In preparation for the penultimate round

So, I've been a bit absent in the month off between the last round and the one coming.  (It takes two pay checks to do one insemination, so there's always a month off.)  I say a month 'off', but it hasn't been a party, that's for sure.  A sick and elderly father in hospital and a Hobson's choice to either wait for the chop or take voluntary redundancy now.  Hmm.  Never a dull moment.  Still, mustn't lose focus.  In the lead up to the penultimate round of my year long devotion to trying to get pregnant alone, I have finally given some thought to donor eggs.  Thought is as far as it will probably ever get.  For the sum of £5000, plus some extra cost for drugs, I can have a donor embryo package in Cyprus that includes donor eggs, IVF, accommodation while you're there, donor semen and drugs for the donor female.  I had a very informative email response to my enquiries from Dogus IVF Centre, Northern Cyprus (www.dogusivfcentre.com)  They match a female donor to your look and use the Danish sperm banks.  I have never really been sure how I feel about this, but with a success rate of  77% it is not to be dismissed.  Compare that with my current odds of 1-12% with donor insemination and my own eggs and it appears to be a no brainer.  There is just one problem...where to lay my hands on £5000 + quickly.  Not going to happen!

Therein lies the dilemma.  If I take voluntary redundancy I may get that sum, but, of course, I wouldn't have a job.  A job that's very flexible and a 15 minute commute with good maternity pay.  On the other hand I may be out of that job in a few months anyhow.  What, I ask, would you do, given the circumstances.  Answers on a postcard please...

Putting all this to one side in preparation for this round, I am getting aggressive and taking 100mg of Clomid per day instead of 50mg.  Dr Svend agrees.  God knows what this will achieve, but hopefully more than two big follicles, or just two extremely mature follicles.  I am a bit short financially this month, due to visiting said sick father (he lives far away), so I'm not having a follicular scan in the UK first this time.  Going to rely on the old pee sticks alone, testing from Day 7, just in case. Trying not to get my hopes up, but inevitably there is always hope before the insemination.  So, all being well, in about 7 days time I'll fly out for the last but one shot of Denmark's finest.

Finally, I received a questionnaire from Storkklinik asking me to complete it for their statistics and records when my baby is born in December.  Of course, I would have been 8 months pregnant now had my successful IUI in March continued past 6 weeks.  It was a little upsetting, but I suppose it just reminded me that I got pregnant on the third attempt so it's still possible now, isn't it?

Round 5 (or round 2 post miscarriage) and 28 degrees

So, arriving in Copenhagen without a sense of humour because I had to deal with Stansted at 5am, I find myself dive bombing into serious bad temper.  It's 28 degrees and I'm wearing a jumper.  To make matters worse that's all I have to wear so that I don't have to pay for luggage on the budget airline.  Not happy.  I make my way on the 5A to Lytgen and make it 30 minutes earlier than my appointment. I calm down once in the cool of the clinic and its clean design.

Dr. Svend appears to give me an ultrasound and confirms that one of my follicles has popped and the other is about to go.  Based on this, he says, I should be inseminated in 30 minutes after a shot of Ovitrelle (an extra 350 DKK or £38) to ensure the second one pops too.  I'm relieved.  As I'm whipping my trousers back on to wait while they do whatever it is they do to the sperm, Dr S says he's very impressed with the quality of my ultrasound report from the London Ultrasound Centre.  'I should think so', I replied, 'it cost £120 - practically half the cost of an insemination'  'You didn't get it on the NHS?', he queries.  'Er...no.'  Where to start?  If I explain why that wouldn't be possible, I might start ranting about being over 40, female, single and British.  And I'm wearing a jumper in 28 degrees.  So I don't.

After a 30 minute wait Dr Jan ushers me into a suite.  He's my favourite.  He's a very friendly, avuncular sort who doesn't make me feel like a muppet asking all the questions I usually bombard him with.  He greets me and then asks me if I'm happy with blond and blue as requested.  182cm this time.  I say yes and sign on the dotted line and up on the couch I go.  Not for the first time I consider just how truly bizarre this is.  A couple of minutes later it's done and off I go to enjoy the sweltering heat of Copenhagen, with a 'good luck' and 'take two progesterone suppositories per day from now on' ringing in my ears.

