23 November 2013

Some Final Thoughts (for now)

I said I would talk more about my last appointment and now (that I'm procrastinating from writing my thesis) is the time.  I met with the doctor who did my last retrieval about 2 weeks afterwards.  I was still disappointed, but recovering very well (the fewer eggs, the easier the recovery I think).  I had questions.  I also think I felt a bit lost.  This has been a very emotional process.  Not difficult necessarily, but certainly emotional.  I put a lot of effort in the past year and a half to thinking about children and my future, I do all of this and then.... it all gets put on hold.  Although I continued to date this past year and a half, I didn't meet anyone special.  I'm finishing up a PhD which means my job status is uncertain for at least 6 months.  I've been finding it just as hard to 'let go' of all the thoughts this brought up as it was to have them in the first place.

So, the first question, would going back on birth control damage my fertility, and if not, how soon could I go back on it?  I had my post-retrieval period and the doctor suggested it would be no problem at all to go back on birth control on the next natural period after.  So in a couple weeks, I'm back on the pill.  There shouldn't be any negative side effect to my fertility for being on the pill, so that's fine.

In the future, if I want to get pregnant, the doctor suggested I still try naturally or 'less invasive' methods before using my frozen eggs, particularly if I want to try within the next three years.  My fertility wasn't that bad, and it could be I still could get pregnant naturally, so she said I should try that first.  Depending on my fertility numbers at the time, she also suggested I might want to try fresh IVF in the future and reserve the frozen eggs as the last resort.  She stressed that as a woman who doesn't know if she has fertility problems, I shouldn't compare myself to those who seek IVF because they already know.  She said I should try less invasive options first because I may not have fertility issues.  Of course, I'm conscious that my age works against me in this, but I understand what she's saying.  In fact two very good friends of mine who are my age now (39) both are pregnant naturally.  These things do happen.  I think being immersed in the infertility world can skew your perspective.

The clinic I used to freeze my eggs can help with sperm donation or with a future partner, or a known donor.  If I want to go down the sperm donor or known donor path in the future there are tests and counseling and paperwork to take care of and the clinic can help with all of that.

To be honest, that was pretty much it.  While she agreed that no frozen eggs was any sort of guarantee, she stressed to me that I don't know the quality of my frozen eggs.  That all it takes is the one.

And that was pretty much it with the doctor.

I then had a counseling appointment with the counselor I saw previously.  We talked about how I felt regarding 'putting everything to sleep' for now.  I talked about how I felt a sort of loss- like, you do all of this thinking about becoming a mother, and then there is no motherhood or even attempts at motherhood immediately following this process.  We talked about how that's hard.  About how when you start to open yourself, honesty and truly, to the idea of becoming a mother, and you decide that it's something you want, that it changes you.  That not becoming a mother, either just for now, or forever, is a sort of loss.  I talked about how I have thought about becoming a 'single mother by choice' and that I'm not convinced that I'll meet anyone with which to start a family in the next year or two (that I want to start a family with).  I talked about how I feel old, that many of my friends have children or are pregnant and that I feel somehow 'behind'.  She pointed out to me that you shouldn't have a child just because everyone else is doing it.  Which wasn't what I meant, but I think is important to reiterate.  It's more the frustration of seeing other people have what you want.  And when I feel 'behind' I guess what I'm really saying is that I feel deficient.

But anyway, that's more of a personal issue to address, and it's not solely related to motherhood, but I would suggest relationships in general.  The counselor did challenge me to consider why I was putting a 2-year framework in place.  That if I want to become a mother, why should I wait that long?  She had a point.  My main issue is that I want to be in a financially secure place, and mostly that I want a job where I will get good maternity coverage.  This means finishing the PhD and getting a permanent position.  If I stay in academia, a lot of jobs are contract and not permanent and this is a problem.  Not impossible, just something I feel I want to have sorted before undertaking what I imagine will be single parenthood.  But, if I get that job next year, then I suppose it's true- why should I wait?  I guess part of it is also an imagined time limit window on how long I'm willing to keep looking for 'the guy'.  That by deciding to just move forward, it's like saying I'm giving up on that.  I think this is something I need to continue to think about.  If I get the job, then maybe I should just move forward.  Watch this space.

And yes, speaking of which, so what does this mean for the blog now that I'm done for the time being?  Right now there are a lot of women considering, and undertaking, egg freezing.  But what about the future?  I imagine this blog is going to go to sleep for a while, but I will use it to post anything I come across that I think is relevant, add to the links on the right hand side, and I am happy to answer questions if anyone has them.  But I think when the time comes for me to use the eggs, I will come back here and update.  That may mean linking to a new blog, but I hope to eventually be able to post about how this story continues.

Otherwise... if you've come here to find information on egg freezing, I hope you find this blog helpful.  I encourage you to talk to other people, make use of the resources that are available to you.  I wish you the best in what can be a difficult and emotional process.  I think a lot of women come to this position, because they feel alone.  I suppose in one way, we are, but then, we aren't at all.  Good luck on your path.

