IVF - The Ins & Outs that aren't in the pamphlet

I had a follower snap me the other day asking about the "real" ins and outs of IVF. You can read all about the steps in all the pamphlets the doctors give you. But they can't tell you how you will feel, will you need care for your kids if you already have them, will you turn into a crazed psychopath on the hormones? That kind of information is harder to find. So I shared my experiences with her to help and thought that could be relevant to anyone else planning on going through IVF too. I know I wrote about my feelings and the emptional side of doing IVF  but this delves a little deeper into the actual process, so if you want to know what to expect from someone without a medical degree the you have found the right place!Please note that everyone reacts differently to drugs and hormones, so this is entirely my experience with them and yours could be the polar opposite. The daily  injections, this is I think a major fear for anyone starting fertility treatment, especially if you are afraid of them. I'm ok with needles but the thought of injecting myself really freaked me out. Jay of course offered to do it for me, but they need to be done at a certain time each day and didn't want to have to rely on him if he got stuck at work or something. So I sucked it up and injected myself, I worked myself up the first time and cried and cried but it actually didn't hurt. You grab some skin on your tummy between two fingers and inject into that fold of skin, it's such a small prick you won't really notice it. You do this everyday so to avoid getting sore by sound the same spot you kind of go in the shape of a 'smile' from one side of your tummy down and around to the other side. I definitely got some bruises and the places of injections can be a bit sore. The only ones I found to kind of hurt were the ones I had to take in the evening to stop ovulating for the last week or so (I'm so sorry but being over 3 years ago I can't remember their name and the finer details) but you had to mix the powder and water yourself to make the injection, a part I actually found fun pretending to be a doctor! These injections made the inception site feel kind of itchy and they would swell a bit more, but nothing major. So please don't worry too much, the injections were one of the easiest aspect of the whole thing.

Will these drugs make you a crazy person or gain weight? for me personally the later was true, I was the heaviest I have ever been when we did the removal of the eggs. However, I actually was super chill and "full of love" when I was taking the hormones. Which was the opposite to how I was when on Clomiphene aka a crazy lady who my husband really didn't like! I had heard horror stories online and in magazine articles of people feeling awful, sick, emotional un stable on ivy drugs but every actual person I know who has done it said they felt totally normal if not better than normal. So I can't promise you anything but I hope you don't end up being one of those people who said they literally could never face doing another round because of how ill they felt, that would suck! Anyway, our doctors told us I may feel really happy as the hormones can give you that lovey dovey feeling, and it did. Jay was very happy with a very loving and touchy feely wife! So yes there are bad sides, hey weight gain, but I found my mood was great. Once again, this is what happened with me, so no promises.

Blood work, more needles! Great! Every second day about a week after I started injecting I needed to get blood work taken so (I think) they could check my hormone levels and figure out when I would ovulate so they could time the harvest (that is a horrible word isn't it when thinking of your lady bits) of the eggs. This was the biggest pain for me as you had to go to a clinic to have this done, trying to fit this all in before work, when EVERYONE else has the same idea means some early starts! I imagine if you already have kids this will be the hard part since you an wrangle kids with a needle in your arm!

Scanning! So many bloody scans. Safe to say you get very used to having a probe up your vagina to scan your insides! Trust me, when they first pull this thing out it is a bit horrifying, especially if you have never had an internal scan before. You probably have had one to get to the stage of needing IVF, but nonetheless its quite confronting as it looks like a skinny dildo with a round ball on the top! It gets better, the doctor then places a condom on it and lube, I know it's for hygiene and to make things easier, but seriously it made me giggle/go bright red/clench my pelvic floor like I have never clenched it before. Even worse was the offering of shall he insert it or I!? I was DYING at this point, from a hilarity standpoint and embarrassment. I leave what option I chose up to your imagination...ok don't actually think about that, but we will leave some part of my life a mystery. Anyway off course there a little bit; the reason why they need to scan "from the inside" is they need to get a really good look at your ovaries to see how many Follicles you have. If you are like me you would have never heard of having Follicles in there, definitely didn't cover that in health class! We are born with hundreds of thousands of follicles in our ovaries and they basically hold an immature egg that matures and then is released into our uterus for fertilisation. The aim of the game with IVF is to get these suckers working in overdrive, so instead of only one follicle working it's magic like a usual cycle, they want you to grow as many follicles as possible. So during the scans this is what they are counting, to see how you are reacting to our hormones and to see how the follicles are coming along size wise. Basically, the bigger the follicle the more mature the egg, meaning it is ready to be harvested. To give you an idea when they are ready,  the follicles reach 16-20mm then they are what they consider "mature" and your egg collection date will be set. So this is where I think my discomfort came towards the end of the cycle. I had 25 follicles so I had about 25 2cm large follicles hanging out in my ovaries, that's a lot more room big taken up than on your usual cycle! So I felt very bloated and my abdomen was tender to touch. If you have kids then this will be another thing that will be tough as I know how toddler love to crawl, kick, stand on their mamas!

