Where should I be heading now

I have been questioning my destiny, my confidence in myself, my future, my hopes. People say everything happens for a reason. I have not been able to find an reason behind whatever has been happening with me for the past 7-8 months.

The stress was getting onto me. 

We decided to take a break from trying for couple of months! 

I am scared of another disappointment, am worried it will make me lose all my confidence.

I kept myself busy with my hobbies. I read two fiction books. In both the novels, the protagonist also struggles with being childless (going through miscarriages, fertility treatments). And of course when I picked these books I had no idea of this being in the story-line, this not being the core theme of the book. I don't know what co-incidence it is but it definitely made sure that I do not forget what I myself am hoping and dreaming of.

So I am reminded again that I need to forget the disappointments and look forward.

Zindagi ke safar mein guzar jatey hain jo maqaam woh phir nahin aatey!

But new "maqaam" can definitely be reached and I have to keep going.

And some more terms to confuse me - Mild IVF / Mini IVF

As I mentally prepare myself for another IVF; I have been getting very confused also. As has been my habit, before starting anything new I try to do as much research as I can on the subject. Hence I keep doing more and more research on IVF; search the internet, talk to doctors, discuss on various forums, speak to females who have undergone IVF.
During one such interaction with a doctor I got to know that there are different protocols that a doctor may follow for you.


One such newer IVF protocol is "mini-IVF" or "Mild-IVF" or "Kato protocol". 


And I think to myself what more new terms will I keep hearing! As it is a struggle to gauge what all terms I keep hearing everytime I start my research on IVF!


So I was told about Mild IVF and was told that it is mostly used for females who have low ovarian reserve. Here is all that I have understood of the protocol (in lay-man terms)


Why is it mostly used for females with low ovarian reserve: The ovarian stimulating drugs given during IVF procedure will not increase the capacity of one's ovaries to produce more eggs. Hence if you have low reserve, it is a very very remote possibility that during IVF cycle you will get many (i.e. 10-18) eggs. Hence the high dosage of stimulating medicines is not going to make you a high reserve female! The medicine tries to stimulate the ovaries so that they are functioning to their best possible result, and for a low-reserve case, a low dosage of the stimulating drugs will produce fewer eggs but good quality eggs. So here the aim is at getting quality and not quantity. And this is closer to natural cycle (where ovaries produce avg 1-2 mature-good quality eggs during each cycle)


What I was also told that when a female starts fertility treatment, mild IVF is not the first option to be tried. In the first cycle it is best to go with conventional IVF protocol to try and get as many eggs as possible. This increases your chance of getting multiple good quality embryo and a better possibility of a pregnancy.


However, if you have tried more than one cycles of IVF and you have low ovarian reserve; mild IVF is one of the options to be definitely tried.


Benefit of mild IVF: Low dosage of medicine is given and for lesser number of days. So mild IVF is not as costly as  conventional IVF procedure. It is considered safer as it uses less medications and hence fewer side effects.

I could not find lot of literature on this on the internet and couple of the doctors I spoke with said that there is still not enough evidence of success using mild IVF. It however is gaining interest. There is a group of doctors who are definitely using this protocol and have published success stories using mild IVF. Many of the doctors have started to suggest mild IVF in India also.

A pleasant surprise

After the failed IVF and a refreshing vacation, I was ready to start my 2nd IVF try. My husband and I deliberated whether we should go back to the same place or should go to some other fertility center. We decided that we will go to a new place rather than doing a repeat at the same center. Since we were to go to a new place, I knew that I had to undergo most of the investigations again and was waiting for my period cycle to start so that I could begin with the required tests.


But this time the wait seemed longer than usual. I guessed it could be due to the super extra dose of hormones given during IVF cycle that is playing truant with my system and delaying the cycle. Scoured the internet to see if IVF can really cause a delay and most of my research pointed that in many cases IVF medication can cause some impact on one's normal cycles and it takes 1-2 months to get back to normal. 


