Unplugged

I’ve decided to take a little break from twitter, I plan to return soon but in the mean time I still hope to blog through my third ICSI cycle . . .

I’m doing this in an attempt to stay as sane as one can be in a treatment cycle and I think I need to unplug for just a little while.  I’ve been struggling with all the stresses in my life recently, they are all getting on top of me and I guess everything is becoming too much. Even being on twitter from time to time can increase my anxiety which is ironic, as before this is the first place I would turn to. I hope my friends on twitter understand that I need to take a break for a little while and concentrate on this cycle and do what I need to do to get through it, it feels a little selfish but I’m finding it hard to read about other people’s stories at the moment – both those with good and not so good news, all are making me feel more anxious.

My counsellor advised that I have to let go of something, at the time I had decided that I would let go of my brother/SIL situation ('You Can't Choose Your Family'), this only lasted a week or so unfortunately. Right before leaving for my bridesmaids duties he texted out of the blue after not being in touch for about 8 weeks. I won’t go into the details but I wasn’t best pleased with the tone of his texts and I realised he is not the brother I miss, I miss who he used to be.  Since the wedding he has made an attempt to resolve the situation with my parents given that their first grandchild will be making an appearance into the world any day now and he wants them to visit as soon as the baby arrives. He has also been in touch with me again to say he’d like to speak to me this week, I’m not sure how I feel about this as I have enough on my plate but I guess if he makes the call I will hear him out.

I have already accepted I won’t be meeting my niece/nephew anytime soon and I’m acutely aware there is no quick fix to this, but this doesn’t make it any easier to handle. Actually breaking news from Tuesday is that the crazy SIL has contacted my mum to pass on a message to me, to ask me not to contact my brother at the moment, I took 10 steps back in my quest to stay sane when I heard this. Seriously, I give up, they are causing me more grief than I can handle right now.

In terms of my cycle, I’m 12 days into my down reg phase, the injections are going fine, but unlike last time I am struggling with how they are making me feel, I'm literally having to just take one day at a time and I’m trying to be strong. AF has also made an appearance, as expected during down reg it was just a day or so late like last time, yet again no miracle baby here!  The pain has been awful at times but I’m getting through it. So I’m all set for my baseline scan in the next few days and then the plan is to try a different stimm medication this time, one that’s more fiddly and requires mixing so I’ll be having a demo next week.

Both Mr Moon and I are struggling a bit this time round, we feel so alone which is making us hide away a little, probably not a good thing, but it’s becoming increasingly difficult to just ‘pretend’ everything is fine and we are normal when we couldn’t feel further from it. It’s difficult to be full of hope when we don’t understand why there were no real answers in Mr Moon’s recent tests. I saw Dr Angel for my acupuncture this week and she gave me a lot of useful advice, she asked me to keep an ‘open mind’ about this cycle, she’s so sweet, she didn’t tell me to be more positive, she didn’t tell me to less negative, instead something about the way she described just about being ‘open’ to the possibilities made me feel brighter.

I know many others are going through difficult times too and it makes me sad to think there are people out there just like us, feeling these same emotions, I wish I could fix it for them. I wanted to give a little shout out to one lovely lady, @ladyisis, her latest post made me cry and I can relate to a lot of her emotions, we seem to be on the same wavelength, this is the one good thing about twitter, I have found some people that I can truly relate too. Here is her blog with her latest post, please send her some support . . . Don't Look Back

On a positive note, one thing that has helped last week was meeting two tweeps, @ivfchronicles and @lilytaj, in London for the day. I can’t describe how it felt to meet two lovely ladies who know exactly how I’m feeling right now, I felt connected to them straight away. I’m so pleased @lilytaj stopped by in London on her holiday (she lives in Oz) which gave us all a reason to get together and eat cupcakes, yum yum.

My Sperm: A Brief History

A guest post from Mr Moon . . .
Around 2 years ago, and after TTC for a year I was tested to rule out any potential male factors before we could be referred for fertility treatment. The news that came back from the initial test organised by our GP was pretty devastating. I was diagnosed with low count, motility and morphology and what followed was a period of anger, confusion, guilt and helplessness, all of which carry through to today to some degree. This amazing article by Paul Ford which puts all of this into words far better than I can ...

No camp Saunas allowed

Following the initial test the usual things were prescribed, cut the alcohol, saunas, hot baths, and eat a good diet - and come back again in 3 months for a retest. 3 months came and went and the results were very slightly improved, but nothing near normal.

