IVF: what needs to be done

I knew IVF would be a fairly large departure from the natural course (a lot less fun, a lot more pain, about the same amount of anxious waiting). I had thought, however, that these added complexities would be part of the actual process – the shots, the procedure, the waiting to see how many eggs had fertilised. What I hadn’t realised was the sheer amount of organisation involved, long before the first injection. As a heads up to any of you travelling towards the IVF path, here’s what we’ve gone through so far:

Step 1: the fertility specialist

This one I was expecting – you want IVF, you need to see the doctor. While waiting for the appointment to roll around, my main concern was convincing the doc that we should go straight to IVF, and not try IUI to begin with. Let me explain. For most couples who are having trouble conceiving, the first step tends to be IUI, or Intrauterine Insemination. This is basically a more advanced version of a turkey baster, where you wait until ovulation day (predicted by ovulation test kits), and then the doc squirts swimmers directly into your uterus, bypassing the initial journey, and making conception more likely. IVF (In-vitro fertilisation) on the other hand is when eggs are extracted from the woman, thrown into a petri dish with sperm, and monitored to see which eggs fertilise. One of these is then injected back into the uterus, where hopefully it sticks.

My concern with using IUI first is that we have a limited amount of frozen sperm. Also, the rates of success are much lower for IUI (around 20%), compared with IVF (more like 40%). We would potentially use up a chunk of our frozen swimmers when we could get success on the first try with IVF.

So I had gone in to the appointment with the Doc with my argument in mind. We spoke to her about our situation (husband undergoing chemo, one miscarriage, abnormal shaped sperm, frozen specimens only). She told us that IUI was fairly pointless, as frozen sperm tend to not pick themselves up particularly well. She also discounted regular IVF, for the same reason. Her recommendation, from the start, was to go with ICSI IVF, which is a more specialised form of IVF. The eggs are extracted, the sperm is defrosted, and the best sperm are selected from the batch. One sperm is then injected into each egg using a needle, and the eggs (hopefully) fertilise. They then transfer one (or sometimes two) eggs back into the uterus, and again hopefully they stick. This process has a few detractors, mainly due to the absence of natural selection. A scientist selects the best sperm, not the natural process itself. It does, however, have the highest success rate. Personally, I’m happy to trust the scientists, and the process. It has been used for nearly a decade to provide pregnancy, and studies that I can find don’t show any adverse effects when compared to regular IVF. The biggest drawback with ICSI is its cost. The additional procedure carries an extra cost for us of $800.

Mr Nester and I discussed the approach, and decided we were both happy to use ICSI if it meant success. So, on to the next step.

Step 2: the information session

In which you are bombarded with information on what drugs you’ll be taking, how you’ll take them, when you’ll take them, and the side effects of taking them. Here’s a brief rundown:

Drug 1: Puregon (makes lots of eggs develop) taken from Day 3 of cycle until Day 14, injected into stomach fat (ohhh yeah). Side effects include: abdominal swelling, breast tenderness, mood swings, nausea, dizziness, headaches, bloating, tender ovaries.

Drug 2: Orgalutran (prevents you releasing eggs until the doc says so) taken from Day 8 of cycle until Day 14, injected. Side effects: headaches, nausea, itching, soreness and redness at injection site.

Drug 3: trigger shot Day 15 (makes the eggs spill out of you, basically). Injected. Side effects: nausea, bloating, constipation, breast tenderness, tender ovaries.

Drug 4: Crinone (a progesterone supplement), Day 19 onwards. Used as an applicator up the wazoo. Side effects: all of the above, plus the bonus of cottage cheese discharge. Oh yummy.

These do not include the two scans, multiple blood tests, and day in hospital where they knock you out, stick a bloody big needle in you, and yank out however many eggs you produced. Of course, some of the drugs need to be refrigerated, some not, all must be taken at a specific time, and all of this may change depending on your body’s reaction. Easy.

Step 3: the counsellor

A government mandated session, basically to make you aware of who owns the embryos if one of you dies. We chatted to a lovely counsellor, she was great, this bit was easy. It was also free. Win!

