Monday, December 29, 2008

On the road - part 2

Today we're leaving Holland, but we're not going home yet. We're making a bit of a triangle road trip this vacation and will go to my other SIL and her family in Switzerland to celebrate the New Year.

So it's going to be a long day in the car again (about 10 hours), but it's always great fun with the family in Switzerland. They live in a small village at the end of a road, with two donkeys, lots of chickens (so super fresh eggs!), three cats and two bunnies, and with great views of the snow-capped mountains. My hubby has brought his skis, but even though I'm an avid skier, I'm not going to risk anything, so I'll walk this time...

Thursday, December 25, 2008

In church with the royal family

Yesterday evening we went to the Christmas Eve service at my parents' church. Is a great, pretty progressive church (like many of them are in Holland) and it's always packed on Christmas Eve. It's also quite well-known here because it's the church the Dutch queen goes to (not every Sunday of course). Luckily my dad is on the board and my mom was coordinating all the volunteers for the Christmas Eve service, so our places were reserved. Better yet, we got to sit one row in front of the royal family (i.e. the queen, her three sons and their wives). So we had to behave and sing in tune, ha!

During our years of TTC, I've always had a bit of mixed feelings about seeing or reading about these people, none of the queen's children seemed to have any trouble getting pregnant. As soon as they were married, hoopla, about a year later there would be baby #1! Of course, on the other hand it would have been horrible for them to go through IF in the public eye and have all those gossip rags on constant baby bump watch (and of course I don't wish IF on anyone, but I did think it was unfair at the time...).

Anyway, the service was good despite the benches being a bit hard on my (not yet very) pregnant body.

Merry Christmas everybody!

Wednesday, December 24, 2008


Now that I've reached the second trimester of my first IVF-pregnancy safely, I've been thinking why it had to take more than five years since we first started TTC, to get to this point. Even though it is what it is, were there moments where we maybe waited too long, or made a wrong decision?

The first big wait of 1.5 years before getting tested. Why did we wait so long? I was using BBT charts and ovulation kits, so I knew there was no problem there. I'd read that you should give it time, at least a year, before seeking help, so we did.

When we finally decided we should find out what was wrong, it took me some more time to decide where to go. Immediately to an RE, a regular OBGYN,... finally a friend told me I should go see her doc (OBGYN) and I did.

Test for hubby, tests and exams for me. All normal. Still I was put on Clomid for 'super ovulation'. BFN and I wasn't very happy about it, so I talked to the nurse, who immediately suggested IUI, for which I wasn't ready at all yet in my head.

That was all about six months before moving to France. The last year in the US wasn't a very happy one for both of us (mainly work-related), so I thought that might have something to do with our TTTC and had the naive though that once in France, all the stress would be gone.

Of course this was not the case, especially the first six months after the move were very stressful, so of course no BFPs either. Then finally took up the courage to find a doctor - first a general practitioner whom I asked for recommendations. She gave me a name of an apparently very good gynecologist, whom I called and could see three months later. The first visit was fine and she ordered a few more test. However, when we had done those and I tried to make a follow-up appointment, I was told I should call back in November (it was late August when I called) to make an appointment for January. Appalled, I vowed to find another doctor.

Luckily I met someone who was going through her 3rd or 4th IVF cycle and recommended me her RE clinic. I called and could make an appointment for a few weeks later. After the first consultation a fertiloscopy was scheduled, again only a few weeks later.

The result of the fertiloscopy was that everything looked fine, but that they had found some endometriosis in my ovaries, which was removed. The RE told us this could have been a reason for our infertility. So we went away happy that the problem was solved and thought it would work the natural way, but it didn't...

I think we were too happy that there finally seemed to have been a reason for our infertility and didn't hear in what the RE really said, that this could be a reason, but it might also have nothing to do with it. I wonder if I would have been in Holland or the US, I would have heard that when he told us, and it was the language that prevented us from 'reading between the lines'. In any case, we waited eight months before making another appointment...

I think our biggest problem was our diagnosis: unexplained infertility. After every test, every exam, we were told that everything was normal. So we initially blamed it on untimely business trips, not enough vacation, bad overall timing, stress, and think it should just work one day.

But, when you're planning a vacation with the goal to TTC, there will be added stress - and when you try to plan two weeks away without trying to think about your cycle, you bet, you've planned it around your period and not around ovulation.

So we started IUI, full of hope. After three months in a row of BFNs we took a long vacation to Australia. It was great. It was very relaxing. We didn't think or talk much about IF. And when we were on the plane on the way back home, I so not wanted to continue treatment, I was so fed up with all the false hope, the injections, the clinic visits and the ultimate BFNs.

A few weeks later we had another consult with our RE where we had to decide if we wanted to continue with three more IUIs (the maximum number allowed by the insurance) or go to IVF immediately. At that point I had resigned myself to going to do IF treatment again, but I wasn't ready yet for the tougher IVF cycle. So we chose to try three more times with the 'simple' solution, IUI. After #4 was again a BFN, I started to wonder if I'd made the right decision, but with a 'you never know' spirit, we went for #5 (BFN) and #6 (why stop now? Also BFN) as well.

After that, I really felt like we'd wasted three precious months. We decided to go for IVF after the summer break. And got a BFP. And I wondered what took us so long. But that's life I guess...

Tuesday, December 23, 2008

Second trimester start

Today I'm 14w0d pregnant, so officially in my second trimester, yay! What a great way to celebrate Christmas! I've read that according to US-calculations the second trimester starts at 13w1d, but in France they're a bit more conservative I guess (or they just want to do it differently, because they're French after all...).

Up till now everything is going well, I hope it stays that way. The only thing worrying me a bit right now is that the itch (see three posts down) has not gone away yet. Two days ago I thought it was almost gone, but yesterday was not such a good day. Hopefully it will get better very soon. I also don't sleep very well at night, I don't know why, no physical complaints other than the itch and not too much going on in my head, but still I toss and turn a lot...

In the meantime I'm being pampered by my parents, hardly have to do a thing, and my dad is making me a new alcohol-free cocktail every day!

Monday, December 22, 2008

Dutch skies

Well, our road trip was long but went well and we arrived safely at my parents' place yesterday evening. The stopover in Paris was actually kind of fun, I got to sit in at my hubby's meeting which turned out to be a 2.5 hour crazy creative brainstorming session between some very intelligent people. We also had found a parking space pretty easily. The only bad thing was that the meeting was around lunchtime, but there was nothing to eat or drink, so when we finally got back into the car and could have a sandwich and some water, I had a pretty bad headache which lasted for the rest of the day...

So we're now in Holland for a week. It's always good to be back. Everything is so familiar. The Dutch skies are great (although there are no 'typical' Dutch skies - i.e. lots of big clouds, see 17th and 18th century paintings from the Dutch masters - today, it's clear and sunny). My parents are of course also very happy to see us and want to check out my (still hardly visible) tummy. My grandmothers will come tomorrow, so we can show off some u/s pics again. :-) We'll also try to see some friends again this week, always a bit of an 'issue' when we go back to Holland: you try to see as many friends and family members as possible, which then means you're just running and driving around like crazy to do this in the few days you have available and you are completely exhausted when you're back home. And if you don't do it, some people feel 'left out' because you didn't visit them while you were in the country... The best solution is actually to tell everyone to go to a certain place at a certain date and time, so you'll see everyone at once. But that's not always possible (or we forget to organize it beforehand, which is more often the case).

Sunday, December 21, 2008

On the road

Today we're driving to my parents in Holland for Christmas, 9-10 hours on the road. Normally I quite like road trips, but we've done this stretch already so many times that I'm not really looking forward to it, although today we'll have a change of scenery because we have to go via Paris instead of Luxembourg. 'Have to' because hubby told me he has a meeting with an architect... As he'd been traveling like crazy for the past couple of weeks, he didn't want to go there on Saturday (2 hours by high-speed train) and come back the same day, but prefers to 'conveniently' combine it with our trip up north.

