A weighty subject

I love my husband. I have just come back from the most frustrating walk ever (lots of pot holes and bins mid pavement which interrupted my bottom clenching power walking), weighed myself, and quelle surprise I have not lost an ounce in weight in the whole 2 weeks and 1 day of my new fitness regime. Feeling mightily hacked off, I read a mail from my husband that amongst other things said, "just got up to speed with your blog.....I cant believe I am still copping grief re the plane ride home!  I think you need to mention that you told me to take the seat and that I came back repeatedly to see if you wanted to swap...." I should be cross that the bit he finds most newsworthy is that, and not the emotional stuff, but I have to admit it tickled me rather  - and his comment, "point of criticism.... what bit of anonymous do you not get Ana Boulter??" Whoops - I had been planning on doing this anonymously but as you can see I forgot.
Anyway back to the point - having been back to back pregnant for 18 months, its fair to say I am twice the woman I was. My hips and ribs have widened in preparation for each pregnancy and never quite gone back in, so we're not getting off to a brilliant start. A hormonal trip to the hairdresser after miscarriage no.6 resulted in my long brown hair being chopped off and replaced with short blonde locks. All well and good but as my head is now disproportionately small to the size of my large, rotund body, I look ridiculous and the short hair only helps accentuate that. A 34B is a thing of the past and more likely to be a motorway junction number than a bra size for me. Then there's the fact that I have been almost on bed rest since October 2009 - if you have had one miscarriage every subsequent pregnancy comes with a 'do not even breath too hard' warning and exertion is most definitely not advised. Its a bit hard with a toddler to stick to the rules entirely but it does mean that any gym ambitions were dead and buried, which to be honest wasn't something I mourned much. I was quite good at 'what the hell, I'll be pregnant and much fatter than this soon so yes please I'll have the cheeseboard for pud,' in between pregnancy's. Then when pregnant, there is the carb ambush that happens at around 5 weeks and doesn't go until around 12-16 weeks which is basically is Mother Nature (we're gently re-building our relationship - if she can make my cycle return to 28 days and therefore fit in with the flights back to the UK for the IVF then we might be friends again) making sure that any thoughts of weight control during pregnancy are banished before they even started. As if its not depressing enough to not be pregnant, my stomach that used to be famed among friends for its flatness looks as though it is hosting a party for at least 2 babies, my bottom could house another 3 or 4, and for the first time in my life my cheekbones that used to be relatively prominent and my only source of pleasure in my face are nowhere to be seen. I am in the words of Marjorie Dawes from Little Britain's Fat Fighters, FAAAAAAT.
I will never reveal my weight to anyone, if my husband found out what I weigh I would be mortified and go into hiding. I was so concerned that he would see the horrible truth when we were being weighed at our IVF appointment I made the nurse cup her hand around the paper where she was writing the dreaded figure. Poor woman looked like a child trying to hide the answers to a spelling test, I was on the scales poised to rugby tackle her to the ground if she so much as let the light spill through her fingers and reveal the true horror. However, I can reveal that I am over a stone heavier than when this whole debacle started - in fact I am a stone and a half heavier but the extra 7lb really does make it seem hopeless and I am resigned to the fact that unless I have some surgery to remove a buttock, a stone is realistically all I can hope to lose between now and April. And that's pushing it.
So,  I have been on a mad quest to shift the fat which has basically resulted in my own ritual humiliation. I power walk every day, looking like a total idiot (I am not allowed to run because of bad back and dodgy pelvis). On day one I was seen by no less than four of the uber glamorous mothers whose children are in my sons class. They are the type who wear skinny jeans that are baggy on them, hair is always blow dried and perfect by 7am, if they wear make-up you can barely tell so perfectly is it applied. I tend to drop my son off with a touch of the previous days mascara under my eyes making my shadows darker than they already are, wearing one of my husbands jumpers over leggings in an attempt to cover the horror of my bottom and thighs, head hanging as low as it can so that I am not recognised, ready for my walk. I did think about teaching my son to say 'bye bye Granny' to me when he goes into school therefore deflecting attention from my true identity, but as my mother would consider it a disaster if she hit 8 stone and would fit in perfectly with the glamorous mums, I realise that would never cut the mustard. Plus even though she is hobbit sized she is pretty fierce when she wants to be and would kill me if she found out my deception on her next visit out here. 
So, I drop the little man off at school and begin my walk which according to my physio should last no longer than 30 minutes. I don't think she has quite grasped the urgency of the weight loss, so I do 45-60 minutes. When I first started I was passed TWICE by a Chinese woman in full make-up, pearls and very smart walking kit. Buns of steel, and frankly a body I would kill for. On her second passing I got a closer look and realised she was probably around 80. 
I do love my walking though, when I am not dodging anyone I know. I listen to The Archers, which recently has been more of an emotional roller coaster than my life - some idiot in the BBC decided to kill off Nigel Pargiter, one of the best characters, and it has been harrowing listening. Brilliantly done but not ideal if you are already on an emotional precipice. I have cried my way around my walk on many occasions for poor Nigel. Mind you, it does rather put things in perspective and if I think we are having a hard time I only need to think of poor Elizabeth and her children who now no longer have a husband or father. Dreadful (and an example of how I tend to talk about fictitious characters or famous people as though it was real life and they are my  friends - don't start me on Giuliana and Bill Rancic). I do clinical pilates twice a week and have just started horse riding again (we really need to keep this from my phsyio - given that running is a no go she would likely strike me off her books if she found out - I got a roasting from my mother in law on this subject too so the less said about the gee gee's the better), so you would think that I would be dropping some weight. I eat dust and drink air - ok not true but I do eat a low calorie diet, I am not drinking alcohol but I am drinking the equivalent quantity (i.e a lot) of chinese tea's that allegedly boost your metabolism. As a Nearly Doctor I know the only way to shift weight is to eat less and exercise more, so I am doing both. I think I have found perhaps the first flaw in being a Nearly Doctor as opposed to an Actual Doctor - I obviously missed the lesson that talked about the flaws in this theory, of which from personal experience there are clearly many. I do think I would like a little sign to carry around that say's 'fat for medical reasons.' 
Despite the distinct lack of weight loss, I am not giving up, I will definitely continue the regime as if nothing else I am enjoying the newly found scenery and beauty of Hong Kong that I didn't even know existed before (how dreadful is that - we've lived here for 5 years!) and despite getting lost on the trails quite regularly, when I do stick to the beaten track I am building up a few walking 'buddies' who nod and smile as they pass - at  my random outfit probably. I do feel better for the exercise and while it does not seem to be having the effect of restoring my body to its former mediocracy, it is at least filling my time while my son is at school and my house feels empty. I have some 'me' time to think about whatever I like, which for the past week has been our sons dreadful behaviour since starting school (do we really want to do IVF? I can barely cope with the one I have!) although he has been making me laugh a lot so I can forgive him a bit. He asked me last week if he could take his 'massive big poo' to school to show Miss Eileen? How can you not laugh at that?
And on that note - it could be so much worse, my friend has Giardia and hasn't lost a lb. Now that really is something to complain about. 

