D-1

arrived in Spain.
can hardly believe this is happening, it suddenly seems fast. It is what I was dreaming of, it is within the limit I had set myself.
spotting stopped.
tab/blogger does not let me paste the post I wrote on the plane, boo.
nervous and excited.
apartment is very spacious, happy with that.
but it's getting late and we're tired, will try again tomorrow.
xx

D-2

Spain emailed me back:

You should not be worried about, this could happen, but, please, try to moderate your efforts.

Please, let us know the evolution of the spotting tomorrow.

So then, maybe I'll get some sleep tonight. No more bootcamp for me for a while. (one lady in my bootcamp class is 14 weeks pregnant, so I thought I would be alright with my  minus 3 days....)
I'm thinking that maybe I could rent myself one of those electric bikes, mostly used by senior citizens (and sensible moms of twins!). That way I can still get to work super quick without having to worry about the exercise, or DP getting bored with going in a moderate tempo. Plus it would be great to finally go faster than him, effortlessly :-)


I made a little spreadsheet for my medication, just to keep track of what, how much and when to take it all. Some on empty stomach, some on full, some every 8 hours, some every 3 days.... Oh, and the pharmacy lady warned me that the combination of prednisolon and aspirin may cause stomach pains. yippee. I'll try taking one in the morning and the other after dinner.

I tried to get some feel good movies on the tab or on DVD for Friday, but the big PC crashed horribly so that didn't work. O well, time to brush up my Spanish by watching some TV maybe.
Besides, the weather in Barcelona is forecasted to be awesome, so maybe sitting on a balcony is a nice relaxing way to spend the remainder of transfer day.
2 nights to go....

Spotting

I tried to get news about retrieval and fertilisation, but the clinic would not tell me today unless something went wrong.
No news is good news.....
So in theory I'm probably expecting some fertilised eggs.
And now, just before bed I discovered I'm spotting. CD11. I don't get it.
I'm sort of contemplating starting with the progesterone half a day early instead of waiting till tomorrow. But the medication schedule is complicated enough as it is, have to change the estrogen patches tomorrow morning as well, and I'm too tired to call a doctor at this time of night.
Maybe this is just a side effect of today's workout....
One thing is for sure: it is a reminder of how easily things can go off track.
I was hoping to go to bed today feeling like a virtual mommy to my lab-baby-cells, instead I feel infertile again...

Hope this will all look brighter in the morning.

Dates!!!

More medication. And I bought some green tea to make it a more cheerful selection of boxes. Plus I have this vague notion that pomegranate is a symbol for fertility? (wiki says "a symbol of abundance, fertility and good luck")

And then on this sunny Sunday afternoon Spain on the phone. I almost dropped the phone when I saw the number. Egg retrieval is on Tuesday 29, transfer on Friday, June 1st.
Squeeeee!
Flights are booked, thankfully still normal prices. Now I'm trying to find a hotel room that is slightly bigger than the average stamp-size.
DP is out for the day&night with the boys, going camping with his brother and small son (little boy voice:"Sleeping in a tent!".)
So the house is very quiet while my nerves are racing. Half frozen behind the PC, half pacing the room. (in Dutch the saying for pacing is literally 'polar bear'-ing, which strikes me as ironic)
Ahhhhrg.........
Maybe it is time for ice cream. To celebrate both the news and this ridiculous perfect summer weather.

(and to suppress the thought of how to survive my 40th birthday if I test on that day and it is not positive)

More steps

After that frantic Friday I did pick up my eutirox prescription on time (17:35) and started with it the same day. With your reassuring comments I decided not to investigate further, didn't even read up on possible side effects.
The next Friday was much better. Ultrasound in the old hospital was the quickest ever: Hello, it's been a long time, endometrium all fine at 0.91 centimeter, ovaries doing nothing, here's the print, thank you and good luck. Doctor did cross his fingers for me and I was out the door within 5 minutes.
At work I put the print on the scanner (maxed it to 600 dpi) and emailed it to Spain.

Spain of the phone "that is fantastic! 0.91 centimeter, that is 9.1 millimeters! We can do the transfer soon now, your date will be...... between May 28................... and ............June 6................
keep your mobile switched on! we will call you when we know the date.

Umm, I take it those dates are based on my cycle and endometrium. For me Friday was CD8. The only thing I know is that the donor and I both took our last pill on May 13.
The clinic would know what her cd1 was
Ahhh, I could go on and on about possible and impossible dates or retrieval and transfer scenario combinations. But it comes down to: still no clue when I will be going to Spain.

Will go to the pharmacy today to pick up the aspirin and prednisolone. I need them 1 day before transfer. Because if I don't go today I will need them during this Pentecostal weekend and will have a hard time obtaining them.

