How long should you wait to disregard other people’s feelings?

Having personally gone through (and still living with) the tourment of infertility and subsequently the IVF journey I understand how hurtful it is to see baby scans and pregnancy announcement after pregnancy announcement.

So when I became pregnant myself I tortured myself with the debate of posting my happy news announcement because I knew some of my friends were in a similar position as me.

It can become so exhausting worrying about what other people might think that at some point you have to tell yourself enough is enough. Yes, your little announcement might upset a couple of friends but true friends (and those in the same position) should be happy for you.

If not move on. You don’t need to be friends with the whole world nor do you need to be liked by lots of people. In the baby journey the only people that matter are you, your partner and the little miracle you’re growing. Ok immediate family as well and possibly your BFF but really you need to stop with the whole “oh what happens if Jens, uncles’ best friends jack Russel will get upset if I post a 12-week scan” attitude – move past it and live.

Then once that miracle is born share as little or as much as you want too. It’s your life, your rules.

Katherine xox

IVF: the two week wait (2WW)

You have just had your embryo transfer, taken a home pregnancy test and told which day to do the test now what?

Well the first day or two you are likely just recovering from the procedure. You may feel tired, bloated and have some abdominal discomfort similar to period pain. You may also suffer from mild to severe Ovarian Hyperstimulation Syndrome (OHSS).

You can use a hot water bottle to help with the pain but remember not too hot and not directly in contact with the skin.

You can take baths but not too hot. Sometimes it is recommended to resist the use of bubble bath during the next two weeks. Some research suggests that bubble bath can irritate your already delicate vagina and cause thrush or another form of infection.

Common questions:

I’m so bloated / Am I pregnant already?

It is normal to feel the size of a house and look about 5 months pregnant during the two week wait. You can thank good old progesterone for that.

You can drink herbal teas like peppermint to help combat the bloat. It is recommended to up your intake of water as this can help flush out any trapped fluids / constipation.

I’ve got terrible pain / discomfort in one or both my ovaries.

You’ve been through a lot the last few days and weeks. The stimulation medication will have left your ovaries slightly larger than normal (think tennis balls). This can cause discomfort and or pain on one or both ovaries. This symptom shouldn’t be ignored entirely as it could be mild OHSS. Sometimes (but it is rare) OHSS can be severe and lead to serious illness or death. Mild OHSS should resolve itself within 7-10 days (or by your next period if you are not pregnant)

If you are experiencing severe pain and any of the following seek medical attention:

  • rapid weight gain 15 – 20kg (33-44 pounds) within about 5-10 days
  • severe abdominal pain
  • severe or persistent nausea and vomiting
  • blood clots in one or both legs
  • decrease in urination
  • shortness of breath
  • tight or enlarged abdomen.

You can self-help with mild OHSS by increasing your fluid intake preferably with electrolytes. Rest as much as possible and increase your daily protein (at least an extra 60grams).

I have sore boobs / itching nipples

Once again our friend progesterone and the HCG trigger show injection are to blame. This may feel like a very very early sign of pregnancy which is driving you mad. Whatever you do refrain from doing you home pregnancy test. You could get a false positive due to the trigger shot days before.

I feel so sick is this normal

Remember you’ve been through a lot the last couple of days / weeks. You are likely to feel nauseated from the hormones you are still using. That combined with nervous excited can leave a nauseous butterfly sensation in your stomach. Try to eat little but often and plain foods if easier like toast. Also it is worth noting that early pregnancy can cause a decrease on your immune system making you susceptical to germs, coughs and colds.

It’s been a week and I feel like I’m about to have my period

Early pregnancy and your period have a lot in common with each other. Try not to focus too much on the cramping sensations just yet. It could be implantation which usually occurs about day 9. Implantation can cause bleeding (but not everyone gets this). It is usually brown in colour. Some ladies have a little spot of blood in their pants and others a little bit more. Bleeding can last a couple of hours to a day or so. If the flow has increased and / or you are starting to fill a pad every couple of hours unfortunately it is likely your period has arrived. Still wait until test day just to confirm.

Try not to focus on the implantation bleeding if you haven’t had any and your on day 10-12. Not everyone gets this.

I feel pregnant already should I do my test early?

