I was so lucky to have a job to return to at the beginning of 2009 at a time when so many people had been or were being made redundant. Up until the day I returned to work I was still expecting to be told that they did not need me to re-commence work afterall due to the serious recession and contraction of the Irish economy. But despite my feeling grateful to be back in the world of salaried employees, upon returning to the daily routine of office work, I always had motherhood in the back of my mind - would we ever have a baby? If we were prepared to use donor eggs then we could probably be parents within 12 months or so. And so, having heard so much about Spanish egg donor programmes, after researching them for ourselves, we booked to fly to Barcelona on the St Patrick's Day public holiday and have a first consultation with Instituto Marques (IM) IVF Clinic. IM had no waiting list for their egg donor programme and the fees, whilst still expensive - around 10,000 euro (about double a normal IVF cycle in Ireland), were not prohibitive. I was encouraged by the possibility that IM might find us a young Spanish student with brown hair and hazel eyes, (to match mine), with the possibility of even having enough embryos left to freeze that we could end up with a genetically related sibiling (how greedy!). And any baby would, of course, be DH's genetic child which I thought was his right to have and would appease my guilt so much. Any donor egg would lead to an embryo that would grow inside of me and whilst the DNA might not be mine, the baby would literally be 'my flesh and blood'. It would recognise my voice as its mother's upon its birth. Unlike adoption, a donor egg baby would be ours from conception, would look like us both and would allow us to experience pregnancy and childbirth like any other ordinary couple.
Barcelona was a beautiful city - it was easy to fly directly there from Dublin and the clinic was large and well staffed. IM had an expensive-looking minimalist reception area containing couples from all over Europe. Our doctor, Dr Raul Olivares, had excellent English and was very patient and informative. I was, however, very deflated when told that we could not see photographs of our donor or get to choose her from a database. That was up to Instituto Marques to decide. I was also unsettled to learn that the clinic accepted donors up to 35 years of age. I explained that after experiencing 3 miscarriages that I wanted to be guaranteed a donor who was no older than 30 (I was 33 at the time and could not imagine accepting a donor who was actually older than me - what was the point?). I had also formed the impression that IM's egg donors were largely local Spanish university students but was told that IM had no restrictions regarding education and accepted all healthy women up to 35 who wished to donate. I felt uncomfortable that IM would choose our egg donor for us and that we would have no input or choice whatsoever and that the process was completely anonymous. Would our child one day feel betrayed by the fact that they could never trace their genetic ancestry? I also wanted to be able to communicate with our donor if things worked out but this could only be done in Spain anonymously through the clinic...
Dr Olivares must have sensed that we were not sold on their egg donation programme (although we had already prepared ourselves to sign up to it in the 2 months that we waited to travel over for our appointment and were prepared to travel back in June on our summer holidays for an egg donor cycle). He asked me about my history some more and advised that he had recently been conducting a trial for a study for Human Reproduction medical journal in which he had had significant, although limited success with estrogen priming protocols for women with ovarian reserve issues such as myself. We had not been prepared to consider trying IVF again with my ovaries but Dr Olivares gave us a lot of things to consider regarding estrogen priming protocols, in which women's ovaries were dosed up with estrogen for a number of weeks prior to commencing fertility drugs; this seemed to trick the ovaries into functioning as they should again for a limited period of time and producing viable eggs. We became excited about the idea of a new promising IVF protocol; finally perhaps we had stumbled across what would become our miracle special treatment that would finally pay off and bring us our desperately desired baby. I was already fantasing about telling people about how this treatment in Barcelona had made all our dreams come true, as I held our precious genetic baby in my arms.
