· By Tiny Hearts Education
Nikki's IVF Journey
In 2011, a few years before James and I were married, James was diagnosed with testicular cancer and underwent both surgery and radiation treatment. No matter how common the word cancer is; when it’s used in reference to someone you love, it’s overwhelmingly scary. We knew however it was a “good” cancer to get and thankfully after a tough five months he was given the all-clear.
Flash forward a couple of years, and we were now married and talking about having kids. After a couple of months of trying, we started to wonder if maybe there was an issue. I gently persuaded James to see his GP; who unfortunately told him it was a very unlikely and almost a ridiculous thought. Another month, another period. So, this time I told him we would both undergo fertility testing. An awkward moment in a fertility room for James and a blood test for me later, and we had our answer. I was completely fine – incredibly high egg count; gold star for me. But unfortunately, James was not so fertile. We were told he had a less than 1% chance of ever being able to father children naturally; the main culprit being poor sperm morphology (i.e. the shape - they had two heads or something). It was presumed that it was from the effects of cancer rather than his treatment.
Being told that you need IVF is just as hard really as hearing the word cancer. Your mind goes back and forth between the reality and the what if’s. The big what if being – what if it doesn’t work? Your heart grieves your life before this new normal. It’s a hard thing to process. So, we took a few months to let the news settle, and in the new year, we returned to our clinic ready to start.
We met with our specialist, and after genetic testing, blood work, internal ultrasounds, comparison of the sperm he had frozen before treatment and many discussions of our options; we made a plan. We decided, in the end, to use IVF with a process called ICSI. This technique is where they inject the sperm directly into the egg, which is different from typical IVF where they simply put the sperm and egg in a dish together. Using this technique moved our odds from 1% to 40%. It was a no brainer, really!
I started having regular blood tests and internal ultrasounds from the day of my period so that they could pinpoint ovulation accurately. I had to go into the clinic every few days, and after a few visits, I was given my pack of injections with various drugs to stimulate my egg production. I was taught how to inject myself and given very specific times when each needle had to be done. I was also advised to keep well hydrated and expect some mild symptoms such as bloating and mood swings. We were in Tassie for a wedding at the time I was to start, and I remember nervously laughing as I put on my black tie dress and then hitched it up for James to do the first injection. It was a surreal experience, but it wasn’t as bad as I expected. I couldn’t quite bring myself to do the actual injecting for some reason, so James committed to doing them for me. We worked out that icing my tummy first was a good way to numb it slightly. Mostly they were okay, but occasionally they hurt or would get a bit caught as he pulled it out. After about a week we returned for more internal ultrasounds, and blood tests and I moved to two a day. Initially, an implantation day was booked, but my eggs were still immature as I have very long cycles, and it was moved by two days. When you’re so emotionally (and physically) invested in the process, two days can feel like a big blow. But eventually, I reached ovulation, I injected the trigger to tell the eggs it was time, and we headed into the hospital on the 24th of April for the big retrieval.
The day itself was fairly straightforward. We arrived around 6 am, filled out some forms and were taken to a room on the ward to wait. After an hour or so, I was taken downstairs for the retrieval. I was in theatre for around half an hour, and after a bit of a groggy wake-up, I soon woke up enough to talk through the egg count. Often, they see a lot of eggs on the ultrasounds, but when they go to collect them, they aren’t mature enough. My last ultrasound predicted 18 eggs, and to my happy surprise, they retrieved 16. James, of course, was off contributing in his own way in a small room at the back of the hospital! I was discharged by about 9:30 am and spent the next few days with pretty bad bloating, but otherwise, I was okay. Each day following, they called us with updates. From 16 eggs, we got nine embryos; from 9 embryos we got three that divided into Blastocysts. We were a little disappointed it was only three, but still very grateful. After the egg retrieval, I had started progesterone pessaries to allow my uterine wall to thicken in preparation for the transfer. Then after five days, we headed back to the hospital for our embryo transfer. We went into the room and straight away saw our embryo! I was instantly bonded to it. I felt so sure that that embryo was going to become our baby. I can’t explain it. I lay back on the chair, propped my legs up into the stirrups, let our doctor work her magic with a speculum, and that was it. Our embryo was transferred. She checked that it was successfully transferred from dish to uterus using ultrasound and we saw a clear, bright white dot indicating it had gone smoothly—a very surreal moment.
