Answers in Athens - Hysteroscopy

Hubby went and enjoyed the huge buffet breakfast and I collected a lunch box from the hotel reception for after my op. We jumped in a taxi and arrived nice and early at the hospital. Hubby took his book because he had to stay in the waiting area for the whole time.

I was taken to a private room and told to undress and given a gown. After about half an hour they took me down to the theatre in a wheelchair and I was put in a cubical opposite a women who was asleep recovering from her op! I had a drip put in my arm which hurt and then I waited for about half an hour. In that time I met the anesthetist and the surgeon and lots of nurses. I started getting really nervous - not only because I was about to have an op but because it was in a foreign country!
I was walked through to the operating table and my legs were strapped into stirrups and my arms strapped down out stretched. Then I saw the anesthetist go to inject something for the second time into my drip and I said am I going to sleep now and she said yes. As usual I kept my eyes open for as long as I could so I know I'm not pretending to be asleep. Just before I was out for the count I felt my breathing go funny and I think I made them all jump because I started coughing - I think I remember someone saying 'just relax'.

Next thing I know I'm in the cubicle where I was watching the other lady sleep and someone else is opposite watching me! I was shaking like a leaf and my tummy felt a bit crampy but I was fine. The surgeon came to see me and he said he removed a small fibroid and he scraped the lining of the womb. I expected him to say more but apparently that was it!

Eventually I was taken back upstairs to the private room where they left me for another half an hour and then they asked if I felt ready to get up. At last I could have something to eat and drink, and I was grateful to the hotel for some orange juice and a cookie that I managed to have before getting dressed. I had started to worry about Hubby because he must have been waiting for a while and when I saw him I asked him the time and it was after 3pm - I couldn't believe it as we had arrived at the hospital at 10.30am! He had finished his book and was bored but more importantly he was worried about me! We paid our hospital bill and we were given a DVD of the op to take back to the FS.

We got a taxi back to the clinic where the FS watched the DVD and discussed it with us:

The uterus is filled with water so that the surgeon can see everything. You will see bubbles and things floating around! My uterus is a very light pink which is nice and healthy and it doesn't look like there is any infection.

The first 20 seconds is the camera travelling through the cervix and into the uterus.
At 28 seconds you briefly see the camera focus on the right opening to a fallopian tube.
At 30 seconds the camera focuses on a white lump, this is the fibroid.
At 40 seconds the camera focuses on the left opening to a fallopian tube.
At 55 seconds the surgeon starts the cutting along the wall of the uterus making implantation cuts. These cuts are at the top of the uterus called the fundus and is the best place for embryos to implant.
At 2 minutes the surgeon focuses on the fibroid and starts cutting around it. The fibroid becomes more obvious. It is hard, round and white.
At 3:50 there is a small bleed.
At 4:15 the surgeon thinks he has cut around the fibroid enough and use a grabbing instrument to try and pull it out.
At 5:15 the cutting instrument goes back in.
At 7:17 there is a slight bleed.
At 7:37 the grabbing tool goes back in and keeps trying to pull the fibroid out.
At 8:10 there is a slight bleed.
At 8:30 the cutting tool starts again.
At 9:30 the grabbing tool goes back in and keeps trying to pull the fibroid out.
At 10:34 the surgeon decides to stop trying to pull it out and start the light scraping of the womb lining which will get rid of the fluffy, floaty stuff and scrape out the fibroid - although we don't see this as there is bleeding and so it can't be filmed.

The FS believes that it has been so difficult for us to get pregnant because of the position of the fibroid, and that it could possibly have been the cause of the first two miscarriages and if the last pregnancy had continued it could have caused another loss. She believes that now that it is gone and I have implantation cuts, and with Hubby's super sperm, we have a very good chance of getting pregnant naturally.
She suggested that I take femara which is like clomid but won't affect the womb lining as much as clomid can. The femara could help me grow an egg on both ovaries so that our chances are not reduced by my blocked left tube.

