Difficulty getting pregnant....

Difficulty getting pregnant....

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Discussion

BlackVanDyke

9,932 posts

212 months

Tuesday 28th May 2013
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After coming to terms with the fact that I won't be able to conceive and carry a pregnancy, I'm now in the middle stages of applying to adopt. Has anybody else reached the point of looking for other ways to become a mum or dad? There were several couples who'd had extensive IVF etc. at the training/preparation course - ladies and gents, I take my hat off to you all.

missdiane

13,993 posts

250 months

Tuesday 28th May 2013
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I am horrified at some of my reactions to previous announcements of pregnancy by people we know, it also never leaves you, even now every announcement makes me feel quite jealous and I couldn't even tell you why as its not like we are trying again yet smile

Antonia

305 posts

162 months

Wednesday 29th May 2013
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Lotus82 said:
Antonia said:
It will also not overcome people being unable to conceive due to stress/the women's body not being prepared to carry a child.
This is an area of concern for me. As mentioned Mrs Lotus gets VERY stressed. It's part of her make up. It does not and has not ruled her life but when work or life pressures appear they quickly become anxieties for her. For example, we went out to celebrate a friends 30th this weekend and there were a couple of young children at the party, this set Mrs Lotus off and she spent 2 hours crying to her self and would not allow anyone to console her.....she is insular with her problems and does not like to talk to people other than myself. Again, part of her make up which needs to be addressed. Counselling may be something to look at.
Counselling can really help in some situations. But it can't be forced. It sounds to me like Mrs Lotus might be feeling a bit insecure. The down time with you may well boost her confidence. You can also try thinking of ways to boost her confidence and self worth, that might help too.

Lotus82 said:
Antonia said:
Stress plays an huge roll and IVF will not make it better. Really look at your lifestyle, how often do you kick back and do nothing? How are your weekends spent? Going out and socialising is fun but it still contributes to your stress levels. I really would recommend trimming your commitments and activities and give yourselves plenty of time together enjoying the view, reading a book, watching a DVD, listening to music etc. Have you tried reading aloud to one another?
See above.
We are both well aware this is an area that needs loads of work but when you're 32 and it's all you've ever known it's not that easy.

On your advice we have cleared at least 50% of our social engagements to just kick back at home, spend time in the garden and switch off. Did it Sunday and Monday and it was fantastic, both loved it.
Good good! Keep it up, no one would say stop socialising but it is amazing how little time couples of a certain age actually spend at home, together, doing nothing. People expect to have very full lives. It is the same with raising children, some parents forget that a child needs down time and to learn the ability to entertain themselves with their own thoughts. Children today are very much always stimulated and learn to react and respond, not to think and wonder. Sorry I jumping on a hippie soap box now.

Lotus82 said:
Antonia said:
Practical issues: I am assuming your wife has had blood tests for progesterone on day 21 and the chlamydia antigen test, Pap-smear is up to date and she is taking folic acid 400-500 mg per day?
Yep. Had all those tests (twice in fact) and got good results.
Yep. Taking the folic acid.
Good to hear ;-)
Hang in there!

Antonia

305 posts

162 months

Wednesday 29th May 2013
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Lotus82 said:
Thanks everyone for the comments.

Antonia said:
check to see if the mucus in the women is killing the sperm from the man
Does anyone know if this test is done in the UK (NHS) and at what stage?
What I was taught from a leading fertility specialist in London in 2005 was that the "post-coital test" was not used any more because the results were thoroughly unreliable. Way too many false positive results and it was impractical to carry out the test effectively.

So I was fascinated to hear when a couple had had the test here in NL. There is a huge statistical chance the pregnancy achieved after this test was a happy coincidence. Fertility medicine like a lot of medicine comes down to weighing up statistical chance of success versus harm and then choosing the treatment that offers the best compromise. The post coital test and IUI are low risk options but are labour intensive and have dubious success rates when compared to chance.

The test involves taking a sample from the vagina very soon after sex and counting how many sperm were still alive. So for many people it just isn't palatable.

But you can ask the specialist about it in your appointment. Maybe they will be a fan.
Useful info:
http://www.derbyhospitals.nhs.uk/easysiteweb/getre...


Edited by Antonia on Wednesday 29th May 16:06

Lotus82

82 posts

132 months

Tuesday 16th July 2013
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Hello,

So we had our appointment and test results. Wife still showing a very very slight sign of polycystic ovaries but it is incredibly small and the scan was totally clear, my sample showed good numbers throughout (volume, mobility etc) except for a reduced % of morphology, they were looking for 4%-5% of morphology but I was on 1% - what does this mean? 99% of my swimmers are funny looking?

