Roller coaster

It seems my will to live has decided to take off to Australia.  Not sure it's coming back, maybe just bought a one way ticket.  Hence the lack of blogging. You see, I thought it was game over before I started, as per my last post.  But then... Symptoms started to appear, exactly like those I had when I fell pregnant in March.  Weird indigestion, cramps that were poking rather than dragging in sensation.  And so I began to hope. It seemed that, in spite of the odds of having an IUI on the day of an LH surge as opposed to the recommended day after, I might have been lucky after all.  Around day 8-9 post IUI I was convinced I was pregnant.  So much so that I calculated a due date and trawled the 'trying to conceive' forums.  Well, it's usually me that warns you about those, so I only have myself to blame. 

I had all the symptoms. Fatigue, check.  Constipation, check.  Bloating, check.  Weird poking pains, check.  Just feeling pregnant, check. Veins like a road map on breasts, check. Overheating, check. So persuaded was I that I ignored the tell tale shivers on Day 11 and the odd, low blood sugar, shaky feeling that appeared momentarily.  I now recognise this as progesterone plummet and it's a sure sign that I am about to see the red devil.  I began to spot on Day 11 post IUI, but brown spotting, very light.  I was actually pleased, believing that this was implantation bleeding because my new cycle length, post miscarriage, was 32 days so it couldn't possibly be my period.  Perhaps the early ovulation on Day 9 of my cycle should have clued me into the fact that my body had reverted back to it's 24 day cycle. So, on Saturday 30th, on my 25th day, my period began.  I was absolutely floored.  Disappointment didn't cover it.  I actually felt grief.  Again.  This roller coaster of up and down - am I pregnant, am I not pregnant - it is utterly stressful.

And so here I am.  Exhausted, weary and skint.  Nothing new there then.  I can't do this again in August because the flights are too, too expensive last minute.  Next time I will take the Clomid and I will do it in late September.  As I am 44 in exactly one month's time,  time is slipping away faster than a speeding bullet and I am feeling very panicked.

I am still worried about the Clomid.  Will it thin my lining?  If my ovulation is pushed to Day 12 of my cycle won't my luteal phase be too short if my period is due on Day 25?  Should I take progesterone after the IUI?  If so how much, when and for how long?  I've made an appointment with my GP, but I'm sure he won't know the answers because he's not a gynaecologist.  Copenhagen Fertility Centre gave me the Clomid, but are not , it seems, really going to advise me beyond that.  The NHS won't refer me to a gynae.  I feel stressed out, to be quite frank.  Think I might just join my will to live in Australia.

However, let's see what my GP has to say tomorrow.  Perhaps it's time to get a little bolshy and demand some sort of help.  I may be over 40 and single, but I'm not asking for free assisted reproduction treatment, just some bloody help in asking what I should take to help myself.  Surely after paying tax for umpteen years, and after having major gynaecological surgery, that's not too much to ask?

And we're off

It was a little grim to say the least waiting for my period after miscarriage.  I had PMS symptoms 24/7 for almost 4 weeks, still had some pregnancy symptoms and felt completely rubbish.  Not to mention snappy.  Finally on Saturday 4 June it appeared.  A nice little dragging sensation in my abdomen and then whoosh!  Heaviest one I've experienced since my myomectomy to remove those excessively large fibroids.  This is where it helps having a good friend who's Matron of the Emergency Gynaecology Unit and Head of Midwifery at a London hospital. Heavy periods after miscarriage, she tells me, are quite normal.  So, with some relief I settle in and wait for step number two - ovulation.  Those of you who've read my blog before will know that I'm a Day 10 girl in that department, but who knows this time around?  I have a huge box of test sticks to insert into my digital test kit and so I'm ready and able to test pretty much every day from Day 6.

So I tested.  And tested, And tested.  Just beginning to give up thinking that perhaps nature had decided for me that enough was enough and then bingo. Today on Day 12, this morning to be precise at 7 am, there he was - the little smiley face.  If I was a religious person I'd thank God.  As it goes I will just thank my body for playing ball. 

