Had my last scan of this cycle this morning. Retrieval is scheduled for Tuesday. This means I'll be taking my trigger shot Sunday night which will be day 14. This is identical to my last cycle, and one day ahead of my first cycle.
This morning I woke up with a horrible lower back pain on the side of my ovary. I'm sure the enlarged ovary isn't helping any because I also feel pretty bloated in the stomach now, but the truth is, I get my fair share of lower back pain so I wasn't overly alarmed. I was annoyed though because what I usually do when I have this pain is some yoga stretching which is mostly spinal twisting. Given that twisting is a big no-no with an enlarged ovary, I've been suffering back pain all day now. It's not very nice. And of course I can't take any pain killers either. Ugh.
Saw the director of the clinic again this time as my normal doctor was fully booked. I've seen him once already this cycle so I didn't mind too much, although I would probably prefer to see the same doctor throughout. He had a good look and measure of the follicles and the ovary (I think because I also mentioned the back pain). Apparently everything is growing at pretty much an identical pace to the previous cycles so I suppose it's good that I'm reasonably reliable.
He counted six good sized follicles with a couple more behind, so that was good. I was watching the scan as he looked and it was difficult to tell sometimes where one started and another stopped. When they are side by side it's easy, but when they're on top of each other it's not as clear. At any rate, it looks like I have a bit more follicles than last cycle, although obviously they may not all contain eggs. I also have three more days of stimulating. So hopefully it will all go as previous and I get a reasonable number of eggs.
So having the retrieval day, my next order of business was to find someone to collect me from the clinic. I still think this is one of the more demoralizing aspects to egg freezing. My collection is on a Tuesday morning. So I have to ask someone to take off work to meet me. I don't have a partner where it would sort of be their obligation. It's not always easy. I've was pretty lucky the first two cycles but this one wasn't so easy. I had to call and email a few people before I finally found someone who could do it. I had talked to the receptionist about if I really couldn't find anyone and I did have a back-up plan to take a taxi home. It would have worked out either way, but I guess what I'm saying is, it's not nice to feel alone in the midst of this. It's just one more thing you don't really need.
Anyway, it's sorted.
And I'm probably particularly feeling grumpy because of the hormones. I can tell that I'm definitely grumpy!
I have enough drugs to see me through so that was all good. I'll end up with one 225 dose of Gonal-F left in the pen but that means I completely saved money by buying the drugs externally. The only thing I had to get from the clinic was the Voltarol suppository, but they give me that for free, so not a problem. Only four more days of injections left! I'm actually pretty excited that this is almost over!
In other news mulling over in my head, over on the eggsurance forum there has been a woman posting about how she tried to use her frozen eggs. I'm not sure of all the details, but it seems like she had 9 frozen eggs in total, it resulted in two embryos, both of which she implanted, but both of which were miscarried recently. That was a bit depressing to hear. I know there are a lot of factors that go into all of this and you can't really compare yourself to one person on a forum, but I'm just conscious that I'm not going to end up with that much many more eggs than she had. I guess it's important to remember that none of this is any sort of guarantee.
It's not worth thinking about it too much. I feel bad for the woman. There are other options, and I hope she feels satisfied that she did what she could, but it's definitely a blow.
Anyway.
Unless something remarkable happens between now and retrieval, I'll next write to say how it all went. I have an acupuncture appointment on Saturday which I'm oddly looking forward to. You'd think I'd be fed up with needles by now!!
Showing posts with label Gonal-F. Show all posts
Showing posts with label Gonal-F. Show all posts
24 October 2013
21 October 2013
Cycle 3: Day 8
Had my scan this morning. Nothing eventful to report as it all seems to be very routine now. The doctor measured 5 follicles which are 'growing' and 3 that are 'just behind'. I've also now dropped from 300 Gonal-F to 225 and will stay on the lower dose.
I'll be honest. The numbers are slightly disappointing at this stage. As I got 6 eggs from my first cycle and 4 from my second, even though I've been on a higher dose of drugs, this cycle seems to be smack in the middle so far, and that's assuming I get an egg out of every follicle. I was definitely hoping for more. But we're still only about halfway.
That's the other thing- the doctor had said that due to the higher drug dose, the cycle might be shorter. But at the moment it looks like it's going to be just about the same amount of days. So I have another seven days to go give or take.
It is times like this where I do get a bit frustrated that I am not convinced that the UK clinics are using the best drugs or the best protocols or doing everything they can. On the eggsurance forum, most of the women are from the States and it's like we're doing completely different things. Part of me wonders if I wouldn't be getting more eggs on a different regime. But as per usual, this sort of thinking is vaguely pointless. I have to remember that my clinic has some of the highest pregnancy and live birth results in the UK and not because they're selective and turn anyone away. Newer stuff and more tests isn't necessarily better. But I am used to a system of having more information and more discussion. That doesn't mean it's actually more useful, it might just mean I feel differently about everything.
But I go back to this all being a stressful process (and 7 days of hormone injections later, it's not entirely surprising I'm starting to feel a bit anxious). There are so many unknowns about what I'm doing that it makes me desperate for some small inkling of certainty. And I'm just not going to get it. Who knows if these eggs will fertilize? Who knows if I will ever be in a position to fertilize them?! There's just a lot of questions that I can't answer at this stage.
Oh, and I should also say that since I have a dermoid cyst on my ovary, it's probably not at top form either. Every time I see the cyst on the scan it just annoys me. Who knows how it affects that side of my ovary on which it lives parasitically? So really, I'm not complaining. Or, I am complaining, but I'm more complaining about the unfairness of life, the fact that I find myself in this position at all, and that life hasn't turned out the way I thought it would.
As far as the cycle goes, really, everything is fine so far.
I'll be honest. The numbers are slightly disappointing at this stage. As I got 6 eggs from my first cycle and 4 from my second, even though I've been on a higher dose of drugs, this cycle seems to be smack in the middle so far, and that's assuming I get an egg out of every follicle. I was definitely hoping for more. But we're still only about halfway.
That's the other thing- the doctor had said that due to the higher drug dose, the cycle might be shorter. But at the moment it looks like it's going to be just about the same amount of days. So I have another seven days to go give or take.
It is times like this where I do get a bit frustrated that I am not convinced that the UK clinics are using the best drugs or the best protocols or doing everything they can. On the eggsurance forum, most of the women are from the States and it's like we're doing completely different things. Part of me wonders if I wouldn't be getting more eggs on a different regime. But as per usual, this sort of thinking is vaguely pointless. I have to remember that my clinic has some of the highest pregnancy and live birth results in the UK and not because they're selective and turn anyone away. Newer stuff and more tests isn't necessarily better. But I am used to a system of having more information and more discussion. That doesn't mean it's actually more useful, it might just mean I feel differently about everything.
But I go back to this all being a stressful process (and 7 days of hormone injections later, it's not entirely surprising I'm starting to feel a bit anxious). There are so many unknowns about what I'm doing that it makes me desperate for some small inkling of certainty. And I'm just not going to get it. Who knows if these eggs will fertilize? Who knows if I will ever be in a position to fertilize them?! There's just a lot of questions that I can't answer at this stage.
Oh, and I should also say that since I have a dermoid cyst on my ovary, it's probably not at top form either. Every time I see the cyst on the scan it just annoys me. Who knows how it affects that side of my ovary on which it lives parasitically? So really, I'm not complaining. Or, I am complaining, but I'm more complaining about the unfairness of life, the fact that I find myself in this position at all, and that life hasn't turned out the way I thought it would.
As far as the cycle goes, really, everything is fine so far.
17 October 2013
Cycle 3: Day 4
Had my scan this morning. There was a fuck up at the clinic- as my appointment was just not on the system. I showed up, but they didn't have me down and of course the doctors were fully booked. I had scheduled a counseling appointment for after my scan, so I had that and then the clinic director (not my normal doctor) saw me. So it was okay in the end, although I would have preferred to see my regular doctor, there are only 3 doctors and I always see a doctor so it's not that big a deal. I suppose it's just good luck though that I'm a full time student and could waste my entire morning instead of being done by 10:30 like I'd planned.
So scan reporting first. The doctor saw 7-8 follicles, they're all still small, only about 6.5mm. He's keeping me on the 300 Gonal-F for three more days and then I drop down to 225. My next scan is on Monday. I also start adding the Cetrotide tonight. Got to keep hold those little growing eggs! So really nothing else to discuss about the scan. All is regular. Continue on course.
The counseling session was interesting. I really think it's something I should have done during my first cycle. I did a lot of thinking and working through stuff on my own (some of it's on here). So this was a bit more like me reporting to someone else about the process I feel I've gone through. You know- first having to face up to the whole children issue when I always thought it would vaguely 'happen some day' and suddenly realizing that 'some day' was really on a very limited time scale. Then having to process what it might mean if I don't find a partner in the next couple of years and whether or not I'd be willing to have a child on my own (I would). Of course that comes with no small amount of sadness and guilt and stress. I also talked about how coming to these decisions has changed my view of the future about things like what job I want to take after I finish the PhD as I am thinking about things like maternity cover.
I've made another appointment to see her after this cycle finishes and when I put this egg freezing chapter of my life to bed for now. So I will report back on how that goes. Overall though, I thought it was really good to talk to someone, I just feel a bit dense for not doing it sooner.
So scan reporting first. The doctor saw 7-8 follicles, they're all still small, only about 6.5mm. He's keeping me on the 300 Gonal-F for three more days and then I drop down to 225. My next scan is on Monday. I also start adding the Cetrotide tonight. Got to keep hold those little growing eggs! So really nothing else to discuss about the scan. All is regular. Continue on course.
