Sunday, 23 December 2007

Abnormal Fertilisations - Information

Twenty-four hours after undergoing an egg retrieval procedure, a patient will receive a fertilization report. Occasionally the report will indicate that some of their eggs fertilized abnormally. This article explains the process of scoring fertilization and explains the results.
http://www.infertilitydoctor.com/fertilityflash/vol3_issue5.htm
During an egg retrieval procedure, an embryologist, with the aid of a microscope, quickly identifies and takes custody of the eggs. They are immediately placed inside an incubator in our laboratory where they mature for 4 hours before being introduced to sperm. Then, depending on the quality of the sperm, an embryologist will either incubate each egg in the presence of 100,000 sperm, or inject a single sperm into each egg (in a process called Intracytoplasmic Sperm Injection or ICSI).
The next morning, 22 hours after the egg retrieval, an embryologist observes the eggs and records their fertilization status. A small percentage of eggs will be immature or non-viable. The remainder can fertilize normally, fail to fertilize or fertilize abnormally.

Figure 5 is relevant to myself -

While performing fertilization checks, the embryologist will observe either no pronuclei or 2 pronuclei in the vast majority of eggs. However, a small number of eggs, usually around 5% of all eggs inseminated, will show some number other than none or two pronuclei (see Figures 3, 4 and 5). These are the eggs that are abnormally fertilized.
Having more than 2 pronuclei usually suggests that more than 1 sperm managed to enter the egg. If this happens, there is one nucleus from the egg and one nucleus for each sperm that got in. An egg penetrated by 3 sperm for example, will have 4 pronuclei (see Figure 5). Please note that the egg has 3 separate mechanisms to prevent penetration by more than one sperm, so eggs with >2 pronuclei are uncommon.

This is an abnormally fertilized egg with four pronuclei (circled in blue).

Tuesday, 18 December 2007

Plan of Action

So....mad as I must be....

Going to give it 1 more go - 1 more IVF praying that I won't have crap eggs and that I'll get lots and they will all fertilize..now in dream world...but hey..

So presumably if AF arrived 14th December, my next cycle shoud be due to start around the 10th January. I don't have to go on the pill for a month this time - straight in. I ring CD1, book scan, they heck for ovarian cyst, if no problem...start on 400iu puregon -Not certain what day.

Now - Must take the prescription into town and get it priced up, also go online with Boots. Try and save some money that way.

And that is it for now....

Appearance of AF

Well...it jut gets worse - Xmas Party 14the December - One benefit of IVF not working, alcohol..and in theory on AF until at least 16th...no such luck on my part! AF appeared 14th Dec but waited until I'd arrived at work and had to pop out and get tampons...doh...

So Xmas Party was good - Far too much white wine, another downside of where we went, no alco-pops. ...and felt like crap on Saturday...

Thursday, 13 December 2007

Contents of Letter - No special belated Christmas Present for Mum and Dad..

None of the five eggs retrieved on the 3rd of December fertilised normally and no embryos were available for transfer. It appears on this cycle to be an egg factor, as three of the eggs fertilised abnormally and an abnormal polar body was seen on the fourth egg.

I have explained to Julie that two cycles can sometimes be different although an underlying egg factor cannot be excluded. She may wish to try again and I have suggested 400 IU of Puregon on an Orgalutron protocol. I have discussed the option of ICSI which may optimize her chance of success. Meanwhile I have also mentioned the option of donor eggs.

Tuesday, 4 December 2007

Bad News

Well..I've become a statistic.

At least 2 eggs fertilised abnormally - 1 had 3 sperm inside it - the other I don't think fertilised. I never asked enough questions on the phone - I have an appointment tomorrow and will find out more then. Obviously not happy - Dealing with it - So there you are...what can I say...how come I'm so fantastic with children but have none of my own - why is live so unfair.

I really don't understand and I suppose I have to be thankful for a lot of things I have in my life and yes I made my own choices - But what is wrong with me? I don't think I'm that awful - but I am single no man on the horizon...and can't even manage children on my own...what is the point to my life? Can't just party! Can't just go on holiday...I need meaning...and I so wanted to give my mum and dad a grandchild.....