Because of this we have been put forward for ICSI IVF rather than standard IVF. Process due to start in a month or so depending on lab availability when Mrs Lotus82 starts her next cycle.

Feeling positive - should I be considering the v.low morphology? Any comments welcome.

Edited by Lotus82 on Tuesday 16th July 11:55

h0b0

7,609 posts

197 months

Tuesday 16th July 2013
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Lotus82 said:
Hello,

So we had our appointment and test results. Wife still showing a very very slight sign of polycystic ovaries but it is incredibly small and the scan was totally clear, my sample showed good numbers throughout (volume, mobility etc) except for a reduced % of morphology, they were looking for 4%-5% of morphology but I was on 1% - what does this mean? 99% of my swimmers are funny looking?

Because of this we have been put forward for ICSI IVF rather than standard IVF. Process due to start in a month or so depending on lab availability when Mrs Lotus82 starts her next cycle.

Feeling positive - should I be considering the v.low morphology? Any comments welcome.
A low morphology means that your guys are a little funky looking. It means they can get to the egg but may not have the pointy nose to get in. The ICSI method is where they take your individual sperm and put them directly into the egg. This allows fertilization.

A couple of things to feel positive about. First, it sounds like the doctors have found what they were looking for and it means you have a good chance now. We have been through ICSI twice. The first round resulted in my son and the second will be my daughter in November. The second thing to think about, we did ICSI both times but did not need to on the second round for morphology reasons. (we have other things going on). My results had improved dramatically between the 2 rounds and I was "normal". The cause of my morphology issues had been a couple of very serious illnesses. Sperm takes 3 months to mature so think back and you may have been ill. Also, when they did the test, did they look for infections? If you have an infection in the sample it can be the cause of the morphology. These infections, while not dangerous to your overall health, can be a pain to get rid of. But, once gone your morphology can improve. They will need to cure the infection before they do IVF with normal antibiotics and retesting.


h0b0

7,609 posts

197 months

Tuesday 16th July 2013
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Here is something I said earlier.....

h0b0 said:

ICSI is just a small part of the overall IVF process.
For ICSI they select a sperm and insert it by needle into the egg.



This is because the genetic make up of your sperm is almost certainly good but he may have a funky looking head which will not allow him into the egg.

The eggs are then left to fertilize and monitored. On the morning of the third day they will take a look at the number of cells that have formed. Ideally they want 8 cells and no fragmentation. If they see this they may wait until the 5th day before putting them back in. This gives them more time to observe the progress. Normally, they will see less cells and some fragmentation so they will decide if they are going to wait for the 5th day or not.

This egg is perfect with 8 cells,



This egg would have little chance of success,



However, this one is perfect in my eyes and will be called Liam in 3 months



here you can see 5 clear cells and then some smaller fragments

Few things on egg quality,

A high or low number harvest/extracted does not directly link to quality. We had 14 eggs of which 12 fertilized and 3 made it to day 3 with no expectation of any making it to day 5. None stored 2 put in and one taking hold. These are low results from the initial number that came out and can go some way to explaining our issues. So if you only have two come out do not panic they may be two excellent ones. Also, if your eggs are not going to 5 days again do not worry either. 3 day implantation is fine. Crap quality eggs going in also does not lead to birth defects or other issues.

I have a friend who was told that her egg quality was terrible but they had paid to get this far so they should shove them in. She now has twins.

At some point a decision will be made as to freezing the fertilized eggs. This depends on quality over the first 3 days. If you get frozen (Popsicles) you don't have to go through the stimulation part of IVF next round but do have to do progesterone shots.

Knowing everything I can possibly know about situations is they way ideal with them. This web site, IVF explained is very informative and can assist with understanding the process. I am a numbers person and this site helped me understand the statistics of getting pregnant. For us it was once in 47 years and unfortunately that miracle natural pregnancy ended in miscarriage last year. First try at IVF we were lucky but going into IVF I understood that we had approximately 3:1 odds. It is still impossible not to have your hopes up though for first time luck.

What I will say, and this has no real basis in science, I believe male health is imperative. While alcohol and lifestyle have limited impact on sperm quality, infections can have a big impact on your chances. This impact can be both temporary or permanent. I became very ill due to ecoli poisoning and this infection was discovered everywhere in my body but the most difficult place to kill it was my prostate. By using ICSI they were able to ensure no infection would impact the egg or my wife whereas with normal IVF they could not proceed.

Point being, a couple could be described as infertile one year but this could be due to an infection that once cleared up could make the couple fine the next year. Any changes in sperm quality takes 3 months to come to fruition. So be patient when trying to increase sperm quality.