The counseling session was interesting. I really think it's something I should have done during my first cycle. I did a lot of thinking and working through stuff on my own (some of it's on here). So this was a bit more like me reporting to someone else about the process I feel I've gone through. You know- first having to face up to the whole children issue when I always thought it would vaguely 'happen some day' and suddenly realizing that 'some day' was really on a very limited time scale. Then having to process what it might mean if I don't find a partner in the next couple of years and whether or not I'd be willing to have a child on my own (I would). Of course that comes with no small amount of sadness and guilt and stress. I also talked about how coming to these decisions has changed my view of the future about things like what job I want to take after I finish the PhD as I am thinking about things like maternity cover.
I've made another appointment to see her after this cycle finishes and when I put this egg freezing chapter of my life to bed for now. So I will report back on how that goes. Overall though, I thought it was really good to talk to someone, I just feel a bit dense for not doing it sooner.
13 October 2013
Cycle 3: Day 0
My period has arrived this morning so tomorrow will be my first shot of my third and last cycle. I don't know if it's due to the acupuncture or the natural fluctuations of life, but my period seems heavier and a brighter red. I swear I've never had much interest in the qualities of my period. Getting all involved in your fertility does strange things to you!
I had a doctor's appointment on Friday for my pre-cycle scan. Everything looks okay. There were 7 good follicles on my ovary. My cyst looks to be about the same size. I asked if the seven we were looking at were what we had to work with for this cycle. The doctors said that some of them will go away, but some smaller ones will emerge and it's a good start. I think it's similar to the past two cycles, so that's okay.
So tomorrow I'm on 300 Gonal-F and on day 4 I add the Cetrotide. I'm also going to schedule my next scan for day 4 so that's Thursday. As we are changing the drug dose this cycle, it may need to be more closely monitored. The doctor said he might reduce it ond ay 4 or might keep it the same, so we'll see what happens.
I also paid for this cycle which really hurt the bank balance but it is what it is. When I was paying, I again flagged the issue of the 'follow-up appointment' charge, as I've now been charged twice for it. This time, she went to speak to the clinic director who said that it is definitely not included. So I told her that I thought this was really unreasonable. She said the only time they do a 'free' appointment is in the case of a failed IVF cycle. But I argued that in that case, firstly, the couple comes in one more time after the retrieval so gets to speak to the doctor, and isn't all drugged up and also secondly, as I knew I was going to do at least two cycles, it was fairly obvious that there was a mandatory 'in between appointment' and it was shit to be charged for it. She said she would raise it at the next internal meeting, in the meantime however, I'm out the extra money. I mean fine, in the grand scheme of things it's a small proportion of the money, but I'd rather they bump the overall fee by 100 pounds and then include it then dump it on you like that. It's annoying. And what you don't want to be, in an emotional and hormonally charged process, is annoyed by things that seem really stupid.
I also learned that my clinic has been bought by/has joined a larger network of IVF clinics in the UK. I'm not sure it makes any sort of difference as it seems more of a higher level management issue and each clinic seems to be independently run. But I suppose it can't be a bad thing in the long run, particularly if in a couple years time I'm not in London but somewhere else in the UK, it might be easier to use a local related clinic then go back down to London but that's a long way away to be thinking about. I suppose although it's interesting, it really doesn't seem to impact me at all.
The other thing I'm looking forward to now that this cycle is starting is getting my fridge space back! This is more for my non-UK/European visitors but having had my drug delivery a couple of weeks ago, it's put a serious limit on my fridge space! I have a flatmate, and she gets the bottom half of the fridge, so as you can see from the picture, space has been a little tight!
Anyway, that's all the news from here. I'll keep things updated as this cycle goes.
I had a doctor's appointment on Friday for my pre-cycle scan. Everything looks okay. There were 7 good follicles on my ovary. My cyst looks to be about the same size. I asked if the seven we were looking at were what we had to work with for this cycle. The doctors said that some of them will go away, but some smaller ones will emerge and it's a good start. I think it's similar to the past two cycles, so that's okay.
So tomorrow I'm on 300 Gonal-F and on day 4 I add the Cetrotide. I'm also going to schedule my next scan for day 4 so that's Thursday. As we are changing the drug dose this cycle, it may need to be more closely monitored. The doctor said he might reduce it ond ay 4 or might keep it the same, so we'll see what happens.
I also paid for this cycle which really hurt the bank balance but it is what it is. When I was paying, I again flagged the issue of the 'follow-up appointment' charge, as I've now been charged twice for it. This time, she went to speak to the clinic director who said that it is definitely not included. So I told her that I thought this was really unreasonable. She said the only time they do a 'free' appointment is in the case of a failed IVF cycle. But I argued that in that case, firstly, the couple comes in one more time after the retrieval so gets to speak to the doctor, and isn't all drugged up and also secondly, as I knew I was going to do at least two cycles, it was fairly obvious that there was a mandatory 'in between appointment' and it was shit to be charged for it. She said she would raise it at the next internal meeting, in the meantime however, I'm out the extra money. I mean fine, in the grand scheme of things it's a small proportion of the money, but I'd rather they bump the overall fee by 100 pounds and then include it then dump it on you like that. It's annoying. And what you don't want to be, in an emotional and hormonally charged process, is annoyed by things that seem really stupid.
I also learned that my clinic has been bought by/has joined a larger network of IVF clinics in the UK. I'm not sure it makes any sort of difference as it seems more of a higher level management issue and each clinic seems to be independently run. But I suppose it can't be a bad thing in the long run, particularly if in a couple years time I'm not in London but somewhere else in the UK, it might be easier to use a local related clinic then go back down to London but that's a long way away to be thinking about. I suppose although it's interesting, it really doesn't seem to impact me at all.
The other thing I'm looking forward to now that this cycle is starting is getting my fridge space back! This is more for my non-UK/European visitors but having had my drug delivery a couple of weeks ago, it's put a serious limit on my fridge space! I have a flatmate, and she gets the bottom half of the fridge, so as you can see from the picture, space has been a little tight!
Anyway, that's all the news from here. I'll keep things updated as this cycle goes.
16 September 2013
Meeting with the Doctor
Today I had both my follow up meeting from my last cycle and preparation meeting for my next cycle with my doctor. Again, I got charged for this visit and I plan to call them later this week to hammer out what the deal is with getting charged for this appointment. Last time they said they charged me because I had a scan, but I didn't have a scan this visit. I should have argued when I was there but I wasn't in the right mindframe to do it. I've been incredibly stressed all day and I just couldn't deal with it. Probably a mistake. Whatever.
Anyway.
Here are the things we talked about in no discernible order.
Probably one of the most important is we discussed my results from the last cycle (4 eggs) compared to the first cycle (6 eggs). Of course this disappoints me somewhat, but then if I had 2 ovaries I would have 20 eggs total instead of 10 (lets say) and I'd be perfectly happy with that. So I don't feel like I can be that upset about it. I stressed this was my last possible cycle due to financial considerations. So the doctor said that as it was my last cycle he felt we could try to push the ovary a bit more and he's going to increase my Gonal-F and see how it goes. In both of my cycles there had been additional smaller follicles that didn't catch up or grow as fast and I guess he's hoping to catch them by upping the drugs. As with most of this process, I have to trust that he is basing this decision on his experience and expertise and I trust him. I'm conscious of having read other women who didn't respond well to higher drug doses, but I trust that my clinic scans me every other day, and will monitor me closely and he wouldn't suggest this if he didn't think it was a good plan. It's hard to feel like I'm gambling with my last cycle, but on the other hand, I've read about a lot of women on the higher dose of Gonal-F, so it's not like it's that odd or extreme. I'm sure it will be okay. I'll obviously keep track here of how everything goes.
In keeping with that, I got my prescription for all the drugs so I need to get in touch with Healthcare at Home to send it in and arrange the delivery. I'm going to remember to insist that they include the sharps bin this time!
We arranged my norethisterone prior to the cycle. As my cycle is about 30-31 days, I'm going to do 9 days of the norethisterone. For the first cycle I did 8, the second I did 7. So this is another change although one I'm more on board with. The nurse had suggested I do 9 for my second cycle but the drugs didn't arrive in time so I could only do the 7.
We talked about birth control pills. Specifically about whether or not I could go back on them after the third cycle and if there were any implications for future fertility. He said there is no indication that birth control pills affect ability to conceive and that I should be fine going back on and he had no reservations. So that was good news. I miss my birth control pills!
We talked about my period. Okay, skip over this if you don't want specifics. Basically I've noticed that as I've gotten older, my period is much darker, and lighter, and a bit shorter. Of course as I go through all of this I just panic that this somehow means my womb is an infertile place and I can't conceive. He said the color of your period means absolutely nothing. He also said that the frequency of your period and heaviness have more to do with your ovarian reserve than your ability to get pregnant. He pointed out that there are women close to 50 who get pregnant- they have no eggs left, but their womb can still healthily function. Obviously I am not planning on being 50 and pregnant, but this was comforting news.
We also talked about the counseling service that is available. I sort of wish I'd picked up on this sooner. They have to counselors who have an office space and I just need to call and arrange an appointment and they will often schedule alongside your scan if the timing works out. Although I might start this sooner seeing as how once my scans start there isn't much time left for any counseling. At any rate, it will probably take time to arrange it anyway. So I'm going to do that and will also have updates here.
So really, that was all great, other than being charged 120 quid for the visit. This irritates me to no end, but my comfort and trust in the clinic outweighs my annoyance.
