus and growing.

So hopefully I am 3rd time lucky.

Grant me a moment of clarity

I have been obsessive with the fertility business since I started my IVF treatment in February. When the first cycle failed, I was determined to do whatever I can to increase the chances of the second cycle. When Dr Lynn said acupuncture helps, I went full on when I was back home in Malaysia. I visited a TCM doctor for acupuncture, cupping and massage on a daily basis. I spoke with everyone what I was going through and out of good intentions, everyone had their opinions on what, how, why, which, when. My head was full of ideas or were they really distractions??
When I came back, Melbourne weather experienced a cold snap. On last Wednesday, the morning temperature fell to a low 3 degrees Celsius in autumn, the Bureau of Meterology claimed it was the coolest April morning in 56 years. My body did not take it well. I wasnt exactly sick but it wasnt right. I wanted to change my diet, I wanted to find a reliable TCM doctor and at the same time, I was on my second IVF cycle of injections. My actions, to say the least, were frantic and I found myself going in circles. My other half was so concerned that he wanted me to stop the injections. I almost went out of mind. Whether what was to happen next is my own doing or some other cause, my body did not respond to the injections.

Last Friday on the fourth day of my FSH (Gonal brand) injections, my ultrasound showed I had only one big follicle and my doctor told me I had to abandon the cycle as more follicles/ eggs are expected to continue with the treatment. No egg collection, no embryo, no transfer, no pregnancy, no child. I wasnt dissapointed, I was very tired. Tired of what I made my body to do. Vigorous trials of this and that to make me fertile or pregnant. Eager turned obsessive cant be good. It's time to return to basics. Return to clarity. Tonight this is my prayer:

My inner light guides me through the pathway of my life,
Whole and at one;
I raise my eyes to see all and understand,
Where and how;
To place each foot forward.

A prayer that a naturopath student taught at the Australian College of Natural Medicine.
Photo taken from the Cream Trip on the Bay of Islands, NZ.

Blessed are those who mourn

- a picture of oak regeneration after a forest burn.

Blessed are the poor in spirit, for theirs is the kingdom of heaven.
Blessed are those who mourn, for they will be comforted.
Blessed are the meek, for they will inherit the earth.
Blessed are those who hunger and thirst for righteousness, for they will be filled.
Blessed are the merciful, for they will be shown mercy.
Blessed are the pure in heart, for they will see God.
Blessed are the peacemakers, for they will be called sons of God.
Blessed are those who are persecuted because of righteousness, for theirs is the kingdom of heaven.
Blessed are you when people insult you, persecute you and falsely say all kinds of evil against you because of me. Rejoice and be glad, because great is your reward in heaven, for in the same way they persecuted the prophets who were before you.

Matt 5:3-11

Once again I feel I am asked to be faithful to His Word. When I started contemplating using IVF, I did wonder what it really means to my God. Was I trying to play Him in manipulating in His natural creations? Was I impatient in waiting for His blessing that would come in time in one form or another? In days like these, I could only doubt myself, my faith and my future. 3 days before I am supposed to take my blood test for pregnancy. I found out I am not pregnant by way of menstruation. It's hard and it's truly a stake through the heart. And I mourn and I remember His promise. Blessed are those who mourn, for they will be comforted.

Things I go through

Two days before my embie (short for embryo in the IVF world) transfer last Monday, I started on the Crinone gel. It's a tube that releases progestrone hormone slowly into the uterus, so it was a vaginal applicator that IVF women uses an hour before bed. Progestrone helps to prepare the uterus lining for the embie implantation.

The symptoms are the worst of the entire journey. I didnt get any cramping which is the common symptom but I had an array of other types. Hot flushes, feeling hot and cold in a span of minutes, wanting to pee at night, constipation, bloatedness big time - I feel fat and I want to run off the weight but I feel tired all the time. Feeling sleepy at odd times e.g. falling asleep on the train while reading my papers or surfing on my phone, quite embarrasing. Feeling hungry all the time, I had to have rice the other day for breakfast. And my breasts feel like they are going to burst any second, so tenderly painful makes sleeping face down almost impossible.

Another 6 more sleeps before my pregnancy test on Friday. Now everything is in His Almighty Hands. May you receive my night prayers.

May your unfailing love rest upon us, O LORD, even as we put our hope in you.
Psalm 33:22

Day of embryo transfer I experienced life and death

"You would know the secret of death.
But how shall you find it unless you seek it in the heart of life?
The owl whose night-bound eyes are blind unto the day cannot unveil the mystery of light.
If you would indeed behold the spirit of death, open your heart wide unto the body of life.
For life and death are one, even as the river and the sea are one.


In the depth of your hopes and desires lies your silent knowledge of the beyond;
And like seeds dreaming beneath the snow your heart dreams of spring.
Trust the dreams, for in them is hidden the gate to eternity.
Your fear of death is but the trembling of the shepherd when he stands before the king whose hand is to be laid upon him in honour.
Is the shepherd not joyful beneath his trembling, that he shall wear the mark of the king?
Yet is he not more mindful of his trembling?


For what is it to die but to stand naked in the wind and to melt into the sun?
And what is it to cease breathing, but to free the breath from its restless tides, that it may rise and expand and seek God unencumbered?