Any questions about anything let me know. We have experienced. Miscarriage, polyps, female infertility, Male infertility, Ultrasound both male and female, placenta previa (placenta over cervix) Gestational Diabetes.
Here is the update on that egg pictured earlier,



That's him in his play room with all his toys wanting to just attack me.

Using ICSI does not increase the chance of being Ginger. That's genetics

Edited by h0b0 on Tuesday 16th July 13:43

Lotus82

82 posts

132 months

Tuesday 16th July 2013
quotequote all
h0b0 said:
A low morphology means that your guys are a little funky looking. It means they can get to the egg but may not have the pointy nose to get in. The ICSI method is where they take your individual sperm and put them directly into the egg. This allows fertilization.

A couple of things to feel positive about. First, it sounds like the doctors have found what they were looking for and it means you have a good chance now. We have been through ICSI twice. The first round resulted in my son and the second will be my daughter in November. The second thing to think about, we did ICSI both times but did not need to on the second round for morphology reasons. (we have other things going on). My results had improved dramatically between the 2 rounds and I was "normal". The cause of my morphology issues had been a couple of very serious illnesses. Sperm takes 3 months to mature so think back and you may have been ill. Also, when they did the test, did they look for infections? If you have an infection in the sample it can be the cause of the morphology. These infections, while not dangerous to your overall health, can be a pain to get rid of. But, once gone your morphology can improve. They will need to cure the infection before they do IVF with normal antibiotics and retesting.
Great. Thanks.

Looking back to when I passed on my sample I was still engaged in a rather regular social life I.E. I was drinking a solid 15 pints a week every week (since reduced this). Would alcohol have an impact on morphology? No infections or illness for years, in that regard I am as fit as a fiddle.

The play room in the image above looks fantastic. Bet he is spoiled for choice when it comes to which toys to play with.

Edited by Lotus82 on Tuesday 16th July 14:44

h0b0

7,609 posts

197 months

Tuesday 16th July 2013
quotequote all
Lotus82 said:
Great. Thanks.

Looking back to when I passed on my sample I was still engaged in a rather regular social life I.E. I was drinking a solid 15 pints a week every week (since reduced this). Would alcohol have an impact on morphology? No infections or illness for years, in that regard I am as fit as a fiddle.

The play room in the image above looks fantastic. Bet he is spoiled for choice when it comes to which toys to play with.
It's too easy to find "reasons" and then focus on them too much. After doing a lot of research my belief is that drinking does not have an impact on morphology until you have a very serious drinking problem. So, don't go out there and be a raging drunk but do not worry about the odd drink. If you had a kick in the balls that would be more likely to be the cause.

Liam has plenty of toys but just wants to play with (/beat the crap out of) his dad.

Lotus82

82 posts

132 months

Thursday 1st August 2013
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Can anyone explain why the NHS is so slow and truly insensitive when it comes to IVF?

After trying for 18 months our GP referred us to a consultant. First consultation was January 2012. 3 further consultations were had between then (with juniors doctors) and we were finally referred to an IVF hospital in December 2012.

Waited 4 months to get an appointment for our tests (give blood, sample and ultrasound < could this really not have been done sooner?) at the IVF hospital. Waited an additional 5 months to get the results and have a sit down with a senior nurse to tell us we are go for IVF.

Waited for Mrs Lotus82 first bleed to start and called the IVF hospital. She was rudely address and made to feel like we were putting the IVF ward out with our requests (despite being told to call on that day), Mrs Lotus82 was then told we will not get IVF this month and to call back next month, the reason? A letter that was posted 4 weeks ago has not yet arrived - who still uses POST! Do you not have a computer system that updates instantly?

I very much doubt you get shirty McMillan nurses but the ones we have come across seem to act like they are dealing with drunken idiots rather then couple going through one of the most sensitive periods of their lives.

1x annoyed Lotus82
1x truly upset Mrs Lotus82, not only has she been addressed poorly but since the IVF hospital period started (Jan '13) she has gone through 7 monthly disappointments.

Years into this process and the saga continues.

Engineer1

10,486 posts

210 months

Thursday 1st August 2013
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The whole thing is run badly, and dependant on your postcode you may get 1, 2, 3 or no NHS funded trys. I suspect part of the delaying is down to the fact that once things start down the we're getting some help route the pressure is lifted and natural conception may occur.