 

Once those follicles are nice and big you take a trigger injection which makes your body prepare to release them, your extraction os scheduled exactly 12 hours after you take that shot. This is when they go in and remove all the eggs with (don't read the next paragraph if you are freaking out about this bit as I'm about to describe the thing they use to take them out)

It's another internal ultrasounds dildo but with a giant needle attached to it!

Ok safe now so you are given some sort of local and some happy drugs so you are a bit out of it but not knocked out. I have senile found out from a friend who had as many eggs as me they usually knock you out as its obvious more painful the more eggs you have to retrieve, no idea why I didn't get that option but hey I survived. I barely remember it but Jay said he was trying not to freak out watching it all go down. I'm glad they let your partner sit in with you, as it definitely helped calm my nerves. The whole process was over in 30 minutes and afterwards you have a nice cup of tea and a biscuit for another 30 minutes to check you are all fine.

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You are told to take the rest of the day off work and that you will have cramping but they said most people can go to work the next day with pain relief. I woke up the next day and was quite sore, but that was to be expected with the amount of eggs we had taken out. I spent an extra day at home curled up on the couch with a hotter bottle but felt ok the next morning. If you are ding this with kids then I would try to organise some help or if you have family around maybe send them for a sleepover for a night or two.

 

Once they take the eggs that's when the baby making magic happens, not quite as romantic as in the bedroom but still so amazing. Wonders of modern medicine! We had to do ICSI, the step up from IVF. In IVF they pop the sperm in a dish with an egg and its a whose strongest wins scenario were one sperm fertilises the egg. In our case Jays swimmers can't even mange that, useless, so they choose the best looking sperm and injected them into all of the eggs.

The worst bit after this is waiting by the phone to hear how your eggs are doing. Even if they get a lot out not all of them are going to thrive. We ended up loosing 6 of this embryos as they just didn't develop like they should.

This is the time all that emotional stress comes, as you worry about the eggs and their development, then that ramps up even further during the transfer and the dreaded two-week wait till that pregnancy test!

The transfer is essentially a breeze in comparison. The hardest thing is you must have a full bladder, so you are lying on a table with your legs in the air desperately holding on why they place the fertilised embryo *well men was a 5 day fertilised egg so it's actually called a blastocyst) back in you! My doctor took 3 attempts to get it in there, he would insert the a catheter through your cervix and you would see little bubbles on the ultrasounds screen and that was the liquid holding the embryo entering your uterus. They check the catheter under a microscope to make sure the embryo left it, and mine bloody didn't. Three times in a row! He said he hadn't had that happen to him in 10 years!!!!! It had me worried but I as just desperate to get to the bathroom before I let go on in the examine room! I went and had acupuncture after the transfer as that's meant to help it "stick" and continue to develop in you. But other than instructions to not get really hot, as embryos don't like heat, so no intense physical activity, baths or spas you are told to do whatever makes you feel comfortable. If thats lay on a couch and rest that fine, but if you want to get back to work or do what you usually do in your day-to-day life then that is fine too. Walking around and doing normal daily activities won't make the egg not implant into your uterine wall. So don;t worry, you don't have to lay with your legs in the air and seeing on bed pans like they did with IVF in the 80s!

So that's that, this was the post on the in's and out's on IVF in our case. I wrote about my journey and all the feelings that came with it here, but after so many requests thought it would be good to share the stuff you can't read in a brochure. I hope it helps!

 

Dads View - Getting Anna up the duff

They say ‘There is always two sides to every story’, probably three, the third being the truth. This is my side. Us fellas are the simplest of creatures when boiled down to the simplest things. We are all the same. In order for us to survive and be happy ‘Feed us and fuck have sex with us’ in return we will do our best to provide you with everything, a roof over your head, a comfortable life, food in your belly and next to that food a baby. That is a pretty standard egocentric view of how things roll. In our relationship I did all those things……except the baby thing. For what ever reason, my swimmers (sperm) are terrible. Not ‘a little irregular’ or ‘a touch inactive’ I'm talking TERRIBLE! Like I said in the beginning, we are simple creatures with one role in ensuring the human race continues and when you are incapable of doing this it’s hard not to feel like you aren’t contributing to humanity,  you're a useless male, luggage.

Luckily for me Anna didn’t share those views, she is a lot more pragmatic with her life approach. She set about putting herself through the only option available to ensure we could have children, pushing needles through which various concoctions of hormones would send her body into overdrive and allow her eggs to be harvested like ripe grapes plucked from a vine. All of which made her sad, happy, sick and crazy…..real crazy. And all for me, us. For this I will forever be enamoured and in her debt. Which is why that is one of the millions of examples of why I coul sail past the ‘I don’t know if I like you anymore' crazy moments fertility drugs brought on because it wasn't her, it's not her fault, we are here because of me.