But before Dr Olivares would book us in for an estrogen priming protocol in the summer, he was insistent that I get investigations done regarding my uterus. He was worried that I might have problems with implantation due to the fact that I had had two late first trimester D&Cs for missed miscarriage. He was the first doctor who ever raised a possibility with me that I may have adhesions or scar tissue in my uterus which might impact upon an embryos being able to implant. He told us that he had seen numerous women who had come to him for donor eggs but still failed to get pregnant; because ultimately their earlier pregnancy losses had caused scar tissue to form. I felt alarmed that such investigations would be necessary when I had been told by Irish doctors that the missed miscarriages would not have impaired my subsequent fertility. Dr Olivares wanted me to have a hysteroscopy in Ireland before any IVF in Spain.
The day before our appointment at IM, DH and I had walked the streets of Barcelona and I had almost driven DH out of his mind my obsessively studying every Catalonian woman of child bearing age that walked passed us; some were beautiful and I would be delighted to have their eggs but then I would see another women and think; oh I could not imagine being given her eggs! It was such a strange sensation. I kept looking into all the prams and trying to decide whether the children were really lovely looking or otherwise. It caused a fair bit of tension between DH and I as by the end of the day he wanted to stop talking about potential egg donors and just tune off and relax but for me, there was no tuning off. The desire for a child was constant. I even dreamt about it when I was asleep. After the stressful initial consultation at IM, we (or rather, I) had forgotten to change the time on my watch and alarm clock to Spanish time and as a result the following morning we missed our direct flight home to Dublin. To get back home we ended up having to catch a flight to London Heathrow and then race frantically to another terminal to get a connecting flight from London to Dublin - the new flights cost 800 euro and we then had to speed to the kennels where our dog was and incur the displeasure of the manager (who clearly thought we were crappy dog owners that we did not collect our dog at the earlier allotted time). Honestly, the things you have to go through for the chance of having a baby; all very stressful for a bank holiday weekend when everyone else seemed to be getting on the Guinness and having the craic for St Patrick's Day. Some craic!
Upon returning to Ireland I proceeded to have quite a time of it trying to convince my GP and then a GYN/OB who specialised in surgery to undertake a surgical hysteroscopy. I needed to find a doctor who was able and prepared to cauterize or remove scar tissue in my uterus if he/she was to find any upon the exploratory surgery, as I saw little point in undergoing the hysteroscopy unless something corrective could be done upon any scar tissue being discovered. I was treated like a bit of a neurotic by various Irish doctors but as I had private health cover and insisted upon the procedure, I was duly booked in for surgery with Dr Gleeson at The Rotunda Maternity Hospital around 7th May 2009. I need 6 weeks recovery time before IVF in Spain so I wanted to get the hysteroscopy over and done with asap. Whilst being prepped to go up to the day ward, I was made to sit in a waiting room with numerous heavily pregnant women, some in labour, who were also waiting in Admissions. I found this very distressing and cried quite a bit (poor DH) and end up waiting in the hallway to be admitted. Hospitals are very bad at segregating women who have lost babies from those who are there to give birth - it feels like salt is being rubbed into your wounds. You are waiting for surgery related to your infertility, or maybe even to have your dead baby removed (as is the case with missed miscarriage) and have to sit opposite a woman who has commenced giving birth to a full term healthy baby. It sucks - big time.
Prior to surgery, Dr Gleeson was confident that he would find nothing and seemed bemused by my many questions immediately before I was to be sedated in theatre, as to how he would remove any scar tissue he might find (would he use surgical scissors - the preferred option or cauterisation? - answer - cauterisation); I had a gut feeling that something would be there - as why had I never been able to fall pregnant ever again after my second missed miscarriage? When I awoke in the ward after surgery DH was by my side and by looking at the clock we both realised that I had been in surgery much longer than the anticipated 10 minutes. Maybe I had been in surgery for 50 minutes or longer judging by the time I went in and the time I was brought back. We only waited a short while and Dr Gleeson appeared by my bed to advise that he was rather shocked to discover that I "did indeed have uterine adhesions". A long band of thick scar tissue at the top of my uterus. When I asked him how such scarring would have been caused he was very frank and did not hesitate but fired out his answer emphatically; "too much force being applied during D&C". My heart sank. I knew it. The missed miscarriages had damaged my womb. Dr Gleeson told me he had inserted a contraceptive Mirena coil to help in the healing process and to stop menstruation so that my uterine lining would not build up as part of my normal cycle during the time in which my uterus was to self-heal from the surgery to remove the scar tissue.