By this time we were on our way to ICSI #1 at Bourn Hall where my the results were slightly improved but still not near the minimum required for standard IVF, let alone a good chance of TTC naturally. 'Normal' seems to change depend on who you talk to, but the current World Health Organisation range is 15m per ml though this seems to be regularly revised downwards, with the minimum being 50m back in 1999. Here is a good Q&A on the WHO numbers and why they should be taken with a pinch-of-salt.

For ICSI #1 we had a good number of eggs and fertilised embryos, it was all looking good. But at Day 3 our embryos started to degrade and none reached the blastocyst stage by Day 5 when we were booked for Embryo Transfer. On Day 5 we transferred a single embryo which was at the compacted morula stage. It was our only option as all other embryos had not developed.

Onward to ICSI #2, this time at Herts & Essex. They performed another test on my swimmers, more improvement, so something was working but the outcome for ICSI #2 though was very similar. At our Day 3 transfer everything looked very good and we put 2 embryos into Mrs Moon. Another devastating failure followed although this time we had a pattern (I am a glass-half-full person), again none of the other embryos reached Day 5, again no blastocysts. We of course don't know if the transferred embryos survived to Day 5 and failed thereafter - all we can go on is the embryos which were left to grow in the lab. 

Despite the agony of another failed cycle we have realised that there is no point in looking for anyone to blame or to be angry at, all we can do is carry on and salvage some hope, so it was time for more research.

At Day 3 an important event occurs in the embryos development, the Sperm DNA is activated within the embryo and the male genome merges with the female DNA (as you may guess I'm not a biologist), so degradation at or after Day 3 may point to some low level issues within the sperm, specifically DNA Fragmentation, Aneuploidy or Chromosomal faults.
It was also clear that there were many vitamins and supplements which various studies have shown to help improve sperm quality and quantity. Up to now I was only talking Wellman conception so after collating the results from Dr Google we settled on the following concoction:

Our House.

MORNING
Vitamin C
Vitamin B complex
L-arginine
Vitamin E
Pyncnogenol
Omega 3

EVENING
Wellman Conception
Zinc
Selenium
Omega 3
Co-Enzyme Q10
Maca
Vitamin C
Vitamin E
Folic Acid
Pyncnogenol
L-Carnitine
Alpha Lipoic acid
This lot will take 3 months to show any results, so there is nothing more to see here at the moment ...

At our WTF2 appointment we discussed the Day 3 issue with our consultant, he agreed that there was a pattern and talked about a new technique, beyond ICSI, that can filter out damaged sperm. Essentially the embryologists use a super high powered microscope that can actually see into the head of the sperm, this is coupled with a different medium which attracts the good sperm for interrogation. This process is called IMSI and PICSI.

We also talked about tests for DNA Fragmentation, though our consultant dismissed these as no matter what the result the treatment recommended would be ICSI (Herts & Essex do not provide IMSI). As Mr and Mrs Moon like to have all of the info we went for the tests anyway.  Firstly, in true Mrs Moon style we have a spreadsheet tracking all of the standard tests I've had performed, here are the results:

And here are the advanced tests. 

DNA Fragmentation = 25.4% (Moderate)
5 Chromosome Aneuploidy = 1.00 (Normal)
Chromosome Karyotyping = Normal
Anti-Sperm Antibodies = Normal
ROS Oxidation = 0.15 (Very Good!)
Sexual Health Screen = All Negative

For once there was some good news here - my ROS value was very low at 0.15 - yay for me! 

Finally there was the dreaded Physical Checkup with a Urologist…drop your trousers and cough, well it's a more lengthy grope and prod to be honest. The doc is looking for evidence of varicocele, undescended testicles or any other abnormalities in 'the area'. He's also looking for evidence of hormone imbalance (lack of testosterone), for example moobs, lack of bodily hair.

So in summary: 
- My sperm DNA fragmentation is a little high (still within normal range).
- At the last sperm test my count, motility and morphology are still below par.
- Everything else genetically is OK and I don't have any weird STDs.
- My balls have descended and my moobs are caused by not enough visits to the gym rather than a lack of testosterone.

For those of you that have made it this far and looking for some magic answer....there isn't one. I've now seen three consultants at two IVF clinics, a Harley Street Andrologist, a Harley Street Urologist, had my crown jewels poked and prodded by a posh middle aged man, and had every type of bodily fluid extracted and tested. The result being that we are a few thousand pounds poorer and none the wiser. The same 'treatment plan' remains:

a) Reduce Heat...fairly easy.
b) Reduce Oxidation by taking supplements and eating/drinking healthily.
c) Reduce General Stress...Not easy when living through infertility.

