IVF & Our Story - Part 3
We must accept finite disappointment
but never lose infinite hope.
Martin Luther King, Jr.
It was April 2016, and I had decided on the off chance to call the clinic IVFSpain in Alicante. The day I called them I got through to some one who was a British ex-pat, so it was easy to talk through our previous treatment and what we were looking for. They ran through a number of possible options we had available to us, but the best thing we needed to do was go over and speak with the doctors in person. I called Joanne, I told her everything about my call and without hesitation she said let's do it, let's at least meet them when we are over in Alicante in May for our annual family trip, what was there to lose. Over the next few weeks the clinic in Spain sent on a lot of material for us to read to through and prep for our meeting, they also asked us to gather up our full medical history from our Irish clinic and forward it on to them so they could analyse our past before we arrived in May.
It was the 4th of May, the day we were to meet IVFSpain had arrived. The night before incidentally we had driven to the clinic just to see whereabouts it was located. I remember Joanne saying before we had pulled up outside the front, "Jesus Will it looks a bit dodgy", that was of course before we pulled up. She thought the gates looked weird from the distance, and turned it out it was uber modern. The day of the consultation that uber modern theme continued, we strolled up to reception, it was like some sort of hotel day spa place, it was nowhere like the clinic at home. The receptionist gave us quite detailed consent forms, there is a lot of legal jargon that needs to be signed off with any IVF treatment. Soon after, doctor 1 took us in to a room, this consisted of a few high level chats, and pricing for for the day. I say pricing, we arrived thinking ok we will have a few chats and a consultation, we were wrong they suggested bloods, and to my horror a sperm sample. The one remarkable thing however was they would have all the results back by midday, at home it would take weeks to get that so quickly. Almost immediately I had to give my sample, that caught me completely off guard as I was not expecting it, so much so I thought I was going to puke, all I can I say I left thinking that went terrible, and I thought great this going to be off to a great start especially if they can't analyse my sample. Anyhow once we had our bloods and sample given we were told to come back in 2 hours and we would meet with a fertility specialist. So far we had met 3 people, the receptionist, doctor 1 and a nurse, everyone of them spoke perfect English and were so friendly. We went off for a coffee and something to eat at the beach nearby, which was a nice change of pace in comparison to home.
When we arrived back at the clinic, we were ushered upstairs to a new level to meet with a fertility specialist. The fertility doctor had our blood results, of which everything was ok and also my sperm sample results. My little guys were increasing ever so slightly, it had gone from 1.2->1.8->2.2 million since August 2015. The doctors first words, your numbers right now do not matter, we can get them to increase no problem. Wow, ok there whoa don't be promising the stars to me I was a bit skeptical but she said all I need to do was take high doses of Vitamin E and C daily, with an anti-inflammatory 2 weeks before an egg collection. God the doctor took us through absolutely everything, it was nothing like before. She got so detailed about the entire fertility process and how it actually works, she was amazing. She explained as my count was low and Joanne's AMH(basically the quantity of eggs a woman has when they are born, as they get older it decreases) was low it would be harder but they would give us the best damn shot they could. She had given us one thing no one had given us before, hope. That was all we needed a bit of hope and she would have our trust.
The main option we spoke about on the day was something called "Embryo Banking". Basically this is doing 1 egg collection, getting as many fertilised embryos as possible and freezing them. You would then do a second egg collection and do the very same, get as many fertilised embryos as possible. You could potentially end up with 5 embryos from each round totalling 10, this would give us 10 chances at getting pregnant. On top of the embryo banking they also suggested a process called PGS ( pre genetic screening ). Let me give you the layman terms, they take all the embryos they send them off to a lab, test them, and they can see if they will work, they are able to tell by the genetic cell make up of the embryos if they will be viable or ultimately fail causing a miscarriage. We left with so many options but at least we had them, options that is. We had a fair bit of thinking to get through. We went off for lunch, or at least I think we did the day had been insane so my memory is scant. We had a great chat and provisionally thought we should do it. We decided to start in August 2016, the next part of our journey was about to begin. This was an investment, the remainder of any money we had would go in to this, it was our last shot at making babies.
When we got back from Spain, we had a renewed sense of optimism, we would actually start the fertility treatment in July as it was more of a longer lead in. They wanted Joanne to do a priming month so they could get as much information as possible about Joanne's fertility. To do this they would place Joanne on the pill, she would get scans done at a fertility scan clinic in Rathgar to monitor progress. As with any satellite fertility clinic you need to do your scans at a local scan company and also get your bloods done, for us we found the Orwell clinic in Rathgar to be top class the whole way through the process, they were so helpful and fast. With regards the IVF drugs, it was harder this time especially on the drug payment scheme. How it is done is we needed a local doctor in Dublin to sign off on the Spanish prescription, once we had that sorted we went to a pharmacy in the city for them to source the drugs. Between the doctor and pharmacy they were so helpful in getting our new batch of IVF medication, but in between it there was a fair amount of fretting that happened at the fear we wouldn't get the drugs sorted out.