Monday, 3 December 2007

Egg Collection


Back from clinic - went well - Even though look like I've been attached by lots of needles - My veins are crap!5 Eggs collected so that is good news. can't remember anything about the collection (and I really wanted to!) and have very little bleeding..oh and choose option 2 for donor! Decided as a bit taller, a bit more information on profile - The lady who went though it with me told me he has very blue eyes and she can always ask him to do me a sketch. The clinic have just rung me to say that they will be doing IVF as the sperm is good enough for that - They seem to call it ICSI if that is the route you have to go. So that must mean they are good swimmers. Tomorrow morning I will get a call. If 2-3 fertilize then I'll be back in tomorrow to get them put back - If 4-5 fertilize then they will wait to see how dividing goes and re-insert on Thursday. I really hope that some of them fertilize....

Sunday, 2 December 2007

Trigger Injection

Well the injection last night wasn't as bad as I expected! Mind you having my own personal nurse to do it probably helped!! So thats it for injections....

Early train tomorrow morning...

Donor Choice Update

Gosh - Far more difficult than I realised!!

Definitely not donor 3, though preferrable for education and hobbies etc I don't think Mexican is a good idea - Would prefer the child characteristics to be more like mine if they are not going to hae a father around - Also when I think about the guys I fancy/meet not really Mexican....and if I met someone after having the baby would prefer it to look more like both of us if that makes sense (Doh..if the next man I date is Mexican...!!)

Donor 1 - What does Large build mean? Chunky? Fat? Broad? I like broad...lol..do like the idea of a sketch that the child can have - Give them something of their "father" but other than that he doesn't really say much about himself. Might prefer a bit taller. Oh other reason for choosing...occupation printer..my grandad was a printer..proven fertility...does this mean it would be more likely to work??

Donor 2 - We medium build and taller so that would give the child a chance of being taller than me!! Especially if a boy. Give more information about himself but no sketch. How important is that? If I were a child would I at east want something?On the flipside - Now the child can trace the father, maybe it isn't as critical. No proven fertility..humm...

At present have a feeling about donor 1.. have however asked clinic about alternate options...problem is that might just make my life more difficult!

Saturday, 1 December 2007

GUARDIAN ANGEL


Let me know what happens to you the morning after you open this e-mail. This is an unusual one. It actually gives you a time tomorrow. Let's see if it works. GUARDIAN ANGEL Forward this message the same day you received it. It may sound ridiculous, but it is right on time We believe that something is about to happen. Angels exist, only sometimes they haven't got wings and we call them friends; you are one of them. Something wonderful is about to happen to you and your friends. Tomorrow at 9:12 AM somebody will address you and tell you something you have been waiting to hear. Please do not break this chain. Send it to at least 7 of your friends.


Donor Choice

DONOR CODE canning 1 Ethnic Group Caucasian – British Blood Group O Positive Eye Colour Blue Hair Colour Dark Brown Height 1.71m Build Large Skin colour Medium Religion Church of England Occupation Printer Education Secondary Interests All sports Donors Pen Sketch (can be given to the mother once a baby has been born as a result of using this donor sperm) yes Proven fertility Yes Length of storage consent (yrs) 10 years HFEA Registration Number Any limitations stipulated by the donor. Caucasian use only; No export Is this donor homosexual? No

DONOR CODE canning 2 Ethnic Group Caucasian Blood Group 0 + Eye Colour Blue Hair Colour Dark Brown Height 1.82 m Build Medium Skin colour Light Religion Christian Occupation Builder Education College specializing in systems of automatics Interests Biking, swimming, cinema, computer Donors Pen Sketch (can be given to the mother once a baby has been born as a result of using this donor sperm) None given Proven fertility No Length of storage consent (yrs) 10 years sperm; 5 years embryos HFEA Registration Number - Any limitations stipulated by the donor. None Is this donor homosexual? No

DONOR CODE canning 3 Ethnic Group Caucasian - Mexican Blood Group A Positive Eye Colour Brown Hair Colour Black Height 1.79 Build Medium Skin colour Medium Religion None Occupation IT Consultant Education Degree in Computer Science Interests Sport, science, nature, long walks, culture, travel Donors Pen Sketch (can be given to the mother once a baby has been born as a result of using this donor sperm) Yes Proven fertility No Length of storage consent (yrs) 10years HFEA Registration Number * Any limitations stipulated by the donor. None Is this donor homosexual? No

Preparation for Egg Collection

Egg collection scheduled for 9am, 3rd December.