Step 4: the paperwork and the rest

Holy cow the paperwork. Three forms to fill out, sign and have witnessed. A police check for each of us, certified, sent off, paid for, forwarded to the fertility clinic. Child protection checks applied for, received, forwarded to clinic. Blood tests, one for Mr Nester, two for me, one of which was not claimable and so cost $90. Oh, and a partridge in a frickin’ pear tree. Also, as we have Mr Nester’s sperm stored at another facility, we have to pay to have it transferred, then pay again to have it stored.

Step 5: the costs

As you can imagine, this was the gasp moment. It is bloody expensive. Without Medicare (thank god for Medicare), we would be out of pocket by around $12,000. Yes, you read that right. 12K, 12 big ones, twelve thousand bloody dollars. With Medicare, we’re looking at about $6,000. Nowhere near as bad, but still a lot. This is all my working out, so there may be some leeway here, but I’m expecting the worst.

All of this leads to next month. Around the 15th Feb, I’ll be collected my meds and starting the process. We’ve done all of the above (aided by numerous check lists and trips to the post office, police station (to certify bloody EVERYTHING), and bank. We’re ready. Except we’re sooooo not. This is going to be a rollercoaster, and if the side effects of those drugs are anything to go by, I’m going to be the screaming, crying, vomiting one. Lucky Mr Nester.

Jane xx

IVF: the beginning

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Another doctor appointment today (I’m going to laugh at that line after the next few months), this time discussing how we get going with, as they call it, “assisted reproduction”. Mr Nester and I had a long chat last weekend, and we came to the conclusion that there’s not a lot of point waiting. Since he is currently receiving chemotherapy, a return to normal fertility levels/sea of swimmers could take anywhere from 3 months to 2 years. Or not at all. And since he will be having more chemo early next year, that will mean we won’t be able to try again until this time next year, at the earliest. That’s assuming the swimmers return, which they may not. So, we’ve decided that instead of adding more uncertainty and more waiting to our already limbo-like lives, we’ll give a big fuck you to nature, and have a chat with science instead.

We spoke to our GP tonight, and he recommended one of the IVF clinics in Melbourne. I looked them up, along with other options, and we’re going to meet with a couple (one recommended, one cheaper!), to see what they suggest. From the website estimates, we’re going to be out of pocket by at least $2700, most likely quite a bit more. What they don’t say (well not loudly) with the prices are that they assume you have reached the Medicare Safety Net threshold (for those from o/s, this is basically an amount of accumulated medical costs where the government will give you more of a helping hand if you go over it). They also assume you have private health insurance (which we do), that covers fertility services (which ours doesn’t). We could be out by another grand or so. We’ll see.

Thankfully, we have a little bit of money set aside, which was to be saved so I could take extra time off work if we managed to fall pregnant. Fingers crossed the treatment works first time, in which case we may be able to make the shortfall back up in the resulting 9 months. Otherwise, we’ll be a little broke. You know what, though? Broke is fine. I’ve been broke, and I’ve been (relatively) well off. Money has never made me happy. Sure it makes the stress less when the bills roll in, but there’s no way I’m letting a bit of cash come between us and the chance of having a family. Not yet, anyway.

So I’ve contacted the two IVF clinics, now we wait to hear back so we can set up the initial appointment. Here’s hoping this is the start of what this blog was meant to be: a log of our journey to parenthood.

Jane xx

Waiting for Ovvo (apologies to Samuel Beckett!)

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I don’t know how women do it every month. Here I am, about 5 days into trying to conceive, and I’m climbing the walls. I want to know, NOW! I’m at least a week away from actually ovulating, and yet this morning I’ve had to physically stop myself from taking a pregnancy test (for those not well versed with these things, this is crazy-pants behaviour). Every quirk of my body becomes a symptom, every minute that ticks by is a minute closer to knowing. I have about 16 days before anything would show up on a test, and thankfully I’m going back to work on Monday, or I think I’d become an obsessive, rocking-in-the-corner type loony.

I think now that we’ve made the decision to try for a baby, all my years of suppressing baby fever have come back with a vengeance. I think if I actually see a baby in the next few days, I will simply melt into a puddle of oestrogen. Ew.

