Diary of an IVF Stim cycle

After a short break and time to recover, heal and pick ourselves up, we have decided to go again for another IVF stim cycle. We have also decided to again share the process with you. We had such an overwhelming response from everyone when we shared our last frozen embryo transfer. We were blown away by the encouragement, support and love shown. We are truely lucky to have you all behind us. I have also been encouraged by the questions and responses from people. Things like, "thank you for sharing, you're really educating me on something I had no idea about" "I have been so surprised by how involved and complicated the process is" "thank you for showing and teaching others about what we went through to get our baby." My number one purpose for sharing our journey has been to create awareness and educate people about the IVF process, so we are continuing to do this. I will take you through and explain each step and stage as we go. Please feel free to ask questions or let me know if something needs further explanation. I need to stress again, as with last time, there is a delay. This won't be live. I put all my energy into each stage and I need the time to then process my thoughts and feelings before sharing this. I'm sure you'll all understand this. It also means that for some parts I can speed things up and bring results of some of the tests to you straight away. We don't all need to go through the anguish of waiting 🙂. As I said previously when we did our first stim cycle 3.5 years ago, we produced 5 healthy embryos. I thought I would never have to do another stim cycle again. I don't have the most positive memories of stimming, lots of tests and scans, sore swollen ovaries, painful egg retrieval and of course the injections. It's fair to say I'm not looking forward to it and I'm filled with thoughts of dread. Once more it's also far more expensive than any of the frozen embryo transfers, so we needed some time to get the money together to pay for everything (approx $11,000) So why are we doing this again? Well I put myself in the shoes of my much older self, in another 20, 30 or 40 years from now, if we had stopped our IVF journey now and we remained childless, would I feel like I did enough? Would I feel like we pushed ourselves as far as possible and left no stone unturned? No. I feel like I would have regrets, of course that much older version of myself may still be child and grandchildless and this breaks my heart, but I need to know I tried as hard as possible to make our dreams come true. So we find ourselves again on the IVF road about to commence our 10th cycle.

I have an appointment coming up with my fertility specialist to discuss the plan of attack for my upcoming stim cycle. My previous stim cycle was done with my previous specialist. I really hope this new specialist makes a positive difference in getting us closer to our dream. I always like to be clear about what is happening, what to expect and what the plan is. Before I have an important appointment I like to write a list of questions and concerns I have, so I can make sure everything is covered and I don't walk away not being clear or being confused about what's going on. I normally write the list over several weeks and ask my husband to contribute, it helps me get things off my mind that are troubling me and making me anxious. I often find myself adding to the list in the middle of the night. This is the list of questions I wrote out, more on the outcome of the appointment later.

At my recent specialist appointment I discussed with my FS the plan for this stim cycle and what my concerns were. She has suggested a slightly different approach to the stimulating drug to improve egg quality (more on that later) as well as chromosomal testing for both of us and genetic testing of the embryos to work out if there are any underlying issues for all those past failed transfers. The chromosomal testing could be done right away with a simple blood test that takes a few weeks to come back. The genetic testing is done once the embryo's have been produced, cells are taken from them and sent away for testing. Due to this, the results can take 3-4 weeks and therefore the tested embryos won't be transferred fresh and will need to be frozen. There is a chance though that not all embryo's would be suitable to be tested and we would be given the option of transferring these fresh at the time. So I may, or may not have a fresh embryo transfer after stimming, it just depends on the genetic testing, the quality of the embryo's and the risk of hyperstimulating. I was really close to hyperstimulating with my last stim cycle, so this is something that will be monitored very closely, if it looks like this is the case this time, all the embryo's will be frozen and then a frozen transfer will happen at a later date. In the lead up to the cycle I need to be taking medroxyprogesterone or provera for 10 days each month to regulate my cycle, continue with the thyroxine and the regular pregnancy multivitamins that I've been taking for over 8 years now. It is also a requirement of the genetic testing that the retrieved eggs undergo a procedure for fertilisation called Intracytoplasmic sperm injection (ICSI) this is something we haven't done before. I'll explain more about stimming, ICSI and genetic testing as we go along. Overall I'm feeling really positive and excited about starting another stimulated cycle from scratch, I feel like we're turning over a new leaf and starting fresh. With all the last cycles as we used each frozen embryo, I felt like the chances decreased with each transfer as we moved through the better quality embryos, kind of like "what are the chances like now when it didn't work with the better embryo's?" By the end of our 5 embryo's I felt like our chances had diminished so much. This time we are starting afresh, we have a new plan of attack, a breath of hope and positivity. Fingers crossed this will be the recipe for success. Xxx