Only when you drink from the river of silence shall you indeed sing.
And when you have reached the mountain top, then you shall begin to climb.
And when the earth shall claim your limbs, then shall you truly dance."

On Death by Kahlil Gibran

Today was my day of embryo transfer. To relate my experience, here is an email that I wrote to share my experience with a fellow IVF journeyer.

Dear Naf

Sorry for the long silence. it's been really hectic for me at work and with the IVF journey.

I guess to cut the long story short, I am now waiting to see my only fertilised embryo transfered today will result into a full pregnancy when my blood test shows next Friday.

To say the least, it had not been an easy journey, just over a week I had experienced ups and downs. With natural pregnancies, most times all that's happening with the ovulation, fertilisation and embryo growth all happens inside our bodies without us knowing but knowing what actually happens to my eggs and the embryo every step of the way is excruciatingly difficult to not feel involved and invested.

I had only 5 eggs collected last Wed - that was a down for me. When I found out that 4 of them got fertilised, I was really estatic the next day. 80% success that must be good. Over the weekend I did everything within my control to prepare myself as a nest - I detox - no meat, no milk and only partake really good fresh quality food and we even went for a massage to relax. This afternoon on the day of transfer I found out I had one early blastocyst, according to the embryologist, the growth rate was normal but the other 3 didnt survive. She was careful to use the words - "unfortunately the other 3 embryos growth rested". You can use any words you want, I felt they died and left me as their mother. Very quickly after I was whisked into the operating theatre room which had a bed that was 3/4 of a normal bed size with 2 handles at the end. The idea is for me to put my feet on each of them so I open wide for the doctor to insert the clamp to open wide for the catheter to go in. The doctor Dr Monroe was the sweetest man I met, he was joking with me and put his palms on my cheeks, I felt like protected like his daughter. The nurse had the ultrasound equipment on me so my husband and I saw the entire thing - the long straw-like catheter that the embryologist used to inject into the uterus and the one small white spot of the blastocyst that showed on the ultrasound screen.

While all of them in the room is talking through the procedure, I was weeping, honestly was it joy watching potentially my first child or was I weeping for the loss of the other 3 embryos who never made it. Once the floodgates opened, I sobbed uncontrollably and I knew I was weeping for the loss. It's crazy handling one success in my womb whilst trying to understand what actually happened to the other 3.

Anyways, it's done now. I am praying hard for this one to grow. I will know next Friday. I really hope you have a successful journey, hopefully your first one is the right one. I found the Monash IVF friends newsletter useful as I read others' experiences to keep things in perspective. Results ranges from first one a success to others who had repeated cycles before a success. That's why I am sharing my journey with you. Hope it was useful.

please take care, write soon,
Jo

You gotta love Karl Lagerfeld

One of the longest personality in the fashion industry. He designs for Chanel but is a household name himself. I really started getting interested in Karl when I stumbled upon a book that he co-wrote and it's not even on fashion. Fancy that!

It's The Karl Lagerfeld DIET by Karl and his doctor Jean-Claude Houdret. He was motivated to lose lots of weight so he could wear his favourite clothes. At the end of his diet he lost 42 kilos. Amazing!!!!

I started following parts of his diet of lots of fish, protein shakes and I lost 1 kilo. With so much going on with IVF and work, I have been slacking on following the diet properly. But it's a working diet, it will take lots of discipline cooking for myself and something else for the family but it's well worth it knowing I could look better in clothes and watching my tummy flatening out. Fantastic feeling.

But Karl is a legend and slowly I found him interesting in so many ways. He is super creative, see his latest Chanel Spring 2009 white collection. It is to die for. He has a real interesting way looking at life. Always very witty.

Here is one of his quotes:
"The worst thing is when friends say, 'Remember the good old days?' Forget about the good old days!! That just makes your present secondhand. What is interesting is now. If you think it was better before, then you might as well commit suicide immediately."

Making the present secondhand? Classic!!!

On a side note, it is the Egg Collection day today. I was in at Day Surgery Unit (also known as DOSA at Monash IVF) at 9.30am, waited till about 11.20am and after talking to the patient coordinator, nurse, anathetist, gynaecologist (Dr Melissa Wong) and Embryologist before I was put out for the procedure. I was slightly dissapointed when Dr Wong told me she managed to drain 5 eggs from my ovaries, but I guess if all of them do fertilised I can have 5 children - too many to handle but dont mind entertaining the idea. I do like a noisy big home with teenagers and children of different ages colouring our lives. I am feeling really sore, Dr Wong pierced through the vagina walls to get to the ovaries. Tomorrow is another big day, everyday seemed to be a big day these days. I will know how many eggs got fertilised so I pray that there will be some for the embryo transfer. Also made our decision while I was feeling light headed in recovery mode from the anasthetic to build our new home with Premier Builders Group. Will talk more in future postings.

Leave it to science ..and shoes (ahem!)

9 March which is Day 9 of my IVF cycle, also known as CD9 as one of fellow journeyer Naf calls it. I met a lady same age, now residing in Chicago trying to have her 2nd child via IVF. She's also with Dr Lynn Burmeister.