Well, Dr Olivares in Spain was on to something afterall; my GP expressed surprise and well, ....fancy that! The whole experience confirmed to me that the majority of doctors, even so called 'specialists' were just making educated guesses the majority of the time and were playing blind and gambling with men and womens' fertility and lives. Although I was devastated by the diagnosis of Asherman's syndrome, I also felt that perhaps at last there was an explanation for the fact that I had been able to conceive naturally, but then never again after a second D&C. See my link on Asherman's syndrome; http://lastoneofmykind.blogspot.com/2011/01/what-is-ashermans-syndrome.html
We returned to Barcelona in late June 2009, after weeks of taking oral estrogen and wearing estrogen patches. The timing was kinda shitty as my father was over in Ireland visiting me from Australia and I had to cut short the time spent with him; he went off travelling the UK with my older sister, which I would have liked to have done with them. But well into our 5th year of marriage, DH and I were were desperate for a child and that came first (my father had his own life; second wife and second set of children in Australia so I figured I should put my life with my husband first). It seemed that DH and I always used all our summer holiday leave on fertility treatment. For the fourth year in a row we were doing IVF on our summer holidays; we joked that it would not be summer if we weren't doing IVF-black humour helped a little.
In Barcelona we stayed in a nice hotel and ate yummy tapas every day. The weather was gorgeous. We were feeling pretty positive and joked about naming our baby 'Barcelona' (as Victoria and David Beckham had named their first child Brooklyn, as he was conceived in that city apparently!). But 48 hours or so before egg retrieval, the clinic said that not very many egg follicles were evident on my ulstrasound scan and my uterine lining was v. v. thin; blah blah blah ......usual story. We pushed on to egg retrieval (DH had to speak Italian to the Spanish anaesthetist and then translate the questions relating to my general anaesthetic back to me in English, how much did I weigh, when was the last time I ate etc.). Estrogen priming protocol turned out to be a very bad joke. Only two eggs were retrieved and the following day, after two clumsy attempts by the clinic at calling our mobile phones, Dr Olivares broke the bad news to DH that neither egg had fertilised. They were apparently of very poor quality. He offered us donor embryos; (cryopreserved/"on ice" at IM) that couples no longer needed or wanted and had donated to other infertile couples. The thought made both of us cringe and we did not have to pause to even discuss it. We immediately said 'no thanks' - it was not an option. It was bad enough that my genetic material was useless but to have a child that had no part of DH in it was crazy...We both felt very angry at the outcome of the cycle.
We drank lots of rioja that evening in a tapas bar, after having fecked my many boxes of progesterone, steroids, heparin etc into the hotel room's waste paper bin earlier in the day. We had another 2 days in Barcelona before our return flight home (as we had figured on an embryo transfer) but we both decided that we desperately wanted to get outta Barcelona ASAP and home to our dog Hamish, whom we felt extremely guilty about leaving in a kennel, again. So we went to an internet cafe and paid a ridiculous amount of money to get on the next flight back to Dublin the following morning. IVF in Barcelona had been a huge waste of time, money (about 8000 + euro) and emotional energy. The only thing holding us together was the offer of a dear dear friend in Brisbane to donate eggs if Spain did not work out. I called her crying from Barcelona with the bad news and she told me to forget about Spain and come home to Australia at Christmas time; she would call the clinic in Brisbane and arrange things on Monday. What an angel. Thanks to her, we made it back home to Dublin with a tiny ray of hope that not all was lost.
