Monday, 30 May 2011

You Can't Choose Your Family

Along our TTC journey I’ve shared little tit-bits about the up’s and down’s with the sister-in-law (SIL) situation, it hasn’t been pretty (that’s an understatement) and I tried not to write too much about it on my blog as the ‘situation’ clashed with the failure of our first ICSI cycle and throughout our second ICSI cycle so there was more than enough to deal with. Instead I’ve mentioned it on twitter and here on my blog but probably not enough detail to put you in the picture, one of my tweeps, @saleschick, suggested I blog about it, and I think the time is right.

I could write for hours, but I’ll try (!) to summarise, if you have any advice, I’m all ears.

My brother is my only sibling, we are (were) very close, he’s 5 years older but I guess I acted more like the older sister. We don’t live near each other but talked on the phone 2 or 3 times a week depending on what was going on.
I didn’t share much detail of our TTC journey with him over the years, just key milestones . . . when I had suspected endometriosis, being referred to our consultant and then I shared a bit more info as we approached our first ICSI cycle.  He met my SIL maybe 3 years ago now, they have an incredibly volatile relationship, always breaking up and then getting back together. In the first year or so my brother would ask me for advice ALL THE TIME, he wouldn’t go into much detail but I would give the female perspective and help him work out a way to move forward with her. As time went on, they became more serious, got engaged, it was all moving quite fast. We got to know my SIL more and more, a little difficult at times as they were forever falling out / breaking up and we would just have to pretend that everything was fine. OH and I would try to stay out of any awkward situations and as difficult as it was I would shy away from conversations my SIL would try to draw me in to moan about my brother. My SIL resented that my brother spoke to me quite so openly, so in the last year or so we talked less in general, and definitely less about ‘them’, this was much easier all round.

Anyway, after numerous break-ups they decide they want to get married, and quickly too as they found a venue with availability in 11 weeks (interesting logic there), my parents and I expressed our concerns at the rush as they hadn’t proven they could even live together for any duration of time, he assured us it was fine so we supported them. I had always hoped I could be a bridesmaid for my brother, but seems that my SIL had other ideas, call me paranoid, but instead she proceeded to exclude me and definitely give me the sense that she didn’t like me much. I was hurt, there is no denying that, but I did what any sister would do and I continued to support my brother and helped with the arrangements he was responsible for.

Whilst they are on honeymoon and we were in the midst of our first ICSI cycle, my dad suddenly fell very poorly and was admitted to hospital.  OH and I spent a lot of time up North with my mum, ferrying her to and from the hospital, my brother and SIL also made frequent visits. On one of their visits, there was a tense atmosphere, she ignores us all, packs her bags and walks out of the house. Naturally we’re concerned and for the first time in a long time we ask my brother how are things with them and what’s going on?? He says that we wouldn’t believe it and he’ll send me a copy of a letter she has written to him later that night. The letter is shocking, it basically says that she wants marriage counselling after being married a month, otherwise maybe they should get divorced!? The rest of the letter seems like lots of tiny things that are blown out of proportion that don’t seem that important (we all didn’t know at the time that she was indeed pregnant at this stage). We decide to stay out of it, my dad was our priority and so we encouraged my brother to look into counselling. 

Lets fast forward to the outcome of my first ICSI cycle in Nov 2011, the day we realise that it’s failed I let my brother know as he happened to call, in the very same call, he decides to tell me that my SIL is 5 weeks pregnant and phrases such as ‘we didn’t realise it could happen this quick’ are muttered . . . so after being married for 3 months they are already pregnant, fabulous, I’m congratulatory of course but it was a little hard to hear on that day especially. We took the first ICSI failure hard, it was heart-breaking, I felt I couldn’t look to my brother/parents for support as they had happy news to focus on.  We decide life goes on so put on our brave faces and tried to enjoy a pre-planned family night on the town about 2 weeks later just before Christmas. We see my brother / SIL and congratulate them, I manage to keep my distance from my SIL until near the end of the night, eventually she plucks up the courage to speak to me. I speak honestly as she asked ‘how am I’, I tell her it’s hard, especially with my the problems with work earlier in the year and also my dad’s recent health problems and now the BFN it just feels like one thing after another. She says a couple of comforting remarks along the lines of talking to my mum more for support . . . then somehow she manages to transcend into a conversation about my brother and how difficult things still are (how do I get trapped in these situations!). I don’t say much as I’m in shock really, I let her talk at me for quite some time, eventually I excuse myself for the bathroom at which point I’m a crying mess as she suddenly made the conversation all about her AGAIN, I didn’t want to listen about their problems right now as I had enough on my plate.  OH rescues me and not before long the night is finally over.