The only other thing of interest is that they are doing some building works to the clinic and so I'm lucky I didn't try to schedule for this month as I don't think they would have done it. They're moving around some of the lab and clinical spaces on the ground floor although the doctors offices and scan rooms on the first floor aren't affected. The building works are supposed to finish right when my next cycle starts, so that allows an extra week and a bit for them to run over before it's a problem. I am just going to assume it's not going to be a problem.
Anyway, that's the update. One month countdown to the third and final cycle begins!
Anyway.
Here are the things we talked about in no discernible order.
Probably one of the most important is we discussed my results from the last cycle (4 eggs) compared to the first cycle (6 eggs). Of course this disappoints me somewhat, but then if I had 2 ovaries I would have 20 eggs total instead of 10 (lets say) and I'd be perfectly happy with that. So I don't feel like I can be that upset about it. I stressed this was my last possible cycle due to financial considerations. So the doctor said that as it was my last cycle he felt we could try to push the ovary a bit more and he's going to increase my Gonal-F and see how it goes. In both of my cycles there had been additional smaller follicles that didn't catch up or grow as fast and I guess he's hoping to catch them by upping the drugs. As with most of this process, I have to trust that he is basing this decision on his experience and expertise and I trust him. I'm conscious of having read other women who didn't respond well to higher drug doses, but I trust that my clinic scans me every other day, and will monitor me closely and he wouldn't suggest this if he didn't think it was a good plan. It's hard to feel like I'm gambling with my last cycle, but on the other hand, I've read about a lot of women on the higher dose of Gonal-F, so it's not like it's that odd or extreme. I'm sure it will be okay. I'll obviously keep track here of how everything goes.
In keeping with that, I got my prescription for all the drugs so I need to get in touch with Healthcare at Home to send it in and arrange the delivery. I'm going to remember to insist that they include the sharps bin this time!
We arranged my norethisterone prior to the cycle. As my cycle is about 30-31 days, I'm going to do 9 days of the norethisterone. For the first cycle I did 8, the second I did 7. So this is another change although one I'm more on board with. The nurse had suggested I do 9 for my second cycle but the drugs didn't arrive in time so I could only do the 7.
We talked about birth control pills. Specifically about whether or not I could go back on them after the third cycle and if there were any implications for future fertility. He said there is no indication that birth control pills affect ability to conceive and that I should be fine going back on and he had no reservations. So that was good news. I miss my birth control pills!
We talked about my period. Okay, skip over this if you don't want specifics. Basically I've noticed that as I've gotten older, my period is much darker, and lighter, and a bit shorter. Of course as I go through all of this I just panic that this somehow means my womb is an infertile place and I can't conceive. He said the color of your period means absolutely nothing. He also said that the frequency of your period and heaviness have more to do with your ovarian reserve than your ability to get pregnant. He pointed out that there are women close to 50 who get pregnant- they have no eggs left, but their womb can still healthily function. Obviously I am not planning on being 50 and pregnant, but this was comforting news.
We also talked about the counseling service that is available. I sort of wish I'd picked up on this sooner. They have to counselors who have an office space and I just need to call and arrange an appointment and they will often schedule alongside your scan if the timing works out. Although I might start this sooner seeing as how once my scans start there isn't much time left for any counseling. At any rate, it will probably take time to arrange it anyway. So I'm going to do that and will also have updates here.
So really, that was all great, other than being charged 120 quid for the visit. This irritates me to no end, but my comfort and trust in the clinic outweighs my annoyance.
The only other thing of interest is that they are doing some building works to the clinic and so I'm lucky I didn't try to schedule for this month as I don't think they would have done it. They're moving around some of the lab and clinical spaces on the ground floor although the doctors offices and scan rooms on the first floor aren't affected. The building works are supposed to finish right when my next cycle starts, so that allows an extra week and a bit for them to run over before it's a problem. I am just going to assume it's not going to be a problem.
Anyway, that's the update. One month countdown to the third and final cycle begins!
30 June 2013
End Cycle 2, Cost Update
At the end of cycle 2, I thought I'd post a cost update. You can see the full breakdown from the first cycle here (with the cost of my follow up scan added here). You can also see the drug breakdown comparison from my first cycle bought direct from my clinic to the Healthcare at Home order here. For ease, costs have been rounded to the nearest pound.
The total for the second cycle came to £3485. Given my estimated budget of £10k for 2 cycles, that's pretty much right on target. It would have even been a bit better if I had known about the less expensive drugs from Healthcare at Home for my first cycle. And of course I expect a refund at some point from the 10 years of storage since I doubt I'll use all ten years. I think they refund you £150 for every year not used.
Assuming I go for a third cycle I will be able to shave off a tiny bit more- as the norethisterone didn't arrive in time, I have it set for the next cycle and don't need anymore. I also would get a 450 Gonal-F pen from Healthcare at home as I believe that even if I don't need both doses, it would still be cheaper than the one dose I had to buy extra this cycle from my clinic. Although I only have one Cetrotide left over so I'd need more of those, maybe it would work out to the same then.
Egg freezing is not an inexpensive process, especially when like me, you need multiple cycles. I hope that in the couple of years between now and when I hope to use the eggs the costs may come down a bit as the popularity continues. In the next month I will need to consider my options for paying for a third cycle. My mother paid for most of the first two (I think I paid about £1000 of the total myself), but that is all she can afford. I am going to speak to my step-mother about whether or not she thinks it's worth discussing it with my father or not. I could take money out of my mortgage, or I could use my savings. I have enough to cover the third cycle myself, although it would take a substantial amount of my savings at a time when I may need it (I'm finishing a PhD and my funding runs out at the end of the year).
Still, at the start of this process I said I probably wouldn't have done it if I had to pay for it myself, but now I obviously feel differently and that it would be worth my own savings to finish this journey. I think that's probably worth noting. I have no idea what the future may hold but it's clear that doing this has given me some sense of confidence or comfort that wasn't obvious at the start.
| Previous total cost | £6996 |
| Norethisterone delivery from clinic | £11 |
| Drugs from Healthcare at Home | £584 |
| Egg Freezing Cycle | £2800 |
| 225 Gonal F from clinic | £90 |
| Total | £10481 |
The total for the second cycle came to £3485. Given my estimated budget of £10k for 2 cycles, that's pretty much right on target. It would have even been a bit better if I had known about the less expensive drugs from Healthcare at Home for my first cycle. And of course I expect a refund at some point from the 10 years of storage since I doubt I'll use all ten years. I think they refund you £150 for every year not used.
Assuming I go for a third cycle I will be able to shave off a tiny bit more- as the norethisterone didn't arrive in time, I have it set for the next cycle and don't need anymore. I also would get a 450 Gonal-F pen from Healthcare at home as I believe that even if I don't need both doses, it would still be cheaper than the one dose I had to buy extra this cycle from my clinic. Although I only have one Cetrotide left over so I'd need more of those, maybe it would work out to the same then.
Egg freezing is not an inexpensive process, especially when like me, you need multiple cycles. I hope that in the couple of years between now and when I hope to use the eggs the costs may come down a bit as the popularity continues. In the next month I will need to consider my options for paying for a third cycle. My mother paid for most of the first two (I think I paid about £1000 of the total myself), but that is all she can afford. I am going to speak to my step-mother about whether or not she thinks it's worth discussing it with my father or not. I could take money out of my mortgage, or I could use my savings. I have enough to cover the third cycle myself, although it would take a substantial amount of my savings at a time when I may need it (I'm finishing a PhD and my funding runs out at the end of the year).
Still, at the start of this process I said I probably wouldn't have done it if I had to pay for it myself, but now I obviously feel differently and that it would be worth my own savings to finish this journey. I think that's probably worth noting. I have no idea what the future may hold but it's clear that doing this has given me some sense of confidence or comfort that wasn't obvious at the start.
24 June 2013
Cycle 2: Day 12
Had another scan today. Still at about 6 follicles or so. Two of them are larger and could be collected but the doctor is hoping the other four will grow and catch up. I had a good talk with this doctor today. I said that I was feeling a bit discouraged about the lower follicle count compared to the first cycle. She told me that I really had no reason to be discouraged. That it was a reasonable outcome for someone of my age and with one ovary. And that I was responding well to the medication. She said that when they usually see women it's because they are having fertility problems, and I don't even know if I have any problems at all. She reiterated that it's really a lot about the egg quality. She told me she's seen women who get over ten eggs and none are good quality and another woman who came and only got one egg and then she got pregnant. Apparently they've also used frozen eggs successfully. Although they were donor eggs (and so most likely younger than my eggs) there were two frozen and they got a single pregnancy. So all of that was good. She also mentioned that I might want to take advantage of the free counseling that the clinic offers. I mean, I'm not entirely sure what a counselor can tell me. I sort of know what the deal is, it's just stressful. On the other hand, I feel a lot better having talked to the doctor and so maybe it would help to talk to the counselor and considering it's free, why the heck not?
I also asked the doctor about the protocol they use compared to the ones I hear about from the other egg freezers I know in the States. It seems like the UK protocol is much simpler- less drugs and almost no blood work other than the initial blood work. The doctor told me that they've looked at all the results so far from these procedures and they feel they simply aren't necessary. Obviously each doctor will have a different opinion but I do feel good that they at least keep up with these things. My clinic is one of the best in the UK with high results to prove it. They have to know something right about what they're doing.