Before we start this cycle we have to fill out all the necessary paperwork again and have some tests redone. Anyone having any kind of IVF procedure has to undergo STI blood tests and be cleared before commencing treatment. Our previous ones had expired between cycles so another blood test is added to the list as well as our chromosomal tests. We are given a large wad of paperwork which needs to be filled out, signed by both of us and returned to the clinic. I meet with my IVF nurse who goes over the plan for the cycle and explains how to do the injections (again) and what side effects to look for. I also meet with the finance department who explains the costs of the cycle and the stages of payments, the cost of the genetic testing and I sign that I agree to everything and sign financial consent for the payments to be deducted from our accounts. I then meet with the pharmacist to pickup and pay for my medication, once the blood test results come back clear we will be ready to start. Payments for today: Initial cycle payment $6700 Medication $200

Day 1: Today marks the first day of my cycle, (day 1 of my period, sorry for TMI) After finding out that all our screening tests came back clear. I call my clinic to inform them I've started my cycle and I'm instructed to start my injections tomorrow evening. My nurse makes an appointment for my first scan to check on how the follicles are developing in 5 days. It’s crazy but I’m super excited about finally being able to get started on this. It’s been a long time waiting and preparing things, I feel like I’m turning over a new leaf on our 8 year TTC journey. Day 1 of my 10th cycle of IVF, I have everything crossed that we’ll be able to get some good quality eggs and embryo’s from this cycle.

Day 2: Today I start my injections, I’m fairly lucky that I’ve never really had an issue with injections. Granted they aren’t my most favourite thing in the world. But I would take these any day over the internal ultrasounds and the progesterone pessaries. They only sting for a second and it’s over before I know it. Whenever possible Rob generally does them, it keeps him involved in the process and I find that when he does them it hurts less and I’m less likely to bruise. I think because he can be smoother and jab them straight in and out (perhaps it’s also payback for him.) I find when I do them I’m leaning over to try to see what I’m doing and sometimes pull the needle out at an angle. (ouchy and nice bruise!) Each evening at the same time, I (or hubby) inject into my abdomen Gonal-f which is a synthetic form of follicle stimulating hormone (fsh). The purpose of this drug is to stimulate follicular growth in the ovary. The follicle is where an egg is stored within the ovary. The body should naturally release fsh each cycle which encourages one follicle (or two in some people) to stimulate, grow and mature an egg. However, where fsh is not present or is low, the drug is used as a replacement. In IVF a larger amount of the drug is given with an aim to stimulate multiple follicles for optimal egg harvest. Delivering fsh is a tricky thing, too little amount and the ovaries won't respond, too much and the ovaries can 'hyper' or over stimulate. This can be really painful and dangerous. Ovarian hyperstimulation is where the ovaries are over producing and growing too many follicles than they can cope with, side effects can include bloating, vomiting, diarrhoea, increased rapid weight gain, fluid build up on the ovaries, abdomen or on the lungs, shortness of breath and breathing difficulties and in extreme cases can lead to ovarian rupture. We are assured by the specialists that it is rare to get this, however I do know of too many women who have ended up in hospital with it. Ovarian hyperstimulation is more common in women who are taking fsh for fertility reasons, are under 35 and have PCOS. For me that’s Tick, tick, tick. For this reason, regular blood tests and scans are used to monitor those taking fsh to see how the ovaries and hormones are responding to the treatment. If this does occur treatment is generally stopped and all eggs harvested are frozen (if compatible) to allow the body to recover and a frozen transfer is done at a later date. This is my fifth cycle taking fsh. I had 3 cycles around 5 years ago of ovulation induction where a smaller amount of fsh is injected to 'replicate' a natural cycle and to ideally stimulate 1-2 follicles only. The hope is that ovulation is then induced and followed by timed intercourse (sexy hey!). In my case one of these cycles were cancelled due to lack of stimulation and a further two were cancelled due to overstimulation. We then moved onto IVF and I had my first IVF stim cycle 3.5 years ago. With this cycle I was very close to hyper stimulating, we were lucky to have 16 eggs collected, of those only 5 blastocyst embryos could be transferred and none resulted in a 'successful' pregnancy (one was an early miscarriage). For the last stim cycle I was given a lower dose of fsh than I'm taking this time which was very slowly increased to stimulate the egg production, this meant I 'stimmed' for 15 days. Taking into consideration that none of these embryo's resulted in a birth, it may have meant that the eggs produced were immature or low grade eggs. This time around, the plan is to take a different approach by having a higher dose of fsh to begin with, which will then be lowered for the remainder of the cycle, hopefully producing higher grade eggs and higher grade embryo's. Hopefully this change along with the genetic testing is the recipe for success.