I’ve told myself sternly that I won’t be buying any fancy stuff until at least next month – ovulation kits, basal body thermometers, etc etc. Seriously, the industry in making babies is about 1,000 times what I thought it was! I could easily spend all my cash on supplements, planning kits, creams, videos, apps and books. However, I won’t. WON’T, Jane, OK?

Instead, I will obsessively monitor all things cycle related, eat so many superfoods I’ll turn into a freaking goji berry, and make Mr Nester’s day as many times as possible (nudge nudge, wink wink!) in the next week and a bit.

Yours in crazytown,

Jane xx

Fertility apps

Now that we’re officially trying for a baby, and with my personal tech obsession, it makes sense to delve into the world of fertility apps.

Fair warning, I’m about to talk about all things period – feel free to avert your innocent eyes!

I’ve been using a cycle tracker for the last couple of years anyway, as I wasn’t on the pill and I wanted to ensure I wasn’t caught short. This tracking seems to set me at an advantage for the fertility apps, as I now have quite a lot of information on past cycles, which makes it easier for the apps to predict dates of ovulation, greatest fertility, and the rest.

For quite some time I was using a simple calendar type app:

Period Tracker LiteScreen Shot 2014-07-10 at 2.46.52pm

An easy, free app that you simply get going by hitting the “period started!” button (obscure, I know). While it was a little too “pretty” for me (flowers, pink borders and the like), it certainly did the job.

Screenshot from the main page

Calendar view

 

 

 

 

 

 

 

 

Once we had started talking about having kids, I looked for a more specific fertility app (you can also just upgrade to the full Period Tracker app, but I was stingy and didn’t want to pay for it). So I moved on to:

Screen Shot 2014-07-10 at 2.54.41pmOvia

This one was a beautifully designed app, that had a bit more info, and more opportunity to log data – temperatures, cervical fluid (yum!), ovulation tests etc.

 

The only thing I didn’t like about this one was there was no connection to anyone else using the app, and it could be a little, well, huffy at times. Having reminders with “Make sure you log your data!” were helpful in keeping you on track, but seemed a little cranky. I know that sounds stupid, but after looking at the same reminder daily, I was a little put off.

ovia1 ovia2 ovia3

However, this app has a pregnancy companion, Ovia Pregnancy Guide, which is just as well set out. I may in fact head back to Ovia once the bun is in the oven.

My most recent discovery is:

Screen Shot 2014-07-10 at 3.08.52pmGlow

Again, beautifully designed, well set out, with all the same features as Ovia. In addition, you can link it to calorie/food tracking and exercise apps, including one I use (MyFitnessPal), and it will transfer your information across. The best part about Glow, in my opinion, is its forums. Integrated into the app, you can find any topic you’re after, and it’s split into “Trying to Conceive”, “Success Stories”, “Support”, and a number of others. I’ve found this fantastic for reading up on the pregnancy stories when I’m feeling optimistic, and being able to avoid them completely when I’m feeling like conception’s not going to happen any time soon. There are, of course, some nutters on the forums, trolling whoever they can, but I’ve found some genuinely lovely people on there who you can share the highs and lows with, without fear of telling friends, only to then have to “untell” them if something goes wrong with the pregnancy. I’ve been completely addicted to the app since I installed it last week.

glow1 glow2 glow3

 

 

 

 

 

 

 

 

I’ll let you know how I go as we progress with Glow, however it’s been great as a support tool, as well as a wealth of information on what I should be looking for, and what’s happening with me.

Hopefully sometime soon I can review the pregnancy apps I have sitting on my phone as well, when they’re actually needed (instead of me putting in phantom due dates to see what they do!).

Jane xx

New Beginnings

After all that chat about changing our start date due to money saving opportunities, I realised last week that my maths was dodgy. Well done Maths teacher Jane! *face palm*
It turns out, instead of the massive $10,000 difference I thought it would make by waiting a few months, it is instead more like $2,000. So after careful consideration last weekend, Mr Nester and I stared deep into each other’s eyes and mouthed, in unison, “Fuck it! Let’s give it a go”. Ahhh romance!

But really…how exciting!!!!! Apologies for the profuse use of exclamation marks, but if you can’t use ’em now, when can you? We are, officially, trying to conceive (or TTC to those in the know). So naturally, my planning has moved from what happens in pregnancy to which high schools are the best in the area. Ever the careful planner and avoider of the present! Good old moi!

