2020 cancelled?

Love isn’t cancelled

Music isn’t cancelled

Dancing isn’t cancelled

Progress isn’t cancelled

Meditating isn’t cancelled

Dreaming isn’t cancelled

Self-care isn’t cancelled

Reading isn’t cancelled

Having fun isn’t cancelled

@insta_holaa

What a year it has been already… and I am really not sure why and how a non-UK Mother’s Day has triggered me. I don’t remember being this triggered in March when it was the UK Mother’s Day but in the lead up to today (Sunday) I have just not been myself. Even my husband asked me today if I was okay because I’ve been “a bit off for the last 2/3 days”. I told him I didn’t know how I felt and truth is I don’t but there is something about going through Mother’s Day after spending 2 months on hormones to produce eggs, having an egg retrieval, only to be told weeks later that everything is now on hold indefinitely due to COVID-19. On top of all this, my grandfather passed away during this time and my puppy died only days after our treatment was put on hold. I mean can a girl get a break!? So I did take a break for about 3weeks I switched off the part of me that is always preoccupied with baby-making and I just got on with my life like I wasn’t planning on having a family. This is after a lake full of tears and silence and more tears and just silence. I am never quiet so when I’m silent, things are really not okay.

And guess what? The ‘switch off’ time was quite literally the best few weeks I have had in a while. I zoned in fully into working from home and working out and I have a really good balance and consistency now. I even got a pay-rise during this time which is testament to how much I gave in to my work life. I felt great, I felt so balanced – something I am always striving for and I just started to really see myself again. Not through the lens of ‘you are not a mother yet’ but more ‘sister honey girl, your life is full and it is wonderful just the way it is.’ Being in lockdown has meant I have spent more time with my husband than usual and that too has been wonderful, and it has been enriching to spend time together without the ‘baby making’ cloud over our heads… just chatting like old pals and reconnecting without the burden of timed injections, hospital visits and the horrible waiting has been the break that I didn’t know I needed.

For such a long time I had reconfigured my life to fit around ‘baby making’ that so much of my Self was lost in the process but when you’re in it you really don’t realise it. My first day in my new job on the 6th of Jan was my first day of IVF! I remember having to call my new boss to ask her if it would be okay for me to start a bit later on my first day, my first few weeks in the job were filled with hospital appointments all of which had to be during the work day usually mid-morning and in February I missed my first board meeting because I had a week off for my egg retrieval. I am lucky that I landed wonderful bosses who have been incredibly supportive of our IVF but I say all this to paint the picture of how IVF consumes you. So this break, although forced upon us, has really been that pause that we never stopped to take for the last 3 years of journey. And only now it is making sense to me.

I was doing so good because everything was out of my control until they announced that clinics could apply to reopen from 11th of May. And all those feelings I parked on the 17th March after crying myself tired literally just came back flooding and are damn near drowning me at this point… I was doing so good and now I have the added layer of weighing the risks of C-19! We have all seen the stats that suggest black people are more likely to die from C-19 than their white counterparts, add the cases of the black pregnant women who died (may they rest in peace). My clinic hasn’t even called me yet and I do not know what their plans are but these are all factors I now have to consider in addition to the factors that already come with IVF and pregnancy in general. Needless to say, I am freaking the fuck out! On the one hand having a baby is everything I have ever wanted, on the other hand do I want to try to get pregnant with the added anxieties around C-19?! My husband’s protective instincts have already kicked in and he feels so strongly about the risks of C-19 and thinks we should wait. The situation is less clear in my mind, while C-19 gave me the pause I definitely needed it is now putting this horrible hesitation in my mind about how much I want to have a baby and at what cost? The effects of C-19 are making me question the one thing I never thought I would even have a second thought about.

Mother’s day when you have all these thoughts in your head hits differently. I was off all social media when the UK one came and I think for as long as I am not-pregnant I might make it a point to be off social media in the lead up to and on all Mother’s Days. The strongest feeling was that I felt bad for being triggered by other’s people’s day of joy and gratitude and actually, I think a lot of people don’t get this about the #ttcgang, when we are triggered by your mummy joy we genuinely feel so bad and it is that guilt that eats me up more than anything. The second feeling was that reminder; another Mother’s Day and I am not pregnant, and I don’t even know when the possibility might be real again. C-19 took away the mere possibility from me and when you are trying to conceive by assisted means, the possibility is quite literally ALL you have. My sister-in-law tells me off for saying our IVF was cancelled, she always corrects me with ‘postponed’ but without the pending possibility, to me it has felt like it’s been cancelled, much like 2020 so far!

Up until today I hadn’t realised that I had never even entertained the thought of me being pregnant. My default coping mechanism is to not let my mind go there at all… I have not even imagined what a pregnant belly would look like on me, or what my baby’s nursery will look like or even who the baby will look like. The minute we got news we would be starting IVF my husband already started compiling a list of essentials, the only reason I got involved was because I had to help him make sure everything was on the list otherwise my coping mechanism just won’t let me go there. People say things like you have to envision it to fruition, but those people will not be there when I need to drag myself out of a dark hole when disappointment strikes. My embryo transfer would have been around this time and the only thing I had done which even now seems so stupid to me is I had bought a couple of floaty work dresses for ‘when I start to grow’. That’s as far as I will allow my imagination because it’s a practical alternative to my work jeans (well seemed so at the time). All that day-dreaming about my pregnancy and being a mum blah blah blah can never be me. I am not strong enough for that and that is why Mother’s Day today was so difficult because my timeline was filled with those kinds of images and theirs were actual REAL.

I’ve also been thinking about the similarities between most people’s experience of C-19 and my experience of IVF; much of it feels like you are in a trap where you are literally hoping for the best, a big part of it is just a waiting game with absolutely no guarantees, both mess up with most of your plans and take away life’s small pleasures. I think for the first time, the world is experiencing what most women going through IVF feel – a shutdown of sorts of life as you knew it and a long game, seemingly unending and all you can hold onto is hope. IVF does not physically kill you but the emotional ride that comes with it can kill your spirit, even when nothing is happening AND in the context of normal life that must carry on. I remember having a split second moment when my puppy Leo was hit by a van and died where I really felt I was going to lose it – it is less about the puppy and but more about the lack of control over one’s own fate. I had to decide very quickly in that moment which path I wanted to take and sometimes it is not about choosing to do or be better, sometimes it is about saying I CAN’T do this anymore and I WON’T. And just checking out – taking time out to restore, recover, refill. And reminding oneself that not all is lost or cancelled.

I cannot tell you what is next for me/us. I wish I could say ‘yes we are definitely going ahead as soon as they call’ or ‘no we are waiting until they have more data to base their contingency planning on’ but I can’t say either. In true coping mechanism fashion, I will deal with it when I get the call from the clinic i.e. when it becomes real. My husband was keen to agree a decision about it and I said to him we’ve been doing this trying to conceive thing for a while and if there is anything I have learnt is not to get ahead of myself. I could make a decision about proceeding with treatment and spend the next few weeks anticipating the call from the clinic and struggling to sleep etc due to worry or excitement or I can just surrender to the now and hear what their plan/process is when they call and make a decision then. They may even call to say they are not reopening, or they are not doing transfers and I would have invested in a possibility that is taken away from me, again. My only focus now, is WHAT IS REAL RIGHT NOW.

Sending love to all my IVF sisters… whatever decision you take, it is yours to make. We have made it this far and although it may not always seem like it, we have so much more in us to carry on. All my love & all the Light x

How does it feel?

“There is a life to be lived right here in the waiting.” –@morganharpernichols

Before we began I spent a lot of time worrying (and being actually terrified at one point) about what it was going to be like, what I was going to be like. Having gone through the first half now I can say that it was not what I was expecting in the sense that it was not as bad as I expected. I had definitely allowed my mind to get the better of me before we began. So I started off on a pill called norethisterone for 10 days which was okay initially then it made my breasts so heavy and I had the worst backache for a couple of days but after that I was fine. The backache was something else and I’m still traumatised about it now! A few days after the pill I had what they call a withdrawal bleed; the whole point of the pill is to induce a bleed so that IVF can start from a baseline when your uterus lining has shed. At the end of bleeding, I would say on the 5th day, I was instructed to start the first course of injections (Bemfola) and I was to inject myself for 10 days every night. Of course I did not inject myself! My husband did – because I can’t even look at the needles when I’m having my bloods done. I also thought it would be a way for him to feel involved in the process and feel a sense of utility in all of it. On the 5th day of Bemfola, I was instructed to start another course of injections (Cetrotide) to be administered every morning. Both these injections had to be done within a half an hour window of the same time each day so we did 5am and 11pm which suited our life/work perfectly. Over the course of these 10 days, I had 2 scans; one on day 6 and another on day 10 (which was meant to be my last day on injections but they wanted me to do 2 more days of stims (stims = injections). The scans were done at intervals; Day 1 scan – after withdrawal bleed to make sure uterus lining had thinned; day 6 scan – I had 24 follicles; day 10 scan – is when I found out that I had too many follicles and there were going to apply the freeze protocol to prevent ovarian hyperstimulation; day 12 scan – after an extra 2 days of stims for my eggs to mature I was given a date for egg collection. By day 12 I was definitely feeling the effects of the stims, my ovaries were full and it was slightly uncomfortable but nothing I couldn’t handle. I was then instructed to take a trigger shot injection (Buserelin) that night and my egg collection date was exactly 36 hours later. On the day of the egg collection, I felt awful – I felt nauseous, I was VERY hormonal and I just wanted it to be over and done with.

