Bye bye first trimester

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This post is a bit late as it’s been sitting in my drafts for a while. I’m now over the (horrible, slightly bloody, nerve-wracking) first trimester. There is still a really long way to go and I still take it week to week but I am so very grateful to be here.

At about 12 weeks I had my midwife booking in appointment. She was really lovely as she went through all the various checklists and questions and so thoughtful when asking me to run through my previous pregnancies/miscarriages. Unsurprisingly she recommended a hospital birth due to the twin pregnancy, and the pregnancy has been classed as high risk due to the twins, my thyroid (which admittedly is a non issue according to the NHS guidelines), and my quote ‘geriatric age’ (although I used donor eggs being older than 37 still carries risks). Largely due to the twins I’ll have consultant and midwife combined care.

At 13 weeks and 1 day I had my first NHS scan, the nuchal scan where they test for Down’s, Edwards’ and Patau’s syndromes using a scan and blood test. These usually happen between 10-14 weeks. My hospital is a research hospital and they have a brand new state of the art foetal research unit. This means that at the moment I don’t need to go anywhere near the awful EPU that holds so many bad memories. As it’s a research facility the sonographers are all researchers, I was expecting this but not to have 3 in the room. The ‘trainee’ started to do the scan and straight away they were like “woah twins why didn’t you say?” all I can say is it’s a good job I knew already and they obviously hadn’t read my notes – the reason I didn’t say anything was mainly because I get so nervous about scans. Anyway, the more experienced researcher then had to do the scan whilst the other experienced one fired multiple questions at me and the trainee hovered around. I hardly got to see any of twin 1 because they were constantly asking q’s but I could see they were slowly moving around. I actually got to watch twin 2 a bit more. Just like last time he/she was going a bit crazy – drumming their heels on the edge of the sack and then possibly sucking their thumb. The sonographer found it difficult to take measurements because they were so active. Luckily they settled down after a while.

We then had to wait for the results of the nuchal test which was slightly nerve wracking, though as we’d had PGS on our embryos so we were fairly confident that the twins wouldn’t be high risk, and they weren’t which was a relief.

A week later at 14 weeks I had my first consultant appointment, again at the research centre. It was a bit of a non event. I was told more than once that I was high risk due to my geriatric age. I get it, I don’t think they need to mention it more than once. In the end after a bit of a lecture about blood pressure I felt compelled to point out that my blood pressure is great, until recently I ran 35 miles a week, and i’m still doing some exercise.

More interesting was a very quick discussion about my birth options. My hospital induces ladies pregnant with twins at 37 weeks which I’m not too pleased about but chances are I may not get to then anyway. The consultant was pleased to hear I wanted to try a vaginal birth (I don’t really want to say ‘natural’, aren’t all births to an extent natural? It’s a bit like the ‘are your twins natural?’ question. I’d be so tempted to say something like ‘well I guess so as they’re not plastic’). But at the end of the day isn’t the main thing to have 2 healthy babies, it doesn’t really matter how they arrive.

I now have to wait until 19 weeks for my first proper midwife appointment and 21 weeks for my next scan. It seems a lifetime away!

I’m looking a bit inbetween – is she a bit fat or a bit pregnant? So far I’m managing to hide it fairly well at work I think!

I have some pics of the scan but I don’t know whether to post as they look much more like babies. I guess most people reading this wouldn’t mind?

 

 

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11w3d – still paranoid

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Sometimes I think my paranoia is getting a bit better. But it’s still there, lurking in the background. I know that I’m not alone, I’ve read so many blogs by ladies who’ve become pregnant after long (or short) battles against infertility and miscarriages and we all carry those scars with us. The 2 friends I met through a forum have made me feel less of a weirdo. 1 of them had scans every week up to about 30 weeks, the other bought an Angel Sounds Fetal Heart Monitor (a Doppler) and also had quite a few extra scans.

The Angel Sounds friend has given me the monitor. This has created a problem. My husband doesn’t want me to use it. He read negative reviews – some of these were about people who couldn’t find a heartbeat and then wasted the hospital’s time going in (we don’t really care for those reviews), others are from midwives who don’t like them because pregnant ladies may rely too much on them and think everything’s ok when it’s not – especially in later pregnancy when you should be monitoring kicks (I guarantee if I get to that stage I will be obsessively monitoring kicks so no problem there), but the ones that got him were suggesting they could be harmful to babies development and also sound very loud to the baby. But I couldn’t find any really good evidence about that. Plus a stressed pregnant lady is also not good for the baby.

