Angry Chair

Cycle number: 11

Cycle day: 14

Meds: Met

Outlook: Really f%*!ed off

I am beginning to lose faith in the fertility consultants I see, particularly the one I bemoaned in the last post, even though I am lucky enough to go to a hospital which specialises in fertility.

So after last Wednesday's secretive scan, I toddled back on Friday not knowing what to expect. I was thrilled to discover I had 3 follicles maturing on the right side - one at 14mm, one at 14-15mm and one at 15-16mm - and my lining was looking good. She sent me for another oestradiol test (a horrible man who was clearly new to taking blood (or a sadist) and did the whole thing in painfully slow motion so it hurt as much as possible) and told me to halve my Meno.pur dose over the weekend.

So all weekend I was really excited, even though I was having to waste half a pod of drug each night (so pointless) and, yet again, started to think at last this was the cycle that was going to give us a real chance to get pregnant.

I was told to come back in today and so I went. First off, I had to wait nearly half an hour to be seen in a boiling hot waiting room (so hot a trickle of sweat came down to my elbow from my armpit) and then it was a doctor I've never seen before. He was really thorough at the scan, again saying my lining was excellent and then started measuring the follicles. This is where it started to go wrong. The three she saw on Friday have all grown to a mature size (between 20mm-23mm) but there is a fourth that is catching up (17mm) and a fifth which is smaller. He said I have over stimulated and the cycle would have to be cancelled.

I had to fight back tears on the couch (luckily it was dark so he couldn't see). He then was at pains to explain to me why they would not be giving me the trigger. I asked what would happen if I just ovulated on my own and he said "Well you can't have sex". WHAT?!?! "You could end up with quadruplets and you don't want that! Hahah!" He then spent ages working out the precise dimensions of the offending follicles before saying "Yes this can happen with PCO".........again WHAT?!?!

I then went to sit in the waiting room while he went to get the opinion of a nurse. I went in to see her and she said actually they were going to check the "cycle cancellation" decision with another doctor (Ms Helpful from Wed/Fri) but it looked likely it would be cancelled. She then told me to continue with my half dose of Meno.pur tonight and this time I said it out loud "WHAT?!?" She said she didn't want to be the one to make a decision to stop taking it (i.e. that it should be the doctor telling me) but I was like "Surely if I take more tonight, the biggest ones are just going to get bigger, and the ones that are borderline are going to catch up and there will be even more?" and she said "Ok don't take it tonight" - I was in disbelief. 

She then said I would have to go for yet another blood test (my third in less than a week) and based on my scan and the blood test results she would discuss with Ms Helpful tomorrow and give me a call. I then had to fight back tears all the way up to haematology. And - typical - of all the appointments I've had there, this was the one time Bubble couldn't come with me.

So there are several things that concern/down right annoy me:

• If there were too many follicles growing, why didn't Ms Helpful notice on Wednesday and tell me to halve my dose then?
• If there were definitely too many on Friday, why didn't she get me to stop the Meno.pur over the weekend and reassess on Monday?
• Surely my oestradiol numbers are the most reliable source of info - why after 2 blood tests and all these scans was this not picked up earlier?
• If over-stimulation typically happens with PCOS (and particularly after my over-response to Clo.mid) why wasn't I started on the minimum dose possible? They could then have increased it later on if I wasn't responding well enough
• If I ovulate tonight or tomorrow - as seems likely with follicles that big - telling me not to have sex from now isn't a failsafe way of preventing me getting pregnant since we already did it yesterday! So they have put me at risk of conceiving 4 babies
• If my follicles are already so big that I could ovulate at any given time, why then increase the chance of adding a couple more to that number by telling me to continue with the Menopur tonight?! And why did the nurse try to take the decision herself if she wasn't sure (which she obviously wasn't since my layman response made her change her mind)?
• Are these large follicles actually going to rupture at all, or am I going to be left with a mass of uncomfortable cysts that need another cycle off to get rid of?

Overall I'm gutted. It's now been 7 months since we started treatment. This is only my third medicated cycle and the third that has been a wasted opportunity for a pregnancy. All this just to ovulate, and I'm not even getting that right! Pregnancy seems a very very long way away tonight, and a real, actual baby even further. I can't believe that with all the injections, all the blood tests, all the appointments, somehow this has still gone wrong.