You should only do your test on the day that the clinic told you. This is because they have worked out approximately 14 days after transfer is when the artificial trigger shot of HCG should be out of your system. If you have fallen pregnant your ovaries will take over the production of HCG and this is what is picked up on a urine home pregnancy test.

Can I go on holiday during my two week wait?

Yes, why not. You may feel a tad uncomfortable first couple of days after the transfer. Whether you want to go abroad for a week or just have a long weekend away with your significant other anywhere where the two of you can focus on one another is nice.

Can I have sex during two week wait?

Yes, however if it is uncomfortable hold off for a bit until you feel ready.

Is it true I should only use the first pee of the day for my test?

Yes and no. If you are pregnant the test will say so regardless of when you pee on the stick. It is true that the concentration of the pregnancy hormone HCG is slightly higher in your first urine of the day.

Help the line is really pale does this mean it’s negative?

No. Some tests are much more sensitive than others. If you can see the additional line regardless or dark or pale you are likely to be pregnant.

Some ladies rush out and get brands such as clear blue with digital indicator. These tests are the same as the cheaper versions but actually say pregnant or not pregnant.

My test was positive now what?

Congratulations you are pregnant. Now you need to ring the clinic. You will be asked to pop in. You will be given your maternity file notes and additional progesterone if required. You will likely be booked a viability scan for around week 7.

My test was negative

Unfortunately for some this can happen. You will still need to phone your clinic and let them know the outcome. You will still need to take your progesterone until advised when to stop.

I feel alone and ignored by my clinic

Now that you are in the two week wait you are left in natures hands. You have likely had daily contact with your clinic over the last few weeks and now feel abandoned. It is true that you don’t really speak to the clinic but the nurses are available to answer any queries you may have.

There are several support groups on social media available from Facebook to instagram. You may enjoy the silence and peace or you may wish to speak to ladies in a similar situation.

Katherine xo

IVF: embryo transfer

Whether you have had a fresh cycle or frozen cycle the procedures are very similar.

Progesterone

You will have likely started using progesterone pessaries with the first one inserted just after egg collection. The pessaries are normally recommended for rectal insertion until after the embryo transfer. This is due to them leaving a waxy residue which can make embryo transfer difficult if this is in the vagina.

The progesterone is provided to help keep your endometrium (uterus lining).

The procedure

You will speak with your embryologist prior to going down to theatre to discuss the quality and quantity of embryos for transfer. It is recommended for one embryo to be transferred regardless of age to minimise the chances of a multiple pregnancy. (Read here for more information of choosing number of embryos)

You will arrive at the clinic once again and escorted to a cubicle with your partner in attendance. You will require a half full bladder for this procedure and depending on the length of wait can become uncomfortable.

You will walk down to theatre (or wheeled depending on the clinic). You will remove your dressing gown and pop onto the bed. You will be asked to lay down and place legs into the stirrups. Your bottom half will be covered with sheets and your abdomen temporary exposed whilst they pop some lubricant on for the ultrasound scanner. Your bladder will be checked at this stage to make sure it is full. The full bladder helps with embryo transfer. You will feel some slight discomfort from the pressure applied.

Your partner is able to attend theatre with you and they will sit just next to your head and hopefully hold your hand throughout.

The embryologist will repeat several times the process and ask you to confirm your full name and date of birth a couple of times throughout.

You will be shown your embryo(s) on a television screen just before transfer.

Will it hurt?

Yes, it could hurt depending on your personal threshold of pain. For most women the procedure is like a very uncomfortable invasive smear for others its sharp or dulling ache in the lower abdomen.

You won’t be given any medication or sedative prior to embryo transfer.

The transfer

You you have a practice transfer using saline solution before the actual insertion of the embryo(s). This is to check that the tubes are clear. Once you have confirmed your details and seen your embryo(s) on the screen the transfer will begin. You won’t actually feel them insert the embryo(s) as it is so tiny.

Afterwards the tube and vagina clamp will be removed. Don’t feel ashamed if at this stage you feel like you’ve just relieved your bladder all over the bed. It is actually the residual saline flush escaping.

You will be helped off the bed and shown an ultrasound of your uterus before and after the embryo transfer. This may look like a little flash of light on a dark background. You will probably be thinking of nothing other than going to the toilet at this stage so probably I’d your head and go ‘oh yeah, wow’ it’s not that your ungrateful but you are likely uncomfortable from needing a wee so badly.