I’ve been really naughty and used it a couple of times and not told him. First time I found a heartbeat straight away ( I watched some you tube videos first – very helpful as the baby is much lower than you think at this stage -basically just above your pubes) – but only one. Weirdly for me this didn’t send me into a panic. The first time the heartbeat was loud and also very fast – it crept up to over 180 which was quite high for a fetus at 10.5 weeks. However, I thought there was a strong possibility I was picking them both up at the same time. They are very close together. The second time it took me a little longer to find (but I didn’t have a full bladder that time) and I thought I found 2 as I picked up something very central and then slightly to the right and quite a lot quieter than before but the 2 readings were exactly the same (174) so again I thought only picking up 1 baby.

The husband agreed to another scan because my NHS scan isn’t until over 13 weeks. The scan was at 11w3d and I was actually feeling positive. But the night before I had a really weird scary dream – it involved a pregnancy test (that wasn’t the same as a normal test as I had to fill up a massive part of the test with wee), being unable to wee enough on the test and trying so hard that I pissed blood everywhere and kept doing it because I was so desperate for an answer even when everyone kept telling me to stop, and then the results being inconclusive and no-one being able to tell me if the babies were ok even though I was begging them. I guess a lot of paranoia comes out in dreams!

Anyway, the scan was absolutely fine. Saw the babies straight away and even though I didn’t see the heartbeats at first I saw they were both moving. Twin A was really active and seemed to be hitting themselves in the head quite a few times, though I preferred to think they were trying to suck their thumb (I think they’re too young to do that yet). Twin B was upside down and seemed to be having a very slow little move and then stopped and curled up a bit – maybe they were not impressed at being on show. They’re measuring at 12 weeks and 12w1d so a bit ahead. And their heartbeats were exactly the same – I think that’s a bit unusual from all the stuff I’ve read about trying to find twins with an at home monitor. It explains why I can’t find them both on the monitor.

I have to wait nearly 2 weeks for my next scan. I’m going to try not to use the at home monitor unless I get really anxious  as it’s not fair to my hubby. My nausea is slowly going away – it’s not as consistent (though last night I started feeling sick after I ate my chicken fajitas and was convinced that I’d poisoned myself by undercooking the chicken – my paranoia knows no bounds – I’ll probably have a dream about it later) and my boobs though sore and pretty big (for me, I’m a 30b or a 32a usually) are no longer really tender, but I’m reassured now that this is ok.

My next milestone is my midwife appointment which is next week. I feel like a pregnancy imposter so it will be interesting to see how I cope with that stage!

I’m also acutely aware that now I’m pregnant some readers may unfollow my blog and that some may already have done so. I understand – last year I kept following a number of bloggers who became pregnant but when I had my miscarriage I unfollowed nearly all of them. I often chose not to read entries by those I kept following when they appeared in my feed. All I can say is that I get it, and my heart goes out to everyone on this road.

10 weeks, milestones and more bleeding

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This week has been a week of many milestones. On Monday I took a huge leap of faith and went to see my GP to report my pregnancy and get into the NHS system. She knows my history and so there were no big congratulations just an acknowledgement of how far I’d come this pregnancy and an understanding of my remaining concerns. Filling out the form for the midwife referral was very weird – I’ve never got that far before. Despite the fact I must surely be in the higher risk category (4 miscarriages, twin pregnancy, my age etc) my midwife appointment is at 12 weeks and my scan is at 13 weeks 1 day.

On Tuesday I felt like I’d jinxed everything. I was feeling pretty positive ahead of my 10 week scan at my IVF clinic until I went to the toilet just before bed. There was red blood on my liner. And when I inserted the crinone it was all over the applicator. I barely slept that night – every twinge felt magnified and I started to get a bit of lower back ache. Rational me pointed out that I had a lot of backache early on and with my tilted uterus it’s a common pregnancy symptom. Irrational me reminded me that backache and red blood are signs of miscarriage. I eventually fell asleep and dreamt that I bleed all over the bed. I didn’t. When I work in the early hours there was no blood on my (massive just in case) pad and the bleeding seemed to have ceased.