He had mentioned this possibility a week ago already, but was then still leaning towards going there and back on Saturday. Then this week he said his boss would go, so I was relieved. But of course the boss is a smart-ass and doesn't want to work the weekend before Christmas, so now hubby has to go. In a way he even likes it, because the architect specifically asked for him (and he thought his boss would be unhappy about that), so he's kind of flattered...

From here to Paris is 4 to 5 hours by car. The meeting will probably start around noon, so that means we have to leave around 7 am (if we would have taken our regular route, we could have left around 10 am and still be at my parents' place in time for dinner), hopefully find a secure place to park our fully loaded car somewhere in central Paris (when I mentioned that to hubby he was like 'oh, no problem, it's Sunday'. Yes, but it's the Sunday before Christmas which means all the shops will be open - normally not the case in France - and it'll be very busy!), hope the meeting doesn't last longer than two hours (and what am I going to do in the meantime? I know, I shouldn't say this, many of you might trade in a lot for two hours in Paris) so we can get going again, don't get stuck too long on the 'péripherique' to get out of the city and hopefully still arrive on time in Holland for dinner (another 5 to 6 hours).

Pfff, I'm exhausted already (and I probably have to catch up on IComLeavWe tomorrow)!

Friday, December 19, 2008

No infection

Got the results back from my urine test yesterday afternoon: no urine/bladder infection. But the itching hadn't stopped, so I was not feeling very relieved yet. How long before the anti-yeast infection stuff would take effect (it did say on the instructions that the itching could initially get worse)?

My mom, sister and hubby all suggested that it might be due to the utrogestan (progesterone suppositories) I've been taking since egg retrieval (Sept. 30), which would not surprise me, so I consulted the French Dr. Google and indeed found a few forums where women were experiencing the same thing.

So I went to the OB this morning with the test results from the lab (normally they send them by mail, but I had said I would bring them myself) and asked to see the doc for a minute to ask what to do next. Luckily my regular OB was back, so I didn't have to deal with the very friendly, but rather inexperienced replacement (who doesn't even now what a progesterone suppository looks like). She listened to my question, looked at my file and said my body was probably fed up with the utrogestan and that she was pretty sure that's what caused the itching.

So, no more utrogestan, yay! Immediately felt less itchy after that news. Funny how that works...

Wednesday, December 17, 2008

Hospital labels and a possible infection

Well, this morning was the early pregnancy information session at the hospital. But first I had to get my labels printed. They had told me to come about 15 minutes before the session would start, but as I'm always (way too) early, I was there 30 minutes before. No line, so that was good. Before they could make the labels, they had to start a file in my name (so they apparently didn't do anything with the info I gave them the day I registered...?!) and then I got a nice sheet with 30 tiny labels which include a bar code, my name, my DOB and file number.

Apparently these labels are the entry ticket to anything that has to do with checkups, prenatal preparatory sessions, etc. within the OB department. At each appointment you have to give a label and then they charge it to the state-run insurance. So my first label was for the midwife who held the presentation... I must admit that the French health care system doesn't stop to amaze me and it's quite unbelievable sometimes that it in fact runs pretty smoothly.

On to the meeting room. At 9:45am about half the room was full. Then more people came in, some with, some without labels - apparently the line downstairs for printing the labels had become rather long. The midwife tried to start around 9:55am - even more people came in - there were not enough chairs. Attending husbands were asked to bring in more chairs. People kept coming in (you did not need to register for the session). At 10:15am a woman came in telling that there was still a whole group downstairs waiting for their labels. The midwife told her to go and get them so she could finally really start. Still, even after that people kept coming in (I think the last ones arrived around 11am). The room was way too full.

Apart from this, the session was quite informative, but I did wonder if I could not have gotten the same information in 10 minutes from a doctor, nurse or midwife affiliated with the hospital, instead of spending more than two hours in an overcrowded room...

I initially thought that after this session I would have the afternoon off so I could finally get some administrative and household stuff done. But this was not the case. As the burning sensation around my girlie parts (see two posts back) had not gone away yet, I decided I should call my OB, because just reading books and the internet only made me worry too much. Had to wait until after 2pm, because of course no-one here in France is reachable between 12 and 2, not to be disturbed while having their nice and lengthy lunches. Got hold of the secretary at 2.20pm, she put me through to the OB (replacement) who said she would need to see me and might have an opening today, so she transferred me back to the secretary: the 2.45pm appointment had just canceled, so, did I live far from their office...?

I took the appointment, found a city bike (free bike system), flew downhill, and was at the office at 2.42pm. Didn't have to wait more than two minutes. OB asked me what exactly my symptoms were, which is always a nice challenge to try to explain in French - I did look up some words in the dictionary before I called, but forgot the word for itch again, as it is so weird (demangeaison), but luckily she understood what I wanted to say.

So after the little chat, on to the stirrups. She couldn't detect any cut like my OB had seen last week, but said that she saw a lot of white thick discharge, so it must be a yeast infection. But to me that discharge looked just like the remains of the progesterone suppositories, which I told her, so now she wasn't sure anymore. But she said it looked a little reddish too and the itching was pretty bad after she removed the speculum, so she did give me a prescription for something against a yeast infection (a vaginal capsule I have to take tonight). Maybe it is actually caused by the fact that I've been putting in progesterone suppositories for 11 weeks now...? Luckily only five more days of that left.

She also ordered me to go to a lab to have my urine tested for infection, preferably today, so we would have the results before I leave for Holland this weekend. So once I was out the door, I called the lab to see if I could come still come by. Yes, but for I would need to wait 2 hours since last bathroom visit, so had to go there around 5pm.

So I went to the pharmacy first to get the prescription (including a cream to sooth the itching) and then went back home. Took a nap for about 40 minutes. Got up, got another city bike and rode to the lab (slightly uphill this time). Results will be back tomorrow afternoon. Pfff...

Tuesday, December 16, 2008

Happy birthday to me!

Yay, happy birthday to me, I'm singing while all alone at home. :-(

Hubby won't be home from his business trip until tonight, but I'm not letting that stop me from trying to get into a celebratory mood today. And it's going to be the best birthday in a long time anyway, because I'm finally pregnant!

What's on the program:
  • Bake a birthday cake (apple pie with apricots on top, my grandmother's recipe)
  • Go shopping (maybe for maternity jeans at the GAP...? I've been wanting a pair ever since we started TTC and that's over five years ago!)
    Edit: well, no GAP maternity jeans. The GAP here has a limited collection and only regular lengths and those are too short for me (but of course great for the petite French ladies). I did buy some fancy PJs at another store though, with enough stretch for a growing belly... BTW, it was ridiculously busy at the mall (does no one need to work?!).
  • Phone calls from family and friends (I bet my grandma is going to be the first to call, she's a very early bird)
  • Music ensemble rehearsal - I will bring some apple pie for my two friends to celebrate my birthday and pregnancy announcement
  • Hubby's return - which means I can open my present (which we bought together on Saturday, so I already know what it is, but I won't open the package until he's back)!
I actually also really need to clean the apartment, but I've decided that's not something to do on a birthday, so I'll postpone that until Wednesday.

A fun fact is that I was born on a so-called "carless" Sunday (they had a few of those in the Netherlands during the '73/'74 oil crisis). My dad had hoped for a police escort when driving to the hospital, but they just gave him a note... :-)

Oh yeah, and a cool small thing is that the time I posted this is the actual time I was born... (thanks to blogger for giving me the opportunity to cheat between writing and posting)

Monday, December 15, 2008

My new year's eve

Since tomorrow's my birthday, today is my personal new year's eve. A pretty uneventful day. Went to the lab to have a blood and urine test, finished writing and mailing our Christmas cards, booked a trip (with left-over miles from when I still had a career...) to my sister in the US for February, and went to yoga class this evening. Hubby's out on a business trip until tomorrow evening.

I've not been feeling that great these last two days. Yesterday I almost fainted when I was cleaning up the breakfast table (so yes, after I'd eaten) and felt a bit out of it the entire day. I also started to have some burning sensation when peeing. Not all the time though and mostly on the left. I had this last week too and when I told my OB at the checkup on Tuesday she was afraid I would have a urinary infection, but luckily the test came back negative and on further inspection it turned out to be a small cut... Problem was gone two days later so I thought it had healed, but now it's back. So is it the same thing or something else...? I don't like this, it makes me worry too much.

