Green Light

The past few weeks have been extremely difficult. I don’t know whether it’s the cumulative effect of so many problems and delays, or the fact that baby May would have been due on Tuesday, but having to take three whole months off treatment hit me hard and I’ve been feeling close to breaking point.

The good news is I don’t have to take three months of treatment. It just took a little creative thinking and compromise. So what’s been happening while I haven’t been writing?

  • I decided against egg sharing at the private clinic for now. It may seem to make more sense financially, but it just doesn’t feel right. Thinking about it, we wouldn’t really have any less red tape as egg sharers, because we’d be dependent on another couple having IVF at the same time as us and paying for our treatment. I want to stick with our current clinic where the staff are all really lovely (important when they’re shoving catheters in your cervix and taking you on an emotional rollercoaster) – and, as OH noted on her blog, I’m not 100% comfortable with the idea of embryos being created and then thrown away or never used.
  • Nonetheless, we discovered the private clinic are reading our minds (or at least my blog) when they sent me a letter out of the blue offering us a free consultation. We’ve decided to take them up on it, as we haven’t ruled out the option of using them in future, especially if it turns out I need IVF. We might as well ask them all our questions and see whether their staff are lovely too… I didn’t get a great vibe last time, but that might have been because I was new to the idea of treatment and terrified.
  • I saw my whole family the other weekend (a rare occurrence, as we’re scattered all across England, Wales and Scotland) and told my grandparents, uncles and aunt about fertility treatment and my miscarriage. It’s now completely out in the open, which is a relief. Everyone was lovely and seemed pleased for me. I know my aunt struggled with the concept a bit – she isn’t entirely comfortable with the idea of same-sex relationships – but she was very understanding of how difficult it must have been for me to lose a baby while my sister was pregnant, as she’s been unable to have children herself. I’m so glad I had that conversation.
  • OH and I chose our new sperm donor! It’s weird… we have so little information on him, and he comes (no pun intended) with a long number instead of a comedy pseudonym. However, he has similar colouring to OH, which was our main criterion.
  • While we were at the clinic, we explained our predicament about our holiday in June and needing to wait so long for treatment. It turns out their lab is actually closed for maintenance for three weeks in June anyway, coinciding almost exactly with our holiday! That makes me feel a little better about going away. Unfortunately, there was nothing they could do to bring our appointment with the consultant forward, but they booked us in for a practical appointment with the nurses, where we learn all about the protocol and injections. They said we could go straight into superovulation from that appointment, if we didn’t have any questions the nurse couldn’t answer, but that they wouldn’t necessarily recommend it… and after we’d left, I realised that my period was likely to come too early even for that.

And then I had my epiphany. On Sunday. During evensong, when I was failing to pay attention to the sermon.

What if I had another IUI without drugs this month? Now that our new donor’s been sorted, I don’t need any extra appointments for that. Granted, the success rates aren’t brilliant, but that’s kind of the point – superovulation only increases them a little bit, and with odds that low, you have to keep trying as often as you can. The months with treatment are stressful but the limbo in between, the knowing my finite little eggs aren’t even getting the chance to meet some sperm, are worse. I need to keep up that sense of momentum.

So it was with much trepidation that I phoned the fertility clinic yesterday. I didn’t think they could really say no, but… well, actually, I’m not entirely sure what I was scared of, but as OH will confirm, I was terrified. Luckily, when they got back to us today, the nurse was very much on the same page as me. Yes, I can have a fourth natural cycle, and yes, we can still attend our appointments with the consultant and nurse in the mean time so everything will be lined up for superovulation if we need it. Finally, it seems we’ve all found a way to get around the red tape. As the icing on the cake, my period came today rather than on Saturday, which means there’s less chance of me ovulating on a weekend when (a) the lab is closed and (b) I’m supposed to be at a conference.

To me, this is all wonderful news. To OH, it’s more of a mixed bag. She loved my IVF idea, was gutted when I changed my mind, and the prospect of more IUI – of any kind – doesn’t exactly fill her with enthusiasm. I feel horrible about that, but OH has always made it clear that since it’s my body, she wants me to make the treatment decisions and she will support me whatever. I’m so very lucky to have such an understanding and loving partner.