My scan was at lunchtime at my clinic. Straight away I saw one heartbeat but it took a bit longer to find the second. Both babies looked more like babies – they had limbs! And they were moving. One of them turned all the way around in the time we had the scan. This time my husband was more excited – I don’t think he’d been letting himself get excited before. Turns out the bleed was from my cervix, it was likely it had been irritated by something, possibly the crinone gels. That night I had some more bleeding but nothing since then.

I was discharged from the fertility clinic. Out into the real world. And I feel strangely adrift given I have to wait so long for my NHS scan. I’ve had a bit of a wobble the last 2 days so I’ll either be paying for another scan or going to the Early Pregnancy Unit for one next week.

I’m now weaning off some of my drugs. I’m off the clexane for good now because of the bleed (I would’ve been coming off soon anyway), I’m off the progesterone in oil (thank fuck for that – I hate that stuff), I’m off the utrogestan (except I’m not as I’ve got quite a bit left so I’m continuing to take it at a lower dose), I’m on a weaning programme for the prednisolone (I find this a little scary as it’s the only drug I was missing last time I had a miscarriage so I do wonder if it’s been the thing keeping my pregnancy going) I’m still on the progynova and the crinone (gross) plus the thyroxine.

I told my parents the news and they were so happy (I get a bit nervous telling them as my mum always gets over-excited and I’m not quite ready for that yet, though to be fair she was fairly restrained this time). But we’ve not told many other people yet, just my two friends who read this blog and my sister. And two of my university friends have sort of guessed – they know me too well and I see one of them nearly every day, but they think it’s all very, very early still.

Two weeks until the end of this long drawn out first trimester. Please let us make it.

8w6d, cellulitis and other concerns!

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I have cellulitis, or to explain it more explicitly a bacterial infection in my bum cheek muscle caused by the lentogest injections (progesterone in oil). The other day I noticed that there was  a large red, hot area around a bruise on my butt. A quick trip to the GP confirmed it and I was prescribed a week of antibiotics. I wasn’t massively keen on taking them but a bacterial infection could be serious and the ones I’m taking are safe in pregnancy. My clinic didn’t seem overly concerned – apparently it happens with lentogest because the injections go into the muscle. We’d been really careful to clean the injection site etc but I still got the infection. I’ve been advised to put a hot water bottle on the site after injection to help disperse the oil. Trust me to get a butt infection. It actually cleared up after 2 days of antibiotics but I’m taking the whole course.

Last weekend the paranoia got to me a bit. I spent a sleepless night utterly convinced that one or both of the twins had died. There was no real reason for my anxiety other than the timing of my nausea had changed. I was still getting it but for a shorter period of time. I managed to snap out of it to attend a festival with friends (it was one of my best mate’s birthdays) and felt very sick for part of the day so that’ll teach me. I also threw up for the first time when I got home but I think that was because I’d got really hungry as we stayed out longer than anticipated and then I stuffed my face with cheesy crumpets when I got in – like literally inhaled them like a pig without waiting for breath ( I should probably mention that I’ve been stuffing my face a bit – it makes me feel less sick, plus I’m hungry quite often).

Anyway, we decided that to manage my anxiety a bit better (and on the wise advice of a friend who’s been in my shoes) to get another scan. This time we didn’t go to our extortionately expensive clinic, nor could I quite bring myself to go to my EPU as it holds the worst memories for me, so we found a company  that charges less than half what my clinic does, and has sonographers all over the country. I managed to get a lunchtime appointment in central London yesterday not too far from either my or my husband’s work.

This time is wasn’t an internal vaginal scan but on the belly. So much nicer. And the twins are both fine. One measured 9w1d and the other 8w5d (I was officially 8w6d).  Their heartrates are also good. And we could see a real difference since last week in terms of how they look. I’m hoping that scan keeps me sane for another week. I’m acutely aware that things could still go wrong. But yesterday was a happy day.

 

 

 

7w6d 2 hearts

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I didn’t say anything in my last post as I wanted to break my news to a couple of friends who read this blog and didn’t want them to read it on here first. Plus the husband and I were in a bit of shock. So, last week we saw two heartbeats. Yup twins! I had considered twins might be a possibility as my HCG level was high but without knowing how much it was rising it was kind of out of context. So it was a bit of a shock when we were told (though the husband had actually seen both sacs on the ultrasound before the sonographer showed me – I couldn’t see the screen properly at first). One measured 6w5d and one 6w6d (spot on) with good heartbeats.