Yoga class helped not to think about it for about an hour. Belly is very 'present' again this evening and I also feel a bit bloated (but maybe that's because I had a liter of tomato soup for dinner...) and my jeans seemed awfully tight - don't know if I will make it until the January sale before buying maternity jeans!

Friday, December 12, 2008

Friends leaving...

The thing about living in a foreign country is that most of the new friends you get in that country are foreigners themselves too. When we lived in the US, most of our friends were Dutch (which is actually horrible to admit) and many of them (including us, obviously) have in the meantime moved back to Holland or to other countries.

Here in France we found some great new friends and neighbors, a better mix of nationalities this time: German, Spanish, French, English, American and yes, a Dutch one too...

Our German neighbors moved into our apartment building a week after we did, a little over three years ago. We immediately got along very well - dinners, BBQ's, joint outings, etc. followed. We took care of mail and plants when either of us was on vacation, and I took care of their baby during work hours for the 6 week-period between the end of her maternity leave and the opening of their company's daycare center.

Today, they moved back to Germany. He got another position at his company. I'm sure we'll stay in touch, but it won't be the same. I hate to see them go, they are really great and very sweet people. A British friend also announced last week that she'll be leaving town, and moving to Luxembourg this summer...

Oh well, that's the expat life I guess... even though we're not real expats (not send by a company in our home country to work somewhere else for 3-5 years), since my hubby is on a local contract and so it's entirely up to us how long we stay in France. For the moment we have no intention of moving again any time soon and hopefully our remaining friends here will stick around a little longer too.

Thursday, December 11, 2008

12w u/s and checkup

Damn, I've been wanting to blog since Tuesday, but just haven't had the time (amazing how busy you can be even when you're not working...). Bad news first: I'm getting another cold. I'm sneezing and the sinuses on my right side hurt. Hope it doesn't turn into an ear infection. I guess my resistance is really crappy now that I'm pregnant, but I hope my mom's remark that 'some women will have a cold during their entire pregnancy', will not come true for me!

Now the good news: we had our 12 week u/s and checkup on Tuesday and everything is looking great! Our little miracle (I have to come up with some name, but can't think of anything yet. Any suggestions?) was moving around and we could already count fingers and toes! The measurement showed it being 12w3d instead of 12w0d, so it's ahead of the French curve, but my sister later told me that it's actually a bit below the Dutch curve. But who really cares about a few millimeters...?

At the checkup the OB told me to continue with the Utrogestan (progesterone suppositories) for another two weeks, so until the end of the first trimester. However I need to continue taking the Aspegic100 (baby aspirin) for the remainder of the pregnancy. Hmm, didn't really like that, but she told me that because it was started from the beginning, as part of the IVF protocol, we should not change it now, since I'm reacting OK to it and stopping it will probably do more harm than good. I gained 2 kg since the last checkup (6 weeks ago) according to their scale (which I guess I should assume is more accurate than mine, which hasn't shown any weight increase at all).

I told her that I was experiencing some cramps now and then. She first thought I meant in my legs, but I meant in my belly. She checked my uterus and said that it was indeed feeling a little tense/hard, so I was right but should not worry too much about it, and she prescribed a magnesium B6 supplement, which I now take twice a day. It's funny because it wasn't until I had left the OB's office that I realized that I've indeed also been experiencing leg cramps (especially when doing yoga). I've only been taking it for two days now, but already feel that it's working (will now better at yoga practice tonight).

Made appointments for the next three months, u/s appointment for week 22, and lab test for next week. T21 blood test will be in week 16.

I also got some forms to fill out to register the pregnancy with the state-run health and family insurances (which we filled out and mailed right away, because they need to have those before the end of week 14), so they will cover the necessary prenatal visits, allot the paid maternity and paternity leave, monitor that we'll do all the mandatory tests and vaccinations, and pay child/family allowance once the baby is born.

Sunday, December 7, 2008

Pregnancy books in the internet age

I thought it would be a good idea to buy a French book about pregnancy, so I can at least get familiar with all the terminology for the coming months in a language that is not my own. A quick look on Amazon told me that I would have quite a choice - so which one to pick?

I decided to go to the library first and check out their selection. They only had "J'attends un enfant" (I'm expecting a child), 2006 edition (this book comes out with a new edition every year). I took it home. After reading a few pages, I was glad I hadn't bought it. Pretty patronizing, with some 'wise' words on how to dress and mainly geared to the woman who has no clue about her body. Besides, it had a very confusing way of talking about counting the weeks of pregnancy: in one of the first chapters it said that it would talk 'months' from the time of conception, and 'weeks' from the first day of the last period, but then two pages later it would talk about 'you're now in week 3, which clearly should have been week 5 if the author would have adhered to her own rule...

Next step: the bookstore. I browsed the pregnancy book section on a Saturday afternoon in a overcrowded and too warm large bookstore and after five minutes didn't know how fast to run to the exit to get some fresh air... Before I did that, however, I had seen a book that I liked a lot better than the one I got at the library, but it was from 2001, so I wondered if there wouldn't be an updated version in the meantime.

Back to amazon: the book I had seen in the bookstore, "Livre de bord de la future maman" (Logbook for the mother-to-be) was available online, 2007 edition, paperback instead of hardcover, € 6,50 instead of € 22. Seemed like a good deal, and even if the it would turn out not to be a great read after all, I at least hadn't wasted too much money on it.

Now I think the overall problem with these kind of books is that they contain a lot of information that 'we, internet people' have already found online, and 'we, IF people' don't need to have explained anymore (how the reproductive system works, anyone?).

So the book arrived and I could skip the first three chapters. I did however wonder if they'd bothered to write something about IF... Found it as a bit of an afterthought under chapter 4 - the first month of pregnancy. Kind of a weird location, why not as a next paragraph after the one in chapter 2 entitled "Avant votre bébé, il y a vous: tout est prévu pour donner la vie" (before your baby, there is you: everything is ready to give life)?

It did still mention GIFT and ZIFT, which are procedures that I think are no longer used (replaced by IVF)? And it also said that ICSI is replacing normal IVF, which I think is highly exaggerated. But oh well, I didn't buy the book to get wiser on IF...

There were some omissions in the description of ultrasounds (no mention of vaginal u/s option), so together with the not quite correct IF information I wonder if there are more inaccuracies on topics that I don't know that much about yet. Other than that it's actually a pretty handy book and I don't regret buying it (and I'm learning some new French vocabulary).

Cleaning my undies with Goo Gone

OK, time for a silly post! I've discovered that the discharge from my progesterone suppositories is messing with the glue on my panty liners... It stays on my undies, so now I have to treat them with some Goo Gone before I put them in the washing machine! My hubby would say that this is only one more piece of evidence that I'm an addicted Goo Gone user...

Wednesday, December 3, 2008

The costs of an IVF cycle in France

I thought it might be interesting to show the cost breakdown for an IVF cycle here in France - both as comparison with prices in the US, where I know people easily pay $10,000+ for a cycle, and as guideline for any readers who live here too and are planning an IVF cycle.

The total amount of our IVF cycle: € 3,022 (for what's included, see below).

Of this total amount € 2,368 was covered by the general state-run health insurance, minus € 60 (edit: changed amount from € 43 after receiving latest insurance statement) of co-payment. Our additional insurance (we're covered through my hubby's work) paid for the remaining € 654.

Everyone in France, whether employed, unemployed, retired, etc. is covered under the general state-run insurance. Not everyone has the benefit of additional insurance, and if you have it, it depends on the contract what will be covered and what not (luckily we have a very good one). So this means that the most any legal resident of France would pay for an IVF cycle is about € 704 (i.e. the co-payment amount + the part optionally covered by the additional insurance).

This is of course great, and we're very happy that we can benefit from all of this. The question is how long France can keep a health care system like this without going bankrupt. The government is aware of the problem, however changes cannot be made easily because the whole country will go on strike as soon as any president or health care secretary tries to do something about it.