----------------
The other weekend I was talking with HB and we commented how many boys there are in my family: DP has two boys, and both our brothers have two boys. That it would be nice and special if we would have a girl. Then HB asked if I could not ask the lab. It hadn't even entered my mind. After all the other decisions we've had to make you'd think I wouldn't be surprised any more, but I was. Can't even decide if it feels morally wrong. If it would be wrong to have a preference or only wrong if you act on it?
Just glad I don't have to decide or think on it for real.
And maybe slightly guilty I can't come up with boys names that I like and would fit our family while I have at least 4 girls names that I would love.
-----------------------

O well, time for a sunny breakfast on the balcony and then off to the pharmacy!

'positive' step

First two patches of estradiol are on my skin. Made me feel like I have an invisible superpower now, and hopped on my bike. Leaving DP behind with the boys, they all have the day off.

Swung by my doctor's assistant this morning to pick up the last thyroid results.
For those of you who speak thyroid here goes:

test                       my result     (normal range)
prolactine             19µg/l         (1.2 - 29.9)
TSH                       2mU/L        (0.5 - 5)
T4 free                  15pmol/L    (9 - 24)
T3                         1.49nmol/L    (0.89 - 2.45)
Thyroid globulin 66.3 µg/l    ( - 70)
antibodies TPO    218 IE/ml    positive from 101 IE/ml
antibodies Tg       349 IE/ml    positive from 345 IE/ml

Pap smear gives pap 1 which is normal.

So, all positive then! is what I thought. And then I looked up on google why I had the antibody test. And then it said that having those antibodies is no good, especially not when you want embryos to have a good chance to actually implant themselves.

When thyroid antibody positive women were treated with a combination of thyroid hormone, aspirin and prednisone their success rates closely mirrored that of women without thyroid autoimmune disease and far exceeded the results of their untreated counterparts.

Or you know, live baby. From other study:

The women in the treatment group had a live birth rate of 77% compared to 35% in the control group who received no treatment. The treatment group had a low miscarriage rate of 19% compared to 65% in the control group.

10:30
fired off email to Spain immediately saying I am worried, made a phone call to check if they work today (yes, my medical assistant starts at 11 and will speak with the doctor)

Hardly anyone in the office here, but I find it impossible to focus. Patches feel warm on my skin. Trying to stay off google. Just know that the longer I search the more thyroid cancer I will read about. Stress enough without that.

12. Dutch doctor on the phone not concerned, will only prescribe if I get word from Spain. Only available till 1500.

12:12 Spain on the phone, doctor not available yet. Assistant knows she will probably advice on some thyroid hormone, but doesn't know the dosage.

12:35 Dutch hospital emails back that I have an appointment for an ultrasound CD7. Yay

13:03 Spain on the phone: I am to take Eutirox 25 µgram starting today.

13:08 Spain by mail: start Aspirin and Prednisolone the day before transfer as well.

13:41 Dutch doctor's assistant will fax Eutirox prescription to pharmacy.

Step

Yay, got a pick-up paper thingy today that a package wasn't delivered today. Can pick it up at the post office tomorrow. The only thing that that could be is my medication from Spain. Zooming quick, according to the email they only sent it yesterday.
And I was worrying wondering if it would get here in time, but reasoning that stress makes my CD1 late so I had more time and it would be OK.
I forgot to call my doctor today to ask if they had all my results now. Doctor told me she gets the pap smear result in 1 week already, it just takes longer to let the patient know apparently.
And my doctor was also relieved and happy she doesn't have to struggle with foreign prescriptions to end up with medication that is (maybe) not available here.
O well, getting quite nervous now. I've taken up yoga class on Mondays and 'bootcamp' (full body work out) on Tuesdays. I tried the Pilates class on Thursdays but found it both difficult and repetitive, so maybe I'll swap that for another bootcamp session. Both stress relief and stress cover up: all those knots in my stomach are muscles sore from working out, surely.
And at work a new lady started in my team and we have entirely too much fun working together. She is smart and funny and interested and friendly. (and geeky! she is like me! and we think alike) And she totally takes my mind of things.

Big News

Today I received this email:

Dear VV,

 

We've matched you with a donor.

Here are the instructions to continue.

STEP 1 Please take the last contraceptive pill on the 13/ 05 /12

After stopping the pill your period should arrive in 2-4 days

If breakthrough bleeding or spotting occurs while on the contraceptive pill - please contact us.

STEP 2 Preparing the endometrium

 

On the first day of your next period after stopping the contraceptive pill you will start to apply the patches.

PLEASE DO NOT FORGET TO CONTACT US TO TELL US THAT YOU HAVE STARTED THESE PATCHES.

We shall then give you further instructions about when to book an ultrasound (usually day 7-9 of your cycle)

and so on and so forth....

