I managed it!! 1 Egg Fertilised!

Yeah...I know its still a long way to go but hey this is further than last cycle. Phone call 8.40am. I had 1 fertilised egg!! Couldn't believe it. So...drank water (have to have full bladder for embryo transfer).. 0.5 litre then 0.33 litre when I got to the clinic. Still didn't feel like weeing...they said wait 10 mins...then nurse gave me a cup of tea to help... there was another woman awaiting her transfer..she went in...and was far longer than I expected! I was desperate to wee. So...they took me in and scan me and my bladder was TOO full..so...had to go to loo..wee...but stop..managed it but thought I'd relieved myself too much...went back in...it was fine still plenty there!!

So - They did my embryo transfer - 1 embryo on board - Just have to hope that it sticks - Test date 16th February. As from last night doing 2 pessaries each day (morning / evening)

Photo:

Big black area - Full bladder

Area under bladder -Womb

Faint little white line, fluid containing embryo - It's too small to see! :)

Nurse advised me - No lifting, no baths, no swimming.. eat as if pregnant...

Factors resulting in poor egg quality or maturity

Determining the factors resulting in poor egg quality or maturity is difficult. Let's look first at what maturity means, and then at what might go wrong.All the eggs you will ever have were formed before you were even born, halfway through your mother's pregnancy. The eggs all started out with 46 chromosomes. But since we need just 23 chromosomes from the sperm and 23 from the egg, an egg must get rid of the extra 23 chromosomes, in a process called meiosis. Meiosis of all your eggs began while you were in your mother's uterus, but was not completed. The process was arrested, to resume in an egg after it receives a signal from your body's LH surge or the administration of hCG just prior to ovulation. For egg retrieval, hCG is administered approximately 36 hours before egg retrieval. It is the resumption of meiosis in response to that signal that determines egg maturity.
Unfortunately not all eggs receive the message and resume meiosis appropriately. Why? We don't really know. Possible factors include blood supply to the ovarian follicle in which the egg develops, hormone levels in the follicular fluid, the function of the hormone receptors on the egg, LH levels in the early follicular phase, the presence of normal egg chromosomes, ovulation medication schedules, and laboratory culture conditions. Much research is going on to determine the most important factors and to develop a culture environment that best supports maturation of the immature egg.

This is just so Shit

They did ICSI. Only 2 of my eggs were mature. They hope that both fertilise over night. They are warning me that there is a possibility that neither will fertilise. IF either of them do fertilise I go back in tomorrow for them to be put back....why is this all so crap.

Success Rates of Micro-Assisted Fertilization/ICSI

Not all eggs that are recovered from the woman are suitable for sperm injection, although this is usually a very small proportion. About 10% of eggs injected with sperm do not survive the injection procedure, and become damaged. Of those eggs that are injected, about 50-60% should fertilise, but only about 40% of injected eggs will fertilise normally and develop into embryos that are suitable for replacement into the uterus or, if the couple wish it, freezing and storage.
As with conventional IVF, the majority of couples attempting ICSI should get to the stage of embryo replacement, and about 30% of couples will get a positive pregnancy test. Unfortunately, about 25% of pregnancies are lost very early on. Thus, the chance of a clinically recognised pregnancy following a single cycle is about 30%, or one three. In other words, a single treatment cycle has a greater chance of failure than success, and it is important that couples embarking on such treatment should have realistic expectations.

As with all techniques of assisted conception, the results are very much influenced by the age of the woman. Success rates in women over 40 are well below as 10% per attempt, even in experienced centres. The graph above shows the effect of age on success rates in the whole of the UK, and is taken from the HFEA’s data for 2002-03.