I know this seems like a strange decision, but I have decided to wait this month and begin again in early July.  I didn't have to medically speaking, but if I am honest I didn't feel quite right until really recently and I am so sick of being penniless.  All in all it seemed the right thing for me to do.  Not that I've got time to play about with.  However, it would be a waste of money if I'm not physically feeling on top of the world and I quite clearly wasn't. I was suffering quite extreme fatigue, a kind of juddery low blood sugar feeling and had a few headaches. I want my last three chances to be good ones and mentally I also needed to sort a few things out in my head.  It's getting closer and closer to end game for me, but I don't want that affecting my state of mind when I go for an IUI because that creates a Catch 22 situation.  It's all about not putting too much pressure on yourself.  I keep thinking back to the fact that last time I had an IUI, and it was successful, I really didn't feel that bothered or stressed by it because I assumed it wasn't going to work and devoted my energies into finding out about medication for next time.  It's interesting that my state of mind probably allowed me to relax so that it did work.  We have to be mindful how much pressure we do place on ourselves, particularly as we carry that weight alone, financially and mentally and it feels like so much is at stake. We must relax.

I have been trying to relax this past month and I've been on a few dates actually. Before there is any rejoicing about this, they were all disasters.  One guy was a 54 year old masquerading as someone in his forties, another was far too far right of centre for me to entertain and looked as if he'd have apoplexy if a hair was out of place.  I was just checking it all out really and boy am I glad it's not a priority for me right now.  The 54 year old explained, in no uncertain terms, that it wasn't just body clock reasons that men required women to be at least 6 years younger after 38, it was also because 'we want a nice firm body and good breasts'.  I'll just let that comment settle as I'm sure you will be with me in thinking 'excuse me?'  I don't think I even need to comment on his comment, do I?  I am constantly surprised by balding men, weathered men over 40 and their appalling attitude to women of the same age, who actually look a hundred times better than they do! The age dodger proudly told me that he was so relaxed about meeting women on dates now (read for that he didn't give a toss) that he turned up in a cardigan with holes in it. The irony.

I digress. Suffice to say that I am gladly leaving all that behind again to prepare for July's IUI now I know I am still ovulating.  Got the Well Woman Pre-Conception supplements on the go, the exercise plan has notched up to a yoga session, a Pilate's session, 3 spin classes and a body conditioning class and the self esteem is slowly on the way up.  No thanks to the misogynist daters. I have to confess that I have had an alcoholic beverage or two this last month, but frankly I needed a little blow out.  That, however, has now stopped and I'm favouring the nettle tea in place of the Earl Grey.  Difficult for me as I am a total tea head, so I'm actually having withdrawal.  Finally, my sympathetic GP has redone some of my fertility tests and has confirmed that my FSH is still under 10 and that there are no issues with my endometrium, or anything else.  Of course, the fact that I'm still producing a healthy number of eggs is no guarantee that the eggs themselves are any good.  This I know, but at least I can continue on this path for a little bit longer knowing that there is a chance.

Playing the waiting game

It's been four weeks since I had the miscarriage.  As of last Thursday I am still showing a positive pregnancy test, so no chance of getting my period or ovulating anytime soon.  I'm reminded that HCG levels have to go right back to zero, that's negative on a pregnancy test, before your body kick starts your cycle again.  Apparently it can be anything from 3-6 weeks for the cycle to begin after a negative test.  Great.  All thoughts of an insemination in June are out then.  Hmmm. And again, hmmm.  Not that I'm panicking or anything.  I just assumed my body would play the game immediately - it usually behaves, apart from the miscarriage of course.  Never thought I'd see the day I would be begging my body to have a period.