So, in many more words than is really needed, we’re off! I can’t wait to use this blog for its original intention, and to share the pregnancy-baby-tearing hair out journey that is to follow.

Love, Jane xx

PS. Just for a bit of perspective over the coming months, here’s a “before” pic to compare to. I’ll try to keep a week to week comparison running!

Jane, preconception

Friends with bumps

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I had a Skype catch up last week with two very old friends, both of whom are now pregnant, one who is ready to pop! It was lovely to see them both, and fascinating to see them at such different stages of a huge part of their lives. Both are expecting their first child, one is at 38 weeks, the other at 16. The difference in their progression was of course obvious, however it was their completely alternate attitudes that I noticed the most. Ms 38 weeks is enormously organised (as you’d want to be with 2 weeks to go!), and has been so for the entire pregnancy. She has a fantastic attitude of order, with a dose of reality. She eats extremely well, exercises carefully, and has had a great pregnancy despite developing gestational diabetes, which she has handled with aplomb. Ms 16, on the other hand, seems the opposite. She has had a rough ride of morning sickness, and seems quite blas√© about what’s happening to her. While she had planned the pregnancy, her circumstances are chaotic – a new relationship, a pending move to be with the father in an as-yet-unbuilt house, and an aversion to wanting to buy anything for the baby, as she’ll “do all that later”.

Now, I know I’m sounding very judge-y here, and I really don’t mean to. I’m just fascinated by the different approaches people have to having kids. I must admit, my own perspective is skewed by my desire for children, and as I’ve mentioned before, I’ve already completely overanalysed the entire future pregnancy before it’s even happened. Perhaps I have something to learn from 16, perhaps her easygoing approach in pregnancy will translate to easygoing parenting.

Back to me though (c’mon, blogs are inherently narcissistic, and chances are I’m only talking to myself…). It was a lot harder than I imagined to talk to two people who are going through what I want so badly. These are two friends with whom I always feel comfortable, who I know I can be myself around. And yet I found myself plastering a smile on as they joked about me being next, and asked why I wasn’t pregnant yet. Thankfully I wasn’t in the process of trying, or trying to deal with another month gone by without conception, or I don’t think any fake smile in the world could have masked my emotions. I finished the phone call quite melancholy, which is ridiculous. Namely because we’re not trying yet, I’m not dealing with failed attempts at conception, and I’m genuinely happy for my friends! No matter my logic, it was a hard catch up. I can only hope that in 6 months’ time I’ll be the one glowing with pride.

Jane xx

Update: Nothing doing…

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I thought it was time to give an update to say, well, nothing’s happening. Fortunately for us this isn’t a “we’re trying and it’s just not working” post, as that would be far harder to write. For now, this is simply a limbo post. This month was intended to be the “start trying” moment, the exciting beginnings of the next chapter. Instead, it’s more of a “same old” moment.

As I’ve mentioned previously, we’ve decided to wait a few more months, purely for financial reasons. As much as I despise the current Prime Minister, I’d be a fool not to make use of his ridiculously generous maternity leave scheme. Financially for us it means roughly another $10,000, which equates to more time off for me, meaning I might be able to take 12 months off instead of 6. Logically, this all makes perfect sense. Emotionally however is another matter. Ever since Mr Nester and I started the baby chat, the possibility of being a parent and having a child has been swirling through my mind. In the first few months of discussion, I had pretty much everything sorted, down to nappy colours.

Fast forward a few months to where I am now, and the initial excitement has worn off, replaced with what seems like an eternal wait: first, to even start trying, and then the unknown lapse until we fall pregnant. I’ve never been good with uncertainty, with waiting patiently (Mr Nester will be nodding vigorously here), and the time until something actually happens seems to be forever away. In the meantime, I’m still taking pregnancy vitamins, which seems pretty pointless at the moment. I don’t want to stop them though, as currently it feels like the only tie to our plans. Everything else seems frozen in time.

So in the meantime, it’s business as usual. My focus is on our upcoming trip to the UK in September, and the knowledge that not long after that, it will be “time”. Here’s hoping all goes well after that.

Jane xx