We had our second scan at 7w6d because of the bleeding last week, and they were looking good. One is now measuring 8w1d and the other was 7w6d. The Dr waited an age to confirm to us – I nearly had a heart attack. We heard the heartbeats too which was special, though the husband didn’t like it because they beat so fast it weirds him out apparently!

No more bleeding though I’m still getting some brown crinone discharge (that stuff is the devil’s work – I never thought I’d say I prefer cyclogest) and the odd very small bit of brown blood (possibly the crinone irritating my cervix) but I’m trying to take it in my stride.

I’m still really nervous. About everything. About getting through each day and still being pregnant (4 miscarriages will do that to you), about carrying twins, about the risks. But for today things are good.

One day at a time…..

Next scan at 10 weeks (if I can last that long).

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Waiting, bleeding and the 7 week scan

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The wait between the beta hcg result and the first scan is really hard as anyone who’s been in this position knows. The days drag, you find yourself agonising over every symptom and lack of symptom and veering between hope and absolute terror that things aren’t going well. I’m not surprised my boobs hurt – I start and end the day by giving them a good squeeze!

In an effort to distract myself I took a couple of extra days off over the May bank holiday weekend and planned some nice activities. The husband and I went for an early anniversary lunch at Gilbert Scott (a Marcus Wareing restaurant), we got a good deal on a set menu (see pics). I also went for afternoon tea (on a different day!) with my sis and parents for her 30th and then we went for cocktails. My dad was subtle as a brick practically shouting “virgin cocktail? Why?” whilst my mum and sister glared at him (they know I’m planning a transfer soon but I didn’t tell them I’ve already had it – if all goes well I’ll tell them in another week or so). I also went out for dinner and drinks with 2 uni friends – they know a lot about my IVF history and did quiz me on the no drinking – I also told them that we were preparing for transfer.

Last weekend at 6w4d was the day I started bleeding last time. This weekend I went to the Epsom Derby races at with a group of friends (we go most years and my friend makes this amazing picnic). I did have slight cramping resulting in a couple of wary trips to the toilet. Just before going to bed that night came the horrific news of the London Bridge attack (so soon after the Manchester one) and I spent an hour or so checking in with family and friends. I was at London Bridge for the first time since the attack last night for a friends birthday – the sea of flowers, notes and flags from a variety of countries was very moving.

On Monday I worked late and popped to the loo as I was about to leave and saw blood, red blood. I was really not expecting it. I had no cramps or backache like last time. I tried not to panic and made my way home. The bleeding was mainly dark red and stopped after 2 hours – it wasn’t heavy but it was scary.

I phoned the clinic on Tues and they brought my scan forward (it was scheduled for Wed at exactly 7 weeks). I spent a nervous morning at work convinced things were over as my boobs didn’t feel so sore, and my nausea was coming and going.

My husband joined me at the clinic – I was pleased that the appointment was with the really nice sonographer (and not the one who kept messing up my lining measurements). She gave the usual reassurances about how she would take a minute to suss things out so not to worry during that time. She was actually very quick in telling us that there was a good heartbeat and the measurements were spot on at 6w6d (my last pregnancy measured 3 days small and I lost that) and showed us – my husband had actually already seen on the screen as she found it very quickly. She also found the bleeding site and said it looked like it had bled out and I hopefully shouldn’t get any more. Obviously we were overjoyed but very cautions. We’ve been here before and it didn’t end well.

The Dr has taken me off clexane for a few days as a result and has asked me to go in for another scan in a week at 7w6d to check progress and the bleed site.

I’ve been ok. As soon as I hit 7 weeks my nausea increased quite a bit despite the steroids (which can mask it). In some ways this is reassuring. Less reassuring have been 2 days of crinone discharge which is dark brown so obviously stained with old blood. Then yesterday it was a pinky red colour which scared me a bit – although it’s possible the crinone is irritating me – I’ve never used it before and I keep thinking it’s going to give me thrush – I really don’t like it.

I’m sure the day before and day of my next scan the doubts will start to creep in. I’m now 7w3d – in a couple of days it will be roughly the time my last two pregnancies stopped growing.  For now I’m trying to stay as calm as possible.

 

 

 

12dp5dt – unofficial test day

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As mentioned in my last post my official test day was 16 days after my frozen blastocyst transfer. However, my last clinic official test day was 11 days after, and my clinic before that was 13 days after, so I persuaded my husband that I would test on day 12 as I was starting to go insane and just wanted to know. It was also a Saturday giving  me the weekend to get over bad news before going back to work.