So, while I wait I will go back to the donor.  That wonderful Danish man who 'got' me pregnant.  At Stork Klinik you are able to get some very basic details about your donor after you get pregnant if you sign a release form to say you've thought it all through.  There is an argument for knowing nothing, I mean let's face it what good can a few details do you when you've selected an anonymous donor?   But I wanted to know.  I suppose I just felt that it would give me something to tell my child about his/her Danish heritage. I had only specified height must be over 6ft when I made my donor request originally, leaving everything else to chance.  Don't ask me why height was important.  I signed the release form and the information I received back by post was his blood type, height, eye colour, hair colour, weight, physical features and occupation.  It was fascinating.  Really.  Me being me however, I did something I actually feel strangely guilty about, as if I've defrauded the clinic. I knew that Stork only use two sperm banks and both are detailed on their website.  I went on the websites of both sperm banks and did a donor search, inputting my donor's blood type, physical details, occupation etc.  I got a direct hit on one site for the donor, still registered as anonymous rather than open. Exact centimetres, exact blood type (and this was unusual), exact occupation, exact weight etc. I know it was a bit of a long shot, but it seemed impossible that it could be any other donor given the exact combination of details.  The sperm bank said his sperm was sold out at that point, as it probably would be given that the clinic had purchased it recently.  So I took a slight gamble and assumed this hit was my donor. I was able to find out a little bit more about him even though he remained anonymous on the sperm bank.  The bank offered you a chance to buy a little more information in the form of an audio interview with the donor, let's call him A, an extended profile and a family history.  I purchased both for about 25 Euros each.  Two minutes later they were in my email inbox and downloaded.  I was enthralled as I listened and read - all in English.  Bizarrely, A's favourite films were my favourites, his personality sounded lovely, his voice was warm and friendly and his intelligence was obvious.  Even better his family medical history revealed nothing worse than a bit of depression in the mix of relatives and my own family is no stranger to that. Yes, I was very happy with what I had discovered and needed no more information. I just wanted to know that my baby's donor was human really, if you know what I mean, rather than a shot of sperm in a catheter.

Not exactly crime of the century, but I did feel a bit of a cheat. But then, I did it anyway.  I feel a little sad that the lovely A will undoubtedly not be my donor next time.  I had to let Copenhagen Fertility Centre know my donor preferences for the future and I again selected height as being over 6 ft and added hair colour as either brown or blonde and any colour eyes.  It made me think, was I selecting a man that might resemble my ex partner?  Interesting.  Yes, if height is anything to go by!  However, when I got pregnant I didn't really care about any of the donor's details to start with, I was just so glad to be pregnant.  If they had made an error and he had ended up being 5ft 4', I wouldn't have cared.  Dr. J at Copenhagen Fertility Centre, told me 'you might as well specify height, eye colour and hair colour because otherwise I have to pick them and it speeds things up if you select.'    Maybe if he hadn't said this I would have left it all up to fate this time.  Or maybe I would have selected motility and youth if it had been possible!  Given that most donors are under 28, however, that would probably be a bit daft.  Oh yes,  the next time a man over 40 gives you grief about being a woman over 40 trying to conceive, just remind him that a man's motility dive bombs in his thirties.  As one male doctor once said to me, ' actually, the biggest cause of infertility in woman is often their men.'

I have no idea as I write this when I will next be able to have an insemination and I'm hoping that's a WHEN and not an IF, but I do know that when I am able to I absolutely will.  Three more.  For now.  Before I hit 44 and throw myself off a tall building.

Aftermath

Well, it's been 11 days since it all went horribly wrong.  I've had my visit to the Emergency Gynaecology Unit to check what's happened has been 'complete'.  When I arrived the nurse in Reception asked, 'Have you had any bleeding since your last visit?' I looked a little dumbstruck. Of course she wasn't to know that I'd already lost the baby, but it felt absolutely final replying 'Yes, I've had a full bleed, a full miscarriage.  I'm only here to check it's all come out.'  She looked unperturbed, used to dealing with countless women like me, but to give her her due she offered her condolences as she sent me off for a pee sample.  Suddenly inside the loo, grappling with the cap of the sample bottle, I cried.  Don't know where it came from, but I suppose it was just saying it out loud to somebody medical that made it final.

So, one scan later and I'm informed that everything is out.  No D&C necessary, thank God.  After last time (3 and 1/2 hours in surgery and a blood transfusion - they couldn't get around my multiple, large fibroids) I don't think I could have stood that again.  The nurse then explained that I was still showing a positive pregnancy test and would have to wait until it had turned negative before I could count down to my next period and ovulation.  She reckoned this would probably be in the first week of June, given my short cycle of 24 days, if I show a negative test by this week.  I have pregnancy tests to check this.    How ironic that this time I will be willing them to be negative.