For those of you who want to know more, here are some details about what is included in above mentioned total costs:
Pre-cycle lab tests (€ 357 for blood work, pap smear, semen analysis)
3x u/s during stimulation (€ 70 each)
5x blood work during stimulation (€ 6 for nurse, € 19 for lab work)
Pre-ER consult with anesthesiologist (€ 45)
Determination by RE of trigger date (€ 110)
ER (€ 276 + € 243 for general anesthetic)
The actual IVF in the lab (€ 432)
3x beta test (€ 17 each)
u/s to confirm pregnancy (€ 57)
Suppression drugs (Enantone LP - € 137)
Stimulation drugs (Puregon, 2x 900IU at € 363 each)
Ovulation triggering drugs (Ovitrelle - € 41)
Progesterone suppositories (generic version of Utrogestan, 8 boxes of 15 capsules at € 5 / box)
Baby aspirin (Aspegic100, 4 boxes of 20 sachets at € 2 / box)
Follic acid (5 boxes of 30 tablets at € 4 / box)

Some observations/comments:
Nurses are very badly paid here. The one that came to my house to do the Enantone injection could only bill € 3 for the injection and € 2,20 for the house visit. I don't know how they can make a living off of that...
The € 110 for the 'determination of the trigger date' (I don't know how else to describe it) is pretty overpriced, compared to other costs.
I've actually had 5 u/s during stimulation, but our clinic always bills a maximum of 3 per cycle.
A Puregon pen is not included in the cost, since I already had that from my IUI cycles (I think it costs about € 60).
The u/s to determine the pregnancy is cheaper than the ones I had during stimulation because it was not done at the IVF clinic, so not the same prices...
I have not included the cost of a consult with our RE (which we had in July) - he charges € 70.
The above mentioned amount of vaginal progesterone suppositories is based on the period ER - 12w check-up (u/s), baby aspirin from ET - 12w and follic acid from pre-test phase (August) - 12w (although I've been taking that for ages already...).

Monday, December 1, 2008

Hurtful comments

No, thankfully not to me personally, but I did feel a bit violated anyway... Late yesterday evening I was reading the article Her Body, My Baby, on the New York Times website. Interesting read about someone who, after years of infertility and lost pregnancies, had a baby via gestational surrogacy. Some things she wrote about her fertility journey really hit home, other aspects I felt less related to.

Then I started reading some of the more than 300 comments... Many were about the choice of the two photos, which is indeed questionable I think. But others - and those were on the first page (and 'referred' the most) - were plain mean: That it's immoral for infertile couples to go on a quest for a biological baby - if we really want a child, our only option should be to adopt, because there are already enough children in the world; if we can't conceive, that's because it was meant to be, and we should just accept Darwin's fatalism and not burden the health care system. Etc., etc.

It made me sick. I'm not going to defend my IVF pregnancy here, because I know that those who read this blog are 'on my side', and don't need explaining. I'm glad I don't know anyone who thinks about it the way those commenters do, but if I'd meet one, I'd ban them from my life forever.

Not surprisingly, it took me a while to fall asleep.

Tuesday, November 25, 2008

A bit bored

Well, luckily no more lower back pain or cramps today, just a few twinges. Other than that, I'm a bit bored (although I did check off a lot of tasks on my to-do list today), hubby is off around Europe for work this week, next check-up and u/s still two weeks away. Time to watch some Dr. House (but please no episodes with dying babies or sick pregnant women, those give me nightmares)...

Monday, November 24, 2008

Lower back pain and some cramps

So last week, while I was sick, I was worried that my pregnancy symptoms were decreasing and that the baby was no longer alive. Now that the cold/flu is gone, I noticed the symptoms are still there, but get freaked out because yesterday evening I suddenly got some cramps and lower back pain and I'm worried I'm going to have a miscarriage. It came back early this morning and this afternoon around 4 pm (still there while I write this). Absolutely no bleeding or spotting though, just some mild pain, like when you have your period - around day 3, nothing like the horrible cramps I usually have on day 1 and 2. So I assume/hope it's normal, due to the uterus expanding or something, but of course I keep a check on it to see if it gets any worse.

How normal is my IVF pregnancy?

So, how 'normal' is my IVF pregnancy? Or how normal do I want it to be? On one hand, I want it to be as normal as possible, not different from any other, naturally conceived, pregnancy. But, on the other hand, I want it to be different... this might be difficult to explain, and I don't mean that I want complications or anything like that. But the other day, when I thought about the upcoming pregnancy & birth preparation sessions that the hospital is organizing for expectant couples, I suddenly had the feeling that I didn't want to be there surrounded by couples who got pregnant 'the easy way', I'd prefer to be in a group with people who'd had infertility treatments before being able to get pregnant. Because those people have been there themselves... and you don't have to be afraid of someone blurting out a remark on how she got pregnant unexpectantly because she forgot to take the pill, or something like that.

Last week I received a letter from the RE lab, asking to let them know the name of my OB and the results of the first u/s (which, btw, I had informed the RE's office about, but apparently the office and the lab don't communicate very well with each other...) and also informing me that they would send me a form, to be filled out by my OB after the delivery, about my pregnancy, so they would have that info for their statistics. A normal procedure and a sign that my IVF pregnancy will never be completely 'normal' - which is fine by me, because that's how I experience it anyway.

But... they also mentioned I would be contacted by an organization they work with, "which will propose to monitor your child for a longer period of time". WTF? When I read that, a sudden vision came to me of my child wearing a t-shirt saying "I'm an IVF baby". Everywhere you read that 'children born as a result of IVF are no different that other children', so why this follow-up and how long is a 'longer period of time'? A few months, a few years? I tried to find some information about this organization online, but of course there's nothing - welcome to France, this country is so offline, it's unbelievable (more on that in a future post). So I'll have to wait until I get the call/letter to find out what it is all about...

Saturday, November 22, 2008

Feeling better

Wow, I'm finally almost over this horrible cold (or was it actually the flu, just without real fever?). Spent Tuesday and Wednesday in bed all day, felt super miserable. Fortunately things started to improve on Thursday, and even though I'm still coughing (which has resulted in a nice pain in the ribs), I can at least distinguish my pregnancy symptoms from the cold symptoms again, which is reassuring to my constantly worrying mind.

Monday, November 17, 2008

Registry date at the hospital

I had to go to the hospital this morning to register for the delivery date. Today was the first possible date to do this for due dates scheduled for the last two weeks of June. Both my OB and my neighbor had told me to go there as early as possible, because apparently all women want to deliver at this specific hospital (+ the birth rate in France is the highest in Europe), so it fills up pretty fast.

I arrived at the hospital around 9.15 am, already quite busy in the waiting room and it was too warm, so I got a nice coughing attack (and of course I had forgotten to bring water). After about 15 minutes it was my turn - as my OB is linked to the hospital, it was a pretty easy registration (but you wonder how they do it - because they first write down the info on some scrap piece of paper and then when you're gone they're going to enter it - you hope - into the computer system. Ah, the French...). I had registration number 4, so obviously I was well on-time. I had brought all kinds of paperwork (because my neighbor had told me I needed that), but didn't need any of it.

Next appointment is on December 17 - information session about pregnancy and delivery. Will have to get my 'labels' printed then as well, whatever that means...

Sunday, November 16, 2008

Stupid cold

Thanks to my hubby, who was sick two weeks ago (and is still coughing), I suffer from a stupid cold since Thursday. I limit myself to paracetamol (the European version of Tylenol), homeopathic tablets for sore throat, and a little bit of homeopathic cough syrup twice a day. I also took some nasal spray for a few days, convinced it was just saline spray, but when I looked closer at the bottle this morning I saw that it was a little stronger than I thought - so I put that back in the medicine cabinet (and try not to freak out that I took it and it might be harmful...).