12 November 2013

Final Costs

I went to the clinic today for my last follow up appointment.  I have more to say about that, but I thought I'd separate the posts.  This one is going to be about costs.

If you want to see all my posts documenting cost along the way, you can either click on the word cloud "cost" over to the right hand side, or, you can click here.

So here's the final breakdown:

Previous total cost for 2 cycles£10,481
Follow up Appointment£120
Drugs from Healthcare at Home £729
Egg Freezing Cycle£2800
Final Total £14,130

The doctor I saw today did not charge me for the follow up appointment.  I feel confident that if I'd seen either of the other two, they would have.  I'm not complaining.

With 13 eggs in the freezer, that's around £1,100 per frozen egg.  That's expensive.  I mean, that's really expensive, when you consider that one or two may not defrost, and I may not even get a baby from them.  Heck, I may not ever USE these eggs.

It's important to note that I have paid up front for 10 years storage.  If I don't use all 10 years, I should be refunded some amount for the years I don't use (maybe £800 back let's say?).  I also paid for blood tests and things that I might have been able to get done for free or for cheaper through my GP and not through the clinic (£250 or so?).  There was also the added expense of not knowing about Healthcare at Home for my first cycle, and the cost difference for that is explicitly documented in my post about Reducing Drug Costs (£1000 approximately).  

But here's the thing.  If the time comes in the future that I did want to have the option to use frozen eggs, would I regret this if I had NOT frozen my eggs.  100% absolutely.  

In the end it's only money.  Regrets are far more expensive.

29 October 2013

Cycle 3: Day 16

So my collection was this morning and I got 3 mature eggs that were able to be frozen.

This is not the ending that I was hoping for, for this particular journey or this final cycle.  That brings the grand total of three rounds of egg freezing to 13 frozen eggs.  Which is what many women (with two ovaries) get from their first and sometimes only cycle.

I hasten to add that I don't in any way regret that I've done this.  Just that I am a bit sad about the results.  As I think I mentioned in my last post, the odds of a live baby from 13 eggs seems maybe not so great.  Of course there is no way to know that until I actually go to use the eggs.  And even if I had 20 eggs there might not be a baby at the end of it. 

It is what it is.  I'm 39.  It's little bit late.  It would have made no sense to wait longer, although I do wish I had known about this, or done it sooner, these are things you can't change.  So I worked with what I had, and so far this is what I've got.  Which may actually be plenty or it may not at all.

I suppose I just don't have as much confidence as I would like.  But as I say, that's a false hope anyway.

Everything towards the end of the cycle went easily and well.  No problems with any of the injections.  All was easy and simple at the clinic this morning.  I don't have any pain or discomfort at the moment, though I might have a bit of cramping when everything wears off.

I have a counseling appointment in 2 weeks time and I think I'll schedule a follow up to talk through things like, when can I go back on birth control, and talk a bit about future pregnancy and timelines and things like that.  The counseling appointment will probably be a good thing.  The follow up appointment is a necessary thing, and I'll be annoyed, as usual, that I'll have to pay for it.  But it's definitely weird to me to just leave things like this now.  Especially when I have a number of questions.

When that's complete I'll also do a final cost tally.

And I'll probably prepare some final (or final for now) thoughts on this process overall.  I think doing it right now however, probably isn't the best idea.

24 October 2013

Cycle 3: Day 11

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.


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!!

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.

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.

15 October 2013

Cycle 3: Day 2

So I did my first injection last night and it was sort of surreal.  In many ways I feel very unprepared for this cycle, although I'm not really.  I'm just so incredibly stressed right now and I seem to have so many things going on.  Then I'm adding the egg freezing on top of everything else.  The injection was fine though, no problem.  I did read through the little instruction book though just to make sure I remembered everything I'm supposed to do!  Although how hard is it to wipe with sterile pad, screw on needle, turn dial to 300, pinch, inject, hold for 10 seconds, release! 

My next scan is on Thursday to see how they are growing.  I have also arranged a counseling appointment for Thursday.  I should have done this sooner but due to the above mentioned stress, it's just been one more thing on my to do list that slipped.  Never mind.  I've managed to arrange it now for just after my scan so we'll see how that goes.

Part of me wonders if my current stress levels haven't been exacerbated by my hormone injection last night.  Although honestly, I'm sure this is not the case and I'm actually just stressed but I feel particularly 'not with it' today.  Who knows.  It doesn't really matter!  It's all systems go now.  I hope we see a good number of follicles on Thursday...

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.

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.


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!

27 August 2013

The Inbetween

Just thought I'd throw an update here.  It feels like ages ago since my last cycle even though it wasn't.  In between then and now I have had a birthday which makes me 39.  When thinking about fertility, your age makes you stressed.  There just isn't any way around that.  So I try not to dwell on it too much.