The egg collection for me was by far the worst part of IVF (first half anyway!). I was already quite hormonal by that point and now looking back everything just seemed overwhelming to me in that moment. We were asked to come in an hour before our appointment to do more paperwork and prepare for the collection. I was given strict instructions not to wear any jewellery, nail varnish, deodorant/perfume or anything with a scent or alcohol in it. I was also told to bring some bedroom slippers and a nightgown. When we arrived we were taken to our own private room and I was asked to change into the hospital gown. It was at this point that hubby had to go and do his thing and provide a sperm sample. When he got back we were called into theatre (is that what the room is called?) and I kid you not there were about 7 people in there and when you are hormonal, lying down on this bed while they strap your legs in position, with all of them watching over you and doing different things, IT IS TERRIFYING. I was so scared I was tearing up when they were asking me to confirm my name and details. When they asked my hubby to leave the room, I almost unshackled my legs ready to follow him out. I understand all of these people need to be in the room, like the anesthetist, nurses, consultants, but I feel like they should all come in once you’re knocked out because it was the most intimidating feeling and made me worry even more about what they were going to do to me. Anyway, not before long I was completely knocked out and got woken up when it was all done. At first, I couldn’t keep my eyes open and they kept trying to wake me up (at one point I even held my eyelids opens like they do in cartoons, which made them all laugh), when I did eventually snap out of the slumber they were asking me questions and I could not speak. The words were playing in my mind but I literally could not speak – I was trying to move my mouth but I don’t know what was happening no words were coming out. The combination of realising this lack of speech and suddenly remembering where I was and how I was feeling before I got knocked out, the shock of it all sent me into inconsolable tears – I justcouldn’t stop crying. I got even worse when I saw my husband and it was just coming out of me like a waterfall. I think for much of the IVF process I was keeping it together (because I was actually okay) but something about going through a procedure like egg collection makes it VERY real that hey girl, you’re an IVF patient and this IS a big fucking deal.

The way egg collection works, is by draining the egg follicles that the injections stimulated and the eggs are contained in these follicles. I had an amazing egg collection result of 20 eggs!!!! I owe this amazing result to my faith, my high AMH and I think as well to the supplements I was taking during stimulation and 3months prior (which I bought at the Fertility Festival in London for £90 for 3). There is some research out there that retrieving more than 15-20 eggs does not improve pregnancy outcomes so we are just so pleased to have that ideal number from the get-go. Back to the day, after all my crying which went on for about 30minutes, the nurses brought me some food because, oh yeh I forgot, you cannot eat past midnight the night before egg collection and you cannot drink water past 2 hours before egg collection but food was the last thing on my mind but my hubby forced me to eat. I then realised that I was having a bit of bleeding down there so I put a liner on and I peed (something they made sure I did before leaving). Getting off the bed and peeing was painful so I just moved at snail pace. Not long after I peed we were released to go home and I was advised to take a few days off and just rest my body. My egg collection was on a Thursday and on the Friday the clinic rang me to confirm that 19 eggs had been fertilised and 13 embryos had made it to day 1 and that they would call me on day 5/6 to confirm how many made it to freeze. On day 6 the clinic rang again and this time I was back at work and I had spent the last few days just worrying about the outcome out of our embryos… but won’t He do it… the clinic confirmed 10 embryos made it to freeze meaning we had only lost 3 embryos over the 5/6 days. I immediately called my husband and we were both just in shock and deeply grateful after so long to be at this point now, with viable embryos waiting for us. I thank God for his intervention and his promise.

When they say a story is too good to be true, it usually is, in our case more like too good to carry on. As a result of producing so many eggs, our transfer (putting the embryo in my womb) which was meant to take place 5/6 days after egg collection was cancelled due to a standard protocol they follow that if you have 18 or more follicles of 11mm+ in size, it’s an automatic freeze to prevent ovarian hyperstimulation and the negative effect it can have on implantation. I could have been pregnant by now (if this cycle had been successful) but the clinic wants to make sure that my body recovers from all the stimulation and resets before we continue the process again. So that’s where we are now, in the break in between and actually it has been really restorative having this break, although I was upset initially. And there is research (although not conclusive) that suggests that freezing all embryos for later transfer might improve implantation and pregnancy rates and increase the safety of IVF. It is an odd place to be though… so close and yet not quite there yet… and we will have to do more stims (injections) to prepare for the transfer and then there is the worry of losing embryos in the thawing process but I learnt very early on with all things infertility, to SURRENDER, to God, to what is meant to be – will be, surrendering to our medical professionals because they do this everyday, surrendering to the present. I try and just focus on one day at a time when it comes to IVF and as it stands we don’t really know yet when our embryo transfer will be, and you know what, that’s okay.

I am finding it A LOT more difficult now to be ‘not-pregnant’. There is something about trying to reconcile being an IVF patient with the fact that others are having babies naturally, JUST. LIKE. THAT. Your friends, people you know, and it’s everywhere. Don’t get me wrong I am very happy for my friends when they fall pregnant, carry to full-term and give birth to healthy babies but each natural pregnancy is a reminder that I am not a mum yet and that I won’t be able to fall pregnant naturally – it is actually heartbreaking and that is not to take away from someone else’s joy, it is a strong realisation of the lack of it (in the form of a baby) in my own life. Being an IVF patient, without your success yet is SO damn hard to live with when you have to live it in the real world of other people having babies seemingly easier/quicker. The raw honest truth is that it always makes me feel better when someone’s pregnancy has a backstory of infertility, because I can relate to it then. And that’s REAL – If no one else will say it, let me be the one to say it. In addition to all this, I now have people/family asking me about children. Much of my turmoil with infertility was internal for pretty much most of the 3 years but now and I realise this is because we have been married over a year now, people bring up babies all the time. Every family gathering I have been to in the last 6 months almost all the women who know me like that have asked me 2 questions; ‘How is married life?” And ‘Where are the babies?’ This one particular incident literally happened 2 weeks ago at my mum’s… if you know me you will know I like wearing loose clothing and flowy shapes, anyway, one of my mum’s friends made an assumption that I was pregnant because I was wearing a kaftan and literally my mum had to come up to me and scrunch the kaftan to one side to show my ’no belly’. This is a true story. And listen I’m not mad at all this, I’m actually not and in fact, I actually couldn’t stop laughing at the time. I mean yeh partly because of the audacity of it all but I realise as Africans we think we mean well when we do this, the women in our lives want to be encouraging about having babies and this is how they communicate this. What upsets me is the fact that it is never the right time and place for me to educate people on infertility and it’s a whole entire culture to dismantle. My mother’s generation is from a different time and I cannot be angry with them for what they know or don’t know. I know a lot of people my age who don’t know anything about infertility especially those who have had natural pregnancies and they too cannot be expected to understand the sensitivities of infertility. Unless we educate them.

All this to say, there are compounding elements that are making me feel more ‘not pregnant’ than ever before and making me question when? and if ever? but I still choose to practice compassion, towards others and towards myself. I make every effort to honour each day as a gift, for there is a life to be lived right here in the waiting and one day, soon enough, I will be a mamma.

What is IVF? (and ICSI)

You can have both God & Fertility treatment – Noni Martins

IVF seems to be this big secret that is only shared in the TTC community and the information never gets passed down and across to people outside of the TTC community. Almost everyone I have spoken to either has no idea what IVF is or has serious misconceptions about what it actually is. This is compounded in the African community which means people end up saying really irrelevant things to myself or my husband because they just don’t know anything. My mum, being a nurse, has been so keen to absorb everything about the process and I have enjoyed ‘schooling’ her on this because it is really fascinating and wonderful just what science can do for humanity. So this offering is really to explain the IVF process in simple language (where possible) and I hope you will learn something from this post. We are still learning and still discovering and still being wowed by the possibilities that science has to offer. As I mentioned in a previous post, we will NOT be blogging about our IVF journey in real-time and we will not be sharing the success/failure of our process until we feel ready to do so. I am however going to write this post from my own understanding of the IVF process as pertaining to our situation. This does not mean any or all of this has happened, I am just explaining it the way it was explained to us by our nurses.

