18 December 2012

Waiting

No news from the clinic yet on the next steps.  Waiting waiting.

Once I decide to do something I really just like to move ahead with it.

In the meantime, I continue to search the internet for information.  The most interesting bit of information is that egg freezing has proven to be successful so is no longer classified as "experimental".  That's actually a big deal in medical speak.  So that's cool.

If anyone comes along here and knows of a good site, or good blog to add to the links at the side, please let me know.  It's really hard to find good objective information out there!!

17 December 2012

EMail Sent

Just a quick one.

Sent an email to the clinic confirming that I want to go ahead with the procedure.  As my understanding is it must start with your period, I'm looking at February.  Then I actually looked at my diary for February and got a mild sort of panic.

This is no small commitment and my life is a little bit messy at the moment.  I have at least two things in February I absolutely can not reschedule.  I need to better understand the day-by-day schedule for this procedure so I can try to work around it and with it.  This is also complicated by the fact that I usually spend my life one week in London and one week in Cambridge.  It's not the end of the world to go between either, but it's not ideal.  With enough notice I could probably just stay in London (except for when I have a meeting in Cambridge that's not moveable).

And then the ridiculous mind-set drifts in.  I start to panic that I'm wasting months and getting older and every month gone is going to somehow decrease my chance.  I know this is not healthy thinking and I must stop it.  It's easy to see how it happens though.

Deep breaths.

16 December 2012

Blood Work is Back

So now we're catching up to where I'm at and why I started this blog.  I got my results back, and a letter from the doctor.  So here's the deal:
  • Age: 38
  • Height: 5'3"
  • Weight: 185 lb
  • Antral Follicle Count: 9 (one ovary)
  • Anti-Mullerian Hormone (AMH): 9.4 pmol/l
The letter from the doctor used the phrase "reasonably good" when describing my follicle count and AMH result.  He went on to say that, I am still at an age where, "there is moderately good prospects of successful outcome following the thawing and fertilization of these eggs."

It's all very careful language isn't it?  I mean, I know they can't promise anything.  And I'll tell you what else, looking at IVF blogs is disheartening.  Even for example, when I think about my good friend who went through 8(!) rounds.  Yes, she just had babies from the last round, but all of those other eggs, they weren't good enough.  I know egg freezing is not anything close to a guarantee that these eggs will work out.  It's a lot of money.

However.... it's not my money.  Is that terrible?  I'll be honest here.  If it was my own money, I'm not sure that I'd spend it on this.  But since my mom is paying for it, I'm willing to take the risk.  I'm willing to let myself be hopeful.  And put myself through what will not be a particularly pleasant experience.  All for the chance of maybe having something.  But it's something I would really like to have.  At some point.

I do wish I'd done this when I was younger.  I'd have less angst if I still had both ovaries.  If I knew that a good cycle would produce a lot of potential eggs.  But I have to stay focused on my reality.  And I have learned this from the IVF blogs- my reality isn't the end of the world either.  It seems a lot of people trying to get pregnant have worse results than I do and they're going through and getting pregnant.  And I don't believe the doctor would have told me that I had "reasonably good" chances if I didn't.

I am going to go ahead with this.  Probably in February seeing as it's mid December and I'm about to go away for three weeks and will probably be getting my January period right before I come back.  So I'm going to get in touch with the clinic and find out what needs to happen in February.  Then I'll document everything as it happens here.

Stay tuned.

Initial Consultation

So it ended up that I was off the pill for five months before getting to the clinic.  I first went on the pill when I was 19.  As a teenager, I had never had "normal" periods in the sense that I only had about 4-6 a year.  The pill was a life-saver for me.  It regulated my periods so I didn't have to wonder all of the time if I was getting my period or not.  I was on the pill a long time.

At some point when I was 27 or 28, they took me off the pill because I had high cholesterol and was overweight.  My periods were again not regular and it was frustrating and annoying.  I was off the pill for a couple of years.  I don't remember how it happened now, but my cholesterol lowered, I moved, and I managed to get back on them.  I was on the pill until my emergency surgery to remove an ovary due to a large dermoid cyst.  I had a few months off and then went back on the pill, but this time on Cerazette which is a progestogen only pill which had the awesome side effect of eliminating my periods altogether.

I didn't have high hopes for my menstrual cycle going off the pill this time.  So imagine my surprise that for the past six months I've had six 'normal' periods, pretty much monthly.  Go figure.