Originally I thought I would do my third cycle in September or October.  Right now I feel October would be better for me.  August has been a ridiculously busy month and I need to get back into a normal routine.  I'm also considering some acupuncture.  Not just for fertility stuff as I'm not particularly convinced it's helpful.  But for stress.  I am generally very stressed these days and I don't think that helps with making my body a fertile place.  I am only going to have one more shot at this, so I need to feel I've done what I can.  Obviously I should also lose some weight, but that's not particularly happening.

It looks like I will end up paying for my third cycle without parental help.  It is what it is.  I know I'm very lucky that my mother helped with the first two cycles.  Still, it is a horribly expensive process.

I also spend a lot of time thinking about jobs and life after my PhD which is nearing its end (hence a lot of the stress).  When I think about jobs and the future I find I fixate on where I can get good maternity cover.  It's not that I have given up on meeting someone and having a partner, but I feel this tremendous time pressure.  I just don't want to be that old and have a baby.  So probably something I want to do in the next 2-3 years.  Scary.  Getting eggs is one thing.  Thinking about babies is something else entirely.

Anyway.  I need to make a follow up appointment with my clinic and order the next round of drugs.  Obviously I'm going for Healthcare at Home!!  I also want to see if I can get to see the clinic psychologist to talk through my stress and baby thoughts.  After all, it's included in my cycle costs.

In the meantime, I am just enjoying my time off from the cycle.

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.

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

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.

29 June 2013

Cycle 2: Day 17

Sorry again for the day delay, all due to the stupid phone company.  I'm now borrowing internet from my neighbor!

Facts first.  I got 4 eggs and all 4 were able to be frozen.  I'd like to have a bit more information than that, but I couldn't get my phone to work so instead the embryologist call went to voice-mail.  I assume they were all mature and looked good.  I hope the embryologist calls back today, but I'm not sure they will.  I had a couple of other questions, but I can ask the doctor when I go back in a couple of weeks for a follow up appointment.

The day itself was both uneventful and eventful.  My biggest gripe was that although I showed up 15 minutes early to make sure I was there for noon and I was supposed to be having my retrieval 37 hours past the Ovitrelle trigger at 12:30, I didn't even get in to my recovery room to change until 12:25 and I estimate my procedure was probably at 1:00 or even a little bit past.  This just stressed me out, which is not what you really want when you're preparing for a medical procedure.  I was assured by more than one person that it wouldn't make a difference but I was conscious of how few eggs I had to work with and the thought of losing a single one just gave me intense stress.  This was compounded by my internet based knowledge that some clinics trigger as early as 35 hours before the retrieval and since my clinic goes with 37, that already seems on the "late" side of things.  It just put a blip into my otherwise uneventful day!

So given that I was stressed I changed very quickly and was ready to go.  A bit of 'hurry up and wait'.  I could hear couples (mostly couples) in some of the other cubicles.  This is the second time I've heard a male partner be rude to their female partner during what I assume is an IVF process.  I get that men tend to fall into the 'I want to be able to help or I just get frustrated' category but seriously.  This particular couple, it was obvious she was just out of retrieval and every time she saw him she came to enough to ask how many eggs they got.  He said around 15.  Then she'd slip out of consciousness, come back, and ask the same question.  By the third time he started in with, "I already told you this!".  Charming.

Eventually the anesthesiologist came to get me and we had a nice chat.  I remembered a bit about him from the first time and I think he was amused that I remembered what we talked about.  We chatted a bit more as he got me all set, put the cannula in, put electrodes on me.  The doctor who did my procedure was not my main doctor but what I now think of as my second doctor.  I remember asking about the delay and the impact.  I also remember saying that I really wanted 4 eggs as a minimum and that if I got less I'd get depressed about it but then I'd get over it.  They had me scooting down the table into position and I was alert when the mask went over my face, but not much beyond that.  I think I have a vague memory of being transfered from the procedure table to the recovery bed.  I definitely have a memory of the doctor coming to see me in the recovery room to tell me that got 4 eggs.  Although that was very hazy, I know it happened, and then also turned out to be true, so reinforces that it happened.

Eventually I came to, nice and comfortable in the bed.  The machine on my finger monitored my heart beat and a cuff on my arm did my blood pressure every five minutes.  I came around more fully and the nurse told me my friend was here so I said they could let her come sit with me.  They brought me tea with sugar and I drank that while chatting with my friend, none of which I can remember now.  I know I was starving having not eaten since  about 7 or 8 the night before so I also got some cookies and wolfed those down.  Then I got dressed and we went home where my friend made me a lovely tray of macaroni and cheese for my dinner and for 'comfort'.  Yum!

So today I feel mostly fine.  Less cramping then the first cycle, but then, I had fewer follicles.  I can still feel my ovary, so I know it's still enlarged and will stay like that until my period comes.  On my last scan I had asked my doctor if I could cycle this week in Cambridge but he said he wouldn't advise it.  His reasoning was that although the chance is small for torsion, because I only have the one ovary, his advice was to be super cautious about it and even a small risk was not one he would suggest I take, whereas if I had two ovaries he'd be less concerned.  I thought that was fair, so I'm looking at a week of walking around Cambridge this week.  But that's fine.  I need to get my exercise back on track and walking seems a good way to start.