Letting the dust settle

I have often sat on the plane leaving London to come back to Hong Kong in a slightly melancholy mood but excited by the prospect of going home. We adore our life here in Asia and we are extremely fortunate in all that we have, but the one thing that the ex-pat life cannot provide is family. Our trip to Nottingham had been another example of how much I miss mine and wish I could be closer to them. My sister had extremely kindly given birth to her first son a week early so that I could see him, which I like to think was Mother Natures attempt at making amends. My sister might say that it was Mother Nature swapping her dislike from one sister to another as she had the most heinous birth, but nonetheless we were incredibly fortunate to meet the little man who bias as I am, really is adorable. It was poignant as my sister and I had shared a due date, as I had so often wished for (to the point where I was trying to get her to plan her conception at the same time as us. She steadfastly refused for many months which is nothing short of selfish, but then as luck would have it, we had exactly the same date. Now how about that for spooky?!) but as we know, for us it wasn't meant to be. I think it becomes easier as time goes on to see the babies - the 'could have beens' and it also makes it easier if the baby is born to a close friend or relative. I no longer look at them and think, ' I wonder what ours would have looked like,' or 'that could have been us,' as I did so much in the beginning, but I would be lying if there isn't a touch of sadness and a little reflection. Having said that, when the new babies start screaming and I see the familiar tired lines etched on the faces of the mothers, I do wonder if we should be doing IVF at all or just being happy with the fact that we at least get sleep these days?!
On this trip which had frankly been an emotional roller coaster, I was so very sad to say goodbye to my family, knowing I would miss out on seeing the baby achieve so many milestones, and sad that our son who for some reason loves babies would miss out on being close friends with another cousin. My sister in law has a son 6 months younger than ours and I often wish the boys could play together. If we can't have another child for whatever reason, a cousin would be the next best thing.
Still, you can't spend your life wishing and we do have a great life out here in Honkers as the local expats affectionately call it, and I must remember in times of self pity that I do have a live in helper and haven't picked up the iron for 5 years, so life isn't really that bad. But on the flight back I did feel very sad and low. I must interject here that it wasn't helped by the airline upgrading my husband and leaving my son and I to turn right, which just about had me running for the emergency exit. Seriously, what kind of person decides that its ok to split a family up and move the husband to the top of the hierarchy and into business class? I was so cross I promptly cried, then unleashed my full anger on my jammy husband who had left the sanctity of his little booth to come and braved walking into economy to see if there was anything he could do. Yes darling, swap seats would be a start. Husband retreated quick smart to his flat bed and I endured the worst flight I have ever had, totalling a mere ninety minutes sleep as my son, who got a good 5 hours, kept falling off the seat, which was made for a midget and not a regular sized toddler, let alone a posterially challenged middle aged hormonal woman. Still, as I couldn't sleep I did at least have 13 hours to mull over the events of the past week and indeed 2 years, and as the drinks trolley had stopped serving many hours ago, I could do this through very sober eyes.
Stupid as it sounds, one of the hardest things I am coming to terms with is facing the fact that we are having problems. I am well aware that 6 miscarriages would suggest things aren't going too well, but before we had taken the IVF plunge, it did seem as though there was a possibility it could work out by itself and we could gloss over any technical hitches. Slight head in the sand syndrome. Ok, massive head in the sand syndrome. I suppose it must be like an addict admitting they have a problem, once you say it out loud its real, as soon as you start having treatment its really real. I am not one to think too much about stuff as my thoughts have a tendency to confuse me, and I also have the attention span of a dead newt, but when strapped in a tiny airline seat with a 16kg child asleep on your legs (well I should say leg singular, I had lost the feeling of one of them somewhere over Amsterdam and was not sure it would ever regain consciousness) with sleep was as far away as the final destination - some 6 thousand miles - there was nothing to do but think.