In the meantime I continue on the same schedule- 225 Gonal-F and .25 Cetrotide. My next scan is Wednesday and collection will probably be Friday or maybe Saturday but I'll know for sure after the next scan. Seems like I'm on the same time schedule as the first cycle. Oh, and I did say something about how I felt like it was along time and she assured me that this is not a long time. She said some people take 3-4 weeks, and that's a long cycle!
I also asked the doctor about the protocol they use compared to the ones I hear about from the other egg freezers I know in the States. It seems like the UK protocol is much simpler- less drugs and almost no blood work other than the initial blood work. The doctor told me that they've looked at all the results so far from these procedures and they feel they simply aren't necessary. Obviously each doctor will have a different opinion but I do feel good that they at least keep up with these things. My clinic is one of the best in the UK with high results to prove it. They have to know something right about what they're doing.
In the meantime I continue on the same schedule- 225 Gonal-F and .25 Cetrotide. My next scan is Wednesday and collection will probably be Friday or maybe Saturday but I'll know for sure after the next scan. Seems like I'm on the same time schedule as the first cycle. Oh, and I did say something about how I felt like it was along time and she assured me that this is not a long time. She said some people take 3-4 weeks, and that's a long cycle!
13 June 2013
Cycle 2: Day 1
So I went to the clinic today for my first scan and tonight is my first injection. I remembered to take the Gonal-F out of the fridge so it won't be too cold. My scan was fine. Not with my usual doctor as he's on holiday, but with his colleague who I've seen before. There wasn't much discussion or information. Just an 'all good' and a schedule for injections!
I had to pay the big bill today, but since I've already paid for my drugs, that should be most of the money done for two cycles now. I'll do a cost update at some point with all the costs. I was paying for the egg freezing and talking to the office manager and I complained about how my follow up appointment was not included and that I had to a) request it and b) pay for, on the last cycle. She agreed with me that it wasn't good but needs to talk about it with the doctors. Meaning, she couldn't give me anything for it, but I'm glad I complained.
I was also slightly distressed that my cycle seems to be coinciding with all of the doctors being busy or away. I tried to schedule my next scans and could only schedule the very next one, and a day after what I wanted. So my next (second) scan is on Tuesday. I really wanted Monday morning but there weren't any openings. This means I need to go up to Cambridge, come back from Cambridge, go back to Cambridge, and come back from Cambridge whereas I really just wanted to go up and come back once. Oh well. It's a minor inconvenience really. But the doctors being away is a bigger one. I'll find out more on Tuesday about when and with who my next scans are going to be. Not entirely pleased about it at the moment but I'm hoping it sorts itself out somehow.
Not much else to say yet. I did pick up a sharps bin from the clinic as I didn't get one with my drug delivery (even though I was supposed to). So at least that's sorted.
Right. I guess I better go get it done!
I had to pay the big bill today, but since I've already paid for my drugs, that should be most of the money done for two cycles now. I'll do a cost update at some point with all the costs. I was paying for the egg freezing and talking to the office manager and I complained about how my follow up appointment was not included and that I had to a) request it and b) pay for, on the last cycle. She agreed with me that it wasn't good but needs to talk about it with the doctors. Meaning, she couldn't give me anything for it, but I'm glad I complained.
I was also slightly distressed that my cycle seems to be coinciding with all of the doctors being busy or away. I tried to schedule my next scans and could only schedule the very next one, and a day after what I wanted. So my next (second) scan is on Tuesday. I really wanted Monday morning but there weren't any openings. This means I need to go up to Cambridge, come back from Cambridge, go back to Cambridge, and come back from Cambridge whereas I really just wanted to go up and come back once. Oh well. It's a minor inconvenience really. But the doctors being away is a bigger one. I'll find out more on Tuesday about when and with who my next scans are going to be. Not entirely pleased about it at the moment but I'm hoping it sorts itself out somehow.
Not much else to say yet. I did pick up a sharps bin from the clinic as I didn't get one with my drug delivery (even though I was supposed to). So at least that's sorted.
Right. I guess I better go get it done!
27 April 2013
Drug Delivery
About a week after I'd sent off my prescription to Healthcare at Home (HaH) I got a call to arrange payment and delivery. They were really helpful and friendly on the phone. There was a bit of a mess because it was going on my mom's credit card and she's in the States and they needed her to verify the payment but actually in the end it was all rather simple and easy and so the drugs were paid for at the price I was quoted (still can't believe it) and delivery was arranged for today.
They made a point of telling me that some of the drugs require chilling and so would need to be put in the fridge straight away and instructions would be provided. This proved to be true. It was marked on the box...
...as well as on the inventory.
So all of that has gone straight into the fridge, super easy. The rest is all the Cetrotide which apparently does not need to be refrigerated. That's a lot of Cetrotide!
The only disappointing thing about this was that the drugs and the inventory were all that was in the box. I had asked if the sharps bin came with the drugs and I was told in my original contact by email as well as over the phone that everything I needed would be included, but I'm sad to report it was not. On the other hand, I don't think it's that complicated to get a sharps bin (I'm fairly certain I can pick one up from a pharmacy or from my GP). It's just a small hassle that I wasn't expecting. In the grand scheme of things, it's fine. And I think it's probably an oversight or error since multiple people told me that it would be there.
I'm really not complaining all things considered.
So it's weird to have all the drugs again. It's still a month away and I've got a three week trip to the States that's going to happen in between now and then. Part of me is sort of looking forward to getting it started though, and part of me is looking forward to just getting it done.
They made a point of telling me that some of the drugs require chilling and so would need to be put in the fridge straight away and instructions would be provided. This proved to be true. It was marked on the box...
...as well as on the inventory.
So all of that has gone straight into the fridge, super easy. The rest is all the Cetrotide which apparently does not need to be refrigerated. That's a lot of Cetrotide!
The only disappointing thing about this was that the drugs and the inventory were all that was in the box. I had asked if the sharps bin came with the drugs and I was told in my original contact by email as well as over the phone that everything I needed would be included, but I'm sad to report it was not. On the other hand, I don't think it's that complicated to get a sharps bin (I'm fairly certain I can pick one up from a pharmacy or from my GP). It's just a small hassle that I wasn't expecting. In the grand scheme of things, it's fine. And I think it's probably an oversight or error since multiple people told me that it would be there.
I'm really not complaining all things considered.
So it's weird to have all the drugs again. It's still a month away and I've got a three week trip to the States that's going to happen in between now and then. Part of me is sort of looking forward to getting it started though, and part of me is looking forward to just getting it done.
08 April 2013
Reducing Drug Costs
I could have also called this post, "I won't do that again!" or "I wish I knew then what I know now!"
I have just received an estimate for drugs from Healthcare at Home for the drugs and I am blown away by the price difference. Now, just to be clear, my prescription is not quite for enough drugs so I don't 'over order' but let's compare. This was the previous drug breakdown from my first egg collection cycle:
This is what I was just (April 2013) quoted from Healthcare at Home:
Based on my previous cycle, this is two doses short of Gonal F and two doses short of Cetrotide- if my protocol lasts as long as my first. But lets be clear. This means my drugs would be almost 1/3 the cost of the drugs from the clinic!! That is a HUGE difference. Even if I have to order a couple extra doses, it will still be significantly cheaper, even with the delivery fee and credit card fee. I mean, I will be getting a Gonal F 900 pen for LESS than the cost of the clinic 450 pen!!
So this means if my previous projected cost for cycle 2 with no changes was £4471, my current projected cost for cycle 2 with the drugs listed above is £3384. Even if I have to purchase a Gonal F 450 pen and two more Cetrotide from my clinic (although why would I?) the projected cost will be £3628 for a total projected savings of £843. And if I do need extra drugs and buy them from Healthcare at Home then I will save a bit more (around £40 more based on the above costs) even with delivery and credit card fees, so still worth it!
Part of me is annoyed I didn't know to check this out for my first cycle. I'm also a tiny bit annoyed that my clinic never mentioned it, although obviously they make profit on selling the drugs, so I don't entirely fault them. To be honest although I think it would be a nice thing to do, it's really not their job to mention it- I didn't specifically ask if there was any way to reduce my costs either. However, I definitely know where I'll be getting my drugs from for cycle two. I need to get on with ordering them now as I'm out of the country for most of May and when I get back for the start of June it will be time for round two. But I'll keep updated here with my drug purchasing experience. So far Healthcare at Home has a huge endorsement from me (if you can't tell by my repeating their name and posting the link :) )
I have just received an estimate for drugs from Healthcare at Home for the drugs and I am blown away by the price difference. Now, just to be clear, my prescription is not quite for enough drugs so I don't 'over order' but let's compare. This was the previous drug breakdown from my first egg collection cycle:
| Drug | Cost |
| Gonal F 900 pen x3 (£360 each) | £1080 |
| Gonal F 450 pen | £180 |
| Cetrotide x12 (£32 each) | £384 |
| Ovitrelle single dose | £16 |
| Total Cost | £1660 |
This is what I was just (April 2013) quoted from Healthcare at Home:
| Drug | Cost |
| Gonal F 900 pen x3 (£142.56 each) | £427.68 |
| Cetrotide x10 (£10.80 each) | £108 |
| Ovitrelle single dose | £6.48 |
| Delivery Fee | £30 |
| Credit Card Fee | £11.44 |
| Total Cost | £583.60 |
Based on my previous cycle, this is two doses short of Gonal F and two doses short of Cetrotide- if my protocol lasts as long as my first. But lets be clear. This means my drugs would be almost 1/3 the cost of the drugs from the clinic!! That is a HUGE difference. Even if I have to order a couple extra doses, it will still be significantly cheaper, even with the delivery fee and credit card fee. I mean, I will be getting a Gonal F 900 pen for LESS than the cost of the clinic 450 pen!!