Hubby and I are very happy with all this. Although we are impatient to have a baby, we believe that getting pregnant naturally is what was meant for us and so we're going to give ourselves up to 6 months to try.

Answers in Athens - Sperm Analysis & DNA Fragmentation

Hubby's Semen Analysis results:

• Number of Spermatozoa / ml 58,000,000 (according to the World Health Organisation WHO, normal is anything over 15,000,000)

• Total Sperm Number 203,000,000 (normal is anything over 40,000,000)

• Motility 60% (normal is anything over 50%)

• Morphology 20% (normal is anything over 4%)

Hubby's Sperm DNA Fragmentation results:

Fragmentation (%) of Total sperm:

• High fragmentation 7% (normal is anything less than 15%)

• Total fragmentation 10% (normal is anything less than 30%)

Fragmentation (%) of Motile sperm:

• High fragmentation 3% (normal is anything less than 15%)

• Total fragmentation 4% (normal is anything less than 30%)

The sperm sample that Hubby produced was frozen in two vials by the clinic so that if we wanted to do IVF in the future at the clinic and Hubby couldn't get the time off work, he wouldn't actually need to be there as they can use the frozen sperm.

Answers in Athens - the plan!

So our plan of action after our last cycle was to further investigate possible reasons for the failures. So after much research online and advice from some 'real life' friends, we decided to pay for a private hysteroscopy and  some other tests.

We didn't tell anyone of our plan apart from my work as I needed two days off but even then I just said I was having a private operation hence the short notice. It was in fact all down to the timing of my period - you need to have the op after your period but before ovulation so that your lining is thin and the surgeon can see the uterus clearly. Hubby had three days off work and my period had finished and so we put the plan into action.

We got up at 2:30am on Thursday 24th May and drove down to Heathrow where we had pre-booked the long-stay carpark. We got a bus straight away to Terminal 5 which was less than 10minutes away. We checked in on the computers around the terminal and waited about 20 minutes for the bag-drop desks to open at 5:00am - we were first in line!

We passed through security with no problems and went to get some breakfast. We had just finished eating and decided to go to the gate when Hubby saw a pilot he knew so we wandered over to him for a chat. We discovered that he was the pilot taking us to Athens and he got us upgraded to business class! We had a great start to our trip and it continued!

Arriving in Athens we collected our luggage and easily found our way to the Metro and into town. Hubby got his map out and managed to direct us to the clinic pretty easily! At the clinic we ended up waiting for quite a while until they apologised and said they were running behind and did we want to go get a coffee and come back in an hour. We decided to go and check-in to our hotel and get changed as it was very hot.

Our hotel and the staff were very nice and they gave us a large room on a floor near the top were the views were amazing. The airconditioning was a Godsend, the buffet breakfast had a great choice, and the roof top bar and pool were a great place to have a drink and relax!

Back at the clinic we didn't wait too long and we met the lady who was to give us fresh hope and positivity! She went through our history and suggested that my periods that were now only two days long and quite light, were not normal and that I could have scar tissue in the uterus. Also the fact that I have raised Natural Killer Cells could indicate an infection in the uterus. She said that the fact that I have been pregnant three time naturally means that the sperm is probably ok but the environment isn't right for the embryos to implant in. We agreed that it was probably best that I had a hysteroscopy and that Hubby had a semen anaylsis and sperm DNA fragmentation test just in case there is an issue with the sperm.

She performed an normal scan on me to just take a look at things and we noted four important things:

On Day 5 my womb lining should not be as thick as it was - 10mm:

There was an area of the uterus showing up as a white, thickened area on the screen which was probably some scar tissue:

My left ovary has a large 'chocolate cyst' (an endometriosis cyst filled with blood) that is impairing the ovary function but I did have two possible follicles already on the left:

My right ovary was perfect and had four follicles all about the same size on it:

This lead her to believe that I still had a chance to conceive naturally if any problems in the uterus could be sorted.

Hubby was shown to the 'play room' so that he could give a sample to be analysed. We later found out the results of this and they were excellent and Hubby was soooooo happy and proud!

