“It’s a girl…”

I sit in bed whilst E cries uncontrollably and there is nothing I can do to console her.

We’ve just found out her sister, who E is very close to has just given birth to her 2nd child. A girl. 

E always wanted a girl. She has thought of names, but I don’t want to hear them, because it may not happen. E is worried her sister might take the names she thought of. 

There are lots of kids with similar names round here: Freya, Oscar, Noah, Alfie, Sonny. Everyone is so predictable.

It’s been a rocky couple of weeks.

IVF cycle 3 failed.

We did everything this time but still it failed. E underwent steroids and Clexane but still it failed.

We thought. Why? On paper it should be working. We have donor sperm. AMH is good. Womb lining is good. Day 5 blastocysts were formed. Why is it not happening?

Is it the genetics of the eggs? We thought we need to see a new specialist, maybe elsewhere. Talk about PGS (Pre implantation Genetic Screening)- maybe that will help? 

We looked up clinic and found one 50 miles away. We booked a consultation for a week later. E felt better because we were doing something. I just wanted her to be happy…

Then twice this week, in succession two random men, 34 and 39 came in wanting vasectomies. (I’m a GP btw). They had completed their families. I looked at their ages on the PC. I sighed to myself. I’m 39. I felt time going by. My dad had me at 34 and my sister at 39…

We have a follow up appointment booked with our specialist. We’ll discuss some of the things we chatted about with the PGS infertility specialist. 

The 3rd IVF cycle was the best we ever had. 2 early blastocysts put back into her womb. I’ve realised that to improve our odds, we need two more attempts of this 3rd cycle. Because 1 & 2 were trial runs. You need 3-4 goes of your best cycle. But I’m anxious about the costs. I’m always worried about it, but I’ve decided I’ll do extra shifts.

E has settled down a bit. Today will be difficult. But we were expecting this to happen and it’s best we know today, on a weekend, rather than on a weekday. 

5 years. Watching friends and family who weren’t even thinking of having kids, have them. We are in limbo.

I want to cry, but I can’t…

‘Dear baby mine’

Thought I’d share the link to a BBC Radio 4 drama that played recently which E encouraged me to listen to. 

Each episode is 15 mins long and there are 5 episodes.

The drama is about the affects of infertility on a couple but interestingly the point of view is from a man with azoospermia, which is what I have.

Here’s the link: http://www.bbc.co.uk/programmes/b07gf4s2

Those abroad may have listen to it via the BBC website or iplayer radio app. 

Uncharted territory 

E and I are in uncharted territory.

We’re back in the 2WW which is nothing new, but the circumstances before egg transfer were new.

This is our much delayed 3rd IVF cycle (2 cancellations and last transfer 1 year ago).

Our fertility doctor decided to up the Menopur dose to 375 units, to see if the follies grew better and in greater quantity this time around, because on paper it should be working.

But this time round, from day 8, E started Prednisolone (Prednisone / ‘steroids’) 10mg am and Clexane injections  (Enoxaparin / ‘blood thinners’) pm. The latter injection I gave to her, but the main side effect is increased bruising, but thankfully the needle is smaller.

The development of the follies was much better than previous attempts, resulting in more ovarian related discomfort and bloating feeling for E.

Pre egg collection, E had several follies with several becoming morula and potentially blastocysts.


This was the furthest we’ve ever got and shows that at least IVF cycles really needed to get the best result.

So on Saturday we attended the fertility hospital for egg transfer – 2x early blastocysts. Wow! 

And now we’re once again in the 2WW, but the differences are:

  • 2 early blastocysts transferred 
  • Daily Prednisolone (20mg now)
  • Daily Clexane injections 
  • Scratch test done pre cycle, within 2 weeks 

We’ve been in this position before- we want to be positive, but as all assisted conception couples or individuals know- you are expecting the worst case scenario, just to protect yourself. 

A pragmatic point of view 

We saw the specialist again today in view of a repeat scratch test and uterine NK cell biopsy.

Things were NOT as straightforward as expected. Another issue. It seems E hadn’t ovulated. What was causing this delay again? Stress? Slight weight gain? Chance? 

Our specialist is thinking of proceeding with steroids and Clexane whatever the result. But there’s no evidence for this treatment plan.

This blog written by Dr Malpani seem pragmatic regarding the issue.

Distractions 

That’s it. Another episode of…

  

…finished.

Season 2 episode 3.

I’m not finding this season as fascinating as Season 1. It’s not grabbing my attention like the tragic story of Adnan and Hai. 

It’s probably because what Bergdahl appears to have done is extremely stupid and led to a lot of hassles for either side of the conflict. Surely there were better ways of notifying the higher powers of his concerns about his training. 

But I’m sure there’s more to this story than what has been presented so far.

I just found Season 1 much more interesting and each podcast almost ‘unputdownable’.

Complaining

For those unaware, I am a GP, a General Practitioner. I believe it’s called Family Practitioner elsewhere.

GP’s are known as the gate keepers of the NHS as we tend to see people who are acutely ill or have a chronic illness and manage them in the community and refer them to see a specialist only if we cannot manage them. As such GP’s get to know patients over their life and vice versa.

Due to the nature of this, GP’s are the most complained at profession. Some of the complaints are genuine, often where a doctor has been at fault, but mostly the complaints are petty in nature. I have received complaints.

All hospital specialists and doctors have received a complaint at least once in their lives, although some may not be aware they have, because their bosses have dealt with them.

I suspect because that infertility specialists don’t receive many complaints.

Well last week, E and I attended another difficult infertility consultation and for the first time ever in 5 years, I decided it was time our fertility doctors knew the truth of how I was coping and feeling and how we were coping and feeling. Let’s say she was shocked and didn’t know how to react.