Of course, they can't stop us going ahead and having sex if we want to. And a large part of me is very tempted - why should I waste the only chance I've had so far?! Will wait and see what they say tomorrow, but I'm not holding my breath.

Availability

Cycle number: 11

Cycle day: 9

Meds: Met/Meno.pur

Outlook: Headache

I went for my scan this morning. I seem to have a number of follicles on the brew, the largest being about 10-11mm, so I had to go for a blood test to measure my FSH/LH levels and my oestradol levels. I go back on Friday for another scan and to get the results. If I have too many active follicles they will probably reduce my dose as they are very careful to prevent a multiples pregnancy wherever possible, and therefore don't want me developing more than 2 follicles to fruition. I'm glad that something is happening at least - and I'd rather have too many follicles than none at all. Luckily I'm becoming much more adept at giving myself the injections but I'm hoping things will go so well I won't need to do more than this one cycle of them!

A tad concerned about Friday though - the only appointment slots available were between 11 and 12pm, and I have a meeting at work from 10-12...not sure how well that's going to go down. Technically I will only be taking minutes so may just have to leave early and ask someone else to cover for me for the last 30 mins. There's not much I can do though as I need to be seen on Friday and that's the latest I can go.


Was surprised and slightly annoyed at the variation of treatment you can receive at the hospital today. I've seen 4 or 5 different doctors for my scans over the last few months, and most of them are really lovely. Usually, they turn the ultrasound screen around so that I can see what's going on as they are looking at it, and explain what they can see. Today's doctor was very different (I've had her before but she's never been this bad) she didn't say a single word to me through out the scan and didn't show me the screen or the print outs afterwards. She was generally very short and didn't take the time to ask if I had any questions at the end which I really appreciate from the doctors who do. Will be avoiding her from now on.

How to...prepare and inject Meno.pur

Ok, here goes. 

NOTE: This is meant as a rough guide only and is based on the instructions given to me by my doctor. Always follow the advice of your healthcare professional.

Left-right: pod of Meno.pur; ampule of solvent; alcohol cleansing pad; syringe; large mixing needle; small injecting needle

First, clean your hands thoroughly and prepare a clean preparation area.

Remove the cap from the pod of Meno.pur and wipe the alcohol wipe over it. You can now throw away the wipe and cap.

Take hold of the solvent at the bottom, and with the other hand gently flick the top to force the fluid down into the bottom of the vial.

Gently snap off the top of the vial. Mine has a little blue dot which should be facing towards you when you do this, and note the position of my hands. With vials like these always snap away from you. My nurse advised me to do this with a tissue over the vial to protect from any flying bits of glass (nothing like that has happened though, touch wood). If the vial cracks, the glass becomes jagged or get into the solution, discard the vial.

Take the large mixing needle and firmly slot it on to the end of the syringe. Keep the needle cap in place until you are ready to use it. When removing the needle cap, hold on to the lip of the needle fitting (the green edge visible here) to prevent the needle sliding back off the syringe.

Place the needle into the glass vial and slowly draw the fluid up into the syringe. I find it helps to tilt the vial to the side to ensure you get every last drop.

Holding the plunger on the syringe firm so as not to let any of the fluid out prematurely, push the needle through the rubber top of the pod of Meno.pur. Be careful not to smash the needle into the bottom as it can go through quite suddenly. Release the fluid into the pod; the Meno.pur powder will dissolve instantly. Keep the needle in the pod. If you can see any bubbles, give the pod a flick to disperse them. When you are happy, push the needle to the bottom of the pod and slowly pull the plunger up to draw the mixture into the syringe. Try not to draw any air in before or after it. Once you've got it all, hold the plunger steady, and slowly pull the needle out of the pod. Discard the pod. You have to be pretty quick now because once it's mixed it needs to be used as soon as possible.

Tilt the syringe upside down so the needle is pointing to the ceiling. Draw the fluid back slightly away from the needle. Remove the large mixing needle carefully, and replace its cap. Take the small injecting needle and fix to the end of the syringe. Again, carefully pull off the cap (hold the lip - in this case yellow - to ensure the needle stays in place).

Keep the needle pointing to the ceiling. If there are any bubbles in the syringe, flick it until they disperse, or draw the fluid back down with the plunger and then push back up slowly. Slowly and gently push the plunger up so that the fluid goes right up into the needle. Be careful because once it gets there it goes pretty quickly and can squirt out.