In about 4 weeks we'll find out if any of this has made a difference. The best case scenario is that ICSI #3 will work and we won't care about any of this. If we have another failure I can only hope that all of this has made a difference and we can hope for a miracle naturally or with a procedure that is less stressful and invasive for the brave Mrs Moon.
The toughest part of dealing with this is that Mrs Moon that has to go through all of the pain and stress on her body when the problem lies within me. After nearly half a year of avoiding most social situations (they nearly always involve alcohol), making up stories to avoid seeing people during treatment, and generally leading a sheltered life it's very easy to think of giving up...but doing that is just self defeating...we have to go on, stay strong and be there for each other...

Mr Moon.

Book Worm

Mr Moon and I have recently read the book, Test Tubes and Testosterone by Michael Saunders (also know as @theIVFdad) and we thought we'd post our reviews here in case you've heard about it: 

Mr Moon
This is a well written book which is unique as it tells the story of fertility treatment from a male perspective. It is very easy to read and does touch on a great number of topics in a short space of time.

Being in the same situation myself much of the detail I already know however it’s comforting to hear that the experiences (i.e. rude staff) and emotions (i.e. manliness) we go through are common.

This would be a great book for friends and family of a couple that are undergoing IVF as it’s not too technical, distressing nor depressing but does hint at what an IVF couple have to go through…I would not like to give a friend a copy of Zita West.

Not only that if gives rare insight into some of the daily goings on in an ‘IVF home’, even the logistical things that the clinic do not tell you, such as the Ovitrlle injection is harder to insert!

It’s also a good story of hope for anyone embarking on IVF.

Mrs Moon
It’s so nice to read an IVF related story from a man’s point of view . . . I’ve always wanted to know more about what the ‘other half’ thinks when their wife is subjected to many invasive ‘wandy’ procedures and stabbing themselves with needles, this book is a honest and moving story that I would recommend to any couples about to embark on fertility treatment and any family/friends that want to understand more.

It’s a very quick story to read, humorous along the way, delving into just the right level of detail at certain key points. We hear of all the usual ups and downs that any couple doing IVF face and gives an great insight into what it feels like, all made better by that cup of tea!

This is a great read for men or woman and it’s comforting for me to read of another couples story and feel more ‘normal’ again.

Stuck in the Maze

It’s nearly two weeks since my last post . . . where have I been?

• In hiding (yep I’m hiding from ‘my’ own blog, hilarious but true)
• In counselling
• In shopping malls
• Watching Greys Anatomy
• Tying ribbons to confetti cones

I’ve had another tough couple of weeks, my only way through seems to be retract from some aspects of my life and take one day at a time. I’ve been back on twitter a little bit and so some of you may already know what I’ve been up to lately, I’m getting there slowly, but still stuck in the maze running from that black cloud.

Mr Moon has been taking good care of me with flowers and gifts, anything to bring a little smile to my face.

I am happiest at home when we’re in our cocoon where everything seems safe and I can convince myself I can do this, one step out of the door and that confidence quickly fades though. Ms Mellow, my counsellor, is trying to help me with this and is convincing me that I am indeed coping, maybe not as well as I would like (always a high achiever!) but this is ‘coping’, I have not yet fallen into a heap and not got back up again.  I’m keeping up the acupuncture with Dr Angel and I’m still doing the yoga, so keeping my head above water, just.

I’ve also kept myself occupied with bridesmaid activities, my dress is being collected today and the celebratory activities have already started last weekend, only one more day at work and I’m off, yay. I have made some beautiful confetti cones with bits of ribbon tied around them in bows, if you know me in real life, each one has been meticulously made, checked and double checked for perfection.

In other news, Mr Moon has a new job (woo hoo) so this is great to have some good news amongst all the bad. We had our chromosome karyotyping results back too and these are all clear. We’re just waiting on one more test for Mr Moon and then I’ll ask him to write a blog post on all the latest results he’s had.   In celebration of Mr Moon’s success I treated myself with Mr Moon’s money (ha haa) to a shopping trip to the Pandora shop and have a new bracelet with charms, I find a girl cannot have enough charm type bracelets :-)

I’m getting closer and closer to cycle 3 . . . the day after the wedding we will rush back home so I can administer my first down reg injection, how’s that for timing!  I wanted to start after the wedding so I could shift that horrid IVF bloat and have some bubbles to celebrate on the day, the way the dates have fallen means I literally start the next day. I haven’t given it much thought yet, guess I know the drill now, I’m sure the nerves will settle in on Sunday though.

By the way, @toofriedeggs posted this great article on twitter today about The Age of Mechanical Reproduction by Paul Ford, an alternative view on this whole IVF business, a good read if you fancy a peek.