And so that's it for cycle 2.  I'll update the costs again when I get around to it, and I'll update again when I have my follow up appointment.  I also think I'm going to see the counselor that the clinic offers as a service, so I'll probably write about that as well.  And obviously if and when cycle 3 comes on, I'll be back for that as well.  Not quite done with this blog yet!

27 June 2013

Cycle 2: Day 15

So yesterday was a big day!  Sorry to be a day behind but I got home and the phone company had shut off all the phones in my building which meant no easy internet.

Anyway, yesterday was scan day.  Back to my regular doctor.  Had a good scan and a good chat with him.  The decision was made to trigger, so my collection is tomorrow (Friday).  That's one day short of the last cycle but pretty much the same.  I have 4 large follicles and any further stimulation could cause me to lose them.  I may lose one already but we'll see.  There are also 3-4 follicles just squeaking past 11mm.  Apparently that's the threshold for finding mature eggs.  So they will sweep all of them in the hopes of finding some.  But I guess I should be looking for about 4 eggs tomorrow and anything more would be great and anything less will make me depressed and then I'll have to get over it.

So my appointment is at noon tomorrow.  This meant I took only Cetrotide last night before 10:30 (I took it around 9:30, and I did it in a restaurant bathroom.  Not ideal but it was all rather short notice and I figured that was better than cancelling my plans.).  Then at precisely 11:30 at night I did the Ovitrelle injection.  This was a different system than the one I got on my first cycle.  This one came in a pen just like the Gonal-F so super easy.  Not that the pre-filled syringe wasn't easy as well.  I like injections that are easy.

And now I wait.  Today no injections.  No food or drink past midnight.  On the first cycle my collection was early in the morning, so it was easy not to do food or drink.  This time I have to wait out half a day which is going to be a bit more challenging although obviously not nearly impossible.  Just annoying really.  Also no deodorant or anything so I'll take a shower before I go and hope it's not too warm out.  Oh, and of course there's the lovely Voltarol suppository that I just need to "pop in" before heading to the clinic.  Fun times.

I've arranged a friend to come meet me and go home with me.  Much easier this time as the first person I asked could do it.  And she's super sweet, she asked me what I wanted as some comfort food so she'd make it for me when we get back to mine.  Macaroni and cheese, you are mine all mine!

In other news I learned how I get moved from the procedure room to the recovery room.  Apparently they wheel in the recovery room bed and slide you across.  That makes sense.  I knew it wasn't the same bed!  I also asked about follow up appointments.  Apparently the reason I got charged for the last one is I had a scan.  A talking follow up appointment is free, but the scan costs.  I still find that slightly annoying, especially since I was "feeling" my ovary and I think it's reasonable aftercare to have a look and make sure nothing is wrong.  But this time I know, or rather, expect that my ovary will take a while to get back to "normal" so I won't have a scan after but I will make a follow up appointment to discuss what the next steps are.  If I do get 4 eggs I'll have 10 on ice.  That's really not enough for me to feel comfortable.  But I can probably only afford one more cycle.  So we'll see.

The only differences between last cycle and this cycle other than my taking conception vitamins was one less day of norethisterone prior to stimulation.  There haven't been any other impact factors.  I mean, other than I'm stressed, but I'm pretty sure I was stressed for the first cycle.  And I mean "life" stressed not egg freezing stressed.  Meh.  It is what it is!  I'm doing the best I can!  (Repeat).

Oh, the other thing I talked about with the doctor was in vitro maturation of eggs that aren't mature.  He wasn't in favor saying the results are really generally poor and in fact as a clinic they are so underwhelmed by the success of in vitro matured eggs they don't offer it.  Again, who am I to argue with the doctor?  Their success rates as a clinic are high.  I'm sure that it does work for some people, but I guess they look at it as an overall benefit and don't see it as panning out.  So one less thing for me to consider.  That's fine.  I'm okay with that.

So anyway, depending on when I have home internet again, I'll update with the results.  Nothing to do now but wait! (And drink gallons of water.)

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!

21 June 2013

Cycle 2: Day 9

So back from my scan and of course I am depressed.  There just aren't as many follicles as last time.  The doctor (not my normal doctor) measured 6 although I think I saw at least one or two more.  One is way out ahead so it probably won't last the duration.  At this time last cycle I think I had at least 12-14 follicles showing and I only got 6 eggs.  I'm steeling myself to get a low collection number.

Of course this is upsetting.  Firstly, it's upsetting because it's all conjecture.  Each follicle COULD yield an egg and I could do just as well as last cycle, I just don't BELIEVE that is what is going to happen.  So that sort of sucks.  If I go on a 50% yield, I'm looking at a collection of 3.  Of course any is better than nothing.

This is what I keep telling myself.  I mean, what am I getting so upset about?  This is where my fertility is at right now.  If I was trying to get pregnant, this is what it would be.  If I wait around for when I hope to have children, it's going to be worse.  The only thing I can be doing right now is this, and this is what my body produces.  Any frozen egg is better than no frozen eggs.  But it is so hard to not want to place blame or look for some sort of 'answer' to why it's not as good as I want it to be.