Other than that I still sleep a lot, but now it's hard to know if I'm tired because of the cold or the pregnancy. Breasts hurt a lot less (but still a little tender and bigger than usual) and no other new symptoms to speak of. My next doctor's appointment is not until December 9, so I'm getting a bit anxious that everything is still OK. I know I shouldn't worry, but the cold is not helping much. Still taking progesterone suppositories - now only once a day instead of twice - and baby aspirin. My OB told me to continue both until the next appointment, because stopping might do more harm than continuing (hmm, don't you love this kind of reasoning...?).

Eating out

Friday evening we went out to dinner with a friend from Holland, and I did not have a relaxing good time. Every item on the menu seemed to harbor a potential danger - salad (would it have been washed properly?), cheese (would it be raw-milk?), foie gras (out of the question), red meat (I rather don't eat it than eat it 'well done'), etc. etc. Pff, somehow the entire food industry seems to have become suspect. I think I prefer home-cooked meals from now on, even if I don't feel like cooking all the time...

Wednesday, November 5, 2008


Now that I'm pregnant, I'm not allowed to eat raw-milk cheese anymore. Normally I buy our cheese at the market, but since I suspect that all to be raw-milk, I went to the supermarket.

Well... it's practically impossible to find pasteurized cheese here in France, even at the huge hypermarkets! I must admit that I'm mainly looking for hard cheeses (I'm Dutch after all), there are some brie, camembert and other soft cheeses that you can buy pasteurized, but that's not what I like on my sandwich for lunch, and to eat 'laughing cow' for 9 months is not very appealing either...

So, luckily my hubby had to change planes in Amsterdam on his way back from a business meeting last week and bought me a kilo of Old Amsterdam. And my parents are coming to visit tomorrow, also bringing some good old Dutch pasteurized cheese!

Friday, October 31, 2008

First ultrasound

Had first ultrasound this afternoon (at 6w3d). It was pouring with rain and I was very nervous on my way there. Met up with my hubby at the doctor's office, luckily he was a lot calmer than me. After waiting for 35 minutes the doctor finally called us in. After some formalities she started the u/s: one sac with embryo detected, with heartbeat! Yes!! Felt immediately very relieved.

So one embie didn't make it, which I already thought, based on my rather low betas.

Doctor also checked my ovaries, still pretty enlarged from the stimulation: right one between 7-8 cm, left one around 6 cm (normal size should be about 2,5 cm).

Got a nice print-out with all the images. Maybe I'll post one here if I can get it properly scanned.

On to the next appointment with the OB (even though she isn't really one, but I will call her that anyway because it's easier and she's a specialized general practitioner). She wasn't there though, but a replacement, very young, but very nice. A few basic exams, some prescriptions (for the entire pregnancy) for blood work etc, and some warnings about toxoplasmosis and listeriosis and what foods not too eat (most of it I already read on the web of course).

Next appointment (both with OB and for next u/s) around week 12. Seems a long way off... Have to go to the hospital on November 17 to register at the maternity ward. As this doctor is affiliated to the hospital where I want to go, I can stay with her for the entire pregnancy, and don't have to change for the last 2-3 months (like two of my friends had to do). The only thing that will change is the location for the consultations - first seven months at her office, last two months at the hospital.

Have to call my RE's office with the results on Monday and check how long they want me to continue with the progesterone and the baby aspirin (the prescription says at least one month after the first positive beta, and I'm not there yet, so in the meantime I'll just continue).

Now off to enjoy the weekend. Happy Halloween (not that I'm celebrating that here in France)!

Thursday, October 30, 2008

(Bad) mood

Someone told me I was too hard on my sister-in-law (and maybe even on my mother) in yesterday's post. Well, maybe, yes, but that was how I was feeling, so I wrote it down (and it doesn't mean that I don't love them both dearly and really appreciate it that they are always thinking of us).

I have the feeling though that my raging hormones are not making me a nicer person these days. Yesterday I had a music ensemble rehearsal and I lashed out at the violinist, because he told us he was just counting and couldn't listen (yet) to what the others were playing, with the result that he started (and finished) too early every single time. So I told him to listen, instead of count, but he refused. I insisted. He refused. So I got angrier and told him again to listen to the others, isn't that the whole point of ensemble playing...?! He asked me why I was so irritated, I said I didn't know, but that I just couldn't understand his attitude. We started playing again... he finally listened, and we were together...

So, I do apologize to anyone I've been grumpy to lately. Blame it on the hormones.

Wednesday, October 29, 2008

Optimistic or cautious

Yesterday evening my sister-in-law called to check how I was doing. "Oh, I'm so happy for you! I told my colleague that you're finally pregnant and that you might have twins, or even triplets or...!" Eh... looking at my low betas I think it's only one. "Oh, that's fine too, but two would be great!" Hmm, yes, of course (but it also means additional risks - I didn't say that though). I briefly considered sending her Busted's doodles video, but it wouldn't work anyway. She's living a blissfully naive life in a small Swiss village, surrounded by farm animals and lots of women who just got pregnant the easy way (including herself).

My mum can't hide her excitement either, and calls me about ever other day, wondering when I'm finally going to react more enthusiastically myself (for sure not before Friday's ultrasound and maybe not even before the end of the first trimester - which doesn't mean that of course I am really happy that we've already come this far, but also pretty anxious about everything). She also seemed a bit taken aback when she found out that my hubby had told one of his best friends, but I still haven't told my cousin.

Well... it's true that there might not seem to be much logic (at least to her) to which friends / family members we've shared the news with and to whom we haven't said a thing yet. It's just that some people we feel much more comfortable sharing it with than with others. In the meantime my mum is very proud of herself for keeping her mouth shut, which makes me smile.

By contrast, I got a lovely letter from my grandma (the only person my mum did tell), cautiously congratulating us, while not even daring to write the word 'pregnant'. Very sweet.

Tuesday, October 28, 2008

Job interview

This afternoon I had something to distract me from thinking/worrying about this little thing inside me: a job interview. Only the seventh in the more than three years since we've moved to France! This one was not even for a job in my field, but hey, after three years I though I might need to expand my search area a bit.

The biggest problem here in France is that if you don't have a degree from a French 'Ecole Nationale Superieure' of something something, you already don't really count. Then if you've studied something (music recording), but got a job/career in a related field (MarCom/organization, but still in music/audiovisual sector), but not quite what you studied, they get confused and don't know what box to put you in. This then usually results in that they throw your CV in the bin instead of making them curious and inviting you for an interview. On top of that, the professional networks are really really closed, especially the cultural/musical ones...

Oh well, today's interview was for a MarCom position at a business school. I think it went OK, but they really want someone with a marketing degree, which I obviously don't have. Honestly, I can't get very upset about it right now, this pregnancy is way more important at the moment (but yes, of course it would be great if I would finally have a job). I'm leaning more towards freelancing at the moment anyway, much more flexibility, and I think I could get some small projects going. The only thing holding me back is the French bureaucracy...

Friday, October 24, 2008

Decision made

OK - I've made my decision - and two appointments!

Third friend called back - had same OBGYN as other friend that was not happy (the third friend said she thought the doc was OK, but a bit cold).

No news yet from the one with the midwife contact, but I wanted my mind to stop racing and make an appointment for that first ultrasound soon. So got in touch with my friend who gave me the very positive recommendation and asked her about the separate ultrasound person - she said that she had that with both her pregnancies (in two different cities) and she would highly recommend her ultrasound doctor too (not one from the list that the other doc's assistant had given me).

So I first called the ultrasound office - appointment for next Friday, October 31 (they first wanted to schedule me for December, but I said that my RE had told me I needed the first ultrasound 25-30 days after the transfer), yay! Called the doctor's office right after that - appointment for the same day, after the ultrasound.

Feel OK about the decision. If after the first visits I have the feeling that I need to see someone more specialized, I can always change, right?

Still undecided

Well, I'm still undecided when it comes to choosing an OBGYN.

I called my friend's recommendation (the non-OBGYN) this morning, and she would be able to take me as a patient, but she doesn't do ultrasounds at her own practice, so I would need to go to a separate ultrasound office for that, which I don't really want to do.

My second friend does not recommend her doctor, and my third friend has not responded to me yet.

I did call the RE's office to ask for recommendations, but they say they don't know anyone except for Dr 'Speed'... So I considered maybe going to him after all, at least he knows my history, and even though he's speed, he's also quite human...