So this means if my previous projected cost for cycle 2 with no changes was £4471, my current projected cost for cycle 2 with the drugs listed above is £3384. Even if I have to purchase a Gonal F 450 pen and two more Cetrotide from my clinic (although why would I?) the projected cost will be £3628 for a total projected savings of £843. And if I do need extra drugs and buy them from Healthcare at Home then I will save a bit more (around £40 more based on the above costs) even with delivery and credit card fees, so still worth it!
Part of me is annoyed I didn't know to check this out for my first cycle. I'm also a tiny bit annoyed that my clinic never mentioned it, although obviously they make profit on selling the drugs, so I don't entirely fault them. To be honest although I think it would be a nice thing to do, it's really not their job to mention it- I didn't specifically ask if there was any way to reduce my costs either. However, I definitely know where I'll be getting my drugs from for cycle two. I need to get on with ordering them now as I'm out of the country for most of May and when I get back for the start of June it will be time for round two. But I'll keep updated here with my drug purchasing experience. So far Healthcare at Home has a huge endorsement from me (if you can't tell by my repeating their name and posting the link :) )
04 April 2013
Follow-Up Consultation
Today I had my fist meeting with the doctor since my collection. I am sad to report that I was charged for this visit. I feel that this is not ideal and that a single follow-up consultation should be standard with an egg collection procedure. But, you can't be pleased with everything. So the new update on costs is:
But it is what it is. Either I choose a different clinic, or I accept that this is how it is. Can't be pleased with everything. And overall I am really generally pleased. So I am going to stick with them.
So I saw my doctor today and we discussed how everything went and he did a scan to check on my ovary since I said that I could still feel it and I knew it had not gone back to normal size. I was of course concerned it was the cyst but I am happy to report that my cyst is still the same size as it was before and has not grown at all. On the other hand, my ovary is currently about twice it's normal size. The doctor said this was 'normal' and that it can take up to two period cycles for it to return to normal size. When stimulated it can be 7 or 8 times normal size. So my ovary has definitely 'gone down' but it's not all the way down yet. In keeping with this he suggested I stay away from impact exercise and twisting until I don't feel it anymore. I'm glad that I wasn't making it up that I still 'felt' the ovary and also glad I was taking it easy and not rushing back to the gym.
We discussed how the retrieval went. In the end there were 10 follicles and 6 had eggs and all 6 were mature. They can't tell you anything about the quality of those eggs. I asked if there was anything I could be doing now to help improve number or quality as there are many things talked about online. He said the only thing he suggested was that I consider some slow weight loss between now and my next procedure. That's fair. But he cautioned me it needs to be slow and steady, not a crash diet as that can negatively impact egg production or quality. So I need to be a bit more serious about seeing if I can lose 10-15 pounds in the next two months.
He said he felt the protocol was good and he didn't particularly want to change it. He said that as I only have the one ovary he didn't want to be too aggressive or risky because we want to protect the ovary as well. That seemed reasonable to me.
He gave me a prescription for my drugs and said they are happy for me to source them elsewhere if I can get them for cheaper, so that was good and I need to follow up with that over the next couple of weeks. He also said that my retrieval procedure was a bit tricky. That surprised me. I asked why and he said that my ovary moved around a lot during the retrieval. Apparently the dermoid cyst can make it wobbly or a bit less stable, or even float inside the gut, so apparently it wasn't exactly straightforward to retrieve my eggs.
So there you have it. I'll post more about drug pricing as I look into that. In the meantime I have 2 months to see if I can drop some weight. That's not going to be easy though if you consider I'm back in the States for 3 weeks in May. But I'll do the best I can.
| Previous total cost | £6876 |
| Follow-up consultation | £120 |
| Total cost to date | £6996 |
But it is what it is. Either I choose a different clinic, or I accept that this is how it is. Can't be pleased with everything. And overall I am really generally pleased. So I am going to stick with them.
So I saw my doctor today and we discussed how everything went and he did a scan to check on my ovary since I said that I could still feel it and I knew it had not gone back to normal size. I was of course concerned it was the cyst but I am happy to report that my cyst is still the same size as it was before and has not grown at all. On the other hand, my ovary is currently about twice it's normal size. The doctor said this was 'normal' and that it can take up to two period cycles for it to return to normal size. When stimulated it can be 7 or 8 times normal size. So my ovary has definitely 'gone down' but it's not all the way down yet. In keeping with this he suggested I stay away from impact exercise and twisting until I don't feel it anymore. I'm glad that I wasn't making it up that I still 'felt' the ovary and also glad I was taking it easy and not rushing back to the gym.
We discussed how the retrieval went. In the end there were 10 follicles and 6 had eggs and all 6 were mature. They can't tell you anything about the quality of those eggs. I asked if there was anything I could be doing now to help improve number or quality as there are many things talked about online. He said the only thing he suggested was that I consider some slow weight loss between now and my next procedure. That's fair. But he cautioned me it needs to be slow and steady, not a crash diet as that can negatively impact egg production or quality. So I need to be a bit more serious about seeing if I can lose 10-15 pounds in the next two months.
He said he felt the protocol was good and he didn't particularly want to change it. He said that as I only have the one ovary he didn't want to be too aggressive or risky because we want to protect the ovary as well. That seemed reasonable to me.
He gave me a prescription for my drugs and said they are happy for me to source them elsewhere if I can get them for cheaper, so that was good and I need to follow up with that over the next couple of weeks. He also said that my retrieval procedure was a bit tricky. That surprised me. I asked why and he said that my ovary moved around a lot during the retrieval. Apparently the dermoid cyst can make it wobbly or a bit less stable, or even float inside the gut, so apparently it wasn't exactly straightforward to retrieve my eggs.
So there you have it. I'll post more about drug pricing as I look into that. In the meantime I have 2 months to see if I can drop some weight. That's not going to be easy though if you consider I'm back in the States for 3 weeks in May. But I'll do the best I can.
29 March 2013
Costs
I know I promised I'd return with a cost break-down post. After a couple of weeks I have returned to do just that! But first some other house keeping.
My period came and went and I finally started to feel less bloated. It probably took a good 2 weeks before I started to think I felt "normal". However, I have noticed that I still sometimes feel my side where my ovary is. I have not had a follow-up appointment with my clinic (though I hope to arrange one next week). Part of me is concerned that my cysts somehow grew a lot and that's what I'm feeling. That seems slightly irrational, but I have no other way to understand why I feel "something" even when the rest of me feels normal.
I'm also slightly disappointed that my clinic did not mandate a follow-up appointment post retrieval. That seems poor form to me. I'm not sure if it was an oversight, or if it's standard, but I think follow up care is important. So I'll call that out as something that has not made me happy about my clinic. But, as I say, I'll try to get an appointment next week. Mainly because I need to discuss how to proceed with cycle 2 in June. So while I'm not thrilled with every aspect of my clinic, I'm also not unhappy enough to go elsewhere.
Now, on to costs.
A caveat.
After looking around at IVF blogs, it came to me that in the UK other people try to price their drugs cheaper at certain pharmacies. It may be that I could have gotten my drugs for less had I shopped around. My clinic did not suggest this to me, and it honestly did not occur to me. For my second cycle, I will try to shop around for cheaper drugs, and I will post about that here as I do it. However, below were the costs of my first cycle, using the drugs provided by the clinic, at the clinic cost. I had no left-over drugs at all, which I really appreciated.
So here are some quick facts:
My period came and went and I finally started to feel less bloated. It probably took a good 2 weeks before I started to think I felt "normal". However, I have noticed that I still sometimes feel my side where my ovary is. I have not had a follow-up appointment with my clinic (though I hope to arrange one next week). Part of me is concerned that my cysts somehow grew a lot and that's what I'm feeling. That seems slightly irrational, but I have no other way to understand why I feel "something" even when the rest of me feels normal.
I'm also slightly disappointed that my clinic did not mandate a follow-up appointment post retrieval. That seems poor form to me. I'm not sure if it was an oversight, or if it's standard, but I think follow up care is important. So I'll call that out as something that has not made me happy about my clinic. But, as I say, I'll try to get an appointment next week. Mainly because I need to discuss how to proceed with cycle 2 in June. So while I'm not thrilled with every aspect of my clinic, I'm also not unhappy enough to go elsewhere.
Now, on to costs.
A caveat.
After looking around at IVF blogs, it came to me that in the UK other people try to price their drugs cheaper at certain pharmacies. It may be that I could have gotten my drugs for less had I shopped around. My clinic did not suggest this to me, and it honestly did not occur to me. For my second cycle, I will try to shop around for cheaper drugs, and I will post about that here as I do it. However, below were the costs of my first cycle, using the drugs provided by the clinic, at the clinic cost. I had no left-over drugs at all, which I really appreciated.
| Service | Cost |
| Initial consultation and blood work | £490 |
| Norethisterone plus mail fee (£6) | £11 |
| STD Blood work | £115 |
| Gonal F 450 pen | £180 |
| Gonal F 900 pen | £360 |
| Cetrotide x4 | £128 |
| Egg Freezing Medical Cost | £2800 |
| Ten year storage (unused refundable) | £1800 |
| Gonal F 450 pen | £180 |
| Cetrotide x1 | £32 |
| Gonal F 450 pen | £180 |
| Cetrotide x3 | £96 |
| Gonal F 450 pen | £180 |
| Cetrotide x1 | £32 |
| Gonal F 450 pen | £180 |
| Cetrotide x3 | £96 |
| Ovitrelle single dose | £16 |
| Total Cost | £6876 |
So here are some quick facts:
- The 'egg freezing medical costs' included all of my clinic visits, all of my scans, and the retrieval procedure and associated drugs (including suppository)
- The initial consultation and the storage are one-off fees which I won't pay again. Total: £2290
- Total drug costs: £1671
- Projected cost of cycle 2 if no changes: £4471
24 February 2013
Days 14, 15
Last night was my last Gonal-F injection!! It was 187.5 as opposed to the 225 I've been taking for the rest of my cycle. And of course the Cetrotide. The past two days all of the injections have been pretty easy which has been nice. Today I have my last injections before egg collection. At 7pm I take the Cetrotide and then at 8pm I take the Ovitrelle that is waiting for me in the fridge. Monday- no shots! Then Tuesday morning I need to pop in a Voltarol suppository before heading to the clinic super early. The Voltarol is for pain relief and seems standard practice for some UK clinics according to forums on the internet.