I recently answered some questions for an interview on egg freezing in an Australian magazine and the interviewer asked me if I wish I'd done this sooner.  Yes.  Absolutely, 100% yes.  It's hard not to feel like I've let my best years go.  Obviously when I was younger I had hope that things would just work out but that's not what's happened.  So now, at almost 39 I just feel annoyed that I didn't know about this sooner, didn't do it sooner, let all those better eggs go sooner....

Not that any of that is productive.  The only productive thing that I can do right now is exactly what I'm doing.  I need to just try to stay focused on that and not let myself get worked up about things that are completely out of my control.

But it's hard.

Anyway.  I'm sticking to the same dose for injections.  Next scan is Monday with again not my usual doctor but not the one I just saw either, instead the one I saw at the start of my cycle (which I think covers all the doctors because I think there is only the three).  I'll update here again after the scan.

18 June 2013

Cyle 2: Day 6

So I just got back from my first scan after starting the stimulation.  As per last cycle, my follicles are slow starters.  The doctor measured 7.  He also measured my cyst, which does not appear to be growing.  I was a bit disappointed by 7 and thought that was less than the last cycle.  He checked and said at the first scan in the first cycle, he had noted 8.  So yeah, one less so far.  He didn't seem worried though and said that I just seem to have slow starters and it's too early to be able to tell anything yet.  He's keeping me on the same drug protocol as last time.  So I guess that means I'm definitely in for a long stimulation cycle.  And I'm preparing myself for a low number collection.

I think what's hard about the medication is how quickly I can get upset.  I honestly don't notice any other side effects of the stimulation drugs.  But when something happens that could possibly be upsetting, I feel like it's devastating.  That could also be because this process is stressful in general.  Obviously what anyone who is doing this wants is the most mature eggs as possible.  It's frustrating to know you can't really do anything about it.  What the scan shows is what your body has.

I keep reminding myself that if I had two ovaries, these would be really good results for someone who is almost 39.  In fact, if I was getting twice the number, I would be pleased.  So it's not really my body at fault.  I'm simply asking or wanting too much from it.  I'm being unrealistic.  I've come across women with two ovaries who have gotten the same number of eggs from their cycles.  I shouldn't be upset.

I guess it's not that I'm upset.  I'm just disappointed.  But then I remind myself, that the very best thing I can be doing right now to address this, is exactly what I'm doing right now.  And that makes me feel a little bit better.

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!

11 June 2013


So my period has arrived.  Full flow started around 4pm or so which makes tomorrow 'day one' according to my clinic.  I will call them in the morning and arrange my first scan for Thursday which, if all looks well, will also be day 1 of injections.  For my first cycle I started shots on the 9th and had the retrieval on the 26th.  This month my first shot will be on the 13th. If my cycle takes as long, that puts my retrieval at the 30th.  I really hope it doesn't go as long this time!  But I have enough drugs ready in case it does.  I'm actually sort of excited to get this all going again.  I don't think I'll do the day by day journal that I did for my first cycle, but I'm sure I'll update with things that occur to me.

I will say one thing of significance which is, this time around I feel much more calm.  I've done this once already so there are less 'unknowns' and questions that I have.  I've also come to terms with how I feel right now about where I'm at relationship wise, with thinking about having children in the future, etc.  I'm also not scared or nervous, although of course I'm a bit anxious because there is always the worry about how many eggs you're going to get.  But that's the only thing I'm worrying about.  Everything else is much calmer this time around.  So that's good.  And a good thing to know if someone reading this is thinking of doing a second cycle.  I think the second cycle is probably a lot easier.

She says at the start.

08 June 2013

F*** You, Post Office

I've had a very frustrating morning.  I only had enough norethisterone for 7 days and then the head nurse said after discussion I could take them for 9 days but they had to send me more.  So I ordered them and they mailed them to me but I was away last week when they arrived so I got a post slip and had to arrange redelivery.  I've waited all morning for it, it's not here and now the post office is closed for pick ups.  This means I will not be on the norethisterone for the 2 additional days.  I'm annoyed about this but I hasten to add, not panicked.  Mainly because my doctor suggested I only take them for the 7 days anyway (when I said that was what I had left from the first cycle) so it was a late change to add the 2 days.  And not by my doctor.  So it goes to show how... 'not rigorous' the process is.  Still, I had in my head I'm going to take pills for 7 days and then the pills don't arrive due to my FUCKING post office people and it really makes me angry.  I should have just not arranged the redelivery and gone this morning to pick everything up.    SO ANGRY.

01 June 2013

14 May 2013


Well my period finally arrived and I've been in touch with the clinic to arrange my norethisterone start.  When I contacted them I pointed out that my period is definitely not on a 28 day cycle.  After my first collection, my period came March 8.  My next period started April 11.  This period has taken it's time and come May 14.  Of course everything seems to be scheduled around a 28 day cycle and that is not me.  So I commented on this and heard back that they want to put me on an extra day of norethisterone that starts June 1.  For the first cycle I was on 8 days so now I'll be on 9.  It also looks, based on this, that my collection will be late June and my injection start will be mid June.  So it's still a bit of time yet, but the ball is rolling!

