IVF Questions

I promised On Fecund Thought that I would share our list of questions with her, so here they are! It’s proving to be quite a long list already and our appointment isn’t until 10 September.

  • How many fresh and/or frozen cycles will be funded by the NHS? How much do you charge for private IVF and FET?
  • Why do you think IUI hasn’t worked for me? What percentage of apparently fertile women using donor sperm will end up needing IVF?
  • Should we be concerned about the miscarriages, or are they just ‘one of those things’? Does the fact that I have been pregnant still increase my chances?
  • Is there an increased risk of miscarriage with IVF? I’m aware that IVF pregnancies are more likely to miscarry than natural ones, but I believe this is thought to be because infertile women are more likely to have miscarriages rather than because of the IVF itself – is that correct? Is there any chance that selecting the healthiest embryos will actually reduce my risk of an early miscarriage?
  • What do you think our chances of success are, and what can we do to maximise these? What is the likelihood of no viable pregnancy after several IVF cycles?
  • I’m concerned about my cervix making embryo transfer difficult and reducing our chances. How do you plan to address this? Do you do a mock transfer? Should I be concerned about my tilted uterus for any other reason?
  • What’s my AMH and antral follicle count? (I remember being told my AMH was fine, but I’m starting to worry about my age…)
  • Do I need any further investigations? If not, how soon can we start?
  • Is it safe for me to take a prenatal vitamin, magnesium and omega 3s? Are there any supplements you would or wouldn’t recommend?
  • Do you use the long protocol or the short protocol? I’m concerned about down-regulation – since I have a history of depression, would the short protocol be better?
  • How often would I need to come in for scans?
  • Do you use sedation or GA for egg collection, and can OH be in theatre with me?
  • Do you intend to use standard IVF or ICSI, or does it depend on the quality of the sperm once defrosted?
  • At what stage of development do you transfer the embryos, and do we get a choice in how many are transferred?
  • Is it OK for me to use the progesterone pessaries PR?
  • If a cycle is unsuccessful, how long are we likely to have to wait for a review appointment, and how long before we can try again?
  • If a cycle is cancelled, does it still ‘count’ as an NHS cycle? If a privately funded cycle is cancelled, what are the charges?
  • What are the contact details for your counselling service?
  • How much would it cost to store any remaining embryos for a sibling? Would it be feasible to use these embryos in OH?
  • Is it possible to donate any spare embryos to another couple?

I feel rather sorry for whichever doctor will be on the receiving end of these!

Advertisements

When Grief and Faith Collide

About a year ago, OH and I went back to the church where we were married for the first time. I forget the exact date, or where we were on our journey to conceive, but we were definitely making the arrangements. Perhaps we’d just had our first appointment with the consultant, or had booked that appointment, or maybe we were choosing our donor. It was an emotional experience to walk back down the aisle hand in hand and know that soon we would be starting a family.

During the service, a picture came into my head as if from nowhere. I was holding a baby boy in his christening gown. Well, I believed he was a boy, although you couldn’t tell from looking at him. He had blonde hair and blue eyes and a little eczema on his face, and he looked for all the world as if he belonged in OH’s family. I felt sure that this was my son. Had that vivid mental image come from God? Was it prophetic? At the time, I thought it might be. Now I’m not so sure.

So far I’ve resisted blogging about the impact my miscarriage and difficulties conceiving have had on my faith. I’m ashamed, I suppose, of not being a ‘better’ Christian who never doubts or rages or tries to bargain with God. And I don’t want to alienate my non-religious readers, who might not relate to any of this or may even think I’m completely off my trolley. But I feel compelled to speak out about the reality of pregnancy loss and fertility problems, and for me, wrestling with God is a huge part of it. This, then, is a post about what it’s like to be Christian and infertile, and above all a question: what do you do when you thought God was telling you something, but it doesn’t come to pass or no longer makes sense?

