I haven't posted in a while because it's "break time" but something strange happened, and I felt the need to get an answer and share what I learned...
For the second month in a row I had "ovulation spotting" - mid-cycle bleeding to some of you. In the general sequence of cycle events, it was exactly the same both months, but after two years of steady charting, it came as a surprise. I know about the prevailing theory circulating online that it comes from the actual follicle rupture - but that theory just wasn't working for me because of the timing and because of my gummed up tubes. How would such a tiny amount of blood manage to get out through my cervix if larger quantities of fluids under pressure can't get in or out (sperm, imaging fluid from diagnostic tests, the much larger amount of blood that was found in my abdomen when my cyst ruptured two years ago). So I turned to my friend Pubmed and, eventually, found my answer:
259 women contributed data from 470 cycles to this study of menstrual bleeding patterns, and very few experienced mid-cycle bleeding. It was actually only 12 women, and for 11 of them it only happened on one of the two cycles recorded. So the chance of it happening twice in a row is roughly 0.4%. Lucky me, but still way more likely than winning the lotto.
They also took regular hormone levels from the women, and compared the hormone profiles of the spotters and non-spotters. I love numbers, so this was like candy to me, and I know it's hard to make a good prediction on the basis of only 12 women. But the data suggests that mid-cycle bleeding, what we call "ovulation spotting", coincides with higher estradiol levels, higher lutenizing hormone spikes, and higher progesterone levels. They aren't big differences though, and looking at the levels, it's nothing compared to the levels reached during ovarian hyper stimulation (40x higher). Just a subtle increase. But it also supports the lesser discussed theory I found during my googling, that it's a bit of leakage from a slightly enhanced uterine lining when the cervix opens up in the days leading up to ovulation. Some have taken this to mean "stronger ovulation" - I'm not sure that is completely accurate, or at the very least meaningful. Heightened estradiol may or may not reflect egg quality, and I don't know that a higher lutenizing hormone spike makes a difference, it's a threshold thing, and the increased progesterone doesn't look high enough to suggest multiple follicles or anything helpful.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3299419
Unfortunately I can't link directly to the figures, but click on the link, go to figure 3, and you'll see.
So that basically brings me back where so many websites started me off - it happens, but it may not mean anything when and if it does. But it's nice to know.
Happy ovulating ladies!
Wednesday, 18 June 2014
Friday, 25 April 2014
When everything comes crumbling down...
If you've read my blog you know that entering into the IVF world wasn't easy. So having it fail not once, but twice now... let's just say devastation is an understatement. After the first failed cycle, I cried for a while and then focused my energy on whether there was any hope of a second cycle being more successful (there is always hope for a second cycle). I obsessed about it while I waited for our follow-up appointment, and my doctor confirmed my worst fear but at least she had a plan. And that plan was effective, just not enough. But I do have one lonely blastocyst, and I'm not rushing into transferring it. In fact I'm terrified that it will fail too. It's my last shot, but worse than that, is the knowledge that it really is the very last one, that there will not be any siblings even if it does work, GAME OVER.
So now I cry a lot. And get angry and bitter. And cry some more. I can't watch television - every damn show has babies or pregnancies or actresses that either look like they're concealing a pregnancy or maybe it's all in my head... I can't go on any social media either, it's the same thing, babies everywhere. Friends. Celebrities. Women I know are older than I am. This started as "just" blocked tubes and I thought easy-peasy. But no, egg quality issues too, I'm past my best-before-date, and we've tried all we can to get a viable embryo. On average, a 40 year old has 1 good egg for every 10. I've retrieved 27 eggs in total now, and only three made it to blastocyst stage, and two have already failed. 1 in 27 is pretty shit odds. I might as well be 40!
So yes, I'm angry and bitter and hate everyone with their effortless pregnancies. I also feel so powerless. So lost. So sad. The why not me thoughts just lead back to anger again. And more tears. And running out of tissues. And runny nose - where is the GD kleenex!
