A wee bit over waiting to get knocked up

We had planned to have another round of embryo transfers this month. I'd started to get pretty excited about it and happy with the anticipation and hope of maybe getting pregnant and having a baby. Having taken a break for soooooo long, it occurred to me that when I rang the fertility specialist's office to book in for the cycle that I should ask if he had holidays planned. Of course, he does, right when I would due to have the embryo transfer.

Bugger! It's definitely at times like these I miss my fallopian tubes and the old fashion way of baby-making.

There is nothing to be done for it, we just have to wait another month. The first chance we have to try again I will probably be 37. That's right, another year will tick over.

I'm trying not to get to hung up on the age thing. I'm trying having a balanced view of all the impacting factors. So the good news is I've been doing really well on the weight loss front. I have lost the 10kgs I set as my birthday target. I have another few weeks before transfer (and my birthday) I am thinking I could loose another 2-4kgs, which surely can only help.

The best part of the weight loss is that I'm generally feeling a lot fitter and healthier. Thinking back to last year I felt so exhausted and run down. This year I've had a lot more energy. I don't want to jinx it, but I haven't even had so much as a sniffle this winter!

Heading into my next transfer I'll be:

1. 1 year older
2. 10 kilos lighter (at least)
3. A tiny bit less crazy/obsessed 
4. A shit tip fitter.

In the balance of things, I feel like it will be in the favour of fertility.

The next plan - woman meets bike

With the triathlon ending, I decided I needed to put in place a new plan to help me stay on track with losing some weight in preparation for our next IVF attempt.

Actually that is altogether a bit too simple. Just before easter I started to go nutty - again - about how on earth I could possibly stay on track with trying to lose weight again. I know a lot of people have no trouble managing their weight and I'm a little embarrassed, even ashamed, that I just haven't ever been able to get a handle on it. I know it's not rocket science, eating chocolate and cakes + sitting on couch = weight gain. I understand the cause of the problem.

When I felt the dig at myself about my complete failure to get this part of life under some level of control get too strong, almost destructive, I decided it was time to talk it over with a psychologist. I simply wanted to talk about the problems I've had getting some long term thinking happening when infertility treatments drag you into week-to-week and month-to-month thinking. I want to achieve longer term thinking to help me stay focussed on the weight loss goals while doing infertility treatment.

The session with the psych was not what I expected and excellent. Firsty, apparently I'm not completely nutty and have managed to really set some good long term goals. Apparently infertility treatment is typified with the need for short term thinking and the fact that has happened is not surprising. I just need to acknowledge that is going to happen and accept that is a part of the process. Fair enough. In closing she suggested if I really want to do something about my weight I should see a specialist. Not just anyone, but someone who specialised in pregnancy weight management, perhaps someone recommended by Queensland Fertility Group (QFG).

QFG offer counselling support, but don't really have anything on the nutrition front. I hit the net, googling Brisbane dietician Pregnancy and found a few forums discussing the issue, in particular Polycystic Ovary Syndrome (PCOS) boards. A name popped a few times, Desi. I tracked down and had my first appointment with Desi two weeks before the triathlon.

The best thing about seeing Desi is that she has told me that when I get pregnant I can still lose weight. She is often referred patients with PCOS to help them manage their weight during pregnancy. She said the goal would be to have my starting pregnancy weight and ending pregnancy weight be the same, which would mean I would effectively loose about 10 kilograms during the pregnancy. And once I have the baby, straight back into getting off whatever weight I have left to lose. This was like music to my ears. At last, long term weight loss thinking that included getting pregnant and having a baby. Every obstetrician I've seen has said weight gain is the goal. I even asked one (the first time I was pregnant) if I really should be aiming to gain 11-13 kilos given I had such a high starting weight - her response was, well perhaps just 8 kilos would be better.

With Desi's eating plan I've been doing really well on the weight loss front. I still find it hard to resist temptation that seems to present itself so often. I'm trying to find the right balance between saint like and sustainable when it comes to eating. It would a lot easier if I never had to leave the house, but that isn't really possible...

I've also been seeing an exercise physiologist in the same practice. I knew that keeping up my motivation to train after the triathlon ended would be difficult. My last appointment at the exercise physiologist we were talking about the result of the triathlon and he said a strange thing to me. He said given the results I'm getting I seem to have a reasonable base level of fitness, so it is surprising that I have managed to get to the size I am. Hmmmm, I'm pretty sure there is a compliment and an insult in that statement. I tried explaining to him that my natural preference was couch but that over the past few years I would do bouts of PT sessions or gym memberships, until the couch won me back again. I don't think this gave him much confidence.