So after five months I got back in touch with the clinic and arranged my first consultation appointment.  The clinic was calm and quiet.  The staff were friendly.  I met with the head doctor for the consultation.  We discussed my personal history, why I was looking into egg freezing, what my concerns were.  I could sum them up as follows:
  • I have a history of irregular periods, I did not know if this was a sign of a less than optimal fertility.
  • I have one ovary left.  I did not know if this made me not particularly suitable for egg freezing.
  • I'm 38.  Obviously at this age your fertility starts to drop anyway, so I didn't know what my overall chances were, aside from the whole one ovary thing.
  • I have a history of one very bad dermoid cyst and I have been told that I have a small one on my remaining ovary that is monitored every year.  I wanted to know how the drugs used in egg retrieval would interact with cysts.
The doctor I met with was very calm and answered all of my questions.  He wasn't pushy in any way and I didn't feel that he was trying to "sell" me anything.  I'll put down what I recall of his responses in the same order as above.
  • My periods have been regular since going off the pill.  Without further tests, it's not an outstanding indication of anything wrong.
  • One ovary is not ideal obviously, but does not mean I'm not suitable.  Again, further tests are required for a better picture.
  • 38 is getting older but still a reasonable age.  The doctor told me about women who come to him at 40, 42, 45 and how he wishes they came sooner.  He explained how freezing my eggs now would freeze my 'chance' at 38.  He said, I could obviously still get pregnant naturally.  I may never use the eggs.  I may decide to use the eggs.  But that it simply gave me an option that I otherwise wouldn't have and that option would be 'frozen' at my chance now, at age 38.  Which, he reiterated, was not necessarily horrible.
  • We discussed the cyst and my mother's history of cysts.  He said it's very unusual for hormones to affect dermoid cysts and that he wouldn't consider it an issue, though obviously they would monitor it carefully.  And also, the procedure will always come with some risks.  He rightfully noted that I would be rather protective of my one remaining ovary and that it was sensible to not want to do anything that might damage it.
So that was the bulk of my questions answered.  He said that the first steps in assessing my chances at egg freezing would be to do a follicle count on my ovary using a vaginal ultrasound and to do an AMH (Anti Mullerian hormone) blood test.  He said if both were poor, then I would probably not be a good candidate for egg freezing and might instead want to consider egg donation in the future.  If both were good, then I would be a good candidate for egg freezing.  If one was good and one was bad, it might make the results uncertain but it would still be possible.

He told me that in order to try to assure best odds for a future pregnancy, I would ideally want 15-20 frozen eggs.  He suggested that if one assumes an 8-10 egg collection per cycle, that I would be looking at 2 cycles.  He said if they were only able to get 5 eggs in a cycle, I might want to consider 3 cycles, though obviously cost becomes an issue.  They don't recommend more than 3 cycles.  I should add that at this point, I believe I can only afford 2.

So with all of that information, I went ahead with the ultrasound in the clinic.  I was intrigued by the ultrasound equipment, seeing as I have the same test every year on my remaining ovary it was shocking to see how much more powerful the equipment they had was.  Also, it was 3D.  I got to see my uterus like a shining golden chalice.  He said it all looked healthy and normal.  And then my ovary.  I'm looking at the screen, looking for my ovary, because I do this every year and he's showing me something about the ovary and I'm like, "Oh, is that black spot the ovary?" and he's like, "No, that's a follicle.  All of those black spots are follicles.  The entire thing is your ovary."

Really?  I'm used to my ovary being the size of a circle I make with my thumb and pointer finger on the screen, not the entire size of the screen!  He clicked and mapped things and looked around a lot.  He said he didn't see any sign of the cyst that I get checked for every year.  That was kind of weird.  But then, when I was on the operating table, they looked for it visually and didn't see it.  Still, I swear I see it every year on the ultrasound they do at the hospital but I sort of have to believe this guy knows what he's looking at.  At any rate, it was a good result as I had 9 follicles showing on the ovary which is apparently a reasonable amount.  So that meant I was a reasonable candidate for egg freezing.  But I had to do the blood test to find out the rest of the story.

So on to another part of the clinic.  Paid just shy of 500 pounds for the consultation, ultrasound and blood work.  Then met with the nurse who took my blood.  They said they'd get the results back to me in a couple of weeks.  I updated my mom (obviously) and went home to think about everything and wait on the results.

