Dom's Fertility and IVF/ICSI Journey

So we all know that Endometriosis can influence fertility in many ways, in my case, ovulation was near impossible. I didn't find this out for a while. Let me tell you my story.

I was on the pill for a good 10 years before coming off it, with absolutely no issues. It was November of 2019 that I got a period that went until early Jan of 2020 before I went to see my doctor - I know, long time, probs should have gone sooner. She suggested I come off the pill and take a break in the hope of regulating my menstrual cycle again, so I got off it.

In my 2nd Endo excision surgery (April 2020) my Left ovary was adhered to my bowel, and this time, my specialist saved it. I also had an IUD put in. Only a week later my body was in agony and rejecting the foreign object that was the IUD, I couldn't sit down without a sharp stabbing pain up my vagina.  I was rushed to the ED where it was taken out while conscious - 0/10 do not recommend. 

Shortly after I had recovered, I was having that terrible left hand side pain again and was getting super conscious of the fact my left ovary may have to be removed in my next surgery. This made me incredibly fearful about having a family in the future, not just me, my partner Michael too. We decided to give it a crack. 

At my post op appointment I spoke about my concerns with my specialist and he put me on some oral ovulation inducing drugs, and told me how to use it, and how to track for fertile windows. 

 Our first positive ovulation test!

Michael and I tried this for almost 6 months before I was exhausted, upset, and so so over it. Trying to conceive (TTC) is so hard. The pressure it puts on your relationship is beyond anything you can imagine. For someone with a super low libido (me) and someone who has incredible pain during sex and sends them into flare ups (also me) it was not a good time. 

My endo specialist then referred me to a fertility specialist (FS) to test both me and Michael further as we totally should have been pregnant by now. 

We had a zoom meeting with this FS as it was the middle of lockdown here in Melbourne. He was very clinical, didn't not believe I had endo, and wasn't very pleasant. He spoke to us about IUI and IVF and recommended we proceed down the IUI path - which I wasn't too keen on. But he referred us both for tests. I had my AMH, progesterone, testosterone, thyroid, oestrogen, and many other blood tests, as well as a genetic screening carrier test for DNA Defects. Michael was sent to have bloods, and his sperm tested- the count, shape and quality. We both also underwent an STI screening. 

While waiting in anticipation for our results we were of course thinking I was the only issue. It was only a week later and we found out the Morphology of Michaels sperm was off. It was in the lowest percentile. This is why we would never be able to conceive naturally or via IUI, of IVF.  It had to be ICSI. 

What is morphology? Morphology refers to shape and size of sperm. If there are issues with morphology it can make it more difficult to fertilise an egg, due to the fact it may have a flat head, or no head, alternatively it may have a head and two tails, or maybe no tail, so on and so forth. 

What is the difference between IUI, IVF and ICSI?

Intrauterine insemination (IUI) is a type of artificial insemination. Sperm that has been concentrated are placed directly in the uterus when ovulating. 

In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm outside of the body usually in a test tube. The Ovulatory process is often stimulated and monitored. Before releasing the ovum or ova, they are removed from the ovaries and then left to be fertilised by washed sperm. Once fertilised it's transferred to the uterus.

Intracytoplasmic sperm injection (ICSI) is an IVF procedure where a single sperm cell is injected directly into the cytoplasm of an egg. 

IVF vs ICSI infographic

So, here we are being told we need ICSI to conceive. I ended up seeing another FS for a second opinion, and she was very warm and understanding - I gelled with her alot better. 

I underwent my first cycle, Stimulant hormones injected a few times a day, as well as a concoction of other drugs. I was closely monitored with bloods and ultrasounds until I was given the date to go in for my egg retrieval. 

This was the plan, I have my egg retrieval, Michael does his sperm sample the same day, we wait 5 days for the eggs to become embryos, and then I get an embryo put into may uterus to see if we could have a BEBE!

The day of my egg retrieval came around quite quickly, I was a cranky little mess pumped with all the hormones, but I was ready to get it over and done with. Michael dropped me off to the clinic, and he went to go and do his sperm sample so that they could fertilise my eggs once they were retrieved

I woke up shortly after the procedure and they had retrieved 37 EGGS! Great news, fantastic news. Then came the bad news, I wasn't able to have a embryo transfer. I was at high risk of Ovarian hyperstimulation syndrome (OHSS) which is an exaggerated response to excess hormones. It can occur after taking injectable hormone medications to stimulate the development of eggs in the ovaries. Of course, I had all the signs leading up to it, so it was too risky to have the transfer in 5 days time. 

Instead they fertilised the 37 eggs, 22 of which were successfully fertilised. at day 3 I got a call and I was told 18 had further developed, so I had lost 6 more during that time. By day 5 we had 11 Embryos ready to be frozen! 