The next step was to got to the hospital and get the pre-op tests done ready for tomorrow (by now it was 7pm). Hubby was not allowed to come with me and had to stay in the waiting area. I was shown to a private room and the nurse asked lots of medical questions, got me to give a urine sample and then got the stuff ready to take a blood sample. I nearly fainted at the size of the needle she used and the amount of blood she took. Instead of saying 'sharp scratch' as a warning like here in the UK, she said 'deep breath' and quickly plunged the large needle in! But there was worse to come. Next she wanted to do an ECG and with me lying on the bed she said 'sorry' and proceeded to hoist up my top and bra onto my chest and douse me with water so these sucker pad things would stick to me. She had to do it 4 times because apparently I was not staying still enough and making the monitor jump around.

Hubby and I were back to the hotel and in the roof top restaurant by 9pm ready to eat our first meal since the breakfast on the plane. I had to make sure I'd finished by 10pm ready to fast until after the op the next morning! We had a good talk about everything we had been through during the day and we felt happy with what we were doing and what we had been told.

BFN

Big. Fat. Negative.

Devastated!

IVF #5 2WW - Keeping the Dream Alive!

Today I am 8days past 5day transfer or 13DPO. The 2WW is almost over and the wobbles have started.

Time has been going relatively fast and I've been very positive and upbeat but as soon as I hit 11DPO I knew that I normally would consider testing from that day onwards and would get a definitive result! So with each day that passes I know that a test would give me a true outcome by now. It has started to stress me a bit and my positivity waivers.

If I tested now I could end the stress but if it is negative then the dream is over and I'll have to face such tremendous heartache and sadness. Obviously if it was positive then it would shear elation but I would still have an agonising wait until my 6week scan. So in fact the longer I wait the better - I keep the dream alive and I get nearer to 6 weeks.

Official test day is Wednesday when I am 16DPO or 11days past 5 day transfer. We are still planning on going into the clinic for them to tell me the result. This is actually the positive part of me because I'm seeing it as an opportunity to book my scan date when they tell me it is positive! I've pictured every nurse at the clinic walking into the room with the good news - I've been going there for treatment for over 2 years now so I know all their faces!

I've had no symptoms but many ladies don't have any so it's difficult to know what to think. I'm on steroids and they can mask some symptoms. I've been sleeping badly but haven't really had many night sweats which I've had when pregnant before. So for now I'll have to wait a few more days and try to remain positive!

Transfer is a go!

I had another restless sleep last night trying to maintain my positivity and trying to stop my mind running through all the possible scenarios that the trip to the clinic would bring.

We arrived at the clinic at 8am on the dot. I almost told Hubby to leave the bag with my slippers, nightie and dressing gown in the car, because I thought it would be too embarrassing carrying it out when we had to leave in front of other couples if there was going to be no transfer. Luckily no one else was there and as soon as we arrived a nurse told us to come through. I explained that we needed to talk to an embryologist as a transfer might not be going ahead and she went to check. Next thing she said that they still want me to come through to cubicles and then she put my patient wrist band on.
At this point I said to Hubby that they better hadn't be getting our hopes up for nothing getting me all ready like this!

Soon the embryologist came to talk to us and she had good news! Our 9 cell embryo had developed and was showing signs of compacting and becoming a morula. It wasn't a blastocyst yet but was about one and half stages away from that. But at this point it was only very early on day 5 that we were having the transfer and so the embryo may have developed even more if we'd had an afternoon transfer. Today was the best day to put it back into me because in a natural cycle it would have reached the woman's womb today.
The other news was that the 5 cell had started to die and so that would be discarded but the 6 cell was looking 'different' so they weren't sure if that may continue developing. We decided to put the 6 cell back as well as the developing morula.

I was given temazepam to help me relax and Hubby massaged my shoulders and I just lay back and smiled - I was happy so it wasn't hard! The actual transfer itself went really well. The embryologist, the nurse performing the transfer and the nurse helping were all really lovely! The were helping me relax, checking I was ok and explaining every step.