I got so bad tempered in the heat that I caved and bought some cheap clothes from H&M so that I could actually enjoy a bit of sightseeing.  After a spin around Nyhaven harbour, the shops and the castle grounds I made for my hotel in Orestad.  This time I chose Cabinn Metro and I wish I hadn't.  It really wasn't up to the standards of Wakeup and it was  located a metro ride away, by a huge shopping centre and nothing much else.  It was, however, only 485 DKK or £58.

The next day I sat by the river for ages in the heat and pondered my lot, whilst feeling yucky about the ooze that comes from using suppositories. I considered the fact that, if this round doesn't work, I have just two more shots (self imposed end - emotionally need to draw a line and well in to my 44th year).  As if to cheer me up a crazy man on an adapted cycle, complete with sound deck and sound system, cycled past pumping sounds and whooping. Everyone sitting on the wall and by the river whooped and joined in, including me.  I hope it was a good omen.

Crazy Clomid

Well, I just don't know about this drug.  I took it days 3-7 as suggested and the side effects were, thankfully, not too awful.  Hot flashes definitely and a good bit of bloating and moodiness, but no nausea, sore breasts or other horrors.  The thing of it is that I'm not sure how well it worked because, not having had an ultrasound pre ovulation before, I had nothing to compare it to.  On CD6-8 I got ultra hot and had a lot of other tell-tale ovulation signs, but I assumed that it was just the drug because it was far too early.  After all Clomid was supposed to delay my ovulation not make it happen earlier.  So I didn't test on CD8.  I usually test from CD8 onwards.  I wrestled with myself on CD9, the morning I booked my follicular scan at the London Ultrasound Centre. Should I test this morning or not? I decided not. I arrived at the clinic and saw the size of my follicles on a super sonic screen.  One at 21.5mm and one at 14.5 mm with an endometrium of 8.5 mm.  The left ovary couldn't be seen, the little devil. The sonographer estimated ovulation within 24 hours.  Damn it I thought - so my body wasn't lying and I was going to ovulate on CD10 -  which meant that I would have had an LH surge on CD8 or CD9 in the morning.  I had never had one as early as CD8 or before CD9 in the late evening.  Can only have been the Clomid.

Cue mental booking of flights, taking a flexi day off and swapping my planned leave on Monday for leave on Friday.  Plus much testing using an OPK. Of course, there was no smiley face because I'd missed the surge!  However, Copenhagen Fertility Centre were great.  They booked me in the next day and said they'd do a further ultrasound first and we'd decide what to do next.  The London Ultrasound Centre had emailed over my results and the doctor was very happy with them.  The follicles can get quite big on Clomid so it was no guarantee that I would ovulate the next day, though certainly within 24-36 hours.  They reassured me that we had a good window and plenty of options!  So I geared myself up for a hideous 7 am flight, which meant a 3am rise.  Grim.

Riots, looting and ovulation

It's been a difficult week for us Londoners, thanks to the rioters and looters that rampaged the city.  I live slap, bang in between two of the worst affected areas in a zone untouched. My thoughts on it all probably have no place here...best kept for another medium.  All I will say is that, as an ex inner city teacher and Assistant Principal who worked in gang ridden areas, I am not surprised, but shocked.  Do I really want to have a child in London?  It could be like living in a war zone.  Mad Max (crazy movie starring Mel Gibson and some truly terrible clothes) is not so far off, by all accounts.

Anyhow, against the back drop of a world gone completely mad I was beginning to give up hope of ovulating this month.  In any other context that comment would seem completely off the wall.  However, I'm sure any of you charting whilst trying to conceive will know what I'm talking about.  Having returned quite unexpectedly to a 24 day cycle last time, I began testing on Day 6, expecting a surge on Day 9-10.  As each day passed I started to think that I'd hit the 'do not pass go' barrier and I'd stopped ovulating.  On Day 12 though I finally I got my LH surge.  I'm thinking, what the hell is going on here?  How can I have a surge on Day 12 if I only have a 24 day cycle?  Perhaps my body is just taking its time to return to some sort of normality after my second miscarriage in May this year. (I keep wondering if the stress of waiting for breast cancer results in March and the double biopsy in April was partly responsible.)  God knows, but now I feel like I'm playing Russian Roulette every time I do a test for ovulation. It remains to be seen whether or not everything is stabilised by the Clomid. One would hope. So, one more cycle before I try it.