All 11 were successfully frozen, and put away for storage until I recovered to have a frozen embryo transfer. 

We're now in August 2021. Ive had 2 rounds of transfers cancelled. No, not due to covid. Because my uterus wasn't co-operating. To have an embryo transfer my specialist wanted my uterus lining to be above 6mm in thickness. I couldn't get to 6mm without bleeding (period) and obviously they’re not going to be putting an embryo in you when you're bleeding, it wouldn't stick. 

By this point I was in huge amounts of pain again in my left side from my ovaries being stimulated time and time again. My FS recommended I go back to see my endo specialist and have another surgery to start again with a fresh plate. 

October comes around and I had another Endo excision surgery, this is the surgery where I then lost my Left ovary... It just couldn't be saved this time and was causing more trouble then good. 

After losing my Left ovary.

I had a 2 month recovery from my surgery and moved all my frozen embryos to another clinic. A clinic where the FS specialised in Endo and male infertility also. She is Incredible. I explained what had been happening at the other clinic and she asked the drugs and dosages I was on. Shocked by what I told her, she decided to put me straight onto a Natural Killer Cell (NKC) protocol to start the day after my wedding. 

What are NKC? Immune cells in the uterus are important in the early detection and elimination of foreign cells, such as infections or cancer, but can sometimes be confused when it comes to embryos and instead attacking them rather than protecting them. 

The first cycle I did with her was called a Hormone replacement therapy (HRT) cycle. It was exhausting, I had needles, oral medication, patches, and pessaries, steroids, and blood thinners. I was monitored through multiple ultrasounds and blood tests before doing the transfer. 

I was given the all clear for a transfer as my uterus lining had reached 6.4mm. I couldn't believe she had done it - amazing. Michael and I drove to the clinic at 7am for a 7:30 admission, and 8am transfer. The process was quite simple. 

I had to have a full bladder and lay down on the bed. the Embryologist came in to see me and confirmed the embryo had thawed well, she then showed me a picture of it and asked if I was ready.

Soon after my FS came in and I was off my rocket on some anti anxiety meds and pain relief. They put an ultrasound on my tummy so they could see where they were putting the cannula in my uterus to pop the embryo in the right place. Soon after I was on my way home and waiting the long two week wait. I was so sick, vomiting consistently, tired, fatigued. DID IT WORK? AM I PREGNANT?

12 days later I went for bloods to test my HCG level to see if I was pregnant, it was unsuccessful. Turns out the vomiting ect was actually my body rejecting the embryo. 2 days later I got my period and called the clinic with my day 1.  They spoke got my FS and I received a whole new script of medications, this time they wanted to have one dominant follicle release and be triggered - like the egg freezing cycle I did, but then implant the embryo to trick my body. 

I was monitored all through this cycle too, I had my last ultrasound the day before transfer but unfortunately my pain relief drugs did not work, and I was in agony. Good news though. my uterus lining got to 6.4mm this time. Incredible, it just keeps getting better. I opted to be admitted into hospital and put to sleep this time around for the Embryo transfer as I was so frightened from the ultrasound the day before and it had sent me into a major flare up. 

I was admitted to hospital at 10am, and asleep by 11am for the transfer. It was a much nicer experience for me. I woke to the news it was all implanted nicely and got a picture of the embryo in my uterus. I had some crackers cheese and sandwiches and was on my way for the two week wait again. 

Embryo in my uterus

6 days post embryo transfer I went to get my lashes infilled and it was a 17 degree day and I was laying on this bed, sweating profusely and so fucking hot. once I left the appointment I text Helene and I was like " bro, I'm either pregnant or I've got covid" 

I went home and uber eats-ed a pregnancy test lol. I then tested - pregnancy tested I mean. 

Positive pregnancy test

PREGNANT - WHAT?  I couldn't believe it. I bought another 5 pregnancy tests and every time I went to the toilet I did a wee on another. Michael and I just couldn't believe this was happening. I think after a while you kind of accept it might just not be for you. I had already accepted that being a mum, just may not be in my plan. 

Each time as the days went on the lines were getting darker and stronger. 

An even more Positive pregnancy test

I had my blood test on day 12 and got the phone call confirming I was in fact PREGNANT. I could and still can not believe it. 

2 years to get to this point! 173 needles, 245 pessaries, 27 blood tests, 19 ultrasounds, 4 emergency hospital admissions, 3 endo surgeries, 26 patches, 1 lost ovary, and 283857584 tears. Holy fucking shit - The body that has ALWAYS let me down has finally done it. 

Now the wait until October for our little jelly bean to arrive, and we could not be happier.