So what is IVF? IVF stands for in-vitro-fertilisation which basically means fertilisation ‘in glass’. It is a method of assisted reproduction where a man’s sperm and a woman’s egg are combined in a laboratory dish, where fertilisation is expected to occur. For a couple with a male-factor or male infertility, there is a slight variation to this part called ICSI which stands for intracytoplasmic sperm injection. Treatment will be exactly the same as with IVF. The only difference is that instead of mixing the sperm with the eggs and leaving them to fertilise, a skilled embryologist (embryo specialist) will inject a single sperm into each egg. This maximises the chance of fertilisation taking place as it bypasses any potential problems the sperm will have in getting inside the egg – (Via HFEA). Once the referral has been made by your GP/specialist to a fertility clinic and all the paperwork has been completed and processed (please see our fertility timeline so far), IVF starts off with a consultation with a head nurse who will go through the forms you have filled in, confirm details, take more signatures and give you an overview of what lies ahead. At this consultation, you are advised to notify the clinic on the first day of your normal period which will set the date for the whole process to kick off. Everyone’s IVF journey is very different and some people (like me) have a short protocol IVF and others, a long protocol IVF – I still don’t know what the difference is but click the link for information on the long protocol. In my situation, because my AMH is very high, there are concerns that I may have an excessive response to the stimulation, something called Ovarian Hyperstimulation Syndrome – OHSS (more below). Anytime there is such a concern, the short protocol is applied.

So on day 1 of your period, you ring the clinic and they book you in for a drug appointment which is basically to talk through all the drugs you will be administering for that round of IVF and the nurse teaches you how to do the injections because they are slightly different depending on what you are having. Sorry, before your drug appointment, the clinic writes to you with an invoice for the medication – you pay for your medication even for an NHS funded cycle. I opted for the NHS prescription pre-payment certificate which works out cheaper and it cost me £30 for 3 months and I can get as many prescriptions as I want, even non-IVF-related ones. My drugs would have cost me £50 and If I needed more for whatever reason I would be required to pay more so I would highly recommend the pre-payment certificate for anyone doing IVF via NHS (or anyone who has to pay for repeat prescriptions generally!) At the same drug appointment you are given dates of when to start the medication and when to come back in for transvaginal scans – this is how they check progress, internally! The real IVF starts when you go home and map out your life for the next 4-6 weeks and start your medication – I will share my self-made colourful IVF calendar, which I am very proud of, at a later date!

Our protocol will follow the general timeframe below but as with all things IVF, this can change and vary quite a bit depending on how one responds to treatment:

  • Day 1 – 10 – Take Norethisterone 3x a times a day with food – this is a pill to induce a withdrawal bleed to thin the uterus lining
  • Day 11 – 15 – Withdrawal bleed – the shedding of the uterus lining
  • Day 16 – Transvaginal scan to confirm uterus lining is thinned
  • Day 16 – 25 – Bemfola stimulation injections x1 every evening
  • Day 21 – Transvaginal scan to check the progress of the follicles
  • Day 21 – 25 – Cetrotide stimulation injection x1 every morning
  • Day 25 – Transvaginal scan to check number and size of follicles
  • Day 26 – Trigger injection to mature the eggs (must wait to be notified by the nurses what time to take it!)
  • 36 hours later – Egg collection under general anaesthetic – this is when ICSI for us will take place, fertilising the egg and sperm in a laboratory dish
  • Between 3-5 days after egg collection – transfer of 1 embryo into the womb.
  • 2 weeks after Transfer – pregnancy test at the clinic

On paper, the process seems quite quick but as I said, things can vary with IVF and sometimes there can be delays in terms of how you are meant to respond to treatment and how you actually respond to treatment. For example, you might not have your withdrawal bleed within the 5 days after Norethisterone. Or in a much less preferable situation, you could have Ovarian Hyperstimulation Syndrome which puts a pause on the entire process. Because my AMH is high, it is likely that I could get OHSS which is when the ovaries develop too many follicles as an over-response to the medication. When this happens, fluid from the blood vessels may leak into your abdomen and in some cases into the space around the heart and lungs. The kidneys and liver may also be affected, but this is usually mild and will settle without medical intervention. Approximately a third of patients will have mild symptoms, with only 2-8% of patients needing medical intervention (via NHS). They warned me about the risks related to OHSS and made it very clear that I should let them know if I start to get any symptoms. They stressed even more that if do end up over-stimulating – that is, 19 follicles or more of 11mm plus in size, the transfer would be cancelled, the embryos would be frozen (FET) and I would have to wait 6 weeks before the process continues. Not ideal but they need to make sure that my body is fit enough to hold and carry the baby for the 9months.

This is one IVF cycle in a nutshell from start to finish but like I said can be different from one couple to another. If a cycle is unsuccessful, the clinic will do some investigating into potential reasons why and any information from this will be taken into consideration for the next attempt. If you have any embryos remaining which were frozen from the first round of stimulations, you do not have to go through the stimulation process again and you can just have another transfer at a suitable time when the uterus lining has been thickened again ready to receive an embryo. An interesting little fact I almost forgot to mention is that my clinic uses Embryo glue when they do transfers; EmbryoGlue is a medium developed to closely resemble the environment in the uterus at the time of implantation. It is not a glue in the common sense, but acts as an adhesive by increasing the chance of implantation of the embryo to the uterus. The embryos are placed in the solution and allowed to soak in it for a fixed duration of time prior to the transfer (via NHS). However, like most things in the IVF world, (and as you will see when I share information from the Fertility Festival which I attended), there if a conflicting body of evidence about it’s effectiveness and further research is required. I think it’s still cool though! Ha. Another thing to mention, is the success rates of IVF as they are not as high as everyone thinks. How successful IVF will be depends on the woman’s age and the cause of infertility. The below percentages show the average chance of a birth from IVF treatment. These figures are for women using their own eggs and their partner’s sperm and use the per embryo transferred measure (via HFEA).

  • under 35: 29%
  • 35-37: 23%
  • 38-39: 15%
  • 40-42: 9%
  • 43-44: 3%
  • over 44: 2%.

For context I thought it might be worth sharing our journey so far minus the IVF bit (click here) – just to show a timeline of things and potentially for anyone looking to go down this route, to show how long it can take. I think we are very fortunate living up North because there was no waiting list for our referral and so everything has moved quite fast. Just after the new year, I had a bit of a meltdown when it started to hit me that we are ACTUALLY having IVF, it wasn’t hypothetical anymore and I just started getting really anxious to the point where I was struggling to sleep. At the time I did not have any of the information above and so I think it was just the enormity of the unknown and feeling so in the dark about what was to come. I sat down with my husband and told him how I was feeling and he did a mixture of comforting me but also scaremongering because in his mind it was better that I was prepared for a bad experience but we obviously hope for an okay experience _ I was going to say ‘good’ experience but I think that is asking for a lot! It’s very hard to tell what IVF is going to be like until you start going through it… it does not matter how much reading you do, how much information they give you, how many youtube videos you watch, you can never know how YOU are going to be, how YOU are going to experience it, it is such an individual journey and I cannot tell you how grateful I am to be doing it with someone else. I personally would not be able to do this without my husband and our life experiences have been so instrumental in our coping mechanisms because we accept things for what they are and work on solutions and being informed rather than dwelling on outcomes, which are often out of our control.

I hope this has been useful to some of you and an interesting read for the rest of you. I am more than happy to answer any specific questions in my DMs and I am always happy to chat, especially about this so honestly feel free 🙂

love & light

Noni x

Our fertility journey so far…

Investigations:

End of March 2019  – I was admitted into hospital via A&E with a second episode of pelvic pain (the first episode a couple of days before, I had waited 5 hours in A&E and left before I was seen as the pain had calmed down).

While in hospital this second time – In my discussions with the consultants & nurses, it became apparent to me that I had waited too long before seeking help with fertility, at this point we had been TTC for 2 years 3 months.

3rd April 2019 – Gynaecology appt – referral by my GP – which was initially to discuss the unexplained pelvic pain but became more of an investigation into our fertility.

In-between April & August – I had many blood tests done on me, ‘Day 3’ blood test to check my hormones, full blood count, HIV test, all of it

6 August 2019 – Transvaginal scan to rule out PCOS which I do not have, however, they found a mass of some sort but the test was done just before my period was due and it turned out to be a collapsed follicle – confirmed by a second transvaginal scan at a different time in my cycle. It is worth mentioning here that I have an irregular cycle!