I haven't really discussed the miscarriages in much detail - in the blog or indeed as they happened. I definitely talk about them on a fairly one dimensional level, and with the risk of sounding very hard and cruel, I didn't really do much crying when they happened, so to the outside world I think I came across as quite a cold fish. I am not sure if I am or not, I was most certainly sad when they happened, but sitting on the plane staring into space I realised that I have learnt quite a lot about myself throughout this process. I think in essence I don't like to go too deep and the reason for that is I am quite an emotional character and I don't have brilliant self will. I think if I allowed myself to really digest in it's entirety what has happened, I might not be able to pull  myself out of a fairly dark place. I also feel that there are so many other dreadful things happening to people in the world, some of whom I am friends with, that in the grand scheme of things our problems are not quite as bad as they could be. Life can be very mean to the people who least deserve it. So I am not saying I am shallow - I hope I am not - but I am not sure that thinking things over too much is necessarily a good thing. For me anyway.
I don't know if I have become more religious - well actually thats a lie, given that I wasn't even a tiny bit religious before we got married, and then decided that there was perhaps more to the whole Big Book than I had previously thought,  I am considerably more religious but a long way off the level that would grant me a pass into the inner sanctum of worshipers. However, I definitely do think a lot about why things happen. I did for a long long time blame myself for the miscarriages. I blamed the fact I used to smoke, the fact I am not adverse to a glass or wine or two (my maiden name was Boulter and my nickname was Two Bottles Boulter. Ahem). I thought each miscarriage was punishment for something I had done in the past. I once drove passed a cat that had been hit on the road, but I didn't stop to help it. If I had, would the cat be alive now and was I being punished for letting it die? In fairness I don't know if it did die, but you can see where I am going with this. I would see a correlation with the smallest indiscretion and our misfortune. I then started to think I was very ill, that I had polycystic ovaries, that I had ovarian cancer - not helped by the millions of e-mails circulating at that time raising awareness for ovarian cancer, bowel cancer, fingernail cancer, you name it. I would google the symptoms and be convinced I had each one and that is why I was not getting passed 8 weeks of pregnancy - not even worrying for a second that I might actually be ill, just more that the illness was rudely getting in the way of my pro-creation.
I have definitely mentally covered more or less every sub topic to be found on the subject of miscarriage, loss, fertility issues and probably in a far more dramatic way than is really necessary. I suppose emotions are really the only thing in life you can't control - you can make sure that they are tempered for the outside world to see, but there is very little one can do to actually try and influence them when alone with them. Well, thats how it works for me, and during the 13 hour plane trip to Hong Kong I had some 'quality time' with my emotions, which was interesting at best! I'm not sure I would recommend it - certainly not if during this time one of the most pressing thoughts is 'I wonder what my errant husband is up to now in business class' but it definitely gave me perspective. I resolved that as soon as I forgave my husband for abandoning me in economy, we would attack with vigour and excitement the road ahead, and perhaps it was time to let the events of the past be exactly that, the past.

The meeting- part two

Before we were called to our appointment, I took the time to have a look at the people we were sharing the waiting room with. It was strangely calming to see people just like us, sitting in their little sections, reading magazines, drinking coffee, smirking at tests. I felt like we were part of a club – the Assisted Pregnancy Club. Not quite the same as the Mile High club – neither are groups I would like to join, but the former we have found ourselves involuntarily fully paid up members of. The latter you could not pay me enough to become a member of.

Sometimes (a lot of the time) I feel like I stick out like a sore thumb. In the company of my friends in Hong Kong I am one of the few mums with only one child. When their second children were small babies it didn’t seem to matter, but now that they are growing up, having their own play dates with the siblings of the children that are my sons age, I feel more and more like I am the odd one out – being left behind.  People are announcing pregnancies at a rate of knots; so far I have shared due dates with 3 people, 2 of whom have gone on to have their babies, one of whom is still pregnant. I have watched their their bumps grow, heard the stories of their births and wondered what it was I did in a past life to not only lose our babies, but have to watch other people follow the path we were at one time on? Luckily they are all people I love dearly so after the initial upset, it’s easy to forget our loss and focus on their joy and enjoy their little bundles, but Mother Nature doesn’t know that and I think she could have been a little more lenient.

As our son grows up, more and more milestones remind me that this is not how we planned it. For example, he has just started pre-school. He goes 5 mornings a week for 3 hours. He loves it. I hate it. I had always thought that by this time in our life, he would be at school and I would be at home looking after a new baby. Never did I think that I would be coming home to an empty house. Silence and emptiness do nothing to help the mood, which I suppose is another reason I am blogging. It gives me something to do.