Outcomes of Pregnancy Achieved With ICSI
What are the risks of ICSI treatment? ICSI is an invasive technique and may result in the use of sperm that would not otherwise be able to fertilise an egg. For these reasons, concerns about the potential risks to children born as a result of ICSI have been raised, and several follow-up studies have been published. ICSI is still a relatively new technique, and all children conceived using ICSI are still very young. Consequently, these follow-up studies involve relatively small numbers of children and do not include effects that may only be seen in older children or in the next generation. Clearly, more studies are needed, but the use of ICSI has been potentially linked with certain genetic and developmental defects as explained below.

What is ICSI and the Implications

Note: Not taken from my clinic website



ICSI, short for intracytoplasmic sperm injection, is the direct microinjection of a single sperm into a single egg in order to achieve fertilization. It was originally developed in 1992 to assist fertilization in couples with severe male factor infertility.

Who Should Consider ICSI?

• Previous poor fertilization with IVF
• Decreased number of eggs for fertilization
• Variable sperm count
• Unexplained infertility
• Many patients choose to undergo the ICSI procedure in order to maximize their success even when the procedure may not be necessary.

What are the risks associated with ICSI?
There are several risks. First, during the ICSI procedure, a small number of eggs -- usually less than 5 percent -- can be damaged as a result of the needle insertion. Second, the overall risk of having a baby with a chromosomal abnormality in the X or Y chromosomes is 0.8 percent, or eight per 1000, which is four times the average seen with spontaneous conception. At present, we do not know the reason for this increased risk. It is important to understand that the following problems can be associated with sex chromosome abnormalities:

• Increased risk of miscarriage
• Heart problems for affected infants that may require surgery
• Increased risk of behavior or learning disabilities
• Increased risk of infertility in your children during their adulthood
• The risk of having a chromosomal abnormality like Down's syndrome is not increased with ICSI but increases with maternal age.
• Several studies that have addressed the issue of developmental delays in children born of ICSI. However, there is no conclusive evidence that this is the case.

Will all of our eggs be injected?
If you decide to proceed with ICSI, we will make every effort to inject as many eggs as possible. It is important for you to understand that only eggs that are mature can be injected with sperm. IVF laboratories can easily tell if an egg is mature or immature. Although the immature eggs are incubated with sperm, the likelihood of fertilization is very low. On average, we are able to inject 75 percent to 80 percent of the eggs that are recovered.

Are there differences in embryo quality or pregnancy rates between ICSI and non-ICSI embryos?
There appears to be no difference in the overall embryo quality achieved with ICSI embryos when compared to non-ICSI embryos. Similarly, no difference in pregnancy rates has been shown between ICSI embryos and non-ICSI embryos. Although unproven, there is a belief among many infertility specialists that ICSI may increase embryo yield from a given number of eggs recovered, which has contributed to the increase in ICSI procedures.

Egg Collection

Well this seems to have gone well so far. They managed to collect 7 eggs. Back home 12.10. Feel ok in fact could have gone to work! Will take it easy this afternoon and migh be catching up with my next door neighbour, Becky.

I asked them how mature they looked. They said several of them looked good (mature) but a couple were dark (possibly not mature/abnormal). Discussed whether it should be IVF or ICSI - Think that they will go along the route of ICSI though there is the risk of damaging the egg as they have to remove the outer layer of the egg an just inject 1 sperm into each. Think they would inject a sperm into all 7 eggs even if a couple look not so good. Think they might be calling me this afternoon to confirm what they have decided but not certain... if not I get a phone tomorrow morning...

Egg Collection tomorrow

Well..nearly there yet again...most people worry about the 2 week wait..me..I worry that I get a phone call Thursday telling me its not worked again...I suppose first hurdle is hoping they actually get some eggs tomorrow...I really hope that they do...

IVF2 : Last Scan before Egg Collection

Last scan - Everything looking good so far - 8 follicles so hoping that 8 good quality eggs..in fact as long as at least 1 I'll be happy - ok ok yes I'd prefer 3 so that maximum chance of success but after last cycle...pleased that the lady doing the scan did the photo - I never actually asked so was really pleased when she did it, I thought I was being a bit cheeky asking again!