24 September 2019 – We got the results for hubby’s sperm analysis via our GP and discovered we have a male factor (low count & poor motility) which significantly reduces the chances of spontaneous (natural) conception. It became clearer to us after research and discussions with Hubby’s renal consultant that dialysis does affect sperm count and most people on dialysis need IVF to assist. Normal fertility is restored if a patient has a transplant.

30 September 2019 – Final appt with our gynaecologist to confirm results of sperm analysis and advise the next steps. He referred us for IVF on the same day and advised that our chances for success were high because I just haven’t been exposed to healthy sperm and there is nothing that has come up in my investigations that might hinder implantation.

Pre-IVF:

3 October 2019  – We received forms and a questionnaire to fill out from our local NHS Clinical Commissioning group which would be used to confirm our eligibility for NHS funding – we also had to enclose copies of our ID/residency (we are both British citizens).

15 October 2019 – We received confirmation that we met the criteria for NHS funded treatment and that our Clinical Commissioning Group will fund up to 3 cycles which we must have received before we reach the age of 40.

22 October 2019 – We received a letter from the Fertility Centre welcoming us as new patients and directing us to their website to watch the information videos. This letter also contained an appointment for me to attend for some blood tests (which I had already done previously but they need to do their own tests.

31 October 2019 – Blood test appointment to test my AMH – which came out quite high.

18 November 2019 – We received a letter from the Fertility centre informing us to ring them to book an appointment to start our NHS IVF treatment, accompanied by LOTS of information sheets/leaflets and LOTS fo consent form to fill out.

Consent forms (we had one each of the following);

  • Acceptance of NHS funding and consent to pay fees not covered by NHS
  • HFEA Patient information form
  • Accounting for interests of the child
  • Consent to Chaperone
  • Checklist confirming you have received all the information sheets and understand the nature, purpose and implications of treatment
  • HFEA Consent to disclosing identity information
  • HFEA Men’s consent to treatment and storage (IVF and ICSI)
  • HFEA Women’s consent to treatment and storage (IVF and ICSI)
  • Embryo freezing and thawing consent
  • Consent to treatment, process and risks of IVF & ICSI

December 2019 onwards – to be shared at a later date.

The Show Must Go On

And then I surrendered. To the soft. And the sweet. And the sorrow. Not shying away. Allowing each inhale and exhale to source a new life in my cells from their exchange. Let this teach you. Within each release, lives an offering. What we let go of creates room for beginnings… Your winter may last for days, months, lifetimes. But do not mistake this as a dead bloom. Forever closed off to others. For this season isn’t for rising, just yet. This season is for letting the light pour itself into our emptied hands. Let this teach you. – @danielledoby

When we got the confirmation that IVF would be our only option, I felt I needed a break. From blogging. From talking about fertility. I just needed time to sit with everything, the last few months, everything that had come to light and everything else in-between. I always said that with blogging about fertility that I would write when I feel like it, when it comes to me, because the thing is our lives are so multi-dimensional and multi-faceted and so are we as people. And so while yes, dealing with infertility has been a real struggle for me, the break from it all gave me a renewed perspective about how much light we let in or don’t let in into our lives sometimes because we are holding onto a feeling, a struggle. Making room and time for other parts of my life made me feel whole again, functional, instrumental in the construction of who I am trying to be and the life I am trying to lead. I’ve been able to make time for joy too, meeting/connecting with my friends and occupying spaces that remind me of who I am. A long while before this I had unfollowed all the #tryingtoconceive hashtags on Instagram because I found it overwhelming to be trying to conceive yet seeing sad stories almost daily from the trying to conceive community. I fully sympathize with everyone in this community and I fully understand just how hard it can be but the sensationalism that can come with social media was too much for me. I am exactly the same with the News, I don’t watch or read the News… because my spirit cannot handle a constant stream of bad/terrifying messages, I am just not made for it. And I have always been one to choose my wellbeing over ‘general information’.

When we first began our investigations, I was very keen on knowing everything. I googled everything, I read and watched everything I could find but none of it ever made me feel at ease. What pacified my anxiety was attending each of our appointments and finding out more about our fertility health. The KNOWING, that real concrete knowing about our situation SPECIFICALLY put me more and more at ease with each appointment. Because the thing is, what you find on google is often generalised, and what you find on IG is often unique to that individual/couple. If your own fertility issues do not apply to either you can often be left feeling more in the dark and feeling like something is really wrong with you. And so now, I have really come into a space of surrendering. To the truth. Our truth. Not speculation. Not generalised information. Even up to now we are still finding out and learning new things with each of our appointments. At my last one, at the IVF clinic, I found out that I was VERY fertile. Something that I feel contradicts what the previous specialists were saying to me regarding my irregular cycle. They told me I was so fertile that they are worried I might over-respond to treatment which would not be ideal and so I will be having a milder IVF than normal. In March we thought we would have had one cycle of IVF by now and we were wondering what it would be like to be pregnant around Christmas. The point I am trying to make is this… surrendering does not mean you are giving up hope, not at all, for me, it simply means I am giving up trying to dictate the eventualities and timeframes around our fertility journey and just giving it all up to God, to science, and to intention. We have a true desire to be parents and I believe God will meet that desire and the science will facilitate our preferred outcome.

I mentioned before that I haven’t cried about this for quite a while now (about 5months) and some of that has to do with my puppy Leo, the sweetest puppy you will ever know!, but a lot of it has to do with just resetting my mindset. When I went to my first appointment at the IVF clinic, I went on my own, it was just a blood test so I figured I’ll be fine but when I got there I got overwhelmed with so much emotion and the other people in the waiting room were all couples and I started welling up and before things got out of hand, I got called in by the nurse and she was very matter of fact about everything – because I mean it was just a blood test – and I left after like 5mins and I just thought to myself, what on earth was all that near-crying about!? Our minds can trick us into emotion but we can also use our minds to control our emotion and I’ve really been trying to practice this. I have been thinking a lot about if/when I actually fall pregnant and have a baby and I keep imagining myself holding this baby and looking back at how s/he came about and I would hate for the memory to be that of pain and sorrow. I want my children to be conceived/birthed from a place of balance, a place of intention, the right energies, a place of faith. I think often about how when you are trying to conceive and there are no issues, you are making love or enjoying the pleasure of connection between you and your significant other. I think so much about the fact that we don’t have that opportunity and we won’t have the wonderful surprise of taking a test and voila! The IVF process is a process of scheduling, everything is controlled and dictated, to the T. So my mind has really been centered on how can I recreate the bliss of spontaneous (natural) conception in this simulated and very unnatural process. Disclaimer; I say bliss to mean just the sheer unknown and I say unnatural for the lack of a better word – all routes to parenthood are valid. When you go through IVF you know too much because EVERYTHING is scheduled and because it seems so scientific and fool-proof (which it really isn’t – 38% success rate for under 35s)  it can be very hard to deal with when that doesn’t work out. And I feel that my surrendering to the smaller unknown that you have with IVF will help me accept any eventuality with grace.

Because the truth is… The Show MUST Go On. Right after my near-crying blood test appointment, and I mean 2 mins after I got a call for an interview for a job which I went on to secure. A job opportunity that has been a long time in the making and I am so excited for. Like I said before we are so multidimensional and we live multifaceted lives and the one thing infertility has taught me is to keep it moving. You simply do not have a choice, because you still have to work, be a wife, be a friend, a sister. We allowed our desire to become parents consume a huge part of our lives and we put a lot of things on hold because were always planning for that baby. I don’t subscribe to that way of living anymore and instead, I want to be like water; occupying spaces that welcome me and moving past ones that do not. I also want balance. My only life mantra is to always seek balance in EVERYTHING. While my desire for a baby is very real and very strong, I also desire to be happy with what I have, as I am. As we approach our 3-year mark (in Jan 2020) of trying to conceive, ‘I will not mistake it as a dead bloom. For this season isn’t for rising, just yet.’ But in other aspects, January marks new beginnings, which one must make room for, for the light to enter; starting IVF and starting my new job.

The Show Must Go On. ‘And I surrender to the soft, the sweet and the sorrow’. Have a wonderful Christmas with your loved ones and a happy arrival into the New Year.

Love & (all of the) Light(s)

Noni x

Love Laid Bare x Un_fertility

I had the pleasure of sitting down with Dionne LDN of Love Laid Bare and we talked about my infertility journey so far and everything else in-between. Her line of questioning really made me stop and think and I felt so safe to share with her.

You can listen on Soundcloud, Spotify & Apple podcasts.

 

Please also checkout Dionne’s blog & instagram for more podcasts on other really important matters for our generation.