I have almost, but not quite, made up my mind to try again straight away, but have this nagging feeling that my body's eggs may just be too past it and the Spanish clinics are right (see my very first post).  However, I've arranged with the new clinic, Copenhagen Fertility Centre, to have the next insemination unmedicated.  Partly because I will have no idea when I ovulate this time and may not get a proper period to aid me in counting the cycle days, so trying to match it all up with taking Clomid days 2-5 of the cycle would be a total nightmare.  And partly because I'm chicken shit and want it to work without drugs!

I asked the nurse at the EGU how everything 'looked'. The nurse who scanned me said my endometrium was a healthy 8 mm just after the miscarriage, so this issue of a thin endometrium seems to be an issue no longer.  In fact it was a good 26 mm when I was scanned before I miscarried, so all the signs say that I was worrying needlessly over this.  The scanner told me there was no hint of an issue. I'll take this opportunity to mention that the lady who scanned me back in October 2010 told my GP that I would be wasting my money because my endometrium was too thin.  Not so love, but thanks for making me worry for 6 months anyhow.  The other good news was that my ovaries still have their follicles and my left ovary appears dominant with a very big follicle to boot.  No idea what this means really, but probably explains the concentration of twinges, pokes, stabs and dull aches on that side when ovulating and when I got pregnant.  Everything, it seems, is looking good, its just down to my eggs and the pot luck of sperm meeting egg during the one shot I get each month.

So there we are.  Some of you tackling donor insemination after 40 might like to take a look at http://flowerpowermom.com/a-child-after-40-online/  It's a new site and she's looking for moderators.  Her story was certainly helpful to me, giving renewed hope after this set back, so take a look if you're flagging.

I faithfully promise to devote the next post to the issue of the donor and the slightly sneaky way I got more info than the clinic offered.  Investigative skills can be useful.  In the mean time, I'm suffering the irritation of being checked out for anaemia and, scarily, insulin deficiency.  I am quite shaky, excessively tired and feel a bit odd.  I hope it's just a reaction to being pregnant and then not being pregnant because I really don't want to see the inside of any more medical facilities unless it's to be inseminated. Once I feel a bit healthier, I will be back to the exercise classes and I'm aiming to drop a few pounds.  There's a whisper of a double chin creeping in and it's going to go if it kills me.

The Fat Lady Sings

Sadly, last night I miscarried and it was the loneliest night I think I have ever spent.  On Tuesday, Week 6 exactly, I felt odd and shivery.  I also felt like I was getting my period and had cramps that just weren't like the ones I'd been having as my uterus was making ready for the baby.  My breasts were still sore, but not getting any more so and definitely not as bulbous, if you'll forgive the use of that word, as they were a few days ago.  I was exceptionally tired, but not quite in the same 'by 4pm wiped out' way as I was a few days past.  I felt shaky, low in blood sugar and ratty and most telling of all I was spotting.  Then came the low, tense and tight cramps, right above the pubis.  I recognised them as similar pains to those I have experienced when having a particularly bad or painful period.

I had spotted before in pregnancy, around the same time at 6 weeks, and it had come to nothing, so I would not have been overly worried had I not had other symptoms.  To be honest though, symptoms aside, I just knew something had changed a few days ago.  I just didn't feel pregnant.  So a visit to the Emergency Gynaecology Unit was in order. A scan revealed a gestational sac in the correct place, so not an ectopic pregnancy.  However, the sac was only 4.7mm and not the size it should be for my pregnancy at 6 weeks. It seemed to spell out only one thing - baby had stopped growing at 4-5 weeks.  The next step was to take a blood test to check progesterone levels.  If the levels are under 10 the pregnancy is failing, if between 10-50 it's a grey area and above 50 is ok, with 80+ being good.  I missed the call from the hospital giving me the results, but by 8pm I had started bleeding properly and the pain was conclusive.  There was no question of it, baby was no more and my body was rejecting it.

I cried from the deepest part of me and wished, sadly, for my last partner to be there just to give me a hug.  I'm sure this was only because he was there last time and I needed that intimacy from somebody.  However, I am on my own now and there is nobody there at times like these, so I made do with a few texts to friends who knew I was pregnant and had supported me and just let myself cry out.  In the end I fell asleep.