Anyway, back to the meeting room and I felt at ease and ready for our appointment. When Dr UK IVF came to call us in I was immediately a fan. He was a normal, nice, family man who frankly could have been a banker, accountant, brain surgeon, or any other profession that did not require looking at my private parts and talking about periods and cycles. It can be exceptionally uncomfortable and embarrassing discussing such personal aspects of your life with a stranger, but Dr UK IVF immediately made us feel relaxed and I only semi cringed when I remembered the fully comprehensive questionnaire we’d filled in and I knew he’d read. Words like period (which sends my Dad scurrying into his study faster than Jenson Button to the chequered flag) and sperm were just words, and it was easy to be frank with him. The AMH levels were discussed immediately – and again we were reassured that the test is not entirely reliable, I had had it 2 days after my ERCP which could have impacted it, and anyway it didn’t matter as I had a good number of follicles.

Then we got down to the nitty gritty. Dr UK IVF talked us through the process of IVF and of Array CHG - Chromosomal screening. I tried very hard to take it all in but there was so much to listen too and I have to be honest, I wanted to fast forward that bit and just have it done. Again, slap dash as Mum would say, impatient. He used lots of long words and had a flow chart, which for a stay at home Mum was about the most intellectually stimulating topic of conversation I’d had in a long time and I was struggling to keep up. I understood the timeline of injecting hormones into myself to control the ovaries and then a week later start injecting a stimulating drug to make the ovaries ovulate, more blood tests at this point and daily or alternate day scans to see what’s up (brilliant – my friend the probe makes his entrance again). A different type of hormone is injected a week after the ovulating injections, and then 36 hours later I have my eggs harvested. It sounded fairly invasive and intense but when it comes to all things medical I am no shrinking violet and am more than equipped to deal with any of this. I’ve spent more or less my whole life under the watchful eye of some doctor or another mainly due to degenerate discs in my back, hospitals don’t scare me, in fact I find it probably a bit too easy to sign myself over to the men and women in white coats. I couldn’t keep track of the number of injections but I knew it was a lot and I may be doing them myself, but as a Nearly Doctor that’s no biggie and I’d already been injecting myself with steroids for the last pregnancy so I could tick that off the list. The bit of the process however that started another wobble was the egg harvest. Rewind to AMH levels and 6 miscarriages, all chromosomal abnormalities, and here’s our next roadblock. Will they get any eggs? Will they find one that they can use? Will they all have gone bad? What if we do all the injections, complete the process and find we’ve got nothing to work with? Even as I type this I start to panic. When you involve scientists, there is no hiding from the truth. Dr UK IVF was saying that there was a problem and we needed to find out what it was before we could possibly have success. A list of 20 blood tests was put on a sheet of paper in front of us, testing literally everything. My chromosomes, my husbands, my liver function, protein level’s, HIV, thyroid, a blood clotting disease that I had already had tested the previous summer and come back with a ‘mutation’ which is the most hideous word. Some that I cant pronounce and have no recollection of what they were, but one tested my immune system which is a dreadfully scary test to have – have I got cancer? Is there some deadly disease coursing through my body that I do not know about? I felt like I was being bombarded with too many issues to deal with, the major one being the IVF, the secondary one being my general health. To date, not all of the tests have come back, luckily the ones that have are ok, we have 3 more weeks to wait for the full compliment to be in and we will know what we are dealing with, totaling 9 weeks of the unknown. I wake up in the night in a total panic from a dream where I am being told I have some horrible disease, or that its not possible to go ahead with the IVF, or on a really bad night, both.  The waiting is intense. I was so worried our hedonist lifestyle in Hong Kong (over here we are all very lucky to have live in domestic help – babysitters are not a problem which means going out is very very easy. Add that to an extremely social ex-pat life and you have a recipe for dialysis) and the impact it would have on our chances, I swore I would not drink between then and the treatment, which I have stuck to if you ignore Christmas that got rather in the way a week after we returned. I found and still find myself making deals with God – I’m not even particularly religious but I prayed and pray, asking that if He would help us get through this I would do charitable work, go totally organic, be kind to even the most irritating people and generally turn myself into a modern day Mother Teresa. I think God probably has the foresight to see that with all the good will in the world, that’s pushing it a bit but I hope he sees that I am trying to adopt a more tolerant and caring approach to life.

I had 20 vials of blood taken that day, my husband had 5. The upside said the nurse, was that I could have a Kitkat afterwards to bring my sugar levels back up. I don’t like chocolate, so my upside was somewhat of a let down.