Hmm, so I called a friend who had several IVF cycles with Dr 'Speed' and stayed with him for the first five or six months of her pregnancy. She basically said that yes, I could go to him, but I would always sit at least one hour in the waiting room before he would see me and then have a very speedy consultation. So... probably not.

She did however offer to call her sister-in-law (who's a midwife) for me and ask her for OBGYN recommendations. So I'm waiting to hear back from her, as from my other friend who hasn't responded yet.

Oh yeah, the other thing I found out is that apparently here in France for the first six months of your pregnancy you go to an OBGYN and then for the last three you need to go to another one, who's affiliated to the hospital you want to give birth at, and whom you stay with until the delivery (but you cannot go to this one from the beginning of your pregnancy). Strange...

Thursday, October 23, 2008


Today I had my third beta: 853 - everything is going fine, yay! (and thanks to the betabase I now know that the doubling time between beta 1 and 2 was 48.1 hrs and between beta 2 and 3 49.31 hrs - if this interests anyone at all).

I had a strange conversation with my RE's office though. When I had gotten the result from the lab, I called my RE's office to tell them (standard French procedure, see my post below on 'labs and nurses - the French way). The assistant asked me if I already had an OBGYN for the rest of my pregnancy. Eh, no... She told me I could stay with them, but that would mean with Dr. 'Speed'. Eh, no thank you... Or otherwise find an OBGYN myself. Oh, but what about the ultrasound that they told me they want me to have about a month after the transfer (which means next week), would that not be done at the fertility clinic/RE office? No, I should just schedule that with whichever OBGYN I'm going to pick...
So that's it? No last 'good luck' RE visit? Why won't they do that first ultrasound? Wouldn't that be a better way to really say that the IVF procedure was a succes? I think it's weird...

Pff, so now I have to find an OBGYN. Of course I could call the RE's office tomorrow morning and ask them for any recommendations in my neighborhood (I forgot to do that this afternoon). I also asked three friends who live near me and had babies last year. One already responded and said she had a wonderful doctor, who was recommended to her by the hospital, but that she's actually a general practitioner, who does have a lot of pregnant patients, but is not an OBGYN. Hmm, if she was a real OBGYN, I would immediately call, but now I'm not sure. Maybe I should just call, explain my situation and see if she thinks I can be her patient or if I should go to a more specialized doctor?

Well, I have to wait until tomorrow anyway before I can call, so have some time to think this over a bit. If you have any great suggestions, please let me know!

Tuesday, October 21, 2008

Happy and sad

This morning I'm both happy and sad. Happy that my beta has doubled like it should have, that I dare to dream a bit more about what is to come (and therefore had a pretty bad night, because my head was way too full to fall asleep).

But I'm also sad, because my blogger friend PJ's beta dropped to 5 yesterday... I found her blog only about a week or two ago, and it was comforting to have someone who was in the 2WW at the same time, who was having similar neurotic spells, similar dreams, and who'd been through quite a journey herself too. I hoped and prayed that her beta would double like mine, and we could go on this special journey together.

I'd also like to use this to respond to those around us who tell us we should just relax, we shouldn't google too much, we should leave the pee sticks in the box, because we're healthy, so why should it not work... Well, as much as they are right, we have all been experiencing more negatives than positives, no matter if our fertility journey started 6 months or 6 years ago. So we have a reason to be cautious, neurotic, stressed out and overjoyed but still scared at a first positive result. Despite the hopes and prayers, despite us being healthy and perfect looking embryos being transferred back into our wombs, we know that it can go wrong. We've all studied equally hard for our exams, but why some pass and some fail remains a mystery to us.

All these thoughts never leave us, but especially during the 2WW, when there are no daily clinic visits, less or no hormones to inject, when we've done everything we could, and we just have to wait, they drive us nearly insane (thank god for blogging though!). We don't want to think about it failing and having to start a new cycle again (if that would be a possibility at all). Of course, because we don't want the injections, the clinic visits, but most of all, because we're afraid the next time will not work either and maybe it will never work at all...

So, I am hoping and praying that this one sticks. That my beta will continue to rise, that the first ultrasound will show a sack with an embryo, in the right place, that there will be a heartbeat, that I will be able to carry a healthy baby to term.

I feel very blessed already. I think I've deserved it, but I know there are many women who deserve this as much or even more than I do. So PJ, kalina, splitpea, emily, busted, and all those I don't know but are going through the same, I wish with all my heart that you have the strength to continue and that you will have BFPs very, very soon!!

Monday, October 20, 2008


Today's beta is 310! Yay!!

So, I'm now trying to calculate my doubling times (unfortunately the doubling calculator on doesn't work, at least not on my Mac) but I'm not that great at logarithms and exponentials... Exact number will have to wait until I have an Eureka moment or I'll ask a math-wizard, but a rough calculation gives a doubling time of just over 48 hrs.

3rd beta on Thursday.

Saturday, October 18, 2008


I've done something stupid this morning: I took a home pregnancy test. It was positive (of course), but the line was not as dark as I would have hoped. So now I'm worrying that my beta is going down instead of up...

Of course this is completely stupid, because I have nothing to compare this line to - I didn't test yesterday or the days before and I don't have another kit at home, so can't test tomorrow (my initial idea was to buy several kits and test a few days in a row, but in the end decided I shouldn't spent too much money and try not to obsess about it).

Other than that my symptoms are still the same: sore breasts, tired, lower back pain, and some (minor) cramping. I wish I could just be a normal ignorant pregnant woman...

Wednesday, October 15, 2008


Well, of course I had to google some more about hCG levels and luckily found some quite reliable sites that were able to reassure me that 55 is actually a pretty ok number and that you basically can't say anything after just one hCG test. So a new waiting period starts - 5 days until Monday - but for the moment I'm pregnant!

So far so good

Got my beta hCG result: 55 - BFP!
Well maybe not BF, the number seems quite low when I compare it to what other women had at this stage (12dp3dt), so I'm not jumping for joy yet (it's also quite surreal to have a BFP after more than five years of TTC/BFN). But the assistant at the clinic said it was positive and we should wait and see what the second beta is on Monday. If that one's OK, then maybe I'll be able to relax a bit more...

Tuesday, October 14, 2008


Another not so great night. Lots of trips to the bathroom. After the fourth one I finally registered in my sleepy head that it was more cramping than having to pee that woke me up. Not super horrible cramping, but still, it kept me awake. In a normal cycle I would have swallowed an Aleve already, but don't want to risk anything now. Tried lying on my stomach / curled up / deep breathing, but it didn't help much. Finally put one of those microwavable heat things on my stomach, which worked and allowed me to sleep for another hour until the alarm woke me up.

No night sweat this time, although now and then some minor hot flashes. Breasts still hurt, no spotting or bleeding yet, so I'm still hopeful (or am I just in denial?). Also felt better after seeing that someone left a comment on my blog (yay! thanks PJ!) and reading a long email from my sister. Hubbie left for the airport, I think I'm going back to bed for a little bit.

Monday, October 13, 2008


Had a horrible night. Got up four times to go to the bathroom (note to self: don't drink too much tea just before going to bed). Woke up again around 5.30am from a night sweat. No!!! Tried not to freak out too much, stayed under the covers and managed to fall back asleep. But of course then the dreams started... Woke up half an hour later, crying - because I knew it was all over: night sweats and no more sore breasts (I dreamed other, really ridiculous things, but that's not too uncommon for me). Hubbie asked what was wrong, so I told him, then checked my breast... still hurting. So I calmed down a bit, but still not happy about the night sweat. Now I'm slowly trying to start the day as normally as I possibly can...

Friday, October 10, 2008

Labs and nurses - the French way

I had to go to the lab on Wednesday to have my estradiol level checked. Here in France, you can't just go to your own clinic to get this done, but you need to go to a 'laboratoire d'analyses médicales' of your choice (there are lots of them). In a way this is convenient, as you can choose one that is close to home or work, but what I hate about it is that these people at the lab have no knowledge at all about your medical/infertility history, and sometimes ask stupid questions, which would never be asked if you could have this all done at your own clinic. Plus, it's not just only for the (simple) blood work, but I also had to go there for a pre-IVF vaginal examination (so they asked if it was for a yeast infection...). On top of that, you always have to call them yourself for the results, they will never call you.