Day 6: After 5 days of injections I went for my first scan and blood test, the follicles are developing nicely with the largest at 11mms, the aim is to get a good amount above 16mm. The ultrasound technician counts approx 25 follicles on each side, but I'm told there are probably many more there that aren't currently visible on the scan. She has some trouble finding my left ovary and had to apply a lot of pressure onto my abdomen to bring it into view. I can certainly feel that my ovaries are expanding as the scan was quite uncomfortable. The nurse is really happy with the results and it appears that the follicles are also responding quicker than last time. I am instructed to start another drug, Orgalutran tomorrow and have another scan in 2 days.

Day 7. These are the orgalutran injections, I will inject one of these each morning from today until 36 hours before the egg harvest. Orgalutran is a GnRH Antagonist, which is designed to 'prevent' premature ovulation before the egg harvest procedure. So one drug to grow the follicles, the other is to stop the follicle releasing the egg before they are ready to collect it. Another scan tomorrow morning to see how things are progressing.

Day 8. This morning at 7am I had another pelvic ultrasound. The follicles are developing really nicely with the largest being 15mm and approximately another 6 over 11mm. They are right on track and egg harvest is scheduled for 5 days from now. I've certainly responded quicker than my previous stim cycle. The nurse also tells me she can count approximately 35 visible follicles on each ovary, many of them small and immature. I will have the trigger injection in 3 days, they will call me with a specific time once they know when the egg collection will be. The trigger injection is exactly 36 hours before the egg collection. I continue the injections of gonal f and orgalutran up until the day before the trigger injection is required.

Day 11. Tonight at 9pm I have the trigger injection ‘Ovidrel’, or should I say 'injections!' They give you a whopping 500micrograms of chroiogonadotropin alfa (rch) to make good and proper sure that the follicles open up and those precious eggies release. It's fair to say that my ovaries feel rather large at this stage. It's a sensation of having a really full and slightly sore bladder, or rather one each side. Also, as they are rather swollen, whenever anything else in your pelvis moves or changes if gives you an added squeeze or pain, like as your bladder becomes fuller, if you lean over or cough you're certainly aware that your ovaries are fighting for space in their cramped little home. Fingers crossed for lots of eggies the day after tomorrow for egg collection.

Day 12: The day before the egg harvest. Today the second payment for the cycle comes out of our account for $3,800. This is a diagram of how the eggs are retrieved. I’m fairly nervous about tomorrow, not so much about the procedure itself (maybe a little about the pain afterwards) but about the amount of eggs that are retrieved. I’m really hoping for a good result to make it all worth it.

Day 13. The egg harvest procedure: We were up at 5 am so we could be at the clinic at 8am, we need to be there an hour before the procedure is scheduled at 9am. We wanted to allow plenty of time with peak hour traffic. I have fasted from the night before so no breakfast or even a cuppa this morning. We arrived and are checked in. The nurse checks over all our paperwork to make sure everything is in order. We also have to make payments for approx. $1300 for the hospital, anaesthetist and surgeon fee. It's crazy with how much they charge and the $11,000 we have already paid before today that these things aren't covered. Although I do feel thankful that this amazing technology is available in this day and age, the outrageous cost make me feel a little taken advantage of, and before you mention it, I know you’re all thinking it but the bulk bill clinics don’t offer the services we need and we do get a Medicare rebate for a portion (I’ll open up that can of worms another day when I’m feeling up to it) Anyway in the hour lead up to the procedure I have to remove all my jewellery, I was weighed and measured (glorious!) and got dressed in an attractive hospital gown with lovely disposable socks. I sat in a small waiting room with hubby whilst an array of medical staff come in to confirm my details and ask various questions. The IVF nurse, the embryologist, IVF doctor, admissions nurse and anaesthetist all did their checks and filled out their paperwork. I could tell from the look on Rob's face I was being blunt and short with everyone. I honestly just get so tired and over this merry-go-round. Everyone comes in smiling and wishing us luck, but it's hard to be excited and hopeful when you've been here so many times with no success. When the time comes to go through to the theatre I'm asked to quickly empty my bladder then jump on the table and scoot down into the stirrups, in front of an operating room filled with a plethora of people in scrubs. The anaesthetist inserts the canula into my hand and I drift off into a world of ignorant nothingness.