Today is a bank holiday but our body functions doesnt stop for holidays and so is the staff at Monash IVF. They are really dedicated professionals working tirelessly to help people like us. We were there at 7.30am for my ultrasound. The sonographer (ultrasound professional) was still sleepy, so was I when I met her at the reception. But she was cheery and was really supportive throughout the experience. I was placed in a dark room with large equipment and a TV screen opposite the bed. She was gentle as she scans my ovaries looking for large follicles signalling ripening eggs. She mentioned the lining looks thick which is good news to prepare for the embryo implantation then she started on my right ovary - we saw 3 large black sacs, and she clicked on the perimeter of the black sac to measure if they were viable. So far so good. There were maybe 3 or 4 with one overlapping the other. She moved on to the left ovary, I felt it was pushing against the wall of some organ but thankfully the black sacs were as clear as day, there were another 3 which she counted. Then it was done.

Next I waited for less than 5 minutes before I went next door with the nurse to get my blood test done. As usual, my tricky veins on my arms presented a problem for the nurse to extract blood from me but slowly she got the amount she wanted and I was allowed to leave.

It must have been the feeling of wanting to be rewarded for the past week's efforts. We wanted to have a good hearty breakfast to mark the occasion but I thought I had "fasted" enough and I could now buy myself a pair of heels. Especially ones inspired by Jane Aldridge, the 17 year old blogger from Dallas, Texas. She is adorned with designer clothing and shoes. When your blog is called Sea of Shoes, what do you expect? I made my decision really quickly when I tried on a 3 inch high platform on a 5 inch heel. I was as tall as Alex when I stood up. It was all black leather and it had a sexy tassles as the T strap of the heel. The shoes were exquisite and they look great in skinny jeans.

Starting the cycle

It's my Day 2 of the Synarel nasal spray, although the fluid taste revolting at the back of my throat, I am getting used to it. I used the nasal spray twice a day, about 12 hours apart alternating between left and right nostril. One press on the spray, remove the spray from the nostril and sniff so the spray mist gets absorbed into the thin blood capillaries on the lining of the nose. It's not that difficult. Just not easy getting rid of the taste - tried drinking water, soup, having toast & jam, only strong coffee works but I am trying to eliminate coffee altogether from my diet.

This evening, I started with the Follicle Stimulation Hormone on an injection pen. The brand I am using is Puregon. It's not a walk in the park. It's painful and I took a little time to get over the fear of injecting a long needle into my flesh. The pain increases as I push the fluid into my body. Thankfully mine is a boost cycle which means a short cycle, next Monday on Labour Day I will go in for my early ultrasound and blood test to see if the follicles are growing well. If they are growing well, I may need a few more injections and it's done.

I asked myself over and over again how I am feeling through this experience. Work has been so busy and absorbing, I hardly had time to think about it much. I tried to read every literature Monash IVF provided me, unfortunately it will always list the potential risks to indemnify themselves from uninformed consent. What they need to do is balance these literature with success stories, stories of couples who made it and what they went through to get there. My patient coordinator Sharon tells me Dr Lynn has a 45-50% conceive chance. I am trying to be optimistic but it doesnt mean much to me. There is still a chance I could be one of the two who wont conceive.

So I just concentrate on the facts which is my usual style, understanding the treatments I am getting, the processes they are recommending and the implication of using the treatment. We also found out we didnt really had a choice, we had to use Assisted Reproductive Technologies otherwise we will be childless, unless it's a miracle baby. I do think every child is a miracle baby these days.

Nesting

Life is a little overwhelming for us at the moment.
We have decided to embark on using in-vitro fertilization to get pregnant. Tomorrow I will meet with my nurse to get my 'hormones'.

Since our first appointment with Dr Lynn Burmeister, a fertility specialist, we have been moving fairly quick like clockwork. Immediately after the consultation, we both did a blood test at Melbourne Pathology and signed for Monash IVF membership. We tee-up the next few appointments for my laparoscopy and Alex's additional semen test. The following week I was admitted for day surgery to undergo laparoscopy. At least we found out why it was difficult for us to be pregnant, one of my fallopian tube is blocked. Dr Lynn didnt waste any time in recommending IVF as a solution.

In the course of 2 weeks, we learnt about what really happens when a couple goes through IVF and the different stages, the potential risks as well as epidemological studies comparing IVF babies with normal babies, IVF mothers with normal mothers. We attended counseling as required by law and had to sign a couple of consent forms to provide instructions on what we do with our remaining fertilized eggs if we are fortunate to have more than we need.

In the midst of it all, I am trying to keep healthy, taking lots of long walks on the beach to digest it all. Spending lots of time alone praying. I feel I am more determined to push myself harder in physical exercise, not sure why. I ran for a long time today, it's my first proper run since I had torn my anterior cruciate ligament on my left knee in August. I guess I must feel I needed to be strong for what's to come. I realized I am not coping entirely well either as I get pretty worked up over minor details on topics like our home building plans, timings for our overseas trip to gain first entry as permanent residents and making sure we enter into a building contract before end of June. Perhaps some Eckhart Tolle may help me through this period...