The night before I didn’t sleep well. I convinced myself it hadn’t worked as my nausea had diminished. However, I had started to get very tender nipples and my sense of smell was heightened (though I always get this when pregnant, I also get it when my period is due). In reality there was just no way to predict the outcome.

I woke at about 4 needing the loo so I peed in a jug (the jug from my OHSS days – not a jug I use in the kitchen!). I then went back to bed for a few hours but slept fitfully. At about 7 I woke my husband and went to test the pee in the jug. This happened…

12dp5dt

The test line was a lot darker than the control line which was reassuring (having suffered 2 chemical pregnancies in the past). First hurdle passed!

I tested again 2 days later and the result was very similar (with the control line slightly lighter than the test above and patchy). I phoned the clinic as I needed more meds and they booked me in for a beta HCG blood test the next day. I also had another intralipid on my official test day (16dp5dt).

My hcg result on 15 days post 5 day transfer (or 20 days post ovulation) was 3880 which the clinic were very happy with as it’s quite high,  progesterone was 168.3 which was fine (thank goodness no need to increase the frequency of the progesterone in oil injections). My clinic doesn’t repeat the hcg test if results are good and as I’ve not had a repeat I have no idea if it’s rising as it should.

I’m struggling a bit at the moment with my own thoughts. Some days I feel positive but others my past experiences, especially my last pregnancy , are overwhelming and I convince myself there will be no heartbeat on my scan or that we’ll see a heartbeat at viability scan and then on the next scan there will be nothing (which has happened to me twice). It hasn’t helped that my nausea is very unpredictable. Some days it lasts all day and can increase in the evening. Other days nothing. My boobs are still sore – I check them everyday (more than once a day). I have read that prednisolone (the steroids I’m on) can mask symptoms, particularly nausea. I just have to be patient. Viability scan is at 7 weeks. Seems like a lifetime away.

I’m just taking each day but for now I am pregnant and thankful for that!

Symptoms in the 2 week wait, what not to do, and feeling loved

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I meant to document the last ‘2 weeks’ a bit better in real time. Even if it was just to add to the plethora of blog posts about symptoms.

So here is a list of totally meaningless* symptoms from the last few days. *Meaningless as if you consult Dr Google long enough you’ll always find someone who got pregnant with these symptoms and someone who didn’t!

  • 1dp5dt – nothing – to be expected!
  • 2pd5dt – nothing, getting up to pee in the night (always get this from the progesterone).
  • 3dp5dt – nothing, peeing in the night, maybe a little bit of twinging in the ovaries which could be down to  them settling down after the low dose of stimulation
  • 4dp5dt – nothing apart from the peeing.
  • 5dp5dt – nausea. This is new, not had nausea before test day before. Consult Dr Google who informs me this is likely to be due to the very high levels of progesterone I’m on. I was on similar levels last time and didn’t get this (and I got pregnant, albeit briefly). However I’m on different types this time (crinone, prontogest, lentogest) so very explainable.
  • 6dp5dt – nausea. Wondering why my boobs look and feel totally normal. Poke them a lot. The 2 times I didn’t get sore boobs I didn’t get pregnant.
  • 7dp5dt – nausea. Back ache like I get before my period (not as worried about this as might have been as I got this on my last FET).
  • 8dp5dt – nausea getting worse – woke me up. Back ache. Stabbing pain in boobs.
  • 9dp5dt – nausea – wake up in the night and almost puke. Back ache, stomach cramps – like full on period pains. Period would be due now. Poke boobs – little bit sore (maybe because I keep poking them).
  • 10dp5dt – nausea lessoning. Bad period pains. Boobs teeny bit more sore (but only when I squeeze them). I tested this day last time. Husband is refusing to let me test!
  • 11dp5dt – nausea has practically gone. This was official test day at my last clinic.

My official test day is 16dp5dt – this is ridiculous! I’m not waiting til then. I am veering between positivity and negativity. One minute I think it’s worked, the next I don’t think so. You’d think by transfer no 7 (!) that I’d be a bit more practised at the 2 week wait but it really doesn’t get any easier.

Yesterday I received these beautiful flowers from 2 of my friends to let me know they were thinking of me. I’ve hardly told anyone about this cycle but they know. I met them both on an online fertility support forum and we met physically at a meet up and hit it off (partly as we found certain other people on the forum annoying!). We don’t really participate in the forum anymore but remained good friends and have supported each other through failed IVF and miscarriages. They both have their miracles but have remained a great source of support. I was really touched to receive the flowers.