The exercise physiologist got me to set a new training goal. I kept it pretty basic, 5 kilometre Bridge to Brisbane run in September, but I'm thinking of revisiting that. This week I've decided to give riding to work a go. You see, the best I've ever done at losing and keeping weight off (for longer - I still gained it all back eventually) was when I used to walk to and from work most days. The walk took me 35-40 minutes. I got to thinking, if I could get that amount of exercise built into my day again I would probably have a much better chance at success.

I did a full test run of the ride last weekend to make sure I'd be able to manage it and learned on the bike it is just under 14 kilometres from home to the office, it takes me around 55 minutes and it is pretty hard work in a number of places (requiring me to get off bike and push!). I've ridden to work Monday, Wednesday and Friday this week. It is still taking me 55 minutes, but I think it is getting easier. My new goal is to be to riding to work 5 days a week by July, and come spring (let's say October), I want to be riding to and from work most days (weather permitting - I need to see if this plan will be impacted by our hot hot hot summers).

I think my bike might be too small for me, which wasn't a problem when being ridden once or twice a week however now with regular, commute riding in mind I might need to trade it in (jeez, I just bought the damn thing!).

And by the way, my butt is killing me! It is going to have to toughen up if I'm going to be riding to and from work every day!

Triathlon triumph!

It's been along time since I've done something that wasn't work that I have been really proud of. Entering the enticer length triathlon definitely was well outside my comfort zone and having completed it I have felt exceptionally pleased with myself.

On the day I was the first in our team of 3 to do the course. I completed the 400 metre swim in 10:16 minutes, the 10 kilometre ride in 35:27 minutes and 4 kilometre run in 32:29 minutes. My following 2 team members were both faster than me, but it didn't matter. I'd done it.

Looking hot in my make shift triathlon outfit.

Today I looked at the scores. Our team came in 951st place out of 966 teams. But what surprised me was the 22 teams that didn't finish and the 79 teams - of 3 people each - that didn't even start. I am now even more pleased with myself knowing that so many people set themselves the goal/challenge of running the triathlon and many do not finish and more don't even get started on the day.

Signing up for the triathlon did for me what I needed it to. It got me motivated to get up and exercise. It gave me a challenge that made me push myself into excercise I'd never committed to before (running!). And it helped me get started on losing some of the weight I want to lose.

I'm currently down about 7 kilograms from when I started triathlon training and well on the way to being my lowest weight in the many years of the baby making mission. I feel great about that but also, for the first time since it happened, I've been a little bummed that I don't have any fallopian tubes. No chance at getting knocked up without medical assistance. However, I reminded myself that no chance at natural conception has also meant that I've completely stopped worrying about trying to get pregnant ALL OF THE TIME, making me much more mentally stable generally.

I was initially planning to have a another crack at embryo transfers this month, but we are putting it off for at least another month, giving me some more time to knock of a few more kilos and top up the bank account.

I'm planning to keep up the training with a view to running the Bridge to Brisbane 5 kilometre run in September. I still dislike running - but I've been assured by my uber fit work colleagues that it will get easier. I hope so.

Coping strategies: Prepare me for another roll of the dice

Yep, that's right, I signed up to do a mini triathlon.

Regular readers, and those that know me, will know I do not have the body of a triathlete. Far from it. So why am I doing this triathlon?

In February we had our catch up with the fertility specialist to go over the latest pregnancy loss and talk about our next steps. It was another tough appointment. Once again the specialist wanted to revisit all the pregnancies and subsequent losses.

The surprising news to us is that the specialist believes we have an excellent prognosis, with really shit luck. Basically, four out of the five of our pregnancy losses have been completely random events, that can happen to anyone. To have them happen to us, four times, is unlucky (and in the case of the heterotopic pregnancy rare and unlucky). These were the ectopic pregnancies and the 2 trisomy miscarriages. Our most recent miscarriage is the only loss that wasn't completely random or unrelated to anything specifically to do with us. They don't know what caused it, but it was definitely something to do with us - our genetics.