One piece of interesting news I did have was from the clinic in Southampton, Complete Fertility Centre.  The women I spoke to took my case and fertility stats to a daily discussion with the gynaecologists and the view of the doctors was that they would treat me even though I am about to be over 43.  All I had to do was ask my GP to refer me as a private patient and we could get cracking straight away.  I was really encouraged by that, to be honest.  The clinic does sound good and it would be less stressful. However, I feel happy enough getting a follicular scan at a clinic here when I start the medicated cycle and then flying out to Copenhagen, so I'm not going to take it up.  I have researched the success rates and Copenhagen Fertility Centre still wins.  It's not so much gloom and doom over there for women over 40 either.  However, I have been really impressed with Complete Fertility Centre and it is affordable at £900 a pop after the initial tests.  For someone on an average wage it's possible to do this once very 2 months.  As I said last time, I would definitely consider it if I was under 43. It's the cheapest I've found in the whole of the UK.  If anyone can better it, let me know...

Finally some answers

My GP referred me to another GP within the practice.  No further forward as she's away for another two weeks.  However, I rang the clinic in Denmark and they arranged for me to talk to Dr. Jan again. Relief. He discussed the Clomid according to my personal requirements, confirming 1 x 50mg a day from day 3-7.  He then advised progesterone after IUI because my cycle is short, and if Clomid delays my ovulation, the luteal phase won't be long enough.  2 x 400mg pessaries for 15 days to start with.  Again relief.  This what I want.  Facts and figures - how much, when and for how long.  I explained I'd been spotting a lot the last few months up to 5 days before my period and he agreed it's not quite right. Probably a corpus luteal defect (sounds like something legal) and even though it's only recently been a problem it's not a great sign. I think, being honest, I'm just heading into menopause quicker than I thought.  I think back and I realise that as soon as my cycles dropped to 24 days, as opposed to the 26-28 days I've had all my life, I started getting that weird low blood sugar feeling, nausea and shivers before my period.  It all makes sense now.

Dr. Jan suggested that I get a follicular scan on Day 8-9 in London to check the follicle size and potential ovulation, which will then help me figure out when to fly over to Copenhagen.  All I have to do is then call CFC (Copenhagen Fertility Centre) with the results and they will advise me when to go.   This cuts down the stress of worrying about exactly when my follciles are big enough before, during or after I get a positive ovulation test and how many days I will have to go to Denmark for -1 or 2. CFC will rescan me when I get there, before we go any further, and determine if I need Ovitrelle or not to 'pop' them or if I should do the IUI a day later. I've got the The London Ultrasound Centre and The Birth Company on speed dial. Here are the links. For £120, they scan, provide a report immediately, send any info you want to the clinic of your choice and require no referral.

http://www.thelondonultrasoundcentre.co.uk/follicle-tracking-scan/

http://www.thebirthcompany.co.uk/

It may be £120 per scan, but even if I add that to the IUI price at Copenhagen Fertility Centre it's still only a total of £400 per cycle, including the donor sperm.  No clinic in the UK can match that for the procedure and the sperm.  Even when I add on flights. Although, I've just found out about a great new clinic in Southampton called Complete Fertility Centre which is linked to the NHS. It's only been on the go since January 2010, but...it's only £900 per cycle including sperm!  Compare that to the whopping £1800-2000 per cycle in London clinics.  Unfortunately for me,  they won't treat women over 43.  What a shame!  Here's the link though, because if I was of a treatable age, I would definitely do it, just for the ease of staying in the UK and having start to finish fertility care.  I only wish I'd found out about it sooner.

http://www.completefertility.co.uk/index.php

I realise, sadly, that I really, really am nearing the end of my time, but at least I feel less stressed now with my last 2-3 goes.  I know what to do and that's half the battle. In mental preparation for a potentially childless future I've bought a book called 'Beyond Childlessness'.  It's really helpful actually. I need to prepare.  I  don't want to crumble into a heap and end up with 40 house cats and a slum for a house.  Let that not happen to me.  Repeat, let that not happen to me.