To be at clinic or 8.15am.

I believe that before treatment they will discuss how many embryos I'd like transferred, as I am over 40 I can have a maximum of 3

1st December - Last Injections
  • Last Buserlin injection (WAS) 7am
  • Last Puregon injection 7.30pm, 300 iu.
  • HCG Injection 10,000iu injection tonight, 9.30pm

3rd December - Egg Collection

  • Nothing to eat after midnight
  • can drink water up to 6am
  • No nail varnish, make up, deodorant, perfume
  • Take dressing gown and slippers
  • Will be given Voltarol 100mg & Flagyl g suppositories (ick) inserted rectally for pain and infection
  • IV sedation (Midazolam & Alfentanyl) will mean semi-conscoius during procedure, might not remember anything
  • Discharged after eaten, drunk and had wee
  • Start cyclogest that day
  • Do not drive for 24 hours
  • Taken home by responsible adult (Ed is to pick me up from clinic to get me back to office)
By the time I go home from the clinic I will know how many eggs they have collected

Will get a phone call on Tuesday to confirm Embryo Transfer
  • Tuesday after 10am (if only limited embyros)
  • Thursday after 10am (If a choice of embryos)

Friday 30th November

On Thursday I was sent a guardian angel - one of those chain mails that goes round. It told me "Tomorrow at 9:12 AM somebody will address you and tell you something you have been waiting to hear"- As I'd read it - I thought about my scan - 9.12am was about the time I'd hear my result. Maybe I do have a guardian Angel.

I was slightly late getting to my appointment (8.30am) then had to wait as they were running a little late. Well....went in..not hopeful..and...left ovary 1 follicle, right ovary 4 follicles..and maybe a couple that might catch up. Never asked for photo as thought it would jinx it.

The Nurse - saw a lovely nurse today, didn't catch her name. She was really surprised to tell me that everything was now on target!! She doesn't really understand it but my follicles had decided to get there act in gear! Poor woman was trying to subtly say something about my age lol I let her off the hook by saying yeah I know I'm an OAP - She didn't want to upset me but of course I am realistic and realise I'm not as young as I could be!!! So now everything goes ahead!

Friday and Saturday night 2 more lots of Puregon (300iu). Then trigger shot Saturday night - In to clinic for 8am Monday for Egg Collection...

So my guardian angel was looking after me - Thank you xx

Thursday, 29 November 2007

Date Update

Well..umm.. txtd Brendan yesterday letting him of hook..tonight I get a reply!! Seems hes had flu and only just gone back to work today. Also might be off to Scotland for work. He says he 'll ring me next week..lets see...

Right...well did my 400iu injection early today. Just after 6pm - I decided it might give my follicles a higher chance of growing ready for tomorrow morning.

So early train tomorrow, appointment at 8.30am. Fingers crossed.

What is AMH?

Not trying to pre-empt tomorrows scan but I believe that my FSH can come out good when really its not - Maybe I should have had this test? Will have to see what happens tomorrow.

Anti-Mullerian Hormone (AMH) is a new blood test developed following clinical research which measures ovarian function – how your ovaries are working. It is more accurate than a simple oestrogen test. Currently it is not available on the NHS.It can help reassure women about their current and medium term fertility – important when deciding when to try for children ,especially for women who work. It can also help to predict a likely menopause, and is starting to be used by some clinics to help judge possible IVF success and also as a marker of polycystic ovarian syndrome – a common hormonal condition.

More information:
http://www.tdlpathology.com/index.php?option=com_content&task=view&id=201&Itemid=73

Wednesday, 28 November 2007

Second scan on puregon

Managed to get to the appointmnet for 8.15am even though it wasn't until 8.45...

Not good news.

Different scanning lady again. Hate the way they pull faces about my fibroid. Any way..lining good..however..left ovary..1 follicle...right ovary..none... how can that be? there were 3 on Monday! So not good news... went in to see the nurse and she said that there were still 3 follicles on right HOWEVER they haven't grown.