The specialist also explains that our cohort of embryos is the best he's seen in years. They were all such high quality and we were lucky enough to make so many in our full IVF round (a luxury I particularly appreciate knowing how hard many of my other infertile friends find it to get quality embryos).

So I'm sitting there crying wondering if I can go on with it, while I have five 4 cell, grade 4 (on a scale of 0-5 with 5 being the best) embryos on ice. Meanwhile my specialist is saying I'm almost a best case scenario and would be mad not to go on.

Well, it still doesn't feel that way. It feels like the impossible.

It hurt a little bit, but Matt asked about my weight and whether it is worth taking a break and losing more of it. It hurts because it is not like I haven't wondered myself if it really is just my weight that is stopping us from succeeding in this venture and to know that it is clearly playing on Matt's mind. It hurts because of the stupid Biggest Loser story line about single Brenda whose partner left her because they failed to have children. It hurts because we started to trying to have a child over three years ago and I know if I'd just had any ability to think long term in those three years I could have lost a lot more weight - my sister is tribute to that.

In the same amount of time I've been trying to have a baby my sister has lost an extraordinary 55kg and is still committed to getting the last 8kgs off. I on the other hand have lost 7kgs, gained 8kgs, lost 7kgs, gained 2kgs, lost 5kgs, gained 6kgs, lost 7kgs and so on... I can pick the pattern to it - leading up transfers I lose weight, following pregnancy loss I gain it. My emotions are playing a strong role, as they always have, in my weight management.

My specialist is a tubby fellow and appreciates that for those of us that carry the extra kilos how hard it is to shake. He confessed that he'd given up chocolate in 2012. He also again tells us that any weight off will help, not just in getting pregnant, but in general pregnancy health and baby health. Small numbers help, even just a couple of kilos. He is very clear that given my age it is not worth taking a long break to lose a large amount of weight as the advantage of the weight loss will be undone by the disadvantage of being too old. Ughhhh. He says I can get back into transfers after I have my next period, but to take a break if I need it, but not for too long. He also, for the first time, recommends I see one of the Queensland Fertility Group psychologists  given the difficulty I'm having deciding, but also because I am going be extremely anxious when I do get pregnant. This I am of course already incredibly aware of.

It is hard because it feels like my weight is the only factor the specialists can suggest could make a difference to our achieving a healthy pregnancy.

I need to stop thinking month to month, cycle to cycle and start thinking in longer units of time. I decide I need to start planning for things that are months off and stop just thinking about getting ready for the next transfer. I decide I should set a weight loss goal for the short term (4 kgs before a family wedding) and the longer term (10 kgs before my birthday in July).

With my new resolve I set my alarm to get up the next morning and go for a walk. When the alarm goes off I quickly switch it off, ignore it and roll over. A classic problem for me. Motivated the night before, zero motivation when I have to implement the plan.

I mention my lack of motivation to a work colleague who has gone triathlon mad and she suggests I sign up for the BRW corporate triathlon. It is a short triathlon, with only a 400 metre swim, 10km bike ride and 4km run. Despite having almost no running ability I decide I should do it.

As it turns out being signed up and committed to the triathlon is just the motivation I needed and I actually jump out of bed when the alarm goes off. I've been training for about 4 weeks and there are 4 more weeks to race day. I'm not going to win the race, but I certainly am improving my fitness and dropping a few kilograms to boot. I'm actually enjoying doing a the mix of training. We bought new bikes and Matt and I have been enjoying regular bike rides. We both hate running, and since Matt doesn't have a weight problem nor need to run a triathlon in a few weeks he has now given up getting up for running training sessions. I've been fitting in 1 swim a week.

The triathlon has given me a different goal to focus on. My health and fitness and running the best time I can in the event. The baby making mission is still the motivator behind it, but I'm going to wait until after the triathlon to do our next embryo transfer.

I'm also letting myself let me hair down a little over easter. I'm going to enjoy a few drinks and chocolate and then from next week I'm getting back on the wagon to make the most out of my last few weeks of training.

In May we plan to roll the dice again, and give baby making a chance.

Getting on with it - again

For the last couple of weeks I've just been getting on with it. Back to work. Hanging out at home on the weekend. Planning our annual beach holiday. Even with the terrible sadness of this miscarriage, in just a couple of weeks it feels like another blip and everything is again about next time.