It has been nearly two weeks. Two weeks that I could only cry about it, I couldn't even write about it. I still don't know what to say about it. What to do with all these emotions, all this anger and sadness. I try to find ways to pass the time, but it confronts me all the time. And I want to scream. Two weeks ago, while I was actively bleeding and fearing the worst, I was also getting the annoying questions from family about if we will have another baby, and oh, I thought you wanted more, blah blah go fuck yourself... all I could say was that sometimes it doesn't work out that way. I wanted to say more. I wanted to say the first one broke me, caused permanent scarring, and we've exhausted our treatment options. I want to tell the world, but I can't. Because all I can do is cry. For five years I've wanted to have another baby. For two years I've thrown everything at it, and failed. FAILED. It isn't the first time I've encountered a challenge that no matter what I do, I just can't achieve my goal. And it hurts. It hurts to put so much effort into anything and fail. It hurts even more to see others achieve your goal effortlessly. And there is nothing you can do about it.
So now I cry a lot. And get angry and bitter. And cry some more. I can't watch television - every damn show has babies or pregnancies or actresses that either look like they're concealing a pregnancy or maybe it's all in my head... I can't go on any social media either, it's the same thing, babies everywhere. Friends. Celebrities. Women I know are older than I am. This started as "just" blocked tubes and I thought easy-peasy. But no, egg quality issues too, I'm past my best-before-date, and we've tried all we can to get a viable embryo. On average, a 40 year old has 1 good egg for every 10. I've retrieved 27 eggs in total now, and only three made it to blastocyst stage, and two have already failed. 1 in 27 is pretty shit odds. I might as well be 40!
So yes, I'm angry and bitter and hate everyone with their effortless pregnancies. I also feel so powerless. So lost. So sad. The why not me thoughts just lead back to anger again. And more tears. And running out of tissues. And runny nose - where is the GD kleenex!
It has been nearly two weeks. Two weeks that I could only cry about it, I couldn't even write about it. I still don't know what to say about it. What to do with all these emotions, all this anger and sadness. I try to find ways to pass the time, but it confronts me all the time. And I want to scream. Two weeks ago, while I was actively bleeding and fearing the worst, I was also getting the annoying questions from family about if we will have another baby, and oh, I thought you wanted more, blah blah go fuck yourself... all I could say was that sometimes it doesn't work out that way. I wanted to say more. I wanted to say the first one broke me, caused permanent scarring, and we've exhausted our treatment options. I want to tell the world, but I can't. Because all I can do is cry. For five years I've wanted to have another baby. For two years I've thrown everything at it, and failed. FAILED. It isn't the first time I've encountered a challenge that no matter what I do, I just can't achieve my goal. And it hurts. It hurts to put so much effort into anything and fail. It hurts even more to see others achieve your goal effortlessly. And there is nothing you can do about it.
Monday, 7 April 2014
A day by day guide to IVF - After retrieval
Before retrieval, you started to slow down, you felt heavier and more bloated and you just wanted to sit. Tip - pregnancy will be much the same, times 10.
After retrieval ladies feel various things. Some were overstimulated and are really swollen and watching for OHSS. I felt pretty good, although taking it easy, resting, but not bed-rest, were in order for the first 24 hours. Then it slowly started to improve.
Day 2 - feeling better, but taking it easy. I spent most of the day with my feet up, but got up and moved around about every hour. Drinking water and gatorade constantly and then having to pee all the time helps with that.
Day 3 - felt even better, but should have taken it easy. I spent a little too much time on my feet, so I was extra tired and a little sore, but nothing a good rest and tylenol couldn't fix.
Day 4 - feeling almost back to normal, with one exception - accidental twisting. this is the point at which I have to be careful when sitting up, rolling over, or accidentally reaching across my body for something. I don't know exactly what's going on inside, but it feels like the swelling went down leaving my ovaries unsupported all of a sudden. So no sudden moves. I have to remember that... Also, progesterone is really kicking in, and symptoms are fatigue and boobs feel bigger (but not sore). Luckily my embryos are still safely tucked in the lab, so I have no illusions of "pregnancy symptoms"
Day 5 - transfer day is an exciting day, and since the news was good this time, it was psychologically a feel very good day. Physically, it's still a "no sudden moves" and progesterone-fuelled (which is a misnomer, because what I lack is fuel) day. I can barely stay awake long enough to take my 10pm dose.
Day 6 - 8 - more of the same. On the bright side, if you can call it that, my daily test strips are stark white now, so now I just have to keep peeing until the strip turns pink again. All the cramping is on both ovaries, no where else. Despite not watching what I eat for the past week (and on activity restrictions), my weight is remarkably stable.
Day 9 - Woke up at 5am for unknown reasons, and was ready for a nap at noon. This was a problem as I had a lot of work to do, all of which involved sitting quietly, reading, and writing. Not the best day. On top of the extreme fatigue I had a heavy feeling in my uterus, and my first ever charley horse!