I've arranged for my friend to be there by 10 and I imagine I should be able to leave by 11 at the latest. So the end is almost here. I can see it. I'm both nervous and excited. And I'm not going to lie, I'm also excited to get my life back for a couple of months where I'm not injecting myself every night and giving up alcohol and caffeine.
My right side where my ovary is feels a bit tight but honestly it's felt worse at different parts of this journey. I've been very careful to avoid twisting and I can't help worry about things like OHSS and what happens after egg collection, but by the time my period comes it should all be flushing away and reverting to normal.
It's easy to get wrapped up in this experience but I still find it challenging that the support and advice for egg freezing is just dwarfed by IVF. The issues are entirely different. I do find it useful to read IVF forums for understanding issues regarding the egg collection process, but all this DH this and BFN/P that- it's not relevant to my journey and in some ways highlights the wrong thing about this process as it only painfully reminds me that my life is not where I had hoped it would be at this point.
It's also interesting the responses I've had from different friends about what I'm doing. I have been reasonably open about telling friends of mine what I'm doing and the results have ranged from "That's amazing and you would make a great mother." to "Why would you do that?" to "Why don't you just get pregnant now?". The responses have not necessarily coordinated with the friends I thought they would have, either.
I'm not rushing in to any decisions. I just feel that this gives me an option I would otherwise be passing up. And I believe that it is a good idea and the right thing for me to be doing at this time. In addition, having lost an ovary already, it makes sense to try to preserve eggs from my remaining ovary which, as discussed already has a small cyst on it, because as I well know- anything can happen and then your choices can be taken away from you.
On the other hand, it puts into stark relief things about my life that have disappointed me. It forces me to consider things that I have not necessarily been considering. And I feel it is additionally challenging to be undertaking all of this alone without anyone to truly share 'the burden' of the harder thoughts with. Or just the stupid moments of having injections and sharps boxes.
It's part of the reason I made this blog, and have tried to find others. Or maybe I'm just someone who likes sharing. Anyway. Enough Sunday morning rambling! I will continue to keep this blog updated with the results of this cycle, any thoughts in between, and when I do the second cycle (which I am entirely assuming I will do as there is no reason at this point to think I won't) I'll return to it, though possibly not the day by day description that this first cycle has been. But as my doctor says, that's still a ways away. First things first!
Last day of shots today!! Woohoo!!
I've arranged for my friend to be there by 10 and I imagine I should be able to leave by 11 at the latest. So the end is almost here. I can see it. I'm both nervous and excited. And I'm not going to lie, I'm also excited to get my life back for a couple of months where I'm not injecting myself every night and giving up alcohol and caffeine.
My right side where my ovary is feels a bit tight but honestly it's felt worse at different parts of this journey. I've been very careful to avoid twisting and I can't help worry about things like OHSS and what happens after egg collection, but by the time my period comes it should all be flushing away and reverting to normal.
It's easy to get wrapped up in this experience but I still find it challenging that the support and advice for egg freezing is just dwarfed by IVF. The issues are entirely different. I do find it useful to read IVF forums for understanding issues regarding the egg collection process, but all this DH this and BFN/P that- it's not relevant to my journey and in some ways highlights the wrong thing about this process as it only painfully reminds me that my life is not where I had hoped it would be at this point.
It's also interesting the responses I've had from different friends about what I'm doing. I have been reasonably open about telling friends of mine what I'm doing and the results have ranged from "That's amazing and you would make a great mother." to "Why would you do that?" to "Why don't you just get pregnant now?". The responses have not necessarily coordinated with the friends I thought they would have, either.
I'm not rushing in to any decisions. I just feel that this gives me an option I would otherwise be passing up. And I believe that it is a good idea and the right thing for me to be doing at this time. In addition, having lost an ovary already, it makes sense to try to preserve eggs from my remaining ovary which, as discussed already has a small cyst on it, because as I well know- anything can happen and then your choices can be taken away from you.
On the other hand, it puts into stark relief things about my life that have disappointed me. It forces me to consider things that I have not necessarily been considering. And I feel it is additionally challenging to be undertaking all of this alone without anyone to truly share 'the burden' of the harder thoughts with. Or just the stupid moments of having injections and sharps boxes.
It's part of the reason I made this blog, and have tried to find others. Or maybe I'm just someone who likes sharing. Anyway. Enough Sunday morning rambling! I will continue to keep this blog updated with the results of this cycle, any thoughts in between, and when I do the second cycle (which I am entirely assuming I will do as there is no reason at this point to think I won't) I'll return to it, though possibly not the day by day description that this first cycle has been. But as my doctor says, that's still a ways away. First things first!
Last day of shots today!! Woohoo!!
22 February 2013
Day 13 - Scan
The end is in sight!
Had my scan this morning. The doctor said that Tuesday would really be better for collection as the goal is to have as many good eggs as possible and I do have some follicles lagging behind. I'm sure that I could question him for his reasoning and thinking, but as my IVF experienced friend said, "What is he going to tell you really except that this is what he thinks they should do based on all the other patients they've seen and the results they've had with different protocols?". It's true really. Whatever they say to me isn't going to be the magic pill that "promises" the prize. Either you trust your doctor, and the clinic, or you don't. So lesson of the day- be very happy with your clinic and doctor because that's really all you've got.
At any rate, he counted 13 follicles and there may have been a couple others. They are getting big! He suggested that I should be looking at 5-10 eggs. Of course there is a massive difference between 5 and 10. And there is absolutely nothing I can do about it except wait and see. Obviously I hope for 10 and I will be disappointed with 5 but it will be what it will be and lets just hope that it's not any less than that which is of course, also entirely possible.
So I have my final drugs now, and I need to be back at the clinic at 8:30am on Tuesday morning for my procedure at 9am and I might be able to go home by 10 and hopefully by 11.
Tonight, I'm on the same drugs as usual- Gonal-F at 225 and Cetrotide. Then tomorrow I do them again but the Gonal-F reduces (I have it written down- I think it's one eight something or other). Sunday at 7pm I take the Cetrotide and then at 8pm I do the Ovitrelle which came pre-packaged and is currently in my fridge waiting for me. Monday- no shots! Hooray! Before I head to the clinic on Tuesday morning, I take a suppository. I think it's a painkiller. I'm not sure, I'll need to double check, and I will post more about all that later.
This has of course prompted me to consider does the procedure actually hurt? It may sound stupid but it hadn't actually particularly occurred to me. Then of course I made the mistake of looking at the internet which is full of both sides- people in pain and people feeling nothing. Well, there just isn't any way to know what it's going to be like until it happens. I'd say my tolerance for pain can be pretty high, but I do tend to flinch. Hopefully I get enough sedation to just knock my ass out.
I've arranged for my friend to come meet me at the clinic and go home with me. It's all heading to the finish line now!
I did say to the doctor today that my ovary feels uncomfortable, my digestive system seems to be a mess, and I've been feeling particularly grumpy. He said it's all normal. At least I can be objective at the moment. The hormones haven't gotten that bad yet!!
Had my scan this morning. The doctor said that Tuesday would really be better for collection as the goal is to have as many good eggs as possible and I do have some follicles lagging behind. I'm sure that I could question him for his reasoning and thinking, but as my IVF experienced friend said, "What is he going to tell you really except that this is what he thinks they should do based on all the other patients they've seen and the results they've had with different protocols?". It's true really. Whatever they say to me isn't going to be the magic pill that "promises" the prize. Either you trust your doctor, and the clinic, or you don't. So lesson of the day- be very happy with your clinic and doctor because that's really all you've got.
At any rate, he counted 13 follicles and there may have been a couple others. They are getting big! He suggested that I should be looking at 5-10 eggs. Of course there is a massive difference between 5 and 10. And there is absolutely nothing I can do about it except wait and see. Obviously I hope for 10 and I will be disappointed with 5 but it will be what it will be and lets just hope that it's not any less than that which is of course, also entirely possible.
So I have my final drugs now, and I need to be back at the clinic at 8:30am on Tuesday morning for my procedure at 9am and I might be able to go home by 10 and hopefully by 11.
Tonight, I'm on the same drugs as usual- Gonal-F at 225 and Cetrotide. Then tomorrow I do them again but the Gonal-F reduces (I have it written down- I think it's one eight something or other). Sunday at 7pm I take the Cetrotide and then at 8pm I do the Ovitrelle which came pre-packaged and is currently in my fridge waiting for me. Monday- no shots! Hooray! Before I head to the clinic on Tuesday morning, I take a suppository. I think it's a painkiller. I'm not sure, I'll need to double check, and I will post more about all that later.