For those of you who don't like numbers or don't care about dates: that is next week. O god no, it's this week, Sunday already! (Blimey!!)
I should have my Thyroid test results back on Friday, but result of my pap smear (tomorrow) will take 3 to 5 weeks. I'll double check if that changes anything, maybe not...
O well, give or take a month after that last pill we should know if it worked. That's my 40th birthday!
So exciting I can hardly think!

micro step

The IM doctor asked if I was taking folic acid, and I had to admit I've stopped taking anything after my last bad news.
So I went to the drugstore to buy a new bottle, and found that "women's vitamins" had a 30% discount.

I did buy that big pink box that says in quite big letters Multi becoming pregnant. While rationally I think the Multi refers to multi vitamins I quite like the ring of it. Yep, still secretly dreaming of twins. Yes, I'm aware of the risks and my age. I'm also aware of the risk of not becoming pregnant at all. That's probably why the box strikes me as wildly optimistic, with that whole suggestion of getting pregnant by simply buying € 8 worth of vitamins and folic acid.

Anway, at the cash register the young lady gave me some free samples: body lotion and anti wrinkle cream..... ;-)

no tiny step

All happy with my form and an appointment with my GP, all wheels in motion to get my pap smear.... and of course I started to bleed on CD18. No pap smear then. Sigh.
Such a small step and still I manage to stumble.
New appointment next week.

Boss pops up, saying that at that exact day I should go to a workshop in Luxembourg! 5 hour one way trip. He makes it look like it is an opportunity for me to learn, while it is just boring.
When he hired me he made promises about career opportunities, but in the mean time he hired two other people for the one position he had in mind for me. Somehow that makes me less inclined to believe in his 'opportunities'
Main reason now to have this job is so I can have lunch with DP and HB.
Today I forgot my work phone at home so when they called me for lunch I missed it. I was 1 minute late at our usual meeting spot and they had left without me.
On the way home DP managed the same trick again. Call-no answer-leave without me.

Sometimes I want to scream!!!

(and I haven't even started taking hormones yet. OK, yes, the pill. So maybe that is a micro step on the way to get this show on the road before my 40 birthday. 6 weeks to go.....)

tiny step

Amazed.

I called the national women's health screening organisation to ask if I could please have my pap smear now rather than having to wait for my birthday.

Maiden name - date of birth - zipcode, 30 seconds later my form was in the mail.
Have a nice day.

No being transferred, no waiting with horrible music, no not possibles, no nothings.

It's a feeling like when you think a door is heavy, you take a deep breath, bend your knees and put your shoulder against the door to push and then it swings open at the gentlest touch. Stumbling through.
Another small step.

More on clinics first appointments

What I forgot to write before.

First clinic is the Instituto Marques (IM).

I need to send the results of my thyroid tests. Both clinics asked about my last pap smear, anytime from the last three years, but I have no idea.

Doctor at the IVI did catheter test and ultrasound as well. Both doctors insisted I had recently ovulated, because they saw a collapsing follicle on the left. It was CD8 when they saw it and they estimated ovulation would have been around CD6. I reckon that would be a pretty useless day for an egg to go on tour. Even with my endometrium at 8 mm.

IVI doctor searched and found 1 antral follicle. My dr Google degree may have expired, but anthral follicle AFTER ovulation? Oh well, if ovulation is on its own schedule, why not the AFC as well. IVI doctor also worried he saw a small polyp, then filled me up with serum and decided it was mucus after all.

What I hadn't realised is that what goes up must come down, so back at the hotel I found out my jeans had a wet area that wouldn't dry. Thanks to the weather forecast of rain DP had made me bring a change of pants as well. (Generally we travel super light, small hand luggage only)

Treatment plan very simple: Start the pill on CD1 and stay on it.

IM will tell donor and me to stop at the same time.

I will start oestrogen patches on my following CD1, and have 1 scan around CD 5-7 to check lining.

Donor gets stimulated, retrieval day happens. I'll start progesterone supplements and fly to Spain. Transfer 3-5 dpo.

I can fly home the day after.

14 dpo POAS. If it is negative ask for blood test to confirm, keep taking supplements just in case things are slow.

If positive were to happen keep taking supplements for 70 days.

Jump

April 21st

We signed.

We have X/Y gametes frozen.
DP was all merry and gay about it. Twinkly eyes, squeezey hugs, smiles... I guess that was the big difference between the first day with appointments, that was a big part about my body and the next day it was about his contribution. I was just glad that our decision was made, paperwork done, bill paid. Maybe a bit tired of the tension and organisation that got into all of it to be excited now.
I'm happy with our decision, happy with the clinic, feel good about it, don't get me wrong, just not excited. Maybe I'm afraid to get my hopes up (and crushed again...)

Want to say some more about clinics, but will keep that for the next post.
xx