Contacting a Clinic

So my first step was to contact a clinic.  A very good friend of mine has been going through IVF for two years now (and just gave birth to twins after 8 rounds).  Although she didn't have any of her treatment here in London, she had been considering it, so had done a lot of research on "the best clinic".  I'll admit to being very lazy in this regard and just asked her which one I should go to.  But in all honesty, I would have asked for her input anyway, and she's ridiculously meticulous about these things, so I don't think I would have chosen better.

I'm not sure yet if I should reveal the name of the clinic, particularly as I'm going through the process, so for now I'll keep it anonymous.

I contacted the clinic by email to ask about egg freezing and what would I need to do if I was interested in finding out more.  They sent me an email with information sheets about the procedure, and the costs.  Which were not insubstantial.  I read through it and contacted them to ask about getting an initial consultation and also said that I was on the birth control pill (Cerazette).  They emailed me back to say that they don't recommend doing any tests until you are off the pill for four months, so if I wanted to proceed, I should go off the pill and get back in touch in four months.

I copied my mom in on all of the email.  As she's paying for this, I want her to feel part of the process and know what I'm going through.  We talked about it.  Confirmed the cost commitment.  I reiterated to her that I may not be a suitable candidate.  That the first thing I need to do is talk to someone who knows about this stuff.  Get the basic tests done.  Get information.

She understood and agreed.

That was six months ago.

Who What Where Why

I've been searching the internet for some blogs on egg freezing as it's something I'm about to embark on.  I've come across a couple of helpful blogs but not as many as I'd like, so I thought I'd keep track of my own feelings, and also share them in order to add a voice to what's out there.

First up, I'm not a doctor, and I can't answer questions like that.  But I want to talk about my journey, and how it all goes for me, in the hopes that my experience may help someone else come to what is ultimately, a very personal and unique decision.

This is my story.

I'm 38 years old.  I live in London, although I'm also American.  This is important to the story because some time earlier this year, my mother sent me an email after having read this article in the New York Times about parents who were offering to pay for their daughter's to have their eggs frozen.  She was nervous about broaching the subject, as I should also point out that I'm 38 and single.  I've never had any serious or long-term relationship.  My parents have over time "bothered" me about my single status and I usually tell them off for it if they start to get too pushy.  So I can understand why my mother was tentative about raising it.

However, I wasn't upset by her bringing this up.  At 38, although a number of my friends stayed single and got married very late, many of my friends are having their first children now.  In fairness, some had them a few years ago, although I don't know many who had children before 30.  So my Facebook and conversations have been invaded by pregnancies and babies.  IVF and infertility.  I always thought I would find someone and have a family.  I've started to feel like I was going to miss my chance.

I should also add that this wasn't necessarily new thinking, as I'd had a fertility related issue when I was 33 and I had emergency surgery for an ovarian cyst and lost one of my ovaries.  I remember the doctor saying to me at the time that if I was going to consider having a family, that I should think about it sooner rather than later.  I don't let things like this get to me, but I did feel it was fairly inconsiderate.  It wasn't like I could just magic up a relationship, snap my fingers and have everything in place that would enable me to have a family.  It wasn't like I'd never thought about it before.  It wasn't as though I didn't want it.  I just didn't feel I had control over it.

Last, I've started to consider my legacy and purpose in life.  Not that I never considered these things before, but I've thought about it more.  I'm an only child.  It's possible that at some point in my life I will come in to a reasonable inheritance provided my parents don't blow through all their savings.  What's it all for?  Who will I leave my  things to?  Like I said, I always assumed I'd have kids- a family.  I'm just more and more aware that the window is shrinking.

And I've thought about things like adoption.  But I had no idea how difficult adoption was.  How they don't like to give babies to single women.  Or women over 40.  So when you reach a point in life where you are able and willing to give a child a home, you just aren't a good option.  It's not that I wouldn't consider it, but I learned I can't count on it.

So when my mom brought this up, I thought about it.  And then I thought about it some more.  To be honest, I didn't have any idea what state my fertility was in or if egg freezing was viable for me given my medical history.  But I thought maybe it wasn't such a bad idea.  And I definitely thought it would be a good idea just to find out the basics and talk to a specialist.  So I agreed to go.  And so my journey begins.