This has of course prompted me to consider does the procedure actually hurt? It may sound stupid but it hadn't actually particularly occurred to me. Then of course I made the mistake of looking at the internet which is full of both sides- people in pain and people feeling nothing. Well, there just isn't any way to know what it's going to be like until it happens. I'd say my tolerance for pain can be pretty high, but I do tend to flinch. Hopefully I get enough sedation to just knock my ass out.
I've arranged for my friend to come meet me at the clinic and go home with me. It's all heading to the finish line now!
I did say to the doctor today that my ovary feels uncomfortable, my digestive system seems to be a mess, and I've been feeling particularly grumpy. He said it's all normal. At least I can be objective at the moment. The hormones haven't gotten that bad yet!!
20 February 2013
Day 11 - Scan
So I had a scan this morning with a different doctor. All going well. I saw her count ten follicles and I saw a few more she didn't count. She said it was good that they were mostly growing uniformly- that there weren't one or two 'ahead of the pack' in terms of growth which is good. I guess they try to generally measure only the biggest ones. She said they were also growing at a regular and steady and desirable rate. So that was also all good. The sad news is she said my collection could be Monday or even Tuesday. It just keeps getting pushed further away!! Ugh! I hate the waiting!!!
Also this means I need to try to rearrange my "support" person as the person I had lined up is only free Thursday and Friday. I think I've arranged someone though, so that's good.
I'm staying on the same dose of Gonal-F (225) plus the Cetrotide.
I asked if I was at any risk of OSHH. The doctor told me that she didn't think so- especially as I had only one ovary. If I had two ovaries, then maybe. I thought this was interesting as I haven't seen anything about OHSS risks being reduced by having one ovary, but hey, I'll take it.
I learned the leftover injection pen and vials can go directly into the trash. I'm not sure I 100% believe this, but the nurse said that they just put it all in regular trash so I can put it in my trash at home. So I guess I will, even though it feels vaguely wrong.
Also, I learned that the clinic does see patients on the weekend for procedures- but they don't do scans and regular consultations on the weekend. That seemed reasonable.
I definitely feel a tightness or pressure on my right side where my ovary is. It's mildly annoying but not painful. I can't say I've really had any other side effects that I've noticed. I have some mild bruising across my belly from all the shots, but it's not that bad, and not painful.
Just back to shots and waiting...
Also this means I need to try to rearrange my "support" person as the person I had lined up is only free Thursday and Friday. I think I've arranged someone though, so that's good.
I'm staying on the same dose of Gonal-F (225) plus the Cetrotide.
I asked if I was at any risk of OSHH. The doctor told me that she didn't think so- especially as I had only one ovary. If I had two ovaries, then maybe. I thought this was interesting as I haven't seen anything about OHSS risks being reduced by having one ovary, but hey, I'll take it.
I learned the leftover injection pen and vials can go directly into the trash. I'm not sure I 100% believe this, but the nurse said that they just put it all in regular trash so I can put it in my trash at home. So I guess I will, even though it feels vaguely wrong.
Also, I learned that the clinic does see patients on the weekend for procedures- but they don't do scans and regular consultations on the weekend. That seemed reasonable.
I definitely feel a tightness or pressure on my right side where my ovary is. It's mildly annoying but not painful. I can't say I've really had any other side effects that I've noticed. I have some mild bruising across my belly from all the shots, but it's not that bad, and not painful.
Just back to shots and waiting...
18 February 2013
Day 9 - Scan
Back from the doctor, had a good chat with him about the whole cyst thing. He showed me how a (my) dermoid cyst looks a lot like the bowel. Because my dermoid cyst is very small, it can be difficult to spot. It is able to seen now because the ovary is enlarged. It "moves" with the ovary. But, when the ovary is smaller it can be hard to see from the surrounding gut. He reiterated that it's very small and nothing to be concerned about. So I feel much better about all of that.
On to more exciting news! Follicles! Now I see from reading other blogs that people get measurements on their follicles and I don't know what mine are. So I can't say if I have good size ones or not. I know they are growing though, because the doctor says so! However, they are growing slowly. So instead of collection being Thursday or Friday this week, I may be looking at Monday. Which frankly, sort of sucks. But I'm going in for another scan on Wednesday and then again on Friday. So this is going to be a very busy week for my vagina. :)
I was careful to count the follicles he was measuring- so he measured 8 but he didn't measure a bunch that were on the other side. So I counted ten or eleven follicles. Obviously some are bigger than others. Anyway, from everything I can gather, this seems like a good foundation. So I'm excited. I just now wish the little eggs would mature faster!
Obviously I'll find out more on Wednesday. Unfortunately I don't see my regular doctor but I'll see another doctor in the clinic. Although I'm not concerned about that. I'm scheduled to see my regular doctor again on Friday. I have this sneaking suspicion that perhaps they aren't open over the weekend? I hope that's not the case as it would upset me to think that my collection is predicated on what is best for the doctor's schedule and not what's best for my body when I'm paying a lot of money for this. But that's me making a gross assumption. I'll not worry about that until Wednesday, when I'll try to glean more.
Oh, also, this longer stimulation time is a little bit annoying on the budget. At this rate I'm going to be paying an extra 50-60% for the expensive drugs because I'm going more days than I thought. In the grand scheme of things, it's okay, but it's a little bit annoying and I wasn't necessarily prepared for that length of extension. I'm figuring it will be an extra £600 (~$900) per cycle. Across two cycles, it's something to think about. But hey-ho, in for a penny in for a pound!
Oh yeah, last thing- when I asked about the break between cycles the doctor said that after collection my period would hopefully come around the 11th of March. Then April, then May, and THEN I could consider the next cycle. So assuming everything goes as planned, my second cycle will be June. Which gives me a good amount of time to relax and have fun in between. Of course the doctor says to me "One step at a time!". But I am a busy person and I need to schedule!!
Tonight, the further adventures of the human pin-cushion. I'm still staying on Gonal-F at 225 with the Cetrotide.
On to more exciting news! Follicles! Now I see from reading other blogs that people get measurements on their follicles and I don't know what mine are. So I can't say if I have good size ones or not. I know they are growing though, because the doctor says so! However, they are growing slowly. So instead of collection being Thursday or Friday this week, I may be looking at Monday. Which frankly, sort of sucks. But I'm going in for another scan on Wednesday and then again on Friday. So this is going to be a very busy week for my vagina. :)
I was careful to count the follicles he was measuring- so he measured 8 but he didn't measure a bunch that were on the other side. So I counted ten or eleven follicles. Obviously some are bigger than others. Anyway, from everything I can gather, this seems like a good foundation. So I'm excited. I just now wish the little eggs would mature faster!
Obviously I'll find out more on Wednesday. Unfortunately I don't see my regular doctor but I'll see another doctor in the clinic. Although I'm not concerned about that. I'm scheduled to see my regular doctor again on Friday. I have this sneaking suspicion that perhaps they aren't open over the weekend? I hope that's not the case as it would upset me to think that my collection is predicated on what is best for the doctor's schedule and not what's best for my body when I'm paying a lot of money for this. But that's me making a gross assumption. I'll not worry about that until Wednesday, when I'll try to glean more.
Oh, also, this longer stimulation time is a little bit annoying on the budget. At this rate I'm going to be paying an extra 50-60% for the expensive drugs because I'm going more days than I thought. In the grand scheme of things, it's okay, but it's a little bit annoying and I wasn't necessarily prepared for that length of extension. I'm figuring it will be an extra £600 (~$900) per cycle. Across two cycles, it's something to think about. But hey-ho, in for a penny in for a pound!
Oh yeah, last thing- when I asked about the break between cycles the doctor said that after collection my period would hopefully come around the 11th of March. Then April, then May, and THEN I could consider the next cycle. So assuming everything goes as planned, my second cycle will be June. Which gives me a good amount of time to relax and have fun in between. Of course the doctor says to me "One step at a time!". But I am a busy person and I need to schedule!!
Tonight, the further adventures of the human pin-cushion. I'm still staying on Gonal-F at 225 with the Cetrotide.
17 February 2013
Day 7 & 8
Missed a day of posting because yesterday was a horrible disaster. Nothing to do with the egg freezing mind you. More to do with a friend of mine getting attacked and mugged on my doorstep. This would have been bad enough, but it was followed by a car with shot people in it coming to find the police for help (who were obviously at my flat) and then a million police showing up to deal with that, while I was left to deal with my traumatized friend before the police got around to coming back to her.
On top of which, this incident has pushed my flatmate over the edge. She just got home having left the house in a panic yesterday night after the excitement. I'm fully expecting her to give me notice that she's moving out, but as it is, she clearly isn't talking to me. Charming.
So yeah... injections.
Last night they were about an hour late. Tonight I got them done on time. I'm looking forward to my scan tomorrow. My right side is definitely feeling tight and bloated. I'm finding it hard to regain my 'happy place' of thoughts with all of this bloody drama going on. I mean you have got to be kidding me!! But I'm not freaking out, so that's good. Definitely looking forward to the scan and talking to the doctor tomorrow. It's not until the afternoon, but that's okay.
I hope for some good follicle news and a better idea of collection day so I can arrange for my friend to come with me. Getting close now!!
If only there wasn't all this outside stress now to also contend with.... I'm not sure how much positive vibes and calmness help with follicles and eggs or how much stress and agitation may hurt follicles and eggs. All I know is- it is on it's own a somewhat stressful thing to undertake. It's a shame that my life at the moment is adding to it in a negative way!
Tomorrow is another day.