Have to be at the clinic early on Wednesday, so early night tomorrow. They will ring me Thursday to say how things have gone. Then hopefully either back to clinic on Thursday or if really successful Saturday. Fingers crossed that i do have to go back one of these days for the embryos to be replaced.

Spent another £50 - This time on 1xOrgalutran, injection a little later than planned 6.50pm, then Pregnyl - to be done at 9pm. Going to Carolines house, my own personal nurse x

IVF2 : This weeks plan of Action

Monday - Appointment at 8.45am for last scan - As long as this goes well will be taking Pregnyl this evening to trigger ovulation.
Wednesday - Early train for Egg Collection. Still to arrange whose picking me up, my last pick up person won' be able to help as they'll be in a meeting. Not too worried about this..
Thursday - Dreaded call - I'm really not looknig forward to this - What if it is exactly the same as last time? What then? Dealing with it won't be good....dependent on this call with be:

• No fertilised eggs again - Over - No more - Baby never to be
• Back to clinic for embryo transfer if only 1
• More than 1, back Friday or Sat for for embryo transfer. Not certain how they deal with the weekend as if same as last time that would be Saturday...
• 2 weeks after embryo Transfer - Period or test

I don't want to think further than Thursday to be honest - Thursday is going to be an awful day...

IVF2 : Fridays Scan..

Well everything going well so far though egg collection has been moved from Monday to Wednesday, I assume to let some of the smaller ones catch up. The nurse was pleased that was the main thing. Some of the bigger follicles were 16mm.

This photo shows a few of my follicles but they can't capture all of them.

IVF2 : Donor Choice

DONOR CODE canning 1
Ethnic Group Caucasian – British
Blood Group A Positive
Eye Colour Blue
Hair Colour Dark Brown
Height 1.81m (Just under 6ft)
Build Medium
Skin colour Light/Fair
Religion Church of England
Occupation Recently left the Navy
Education NVQ x2
Interests History, walking, football, cycling
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. Discard after death
Is this donor homosexual? No

DONOR CODE CANNING 2
Ethnic Group Caucasian - British
Blood Group O Negative
Eye Colour Blue
Hair Colour Light Brown
Height 5’10”
Build Medium
Skin colour Fair
Religion None
Occupation Tele marketing
Education Secondary Education
Interests Music, sports, socializing
Donors Pen Sketch (can be given to the mother once a baby has been born as a result of using this donor sperm) No
Proven fertility No
Length of storage consent (yrs) 10years
HFEA Registration Number *
Any limitations stipulated by the donor. *
Is this donor homosexual? No

IVF2 : 2nd follicle scan

Appointment 1.45pm.

I actually like Janet Brown the scanning lady now... not because she did anything special but I've got used to her.

My lining is good.

I still have 9 follicles growing! Well that is a real relief after last time... growing slowly but the nurse said this is better...

Next scan Friday.

Egg Retrieval probably Monday!

IVF2 : First follicle scan

1.30pm appointment today.

Had 4 days of 400iu of Puregon, also start second injection this evening, though forgot to ask how far apart these needed to be in time.

As for scan - Better result than when I started last cycle.

Left ovary - 2 follicles started (last cycle 1st scan there were 0)
Right ovary - 7 follicles started(last cycle 1st scan there were 3)

Think they were measuring about 1cm....(last time 11-12mm so about the same)

Wednesday appointment - 1.45pm
Friday appointment - 9am

Clinic Bill / Drugs to start

IVF - Single Cycle £2750.00
HFEA FEE - IVF £104.50
Donor Sperm & Prep £400.00
Total £3254.50

Finally ordered from Boots online. Boots online was nearly £500 cheaper than the store - How scary is that - It was also over £300 cheaper than clinic. I still might need extra but at least I saved some - £300 is the sunny holidayI've been looking at in Corfu!