 

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I’ve been pretty busy since the transfer which has been a bit of a distraction but perhaps not the best way to feel ‘relaxed’ in the wait. I’ve tried not to work long hours but inevitably I’ve worked late a few times. I went for drinks with some old work colleagues (managing to more or less get away with the virgin cocktails). I practiced my driving with my husband – this was not the best plan. I stalled the car at a major junction which stressed me (and him) out. Then I freaked out that I’d impacted implantation! My husband had a planned op so I visited him in hospital and then looked after him for a bit (he’s recovered very quickly). So this weekend I’m just busy doing nothing! A little walk, TV, reading and maybe a bit of yoga.

Why is this so hard!?

 

 

The IVF archives: dealing with severe OHSS

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I don’t currently have OHSS. But on my first IVF cycle I did. At the time I was new to IVF and scared and in horrific pain, and there was a real dearth of information out there about OHSS. I’ve been meaning to write about my experience and pass on tips for dealing with it in case it helps anyone who finds themselves in a similar position.

OHSS is ovarian hyper stimulation syndrome. It is highly unusual to get severe OHSS, but those undertaking IVF should be aware of the symptoms and how to manage it. I am not writing this to scare anyone, most women will feel a bit uncomfortable after egg collection but that won’t lead to OHSS. Those who have a lot of eggs / follicles are more likely to be at risk.

OHSS is thought to occur due to the additional liquid in the follicles around the eggs being released and finding it’s way into an alternative cavity – mainly the abdomen. The liquid needs to be dispersed – I think partly back into the areas where it belongs.

Roll back a few years to IVF cycle no.1. This was my one and only NHS funded cycle. I was pleasantly surprised at how quickly it proceeded once we were in the system. I was initially warned I was at potential risk of OHSS due to my polycystic ovaries and because I was petite. Following my first couple of scans which showed a large number of follicles developing the OHSS warning was repeated and I was advised to drink plenty of fluid – which I was doing already.

Turns out my ovaries were having a field day. Despite not being on a particularly high dosage of Gonal F I had over 30 follicles. I kept exercising for a while but about 7 days into stimming and whilst out running I felt so uncomfortable I knew I had to stop exercising (I didn’t want to get ovarian torsion where the ovaries can twist round and cut off their blood supply). By the day before egg collection it hurt to walk. Apparently my ovaries were the size of large oranges (usually ovaries are 3-5cm).

At egg collection they took out 33 eggs, 26 of which were mature. I felt quite uncomfortable afterwards. I was advised again to drink a lot of fluid.

I continued to feel a bit unwell whilst our embryos developed – quite hot and with intermittent sharp backache. I did get a couple of calls from the nurses to check up on me. I kept drinking a lot – mainly water. I couldn’t eat much. Meanwhile our numbers dwindled – 16 eggs fertilised and by day 5 we had 2 blastocysts. It is likely the huge numbers affected the quality but that is a blog post for another day. In the 5 days since collection I’d noticed that my stomach was swollen and hard. On the night before transfer I had really painful backache and was unable to sleep much. On the day of transfer I planned to go to work for the morning (I’d told no-one there about the IVF) but couldn’t get my skirt on properly – the only way was to pull it up under my boobs – I literally looked about 6 months pregnant. I found some loose trousers and put them on (with the buttons undone). I went into work and on the tube nearly passed out. I somehow got to my office and told my boss I wasn’t feeling good and felt faint. She took one look at me and called me a taxi which I got all the way home.

A few hours later I went for the transfer. I explained I felt unwell and they examined my hard stomach and the embryologist wanted to call off the transfer (the Dr was a bit more ambivalent). But the hospital refused to freeze our 2 embryos so I felt I had no choice but to go ahead and transfer both or I’d have ended up with nothing – no transfer and no frozen embryos.

Following transfer the hospital assigned a nurse to me who would phone every day to check as I was now considered high OHSS risk. She gave me a measuring jug. Basically they wanted to monitor my fluid output. Yes, I had to wee in a jug. I also had to write down how much I was drinking. I asked if there was anything I could drink that would help – they said just lots of water. This is actually poor advice. My research showed that what you needed was to clear the fluid from your system and plain water could just add to the problem. Electrolytes such as coconut water or sports drinks (without the sugar) were actually best. Carbohydrates and sugar should be completely avoided and I should eat protein and salt (though at this point eating was the last thing on my mind). I was also given clexane to inject to prevent blood clots.