A couple of weeks later we see them again at my parents for Christmas day, we notice that they are both being a bit weird with us but put it down to the fact that it’s an awkward situation for all, we just had our BFN and they are pregnant.  Move forward to a phone call in early February, I’ve had a 3 week break away on holiday and I’m feeling stronger so I mention to my brother that I’ve realised I need more support from my family as the ICSI cycles are really tough. Surprisingly he is quite abrupt back and we get into a heated conversation where he basically says - what did you expect when I told my SIL that hearing about their pregnancy was like a ‘slap in the face’. Obviously I’m outraged and in tears, this was a phrase I’ve never used before and suddenly I’m being accused of this and also lots of other mixed up things that have either been blown out of proportion or untrue. Over the next few couple of weeks there are a series of emails exchanged where I try to explain that is not my recollection of the evening, I maintain my dignity in it all, I don’t lower myself to her level and I don’t go into any detail as I can see it’s not going to get me anywhere. I also find out that she has read all of my private emails, chat messages and texts with my brother!? Randomly she texts me one day with disgusting and vile comments about how she will be making my parents grandparents first and that they have made a 'baby out of love' and that I have 'wrecked the family', basically rubbing our infertility situation right in our faces, completely unforgivable. Again, I do not lower myself to her level and I don’t reply.

I eventually persuade my brother to meet with me, it was awkward at first but then it was good to have a chat and see him. I clearly explain that I have done nothing but support them and suddenly I am being accused of numerous lies. He’s in a tricky situation, it’s clear to me what she is doing, but not so much to him. She is of course having the worst pregnancy which is not making any of this easier. I leave it with him to discuss it with her to decide a way forward. Instead of moving forward we take ten steps back, over the next few weeks sends more abusive texts to me and also calls my mum on several occasions dragging her into it all and being very rude to her about her issues with me, wtf?! Again, I don’t reply to any of her mad texts.

At this point, we’re at a complete loss of what to do and we are approaching egg collection for our second ICSI cycle, OH speaks with my brother and asks that he give me some space for the next two weeks minimum until I get in touch. Our second ICSI cycle also failed, again another heart-breaking and difficult time for us both. A few weeks later I make contact with my brother (by text during the day, apparently I’m not allowed to call him in the evening in case ‘she’ is there), we agree a date/time to talk properly which was last week. The call was hard, I still ask after her and the baby (am I a mug?) . . . I’m only really interested in my niece/nephew, they have decided that the only way forward is for my SIL and I to talk about the conversation in December . . . I have to remind him that this is so much more than that ‘conversation’ now, she has since dragged up so many many other things, yet I have not retaliated and said what I think of her and her behaviour over the years. I know what she wants to do, she just wants an opportunity to have her say to my face, this won’t get me anywhere because if I say one little thing about what I think about her actions she will surely just come back and say you can’t speak to your brother (which is her ultimate plan anyway). Judging by her recent behaviour I will just have to sit there whilst she shouts and tells her ludicrous lies to my face, I’m not strong enough to deal with that right now, especially when I don’t get my brother back, I explain this to him and he hadn’t really thought about it from my point of view. We have a family wedding approaching where I will be a bridesmaid to my cousin who has been more of a sibling to me of late (and which I am so grateful for) . . . my brother and SIL would like to come to the wedding even though my SIL will only be 2 weeks from her due date and it's a about a 7 hour round trip (ludicrous right? she just wants to put her belly in my face I’m sure and ruin the day for everyone). I’ve asked my brother to think about how this is going to work with the situation with me and also my parents with my SIL, it just seems like madness.

I just want a relationship with him for now (realising that it can never be how it was, but I would like to be able to speak to him occasionally) and maybe time will heal the rest, but he explains that can’t work as she won’t allow separate relationships. The call just ends with tears and he said he’ll have a think about things.

So that brings me to now. I’m grieving for my brother as I've lost him for now.

Tuesday, 10 May 2011

3 Mooncat Years

Many moons ago :-) OH bought me Mooncat, she has been with us 2 years today (my best birthday gift ever) making her 3 moonyears old. This is just her pretend birthday as she was a rescue cat and the cattery estimated her at 1 year when we met her, she had been abandoned or lost her way when pregnant and we took her in to our home. She's such a cutie pie, full of cuddles whenever you need them.