We left our appointment with a potential time of April for IVF, when hopefully all the ‘retained product’ of the last miscarriage had gone. We had tones of literature to read about Array CGH (more about the technicalities later as I feel this is a ludicrously long blog and very confusing!). I was allowed to exercise again, and I resolved to get my back and pelvis (somewhat shot from my last pregnancy) in tiptop condition, lose the stone or so I had put on throughout the pregnancies, and we would treat our bodies like temples. In the car on the way to Heathrow we were quiet and reflective. More than ever we had been made aware that IVF is not a given, it is a delicate and fragile process that has no guarantee’s. It is not always the answer, as I had naively thought, and for the next 4 months we would be in no mans land. For a control freak such as me, getting to April was going to be another test. Because even thought we’d had 6 miscarriages, Mother Nature thought we could do with another test. She and I are on no speaks by the way, although I try as part of my bargaining with the Big Man to believe she does mean well. 

The meeting - part one.

I should explain that I grew up in a small village (well town now, but when I grew up we didn’t have quite so many new houses and Range Rovers) just outside Nottingham. I also went to University in Nottingham. I do like the area but I do feel as though it has a tendency to draw me back when I would perhaps like to be somewhere else. Take University for example. I studied Broadcast Journalism. A fairly new course, it was available in Nottingham or Bournemouth. I liked the idea of the seaside and my sister was in Southhampton so I thought it could be fun to go to Bournemouth, but all those nice advisers that guide you through the UCAS forms as they were then, said resolutely, ‘Nottingham is the best course, it’s industry recognised and you will be extremely lucky if you get in.’ Makes it quite hard then to say you’ve chosen a stick of rock and deck chair over journalistic brilliance, so I chose Nottingham. All my friends packed their cases and went off to a life of student digs in glamorous places such as Oxford, Manchester, Leeds, Hull  - ok I realise that is stretching the glamorous bit – but none the less their adventures started in new cities, mine was 15 miles away from Mum and Dad and frankly, dull. Anyway, my advisors were irritatingly right, it was the best course and I did do quite well out of it.

Fast forward quite a few years and here I am back in Nottingham to start another milestone in my life, IVF. Dr HK IVF had said a couple of weeks earlier, in tones I had heard many years before, ‘There are two centres you can do this, New York have a gold star lab and are fully proficient in the process and have very high success rates. Or there is a place in England you could go to. Have you heard of Nottingham?’ Have I heard of a place called Nottingham? Just call me Robin Hood. Not to be put off, I immediately and vocally voted New York; I could see myself and our son walking around Central Park, amusing the locals with our very British accents and being signed up as the next Piers Morgan (ok that’s ridiculous) while my husband made a name for himself as a banking Guru on Wall Street.  Interrupting my day dream was Dr HK IVF who went on to say, ‘The Doctor in Nottingham is the pioneer in this treatment, the world leader. He trained the guys in New York, so they are good, but he has the best lab and why would you go to someone who had been trained by the best when you can have the best?’ or words to that effect. Exit New York stage left, hello Nottingham. But every cloud and all that, Mum and Dad, or Granny and Poppa as they would be in this role, were nearby and we could stay with them and they could help with the little fellow. Having not ever been able to rely on Grandparents as we live in Hong Kong, my first experience of being able to share the load was this trip, and I really do have to interrupt the flow at this point and say thank goodness we did chose Nottingham. When the going got tough and I needed a moment, Mum and Dad stepped in and took control, our son thought he was a King and had the best holiday ever, and I allowed myself to be looked after by my parents. We hadn’t even got as far as discussing the actual treatment but I knew that if we did go ahead, there would be no way I could do it in New York, I needed my Mum and Dad as my husband would be in HK for most of the slog having to work. He was happy knowing that while he couldn’t be there to hold my hand, Mum and Dad could. It also made me realise that our baby hopes were our whole family’s baby hopes, I can see now how hard it is for my parents and my mother in law to see our struggle. Being a mum, seeing your child or children go through difficult times is just unbearable, at any age.

So, here we were, not in New York, in Nottingham meeting our doctor for the first time. First things first and I had to have a vaginal scan. Not something I would ever put my hand up for, in fact when I had our son, I was more terrified of having an internal than I was of giving birth. I am a prude and I do not in any way like lying on a bed, legs akimbo while some stranger puts a phallic shaped object in a place I like to keep private. I also have a brilliant ability to be wearing odd or holey socks on such occasions; which adds to my deepening embarrassment. On this occasion it was two nurses who were doing the deed, one a trainee (brillant). They were incredibly kind, ‘have you had this done before?’ Oh yes, just about a billion times,  mainly to tell me my baby is no more,  to confirm my infertility is a first. You can see my mood was darkening and I was beginning to panic. We all fell into an uncomfortable silence and the probing began. The nurses wanted to see the state of my uterus, fallopian tubes, and ovaries and count the follicles on each ovary, which would give a good indication of how many eggs we might get. Or not, seeing as I had decided it was all a waste of time. It took forever to get there, first of all we got to a junction, turn left to left ovary, right to right ovary, but there was an obstruction. Retained product from my last ERCP. That’s nice. A visible reminder of the reason we are here – my babies don’t survive. My eyes prickled a bit so I started making jokes, which bless them they laughed at when I am sure they were really thinking, ‘we’ve got a right nutter here.’ We finally got to the left ovary and the nurse began counting. This is where the IVF handbook would have come in handy as I had no idea what she was counting or why. Luckily she explained that she was counting follicles, and God love her said ‘oh that’s nice, you have 11 on this side.’ I didn’t say a word. She then did a quick detour around the retained product and started on the right side. ‘Wonderful, you have 12 on this side. You have very nice ovaries, they are a bit small but all good.’ Pardon? You said wonderful? What does that mean? Well, they explained, that’s a good number of follicles which should lead to a good crop of eggs. Que?? (In total Manuel from Fawlty Towers  style – seriously – I do turn into a total idiot in times of stress) But I have a lower than low AMH – this cannot be right? I told them my ‘score’ and they too looked puzzled, it was indeed odd to have that score, my history and these ‘nice’ ovaries. Not to worry, they said, forget the AMH score, this is good so far.