In the weeks leading up to our first treatment, I felt exceptionally close to God. I’m struggling to write this paragraph now because it’s painful to remember how happy I was, and because there’s more background than I can explain here. But basically I had trusted God through coming off my antidepressants in preparation for pregnancy, through mood swings and heightened anxiety and the resurfacing of old behaviours, and I remained well. I had trusted God in leaving my therapy group and in looking to Him to help me with my remaining issues. I asked him to teach me how to trust, to relinquish my need for control, to learn to cope with being let down, and I could see real progress after so many months of languishing in therapy. When I faced an issue, I would go somewhere quiet to pray and the answer, the best way forwards, would come to me. It was exciting and I really felt that God and I were on the same page, that we wanted the same things for my life.

When I thought I was having a very early miscarriage, it didn’t affect my faith. I was grieving, but as before in my life, I was able to draw comfort from God. On the Sunday I made an effort to go to church even though we were in another country. The priest introduced a baby to the congregation and I cried and they felt like healing tears. I thought the pregnancy was over, it was sad but very common, and we’d be able to try again soon.

But as the pregnancy dragged on, non-viable and incomprehensible, I begged and pleaded with God to stop torturing me. I didn’t normally ask for specific outcomes in my prayers, just the strength to cope, but surely these were special circumstances? Surely He would hear me and ease my suffering. Yet still, my hCG levels continued to rise too slowly. I stopped praying. I couldn’t even pray for others because I believed God didn’t listen, not to me. And church was torture. I remember having to look happy through my tears at Harvest Festival and singing, “Can we know that thou art near us / And will hear us? / Yea, we can!” I rewrote the last line in my head and it wasn’t pretty.

Slowly, slowly, I came through it. I asked others to pray for me and I prayed to the saints (even though I’m not Catholic). I learned about my condition, pregnancy of unknown location or PUL, and could make a little more sense of things. I read Jennifer Saake’s book Hannah’s Hope on infertility and miscarriage, which was extraordinarily helpful. I let go of what I wanted enough to ask God simply to help me cope, and I began to notice the good things that had come out of the situation: how I was letting OH comfort me (normally I try to be the strong one), how the loss of my baby was miraculously healing my relationship with my sister, how I was softening and becoming more tolerant towards others. And most strikingly, while I was still pregnant I had another vision of that baby boy. This time I could feel him in my arms, the caress of his flailing hands on my face.

Let’s fast-forward a little to our second cycle of IUI. By now I was back to my usual prayer routine, my relationship with God mostly healed, even though we had also suffered further setbacks: a delay in my referral for an HSG and a treatment cancelled when I ovulated too soon. But this time I was filled with hope. On my blog I hedged my bets, saying, “I’m sure God is telling me I will have a child – He just doesn’t say when or how.” That wasn’t entirely honest; it was how I had felt immediately after the cancelled cycle, but in fact I was becoming more and more convinced that this was The One. And I knew I might be being stupid, so I sat down and prayed about it. I let go of all my conviction that I would be having a child in November – that took a lot of courage – and for a moment I was empty and grey, but then I felt hope rushing in, yellow, like the sun. And I was certain it did not come from me.

So what do I make of it all, now that the second cycle hasn’t worked and the third not either?

I realise that I have been trying to control the uncontrollable by looking for signs and imagining I know what’s going to happen. After our second IUI, I raged at God for a bit but I soon relented and prayed for help. I asked Him to help me see the good things in my life, because I just couldn’t. Over the course of that day, they came to me – my OH, my career, my sense of humour, my beautiful niece, even the state of our finances (our budget is very tight because of fertility treatment, but we have enough to live off and won’t be too affected by the government cuts for now). I asked Him to show me the way forwards and I understand I had to just trust in His timing and not try to control the process. No more bargaining with God, no more lucky toilet cubicles in the fertility clinic, no more reading too much into the magpies near our house. That’s why I went into the third cycle of treatment with no expectations and why I was disappointed, not devastated, when I didn’t get pregnant. I still cried and I’m so fucking sick of crying and waiting but at least I’m not being torn apart.