D, thank you so much for this opportunity to tell my unconventional story. The work that you are doing is important and I want you to know that we see you, and we need you.

Noni x

God, Infertility & Me

Oh, the blessing. Oh, the blessing.

Can’t you see, what God has done.

– Jesus Is King, a film by Kanye West

So the truth is, I hadn’t really been into the ‘Christian God’ thing for quite a while… I was always spiritual to a degree, spiritual including feeling things from my ancestors and I always believed there was/is a higher power, something bigger than us, something we owe our own individual power to. Organised religion was and still is not for me… I think when you know too much it becomes increasingly difficult to continue to believe in a concept that just doesn’t ring true to you. And although I was raised a Christian, this is how I feel about organised religion; the focus is way too much on the church and the pastor and other physical things of the world than it is about a true one-on-one relationship and experience with God. So I don’t subscribe to the organised (for man) part of religion and when I initially intended to write this post I had very different feelings about God and in particular where fertility was concerned. However, dealing with infertility, led me down a path of seeking, of searching for understanding and it is from that space that I reached out to God.

I was watching Bishop TD Jakessermon today and he said that God is a God of intention and that he sets things up, sometimes to prepare you for something bigger and sometimes to show you that he is still God even if, as in my case I wasn’t really checking for him at the time. It made made think about the time I ended up in hospital with pelvic pain which I talked about in my first blogpost and how at that point we had been trying to conceive for over 2 years and how even then I had no intentions of seeing someone about our struggle because in my mind I had planned to see someone if we were not pregnant by January 2020. But out of nowhere I had this pain I have never had in my entire life, which was preceded by 7 days of light spotting and ended up in hospital for 2 nights and at the end of it had senior nurses and senior doctors telling me that 2 years is too long to be trying without seeking any medical help and that they will be referring me to a gynaecologist. Note how they did not give me the option to do so myself via my GP. As I was listening to TD Jakes I realised that if that hospital incident did not happen, I would still be in the dark about ALL that we have discovered about our fertility in the last 6months, we would still be trying not knowing that we have a male factor which significantly reduces our chances for spontaneous (natural) conception, because in my basic mind, we were going to seek help in January. Are you getting what I’m saying right now?! We are on the verge of starting IVF treatment and God-willing having a family soon, and the thought that if that incident had not occurred we would still be where we were in March, right now, fills me with tears because God in his omniscient mind made sure we were on the trajectory that we are on now. God is in the detail.

When we started our investigations, I was initially okay but with the waiting and the results, and another day/month not falling pregnant, it increasingly became very difficult not to be consumed by everything and I started looking for churches in my area. But again when you know too much, and know yourself too much I didn’t want to go to a church and pretend to be connecting and experiencing God when I wasn’t and I honestly have no shame about knowing what I am seeking in terms of the presence and experience of God and I remembered how Bishop TD Jakes’ ‘Woman Thou Art Loosed’ album saved my mother through what was such a painful and horrible time for her. It was the 90s and I was very young at the time but now as an adult, knowing what it was she was going through and how we spent full days in worship to this album over the school holidays in my Dad’s apartment in South Africa (while he was at work) and how she held on to God during this time. In my search for God, I searched for that same God that was there for my mother and I searched in Google for the ‘The Potters House’ UK because I knew that was the name of TD Jakes’ church and I thought he might have some version of his church somewhere in the UK, the same way they have Hillsong Churches everywhere now. What I found was even better… something he has been doing but I had no idea was available, I found his YouTube channel with recorded sermons from his church which were uploaded every Sunday. I could have cried seeing this and I internally wrestled with the tradition VS unconventional way of connecting with God argument and that whole notion that church is where 3 or more are gathered played on my mind and I kept asking myself, if I am going to watch this alone at home, is it right? Will God connect with me? But I asked myself the more important question; what rings Truer to you? That is, what will foster a genuine connection and experience with God that is personal and about YOU & GOD? Then I thought about the unconventional in un_fertility and I thought I am out here campaigning essentially for unconventional routes to fertility yet I am here wrestling with the idea of an unconventional route to God. When TD Jakes said God sets things up…. He wasn’t lying! God is in the detail.

So for the last few months, I have been tuning in every Sunday to Bishop TD Jakes’ sermons on YouTube and it has been the weekly dose I need/ed to gain renewed perspective on our fertility journey. I talk a lot about the everyday of infertility being hard but because God led me/us on this path of discovery and the investigations and the outcome, I have found the journey less hard because we know now… we know what the issue is and what the “solution” is. I initially started watching the sermons on my own but now my husband sometimes joins me and he takes away his own perspective. For me personally, coming back to God… I don’t really like the word ‘back’ in this because back implies you are returning in the same way and to the same thing which for me is not the case because I am completely re-innovating the way I seek and receive God. But anyway coming back to God has shown me even when I am wavering, he isn’t, that even when I am not seeking him, he is constantly seeking me… a few days before I got married, one of my really good friends Kudzi said to me “I want to pray for you because I feel like you don’t think or realise what God can do for you. Is there anything in particular you want me to pray for?” At the time as I previously mentioned, I wasn’t down with God like that and I wasn’t even thinking about God to be honest and what she said is only making sense to me now, because it’s true I did not believe that God did things for me, I believed I made decisions that bear different consequences and that the Higher Power gave me that freedom and power to exercise. I did not believe in a God, I believed in an ideology of a higher power, something abstract, something very general. But I replied to my friend and I said “I am worried I won’t be able to have children” – this was 15months ago when I said these words and even with that frame of thinking it was not until 6 months ago that God forced me into a position that I had to be referred for fertility assistance. I can’t say this enough, God is in the detail.

I was talking to Dionne of Love Laid Bare during a recording of a podcast (coming soon) and I was telling her the story of how un_fertility came about and I was just explaining to her that for a long time before I started it I had this strong pulling towards something but I didn’t know what, all I knew was I needed to be doing something ‘meaningful to help women’, this was all the clarity I was getting from the energies I was receiving and at the time I was barely on social media, in fact I despised it and the more clarity I gained, it was Instagram that I was going to use. And here is something I haven’t told anyone yet, in my quest to find this meaningful concept/platform/business for women, I actually began preliminary work and research on a clothing line for “unconventional” women like me. I had spoken to different designers, I was getting a logo done, a manifesto, a business plan etc… this all started in February. And in March that’s when I ended up in hospital – on abcompletely different trajectory. God. Is. In. The. Detail. I have a lot of women following my story who have their own private stories which they haven’t shared with me but they are learning/becoming informed or gaining perspective through my story. I have met women who have shared their IVF success stories with me, one who I consider to be my mentor in all this. I have had opportunities to speak on radio and a podcast about infertility – opportunities to break the silence, shame and stigma. All of this would not have happened if I had not been willing to share my story and more importantly all of this would not have happened if I had not been receptive to what God was trying to show me and where he was leading me. The entire 6month journey would have not have happened If I had missed him – in the detail – because I was so focussed on the outcome I wanted.

I still believe that as christians we are constantly telling couples who are dealing with infertility to pray, pray and pray and not telling them to seek help. I do not subscribe to that way of thinking because it encourages denial and perpetuates the stigma around infertility. Even with God in your life/heart, I encourage anyone to seek medical help for medical problems. Although I have reconnected with God, I have not prayed the prayer asking Him for a child/ren, what I have prayed for is understanding – I have prayed for God to equip me with the mind-frame I need to endure this process, and more so now as we enter the realms of IVF. I have prayed for acceptance, for peace in our current reality, I have prayed to maintain joy outside of this process. And with all that God has shown me in the last 6 months alone, I pray for His will to be done and I pray I continue to be receptive to his will.

Because God is in the detail – and not in the outcome alone.

Final results (part 3)

“You know, your husband’s reaction just reaffirmed to me that God is out there working on us. How his experience readied him for this situation, how God brought you two together so that you wouldn’t have to deal with fragile masculinity while also navigating through this challenge. God knew what he was doing when he brought you two together.” – @anisiamichael

So let’s take things back to a couple of weeks ago… It was a Friday and we had our appointment at 3.30pm to get my husband’s semen results. Already I knew something wasn’t right because they had called him to come in to ‘discuss’ – usually if it’s all good they will just tell you that it’s looking good over the phone. Anyway I went to work and for pretty much the whole day I was having anxiety attacks. But the thing is I wasn’t worried about the results – I was worried about my husband and in my mind I kept playing the scene where he gets the bad news and I thought how am I going to be able to be there for him ENOUGH for him not to internalise this. I worried about him and for him as a man, as a Nigerian man but also just as my husband receiving not so good news. I am not even joking when I say I had to keep going to the toilet at work just to do breathing exercises so I didn’t self-combust. Eventually, the closer it got to 3.30pm my anxiety had calmed down and I was in strong supportive wifey-mode at this point and I met him at the surgery.