On top of which, this incident has pushed my flatmate over the edge. She just got home having left the house in a panic yesterday night after the excitement. I'm fully expecting her to give me notice that she's moving out, but as it is, she clearly isn't talking to me. Charming.
So yeah... injections.
Last night they were about an hour late. Tonight I got them done on time. I'm looking forward to my scan tomorrow. My right side is definitely feeling tight and bloated. I'm finding it hard to regain my 'happy place' of thoughts with all of this bloody drama going on. I mean you have got to be kidding me!! But I'm not freaking out, so that's good. Definitely looking forward to the scan and talking to the doctor tomorrow. It's not until the afternoon, but that's okay.
I hope for some good follicle news and a better idea of collection day so I can arrange for my friend to come with me. Getting close now!!
If only there wasn't all this outside stress now to also contend with.... I'm not sure how much positive vibes and calmness help with follicles and eggs or how much stress and agitation may hurt follicles and eggs. All I know is- it is on it's own a somewhat stressful thing to undertake. It's a shame that my life at the moment is adding to it in a negative way!
Tomorrow is another day.
16 February 2013
Day 6 - Shots
Just a quick one on the shots last night. Again I was a little bit late so I just wanted to get home and get it done. I was still just trying to get my mind in the right place after the panic. I am also going to guess that my reaction to the cyst was maybe due to all these hormones I'm taking? At any rate, I just thought I'd have a nice calm night of doing my injections and going to bed.
So first I finished off that 900 Gonal-F pen which kept sticking at 25. I was careful to ensure it pressed the entire way down for the last dose and did not get stuck on 25 so that was good. Then I went to mix up the Cetrotide. Did all the steps, ready to go, get the needle in (and it was a bit pokey in the place I selected), I look down and realize I didn't expel the air bubble! Ugh!
So I had to withdraw the needle which now had a bit of blood on it and blood welling up (because I picked a pokey spot). I slowly expelled the air bubble which also meant a little bit of blood that was in the needle tip came out. I wiped it with the alcohol wipe and let it dry and didn't let it touch anything else and when the air was gone I picked a new spot and did the injection.
You think you're just getting to be good at all this stuff and then oops! At least I caught it.
I'm starting to feel a bit of "tightness" in my right side (where the ovary is). It's not pain or even twinges, but more like a small fullness. It's interesting of course because I can compare the two sides as one has no ovary and I can tell a difference. Or maybe I'm just getting a little bloated. To be fair, none of it is particularly bothersome. And other than yesterdays breakdown in tears, I can't say I've noticed any side effects in particular. Although I still have five or six days to go... I tell you what. I'm already looking forward to my "down time" between cycles. The one thing I am starting to feel is just a bit stressed again. I just want to get to the end and know how it's going to go (and really know if this was all worth it)!!
So first I finished off that 900 Gonal-F pen which kept sticking at 25. I was careful to ensure it pressed the entire way down for the last dose and did not get stuck on 25 so that was good. Then I went to mix up the Cetrotide. Did all the steps, ready to go, get the needle in (and it was a bit pokey in the place I selected), I look down and realize I didn't expel the air bubble! Ugh!
So I had to withdraw the needle which now had a bit of blood on it and blood welling up (because I picked a pokey spot). I slowly expelled the air bubble which also meant a little bit of blood that was in the needle tip came out. I wiped it with the alcohol wipe and let it dry and didn't let it touch anything else and when the air was gone I picked a new spot and did the injection.
You think you're just getting to be good at all this stuff and then oops! At least I caught it.
I'm starting to feel a bit of "tightness" in my right side (where the ovary is). It's not pain or even twinges, but more like a small fullness. It's interesting of course because I can compare the two sides as one has no ovary and I can tell a difference. Or maybe I'm just getting a little bloated. To be fair, none of it is particularly bothersome. And other than yesterdays breakdown in tears, I can't say I've noticed any side effects in particular. Although I still have five or six days to go... I tell you what. I'm already looking forward to my "down time" between cycles. The one thing I am starting to feel is just a bit stressed again. I just want to get to the end and know how it's going to go (and really know if this was all worth it)!!
15 February 2013
14 February 2013
Day 5
I have two tiny circular bruises on me from the shots. The biggest and darkest is actually from my very first shot. They seem more likely to bruise if they well up with blood when the needle is removed. To be fair, I don't have that many dots on me having now given myself a total of 8 injections. Maybe half have been followed by a blood dot? Oh yeah, in other news I was talking to a friend who did many IVF cycles and she said that she had been told to stay within a two inch radius of the belly button and not to go out to the sides. Which could have explained why the shot I did further to the side hurt more. So sticking closer to the belly button it is!
I did the Gonal-F first again tonight. I was holding it in for the ten seconds and then I moved my thumb and saw it was stuck on 25 again! So I moved my hand and pushed the plunger more firmly and the last 'click' went and the rest of the drug went in. Now I know what happened yesterday. Which makes me feel better about doing the second injection of 25- it was the right thing to do. Today though, I got it all in, albeit after a bit of a pause.
Anyway, on to the Cetrotide. Today with pictures! So first, out of the box we have a sealed container, and an info booklet. Peeling off the top of the sealed container we have two alcohol wipes, two needles, a pre-filled syringe, and a vial of the Cetrotide in powder form. Let me preface this gallery by saying that if you are going to take Cetrotide, make sure you read and follow the instructions that come with it fully- this is an abbreviated version and is no substitute for correct medical advice.
Now they say that it dissolves instantly. But then it says if it doesn't all dissolve you can swirl it gently. They say not to shake it as that adds air bubbles. As you can see from the photo on the left, it really doesn't dissolve cleanly. It takes quite a bit of swirling and scraping at the bits stuck to the bottom with the needle. And some tapping on the side of the vial. It's really a matter of being patient. It does get there eventually, even if I did get a few air bubbles in it (as shown in image on the right) but some gentle tapping sorts those out.
The part that I didn't show is how you are supposed to turn the vial upside down, draw down the needle so it's just in, and then suck up all the liquid. This is not so easy. You don't want to withdraw the needle, and you want to get all the liquid, and not fill up the syringe with air. Again, I think it's more about patience. Taking your time, and if you get too much air, pushing that back so you have space to try to get the rest of the liquid. I managed to get pretty much all of it eventually, as well as a bunch of air. So then I swapped out the big nasty needle for the injection needle (as shown below) and slowly pressed the plunger until the tiniest bit of liquid was visible on the tip. Ready to inject, and so I did.
Next scan is early tomorrow morning. I need to get myself to bed to get up early to get across town to the clinic. I'll be getting more drugs tomorrow as I only have enough Gonal-F left for one more injection at 225 and 2 more Cetrotide boxes. I will definitely be asking about when possible collection day is going to be. Lets hope everything has been continuing in the right direction. I continue to oscillate between being hopeful and being terrified there won't be anything out of this. Useless, I know. And I try not to do it, but I don't see how it can possibly be completely avoided.
I did the Gonal-F first again tonight. I was holding it in for the ten seconds and then I moved my thumb and saw it was stuck on 25 again! So I moved my hand and pushed the plunger more firmly and the last 'click' went and the rest of the drug went in. Now I know what happened yesterday. Which makes me feel better about doing the second injection of 25- it was the right thing to do. Today though, I got it all in, albeit after a bit of a pause.
Anyway, on to the Cetrotide. Today with pictures! So first, out of the box we have a sealed container, and an info booklet. Peeling off the top of the sealed container we have two alcohol wipes, two needles, a pre-filled syringe, and a vial of the Cetrotide in powder form. Let me preface this gallery by saying that if you are going to take Cetrotide, make sure you read and follow the instructions that come with it fully- this is an abbreviated version and is no substitute for correct medical advice.
Right. The first thing you do is get the little vial of the powder, remove the blue cap, and wipe it down with one of the alcohol wipes. You can see when the blue cap is removed it exposes a rubber stopper end where you will insert the needle.
Next, you attach the big (yellow ended) needle to the syringe. On a hard surface, you insert the needle into the rubber stopper and then depress the plunger to add all the liquid in the pre-filled syringe into the vial.
Now they say that it dissolves instantly. But then it says if it doesn't all dissolve you can swirl it gently. They say not to shake it as that adds air bubbles. As you can see from the photo on the left, it really doesn't dissolve cleanly. It takes quite a bit of swirling and scraping at the bits stuck to the bottom with the needle. And some tapping on the side of the vial. It's really a matter of being patient. It does get there eventually, even if I did get a few air bubbles in it (as shown in image on the right) but some gentle tapping sorts those out.
The part that I didn't show is how you are supposed to turn the vial upside down, draw down the needle so it's just in, and then suck up all the liquid. This is not so easy. You don't want to withdraw the needle, and you want to get all the liquid, and not fill up the syringe with air. Again, I think it's more about patience. Taking your time, and if you get too much air, pushing that back so you have space to try to get the rest of the liquid. I managed to get pretty much all of it eventually, as well as a bunch of air. So then I swapped out the big nasty needle for the injection needle (as shown below) and slowly pressed the plunger until the tiniest bit of liquid was visible on the tip. Ready to inject, and so I did.
Next scan is early tomorrow morning. I need to get myself to bed to get up early to get across town to the clinic. I'll be getting more drugs tomorrow as I only have enough Gonal-F left for one more injection at 225 and 2 more Cetrotide boxes. I will definitely be asking about when possible collection day is going to be. Lets hope everything has been continuing in the right direction. I continue to oscillate between being hopeful and being terrified there won't be anything out of this. Useless, I know. And I try not to do it, but I don't see how it can possibly be completely avoided.
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