Once Joanne's priming month was done it was nearly mid August, and the IVF drug cycle begun. This time it was a bit more complicated, rather than having a pen to inject, it was now 2 vials of powder and 1 vial of saline solution. These had to be mixed by us each night, and injected with a proper needle, this was quite daunting for us both but we watched countless videos on YouTube to make sure we were doing it right. Like before we had become a team and after a while we had the process down to a tee. When Joanne was coming to the end of her drug cycle she was in to the Orwell every few days for scans to see how big the eggs were growing. We had planned our trip back to Alicante on a certain date given to us from the IVFSpain clinic, basically we needed to be back there when Joanne's eggs were coming to a certain size. This was a real adventure now, it was going back to our favourite place to go on holidays but for a more life changing reason. Our trip would be for 10 days a Thursday to a Sunday, I think of those 11 days we spent 8 of those going back and forth to the clinic, it was scans and bloods nearly every day. It culminated on the 8th day which was the Friday, the egg collection with a new clinic was here.
We arrived at 10am, and almost straight away we were brought in to the operating theatre waiting room. We were ready, we prepared as best we could for this we had done everything by the book. We spoke with the embryologist for the procedure who was lovely ( they always seem to be, even in Dublin.). Joanne had asked to be knocked out for this one like at home, because the procedure is quite invasive. They carted my wife off and I was brought to a room to produce a sperm sample. Once I was done I was allowed back in to the private ward room. The wait seemed like forever, all I could hear was nurses speaking Spanish which was a little unnerving just not knowing what was going on. After about 35 minutes Joanne was wheeled back in... my heart sank... she was in floods of tears and so upset. Writing this now I still feel so shit about it seeing her so upset. They hadn't given her the general anaesthetic, they didn't knock her out, and she was awake for the whole collection. She wasn't prepared for it , it was so horrible and she had gotten upset. It was such a sad ending to a crazy 3 month process, but there was an upside they had collected 6 good mature eggs for them to begin fertilisation. The clinic would have us back in the next day for our first update in person on what fertilised. On the Saturday morning we headed in and met with the embryologist again, we were told they had fertilised 6 eggs, YES WE HAD 6 again to work with. We were also given a new time line for the next treatment and our new prescription which included a mysterious drug called Saizen Somatropin which I will talk about later. Also on the upside the fertility specialist from May was right, my sperm sample had doubled it was now 4.8 million, who knew vitamins could actually work.
I am going to cut the story short here, we had our 5 day wait to go through again when we got home, each day the embryos decreased and finally all we were left with was one again. We had moved clinics, we had gone 2614km and all we managed to get was 1 embryo. Now the thing is this embryo was classed as AA grade quality which means it was excellent from an embryologist's perspective and would be frozen to be kept in reserve with the next rounds embryos. It sounds ungrateful here and defeatist but to invest so much of our lives in to something to get such a low result is soul destroying. Yes some say all it takes is one but when you are so deep in to a process it is very difficult to buy in to that thought process. This was two rounds of IVF , one in Dublin and one in Alicante, it seemed we had got no further. It got to us a lot at this point this, it brought us and our mentality down, I am not afraid to say it but this shit breaks you more than you will ever know. It tests your capacity to keep ticking over each day. I know how Joanne feels and I know how much it affected her but I felt the very same, I felt it was hard to stay anyway positive. We did eventually regroup despite the down days and ploughed ahead with the next round which was scheduled for the end of November.
From the moment we got home from Spain we needed to get the next cycle's drugs sorted. This was bloody hard because one drug Saizen Somatropin was like gold dust to source. With this rounds drugs and the previous cycle I made sure to take care of everything as Joanne did not need that stress on top of everything else. Saizen is basically HGH(human growth hormone) and is used to supplement the main drug for egg growth (Pergoveris). Saizen acts as a growth hormone within the ovaries to further stimulate growth. The problem however this drug is primarily used in this country for kids mainly with growth development issues, it is not used for IVF in Ireland. It is very much a break through drug being used in the IVF world. With that in mind most pharmacies are not very keen to source the drug as the company that make the drug do not like it being used in-conjunction with IVF. I tried everything to source it, I rang pharmacies in the UK with the intention of getting the drug and paying full price for it especially if it somehow gave us a leg up. It was nearly impossible to find but I got it ordered with an ASDA just outside Manchester city centre(ASDA and Sainsburys in the UK are great resources for IVF drugs). I was all ready to book my flights to Manchester until I told a friend of mine who had been through IVF herself, and she told me to call the pharmacy in the Beacon Sandyford. I thought this isn't going to work I have tried all over the country to get it and faced closed door after closed door. I spoke to the head pharmacist at Farmers Pharmacy at the Beacon Hospital, he said he would try his very best to source the Saizen and all the other drugs too, but give him a couple of hours. The man kept his word, he found us everything I was so happy my friend had told us about him and he managed to get it all sorted under the drug payment scheme also. You know people say there are so many bad people in the world but there also so many good people out there willing to help.