I tried not to make a huge fuss about it in case he was worried but while we were waiting to be seen, I just said to him “Whatever the results babe, it doesn’t matter. We are going to be parents and I would hate for you to internalise any part of this process because we have many options ahead of us. It doesn’t matter what we hear today, what matters is KNOWING what is available to us and what to do next.” My husband, being the chilled guy that he is, was like “I am not even worried… I have dealt with devasting news before (when his kidneys failed at 22) and I was in it alone, this time I’m not on my own and I am more emotionally evolved. I am not internalising this at all.” I know my husband and one might think oh maybe he was putting a brave face on but I felt it in him – he had a real acceptance of the dissonance that can happen between one’s physiology and one’s own vision of how it should be. And to be honest, at the very beginning of this process, the gynae had said that having been on dialysis for over 10years now, it is likely that his sperm will have been affected by this over time. Anything that affects the general health or natural functioning of the body can affect sperm quality. Just a quick one on dialysis – what my husband has is Renal failure which is when one or both your kidney fails i.e. stops working completely. In my husband’s case both his kidneys failed when he was 22 and at the time he didn’t really know what was going on but he wasn’t feeling well and he went to see a doctor and his BP was incredibly high and they were shocked he was still conscious. So when your kidneys don’t work properly you have to have dialysis a certain number of times every week; which involves being attached to a machine to remove waste products and excess fluid from the blood. You are connected to the machine via 2 needles linked to 2 tubes; one to take the blood out of the body into the machine and the other to bring the clean blood back into the body. Because Afro-Carribean people generally do not donate their organs, my husband has been on the waiting list for a kidney transplant for about 8 years because he has the rare blood type that is commonly found in Afro-Carribean people.

Studies looking at the sperm of men receiving dialysis treatment do show that many men have reduced sperm counts, and the sperm that are present are underactive. This seems to be due to failure of the sperm to develop in the testicle. Sometimes there is associated testosterone deficiency, but it is not clear from research whether testosterone treatment restores the numbers and function of sperm in men with kidney failure. After successful kidney transplantation, sperm numbers generally rise and there are reports of men who were infertile whilst on dialysis fathering children after transplantation. (© National Kidney Federation). So a huge part of me, although I hadn’t even looked this up at the time, wasn’t entirely shocked by the results because I mean 10 years of anything will have an effect on someone’s physiology. The GP basically explained to us (what most studies which I have now read up on say) that my husband’s sperm count was low and the motility (movement) wasn’t great either and that this significantly reduces our treatment option down to IVF. My husband did have some good sperm in there, what they call ‘progressive’ sperm and with IVF they would only pick the best sperm out of the lot to use for fertilisation with my eggs. Not long after seeing the GP we also saw the gynae who reiterated the meaning of the results but he said something that gave us so much hope… he said “The reason you haven’t fallen pregnant is because you haven’t been exposed to (healthy) sperm and since we pick the best with IVF for fertilisation, I don’t see any reason why the embryo would not embed itself in your uterus once we put it in the right place – because you have no underlying condition that might affect that process. So the chances for successful IVF are very good in your case.” It was so good to hear this but of course we know we have to maintain a level head because as we all know it is not always successful. I should add at this point that I had another transvaginal scan that did not show anything this time and whatever they saw last time was gone (YAY!). It is most likely that it was a collapsed follicle before my period.

So what is IVF? The process of IVF involves retrieving eggs from the ovary and combining them with sperm in a dish. If they fertilize, one or two embryos are returned into the womb to, hopefully, produce a healthy baby. We are doing IVF under NHS so we should be getting 2-3 cycles which is basically works out as 2-3 egg retrievals. Any embryos that are not used are frozen, so even if it is successful the first time any remaining embryos are frozen and stored for future use. I will do a full post on the IVF process as I know it but for now, in a nutshell the IVF process is as below:

In-vitro-fertilization-(IVF)-tunisia

A lot of people have been asking me how I am and how I feel and the truth is I don’t necessarily feel anything. And a huge part of that is just so I can maintain a level head about it all. I want to be prepared for both any good or disappointment that can come with this and I just feel that not getting ahead of myself and also not over-worrying is a good place to be. What I am happy about is the KNOWING, I talk a lot about the gift of knowing on this blog and for me that has been the best thing to come out of this journey. A knowing about our fertility health, about the options out there and more so the options available to us specifically because every case is different. My worst fear was to get to the end of all this and be told that we have unexplained infertility – for me personally – I wouldn’t have known how to process that. Although yes the results were not good news, they are concrete and something we can actually work with and I’ll be honest there is an element of relief on my part that we are going straight to IVF because after almost 3 years of trying the last thing I would have wanted is another prolonged process of trying out all the other treatment available before IVF and then not having success with that and then having to face IVF carrying all that disappointment. Going straight to IVF means the trying process is not extended and also there is a cut-off with IVF because once your cycles are done you have to re-evaluate and decide where or not you want to self-fund and go private or become parents in a different way. I personally want to be able to draw the line at some point and I feel the benefit of being funded by the NHS vs the cost of self-funding makes you consider drawing the line at some point. That’s not to say we would never go private if the NHS cycles were unsuccessful, but the end of the cycles offers a chance to just stop and figure things out as opposed to a long and disappointing stretch of failed treatment. I don’t know if I’m making sense but there is some relief for me in this being our only ‘assisted’ option.

I am however, extremely anxious about shutting down my natural menstrual cycle and the hormones that do all that (more on this in next post). I have always been quite conscious about what I put into my body and even when I was on contraception, I had the copper coil which releases no hormones at all because I can’t be sure what all these hormones are doing to our bodies. So that part I am worried about and there are so many stories from women who’ve had IVF and what it did to their bodies before they even fell pregnant. But the desire for a baby outweighs all of the anxiety and I have to deal with it, obviously. I don’t know exactly what to expect and as they say, ignorance is bliss so at the moment, I’m seeking solace in that. Of course this ignorance can’t last forever and I will have to have a moment of reckoning but for now, having signed the dotted line on the referral form and begun this journey, I am taking it one day at a time. I would like also like to add at this point that I will NOT be blogging about our IVF process in real-time – my husband and I would like to have that experience in private (the same privacy afforded to people who conceive naturally) because we don’t know what lies ahead and protecting that outcome, whichever way it goes is important to us. I will continue to blog about in/fertility related stuff but nothing about what is going on with us until we see it fit to do so again. Please know that this is in no way a response to any stigma, or shaming or silencing. Silence is okay if it is your own choosing and in this case,  it very much is my/our own choosing. I hope to be telling you good news in the near future and if that is the case, I want this time to be about my family – and not about the blog. I will continue to be here for any questions, suggestions for posts or one-to-one chats.

Please keep us in your prayers – for God’s will to prevail.

Love,

Noni x

Results (part 2)

“Infertility reveals the darkest & most vibrant days of your life. Lean in & honour both” – @mstiagendusa

When I began this investigative journey, I went into all my appointments not expecting them to find anything or pin-point anything. I just expected the worst-case scenario – which for me would be to find out that our infertility is “unexplained”, because I mean what do you do with that?! In the same breath, however, I feel like each time I see someone or have some sort of test, SOMETHING always comes up – almost as if my body wants to deduce it to SOMETHING and consequently influencing the specialist to think the issue is “this” then it’s “that” then again “maybe this!” So I am a bit anxious now when I go for any testing because there is always something!

So the first thing that has been ruled out is PCOS – I do not have the 2 features to meet the criteria as explained in my previous results post so that’s good – all I have to contend with is the irregular periods (and suspected irregular ovulation). Turns out though, in ruling out PCOS, something else was discovered in my right ovary during the transvaginal scan. I quote ‘There is a 22mm x 22mm x 10mm area of increased echogenicity on the right ovary with peripheral vascularity on colour doppler. Collapsing follicle or Endometrioma?’ I knew something was off when the surgery called to say the doctor wanted to see me to discuss my scan results because usually when there is nothing to raise an alarm, the secretaries tell you or they arrange a telephone call with the GP. But still, I was very chilled when I went in for my appointment until she mentioned endometriosis. Up until that point, I genuinely knew nothing about endometriosis – I had heard about it and knew people who suffered from it but I knew nothing about it especially in the context of trying to conceive. So obviously I asked the GP lots of questions and she basically explained that Endometriosis is a condition where tissue similar to the lining of the womb starts to grow in other places, such as the ovaries and fallopian tubes (NHS). And potentially this might be what is going on in my right ovary. We also started discussing my stint in hospital (that birthed this whole journey) and how the pain was on the right side of my pelvic area and even that morning before I saw her and the 2 days previous, I had this tinge of pain in my right pelvic area where the ovaries are located but I just put it down to ovulation ? I don’t know. And it’s a pain I often have but it’s such a slight pain (compared to period pain) that I have always just brushed it off. Also, I have very painful period pains which is another symptom of endometriosis. We both agreed that the coincidence was a bit much BUT she also explained that because of the timing of the scan and where I was in my cycle (I had just ovulated – the nurse confirmed it at the time which made me so happy!) that it could be the collapsed follicle when the egg is released and if not fertilized results in a period. And this would make sense because a few days after my scan my period came.