Honestly I could have cried, but I still had the undignified process of getting off the bed in just my socks and a woolly jumper, if I had started crying they may have felt compelled to hug me and that would have been highly awkward. A week of thinking I was infertile and our IVF dreams were dashed, and one cheeky probe into the hub, and all is well? I resolved to ask Dr UK IVF as soon as we were in his consulting rooms, but for now it was a mad dash back to the waiting room to tell my husband the good news. And to find out how he’d been doing…

Our IVF centre in Nottingham is rather nice. We are paying privately to have this done, and its sweet the effort they have gone to to make us feel at ease. They have lovely coffee, every magazine you could hope for (including Good Housekeeping which is my absolute favourite), nice newspapers for the men and a whopping great plasma screen TV which sadly let the side down as it was showing Jeremy Kyle. Still, it was as comfortable environment as you could hope for, given the other 4 couples and I knew we were here to have our bits poked and for the men, to produce a sample. Schoolgirl smirk. Honestly, neither my husband nor I know why we smile at this part of the process in a very childish manner but not at my internal scans, but we do. I trotted back from my scan to convey the good news about my nice ovaries, but there was no sign of my husband. He must be doing his sample. While I waited, the room filled up with men who I had not seen when we first arrived, they must have been whisked away to 'perform.' I was gratified to see that they all came back with a small grin and their wives struggled to keep a straight face too. I realise we were all probably behaving in a very adolescent manner, but sometimes its the little things that keep you going. I settled down to Good Housekeeping and then my husband came back, smirking a little. This is not his blog so I won't reveal the details of his part of the appointment, but all was well. He was delighted at the ovary news, we giggled nervously at the first chink of light in the process, and waited for our name to be called.

Holidays and hormones

I am sure there is handbook out there that prepares you for the challenges of IVF before you embark on it. We haven’t read it if it does exist, so we are learning the hard way that the road to IVF is not only full of potholes, there are quite a few dead ends and it is unbearably long.

First of all on our journey, I had a blood test taken in Hong Kong a couple of days after my ERCP for the last miscarriage, to determine my AMH levels. It’s a nifty little test that can tell a woman what her ovarian reserve is, simply put – how many eggs you have got left. As I had got pregnant every time we tried and had 6 pregnancies in the last 18 months, I was fairly sure mine would be ok and therefore didn’t give it a moment’s thought.  I was more concerned with the sub zero temperatures the UK was experiencing at the time. As we have lived in Hong Kong for 5 years we are officially pathetic when it comes to the cold and my wardrobe is not sufficiently equipped to deal with such temperatures. 

The trip had been organized in a rush – which I am sure my mother will say is the story of my life. Impatient. Can’t possibly wait. Thing is, when you already have a child and you are trying for another the age gap between brother and brother/sister becomes an obsession. There are those that will say having a bigger age gap is brilliant as the older child will cope far better with the baby, but for the couple trying, every month that passes is a month separating the children and their potential friendship further. Love any sibling as I hope my son will, I have no doubt that if I am still trying when he is 7, a newborn who will become a toddler who will become an irritant is not what he would like – and you can’t really blame him. He wants a playmate now, and in an ideal world, we want that for him too. Our doctor in Hong Kong had played a blinder and contacted the Doctor in England who was the world leader in this field – they’d gone to Uni together - and he had agreed to see us. He had one appointment before Christmas and even though that meant uprooting my son and I last minute and flying to the UK alone, my husband joining later as he had that rather large commitment called work – we accepted the appointment. We already had a holiday booked to Dubai for a couple of weeks before, and so we went on that full of hope and optimism. The downside was the fact that hormones and an exercise ban for the past 18 months have taken their toll on my body and I have gone from relatively acceptable in a bikini to definitely not.  However, fat and all I had a week to soak up the sun, be with my family and enjoy life without thinking about babies. Which I did, if you ignore the tears around the pool as I realized my son was pretty much the only child staying at the hotel who didn’t have a brother or sister to play with. There were a few misty eyed moments as the lovely proud pregnant lady rubbed her tum in her bikini – although it’s debatable if I was sad for my lack of bump or my definite collection of bumps plural that made up my wobbly thighs and tummy. But I could have a glass of wine, which was nice (should be for the amount they charge for alcohol in Dubai – criminal) and I was grateful that I was able to spend quality time with our fast growing up little man.

Restored and recharged I flew to England.

