4 February 2019

IVF Appointment.

Our long-awaited IVF appointment.

Our first Glasgow appointment had been 6 December 2017, we were told it could be "up to a year" as they needed to create the genetic probe once we got to the top of the list. We got the appointment letter through over a year later, and although it was only a few days into February, mentally that was another month, and it just still seemed so far away.

By the time we made it there, on 4 February 2019 I had known that I was pregnant for 19 days. I had had two ultrasound scans. I was scared that this was another pregnancy that was not going to work out. I went along to get information, to press pause, and to move forward.

I didn't tell the PGD nurse straight away that I was pregnant, she started asking me questions, and as part of IVF they have to know when your last period was, because it can help figure out the timing of the next one, after which they can start treatment. So at the point that she asked about that, my response was "well... about that!" So that changed the course of our appointment. She didn't smile and congratulate us, which was refreshing at that stage, she acknowledged the risks, and said that we would go through the information a little differently.

She explained that the appointment would usually take fresh blood samples to analyse my AMH levels again (hormones that show if you have plenty of eggs or not), and go through the whole process with what happens next. She still did that with us, but potentially focused more on the genetics side of it, to help us to understand the risks a little better. We met with two different geneticists, and the person who explained it best was the PGD nurse. Nurses are definitely un-sung heroes. She explained that with our translocation, we have a 30-50% chance of successful pregnancy resulting in live birth, a 50-70% chance of unbalanced pregnancy resulting in miscarriage, and within that, less than a 1% chance of live birth with severe defects and disabilities.

She showed us the information that came from the team who created the genetic probe, and explained that they use fluorescent dyes to isolate the imbalances that they are looking for. It was really quite interesting, the science behind it all, and I'm sure I'd be just as fascinated if it wasn't happening to me, but definitely a lot more emotionally detached too! I'm not sure if that would help or hinder my understanding though. She had a table of the 16 "options" as it were, and one of the columns had the word "viable" at the top. She explained that those options marked yes were able to be identified in the probe, but they had not been able to create a probe for those marked no. I looked down the list and saw that most of the no options were those with significant amounts of missing material, and not any of the main 4 that I believe are more common, so I was not too concerned by this. I'm not sure if she would have shown us it in that much detail had I been more emotional and reliant on IVF, if I had not been pregnant at the time.

She explained the timings of IVF if we go through it in Glasgow. It all actually seemed very fast. Next period, get in touch, then likely the following, depending on the week that was in it, and if there was a slot available that week, I would start all the hormone injections. Two weeks later I would go in for scans of my ovaries, they would look at how many follicles and recommend (or not) the trigger shot, that triggers the follicles to release the fertile eggs. Then I'd go back and get those eggs extracted. All very medical and clinical and not at all embarrassing. My husband, at the same time, would have to go into a disabled toilet with a cup, and think happy thoughts. Dignified.

Once fertilised, the embryos are left for 5 days to mature, they are biopsied, and then about a week after they are extracted, hopefully one is viable and can be put back in. Then there's the two week wait. Grim.

So she asked if we had any questions, and we spoke about how disappointing the experience had been when we had been for our initial appointment in December 2017. I explained that I had asked about embryo storage of extra viable embryos, knowing that they had already given us statistics, to be told that I should prepare for it not working, and when I asked them to give me the cost anyway, if we were looking at it in a more optimistic way, I was told, essentially, that I shouldn't be optimistic. So with the nurse suitably horrified at that anecdote, I then added that we left that appointment and I wanted nothing to do with IVF in Glasgow, I didn't see the point of us even going there, and wanted to run and jump out of a window. So she said that she would pass that on. I think at the time, of the first appointment that is, I was going with such a logical mind, that was coloured by my emotions, but I knew the chances, to be told to completely ignore the chances as it was unlikely to work, was such a horrific blow and really impacted me in such a negative way for a long time. I was glad that we were able to share that while hopeful that our current pregnancy would work.

The nurse gave us as much time as we wanted, but the appointment didn't take as long as it should have done, had I been starting the process for real. We left and she told us that our case would remain open until we have a healthy, live birth. She asked us to keep her informed of the progression of our pregnancy, and wished us luck with it. I left feeling a lot more positive about our chances with IVF, even though I still didn't really want to do it.

Then we headed to Costco, where one of the samples that day was an amazing lasagne, and I knew I wouldn't get away with going back for seconds. Another sample was gin and tonic, but the tonic on it's own was lovely.