Endometriosis does not necessarily cause infertility but there is an association with fertility problems, although the cause is not fully established. Even with severe endometriosis, natural conception is still possible. As the severity of the endometriosis increases, scar tissue (adhesions) become more common and the chance of natural conception can decrease. There is an association between infertility and endometriosis, but the cause has not been fully established. Minimal to mild endometriosis sufferers have an almost normal chance of conception but some sufferers are infertile for unclear reasons. In cases of moderate and severe endometriosis chances of natural conception are reduced. This is because there are more adhesions that can trap the egg and stop it from moving down the Fallopian tube. Drug treatments have not been found to improve fertility. However, the removal of cysts, adhesions and nodules during surgical treatment has been found to increase chances of conception. Endometriosis can cause delay in getting pregnant, but once you are pregnant, pregnancy is expected to be no different from normal. There are reports of women who had more pain in the first few months of pregnancy. In general, pain improves, but may return after giving birth as periods return. © Endometriosis UK

It’s easy to speculate and run wild with explanations but speculations serve as assumptions to be confirmed or ruled out so I will be having the scan again but this time at a different time in my menstrual cycle, however, I have to see my gynae first who will further interpret the scan results and perform the second scan himself. This won’t be until the end of September because our appointment was booked 8 weeks in advance to give time for my hubby’s sperm results to come back. That’s another thing, sperm analysis results take the LONGEST time! Had I known this we would have started the investigations with him. Another update – regarding my blood/hormone results – I saw my gynae who interpreted the results and said my hormones look fine and do not suggest PCOS or a hormonal imbalance of any kind. Again – good! I then asked about what my GP said that I may not be ovulating and he said well because of your irregular cycle you are ovulating irregularly we know that but what the GP meant is that it is harder to know with your cycle when you are actually ovulating, is it slightly earlier than the norm or much later, we cannot guarantee when you will ovulate like we would be able to with a more regular cycle. So on this point I just want to stress the importance of specialism in medicine – my GP is not as equipped to make a gynaecological diagnosis from my hormone results as someone who trained in that specialism. So GPs speculate because that’s the nature of their investigations as GENERAL practitioners but a specialist like a gynae can give you more (dare I say accurate) insight on your results because that’s their forte and they will know, having dealt with thousands of samples of data and outcomes what is a red flag or not. My gynae was very calm and satisfied with my blood results that it put me at ease. My husband then asked about what our options are likely to be in terms of treatment and the gynae advised that it now depends on the sperm analysis; if my hubby’s sperm analysis is abnormal then our only option is IVF but if his sperm is normal then there could be interventions available to us before IVF such as hormonal treatment (clomid) for me to regulate my irregular cycle or IUI which is basically intrauterine insemination of my hubby’s semen into my womb at the optimal time for potential fertilization. My husband has been a dialysis patient (due to renal failure) for over 10 years now and he has regular dialysis which the gynae advised can affect sperm quality so there is that speculation – hopefully to be ruled out! (I will write about dialysis in another post at another time because I think that’s a condition that almost no one knows about – even I didn’t know before I met him – and it can happen to anyone and both my husband and I are big on raising awareness about kidney failure).

So, sperm analysis tests for several markers of sperm health, including:

  • the number of sperm in 1 milliliter (ml) of semen
  • the size and shape of the sperm
  • the ability of the sperm to move correctly

In couples that have been unable to conceive, some estimates suggest that there is a male factor present in 40 to 50 percent of cases, resulting from one or a combination of:

  • low sperm count in a sample of semen
  • poor sperm movement, known as motility
  • abnormal sperm size and shape, known as morphology

Sperm count or concentration

World Health Organization (WHO) guidelines suggest that a normal sperm count is at least 15 million per ml or no fewer than 39 million sperm per sample. Having less than this indicates a low sperm count.

Sperm motility

Sperm motility is the ability of the sperm to move efficiently. Low motility can reduce the sperm’s capacity to move through the female reproductive system to fertilize the egg. In a typical sample, at least 50 percent of the sperm will demonstrate normal motility.

Sperm morphology

Morphology refers to the size and the shape of the individual sperm. Normal sperm have a long tail and oval-shaped head. Abnormally sized or shaped sperm can have difficulty reaching, penetrating, and fertilizing the egg. Normal semen contains a minimum of 4 percent sperm with standard form.

© Medical News Today

So this is where we are so far… I have generally been quite busy (enjoying my love affair with SUMMER) and haven’t really been thinking about this too much but I was with my puppy (Leo) the other day and I realised that I haven’t cried in months about this infertility thing. My husband initially said I couldn’t have a puppy years ago but I’m now thinking how strategic his change of mind was when he told me in April that he would be getting me a puppy. I had been in hospital, I had been so down, had cried so much about this infertile life but I kid you not I have not cried once since Leo came into our lives. I don’t know if my hubby knew the effect a puppy would have but it has worked. Obviously, he is not a real baby and he will never replace the desire for one but now I am never home alone, or upset for too long because I just see his face and all is well in the world. Even now I’ve been typing for a couple of hours, he has been whining the whole time and he is giving me the sad puppy eyes. As well as filling my heart with a new kind of joy he has kept me so occupied that I haven’t spent much time feeling childless.

All in good time. This I know.

love & light

x

Trying to conceive

It’s 2019. Fertility should be more than “just wait and see.”

So I am currently in-between appointments and thought it might be the best time to go over the trying to conceive tools I have tried for anyone else out there who might be considering what to do next. The one thing I have definitely picked up on in the black/african community is how people without actually saying much make you feel uncomfortable for using trying to conceive (TTC) tools. Which goes back to the whole stigma and the idea that it should just happen for you and you don’t need ANY assistance of any kind. That’s cool if that is someone approach but it is not mine and anyone who knows me, knows how much I love an app so when I started exploring the infertility world I was so surprised by how many useful tools are out there, some free, others not so cheap! The one thing I will say is don’t be discouraged about using some kind of tool to assist you in becoming pregnant. The tools I have tried have given me so much wealth in terms of information about my cycle – a lot of which I might not have known had I not been charting and measuring one thing or the other! Of course, I haven’t tried everything but I think I have tried most in the last 2 years and 8 months. Also, I cannot give you ALL the information and this is purely my experience and opinion in bite-sized format so please click the links for further information and approach with an open mind, people respond differently to different things. I am more than happy to take any questions and chat one-on-one.

Flo app1

Claims: Number 1 mobile product for women’s health offering a Period tracker and ovulation calendar allowing you to log over 70 symptoms and activities to get the most precise AI-based period and ovulation predictions.

My experience: I agree with this claim. Out of all the period tracker apps I’ve used, Flo has been the best one for me in terms of the other things it can do, the simple and visual interface, the predictions that adapt with the information I put in. I have been using Flo for about 8 years now to chart my period and in terms predicting when my period is due it has been pretty accurate plus/minus a day or two each cycle. You can log plenty of other things like sexual activity, vaginal discharge, symptoms, mood, stress, alcohol intake, water intake, sleep, and weight. It also works with the Apple health app to log your steps. I don’t tend to use all these functions but there are there when I need them. You can also chart your basal body temperature (BBT) in the app which just helps it predict ovulation. Overall I was very happy with Flo however when we started trying I did feel that there would be more advanced tools out there because primarily, Flo is a period tracker and I had used it in this way for years. I still use Flo in conjunction with the other apps below.

Price: FREE! Perhaps the real plus about Flo is that the app is free and there are no extras that need to be bought. I think Flo is ideal when you’re still in your early days of trying or just to chart your periods.

Natural Cycles

Claims: FDA cleared as a medical device, the contraceptive app is 93% effective with typical use and 98% effective with perfect use. The intelligent contraceptive app identifies your fertility from your body temperature. Natural Cycles takes fertility tracking one step further. The app uses an algorithm which learns your unique cycle from the BBT temperatures you add. Once Natural Cycles has analysed your temperature curve it can detect ovulation, learn your fertile window and tell you where you are in the menstrual cycle. With Natural Cycles you’ll get a personalised fertility status every day.