Day 10 - Also woke up at 5am, but managed to fall back asleep so the day wasn't as bad as yesterday. Heavy feeling, cramps continue. I'm pretty sure that on my first (failed) cycle that I was feeling "better" by now, not worse, so this fills me with optimism.
Day 11 - Woke up at 4am! Headache since 10pm last night. Tried to nap at 11am, but no luck.
Day 12 - Feeling like my ovaries have healed. Pretty sure I felt this way on day 9 during the first cycle, so that's my estimate 9+ days for ovaries to heal. Obviously it will depend on how stimulated you were (I retrieved 13 and 14 on my two cycles), and if the cycle is successful, the hcg from pregnancy will complicate matters.
Day 13 - 14 - Despite progesterone, I always start bleeding. I asked my nurse about it - it doesn't mean it isn't working, some women's bodies don't need the progesterone drop to begin. As if progesterone suppositories weren't gross enough... My clinic schedules a blood pregnancy test on day 18, but I always call when I start bleeding to put myself out of my misery (ok, so it is misery either way, but at least I can stop the progesterone). A home pregnancy test is likely to be accurate by this point, but my my estimates as many as 10% will still be false negatives - keep hope alive, ladies!
After retrieval ladies feel various things. Some were overstimulated and are really swollen and watching for OHSS. I felt pretty good, although taking it easy, resting, but not bed-rest, were in order for the first 24 hours. Then it slowly started to improve.
Day 2 - feeling better, but taking it easy. I spent most of the day with my feet up, but got up and moved around about every hour. Drinking water and gatorade constantly and then having to pee all the time helps with that.
Day 3 - felt even better, but should have taken it easy. I spent a little too much time on my feet, so I was extra tired and a little sore, but nothing a good rest and tylenol couldn't fix.
Day 4 - feeling almost back to normal, with one exception - accidental twisting. this is the point at which I have to be careful when sitting up, rolling over, or accidentally reaching across my body for something. I don't know exactly what's going on inside, but it feels like the swelling went down leaving my ovaries unsupported all of a sudden. So no sudden moves. I have to remember that... Also, progesterone is really kicking in, and symptoms are fatigue and boobs feel bigger (but not sore). Luckily my embryos are still safely tucked in the lab, so I have no illusions of "pregnancy symptoms"
Day 5 - transfer day is an exciting day, and since the news was good this time, it was psychologically a feel very good day. Physically, it's still a "no sudden moves" and progesterone-fuelled (which is a misnomer, because what I lack is fuel) day. I can barely stay awake long enough to take my 10pm dose.
Day 6 - 8 - more of the same. On the bright side, if you can call it that, my daily test strips are stark white now, so now I just have to keep peeing until the strip turns pink again. All the cramping is on both ovaries, no where else. Despite not watching what I eat for the past week (and on activity restrictions), my weight is remarkably stable.
Day 9 - Woke up at 5am for unknown reasons, and was ready for a nap at noon. This was a problem as I had a lot of work to do, all of which involved sitting quietly, reading, and writing. Not the best day. On top of the extreme fatigue I had a heavy feeling in my uterus, and my first ever charley horse!
Day 10 - Also woke up at 5am, but managed to fall back asleep so the day wasn't as bad as yesterday. Heavy feeling, cramps continue. I'm pretty sure that on my first (failed) cycle that I was feeling "better" by now, not worse, so this fills me with optimism.
Day 11 - Woke up at 4am! Headache since 10pm last night. Tried to nap at 11am, but no luck.
Day 12 - Feeling like my ovaries have healed. Pretty sure I felt this way on day 9 during the first cycle, so that's my estimate 9+ days for ovaries to heal. Obviously it will depend on how stimulated you were (I retrieved 13 and 14 on my two cycles), and if the cycle is successful, the hcg from pregnancy will complicate matters.
Day 13 - 14 - Despite progesterone, I always start bleeding. I asked my nurse about it - it doesn't mean it isn't working, some women's bodies don't need the progesterone drop to begin. As if progesterone suppositories weren't gross enough... My clinic schedules a blood pregnancy test on day 18, but I always call when I start bleeding to put myself out of my misery (ok, so it is misery either way, but at least I can stop the progesterone). A home pregnancy test is likely to be accurate by this point, but my my estimates as many as 10% will still be false negatives - keep hope alive, ladies!
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