You will pop back into your cubicle and asked to rest for a little while. Have a drink some biscuits pop to the loo again and the. You will be allowed to return home (or to work).

You will need to continue taking your progesterone pessaries and can start vagina insertion if rectal had caused discomfort from constipation.

You are now on your official two week wait (2WW).

Katherine xo

IVF: egg retrieval process

You’ve done your stimulation injections and now you’re going onto the next step but what it is?

Up to 48 hours before your procedure you will self-inject with HCG hormone to help release your eggs.

You will arrive at the clinic about an hour before your allotted time slot. Change into a theatre gown and have a cannula fitted and left to wait. You will hopefully have a partner there for support. Your partner (if applicable) will provide a sperm sample whilst you are in theatre, this will be cleaned and combined with your eggs for fertilisation latter in the day.

You will likely walk down to theatre and be asked to remove your dressing gown and lay on the bed. The anesthetist will inject several items through your cannula one is a saline solution to flush and make sure your vein is ok. You will be given anti-sickness medication and some sedative. The sedative is designed to help you relax and doesn’t take away any pain. For some ladies the sedative can make you groggy or fall fall asleep but not everyone is lucky to experience this.

Will there be pain?

Yes, you could experience pain or mild discomfort this is very much dependent upon your personal pain threshold.

You will be given some sedative which is designed to help relax you and is not actually pain relief. If you experience some significant discomfort you may be topped up.

What will it feel like?

The procedure itself starts of feeling like a very invasive smear test. The consultant will use long medical needles to extract your eggs from their follicles. These are inserted into the vagina and up to your ovaries guided by ultrasound. The first needle may take you by surprise and can be uncomfortable or painful. Depending on the number of follicles (which would have been stated during your intravaginal ultrasounds days before) will depend on how many times the needle is inserted. Remember if you have follicles on both ovaries the procedure is repeated on both sides.

If you are not great with pain please speak with your consultant before the procedure. You will find it better to try and relax during the procedure. The more relaxed you can try and make yourself the less tense your uterus will be. You could be in theatre for up to 20 or so minutes.

What happens after?

Your stomach will be wiped down from the petroleum jelly used for the ultrasound. You will then be wheeled round to your cubicle to your awaiting anxious partner. You will be helped from the bed into a reclining chair / bed (depends on your clinic). You will be given a couple of blankets to keep warm and left to rest for a little while.

You may fall asleep which is a normal side effect from the sedation. You will likely feel cramping from the procedure which ranges from mild to severe menstrual type cramps. You can take some paracetamol for this later if not already provided some. Some ladies are given a small dose of codeine with paracetamol. Again the combination depends on the clinic.

Once you’ve rested a little while you will be asked to drink and eat something as well as go to the toilet. Only when you are able to do these will the cannula be removed and you will be able to go home. Before you finally go home the embroyogist will speak with you to remind you how many eggs they were able to collect and let you know the next step.

Some ladies are able to go back to work but it is recommended that the day if egg collection you are able to go home and rest. You will likely feel sore and uncomfortable – a bit like the build up to Aunt Flow (AF) arrival. You can use a hot water bottle on your stomach just make sure it’s not too hot or making direct contact with the skin.

The following days afterwards

You should be able to resume normal duties the next day albeit using some mild form of pain relief like paracetamol.

You should receive a phone call from the embryologist (usually between 9-10am) the next morning to let you know how many eggs fertilised over night.

You will then receive regular telephone calls to give you an idea of how your embryos are developing. The embryologist will inform you or the days they will call and then next steps. If you have any questions don’t hesitate to ask them.

Some outcomes are not as positive as others so you will need to be prepared for all types of answers which include:

  • Unfertilised eggs
  • Low quality of eggs fertilised
  • All eggs fertilised
  • All eggs fertilised to move straight to freeze cycle
  • Embryos not developing as well as should or stop cell division altogether
  • Embryos develop well and cell division is in line with expectations.
  • Embryos forming to day 3 / 4 morula
  • Embryos left to progress to day 5 blastocyst

Should you progress to the next stage you will need to prepare for embryo transfer. Read the next article on IVF: Embryo transfer

Katherine xo