This morning I am still upset and in pain, but have talked to the hospital and arranged for a scan, blood test and HCG test next week to ensure full 'evacuation'.  The blood results showed a progesterone level of only 7, so I was correct in my assumption that baby had stopped growing at 4-5 weeks.  Once a negative pregnancy test has been seen I can ovulate at any time and it's possible to try again.  Yes, yes, I know I said I wouldn't do that, but it's funny how your decisions can be called into question so very quickly.  I move fast and even though my miscarriage isn't even over today, I need action to help me get over things and have already contacted the new clinic.  I've asked if  I can have my first insemination with them unmedicated, reasoning that just after pregnancy you are a little more fertile.  Plus, I don't want to hammer my body with meds after all this. 

I may not do it, but I need options.  Choice and options keep the 43 year old single girl, and I use the term loosely, sane and moving forward.  At least I did get pregnant, and on the third attempt.  If I had lost the baby later I really don't think I would have considered trying again, but it has been early enough for me to consider it.

So I am sad today and feel quite sorry for myself on the one hand, whilst on the other I am looking forward to the options I have created for myself.  The Fat Lady has sung this month, but she hasn't yet sung at all my venues.  For any of you going through this, my thoughts are with you and take heart that miscarriages happen to women of all ages and are very common.  They are more common as we age, but are not specific to age.

I will talk about the donor, as I said I would in my last post, but I think it's a topic for a few days after this is over. It may be a bridge too far for me today.

Third time lucky

Looks like I won't be needing a visit to that new clinic I sized up, nor will I have to take the proposed Clomid after all. I almost can't believe I'm able to write this but... I am pregnant.  In terms of the internet's best due date calculator I am 4 weeks pregnant to be precise.  I can't quite get my head around it and am still dashing to the loo every ten minutes expecting to see the red visitor.

Around 8 days after the insemination, I knew.  There were only two tell tale signs that were markedly different, given that all cramps, bloating and twangs could be either pms or pregnancy.  The first was this... Normally, 7 days before my period I have extremely intense irritation and snap at the slightest thing.  I describe it as a kind of tummy flip.  I don't appear to have any control over it and when I think back to all my terrible arguments with my last boyfriend, each one was right before my period.  Including our ultimate one.  So when I was 5 days away from my period and felt serenely calm I knew something was definitely going on.  The second thing was a total lack of sore boobs.  Again, these normally kick in around 7 days before my period.  I must have looked like a crazy woman, constantly tapping and touching them for signs of soreness, oblivious to the public.  There are names for people who do that.  3 days before my period I could feel them just beginning to ache, but in a different place. I cried for a whole day as I'd been so convinced that I was pregnant, I couldn't believe it had just been a delayed period.  Just out of sheer bloody mindedness and spite I took a test the next day and I was completely floored by the very faint line that popped up next to the control line.

I took another the next day and another the next, both faint positives.  I was convinced that I had an ectopic or non-viable pregnancy as the lines were so faint.  Why in God's name are my HCG levels not rising?  So I waited another three days, driving my self and my friend, D, truly mental by reading forum after forum.

Finally I tested on Monday, 3 days after my period was due and there it was - a dark line, not quite as dark as the test line, but clear and bold, appearing in 10 seconds.

You'd think that I would be ecstatic immediately, wouldn't you?  And let me tell you I really, really am. But.  And here's the truth. I am now overly aware of (read completely obsessed by) every little cramp, pain and twang and am STILL driving myself loopy. Is it ectopic? It's bound to be. How could it attach to my thin endometrium? What if it has attached to the scars where my fibroids were removed?  It won't make it. I'm 43; the miscarriage rate is 50%. It's inevitable. Aaaaahhhhhh!

Fortunately, for everyone concerned,  I have calmed down a bit and have booked myself an appointment with my GP to get myself in the system.  Finally some professional care that doesn't cost me a mortgage payment.  He can check out my ectopic fear in a couple of weeks and monitor any weird pains, which I seem to have a lot of.

Now, lots of women want to know what you did differently when you are finally successful and I did a few things that may have made a difference.  I will tell all in my next post.  For now, I'm still reeling, hoping that I maintain this much wanted mini-baby and terrified about, well everything really. 

So my parting words for this post?  If a 43 year old woman with a recent late miscarriage, followed by a full on open abdominal myomectomy,  leaving a thin, irregular and scarred endometrium can get pregnant by donor insemination and without ANY fertility drugs, then so can you.  It really is not over till that fat lady sings.