Dosage upped to 400iu for next 2 nights. She really didn't look positive. Has told me to talk to my follicles..humm.at present I'm cursing them!

She has said that my body hasn't reacted how they'd expect with drugs so may need to change protocol for next cycle... not that I know whether I'll do another cycle. I feel totally let down that it looks like I couldn't even get to Egg Collection - I hadn't even considered failing this early.

I suppose there is still a small chance, so Friday 8.30am.

Tuesday, 27 November 2007

Wednesday - Things to Ask List

  • When will I get a call about the sperm?
  • Can I have a photo of my follies?
  • Can I have some needles for the morning injection?
  • Check Drug supplies before appointment
  • OMG how expensive is that extra drug I've got to buy
  • Do I have to bring food with me on egg collection day?
Humm..this post will get edited as I think of things this evening!!

Water

Water - Well I keep thinking about drinking it but actually drinking it is another thing!! Really am struggling to drink the 3 litres the nurse suggested...but making an effort honest...don't want them not to grow cos I'm not feeding them water!!

Just a brief post - Not much to say -Scan tomorrow morning at 8.45am. Lets hope that I get there on time and no emergencies on train! :)

Quiet in the office with most of my team in Glasgow! Probably a good thing but then I've not been THAT touchy in the office.

Nothing from Brendan, which in reality is probably a good thing - In fact I know its definitely a good thing.

I wish that the next week would go really quick.

Monday, 26 November 2007

Date

Amongst all this madness I go asked out on a date!! Aussie called Brendan. Spent Saturday with him (8.5 hours so I assume we got on pretty well!) - Great day but I'm not going to hear from him again - Usual stuff maybe I'd be better off looking my age. He never realised quite how old I was...and had to admit it after he asked what Year I left High School! So its now Monday evening and I've heard nothing from him. His loss...hell how would I explain this??? Life is crazy sometimes...I'm cool about it..just a shame...

First Scan after starting Puregon, 26th November

Interesting morning or a day off!!

Got up at 6am so that I could catch the 7.01am train. All going to plan until someone pulled the cord on the train!

http://www.newburytoday.co.uk/News/Article.aspx?articleID=5711

So rather than getting in at 7.45am I got in a 8.45am!!! 1/2 an hour after my appointment.

So...circle line to Portland Street and into the waiting room.

http://www.londonwomensclinic.com/

The Scan (Janet Brown) - 26th Nov

Humm...not keen on this woman..oh well..just not very friendly...never mind...

So right ovary 3 follies around 11-12mm. None on left at present. Think this is what you'd expect however I'm a little disappointed. This means they are developing...slooowwwww...

So..booked in for next scan on Wednesday - Dosage of Puregon increased to 300iu for next 2 nights- I might try and take it a bit earlier than I have, obviously still in the evening.

Action Plan After Today
28th - Scan (remember to ask about donor sperm!)
30th - Scan
3rd or 5th Dec - Egg collection
5th or 7th Dec - Assume embryos put back
18th or 20th Dec - Approx test date??? Not certain whether meant to do 14 days after embryos back or egg collection!!

First 7 Days of Puregon

Tuesday - 20th November - First Puregon injection - 250iu per day for next 7 days. use the pen - Not so keen as the morning injection!!

Puregon is a hormone called Follice Stimulating Hormone (FSH) which is reponsible for the growth of follicles in the ovary.

From Wednesday morning, 21st reduced the amount of Buserelin to 0.2.

Ended up having a few bruises on my tummy...

Friday, 16 November 2007

AF Arrived!

Well AF arrived yesterday, earlier than I expected. Thought it would be Saturday.

So still doing injections, scan booked for Tuesday morning, 8.45am. Presume that will be the day I start next lot of injections....