After 3-4 days of wait, I decided to take a HPT. To my utter surprise it came positive! I could not believe my eyes at all. And this was not a dream. The HPT very clearly gave a positive result. I cannot describe the feeling that I experienced that morning. I wanted to sing and dance :-) I could not stop myself from clicking a picture of the HPT stick showing the positive line :-D


I had not mentioned to my husband that I intended to test myself for pregnancy (as it was the remotest of possibility). He was still sleeping when I did the test, so when I told he jumped off the bed :-D


We both were happy and apprehensive. Went to a lab to get hCG tested. The wait before the test results came were agonizing. I wanted to believe the HPT but did not want to jump to any conclusion before a more definitive results were there.


hCG levels were just as they should be for about 5-6 wks of gestation! So it did happen. I did get pregnant and got pregnant spontaneously not with any IVF support. Next day went to a gynecologist to seek her advice. Was prescribed susten and rest as much as possible to support the embryo. She said it does happen at times that after IVF, people can get pregnant spontaneously. She mentioned that a way to know if pregnancy was going well, the hCG level should be tested every 2-3 days to see if the levels are doubling. I got another hCG test done. When the results of this test came, we had our first disappointment. The hCG level had increased but only marginally; it had not doubled! I spoke with the doctor after the result and she said there could be 2 possibilities: Ectopic pregnancy OR Failing pregnancy.


The only way to rule out ectopic was to get a scan done. The scan results showed a invitro yolk sac. Glad that it was not ectopic; the scan also showed that the size of sac was not as per the gestation duration. The radiologist indicated that the chances were 60-40, with 60% being on the negative side of pregnancy not going through.


We were worried and upset. Got the happiness of knowing I was pregnant but the fear of loosing it was too much. I now let every thing to God's will. Took the required medicines, took as much rest as I could. Stopped going out completely. Wanted to give the pregnancy as much support as I could.


Unfortunately 3 days after the ultrasound, I started to bleed. End of it all :-( Had a miscarriage!


And just like that we were back to square one! 
It was not meant to be, however it has given me some hope that I can get pregnant. I just have to keep my faith in it and keep my hope alive.

Recharging myself

After the disappointment of negative IVF result, I spent days doing a re-run of my post-transfer days. I would keep trying to look for reasons on why did the embryo not attach to my uterus; was it due to the fact that I did not lie down for more than 15mins after the transfer; was it because I did not take complete bed-rest during the initial 3 days; was it because I traveled to get myself injected rather than calling a nurse home. I would just go on and on running all these things in my mind and feeling very very guilty that probably I was not careful enough with myself and got over-confident in myself and believed that the embryo will definitely attach! Maybe had I taken a bit more rest, it could have been different!


I knew I had to do something to get out of that mode. But did not know what to do. One day I gathered the courage to call couple of other females who were part of the same IVF cycle as mine. I did not want to pry onto their privacy but I was desperate to find hope somewhere, find answers to my unending doubts. If someone else had success I too stood a chance (not this time but for sure in the next attempt). At the back of my mind I was aware of the fact that if they had a success; it might make me more depressed, make me feel more of a failure. And failure is something which I have always had extreme difficulty in dealing with. After mulling over this for few more days; I eventually picked up the phone one day and called one of them. Unfortunately she too had not found luck this time. What an irony; I was wanting to talk to someone to give myself some hope and here I was talking to the lady and trying to cheer her up with words of encouragement to try one more time rather than taking the failure to heart. In a way it felt more like talking to myself and those words that I was telling someone else had a very cathartic effect on me.


I also felt the need to to go away from my house for few days, just get away from the place or else I will get stuck in the whirlpool of these depressing thoughts.


Took a month long vacation where I travelled to visit my friends / relatives. And did it change my mood; YES it definitely did. None of the people whom I visited knew about my IVF story; so not for a day did I have a conversation with anyone regarding my failure. This  definitely helped me get out of the sadness I was feeling earlier. Helped me accept the failure. I stopped thinking of past and started to think ahead. It gave me a new strength, new hope. 


I am glad that I took that month long time-off; it has brought back a smile to my face :-)