11 May 2013

OMG I Hate Waiting!

I'm waiting for my period so I can let the clinic know the first full day so I can plan my norethisterone for my next cycle.  Now, my period is slightly over the 28 day cycle, but my period was like the 8th, then the 10th, then the 11th.... and now it's the 11th and where is my period??  I'm getting a few 'hints' from my gut that it might be on the way, but really nothing. Not a glimmer.  It's ridiculous.  It's like the more I think about my period, the more my body decides it's going to keep it from me.  It's amazing how easy it is to get stressed about things that you normally wouldn't care at all about.  Because if I'm not thinking lighthearted thoughts about how silly it is, I'm thinking more damaging thoughts like, "OH MY GOD THERE'S SOMETHING WRONG."  Which is also silly, in its own different way.  But it's so easy.  It's so easy to slip into these sorts of mindsets.  And I think it's particularly easy to do it when you've only got yourself to talk about it with.  I'm sure there is nothing wrong and my period should arrive tomorrow.  Or maybe it arrives the day after.

It's fine.

But it's also annoying.

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.

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:

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:

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:

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


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.

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
I suppose it's also important to note that I was on drugs for 15 days which is longer than average and so obviously increased the costs.  If I can reduce the drug cost, that will obviously make a difference.  If I could get my cycle 2 cost to under £4000 I'd be happy.  But, I'm also happy to note that this is all pretty close to my rough estimate of what it would initially cost for two cycles (I'd assumed £10k) and that was assuming I wouldn't be on the stimulation drugs for as long.  So there you have it.  Just my experience of course.  I would be very interested in hearing from women in the UK about their comparison costs.  Please leave me a note if that's you!!

28 February 2013

48 Hours Later

I'm finally starting to feel a little bit more normal.

When I wrote my last post, I was at home relaxing after the procedure.  I did manage to go up to Cambridge that night and I did note that the more I moved around the more "crampy" and "achy" my abdominal area seemed to be.  And it wasn't only concentrated on my left side where my ovary is.

I took some paracetamol as I was told I could and slept okay when I finally got home, although I woke up with more abdominal discomfort and a bit of bloating.  When I got up to go to the bathroom, I had a lot of gas but not much productivity.  This reminded me that when I had the surgery to have my ovary removed, they told me that abdominal intrusion can make the digestive track seize up.  In fact, they wouldn't let me leave the hospital until I'd pooped back then.  So I started to wonder if something similar wasn't going on.

Yesterday I had a course to go on so I did that and continued to have the occasional over the counter painkiller.  Uncomfortable, but not really worse than bad period pains.  I was noting that it seemed more 'abdominal' than 'right side' and although I was drinking a lot, and peeing a lot, no other action was going on.

As I didn't bring my bicycle up (like I usually do) I decided to walk home last night which is a little over a mile.  It wasn't the most comfortable walk, but I took it slow and steady.  I felt that getting some light physical activity in might help my system get moving.  Got home, lots of air, no action.

This morning however, my abdominal area feels much better.  I got up and had results in the bathroom.  I have no idea of I'm making connections that aren't there, but I do know I feel much more comfortable and generally better.  Still a bit of bloating and now any aches are pretty much identifiable as on my left side where the ovary is still enlarged.

Also, I've noticed that I think I bit my tongue under sedation and maybe it pressed on my jaw a bit funny if they gave me an oxygen mask as both sides of my jaw, close to my ears is sore to the touch.  First I thought it was a pimple, but then I noticed it was on both sides and think it was something else.  The tongue thing is annoying, but it will sort itself out.

So I guess I just wait for my period and finally my body can return to normal for a bit, before I go for it again in June.

I feel less disappointed by my six eggs.  And I'm really pleased that they are there waiting for me in the freezer.  It does make me determined to do at least one more cycle, but I am glad that I have done this.  My chances at future pregnancy only diminish from here on out, so those six eggs, and whatever I get in June are a great investment.

When I get back to London I will try to do a break-down post about my costs, as I think it's something useful there should be more information about.  I should also have my formal letter from the clinic regarding the extraction, so I will post if there is anything interesting from that. I may also, in the interim, post some thoughts on future parenthood.  But in general, I suspect this blog will go a bit quiet until my next cycle starts up.

I'm glad that my story has helped some people.  Any questions, please email or leave a comment.  And if you are starting your own journey and begin a blog, please send me the link and I will add it to the blog roll on the right.

26 February 2013

Day 17 - Egg retrieval

So it's about a quarter past noon and I am at home sprawled on my couch chilling out.  I don't know anything yet, so I'm going to probably save this post as a draft and update it later so it contains the entire story of the day.  Although if you're reading this and I've posted it, it will contain the full story.

But while it's relatively fresh in my head, let me record how today has gone so far.