First thing that happened; an e-mail with my AMH results had come in overnight, and I woke up on the first morning to read that lo and behold, this fertile creature that I envisaged myself to be, was in fact verging on infertile. My score was 3.62, which is interpreted as low fertility. So low that some IVF clinics won’t even let you through the door.  Fast as you like, I was googling madly to interpret the results and see what the prognosis was. Bad. Awful. Not even a tiny bit ok, just dreadful. My poor Mum, who was struggling to come to terms with the whole IVF process already “just explain it to me one more time darling” got the brunt of my horror with incoherent ramblings through a torrent of tears, which I swiftly followed by a panicky e-mail to a friend of a friend - who happens to be an embryologist (you never know when your friends careers will come in handy, but at some point they all tend to. Even my friend who is a taxidermist) - asking for her view. My husband was 8 hours ahead in Hong Kong – so he got a hysterical call from his wife. Well his answer phone did – he was at a meeting, which just left me alone with my thoughts, which with an imagination like mine is a dangerous place to be. I felt physically sick. I was in England to have IVF that can screen for Chromosomal problems, which would in turn result in a successful pregnancy and we could complete our family. Yet here I was in my thermal PJ’s, jet lagged and cold, husband other side of the world, facing the stark reality that my baby making days were over. I cannot describe the feelings I had. As dramatic as it sounds, I honestly felt like part of my world had ended - and this fear of IVF not working has never gone away. For the first time it was abundantly clear that this was not a guarantee, far from it - we could end up spending a tonne of money, investing a year of our lives, and putting my body through a rigorous medial trial, all for nothing. I felt such a stab of disappointment - and I still get that same breath taking panic. It tends to wake me up in the night in a dripping sweat, and more regularly than I should admit. Stupid thoughts that shouldn’t even be in your subconscious surface at these times of panic. Should we look into adoption? Is this fate saying enough’s enough, just be content with the son you already have? Would my husband leave me for a woman who can have children? For the record he said no, unless she was a movie star in which case he said it would only be fair to consider his options. I felt numb. On that occasion, my saving grace was my son, who roused from his bed, gave me a sleepy smile and when I asked him if Mummy could have a cuddle, he obliged - wrapping his chubby little toddler arms around me. I went from despair to gratitude fairly smartish - we do have a son and we are so incredibly lucky. Yet when the lovely warm fuzzy moment had passed, reality started to sink back in again. As wonderful as he is, we DO want to have another child, this was not supposed to happen. I'm not brilliant at being down in the dumps or negative - I get rather bored with the whole glumness - probably because I have a very short attention span and it bores me, so after a little while of woe is me I did what is now predicable. Google.

It appeared with further investigation (well past page 5 of the search results) that all might not be lost – an e-mail from my embryologist friend confirmed this. The AMH test it appears has flaws, and while my score was undoubtedly low, it was not necessarily the end of the world. Women with lower scores had responded very well to the hormone stimulation drugs and produced just enough eggs to proceed. I’d been pregnant 6 times in 18 months for goodness sakes – surely that was proof enough?

We had a week to wait before our appointment and it was frankly an uphill struggle. I dealt with it by taking advantage of the exchange rate being in my favour and emptying all of my favourite UK shops of their wares. I didn't really want to talk about it - and when the nasty niggle of AMH levels, infertility and general despair crept back into my mind, usually after my son had gone to bed; I helped them disappear with a dose of red wine and British TV. Doctors should actually start prescribing that as a cure – it really does work. For a little while anyway, just long enough to gather one’s sanity back and at least create a calm exterior.

We had 5 days until my husband landed and 7 days until the appointment. I can honestly say it was one of the toughest weeks of my life. I did a lot of soul searching, a lot of secret crying and more praying than I think I have ever done in my life. When my other half, and I mean that literally not figuratively -I really don’t work without him - arrived, he did as he always does, calmed me down, talked rationally, and shared the burden away from me. We had a wonderful weekend, and by Monday, D-Day, we set off for our meeting.

The road to IVF has rather a lot of speed bumps....