That night I had such bad backache I woke up crying. The nurse said to keep up the fluid intake and because I was still peeing a good amount that I was doing ok. But if I stopped being able to pee I had to go straight in. The following night I was screaming with the pain so my husband phoned A&E at the hospital but they said to wait until the IVF clinic opened up as they were best able to deal with me. By the morning I was vomiting but as I hadn’t eaten much it was pretty dry heaving. We went straight to the clinic as soon as it was open. I must’ve looked a right sight – the only thing I could fit in was an old tracksuit, I was white as a sheet and I was unable to stand up properly. My husband literally lost his shit with the receptionist, poor woman, shouting that they do something. The waiting room was full of couples waiting for their IVF appointments and I must’ve looked like the worst IVF advert ever. I was rushed into the IVF theatre very quickly.

Once there I begged them to do something. My Dr wasn’t particularly helpful. She said they could put a drain in my side but it wouldn’t cure the OHSS just help manage it a bit. I had done some research on the drain and begged them to do it. They gave me a local anaesthetic and stuck a scalpel in the right side of my stomach and threaded a drain into it. It was painful but I didn’t care. Right away they opened the valve on the drain which led into a bag and a watery bloody liquid started to drain in. They also put me on a drip to replace fluid. I had to be monitored for a few hours, during which point one of the nurses came over and gave me a hug and said I was going to feel so much better now. She was actually right – as the fluid poured into the bag the incredible pain in my back dwindled. I wish the Dr had had the guts to say that I’d feel better if I had the drain, it’s really all I needed to hear. After they had drained out 2 litres of fluid the valve was closed, they did some blood tests and gave me some strong painkillers (which were apparently ok to take during pregnancy – though by this point I really wasn’t considering the possibility of a successful transfer much). I discharged myself because I was so pissed off with the hospital and because they said I could go home if I wanted. I had to drain off a further litre of fluid later that night. It was very difficult to walk with the drain as small movements made the drain move around and that was painful. I also had to strap the bag for the drain onto my leg but they couldn’t find a strap small enough so although it was supposed to go under my clothes the nurse had to put it outside. I also had to wear compression socks as I was at risk of blood clots.

At home I continued to drink coconut water and sports electrolyte drinks (as I did a lot of running I already had a supply of tablets that could be dissolved in water), and ate small amounts of egg with salt. The drain helped so much. The hospital phoned me every day to check progress, after 2 days I got a slightly panicked call from them. Apparently they’d only just checked my blood results which showed dehydration severe enough to require hospitalisation and I needed to go back to the hospital straight away. Turns out that I was actually hydrated ok by then but should never have been discharged the first day and instead should’ve stayed in hospital overnight.

About a day after that I woke with a really swollen right leg (the same side the drain was in) so had to go back to the hospital to get checked out for blood clots. Luckily I didn’t have any. The swelling was just the liquid collecting in one side of my body – assisted by the fact I could only sleep in a certain position.

Finally 5 days after I had been given the drain it was removed. My stomach was no longer swollen rock hard and my back was no longer in agony. I continued to eat mainly protein and drink electrolytes for a few more days. I was back at work about 12 days after my transfer.

Whilst I had a positive pregnancy test it turned out to be a chemical pregnancy – one of  many false starts under IVF.

So in summary in my experience OHSS manifests itself through a swollen hard belly and very severe backache. If you start vomiting you must attend hospital immediately, likewise if you are unable to pass urine. To manage OHSS drinking electrolytes really helps, as does avoiding carbs and sugar,  eating protein is also a good idea. I found the drain gave me almost immediate relief – but this will only be offered in severe cases. It is quite uncomfortable (I couldn’t leave the house with it in apart from to go to hospital) but worth it.

I hope no one reading this has the same experience as me, but if you are then believe me it will get better. The best thing is to be informed and get regular monitoring.

I changed clinics for my next cycle as I had only one NHS cycle paid for. My new clinic were very on top of the OHSS risks and put me on a different protocol – a bit like a mild cycle. I didn’t get OHSS again.