Now to bed x

Saturday, 10 November 2007

Acupuncture may reduce the success of IVF

Acupuncture may reduce the success of IVF
MacKenna RobertsProgress Educational Trust - 27 October 2007

[BioNews, London]

Contrary to the widely held belief that acupuncture enhances a woman's chances of successfully becoming pregnant whilst undergoing IVF treatment, a study at the University of Oklahoma found that women who combine acupuncture and IVF were 37 per cent less likely to conceive than those who underwent IVF treatment alone. The new findings caused head researcher Dr LaTasha Craig, to warn that acupuncture should not be recommended until further research has been conducted to resolve the discrepancy between this study and earlier research.
Previous studies had appeared to indicate a marginal increase in IVF efficacy or showed no obvious benefit, allowing some to scientifically postulate that the ancient far eastern medical practice of acupuncture might somehow affect certain muscles and glands of the nervous system to help the lining of the uterus become more receptive to embryo implantation.
The latest study evaluated the results of 97 patients with an average age of 35 who were randomly divided into two groups. One group received acupuncture for 25 minutes before and after embryo implantation. The pregnancy rate for the IVF group without acupuncture was 69.9 per cent compared to the 43.8 per cent less successful pregnancy rate for those who received the two-pronged acupuncture 'therapy' approach. Dr Craig suggested that other factors may have counteracted any therapeutic effect of acupuncture such as the stress from undergoing acupuncture just before IVF or from travel in traffic to external acupuncture clinics and onto IVF appointments.

Some clinics regularly offer acupuncture with its IVF services, according to Mark Bovey from the British Acupuncture Council, who was alarmed by the results. Although the number of women who undergo IVF alongside acupuncture procedures has skyrocketed, many doctors believe that the placebo effect is a likely explanation for any perceived benefit.

Injections

Well....

Went to clinic on Tuesday, 6th. saw counsellor, discussed donor issues and what I would tell my child. Spoke about guardians and male figures. Then saw nurse about blood results and to collect needles etc for my injections.

On pill, only a couple more days to go then wait a week for my period.

This was the third day of my injection, 0.5 Buserelin, injecting first thing in the morning.

Being trying to drink lots of water but not easy, had a bit of a headache yesterday.

Feel pretty laidback about it all. Well...I think so!

Blood Results

Printed off 1st November (figures) other data from websites

As of early 2006, at most laboratories in the U.S., the official "normal" Thyroid Stimulating Hormone (TSH) blood test range runs from approximately .5 to 5.0.

Late in 2002, this group reported that: "In the future, it is likely that the upper limit of the serum TSH euthyroid reference range will be reduced to 2.5 mIU/L because >95% of rigorously screened normal euthyroid volunteers have serum TSH values between 0.4 and 2.5 mIU/L."

Serum TSH level = 1.3mu/L

Serum prolactin level = 353 mu/L


Oestradiol (E2) this hormone level is determined at the start of the treatment cycle, and 2 or 3 times during the monitoring phase of the treatment cycle during ovarian stimulation. The levels of E2 are very helpful in determining whether the growing follicles are likely to be developing eggs, and can help predict the possibility of ovarian hyperstimulation syndrome (OHSS). In this regard it is possible to tailor the drug dosage and plan how to minimize the risk of developing OHSS.

Serum oestradiol level = 155 pmo/L

Luteinizing hormone (LH) is the last hormone to peak before ovulation and is the hormone responsible for triggering the rupture of the ovarian sac that releases the egg for ovulation.

Serum LH level = 4.4 u/L

The FSH level is also performed as an indicator of ovarian reserve prior to commencing ovulation induction or stimulation. It is important to note that these hormone levels fluctuate in the circulation and hence levels can appear to vary from cycle to cycle. Consistently high levels can indicate the menopause or premature menopause. Consistently very low levels can indicate an endocrine disorder arising from the pituitary or higher centers in the brain.

Serum FSH level = 5.4 u/L (I believe very good for an old bird!)

Saturday, 20 October 2007

Small Ovaries

When I had my internal scan she told me that I have small ovaries, being naive I never actually asked what this meant - Since getting home I've goggled it! I beleive that this probably confirms my decison to go ahead now and not wait...lets hope when I get my day 3 blood results I haven't waited too long.

Article from Telegraph
"A test that shows how fast a woman's biological clock is ticking and how long she has left to start a family has been developed by British researchers.
The technique could revolutionise infertility treatment and identify the one in 10 women who are at risk of an early menopause.
It could also help women in their thirties to decide how long they can safely delay having children while they build a career. The test uses an ultrasound scan to work out the size of a woman's ovaries and a complex computer programme to predict how many eggs she has left. Ovaries are thought to have a finite number of eggs and the number falls throughout a woman's life. When the number reaches around 25,000 - typically when a woman reaches the age of 37 - the decline accelerates and over the next few years women find it more difficult to conceive. When the number reaches around 1,000 the first signs of menopause begin to appear."