So I had dinner last night around 8pm and then only water with the last water being probably  around 10:30 or so.  Was feeling a bit anxious- just went to bed after setting two different alarms.

Woke up before both alarms and also at some time in the night because I had to pee.  I did try to drink a bunch of water yesterday- not only because I hear it makes recovery after the collection better, but also because my veins can be fiddly so it's better if I'm more hydrated than not.  So I just lay in bed in and out of sleep waiting for the alarms.  Eventually got up.  Straight into the shower.  Just a single swipe of deodorant, no other perfumes or scented products.  Took care of the suppository, put my clothes on, grabbed my sealed sharps bin and headed out.

Got to the clinic around 8:20.  The receptionists weren't there yet, although I saw people moving about inside, they didn't come answer the door when I rang.  Had to wait about five minutes for someone to come to work who let me in, asked if I was there for a procedure, had me sit and then it was really a minute or less before one of the nurses came to get me.

First she asked me to empty my bladder, so I did that.  Then she took me into the procedure/recovery suite.  She showed me to a cubicle area and said it would be my area.  It had a hospital type bed covered in paper, a pillow, a blanket, a hospital gown, a blood pressure machine, a chair, and a wardrobe.  She told me I could put all of my things in the wardrobe.  After covering my name and birthday, taking my blood pressure, and checking when I had last eaten or drank, she asked me to change into the gown and then just wait for the anesthetist.  And she closed the curtain to my cubicle.

So I did all this.  It's a bit awkward to try to tie up a gown in the back on your own.  Yet another moment of "Ugh, this sucks to be on your own." but it quickly passed.  I got changed, on the bed, covered myself up with the blanket and tried to just stay calm and rest.  After all, I hadn't slept all that great, and I was nervous.

Another couple came in to a different cubicle for another procedure.

Then the anesthetist arrived.  A kindly older man who asked me again for my name and birthday and when I last ate or drank and we went through some basic medical history that would be relevant to anesthetics.  He seemed to suggest all was in order, so we could get ready to go.

The nurse came back for me and we walked to what I'm going to assume was a prep room.  I'm not at all sure it was the actual procedure room and if pushed I'd suggest it wasn't.  Based on my only other experience with UK set-ups, when I had my ovary out, they prep you in the prep room but everything happens in the procedure room which basically you never get to see.  I could see that there was a very wide door to a more clinical looking room at the other end of what I think was the prep room.  But, I may never know.

Because, basically, they asked me to get on the table which had an absorption pad for under your pelvis.  They brought the pillow and the blanket so once I got settled they had me covered and resting on the pillow.  They attached three electrodes to me and hooked them up to a machine.  In the meantime, the anesthetist needed to get the cannula in my wrist.  Despite drinking lots, my veins were being fiddly so he had me do a bunch of pumping and then he got it in.  Cannula's are not the most comfortable things.  It's not that it really hurt, it was just uncomfortable, but he was very gentle with it and once it was in placed my hand across my chest.  My doctor showed up and asked how I was.  I said I'd felt more bloated since the trigger shot and more uncomfortable on that side, which he said was normal.  He explained the procedure, what they were going to do and went through the possible risks.  With all that done, the anesthetist said he'd give me a drug that might make me a bit woozy and then asked what my PhD was about.  I was telling him, and he said something like, "Oh, so you could tell me how to improve my Victorian terrace house." and I said something like, "Yeah, I could." and the nurse was having me get my leg into a stirrup and that is the last thing I remember.

Next thing I know, I'm coming out of a very pleasant sleep feeling nice and warm and toasty.  There's a blood pressure cuff on my arm I think, or maybe just the thing on your finger.  At any rate, I'm completely back in the cubicle I started off in.  No idea how I got from the one to the other.  I don't feel particularly much of anything out of the ordinary.  My abdomen is a bit crampy, but nothing worse than period pains, although I'm also on painkillers, so I should bear this in mind as at some point they are going to wear off.  A nurses comes in and gives me a cup of water which I drink.  Then she asks me if I'd like some tea and how I take it (with sugar, no milk).

So then she brings me a mug of tea and some hard cookies/biscuits.  I drink the tea, I eat the biscuits and I feel very alert.  Almost euphoric.  I want to laugh.  I suppose it's just the stress of everything being really over.  I ask if my friend has arrived and they say yes.  I look at the machine and realize that it's past 10:30.  I've been out for a while!  The nurse comes back after a bit to take out the cannula.  Another nurse comes to remind me of the info sheet.  What not to do today, what drugs not to take.  And then basically I'm discharged.  They say the embryologist will call me later with the details of the collection and I can get dressed.

I do, I give over my sharps bin.  I realize I'm in a slight daze.  I'm alert, but everything seems a bit surreal.  I meet up with my friend, and we head out.  It's that simple.  I took public transport home although they said not to, honestly, it was completely fine.  I just feel a bit crampy.

On the way home, stopped by the grocery so I could pick up a ready-meal for lunch as I don't have anything in and don't want to have to go out until later, my friend got me up to my front door, and then he went back to work, and here I am on the couch.