But before Dr Olivares would book us in for an estrogen priming protocol in the summer, he was insistent that I get investigations done regarding my uterus. He was worried that I might have problems with implantation due to the fact that I had had two late first trimester D&Cs for missed miscarriage. He was the first doctor who ever raised a possibility with me that I may have adhesions or scar tissue in my uterus which might impact upon an embryos being able to implant. He told us that he had seen numerous women who had come to him for donor eggs but still failed to get pregnant; because ultimately their earlier pregnancy losses had caused scar tissue to form. I felt alarmed that such investigations would be necessary when I had been told by Irish doctors that the missed miscarriages would not have impaired my subsequent fertility. Dr Olivares wanted me to have a hysteroscopy in Ireland before any IVF in Spain.
The day before our appointment at IM, DH and I had walked the streets of Barcelona and I had almost driven DH out of his mind my obsessively studying every Catalonian woman of child bearing age that walked passed us; some were beautiful and I would be delighted to have their eggs but then I would see another women and think; oh I could not imagine being given her eggs! It was such a strange sensation. I kept looking into all the prams and trying to decide whether the children were really lovely looking or otherwise. It caused a fair bit of tension between DH and I as by the end of the day he wanted to stop talking about potential egg donors and just tune off and relax but for me, there was no tuning off. The desire for a child was constant. I even dreamt about it when I was asleep. After the stressful initial consultation at IM, we (or rather, I) had forgotten to change the time on my watch and alarm clock to Spanish time and as a result the following morning we missed our direct flight home to Dublin. To get back home we ended up having to catch a flight to London Heathrow and then race frantically to another terminal to get a connecting flight from London to Dublin - the new flights cost 800 euro and we then had to speed to the kennels where our dog was and incur the displeasure of the manager (who clearly thought we were crappy dog owners that we did not collect our dog at the earlier allotted time). Honestly, the things you have to go through for the chance of having a baby; all very stressful for a bank holiday weekend when everyone else seemed to be getting on the Guinness and having the craic for St Patrick's Day. Some craic!
Upon returning to Ireland I proceeded to have quite a time of it trying to convince my GP and then a GYN/OB who specialised in surgery to undertake a surgical hysteroscopy. I needed to find a doctor who was able and prepared to cauterize or remove scar tissue in my uterus if he/she was to find any upon the exploratory surgery, as I saw little point in undergoing the hysteroscopy unless something corrective could be done upon any scar tissue being discovered. I was treated like a bit of a neurotic by various Irish doctors but as I had private health cover and insisted upon the procedure, I was duly booked in for surgery with Dr Gleeson at The Rotunda Maternity Hospital around 7th May 2009. I need 6 weeks recovery time before IVF in Spain so I wanted to get the hysteroscopy over and done with asap. Whilst being prepped to go up to the day ward, I was made to sit in a waiting room with numerous heavily pregnant women, some in labour, who were also waiting in Admissions. I found this very distressing and cried quite a bit (poor DH) and end up waiting in the hallway to be admitted. Hospitals are very bad at segregating women who have lost babies from those who are there to give birth - it feels like salt is being rubbed into your wounds. You are waiting for surgery related to your infertility, or maybe even to have your dead baby removed (as is the case with missed miscarriage) and have to sit opposite a woman who has commenced giving birth to a full term healthy baby. It sucks - big time.
Prior to surgery, Dr Gleeson was confident that he would find nothing and seemed bemused by my many questions immediately before I was to be sedated in theatre, as to how he would remove any scar tissue he might find (would he use surgical scissors - the preferred option or cauterisation? - answer - cauterisation); I had a gut feeling that something would be there - as why had I never been able to fall pregnant ever again after my second missed miscarriage? When I awoke in the ward after surgery DH was by my side and by looking at the clock we both realised that I had been in surgery much longer than the anticipated 10 minutes. Maybe I had been in surgery for 50 minutes or longer judging by the time I went in and the time I was brought back. We only waited a short while and Dr Gleeson appeared by my bed to advise that he was rather shocked to discover that I "did indeed have uterine adhesions". A long band of thick scar tissue at the top of my uterus. When I asked him how such scarring would have been caused he was very frank and did not hesitate but fired out his answer emphatically; "too much force being applied during D&C". My heart sank. I knew it. The missed miscarriages had damaged my womb. Dr Gleeson told me he had inserted a contraceptive Mirena coil to help in the healing process and to stop menstruation so that my uterine lining would not build up as part of my normal cycle during the time in which my uterus was to self-heal from the surgery to remove the scar tissue.