Egg Sharing Revisited

This week we got some bad news and some bittersweet news from the fertility clinic. The bad news is that the appointment we need before we can start superovulation isn’t until 14 May. I suspected it might take that long – when my miscarriage finally resolved, they also expected us to wait over a month to find out what the doctors made of it all and what the next steps would be – but it’s a bitter disappointment. It means that not only do we get no treatment this month, it will be too late for May as well, and because we’re on holiday in June, that takes us to July. I’m so frustrated, especially when I compare our experience to that of couples treated in private clinics. I sometimes feel that as private patients in an NHS hospital, we get the worst of both worlds – financial costs and NHS bureaucracy. (Although on the plus side, some aspects of our treatment, such as investigations, are free. And OH will disagree, but how I wish we hadn’t booked that holiday!)

The bittersweet news is that we’ve definitely reached the top of their sperm waiting list. At first, I was really pleased about this. In fact, it’s something I’ve been counting on – there is simply no room in our budget to go on paying for sperm, and we need the 75% refund of our ‘pregnancy slot’ too. (This is a fee charged by the sperm bank to customers in countries such as the UK where only a certain number of women are allowed to use the same donor; it’s mostly refundable if there’s no viable pregnancy.) But I’ll be sad to say goodbye to Fritz. In part, this is because we selected him so carefully for his physical resemblance to OH, whereas now we’ll only get a choice of two or three donors. And mostly it’s because he’s the biological father of our baby May. I didn’t expect that to matter to me, but it does. He and I and OH are linked now, and I wish baby May could have a full sibling here on earth.

I was thinking about all of this in bed last night, and it occurred to me that there is another way. When OH and I first looked into becoming parents, we made a choice: we opted for the less invasive protocol of the NHS clinic rather than use egg sharing – donating half of my eggs – to fund IVF in a neighbouring town. At the time, we believed the costs were similar, so it was a toss-up between the higher success rates of IVF on the one hand, and the invasiveness of treatment and inconvenience of travelling on the other. I was terrified of egg collection – in fact, back then I even took diazepam for transvaginal ultrasounds (hard to imagine now!) – so we decided to stay local. But now, my feelings have totally changed. I’m far less scared of medical procedures, and far less willing to go through yet more treatments that have a low chance of success. Superovulation will boost our chances a little, but IVF would boost it a lot. Add in the facts that it now looks as though egg sharing would be substantially cheaper than superovulation, we’ve realised that driving to the private clinic wouldn’t take much longer than getting the bus into the city centre, and we’d still be able to use Fritz – and you can see why we’re reconsidering our decision.

For me now, the downsides of egg sharing are different. The biggest hurdle would be for me to get accepted as a donor in the first place. Although one cycle of IVF as an egg sharer would cost only about a sixth of one cycle of IUI with superovulation, there’s an up-front consultation fee to pay, and further tests needed which I may or may not be able to persuade my GP to do on the NHS. If my hormone levels aren’t good enough, if they decide my depression is a problem, if they can’t find a couple to match us with or if we’re excluded for some other reason, we’ll have paid all that money and still have to find the funds for superovulation at our current clinic. Realistically, that would mean stopping after two more cycles of IUI – which would be devastating given that after three more failed cycles, we’d likely be eligible for IVF on the NHS – unless I can find some other way to make savings. (With all these budget cuts, I’m starting to feel like a Tory.) And of course, between investigations and the matching process, there is no way we’d be starting IVF before July either, so the lack of NHS red tape would only benefit us further down the line. Finally, there’s the unknown – to someone who finds comfort in familiarity, the idea of changing to a different clinic is very daunting. And how will I cope if my egg recipient gets pregnant and I don’t?

OH and I had a long discussion this morning and her preference would be egg sharing, with its lower costs and higher chance of success. However, she’s happy to leave the final decision with me and will fully support me either way. I need a lot more time to mull this over and pray about it, but I’d love to hear about other people’s relevant experiences – of IVF vs. IUI, of egg sharing, of private vs. NHS clinics, etc. What would you do if you were me?