Happy Birthday Mooncat

Monday, 9 May 2011

Pill Poppin'

OH and I are slowly on the mend, we tried to do some fun things this weekend and ended up in London for a nice walk along the South Bank, we had chance to have a good talk too and get a few things out in the open to help each other through it.
Yesterday we even visited our friends who recently had a teeny tiny baby girl, and oh my is she tiny and I loved holding her. She was super cute, I was a little nervous beforehand but it was really lovely (gotta keep my eye on the prize), OH thought it was the happiest I had seemed for days which is pretty ironic!

So I made it in to work today (progress), ugh, can't concentrate much, but I made it here so that's step one complete, so I'll aim to do something productive tomorrow :-)
This weekend, OH has started popping the pills, there are hundreds of them. this is the plan for the next 3 months but we're left wondering what the side effects could be :-/  It all seems a bit drastic (and desperate maybe?), but OH has researched it and there are many people doing something similar with positive effects. I'm not sure what our other options are before heading in to our next treatment cycle as we are at a loss of how to improve our chances so I guess it's worth a try.

Some tweeps have asked about what vitamin regime we have planned as many of you are doing something similar or plan to, here's the list, let me know if there is something missing, or alarming!

Vitamin C 500mg
Vitamin B complex                
L-arginine 500mg
L-Carnitine 500mg
Vitamin E 200mg
Pyncnogenol (pine bark) 100mg
Omega Fish Oil 1000mg

Wellman Conception 1 pill
Zinc 2 pills (30mg)
Selenium 200mg
Omega Fish Oil 1000mg
Co-Enzyme Q10 30mg
Maca 1000mg
Vitamin C 500mg
Vitamin E 400mg
Folic Acid 400mg
Pyncnogenol (pine bark) 100mg
Tablespoon of Tomato Puree (lycopene)*

*hmm this one doesn't sound too pleasant, think we change this to a tablet form.
Fingers crossed it does the trick.

Friday, 6 May 2011


Shucks, this is so hard, I cannot begin to describe how we’re feeling right now, other than heartbroken. Yesterday we had our WTF appointment for our second failed ICSI cycle, amazingly this clinic gave us an appointment only two days after I called them, our first clinic had us waiting a torturous two months.  

I’ve tried to summarise our appointment with the consultant in the hope that it may help some of you in a similar situation and also you may have suggestions for us that we haven’t thought of yet, believe me we are at a loss right now and so all suggestions are welcome! In TTC for coming up to 3 years soon, we have never had one positive pregnancy test, with have 2 failed ICSI cycles under our belt, no frosties ever, and we have never made blastocysts before. Herein lies our problem, if we cannot make blasts then it ain’t gonna work, full stop. So why don’t we make blasts and are we wasting our time . . . are you sitting comfortably?

I thought I would be seeing the same consultant as at our first appointment, instead we saw the new guy, I was a bit sceptical at first but in the end I was pleased we saw him, he has only been at our clinic for 3 weeks, prior to this he was the medical director at The Bridge Centre in London. He sussed me out within seconds after asking me if I studied Biology at school, I held my head up high and said I studied it as my degree, ha!

On the whole our second ICSI cycle did seem to go well and just like last time after Day 3 our embryo’s pretty much deteriorate.   Here is how Cycle 1 and 2 compared:

15 eggs collected, 13 mature, 8 embryo’s. Day 5 single embryo transfer (morula not a blast), no frosties.
13 eggs collected, 10 mature, 6 embryo’s. Day 3 double embryo transfer (1 excellent, 1 good), no frosties.

He said the cycles in terms of eggs/embryos were comparable and he is happy with the numbers, the quality of the embryo’s this time around were better than last time, but the same deterioration happened post day 3. The sperm sample on the day was the best OH has had since we started on this journey so we think the multivitamins he has been taking and lifestyle changes may have had an effect. In essence we are told that the sperm sample can fluctuate a lot and so there is just no knowing how it will be on the day, but it is going in the right direction. Now that I have had two cycles he will admit there is a pattern forming  but it’s not possible to say whether it is the egg or the sperm (or both) causing the problem, it’s likely to be the sperm but impossible to say for certain.
We discussed Day 3 vs Day 5 transfers, his preference is to get the embryo’s back as soon as possible if there are clear front runners, if it’s not possible to choose the best ones then he would opt for a Day 5 transfer. It is possible that the embryos could form blasts within me but not within a petri dish, he has seen the poorest quality embryos work before so you just never know (I know I know, it only takes one).  However for us, if we’re not producing blasts then it’s possible there is a genetic issue.