In the case of the estradiol test, if it would be under 500 pg/ml, I would need to get a HCG shot, which had to be administered by a nurse. Again, for this you can't go to your own clinic, but you have to call a nurse yourself, who then comes to your home. This is of course convenient for chronically sick patients who have trouble leaving their home, but I find it adds additional stress because you sometimes have to try to find a nurse at the last minute (you get the test results in the afternoon and need the injection the same day) and you always get their voicemails, so you're never sure when and if they get your message.

So I planned a bit ahead and left a message with a nurse close to where I live (also important, because if you live too far away, it's not worth it for them to come to you as I think they can only charge 3 euros for a home visit) on Tuesday morning, saying I wanted to make an appointment for Wednesday, but I was not sure that I needed one... By 6 pm I still had not received a response, so I left another message. Got a call back within 15 minutes, there was no problem, she would come by the next day between 5 and 6.30pm, I just needed to confirm or cancel Wednesday before 4pm.

In the end, too much stress for nothing, because my estradiol level turned out to be 1982 pg/ml, well above the 500 pg/ml threshold, so I didn't need the hormone shot after all...

Going crazy

I woke up very early this morning from a night sweat (and a brief, sharp pain in my belly), which freaked me out completely, because usually this is a sign that my period is only a few days away... so now I try to find reasons why this time it might be different.
  • My breasts still hurt - I know this is probably due to the progesterone, but during my first IUI cycle I didn't have sore breasts at all, and during the other ones it stopped about three days before my period would start (so, this can still happen, but the night sweats would be during those last three days...).
  • Every day I'm dead tired in the afternoon. I've had this before, and I know it might as well be a sign of PMS as of early pregnancy, but I think this time it started earlier...
  • I had a night sweat last weekend too. Way too early to be associated with impending period...
  • I seem to be a bit clumsier than usual...
Maybe I should buy a test kit and start testing already, but I'm too afraid the result will be negative. Wednesday seems a long way off...

Thursday, October 9, 2008


My blog has been locked since Tuesday morning because Blogger thinks I'm a spammer. They said they would fix it within two business days, but I guess due to the time difference between here and California, it's already going towards three. Grrr...

Monday, October 6, 2008

No reserve

I just talked to the embryologist. None of the five remaining embryos continued to develop enough to be frozen for a possible future cycle... I feel a bit empty. These two inside me really need to hang on now!

Sunday, October 5, 2008

Giving them back

Friday was transfer day. We had to be at the clinic at 8.15am. Traffic was horrible and I was afraid we would be late (only by about 3 minutes, while hubby was still looking for a parking space, but I still arrived ahead of the doctor). I heard him come in, Dr 'Speed'... "En route!" and off we went to the transfer room, which wasn't ready at all yet - the cleaners had left the waste bin on the step of the exam table, and the doctor's stool was also upside down on the table. So he jokingly complained about it and opened the 'drive through window' to the lab (this window is something that really surprised me when I had my first IUI: you're in stirrups and suddenly the doctor opens this window/door behind him, which opens up to the lab, from where a lab technician will hand him the catheter while checking your name. All the while you're in stirrups with full view to/for the lab... oh well).

While I was getting ready, one of the lab technicians came up to the window to say that they would transfer two embryos back after all, because the quality was not too great and they wanted to give it the most chance (I had briefly discussed this with the embryologist before my discharge from the hospital on Tuesday - we'd choose one, unless the quality would be so-so). My heart sank, until a second lab technician said that one of them was actually looking really good and the other was a bit behind. The procedure itself went all pretty quickly, but it was a bit uncomfortable (I had a hard time relaxing), basically the same as with the IUIs I've had. No guiding ultrasound (the doctors at my clinic must be very sure about themselves, ha) and no gifts of petri dishes and/or photos of the embryos, like they apparently do in the US (but hey, a whole IVF cycle costs a lot less here too, so US patients are entitled to some additional perks I guess).

Just as the doctor was leaving the room, hubby arrived and asked if I was in there. So of course Dr 'Speed' took the opportunity to make a few more jokes. "Is this really your wife?" "Are you sure this is your husband?" A bit lame, but still good to get rid of whatever stress was left.

Had to go to the secretary to get some paperwork done, pay for the ultrasounds, triggering and transfer (all to be reimbursed a 100% later by the insurance). She also gave me some instructions for further blood work, continuation of the progesterone suppositories , and a possible additional hormone injection next week if my estrogen level is under a certain level.

After that we got to talk to the embryologist. She's very kind and reassuring. She told us that out of the 14 eggs, initially 8 were fertilized, but one with two spermatozoa, so that one had to be discarded. Of the the two that were transferred back, one was looking very good (the embryologist thought it was "très joli"), with 8 cells, and one that was a little behind, but otherwise still ok, with 6 cells. The other five were also a little slower (between 4-6 cells I think), but also showed fragmentation - she told us that they don't really know why that happens, but they wanted to keep them until Monday to see if they would develop to blastocyst stage without further fragmentation. If the fragmentation is 50% or more, they won't be able to freeze the embryos....

The coming 12 days will be testing our patience to the max. Here's hoping...

Thursday, October 2, 2008

There is no real answer

Well, I ended up sleeping most of the afternoon, the day of the 'ponction'. Yesterday I still felt pretty tired, but today is OK. Abdominal area is still feeling very tense though, but I think it's more from the stimulation than the 'ponction'.

Yesterday I felt quite insecure about our decision to only transfer one embryo. Would it be enough? Should we change to two or not? But what if one of the embryos divides after transfer..., I don't want triplets! Talked with hubby about it, who had some great philosophical answers, but it mainly came down to that he doesn't want me to run too much health risks and we can always decide to do two the next time, if this time fails. I did some additional research on the web and in some books I have at home, had a good night's sleep, and this morning came to the conclusion that we should stick to our decision. A lot remains speculation, we'll never have definite answers to all our questions, and certainty about which risk outweighs the other. Just statistics and our our gut feeling. So we'll keep it at one this time and hope for the best.

However I still had prepared some questions for the embryologist for when she would call today. When the call came, it was not her, but a lab technician, who actually just wanted to tell me at what time I need to come in tomorrow for the transfer. Luckily I did manage to ask her what the results were: 7 embryos. Not bad! But no additional info about quality etc. Have to find that out tomorrow morning, when we'll speak with the embryologist. The rest of my questions have to wait until then as well...

Tuesday, September 30, 2008


So today was egg retrieval day, or 'ponction' as they say in French. Got up at 6 am and had my betadine scrub shower (yum!). We were at the clinic just before 7.30 am. Went all pretty quickly from there: was shown my room, changed into the hospital gown, hubby left for the lab to do his thing, and a few minutes later the nurse came to have me sign some paperwork and put in an IV for saline drip.

Was wheeled to the OR around 8 am. The OR nurse double checked all my information while still in the hallway, somehow I felt like I was already sedated, but it must have been the stress that made me feel like my answers came out very slowly. Saw that it was my own doc for the procedure, luckily not Dr 'Speed', that would not have been very good to get my stress-level down... The anesthesiologist got to work and I slowly 'floated away'. When I woke up again I was wheeled into the recovery room, it was 8.31 am. Stayed there for about 20 minutes. Was feeling OK, but still out of it - no wonder with blood pressure at 112/47 - 114/51 - 112/53.

Back in my room the nurse again checked blood pressure, bleeding (a bit) and asked if I had a lot of pain - it wasn't too bad, so I gave it a 4 on a scale from 1-10. Hubby came back after about 30 minutes, which was nice. For a moment I thought the pain was getting worse, but luckily it subsided again. At about 10.30 I got a little breakfast. The tea tasted like coffee, so after three sips I left it for what it was. Had some yogurt, toast and water. Blood pressure and bleeding were checked again and we tested if I could get up without fainting or feeling dizzy. Everything was fine, so the nurse took out the IV and I could go to the toilet.