OHSS Risk Factors:

  • Under 35 (I was 36)
  • thin
  • polycystic ovaries
  • producing lots of follicles
  • high estradiol levels (due to stimulation drugs)
  • HCG trigger

OHSS Symptoms:

Me:

  • Swollen hard belly
  • Abdominal discomfort / pain
  • Weight gain
  • Severe backache
  • Nausea turning to vomiting
  • Frequent peeing
  • Hard to stand up straight
  • Feeling dizzy / faint

Others:

  • Difficulty breathing (if this occurs you must go to A&E immediately)

OHSS treatment

  • Drink plenty of Electrolytes (sugar free sports drinks or coconut water)
  • Plenty of sodium (as part of electrolytes or on food)
  • Cut out carbs and sugar
  • Eat protein
  • Drain / drip (in severe cases only)
  • Compression socks – to prevent possible blood clots (you may also be given clexane if you’re not already taking it).
  • Delay embryo transfer – if there is the option to freeze your embryos this is advised. Getting pregnant can actually make the OHSS worse

 

 

Embryos on board

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I had my transfer earlier this week and all went well. The 2 embryos defrosted without loosing any cells, so were still graded good quality,  and had started to hatch before they were put back. The transfer itself was very smooth which I was very pleased about as my last transfer was very difficult. The consultant was happy with how things went. She wasn’t anyone I’d seen before but really made an effort to put me at ease.

As usual I had to drink a lot of liquid beforehand. As I spent the morning at work I started to feel quite uncomfortable – in fact I had one teleconf with a colleague and really couldn’t concentrate because I needed a wee so badly – I have no idea what I said I just wanted to get off the call. As soon as it was finished I had to go and release some of the tension with a little pee! And then I had to take myself off to the clinic early because I just couldn’t do any more work or think about anything as I was so full and was worried about wetting myself on the tube or not being able to walk to the clinic. On arrival we were kept waiting for a while and in the end I had to go and find a nurse to beg for a wee as I was starting to cramp. They allowed me to have a little one. We were finally shown into a room and the nurse scanned my bladder and commented on how full it was – no kidding! So I was allowed to do a full cup of wee. I had probably over drunk but I was so worried about the transfer not going smoothly because of my slightly tilted uterus.

I was offered pictures of the embryos but I declined. If successful then I may see if I can get hold of them but I just chucked some old embryo pics a few months ago that I’d hidden away in a drawer. I couldn’t quite bring myself to chuck my scan pic from my last but one pregnancy (I didn’t ask for one on my most recent pregnancy – for the same reasons).

I didn’t sleep well the night before transfer and when we got home after the transfer I was so exhausted I had to go to bed – which isn’t like me. I really struggled to get up after an hour for my acupuncture appointment. My usual acupuncturist was on holiday but I’d been lucky to find someone else nearby who specialises in fertility.

Now it’s just time to wait. The last couple of transfers I’ve taken some time off work but I went back to work the next day this time. I’ve made a big effort not to stay too late (which I’ve semi-achieved) and I’ve also gone in 15 mins later each day.  At the last minute I decided to take today off which was just as well as last night I got cystitis. No idea why – perhaps because of how overfull my bladder was on Mon. It was really painful last night but this morning seemed to be gone. I’ve been to the GP this morning just in case and all looked fine.

I’m really trying not to symptom spot – but in truth there’s not much going on as it’s early days. I just need to wee a lot which is probably the progesterone. Next week will be the killer – I’ll be analysing every twinge and absence of twinge.

My clinic have a test date 16 days after a 5 day transfer which is quite ridiculous. My last clinic was 11 days and I think the one before that was 13 days. One of the nurses said I was fine to test on day 9 but if negative they’d make me stay on my meds until day 16. I haven’t decided when I’ll test yet but I don’t think I’ll make it until 16 days! But I may not do it as early as 9 days.

5 day transfer timeline

1 day post transfer – Blastocyst hatches out of shell on this day
2 days post transfer – Blastocyst attaches to a site on the uterine lining
3 days post transfer – Implantation begins, as the blastocyst begins to bury in the lining
4 days post transfer – Implantation process continues and morula buries deeper in the lining
5 days post transfer – Morula is completely inmplanted in the lining and has placenta cells & fetal cells
6 days post transfer – Placenta cells begin to secret HCG in the blood
7 days post transfer – More HCG is produced as fetus develops
8 days post transfer – More HCG is produced as fetus develops
9 days post transfer – HCG levels are now high enough to be immediately detected on HPT