Afterwards I relaxed for 30 minutes and then the nurse showed us how to do the gestone injections and she did it really well and it wasn't as painful as I'd expected! These injections are done every other day (as well as the bum bullets everyday) and are extra help to maintain my womb lining. The other thing I started today was the steroids to help fight my Uterine Natural Killer Cells.

The nurse actually hugged me on the way out and said she really hoped that this was it for us and if we needed any help with injections to pop in and see her! We were really touched and so grateful!

So I'm tired but very happy and hopeful. Roll on the 16th May - test day!!!

To transfer or not?

So we got the call about 3.30pm and I knew straight away things weren't good when the embryologist started saying "ideally, today we like to see the cells compacting so you can't really count them".

Our embryos on Day 4 are 1@5 1@6 1@9cells. The 9 cell one would have been ok if the cells had started to compact but they haven't yet. Also they are all still graded -3.

So it's not the good news we were hoping for but there is a glimmer of hope. We are to go into the clinic for 8am tomorrow and speak to an embryologist to see if there has been any development over night, and decide if we want to transfer any of them.

At this point we have decided that if any of them have moved on we might transfer them even if they are behind.

Two days Old

So the embryos are two days old today and ideally they should be 4 cells by now.

We got the call at 3.30pm when we were with guests so poor hubby had to wait another hour before we could have a discussion. All three have developed and 2 are now 4 cells and 1 is now 5 cells. I was really happy about this until the embryologist explained that they all have fragmentation and are grade -3 which is below average. This left me with mixed feelings because it is great that they have all developed but it is worrying that they are poor quality. After all the supplements I've been taking I'm gutted, I was really hoping we had quality over quantity this time.

I have looked back at the results from our last two IVF cycles at this stage:

IVF #3: We had 4 @4 cell and 2 @3 cell. 2 were grade 2 which is good, and 4 were grade 3 which is average. So slightly better than this current cycle.


IVF #4: One embie managed to divide to the four cell stage but there is lots of fragmentation, and the other tried to divide, managed to but one cell burst it's membrane. They were both graded -3. So slightly worse than this current cycle.

Now although cycle #3 didn't make it to a positive end result, it was a much more positive cycle. We had 6 fertilised embryos and by day 4 we had 3 embryos making it to the compaction stage (which is the stage where they either 'switch on' genetically or don't make it) and 1 embryo had almost finished this stage and the other 2 are a bit behind. This gives me some hope because at least one of the average embryos made it to compaction at least.


IVF #4 was a more negative cycle with only two eggs fertilising and one hardly developed into an embryo and the other stopped developing by Day 3.

So this cycle, IVF #5 seems to be a mix of the two. I'm feeling more positive than negative though which is a good thing! No more information until Friday afternoon now when they next look at them - everything crossed!

Waiting for the Fertilisation Report

Even though I was really groggy and tired after yesterday, I couldn't sleep. So many things were swimming around in my mind, such as were the three eggs all viable, how many will fertilise, and what will we do if this is the end of cycle 5!

In the morning while waiting for the call, I nearly drove myself mad playing out telephone conversations with the embryologist in my mind:

"Hello this is the embryologist, I've good news! Did they tell you how many eggs you got yesterday? Yes that's correct, three, and all three/two/one/none (delete as appropriate) have fertilised!"

or

"Hello this is the embryologist, great news - all your eggs have fertilised and split into many so you have loads!"

The actual call came around 10.30am and as soon as I answered, I found myself listening to the inflections in the embryologists voice, to see if that would give me a clue as to whether what she was about to say was good or not, I guessed not. I was wrong! We did get three viable eggs and all three have fertilised!!!!!!!!!!!!!!!!!

The embryologist said that she understands that we have strong views on what we want to do with our embryo's and I agreed and said that yes, we do and we would be wanting to take them to Day5 again and we understand the risks. We had a conversation about why we wanted to do this and she explained the alternatives. She is going to phone tomorrow about 3pm to tell us how they are doing. Fingers crossed and positive thoughts!