Needless to say after all that she put herself through when the first embryo was placed back inside her, we cried with excitement. Only to cry again shortly after we found out the embryo didn’t take and we were back to square one. It’s a roller coaster, one that once aboard you are unable to see the end, duration, path it takes or how scary it is. We saw this as the final roll of the dice, with everything bet on it. I know that this isn’t the case, people will say that there are countless options, surrogates, adoptions, ‘a friend of mine tried this’, ‘just relax and it will happen’, ‘when the time is right it will happen’ the list goes on, and I say this with love, SHUT THE FUCK UP. People are amazing and innately offer positivity and solutions, all road maps to similar trips that have been taken but completely different journeys, similar, but not ours.

After we mentally built ourselves back up enough to attempt the transplant for the second time we had talked ourselves into setting low expectations for success, you can’t be disappointed if you don’t have high hopes. How is that for a defeatist mentality?! Deep down both of us had everything thing we could possibly cross, crossed, hoping that this would work. And it did. I can remember the home and garden magazine I thumbed through in the reception, I remeber the doctors suite in the corner of the building looking out over Ellerslie racecourse, I remember Anna’s face and how she seemed to hold her breath while the scan was taking place, I rember the flicking light on the screen indicating a viable heart beat and I remember how time stood still when the doctor said ‘Oh……we need to have a conversation about their being two of them….you are having twins.’ I also remember jumping up and down, clapping my hands and making a weird squealing noise whilst Anna grabbed the wall to stop her from falling, even though she was horizontal on a bed. I always for what ever reason had wanted twins and as always the universe was delivering.

We had done it!!! We were finally going to be parents, job done. That’s what I thought anyway.

Through out the pregnancy Anna was incredibly sick, even with the blood volume in her body doubling and two humans growing inside of her, she was losing weight. She battled hard in the beginning, going to work and trying to work. It is amazing how much the human body can endure, Anna would try her best to eat and drink but no matter what we tried, nothing would stay inside. I was worried that not only she wasn’t getting what her body needed to sustain itself but that the boys were also going without. Trips to hospital to plunge knitting sized needles into evasive veins so that IV lines could top up the fluid levels that Anna couldn’t maintain on her own were a regular, the intercostal muscles between her ribs stretched and contorted to make space for the every growing little humans she was nurturing, but causing her immense pain at the same tme. Massages, heat packs, cold packs, osteo, chiro, acupuncture, you name it, we tried it, nothing worked. Every morning I would wake up wishing I could, but knowing I couldn’t do a single thing to help, no chance of pain minimization, to stop her being sick.. just a hope that it won’t be as bad as the day before. It took every ounce of Anna’s strength to get through each day, no food, no water, the only thing that kept her full was the love growing inside of her. Love was the only thing that kept all three of them going.

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I have to admit that I wasn’t the most supportive partner, I thought for whatever reason all the fun things I did, we did, were coming to a close and I did what every egocentric vapid individual does. I partied, a lot. I convinced myself that going out and drinking as much as I could, would capture some of the partying I would soon be missing. I don’t think I achieved that. What I did do was leave Anna by herself when she needed me most, as we were heading into the biggest moment in our lives, Anna was alone and I was drunk.

I'm not sure at what point things changed, if something was said, if I did something that pushed her past the point of putting up with it, but it did. Things changed. You quickly realize that if you are going to become great parents, you first need to be a great team, a great couple. We had open honest discussions about what we needed, expected and wanted to be the best we could be for each other.

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As we got closer to the due date, anticipation built. A couple of ‘episodes’ had us pretty nervous, at around the 30 week mark we rushed into hospital thinking that the boys were about to arrive, less than ideal. When it comes to twins, everything in the pregnancy is stacked against you, things can go wrong and often do, we were glad we had an amazing OB by our side at times like this. Steroid injections were administered to build the boys lungs up in the event they did turn up early and we were told to be ready. I was travelling away for work to the 7’s in Wellington the next day, my boss ‘Bosto’ at ZM was super cool and gave me the option of staying home but Anna insisted I go.

It was going to take a village to raise these boys and luckily for us we had what felt like a whole country behind us, family, friends, collegues, strangers, everyone was offering assistance. It was incredibly heartening to know we had that kind of support, we didn’t take it for granted and we made sure we took people up on their offers. I don’t know how we would’ve done it without them.

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It was early march and I had managed to surf quite a lot over summer, sneaking in waves whenever I could, everything was looking good for the following day at Piha so the plan was to be at the beach at 6am before the seabreeze ruffled the water. That night however I enjoyed a few cold yeasts with the lads to watch the rugby and hit the snooze button when my alarm went off at 5am opting for a sleep in. At 6:30 Anna woke me up thinking she had wet the bed, this was a sign of things to come, the boys were up and wanting to meet us six weeks early...

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