Article from the New Scientist

Test to predict menopause revealed (2004) - "UK researchers have shown a strong link between the size of a woman's ovaries and the number of eggs she has left. Hamish Wallace and Thomas Kelsey used this link to create a model that should be able to predict a woman's "reproductive age" to within one or two years using her chronological age and a measure of the size of her ovaries. Ovarian volume can be measured with a simple ultrasound technique that doctors already use to examine the organs.
"In essence, it means we now have the potential to be able to tell a woman how fast her biological clock is ticking and how much time she has before it will run down," says Wallace, at the Royal Hospital for Sick Children in Edinburgh, UK, and a lecturer at Edinburgh University.
"The accurate assessment of ovarian reserve will revolutionise the management of women requesting assisted conception, those who have had treatment for childhood cancer and those who are considering delaying a family for personal or professional reasons," suggest the pair.
Rapid fall-off
The conventional view is that women are born with a fixed number of eggs in their ovaries. Studies show that the number of eggs peaks when a female fetus is just five months old. After this, the number of eggs declines as they age and die by a process known as atresia.
When the number of eggs left reaches about 25,000 - corresponding on average to the age of 37 - there is a more rapid fall-off in their numbers. This key point usually precedes menopause by about 12 to 14 years. There are only about 1000 eggs left by the time a woman reaches menopause.
The average age of menopause is about 50 to 51, with 95 per cent of women reaching menopause between the ages of 42 and 58, says Kelsey, a mathematician at the University of St Andrews. But some women can experience menopause before this.
Reproductive age
Wallace and Kelsey used published data showed that the larger the ovary, the more eggs a woman has. The pair assume that the large difference in the ages at which women undergo the menopause results from the difference in how the number of eggs they had at birth.
They then modelled data from additional studies to produce a prediction chart. "We were trying to make the distinction between your chronological age and your reproductive age," Kelsey told New Scientist. "A 40-year-old woman could be anything between 32 and 48 [in reproductive age]."
The size of a woman's ovaries can be measured by a commonly used technique called transvaginal ultrasound. "The big thing about this technique is that it is non-destructive and cheap and widely available," Kelsey points out. "It's practical."
Kelsey says they are "optimistic" about developing the model as a prediction tool, but notes that more tests are needed to validate the accuracy of the method."

LWC

Well I finally took the plunge.

I've always wanted children, but I've always thought I'd met "the one", someone that loved me and wanted children with me, the perfect family scenario. Its taken me a long time to realise this just wasn't going to happen - Or at least by the time it did I'd be too late to have children - The added problem being that any single available men I've met have already got children and don't want more, and then more than likely have had the snip.

So on Thursday 18th October I went to the London Womens Clinic. £295 later..internal scan complete, programme agreed and CD3 blood test to arrange. The doctor said I had small ovaries, I never thought to ask what this meant. I've since looked it up and found that does mean I potential close to menopause (I suppose obvious at my age any way!).

Oh and the Progamme - IVF - I could have done IUI - But because I did try to conceve naturally in the passed for 2.5 years the doctor felt the best and most likely treatment to succeed was IVF. I'm going to try and keep positive as there is a 1 in 4 chance of success. Oh and as I'm over 40 they reinsert 3 embies for luck. Lets hope I even manage to get to that stage..

What does this potentially mean? Well I could in theory be pregnant by Christmas! Will be interesting not drinking leading up to Christmas and avoiding questions, though I'm assuming the odd dirnk shouldn't be a big issue....

Why a blog? Well - When I succeed I'd like to share with my child my thought processess and how I came to have them in my life - I know it will be difficult for them not having a none father but I hope that they realise how lucky they are and how wanted they were and how the decision to do this was not taken lightly. I believe we the way the world has changed a child with a father still living at home is more of an exception - This doesn't make it right but I hope it makes it easier.

How I tell a child? At this stage, no idea. I do know that I'd want to bring it up from an early age knowing so that at 13 it has no big shocks to deal with....