I was so quickly getting back to normal that I almost forgot to follow up the results of the miscarriage to see  if they could identify the cause. I did eventually remember and was a little surprised to hear that this time it wasn't trisomy. My fertility specialist explained it was probably still a genetic defect, but that looking for chromosome problems is like walking down the street and looking at houses to see which one isn't quite right, where as a genetic defect is like trying to find a faulty toaster in one of the houses, only you don't know what house has it, or what appliance is faulty. Basically, it is really hard to know where to look to find the problem, unless you know what you are looking for.

I decided I don't care. There is nothing I can do about it. Apparently some people find this result terrible unsatisfying. I however find the whole failing to successfully have a baby is a lot more dissatisfying, and can't see the point in dwelling on a faulty toaster.

I've made an appointment for Matt and I to go and see the specialist together toward the end of the month to discuss our best options at this point. We still have 5 frozen embryos, so I suspect it will simply be a case of transferring those, until:
a - we actually have a baby (which in my mind feels so strangely unachievable for a couple that appear exceptionally capable of getting pregnant) or
b - run out of embryos and need to decide if we will make more embryos.

Maybe I'll try and lose some more weight... Don't know that this will make any difference given that getting pregnant doesn't appear to be our problem. [On a side note - that damn biggest loser story line with Brenda trying to get pregnant for 8 years and her partner leaving her to start a family with someone else has been absolutely horrifying to me - so much so I can't watch the show - perhaps for another a post]

Next time perhaps we will be lucky. Next time maybe the embryo/s will be perfect and will develop as they should. Next time, next time....

Back to life as we know it

A month has passed now since the curette and I'm in my fourth week back to work. I'm finding it hard to get the balance right with my part-time hours and my project's deadlines. Without a doubt I'm working less hours, so that's good.

What I've noticed over the last week or so is that I'm finding it really hard to get back on track with the discipline around what I eat and getting some regular exercise. On top of this, after months and months of not drinking, I've got a taste for post-work vinos again.

It seems that earlier in the year my motivation was the best chance of IVF success, then with the gallbladder issue I had no choice but to be good. My frozen embryo transfer cycle came straight after and I was still on roll at that point. Even when everything turned pear-shaped, I was doing a couple walks a day on the beach. The post-op infection led to a range of other problem that meant everything went straight through me. Now that discipline is required to keep the weight from creeping back on, and preferably still going down, I just can't find any. Everyday I wake up with the best intentions and nail it, until about 6pm and then there are snacks, desserts, wine and all things calorie laden. Urrrghhhhh.

Last week Matt and I discussed when we should try again with our next frozen embryo transfer. I've already reached the point of wanting to try again as soon as possible and Matt is happy to try again if I feel up to it. I can't remember when the fertility specialist said I'll be to do another transfer, but I'm hoping it will soon.

This part-time experiment was about being and feeling healthier but it just isn't feeling that way. I've even caught a cold this week making me feel more run down. I've been trying acupuncture and while I'm happy with the needle component, I struggle with the chinese herb and dietary recommendations (ie no dairy), so I'm thinking about dropping it.

I guess I feel uncertain, about work, about my health and about the chance of success with our next frozen embryo transfer.

The year of medical interventions IVF part 1

I've been completely cheating on the blog. It is funny what comes out of the wood work with friends, family and strangers when you start writing some of your inner most thoughts and publishing them for anyone to read. In April I was hit by a few comments that led me to decide to take a break from the blog.

A lot has happened since I last blogged and I thought it was worth getting back to publishing.

May and June were all about IVF. I hoped July would be about first trimester musings, but as it turned out July was all about my gallbladder.

It will take me a few posts to catch up on everything. In case you have been wondering my first IVF cycle was unsuccessful in the sense that I still do not have a bun in the oven. On the other hand, the cycle was very successful in creating multiple viable embryos (essential for future attempts at achieving pregnancy) and for improving my mental health, where for the first time in a long time, achieving pregnancy seems imminent and therefore an overarching panic about not being pregnant has diminished.

In late May I left the fertility specialist's office with my very own cooler bag, filled with legal drugs in their own epipens for easy administration. I remember as I stood at the lift thinking 'I can't believe it has come to this'. It was overwhelming to think that now my conception chances were all about injections and nasal sprays, and not intercourse.