We discussed various tests that we could do to help diagnose or influence how to do our next cycle . . . he thought there was no point in seeing a urologist at this stage, it’s unlikely they will be able to tell us anything given the improvement in OH’s sample over our ICSI cycles. We discussed chromosomal karyotyping, this is a pre-requisite for some clinics before starting IVF/ICSI, it’s unlikely this will show anything for us both as it only detects major chromosomal defects but it may be worth doing for peace of mind. With regards to other tests, DNA fragmentation and Sperm Aneuploidy, he didn’t think these were worthwhile as these figures can also fluctuate, if we were to go ahead with these we have to be aware of the limitations of the results in that they look at a snapshot of the sperm at that time, on the day of ICSI the sample could be better or it could be worse, it will not help us in choosing better sperm. This was a little hard to hear, before we saw him we were adamant that we should do this type of testing before progressing, but we can see his point, it won’t help our upcoming cycle or change our situation (as we’re not going to give up just yet) and so should we bother? He said that the results of a DNA fragmentation test will only help determine whether to do ICSI or conventional IVF, as we’re already doing ICSI it won’t tell us anything new, he asked us to think about what we will do with the results, will it stop us from doing another cycle? I guess the answer is no.

We also discussed PGD (pre-implantation genetic diagnosis) and CGH (comparative genomic hybridisation), these are expensive options we could do in the future, unfortunately for us though it only helps in choosing the best embryos (or eggs) so this may not be useful if we can’t also select the best sperm in the first place to make the embryo. For this the latest technique is IMSI (intracytoplasmic morphologically selected sperm injection) as opposed to ICSI (intracytoplasmic sperm injection). It’s just like ICSI but uses a higher degree of magnification to choose the sperm, it’s thought that the fertilisation and success rates could be higher for people in our situation as they are hopefully choosing sperm that is less fragmented right before injecting into the egg.  I had looked up IMSI briefly before our appointment, I could only find one clinic near us (in London) that does this, it seems to cost a few hundred pounds more which is not much more in the grand scheme of paying for a treatment cycle. IMSI is not available at our current clinic, but the consultant offered that if we decided to pursue this in the future, he would be happy to link us up with a satellite clinic abroad (possibly France) for the egg collection/transfer part of the cycle. This seems like our only option moving forward in the future. Other tests we could do are full chromosome karyomapping and SNIP technology, I’m not sure what this would tell us but it’s something else to add to our list of research for the future. We discussed immune testing briefly too but given that we can’t seem to get to the implantation stage yet (we need to make a decent embryo first) he thinks we should hold off on this for the moment.

Our first ICSI cycle was NHS funded, we are lucky enough to be in the right postcode area to have funded cycles but have a restriction of 6 months between cycles, this is why we opted to privately fund our second ICSI cycle to bridge the gap. This means our next cycle will be NHS funded which is great but means we can’t do any extra fancy stuff, so we’ll take the NHS cycle and give it another try and ramp up OH’s vitamins based on some of our own research we have done, if this doesn’t work we can then perhaps pay for an IMSI cycle afterwards.
In terms of other lifestyle factors, the amount of alcohol we have (not much) he thinks is absolutely fine, he said just be sensible, no binge drinking and advised that during treatment I don’t drink. Eat a sensible diet, have my vitamins, continue with acupuncture if I find it relaxing and the OH should try to keep his stress levels down.

So we agreed a plan:

  • Chromosomal karyotyping – he will write to my GP to see if they will fund this test for us both, it’s just for peace of mind (I’m persistent).
  • Change my stimulation medication from Gonal F (recombinant FSH) to one from natural sources, such as Menopur or similar, just to see if it makes any difference.
  • Agreed to transfer two embryos even though it’s an NHS cycle (did I mention how persistent I am)
  • Keep up the good diet / lifestyle / mind & body relaxation.
Are we filled with hope, no not really, but we have to try again and in the mean time we’ll research IMSI and simply hope for the best. We might proceed with the other sperm DNA fragmentation tests anyway, he understands that we feel helpless and just want to gather as much information as possible. In the meantime the hundreds of vitamins keep arriving through the post box!

We felt relieved after the appointment to draw a line under it and to look ahead, but it didn’t last long. By late evening, I went in to a serious meltdown when I got home, we both did, so much so that we both could not go to work today and face people. I put on a brave face about 90% of the time, it’s impossible to sustain and stay positive and pretend everything is normal, we’re so far from normal that I’ve forgotten what normal is. I don’t want to burden anyone so I find myself distancing myself more and more, who’s interested in someone going through their third cycle or however many more we might need?!

Today is a new day and we do feel a little better, but our life is the same still and we have no choice but to keep putting that brave face on and keep going. 

Apologies for my longest post ever (zzzz).