The problem is that since then, I’ve been feeling more distant from God. I’m mostly not angry with Him, just dispassionate. I think one reason for this is that since I can’t control my fertility, I’m focusing on those things I can (mostly) control: our bank accounts and our house. And there’s nothing wrong with wanting to stick to a budget or declutter and decorate – in fact, we need to do both those things to prepare for a baby – but it’s all about me, not God. I’m relying on my own resources and setting my own goals precisely because I need to feel in control on this turbulent journey. The other reason is, how can I know what God wants me to do and what he’s telling me? Either that burst of sunshine hope didn’t come from Him, or I misinterpreted it. Was it my imagination, or was he saying there’s hope in the long run? And was the baby in the visions fictitious, or a child I’m going to have, or even (it has occurred to me) the child I’ve already lost? I can no longer trust messages that I think are from God and I can no longer trust my own interpretation, so how do I pray now?

I’m sure there are no easy answers to those questions, and I don’t expect answers. What I wanted to do with this post is simply reach out and share my experience. Maybe others out there have been or are going through something similar, and maybe we can help each other. I haven’t lost my faith and I haven’t lost my sanity (in fact, that’s something else amazing that came out of my miscarriage – not relapsing) but these are very challenging times and I don’t want to walk the journey alone any more.

HSG & A Look Back Over 2012

First things first: after what has seemed like a very long wait, I had my HSG on Friday. I was quite scared of the x-ray, both because of the slight possibility it might show I needed further investigations and/or IVF, and because I’ve heard some women find it excruciating when the dye goes in. I have very painful periods, and a bendy cervix that makes it difficult to insert a catheter, so I’d just about convinced myself I’d be in the “this is agony” category. I needn’t have worried! I warned the nurse about my cervix and she decided to try just holding the catheter against it, which didn’t hurt at all and resulted in about half of the contrast entering my uterus – enough to show that my tubes are absolutely normal. 🙂 As for the promised “period-like pains”, they barely registered. Admittedly I’d taken paracetamol, ibuprofen and diazepam before the procedure, but I was still pleasantly surprised by how quick and easy it was.

Knowing that everything’s normal, and that we can finally try to conceive again next month, has been a wonderful end to the year. 2013 feels like a new start and, although it may take a few attempts, there is no particular reason (statistically or medically) to think that I will not be able to achieve a viable pregnancy. There are no guarantees when it comes to fertility, but I know I am lucky compared to most IF bloggers. In the past few months I have been struck by the unfairness of my situation, that not only do we need to spend thousands of pounds on IUI and donor sperm, we also got hit by pregnancy loss, but that’s only one side of the story.

When I look back over 2012, too, I realise that apart from the miscarriage and the grief of the last four months, it’s been a very good year. This time 12 months ago, OH had just left her job in extremely difficult circumstances and we faced an uncertain future. We didn’t know how we were going to cover her share of the bills, never mind find extra funds for fertility treatment. However, 2012 turned out to be the year when our finances improved drastically thanks to an inheritance. It was the year OH could finally go back to uni to study museum and heritage management, something we never thought would be possible before. It was the year she found a good part-time job reasonably quickly despite the state of the economy and some issues with references. It was the year she landed an amazing placement, which is in such a niche area that I won’t mention it here to protect her privacy, but if you follow me on Facebook you’ll know. And of course it was the year that we were able to get started with fertility treatment after an 18-month wait, even though our first cycle of IUI didn’t have a good outcome.

For me, 2012 has been a year of growing much closer to my family and my in-laws. Again, I can’t go into too many details to protect my relatives’ privacy, but it has been a year of healing rifts and learning to look past imperfections (or even more major flaws) to see the good in people. It was the year I left my therapy group, and came off antidepressants, both with unexpectedly good results that have left me feeling far more empowered regarding my mental health. It was the year we got our wonderful cat Bertie (a local stray who rocked up during my miscarriage in need of some mothering!) and the year we had great fun taking part in a musical show at church. It has also been a year of wrestling with God, but I think on the whole, my faith is stronger than it was 12 months ago.

Bertie the cat

Our newest cat Bertie.

I have joked to a few friends that I have two New Year’s Resolutions for 2013: get pregnant and stay pregnant! Seriously, though, I hope 2013 will be a year that I can continue to develop my relationships with the people in my life and with God. I want to continue to work on reaching out to others and learning to trust them, and to keep up my daily meditations in one form or another. I also hope it will be a year of continuing good mental health without too much heartbreak, but I will have to take that as it comes. And I hope all my readers have an enjoyable and fulfilling 2013, with the strength to cope with whatever life throws at you.