Well, Dr Olivares in Spain was on to something afterall; my GP expressed surprise and well, ....fancy that! The whole experience confirmed to me that the majority of doctors, even so called 'specialists' were just making educated guesses the majority of the time and were playing blind and gambling with men and womens' fertility and lives. Although I was devastated by the diagnosis of Asherman's syndrome, I also felt that perhaps at last there was an explanation for the fact that I had been able to conceive naturally, but then never again after a second D&C. See my link on Asherman's syndrome; http://lastoneofmykind.blogspot.com/2011/01/what-is-ashermans-syndrome.html
We returned to Barcelona in late June 2009, after weeks of taking oral estrogen and wearing estrogen patches. The timing was kinda shitty as my father was over in Ireland visiting me from Australia and I had to cut short the time spent with him; he went off travelling the UK with my older sister, which I would have liked to have done with them. But well into our 5th year of marriage, DH and I were were desperate for a child and that came first (my father had his own life; second wife and second set of children in Australia so I figured I should put my life with my husband first). It seemed that DH and I always used all our summer holiday leave on fertility treatment. For the fourth year in a row we were doing IVF on our summer holidays; we joked that it would not be summer if we weren't doing IVF-black humour helped a little.
In Barcelona we stayed in a nice hotel and ate yummy tapas every day. The weather was gorgeous. We were feeling pretty positive and joked about naming our baby 'Barcelona' (as Victoria and David Beckham had named their first child Brooklyn, as he was conceived in that city apparently!). But 48 hours or so before egg retrieval, the clinic said that not very many egg follicles were evident on my ulstrasound scan and my uterine lining was v. v. thin; blah blah blah ......usual story. We pushed on to egg retrieval (DH had to speak Italian to the Spanish anaesthetist and then translate the questions relating to my general anaesthetic back to me in English, how much did I weigh, when was the last time I ate etc.). Estrogen priming protocol turned out to be a very bad joke. Only two eggs were retrieved and the following day, after two clumsy attempts by the clinic at calling our mobile phones, Dr Olivares broke the bad news to DH that neither egg had fertilised. They were apparently of very poor quality. He offered us donor embryos; (cryopreserved/"on ice" at IM) that couples no longer needed or wanted and had donated to other infertile couples. The thought made both of us cringe and we did not have to pause to even discuss it. We immediately said 'no thanks' - it was not an option. It was bad enough that my genetic material was useless but to have a child that had no part of DH in it was crazy...We both felt very angry at the outcome of the cycle.
We drank lots of rioja that evening in a tapas bar, after having fecked my many boxes of progesterone, steroids, heparin etc into the hotel room's waste paper bin earlier in the day. We had another 2 days in Barcelona before our return flight home (as we had figured on an embryo transfer) but we both decided that we desperately wanted to get outta Barcelona ASAP and home to our dog Hamish, whom we felt extremely guilty about leaving in a kennel, again. So we went to an internet cafe and paid a ridiculous amount of money to get on the next flight back to Dublin the following morning. IVF in Barcelona had been a huge waste of time, money (about 8000 + euro) and emotional energy. The only thing holding us together was the offer of a dear dear friend in Brisbane to donate eggs if Spain did not work out. I called her crying from Barcelona with the bad news and she told me to forget about Spain and come home to Australia at Christmas time; she would call the clinic in Brisbane and arrange things on Monday. What an angel. Thanks to her, we made it back home to Dublin with a tiny ray of hope that not all was lost.