It just felt so unnatural. All those ingrained ideas and fears float around my mind. Perhaps as some suggest I am only a holiday and a bottle of wine away from getting up the duff (which for the record, I would like to state did not work on all attempts tried). Even worse I get all martyrish and think perhaps if you can't have children naturally maybe I'm not supposed to. And worse again I start thinking perhaps I'll finally get to have a baby, suffer from relentless post-natal depression, hate the baby and wish I had remained childless.

I sneak the drugs back into the office and hide them in the fridge on another floor of our office in an attempt to avoid any questions and try to conceal that I am doing IVF from my colleagues (ironic given that I write and publish a blog for anyone to read). Back at my desk for the afternoon I am distracted by continually reminding myself to not forget drugs in upstairs fridge. Must remember drugs, must remember drugs, that design looks good, must remember drugs upstairs.

Thankfully I remember the drugs when I'm leaving and get them home safely and into my own fridge. By this stage, I've already been taking a nasal spray for about a 2-weeks and I've had 1 blood test, just to make sure all my hormones are where they should be if the nasal spray is working. Tick - all go for commencing injections.

A few weeks ago Matt and I sat through a 90 minute session with an IVF clinic nurse in which we were shown how to administer all the different drugs. My doctor also has made me use one of the epipens in his rooms. He makes me dial up the dosage and over the bin I push down on the end of the epipen, hold for 10 seconds to witness how the release of drugs is a little delayed. When I get home I put my drugs in the fridge and find they've come with another DVD with instructions. I tell myself 'must watch instructional DVD to ensure correct procedure is followed, therefore increasing eggs produced and all chance of IVF success'.

In fact everything I'm doing at this point was about increasing chances of IVF success. Must not drink wine to increase chance of IVF success. Must exercise and eat well to loose weight to increase chance of IVF success (fertility specialist had again mentioned that any amount of weight loss would help, even 2 - 3 kg - which I decided was achievable and as would increase chance of IVF success was on the to do list!). Must get 8 hours sleep to help stay relaxed and stress free to help chance of IVF success. Must take multi vitamin, pre-conception vitamin, iron tablet and fish oil to increase chance of IVF success.

The next morning I have my set time for injecting. I have to pick a time that I can consistently meet everyday, including weekends, workdays, potential flights. I pick just after 7am as the most achievable consistent time for 10 - 16 days of injections. By this time I realise I don't have enough time to watch the instructional DVD (should have done so night before) and blowing caution to the wind proceed with first injection. I was extremely pleased with the ease of injection and zero pain and decide no longer need to watch DVD as clearly I'm a professional already.

A new year

I'm a big believer in the New Year being the time to make a change and new start. I've had great success in the past with setting myself goals and establishing new attitudes for a New Year. I put a lot of thinking and hope into having a great new year and then being mentally refreshed and ready for 2011. Like a shedding of the 2010 skin. Unfortunately my New Year didn't go as I planned, and instead of feeling New Year was a new start, I felt stuck in a rut. I dragged all the worst bits of 2010 into 2011.

Now, I know this is completely psychological and that I could just start a fresh anyway - but I had hung my hopes on this fresh beginning. Maybe this would have happened even if I'd had the perfect new year that I'd imagined... who knows.

All I know is that I spent a lot of time considering what I should do in 2011 and despite my earlier resolve, I find mid month I'm already wavering.

Having felt the drain of the drugs in December 2010 I decided that I would make a fresh start in 2011. I would take January, February and March 2011 off the drugs and the blood tests and try and attack the other issue that has continually bothered me about our infertility - my weight. 

Half way into January I'm feeling normal again without the physical drain the drugs were on me. Instead of early morning blood tests I'm finally using the ovulation tests I bought online (I figure some monitoring can't hurt). Then this morning I think - maybe I should just get a blood test, to be sure. But I know that would be a short and slippery slope back into the full monitoring and drug cycle again. So right now I'm just saying no, to drugs and blood tests.

Tackling the weight has been slow getting started. I decided I needed to tap into a real program versus just trying to go it alone which was what I did incredibly unsuccessfully in 2010. The floods have messed with that a little with offices closing down and meetings being postoned. But I'm hoping to get a meeting next week and get started on tackling the weight with some help. I am trying on my own, but I just don't seem to get any traction.

Not the brilliant start that I had hoped for - but it is just how things have gone. Perhaps it is just a slow start out of the blocks.