Hang in there, the rest of the process is fairly rough on both of you so find some male mates you can vent on when things get rough, or her hormones kick in.

h0b0

7,609 posts

197 months

Friday 2nd August 2013
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I am in the US so can give you an idea of how it works when you do not have an NHS. If you don't have insurance then you are going to pay the full amount. Doctors over here bill 3 times what they expect to get from the insurance companies. It is part of the game. The issue is that if you don't have insurance you do not have the negotiating power and you will pay full cost. There is an alternative to insurance which is to pay for someone to negotiate for you so you still pay but now you are paying insurance rates.

I have gone for the highest level of insurance which costs me $6k a year for my family and my company make up the other $12k for a total of $18k. This may sound expensive but calculate how much you are paying for "free" health service and you will see it is not bad. On top of the up front costs I have to pay a small amount to see the doctor each time, around $20. They allow $100k of IVF. But, because everything is broken down the IVF portion is less than $20k each round so we get 5 rounds. The true cost of each round is significantly more but those costs come under a different bucket such as "ultrasound" or "inpatient procedure". For reference, the hospital stay for the birth of our first child was over $20k. If we had hit our 5 rounds we can cancel the insurance and open a new policy under my wife's job and start again.

Complicated? Yes very much so and I am sure on purpose. if you are not on top of it you get over charged. Also, I went for the full coverage so doctors eyes light up when they see how much is covered. If I had gone for a lower coverage my experience would be different.

So that's the money side of things, how does the service measure up? It can be hit and miss like the UK and depends on the quality of the hospitals and medical facilities near your location. I am in the NYC area so have the pick of the best so i am very fortunate. For our first child we were told that we had to try for (I think) a year before we would be eligible to see the specialist. We called them early and were seen with in a couple of days. The testing began and my results were done same day. My wife's check up was also done same day to get the ball rolling. Our specialist was excellent but there is only a thin layer over the reality which is this is a business and having people go through the entire procedure quickly makes them more money. For example, my wife needed ultra sound every morning. The queue for these was out of the door at 6AM. It never felt like a factory but that is what it was.

So with my results in we were delayed by about 4 weeks because of timing and an infection I had. Once that was sorted we went in for the IVF. The first visit to the specialist was at the end of March which is when we discovered my infection. We started drugs on May 9th, did ICIS and had a positive near the start of June (If I recall correctly. Definitely around those dates). It seemed like an age to us and reading this thread shows how lucky we are to have the process expedited by money (greed). The first round was for Liam who is a feisty little bugger. (He is a mini me)

Our second round was even quicker. There were no issues for me this time so we went straight into IVF so from beginning to positive was almost the same month!

I believe we have a moral obligation to provide health services to everyone not just the fortunate. So in that I believe in the NHS in theory. I hate the fact that I almost do not trust the doctors in the US because I have too good insurance. I always question if a procedure is necessary or just because my insurance covers it. But, the NHS is being run badly and as a result it is unfair to those who need the services.


Edited by h0b0 on Friday 2nd August 14:31

Chrissy G

193 posts

266 months

Saturday 3rd August 2013
quotequote all
Lotus82 said:
Can anyone explain why the NHS is so slow and truly insensitive when it comes to IVF?

After trying for 18 months our GP referred us to a consultant. First consultation was January 2012. 3 further consultations were had between then (with juniors doctors) and we were finally referred to an IVF hospital in December 2012.

Waited 4 months to get an appointment for our tests (give blood, sample and ultrasound < could this really not have been done sooner?) at the IVF hospital. Waited an additional 5 months to get the results and have a sit down with a senior nurse to tell us we are go for IVF.

Waited for Mrs Lotus82 first bleed to start and called the IVF hospital. She was rudely address and made to feel like we were putting the IVF ward out with our requests (despite being told to call on that day), Mrs Lotus82 was then told we will not get IVF this month and to call back next month, the reason? A letter that was posted 4 weeks ago has not yet arrived - who still uses POST! Do you not have a computer system that updates instantly?

I very much doubt you get shirty McMillan nurses but the ones we have come across seem to act like they are dealing with drunken idiots rather then couple going through one of the most sensitive periods of their lives.

1x annoyed Lotus82
1x truly upset Mrs Lotus82, not only has she been addressed poorly but since the IVF hospital period started (Jan '13) she has gone through 7 monthly disappointments.

Years into this process and the saga continues.
It all comes down to rationing and post code lottery. I can see both sides through my own experience with infertility treatment and working in the nhs.

my wife and I are both consultants in the nhs (in other specialities)and we were entitled to 1 cycle. We had a very bad experience in a private clinic which left my wife fughting for her life with a intraabdominal abscess requiring major surgery. We/she were just very unlucky. However against all odds a few years latter had a baby girl and our recent ivf has lead to twins. We've spent many thousands but can count ourselves very lucky we have been able to afford this. We started when we were trainees.