The embryologist just called around 12:30.  I have six eggs.  They collected six, and all six were mature and able to be frozen.  I don't know if they were all fully mature or the various gradations of mature.  As per usual, I was slightly in shock by the call and so did not have the wherewithal to ask the questions that are now going through my head.


Closer to five than to ten.  But better than nothing.  Not as good as I had hoped for.  But six eggs in the freezer is six eggs I otherwise did not have in the freezer before.  So cycle two will definitely be June.  I guess before then I'll try to have an appointment with the doctor to see if he thinks we should change the protocol based on this one to see if something should change to see if I can get closer to the ten.

Because I was completely out of it for the procedure, I have no idea how many follicles there actually were in the end.  On Friday there were 13.  But I only have one ovary.  The response is within the expected range of five to ten, so that's good, just on the lower side of the expected range, but hey, that's life.

Now I just have to be gentle with my body over the coming days until I get my period and my ovary starts to deflate back to normal size.

I'm not going to lie, I'm a little bit disappointed by six.  But then this entire journey is just one crazy emotional roller coaster ride.  And I need to remind myself- what is the alternative?  Six eggs in the freezer, is six 38 year old eggs that would otherwise have been flushed.  I will do a second cycle.  If I want to preserve my fertility chances, then this is the best possible thing I can be doing at this point in time, and if this is what my body gives me, then that's what it is.  I have to remember, the alternative to this, is to have absolutely nothing.

Six is basically enough for one IVF cycle.  Hopefully I'll get at least as many on the next cycle.  Then I'll probably need to see if I can find finances for a third cycle depending on how the second one goes.  But as my doctor tells me- one step at a time!  For now, it's be gentle, wait for period, enjoy the break in between, and then prepare to do it all again.

25 February 2013

Day 16 - It's the Final Countdown

I can't believe I have taken my last shots of this cycle!  I was very good about taking my two shots last night exactly on time.  My last Cetrotide was at 7:01pm and my Ovitrelle was at 8:01pm.  Go me.

And because it's something new, I also have some new pictures to share.  First, there's the Ovitrelle.  It needed to be kept in the fridge.  I looked online and it seemed reasonable to believe that I could remove it from the fridge about 30 minutes before injection so it was less chilly.  So I did.  Here is the box:

And here is what is inside the box.  One pre-filled and ready-to-go syringe.  Oh, and also there was a little instruction and information sheet, but it wasn't very useful or interesting so I didn't photograph that.

Having removed it from the fridge 30 minutes before injecting, it wasn't noticeably cold in any way or uncomfortable compared to my other injections.  Now, you might notice the air bubble that it comes with.  I did ask the nurse and she said not to worry about the air bubble.  That as the injection was subcutaneous, it doesn't matter.  Air bubbles really only matter if they get into your veins.  But I wasn't thrilled with the big air bubble so I did get rid of most of it before doing the injection although not all of it- as I didn't want to risk losing any of the injection itself.  It went in no problem and then I was done:

I did think one thing interesting about this syringe was how it was sort of "all glass".  The Cetrotide syringes had a plastic plunger.  I thought this was actually a rather attractive sort of syringe.  If such things can be viewed in any was as attractive.  Anyway, I put the cover back on the needle and put my last bit of sharp into my sharps bin!

So here you see it.  The results of my first cycle of sharps.  Pretty much filled the bin.  you can see that it says not to fill above the line and I'd suggest that it was pretty much filled exactly to the line!  This was mainly due to all of the extra and unused needles that come with the Gonal-F pens.  Pretty wasteful, those.  Anyway, I figure I will take this with me tomorrow morning to the clinic and give it to them for disposal so I got to lock down the lid!

And so that's it really.  The only thing left in my bag of tricks is the lovely suppository.

Oh yippee.  It's funny to read some of the forums where people get all squeamish about suppositories.  Honestly, you've been jabbing yourself with needles for two weeks and getting done by an ultrasound dildo every few days and you can't manage to pop something up your bum?  I find this line of modesty sort of amusing.  But in reality, that picture makes it look a bit invasive.  Really, it's very tiny and I'm sure it will be no problem at all.

And so tomorrow I will have answers to questions that no one can answer for me.  Today I am going to drink huge amounts of water and eat sensibly but light (I had a massive Sunday roast yesterday and ate red meat like it was going out of style).  No food or drink after midnight- though I plan to be asleep by then.  Then up bright and early to have a shower and then avoid putting on deodorant or anything else with a scent as instructed by my clinic, pop in the suppository, grab my sharps box, and get on public transport at 7:30 to be there for 8:30 for my procedure at 9am.

It's hard not to be hopeful.  And simultaneously afraid of a bad result.  It will be what it will be.  There is nothing else I can do but wait and see.  And I will update here when I am able.  I still plan to travel up to Cambridge tomorrow night though, so we'll see how everything is going.  It could all be panic stations around here just due to my life, as of now put on hold, resuming with force.