My experience: You might be wondering why I chose to use a tool that sells itself as a contraceptive tool? Good question, and in hindsight this is one of the reasons I did not continue using it. Natural Cycles is an answer for women who do not want to put contraceptive hormones in their bodies (because we all know about the horrible side effects!) and instead want to abstain on the fertile days and keep the body all ‘natural’. The idea with Natural Cycles is to give you a fertility status every day by using your BBT to predict when you are likely to ovulate, so essentially one can also use it to time intercourse for maximum possibility. And they do advertise it as a trying to conceive tool as well – the app has two modes; as a contraceptive tool and a trying to conceive tool. Obviously I used the latter. Natural Cycles come as an app that works with a thermometer (which you have to buy separately!) and you have to take your temperature every morning before you get out of bed. In my eagerness it started off really well and I was remembering every morning, all good… The one thing the Natural Cycles app showed me, which for some reason I hadn’t picked up on before was that I had an irregular cycle – and this is VERY important to know when you are trying to conceive. My cycles can be anything from 33 days to 46 to 52 days – every month is different. So I did the temping for a few months, never quite getting ovulation confirmed each month and it discouraged me and I started slacking. What I also realised with Natural Cycles is that it seems to be based very much on a 28 day cycle and I think it would need years of cycle information to learn to make better predictions for someone like me with an irregular cycle… so it wasn’t a right fit for me personally (I’m sure it has worked for some people). And as mentioned before, Natural Cycles markets itself more as natural contraceptive than a trying to conceive (TTC) tool so perhaps it works better that way round.

Price: £49.99 annually including the thermometer (this is what I paid) or £6.99 monthly subscription and an extra £10 for the thermometer. This was the first trying to conceive tool I paid for. I must admit, I didn’t even tell my husband that I had bought a thermometer because you can feel a little bit crazy when you spend on trying to conceive, something that should happen naturally. After 2.5 years of trying though, you quickly get over that… and as you find out shortly, I have paid more than this!

Ovulation tests

Claims: An ovulation kit is also known as ovulation predictor kit (OPK). The kit detects the surge in LH in the urine and tells you when you may be approaching ovulation. The test predicts ovulation based on LH concentrations in urine. The standard kit has two lines. One line is the control line. It will tell you that the kit is working. The second line is the test line. LH is surging when the test line is similar in color or darker than the control line. The more advanced digital version presents a clear smiley face in the digital display when your LH surge has been detected, so you know this day and the following day are your best 2 days to try for a baby.

My experience: I started off with the standard ovulation tests which were really cheap on Amazon, and I used these when the Natural Cycles app prompted me to measure my luteinizing hormone (LH) on particular days leading up to my predicted fertile days. Using the ovulation test helps paint a clearer picture of what is going on with your hormone levels and helps to accurately narrow down your most fertile days. I personally found the standard test sticks hard to read, whether my line was darker than the test line or not, so I decided to switch to the digital version but alas, even with the digital one I had a flashing smiley for 11 days straight and never got the static smiley. In other cycles, I did not get any kind of smiley face at all. Whether that’s a true reflection of my hormone levels considering the suspicion that I might not be ovulation every cycle, I don’t know but the ovulation tests didn’t work for me so I gave them up.

Price: The standard ones are very cheap and I bought a box of 80 test strips for £10.99. The digital one comes with 10 testing sticks and the digital handle for £22 – I bought this one twice.

Taking Charge of your Fertility

Claims: TCOYF has helped literally hundreds of thousands of women achieve pregnancy, avoid pregnancy naturally, or simply gain better control of their health and lives. This book thoroughly explains the empowering Fertility Awareness Method with access to access to a full-featured charting app, our vibrant TTC community, informative articles, and helpful tips.

My experience: I wish I had found this book by Toni Weschler in the earlier days because it is a big book with so much information and illustrations and hard science – I still haven’t finished it but I would highly recommend it. So Toni’s method is basically the old school method (the Fertility Awareness Method – FAM) of checking your cervical mucus and position every day and logging this information. This can be accompanied by the BBT if you so wish. I did try this, I really did for about 6 weeks, but I couldn’t distinguish the different cervical indicators even with all the instructions and explanations in the book. As you’ve probably figured by now I need things to be presented to me very black and white when it comes fertility, I need to KNOW, not assume, so I did not feel confident about the observations I was making which in turn made me feel less empowered. Also I think the information in the book is invaluable, but when you have already been trying it can feel like such a huge task to get through it in order to feel empowered by it. Toni does say on her website that it is meant for early reading before you have to seek medical assistance and this would make sense because after a couple of years of trying, the last you want to do is try to get through a very thick and very scientific book! But I will finish it one day because it’s such an important book on fertility awareness. The app, compared to all the other apps out there is very dated and clunky in my opinion. They were making some improvements to it when I stopped using it so I’m sure it will get better.

Price: The book was £18 from amazon and the app was free.

Ovusense

Claims: OvuSense provides live updates predicting ovulation up to 24 hours in advance using your current cycle data. This helps you time your conception during each individual cycle, even if you have irregular ovulation timing. OvuSense then confirms ovulation with 99% clinically-proven accuracy. Helping you diagnose any issues and track the effect of any medication you may be taking. Giving you every answer you need about your cycle all in one device.

My experience: There is so much more about Ovusense so I encourage you to click on the link for more info. This is what I am currently using and might be strange for some people but basically Ovusense comes as a sensor in the shape of a sperm and you insert this in your vagina overnight (or whenever you sleep) and take it out in the morning and tap your phone on it (after washing it of course!) with the app open and it downloads all your core body temperature logs and produces a daily graph to identify when you are most fertile in real-time. I prefer Ovusense because it basically does all the work for me without me guessing or missing the temperature reading before it disappears or even remembering to take my temperature. Because you keep it in as you sleep, I have found it easier to remember to put it in and when I wake up once I start walking I feel the little tail so I remember I need to take it out and you have 2 hours to log your reading. So you can take a shower, wash your device without any rush at all. It is also very easy to put in (much easier in squat position) – a bit like wearing a tampon so nothing unusual there for most women. Obviously you don’t use it during your periods or during sex! So far (2 cycles) I have not had a confirmed ovulation and I cannot say what that means… and although I have not been confirmed to have it, Ovusense states that it can be used by women with PCOS unlike most other TTC tools.

Price: This is where it gets a bit interesting… you can get a starter pack for £99 with 2 months free subscription or £199 for a 12-month subscription. Your device will not work without a subscription. I cannot remember what I initially paid but I recently paid £99 for 12 months subscription as part of an offer for returning customers (this is my second stint with Ovusense – took a break for a couple of months and to be fair did not use it consistently enough initially).

Seven Seas Trying for a Baby

Claim: Seven Seas Trying For A Baby contains 400µg of Folic Acid which is recommended by the UK government. Folic acid is essential for your baby’s development as it is needed to promote the healthy formation of the baby’s neural tube. It also contains essential vitamins and minerals expertly blended for pre-conception and early pregnancy which work in harmony with your body.

My experience: I currently take one pill daily based on recommendations from other women, for example, a lady at work fell pregnant quickly while taking these and she had been told by a friend who also fell pregnant quickly about them. I know it’s never that simple and there are other factors that could have played a part but I figured why not, babies do need folic acid anyway. So it’s generally advisable to take these and you keep taking these until the baby is 12 weeks. Obviously, I can’t vouch for their effectiveness but I take them more as a way to prepare my body for a baby when the eventually occurs.

Price: You can get these in any supermarket or Boots for about £5 or on Amazon where I get mine for £4. The box comes with 28 pills, taken once a day.

Ava Bracelet

Claims: Tracks 5 physiological signs of fertility. Clinically proven fertility tracking bracelet which uses sensor technology to reveal what’s really happening with your cycle—whether you’re trying to conceive, are pregnant, or simply want to better understand your body. Worn only during sleep, Ava eliminates the guesswork around tracking your cycle. Tested for cycles 24 – 35 days. Not tested for PCOS.

My experience: I have not used the Ava bracelet as it has only been tested on cycles that range from 24 – 35 days and as you may know by now, my cycles can be and often are longer than this. The fact that it is also not tested on PCOS even though I haven’t been confirmed to have it just makes me think it is aimed at people with regular well-behaving cycles. I also haven’t tried it because of the hefty price tag!

Price: £250 #enoughsaid

So this is my list of trying to conceive tools. Have you tried any of these? How did you or are you getting on? Have you tried any others? I am always very interested in learning about other assistive tools so please do share.

Sidenote: Unfortunately, they haven’t started manufacturing the #justrelax pills yet, for those who are always dying to say that to someone dealing with infertility #shadenoshade #sorrynotsorry #pettyfertilityqueen #infertilityclapsback #okbye !