Puregon £1366.47
Orgalutron £187.45

I've got to still buy pregynl but still got rest in fridge from last incomplete cycle.

CD2 : Clinic Visit

As AF here properly now rang clinic. It ws a bit of a shock when they asked me to get in today as well! Friday was a bit difficult as morning off and meeting in the aternoon, but I thought they'd want me in tomorrow.

So...yet another internal scan - To make certain I have no cysts from the last cycle. All good.

Went and saw the nurse to see what happens now.....so..

CD3 - Thu - 17th - 400iu Puregon (pm)
CD4 - Fri - 18th - 400iu Puregon (pm)
CD5 - Sat - 19th - 400iu Puregon (pm)
CD6 - Sun - 20th - 400iu Puregon (pm)
CD7 - Mon - 21st - 400iu Puregon (pm)- SCAN 1.30pm - Orgalutran injection 0.25mg
CD8 - Tue - 22nd - 400iu Puregon (pm)- Orgalutran injection 0.25mg
CD9 - Wed - 23rd - 400iu Puregon (pm)- SCAN TBC - Orgalutran injection 0.25mg
CD10 - Thu - 24th - 400iu Puregon (pm)- Orgalutran injection 0.25mg
CD11 - Fri - 25th - SCAN TBC - Orgalutran injection 0.25mg
CD12 - Sat - 26th - Orgalutran injection 0.25mg
CD13 - Sun - 27th - Orgalutran injection 0.25mg
CD14 - Mon - 28 - SCAN or Egg collection

That is ABOUT right - It gets all flaky dependng on whether my follicles want to play ball or not!

Is this AF or not???

Well...humm...think my period is here...or is it? Very light...not convinced at the moment. At present have avoided ringing the clinic..I know it sounds stupid but I've had this cold and cough and I suppose I don't have much positivity about the whole thing...drug are going to be over £1500.

Information on Drugs - Orgalutran® (ganirelix)

Orgalutran® is an innovative new product that reduces the time patients will be treated in IVF (in vitro fertilization) from 4 weeks to less than 2 weeks. As a result, patients given Orgalutran in the drug phase of their IVF program will have a much simpler procedure. Their exposure to drugs is reduced, as are the physical and emotional burdens associated with IVF treatment.

Shorter treatment duration makes treatment more convenient

Orgalutran prevents the premature rise in levels of a hormone called luteinizing hormone (LH), during specific infertility treatments such as IVF and ICSI (intracytoplasmic sperm injection). During stimulation of the growth of multiple follicles with gonadotropins such as follicle-stimulating hormone (FSH), a rise in LH at too early a time may have unfavorable effects on the eggs and the possibility of getting pregnant.

Two types of treatment regimens are being used to avoid an early rise in LH: Gn-RH-agonists and Gn-RH-antagonists (Gn-RH being gonadotropin-releasing hormone). Orgalutran is a Gn-RH-antagonist that has the ability to instantaneously shut down the body’s own hormone activity. It achieves immediately what Gn-RH-agonists can take 2-3 weeks to do, and is therefore only required during the final days of stimulation.

Information on Drugs - Puregon® (follitropin beta)

Puregon®, recombinant follicle-stimulating hormone (FSH), is a pure gonadotropin widely used to treat infertility. The product was launched by Organon in 1996, the culmination of a 12-year research and development program.
Easy-to-use, flexible treatment of infertility with the Puregon Pen®, allowing tailored dosing

In women a course of Puregon treatment will stimulate the development of follicles in the ovary. Prior to IVF (in vitro fertilization), the ovaries are stimulated by Puregon so that several follicles develop to produce eggs. These can then be collected for fertilization in the laboratory. In infertile men a course of Puregon is indicated to create sperm cells and/or increase their number.

Puregon is available in various presentation forms, including vials, ampoules, and cartridges to use with a pen device. It can be administered at home, or in clinics by a nurse or doctor.