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I'm doing this to save my friends sanity. They have spent 18 months listen to me talk about miscarriages, blood tests, IVF, petri dishes, vaginal scans and other such niceties. I am almost like a touring biology teacher, except I don't really know what I am talking about. So, I have decided to blog - which is a medium unknown to me and will probably end in disaster but none the less, it's worth a try. I am not sure what the outcome should be - is it a cathartic experience for me? A crutch for others who could be going through the same thing or really as simple as stopping my friends going insane with my constant babble about babies and my inability to have one? Well I suppose time will tell... To get to where we are now, and start blogging in the 'proper way' - according to Wikipedia anyway - i.e daily updates and insightful comments (mental note: must work on insightful) I need to go back a little and explain what's been going on in my life. The long and the short of it is I have had 6 miscarriages in 18 months, so now the husband and I are embarking on the great IVF journey. We hope it ends well which will make it great but for now we will call it the long IVF journey. It has to earn it's greatness. I have to mention here that we are already the parents of a 2 1/2 year old son, who was born not only naturally but I was on the pill. I know. As my sister would say, bonkers. I remember distinctly  being told by my gynae after my 3rd miscarriage that a patient of her's 'had 6 miscarriages and then went on to have 5 children.' Not being able to face the thought of 6 miscarriages - nor 5 children now I come to think about it, I went on a major internet search to 'find a cure' ( I like to give myself 10 out of 10 for trying - you'd have thought if there were cure it could be found on google). When that failed, I cried pittifully at my acupuncturist office. I'm not brilliant at public displays of emotion, and frankly was mortified with myself. She pulled out the name of a truly wonderful IVF specialist who worked at  the Prince of Wales hospital here in Hong Kong, and so our journey took a left at the Multiple Miscarriage sign and followed the directions for IVF. Our problem was unravelling to be a Chromosomal one - too many chromosomes in the embryo therefore making it 'incompatible with life.' Chromosomal abnormalities make up about 70% of miscarriages in the first trimester, it's incredibly common to have one. Some women don't even know they have had one if they are not trying for a baby - it can just seem like a late, heavy period. Given that I was peeing on sticks and monitoring my fertile days as fervently as a soldier on sentry duty, I knew every time at 3 weeks that I was pregnant - could probably have even told you the exact time I conceived. As probably could most of my friends given that nothing is sacred when you are trying for a baby. At this stage in the game I had had 2 ERCP's for miscarriages, both revealed Chromosomal Abnormalities (47 XX + 16 for the last one) and one that passed naturally, so we could only speculate as to why that had happened. The obvious solution was chromosomal. I had done my own personal diagnostics as a Nearly Doctor would. To clarify, I think I could be a doctor I just didn't have the A* maths and biology GCSE's required, but if you could be such a thing as Nearly A Doctor, I would be one. I had read about chromosomal screening, but from what I knew it wasn't available in Hong Kong, and even if it were, would it help us? So we went to see the IVF specialist with a feeling of doom mixed with a hint of hope. We thought he would either tell us we had a problem that couldn't be overcome, or that we could start IVF there and then and in 9 months we would have a beautiful baby. As it happens, he didn't tell us either. He said the same as my gynae, 3 miscarriages is technically bad luck, not enough to warrant Chromosomal screening, which at the time he didn't think we could do anyway, so the only thing for it was to get back on the horse and try again. Joy. So the routine of making a baby resumed - it is routine for all those who are trying will know - romance is absolutely out of the question, marks for technical ability and speed of sperm range from 1-10, all post coital chat is centred on if that was 'the one,' while legs are positioned firmly in the air, cycling as though it were the Tour de France. All of this while trying not to feel too desperate at the thought that we were now in the high risk miscarriage category and subsequent pregnancies were highly likely to end in the same way. It does rather take the fun and to a certain extent the point out of it all, and is definitely one of those times where a real life remote control would have been useful - fast forward to the happy ending, if fate decrees there will be one.  We ARE lucky in that I fell pregnant 3 more times, but it sadly took me to lose all three babies before our IVF specialist said 'enough's enough, we need to do IVF.' He said that two days before our 6th baby's heartbeat fluttered it's last, the ultrasound still showing the tiny but visible beat, yet I was already planning the ERCP. I must say at this point - he was not being remotely cruel, he knew us well and knew how I always needed to have the next plan of attack to focus on - otherwise I would focus on the present day reality of yet another baby gone. However, I will never forget the feeling of  horror when I got home and realised that I had given up on this life before it had - what kind of mother was I? How utterly dreadful to mentally check out of the situation before it had even ended itself - did this baby not deserve hope and the support of its mother? In hindsight I see that wasn't the case. I just simply couldn't bear to say goodbye to yet another due date, cancel another already mentally planned christening and to look my husband in the eye and see his sadness. I find that almost impossible - one of the hardest things to deal with. Its a very strange feeling to see the man who protects you, provides for your family, shoulders the burden of responsibility for you when you can't, struggle to make sense of it all. Seeing this big strong man whom I love with all my heart, cry, is at times too much to take, because like it or not, there is part of me that thinks I have failed him. The echoed words of my gynae telling me 'I had a woman who had 6 miscarriages......' rang in my ears. The thought back then that was so abhorrent - to have 6 miscarriages - was now a reality. So, you can see how I could not let the grey mists descend. Instead I chose to put the all too familer wheels of recovery already in motion, turned into the archetypal Brit - stiffened my upper lip - came home and did what any Nearly Doctor would do in times of crisis - googled for a solution. My search didn't come up with much apart from lots of miracle stories of women who had had similar situations to us and their babies had survived. I did let a tiny glimmer of hope back into my heart, but I think deep down I knew it was over. Two days later and another scan showed that the heartbeat had stopped and we were devastated. This pregnancy had been a physical and emotional test of every ounce of strength we had had and we were exhausted. I had been injecting steroids into my stomach daily, had continual morning sickness and I was so tired I was beginning to forget things. We'd had scans twice, sometimes 4 times a week. Both of us were drained and felt as though the past 18 months had come together for one final blow. The loss of all 6 pregnancies hit home and we really did feel desperately sad and unhappy. Our only option was to see if we could find somewhere that did Chromosomal screening, which luckily for us they do in the UK. So we picked ourselves up, booked some flights for 3 weeks later and embarked on our IVF journey.