It was the end of September and our next visit to IVFSpain was the end of November, but Joanne needed to start taking the Saizen in tiny doses almost immediately. The delivery was so complicated using a little computer the size of an iPod, to deliver the medication, it was confusing as hell at the start but we got the hang of it. At this stage we were so used to administering medication with all manner of devices and needles. In the lead up to the second round, Joanne did all her drugs and scans at the Orwell in Rathgar. Our trip to Alicante was planned for Friday 18th Nov to Sunday 27th November. It was near enough the exact same process as the last round, we were in the clinic 8 days for scans and bloods to make sure everything was going to plan. This time we had the egg collection on the Thursday. The exact same process followed, but thankfully Joanne was sedated this time so it went as smooth as possible. The following day we were back for the embryo fertilisation update, they had collected 7 eggs and 6 fertilised. Vitamins do work! my sperm was getting better with each visit, 1.2->6.2 million, since we started in May with IVFSpain on just Vitamin E and C, I had seen an increase times 6, so if you are a man reading this, it is worth just taking E and C to help a low count.
Saizen Easypod Injector
We went home the Sunday and awaited our remaining days of the 5 day wait. This time round we were left with 3 embryos, this was our best result yet! They were all of a good quality too from an embryologists perspective. So with the previous round we had 4 embryos in total to be tested, each embryo reached day 5 and had gotten to the Blastocyst stage. For the PGS to work the embryos must be in a Blastocyst so you can test for viability and genetic defects. These embryos were sent off to a specialized clinic in Spain to be tested but it would take a solid month for the results to return. Joanne and myself were used to waiting at this stage, the one thing I have learnt from this entire process is learning to be patient. We were hoping we would get the results sometime in the new year, and the plan would be then to transfer the best embryo based on the results in January. In fact we booked the flight and hotel from the 22nd of January - 25th January in preparation. As it was December we got on with life, it was Christmas time after all. We had presents and work parties to attend, overall we were quite happy and positive about waiting for our little embryos to come back with great results.
If you want a happy ending,
on where you stop the story.
December 23rd would be the day we got our results of the PGS testing. Both our last day of work before finishing up for Christmas. The day started badly, I decided to drive in to work that morning, we rarely drive to work but my car broke down, Joanne said "if this is all the bad stuff that happens today" I am glad your car broke down. I eventually got to work, my shock absorber somehow detached and jabbed itself in to the wheel, feck it I would get it fixed. Our phone call with IVFSpain was scheduled for 3pm, every single passing second was torturous like never before. This call meant everything, 499 days of an IVF journey would come to a head at 3pm. Joanne headed home early so she could take the call, I had to stay in work because I was late from the car breakdown. I organised a conference call so we could conference in our doctor from Spain. I also booked myself a meeting room in work so I could take the call without distraction. After some hiccups with the conference we got the call started, we exchanged pleasantries and Happy Christmases with our doctor...then came those words..
"I am so sorry, I have very bad news, none of the embryos have passed the PGS testing"
Just like that our worlds came crashing to the ground, that was it , it was over. The worry, upset, the drugs, the travel, the ups and downs had brought us to the most horrific point. Our doctor spoke and talked through options, frankly we didn't hear a word it was all just a blur. Once the call was all over, I grabbed my stuff and raced home. I cannot express how shit that day was, I cannot tell you how bloody sad that day was. We both had to release our emotion, and yeah I as a man can admit I cried with my wife for ages that day. I had planned to go home to Limerick the following day for Christmas but in reality I felt all I wanted to do was lock myself up in a room with Joanne and cancel Christmas. My family did their very best that weekend to make it a great Christmas and helped console with me, but I felt I was operating on auto-pilot I just wanted to get through it and get back home to Joanne. I got back to Dublin St. Stephens night and we had Joanne's family over for food. The following day we sat and chatted for hours about everything and what we had been through. The hardest thing to take was IVFSpain had analysed everything and put simply we cannot have kids. Our only option with them would be a Donor programme.
To conclude, it is nearly 8 weeks since we got our news. Each day we talk and talk and talk some more, we have learnt so much from this journey. I would highly recommend the clinic in Spain, it was an incredible service they provide, even from the point we are at I cannot recommend them highly enough. They were always so helpful, informative and great people to work with. For our own perspective we have learnt we love each other more than ever, sometimes this journey breaks couples, but it has drawn us together more than ever before. I know that all I want in life and have always wanted is to be with my wife. As a man I felt I had support from family and friends as people looking from the outside in. I do feel however that as a man there is not many places we can go to speak about fertility and that is why I have written these past 3 blogs albeit I was encouraged by Joanne to do so. It is an incredibly difficult process to speak about even sometimes with Joanne, and I have at times bottled up my feelings about it all. Having written this all out however I have gotten such a good release from a therapeutic stand point especially when other guys have emailed me about it.
I would like to thank so many people who have given us so much support and advice over the past few years and in recent weeks you have all been absolutely amazing. Right now though, we are going to kick back and relax, who knows what will happen in the next few years, we have options available to us like donors, adoption and who knows something might happen naturally but right now we have put the IVF story to bed.
Without hope you have nothing, we will forever have hope.
Thanks for reading