Expose your tummy. You need to grab that natural little pouch under your belly button, either to the right or the left (you will alternate sides each time you inject). There is a temptation to grab really hard to divert attention away from the needle, but only pinch gently. When you are ready, push the needle in as quickly as you can (don't stab, be gentle but swift). Once the needle is fully in, press the plunger down slowly to inject the solution - for my single dose it takes about 8-10 seconds. Once the syringe is empty, carefully remove the needle and press a tissue or cotton ball over the inject site for about 30 seconds. ALL DONE!

Final step: pour a large glass of wine or have a large chunk of chocolate.


Also note: be careful how you discard the glass and needles. My clinic suggested I collect them all in a glass container e.g. used jar until the end of my treatment, then I will take them in for the clinic to dispose of. 


Yet another note: Only use each needle/syringe/pod etc. once. If you make a mistake don't assume you can fix it - it's probably safer to start again from scratch.

Pin Cushion

Cycle number:11

Cycle day:7

Meds: Met and Meno.pur

Outlook: Ouchie!

Nothing much to report other than I am slowly become adept at stabbing myself in the stomach with a needle >_< My first self-administered dose was Friday night, and it wasn't the best of situations because we were rushing to get ready and go out so I was even more panicked than I might've been. I faffed around loads, drawing the fluid up, letting it back down because I missed some, getting annoyed by all the bubbles etc. Even wasted one of the fluid pods because I didn't flick it before opening. I then aborted the first stab because it hurt and I thought I wasn't doing it right, so made 2 holes instead of one. It's quite an involved process....!!

When the nurse gave me my first dose last Thursday, I didn't feel a thing - no prick when the needle went in, no discomfort. Even with my much more relaxed last two doses I still feel the needle going in...I suspect I'm not doing it quickly enough. It's pretty hard to get a good angle too on your tum...makes your wrist all twisty.

I am planning to do a photo entry on how to prepare and administer the Meno.pur. I have no idea if this is appropriate, but before I started self-injecting I really wanted to see someone else's idea of how to do it to yourself - it's all well and good watching a nurse do it, of course she finds it easy! - but couldn't find anything illustrated. I hope it will serve both as a reference for those doing it and reassurance that it's really not that scary or complicated for those who are moving towards it.

Other than that, I have just been ticking along. I have a scan on Wednesday to check for follicle progress and to try to work out how many more days of Meno.pur they want me to take...

Baby Steps

Cycle number: 11

Cycle day: 1

Meds: Met (and Pro.vera for the last week)

Outlook: Excited

Well, it doesn't look like I did ovulate last cycle, since AF arrived right on cue after stopping the Pro.vera. I'm not surprised. Unfortunately though this AF is giving me a world of pain >_< Not exactly the best way to be around a fertility festival.

I go for a baseline scan on Thursday and have to take along one of my pods of Meno.pur for my first dose. Very excited about this....I never had a very good feeling about Clo.mid, even before I started taking it, since it relies so much on a chain of reactions in your body working in perfect synch (not something my body is very good at unfortunately). The injects work directly into your system and so it seems much more likely that I will get a good response.

As I wrote in a previous post, I've had some problems with my mum not being supportive at all through my ttc trials, and specifically about serious insensitivity related to infertility. So I took a proactive approach recently and sent her a link to an advice sheet for friends and family of those suffering through infertility. It covers a lot of things I think are really important, and she said it was useful. If anyone you know is treating you insensitively, don't be afraid to speak up and offer advice - they may genuinely not understand how much they are affecting you.

She actually told me that she thought we would be stopping treatment now until after our honeymoon....that's December! She didn't know about my treatment in February so essentially she thought we were putting ttc on hold for a year. I told her how funny I found this - I've been waiting four years so far, I certainly don't need to be adding an extra one on for the fun of it - and also how in a serious sense, I'm less than 2 years away from being 30 and certainly don't need to tempt my egg quality to start decreasing on top of all my other issues. I can only conclude that she doesn't understand that longing for a child, and that she must've had me and my sister because it was the next natural step in her life rather than something she desperately wanted. 

Finally, I found out another friend of mine is pregnant and due in eight weeks! She's sure she told me a while ago but I gently told her I was sure I would remember if she had. I would like now to do a tally of how many people I know who are either pregnant right now or have given birth in the last few months........yep it's 10. There may be one or two I have missed. For some of these it's their second baby since I started ttc. And this list doesn't include people I know solely online on forums and stuff (it would be more like 20 if I included them). I do try very hard to keep focused on my own situation, and let other people's news wash over me, but it is very hard. Especially when you are in the no man's land of never having seen a BFP despite so much trying....it begins to feel like it's all a myth and not something that will ever happen to you.