After about another hour they told me I could get dressed again. A few minutes later another nurse came in to give me back my paperwork and told me to wait for the embryologist ('médecin biologiste'). After that I was free to go home. The doctor came in and told me they had collected 14 eggs, everything looked good. They would call me on Thursday about the results and set a time for transfer on Friday.

We were back home around 12.30pm, had lunch together and then hubby left for work. I'm lying on the couch, feeling OK, but a little tired, so I'll take it easy for the rest of the day. Not much pain, just a bit of a dull ache.

Saturday, September 27, 2008

Triggering tomorrow

Ultrasound exam tonight was much more relaxed with the other doctor. He was early, so now the waiting was for the nurse. Not to worry about abdominal pain, is normal. 10 follicles, between 15-18mm so triggering tomorrow evening, ER on Tuesday morning...

Abdominal pain

I've been experiencing some abdominal pain since Wednesday evening. Of course I immediately though I would be overstimulated and they might have to cancel my IVF cycle, but at the check ups everything was normal. I had told myself to ask the doctor though, but Dr 'Speed' really didn't give me any chance...

Because I was driving myself crazy speculating, I decided to call the clinic yesterday and talk to my own doctor. He wasn't there. So I told the assistant, who asked me why I hadn't talked to Dr 'Speed' about it, but she seemed to understand somewhat when I explained why, looked at my file, said nothing seemed abnormal (estrogen levels Mon: 310; Tue: 503; Wed: 882, Thu: 1388 - about 10 follicles, between 10-14 mm in size on Thu), and advised me to lie down a bit and maybe take a dolipran (=tylenol/paracetamol), and talk about it with the other doctor on Saturday.

Yoga class was a good distraction yesterday evening, and today I hardly have any pain either. Maybe it's only between my ears...

Friday, September 26, 2008

Dr 'Speed'

Dr 'Speed' has a regular OBGYN practice, but here at the clinic he's also the expert 'echographiste', i.e. ultrasound expert. I'm slowly getting used to his way of working, but he can still make me feel completely rattled.

He is always late. Most of the time around 15 minutes, but sometimes half an hour, and one time even 45 minutes, which made all of us women with full bladders in the waiting room feeling like we were going to explode any minute.

When he's finally there, you get the impression he tries to make up for his lateness by speeding us all through the ultrasound exams in no-time. If, heaven forbid, your bladder is either too full or not full enough (so he can't see your ovaries on the ultrasound), he'll send you back to the end of the line (which is a real bummer if you initially were second in line, and suddenly you're nr. 10), no mercy. He sees the follicles on the ultrasound, measures the biggest and then is able to write down the size of the rest as well. It seems to be pretty accurate... Before you have time to pull up your pants, he already opens the door to summon the next patient in.

Last year, when I had to come in for my IUI cycles, he somehow realized he was making me very nervous, so he started making jokes to make me feel a bit more at ease. Which helped, more or less.

However, last Wednesday he got me completely confused. While doing the ultrasound he said something like "it's Friday", so I reacted surprised. "Yes, yes, because we'll skip two days... - if you're OK with it" which made me think that he was talking about the time between triggering and egg collection, which confused me even more, because he had just measured the largest follicle being at 13mm, so not big enough at all to trigger ovulation. I already started to panic that I hadn't brought my Ovitrelle, so I mentioned that to him. "No, no, you don't need that". So I told him I was now very confused. "You just take 125 IU of Puregon tonight and come back tomorrow. Au revoir, Madame". Ugh.

That night I had a nightmare: Dr 'Speed' had forgotten to tell me how many IU of Puregon to take, so I asked my own doctor, who told me 500! Which freaked me out, because it was way to much, but no, no, it was necessary, because my follicles were not growing quickly enough... Luckily I woke up at that moment.

The next day I wanted to ask Dr 'Speed' about some abdominal pain I was experiencing, but again, the whole thing went so fast, and then he got a call on his cell phone, and walked out of the room... Before he got the call he'd made a note for the doctor who would do the ultrasound on Saturday, to say that maybe we'd trigger on Sunday, and had written down how much Puregon to take that evening, but had not given any instructions for Friday, which I needed since there would be no ultrasounds that day. The whole thing started to ressemble my nightmare a bit too much...

While the doctor was on the phone, I told the nurse about it all. He's great and we had a good laugh. Finally Dr Speed was done with his phone call. So the nurse asked him about the instructions for Friday 'for this woman who's triggering on Sunday'. "No, that's not what I said, I said MAYBE trigger on Sunday, that's up to the other doctor who'll do the ultrasound on Saturday!" So he added four more question marks to his note, gave the instructions for Friday and off he was.

Before I left, the nurse told me that if I would wake up screaming that night from another nightmare, I should think of him, because he was probably having one too!

late nights

No ultrasound or blood work today, the doctors and nurses have Friday evening off. I'm glad, because the whole week I haven't arrived back home before 8.30pm and then we'd still need to eat (not such a strange dinner time in France, but still). At those times I really miss all the great take-out places we had in the US, no such thing here...


Started follicle stimulation on September 16. Six days of 150 IUs, then first blood test and ultrasound on September 22. I thought I had brought the whole 'how much water to drink to have a full bladder without feeling I'm exploding' down to a science after six IUIs, but apparently the break was too long, because my bladder was too full, so it masked the ovaries on the ultrasound! Luckily it was not doctor 'speed' (who would've sent me to the back of the line) this time, but a more gently one, who just waited while he let me pee (just a little bit, which is pretty difficult if you have a full bladder). The ultrasound just showed 7 follicles - 2x 7mm on one side and 5x 5mm on the other side. I was a bit disappointed, but the doctor said everything was fine, I should continue with 150 IU Puregon and come back the next day...

Enantone side-effects

I was prepared for hot flashes and other menopausal side-effects that Enantone might give me, but not for two weeks of diarrhea! After a few days I called the doctor's office to check if this could indeed be a side-effect.

My own doctor wasn't there, so the assistant told me to call his colleague, the one that usually does the ultrasounds. I've known him since my IUI attempts and he is always very 'speed', something I really had to get used to (if I ever have...). So I got him on the phone and told him that I wanted to ask him about possible side-effects of the Enantone. "You're bleeding!" he said. I did, but I had read that that could be normal, so that did not worry me too much. "Yes, but I also have diarrhea, could that be related?" "Yes, that's possible, listen, everything is fine, I've got a call on the other line, see you at the ultrasound. Bye!" Ugh, if I hadn't met him before I would have been really upset. Now only just a bit...

So I went to the pharmacy to get something to quiet my intestines down, luckily the pharmacist was a lot more understanding than the doctor and confirmed that it was indeed on the list of possible side-effects of enantone. Pff... it finally subsided once I started the Puregon injections on day 20.

Enantone injection

Started my first IVF cycle on August 28 with an Enantone LP injection, to suppress my normal hormone cycle. Thought maybe I could do it myself until I got back from the pharmacy and saw that it was a real DIY package: two tiny bottles, one with powder, the other one with solvent, which you had to suck out with the pink colored needle into the syringe, then add it to the powder, mix, suck it into the syringe again, change to the blue colored needle and inject the mixture into your belly.... Some great catastrophic scenarios flashed before my eyes, so I decide to make some calls to try to find a nurse to do it for me. Finally found one who was able to come by the same day. Nice guy who made the whole mixing thing seem very easy, but I'm glad he did it instead of me. The French system is pretty good, nurse comes for a home visit and you just give your "carte vitale" (insurance card) at the end, he puts it in some calculator, and the costs are immediately charged to the insurance company. It seemed that it's very under-paid though - he was talking out loud while typing away on his calculator and apparently they can only charge 3 euros for the home visit and 2,50 euros for the injection...

A start

Instead of hijacking two excellent blogs on IVF - Fertile Mind and emily the hopeless (see the side bar for links) - with my comments, I decided to start my own. I'm midway through my first IVF cycle, so there will be some 'flashback' posts, but I hope to be able to catch up soon.