I didn’t shout at her or get physical, I just told her how hard things have been, how I didn’t feel it was working, how I’d lost confidence in the treatment (and her skills, although I did not say this, only implied it), how despite years of treatment, we were no nearer to having a baby than when we started nearly 5 years ago.

What provoked this outburst?

Well I planned to say something. I spoke with E before the consultation and said I would try and say something.

But questions on the day irritated me and provoked my response. Questions such as (paraphrased):

– How are you doing, are you going to an Christmas parties? No we’re not. We don’t get invited to parties with friends with kids because they don’t think of us or don’t want a ‘sad’ couple sitting in the corner surrounded by their kids.
– Why are you so sad? WTF. It’s Christmas. A time for families to come together and kids to open prezzies and think about Santa. We’re currently out of that circle.
– If your upset- have you been to counselling? Yes done that. Even me, a man, went with E recently. Any other ideas? *Awkward silence*
– Oh E, your lining seem thin (when scanning) but you have follicles. – It’s like we’re going round in circles. E does not have a standard 28 day cycle- she is nearer 31-35, so her mid point at ovulation is different. Why do we have to keep on telling her?
– And the worst: E you really should try and lose some weight!- E’s BMI is well within the criteria. She lost an amazing amount of weight at the start of this infertility journey and does fantastically well losing weight when needed, but we both love good food, so our weight fluctuates. The infertility specialist goes on about her weight a lot- almost as if she has nothing else to say. She has said that weight loss would be great, but not essential and without any weight loss, her odd have magically increased from 33% to 38%.

As a specialist who prides herself on being evidence based and attending conferences, she go on about weight loss a lot. She has suggested faddy and ridiculous diets which E has sensibly ignored.

Overweight woman still have babies. And so do underweight, drug addicted, alcoholic some and even women over 40 years age. I see it all the time in my practice.

Our infertility doctor’s response to my quiet but seething anger, suggests to me she has no awareness of what infertile couples really go through- the true stress and anxiety which we all hide within. I suspect no-one has ever complained about or to their infertility doctor worried it would affect future care.

A doctor cannot improve their skills without experiencing a complaint or few in their working lives. You won’t know how good or bad a doctor you are until you receive a complaint or compliment. I have received several complaints in my 12 year working life and they have been stressful to deal with, but I have reflected on those complaints and feel I am a better doctor from having read them.

If your fertility doctor is clinically not very good, you can chose to see someone else, but if they are all terrible with emotional support, it’s likely you just put on a brave face and grin and bear it, which is sad. We should be able to be honest with our specialist and for them to be able to give us some genuine empathy not stunned awkward silence.

Protecting myself 

I’m currently at home by myself on a chilly Winter day watching a 14 year old programme about the pyramids on the National Geographic Channel. 

I’ve encouraged E to go and visit her sister and nephew. She had been umming and erring about going but was missing both of them. 

My reticence to see them has been because of our brother in law. He’s not done anything bad and is not a bad person, but he has been posting a lot of photos on Facebook and Path showing how happy they are. They are expecting their second baby and there life seems perfect. I’m just feeling irritated and sad about it all.

I’ve been very stoic and masculine about our infertility journey so far. It’s my way of coping but sometimes ‘something has to give’. I’m not angry at my brother in law just annoyed. This is why people block or unfriend people but that is quite an extreme move. 

E is upset but not surprised he is doing that. But why shouldn’t he- they have good news and want to share it. But his photos just feel like our noses are being rubbed in it. Like I said I believe he’s not doing it on purpose – he’s just not thinking about us.

Things have been brewing for a while. 

Unfortunately due to an anovulatory cycle out 3rd IVF cycle got delayed and cancelled. Now we’re in limbo again till next year but in my head I feel wrung out. 

We have friends who are going through the early stages of adoption and are happy. Each day is a step forward for them, whereas I feel we’ve gone backwards. I feel that in this fertility journey we’ve never been in control but with adoption you have some control. I feel that after the 4th attempt we should think about adoption again. E is unsure, but also feels wrung out.

And to add to the misery for me, I am currently not speaking to my sister after a big argument with her on October 31st fuelled by speaking about our infertility. My sister felt attacked and the evening ended very badly especially after spending the day helping her move house. She can’t handle the stress related to our infertility and refuses to talk about it. I wanted her emotional support and got nothing. 

A couple of weeks later I visited the fertility counsellor with E for the first time in a few years. I mentioned the situation with my sister. What she said made sense- I am expecting my sister to have empathy for a situation she doesn’t understand and never will. I need to stop talking about it with her because she will never give me the support I want. That is very sad but true. 

(My sister is a difficult person. Our relationship is fractious and often one sided. We are the legacy of a parent with schizophrenia. Our damaged lives are because our maternal grandfather swept this issue under the carpet. But that was what society did the the time and sadly it has left our sibling relationship in a poor state. (Our parents died 12+ years ago btw). She has never been in a relationship and I feel she doesn’t have the emotional intelligence to be in one. She will never understand our sadness. I need to move on regarding this issue but I can’t banish my sister from my life. I now know if I am to remain on good terms with my sister, the subject of infertility should never be mentioned).

So now I remain sat here in this chilly room. I need to put the central heating on. The pyramids programme has finished and I’ll go back to looking at the Auto Trader app in order to buy an approved used car next year. I’ve plumped for the BMW 1 Series.

There ends my emotional dump for now. I’m in two minds about blogging more. I’m sick to death about writing about misery. But when I’m happy with E, I don’t tend to blog – we’re just enjoying life!