Bleugh. Despite all this, yes, I am in good spirits - the weather has been glorious, I have been spending a lot of time walking in the woods and doing little indoor gardening projects at home and following the Royal wedding this weekend I just feel so uber excited about my own ^____^

What Not to Say to an Infertile

I have decided to keep a log of every insensitive, mean or downright ridiculous thing anyone says to me about ttc or infertility, and what I wish I had said back to them; hopefully it will be somewhat therapeutic -_-

(After a failed cycle)
Me: I'm so upset the Clo.mid didn't work, I'm going to be the only one left who isn't pregnant :(
My mum: Nevermind, you have a wedding to plan!
Yes I do, and obviously that precludes me from thinking about, wanting, or needing anything else in life! THANKS FOR THE SUPPORT!??>£"$

(During my "off" cycle due to a cyst)
Me: Luckily I've had all the honeymoon arranging to take my mind off of it
MIL-2B: Well sometimes that can work to your advantage
REALLY?! So my body is going to magically start working for the first time just because I've been thinking about something else?! AMAZING! What was I bothering with all those drugs for??

(From my pregnant SIL-2B when she found out I had PCOS)
SIL-2B: Well I was once told I couldn't have kids so I know exactly how she feels
Apart from the bit where you got pregnant without trying you mean?!

(My dad while I was playing with my BFF's baby)
My dad: See, all you need to do is get your ovaries sorted out and then you can have one of those!
Ahhhhhh is that all? Why didn't you say so before! 

(Pregnant friend who would complain incessantly about not being pregnant even though she and her husband only had sex once or twice a month - she finally got preggo after about 8 months of "trying" even though for about half of that they didn't have sex at the right time. Her benchmark for ttc lengths was her sister, who got pregnant first time on both tries)     
Chum: I know it took us a bit longer than most people, but you'll get there
Good grief, how did you honestly cope ttc for 8 months?! You deserve some kind of medal. And of course, you got there - and against all the odds it would seem - so that means I will too, I'm obviously making a big fuss out of nothing!

(Me fussing about on the sofa because of lumpy cushions)
Me: I just can't seem to get comfortable today
Dad: Are you pregnant?
Me: long pause No -_-
Dad: Oh, coz I've been hearing recently that that's a cause of it (He was referring to my nearly-8 month pregnant sister, who I haven't seen or spoken to since the news broke)
That's a cause of it if you have turned into a gargantuan heifer because you've been stuffing your face throughout the pregnancy.   

(During my "off" cycle due to a cyst, and after 2 failed Clo.mid cycles)
Chum: You never know, you might just get lucky and be pregnant in May. I have a friend who also has PCOS and she got pregnant on her first try when she came off the pill - maybe your first try after the treatment will be similar?
Well, I have a friend who has PCOS who hasn't been able to have a child despite years of trying and many different drugs; how do you know I won't be just like her?
 

Easter Egg?

Cycle number: 10

Cycle day: 32

Meds: No change

Outlook: Intrigued

So I went for my appointment today...saw a very lovely doctor. The most excellent news is the cyst has gone! And the strange news is my lining was very thick - to the point that she even suggested early pregnancy - and I had what she thought might be a corpus luteum on the right. And in an odd twist of fate, I did actually have a few little twinges on the right last night, so I'm wondering if it's possible I did ovulate (none of the usual signs that it's happened yet though..)

They did a pregnancy test there which was negative (surprise!) and she asked me to do another one tomorrow - but obviously if I did O, and by some miracle get preggo, it wouldn't show up until at least a week's time. Either way, I got a script for Pro.vera, so I can take that if it ends up looking like I didn't ovulate. Now I'm not sure how long to wait...

I also picked up my Meno.pur and trigger. The Meno.pur looks so weird, I didn't realise it actually comes as a powder which you then have to mix! No sign of whatever I use to inject it with so I assume I will get that when I go in for my first dose. 

I'm feeling a lot more positive about this next cycle, pleased to be free of the cyst and excited to see how well the injects work =D I would be interested to hear anyone else's experience on Meno.pur....