Regarding funding there may be light on the horizon.New NICE guidance might help change post code lotery but Foundation trusts might ignore recommendation. To give you an example my trust has to save 21 million this year as the money that is ring fenced for NHS trust goes into the community.

Although largely protected the NHS is doing more year on year with less. we are already seeing hospital close and merge and this is only the start so there will be painful choices. For eg for me to keep someone alive on dialysis cost 25k per annum with a survival of 3 years if that patient is over 75. You could treat 5 families with ivf Or do you use a drug that costs 20k to give you a few extra months with advanced Kidney cancer. There is no right or wrong.

I wish you all the best.

Chris


Edited by Chrissy G on Saturday 3rd August 00:26


Edited by Chrissy G on Saturday 3rd August 01:00

Antonia

305 posts

162 months

Saturday 24th August 2013
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Lotus82 said:
Can anyone explain why the NHS is so slow and truly insensitive when it comes to IVF?
Sorry to hear about your frustrations, I hope next month goes more smoothly. Unfortunately in all areas of life you have some experiences that go smoothly and you encounter people who leave you feeling better than the situation should allow and other times things don't go as expected. But the higher the stakes the more poor service grates.

I can say all the usual things that not all NHS fertility units are the same except for the fact that they are all staffed by human beings (as are non NHS ones), it could have been a bad day etc but I am sure you know this already. Stories of other's fantastic experiences will not make you feel any better, all you want is to see those two pink stripes in the plastic window. Of course you know perfectly well that getting wound up about this will only make you feel crap and have no effect whatsoever on the perpetrators.

My advice is put your thinking cap on and try and look to see if there is anything you could do to avoid this happening again (you are after all the bigger person here). Maybe get a contact number/email address of someone who *is* helpful and call them in advance of next month's big day just to check all is well and what/who exactly you need to call.

Good luck, fertility treatment is no picnic.

dgw980

73 posts

174 months

Friday 30th August 2013
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Hi guys. My OH and I have a similar story to most on here. 3 or 4 years of trying but unexplained infertility was how i think it was described. Needless to say I was a long time reader of this thread!

We were fortunate enough to be be able to afford 2 courses of IUI then 2 IVF, the second of which was successful and we now have a 20 month old wee boy. I can vouch for everything that is said re stress, lifestyle etc and in the end I believe this was the biggest problem for us.

One thing that I dont see mentioned often is Acupuncture. My OH went to a acupuncturist(?) specialising in fertility before the second round of IVF. I was a complete sceptic but to be honest it was just easier to let her go than argue! This is the only difference that i can recall between any of the treatments and whether it actually did anything or not i am not so sure - it certainly made my OH feel as if she was being pro-active. What it certainly did was relax and de-stress her at critical times during the process.

As i said whether it was actually a contributing factor or not i just wanted to throw it out there in case it can help others.

Lotus82

82 posts

132 months

Thursday 19th September 2013
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Quick update, we start our injections today. We have a month of relaxing ahead of us which should help no end.

Keep your fingers crossed.

Antonia

305 posts

162 months

Friday 4th October 2013
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Everything crossed here. Remember to talk to one another about what is going on.

Lotus82

82 posts

132 months

Monday 21st October 2013
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Updating this as I find it helps.

Egg retrieval today, it did not go to plan. Mrs dramatically overstimulated from the drugs which resulted in 20 retrieved eggs (wow).

Positive: Hopefully we will have approx 15 eggs that get through to full fertilisation. These will be put on ice.

Negative: NHS do not wish to proceed with us for another 3 months in case the wife overstimulates. Next appointment at the end of January followed by a month of buserelin injections before they insert one of the defrosted embryos.

Positive: My local NHS hospital has a 50%+ success rate with this slower approach and using frozen fertilised eggs.

Positive: We should have a good stock of fertilised eggs on ice so all being well we should not have to go through the whole egg retrieval process again any time soon.

As you can see, more positives than negatives. Mrs is not doing too well at present, however she will improve with rest and we can now look forward to a winter holiday and enjoy a glass of wine and a couple of beers at Christmas.

Lois

14,706 posts

253 months

Tuesday 22nd October 2013
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Wow your poor Mrs! Not surprised she's not feeling great with 20 eggs, but well done her!

Enjoy Christmas then new year new family :-)

Antonia

305 posts

162 months

Tuesday 12th November 2013
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Oh my! That is quite a harvest. I can understand why the hospital want to wait. Over stimulation can be nasty, luckily for your wife she's doing okay. Small steps and fingers crossed for the new year. Remember to spoil yourselves over the holidays ;-)