Tilly as an embryo
We left the hospital laughing at the whole experience, and after that, the waiting game began. I had a bit of cramping and very light spotting, but otherwise, nothing was too obvious either way, and I figured the progesterone was playing into those symptoms. When the weekend came that I was expecting my period, I started to feel hopeful. I was due for a blood test on Monday - the 11th of May – a day I’ll never forget; a month exactly since that first injection. I went into the clinic for a blood test and headed off to work, trying to pretend that everything was fine. At about 9 am, I was driving in the rain to a work appointment and madly drove off to the side to take the call from my fertility nurse. “Congratulations, you’re pregnant”! The sweetest words I’ve ever heard. She gave me dates for different things and talked through what I needed to do from here, but I was already on another planet. I was pregnant. It had worked!
I was due for an ultrasound at eight weeks with our fertility specialist, but at six weeks, I had a bleed, and so it was moved a week earlier. I was reassured that sometimes with IVF, bleeding can be common, and after a few hours it did settle down, which was also a good sign. The day came for our ultrasound, and I was nervous as hell, but once I saw that big beautiful beating heartbeat, I knew everything was going to be okay. The moment I saw that chicken nugget with limbs, I knew it was a girl, and I knew she would be ours. And sure enough, nine months later she arrived safely into our arms.
Tilly one-hour old
I can’t begin to express how lucky we feel that our first attempt at IVF was successful at making us parents. When we went back for our second attempt; however, things weren’t quite as simple. At our first appointment with our fertility specialist, we saw photos of our two other embryos who were currently living comfortably in a freezer and discussed our options. As our first transfer had been so simple, we decided to try for an “unassisted frozen cycle”. For this transfer, all we had to do was monitor my body’s natural cycle, wait for ovulation and pop the embryo back in. It turned out, however, that this was a particularly long cycle and I didn’t ovulate naturally until around day 26 when typical ovulation is around day 14. There was talk about me going on hormones to speed up the process but the very next day I spiked, and it wasn’t needed.
Meeting with our specialist for our round two IVF treatment
Again, we returned to the hospital, saw the embryo, transferred it and saw the little white dot. Weirdly though, for that transfer, I remember seeing the embryo and apologising to it because I didn’t feel confident it would take. I don’t know why I thought that, but I did. Over the next ten days or so I had quite bad cramping and brown spotting. I tried to convince myself this was a good sign, and so I returned to the clinic for my pregnancy blood test, sceptical but hopeful. I finally got a call around lunchtime. It wasn’t those same sweet words this time. I was told by our nurse, that I was pregnant, but the numbers weren’t as high as they would expect at that point and that it was likely I would miscarry. I was so shocked. I didn’t even know that was a possibility. I just expected pregnancy or a no pregnancy answer; not this somewhere in-between scenario. I continued to go in for blood tests to see what this pregnancy was going to do, but sure enough, though the numbers continued to drop and a week later, I started to bleed; a big messy, clumpy, painful bleed. It was a pretty sad time.
A few weeks past and we decided to work towards our next cycle. This time, on advice from our specialist, we decided to try for an “assisted frozen cycle”. This time, rather than waiting for my body to ovulate and using my body’s natural cycle, we used a lot of hormones to tweak things. This was by far the hardest cycle of all 3. I was on a range of hormones in tablet, pessary and patch form. I felt so sick from the get-go with migraines, bloating and nausea. Again, I had blood tests every second day, and this cycle thankfully was much shorter, and I ovulated at day 18. Everything felt like it was on track. We returned to the hospital for our transfer, and it just felt so different from the time before, I felt relaxed and trusting in the process. Maybe I’d faced failure and knew we had survived, perhaps I just knew everything would be okay. But I was confident this time would work, just I had been with Tilly.
Hormones required for my third round of IVF
Again, another white dot, another giggling walk back to the car park and another 10+ day wait. This time, however, I had absolutely no symptoms. So, despite my initial confidence, I convinced myself that it hadn’t worked and I was okay with that. However, a surprise was instore and one blood test and a phone call later, I heard those sweet, sweet words again “congratulations you’re pregnant!”. The thrill was just as big the second time as it was the first. That little surprise turned into a baby boy Henry who is a busy, cheeky, happy 20 month old.
Pregnant with Henry
The question remains, of course – will we have more children? Everyone wants to know, and until we say categorically that we are done they will keep asking. The truth is, I don’t know. There is a part of me that would love to have another child, but it’s just not that simple for us. We have no more embryos left. Each cycle on average cost us about $3000 out of pocket for various reasons. IVF is taxing on your body. There are many factors to consider for us around the idea of another child. So, for now, we enjoy the two beautiful kids we have.