Whilst I'm under for the egg harvest hubby heads off to the andrology department to give his 'fresh' deposit, which will be washed and used today to inject into the eggs that are collected, more on that later. I wake up about an hour and a half later in recovery with several other women in various stages of consciousness. The pain in my abdomen is certainly evident and I'm offered pain relief by the nurse. I'm told that they were able to retrieve 9 eggs, it’s a great result, although it’s almost half what they got last time, I’m really hopeful that they are better quality and will result in a baby, we only need one! Already I'm doing the sums in my head estimating how many might fertilise and of that how many might grow to blastocyst stage and guessing we’ll get approx 2-3 embryo's in the end. I am up, discharged and on my way within an hour of waking. I waddle out the door holding my stomach.

About ICSI. After the eggs are collected and the fresh sperm sample is 'deposited', they are whipped away into the lab so that the embryologist can perform a procedure called Intracytoplasmic sperm injection (ICSI). For our last stim cycle we had natural fertilisation, because we had no known sperm issues. This is basically where the eggs and sperm are placed in a petri dish together and allowed to do 'their thing' naturally. In vitro in Latin translates to 'in glass' and today refers to the process of fertilising an egg with sperm outside of the body. ICSI is another form of fertilisation. It is where one quality sperm is taken and injected directly into the egg. We are required to do ICSI this time around not because of sperm issues or any concern about 'natural' fertilisation rates but because it is a requirement for the genetic testing that will be done. With ICSI not only are the sperm injected into the egg or eggs, but they are 'washed' and individually selected to ensure that only optimal sperm is used. The egg is cleared of any cumoulus cells surrounding it, this allows for better assessment of the egg quality and also to remove any cells that could have been collected from the woman during egg collection which can interfere with the results of the genetic testing. This is primarily why ICSI is required for the genetic testing of embryos- to make sure the egg cell is pure and not contaminated with other cells. Only mature eggs are injected with the best sperm, to produce the best results. Obviously this is also something that costs more than a standard IVF procedure. It is expected that approximately 50-70% (there are varying results on the internet) of mature eggs that are injected via ICSI will successfully fertilise.

Day 14: I'm feeling a bit better today. Still in a little discomfort when I bend over, cough or sneeze, but no real pain beyond mild cramping. The fatigue of the anaesthetic has worn off, which is great. Today the nurse called to see how I was following the surgery and also to update me on the eggs. Of the 9 collected, 6 were mature enough to be inseminated and 5 have successfully fertilised. I am honestly really stoked about this result, I was expecting realistically something more like 3-4 to have fertilised, so am pretty happy with this. Now to wait over the next few days to see how the embryo's progress as there are usually some that stop developing through the various stages. They may still go ahead with a fresh transfer if any of the embryo's don't meet the criteria to be genetically tested. I therefore need to start progesterone (argh! see more on my thoughts about progesterone here) tonight to prepare for a transfer and start to thicken my uterine lining. The lab will call again in a few days with an update on the embryo growth.

Day 16:

Today I got a call with an update on the embryo's. They are now 3 days old and all 5 are still going strong!! Wow, with our last egg harvest we had 9 embryos that fertilised however each day 1-2 would stop developing resulting in 5 after 5 days. 3 days in and all 5 of our embryo’s are still going strong! (fist pumps into the air) The embryologist explains that at 3 days old they would expect the embryo’s to have between 6-8 cells each and they all have between 7-9 cells (like this pic) so they are doing better than expected! (proud mumma). I am booked in for an embryo transfer in 2 days. They will assess the embryo's that morning and if they feel any aren't able to be tested they will look at transferring a fresh one then, I won’t get an update between now and when I go in for the transfer so I cross everything that we still have 5 in another 2 days, or more realistically that at least a good number of these are still going strong.

Day 18:

Up early again (5am) to head into the hospital for the possible embryo transfer. I have to have a full bladder so I drink water on the way. I arrive and have a conversation with the embryologist. All 5 embryo's are still alive which is fantastic, we've lost none so far. The embryologist explains that although all are still alive they are not quite at the stage for testing unfortunately. 1 is at morula stage (stage before blastocyst, I’ve included a pic to help explain) and 4 are at blastocyst stage, however they need the embryo’s to progress to hatching blastocysts before they can take cells for the genetic testing, as they remove cells that hatch out from the outer shell for the test, if they removed cells before this stage it would mean breaking the outer shell, which would compromise the embryo. What does this mean? They can’t do the testing yet as they will need to give the embryo’s longer to develop to the stage they need. I’m advised to make a decision. Have a transfer of one of the embryo’s now fresh and untested, or put off the transfer and wait to see what can be tested. There is no way of knowing at this stage which embryo’s will develop to be suitable to be tested, and I can’t have a transfer tomorrow as the embryo needs to be put back in at day 5 as this is the most optimal time for the uterus. I’m given a few moments to weigh up the options. I think about the reasons why the genetic testing has been requested, after so many previous failed transfers it’s better to know an embryo has no genetic condition that will compromise it implanting or developing. It's will also mean not having to go through unnecessary and expensive embryo transfers with embryos that we don't know if they are healthy, like all the previous ones we have had before today that have been unsuccessful. I also think about my body, I’m still recovering from the egg retrieval surgery only a few days ago. I know I still don’t feel 100%. I'm still in mild pain and discomfort and my body is still full of all the follicle stimulating hormones. Is this the best environment to be putting an embryo back into? But what if all the embryos can’t be tested? Then I may as well use one today, but we don't know which ones that will be, hopefully they can all be tested. I’m assured they if they can’t be and they are still a good quality they can still be frozen to be used later even if they are untested. I’m also told by the embryologist that the success rates with frozen transfers are higher, although they are unsure if this is solely because if an embryo survives both freezing and thawing it’s a strong embryo or because of the women’s body having more time to recover from egg harvest. After so much angst, I decide to not have a transfer and hope that all the embryos can be successfully tested, then we will know what we are dealing with and hopefully increase our changes with only using genetically 'normal' embryo's. The embryologist will call me tomorrow with an update of how many can be tested and how many can be frozen.

Day 19.

I have received a call from the embryologist with an update on the embryos. The embryologist informs me that only 2 of the embryos were at hatching blastocyst stage at day 6 so they are the only ones that have had cells removed and sent away for testing. Only two, out of the 5 embryos only two can be tested. Not amazing results but there are still another 3 untested ones left over right? ...No, only one of the remaining embryo’s now meets their criteria for freezing, the other two have stopped developing and will be disposed of. I immediately get regrets about not having a transfer yesterday, but I'm told these embryos can't be transferred now as my cycle is now too far advanced and they don't believe these two embryos are compatible with life. Wow, that's a kick in the guts. Those embryos will now be destroyed. Destroyed. I'm of course devastated about this, but I'm trying to hold onto hope that at least one of the embryo's that have been tested come back normal and give us a chance at a baby. The results will take 3-4 weeks to process. So for now, that's it from me. Time to recoup and cross everything our embryo genetic test results come back normal. I will update you on the results in a matter of time. If you have any questions about this cycle or anything about IVF please post them below and I will do my best to answer them. Thanks everyone for your support.

We have the results of our genetically tested embryos.

But it’s been a while since I’ve posted so I thought I would just summarise things. This was our 10th IVF cycle. To date we have created 14 embryos together, we’ve had 5 embryo transfers and we still have no baby after 6 years of IVF & 8 years of trying to conceive. This round we did a stimulated cycle with ICSI which created 5 embryos, only 2 of these embryos made it to be 5 day old hatching blastocysts which were able to be genetically tested, one embryo was frozen without being able to be tested. We’ve been waiting 4 weeks anxiously for the results of the genetic testing of these 2 frozen embryos, all our hopes are riding on these results. I received the call one day at work, my heart is absolutely racing, I can hear my blood racing around the blood vessels in my head, my palms are sweaty, the anxiety in the pit of my stomach makes me want to vomit, please, please let at least one of these embryo’s be normal. The geneticist on the phone explains the results, the first embryo is abnormal, she tells me what’s wrong but it’s lost on me, I stopped listening at ABNORMAL, I absorb nothing and want her to hurry to the result of the second embryo. Finally after hearing a string of words that make no sense and seem irrelevant like mutation, deletion and numbering various chromosomes, she finally gets to the result of the second embryo. It’s also abnormal. ABNORMAL, ABNORMAL, ABNORMAL, this is the only word I hear ringing in my ears. She begins to again explain why the second embryo was abnormal but I honestly can’t process it, I can’t even absorb it, I hear nothing, what difference does it make? It doesn’t matter how they are abnormal to me at this point, what she is explaining is that they won’t ever be a baby, the words “we believe these embryos are not sustainable of a pregnancy or life and will be destroyed” hit me like a knife. I hang up the phone to the lady’s pointless apologies. I’m absolutely gutted, hysterical, the air is taken from my lungs and I can hardly breathe. What is the point of all of this, all the years of scans, blood tests, injections medications and tens of thousands of dollars, all for nothing but abnormal embryos. All that hope, the dreams of one day holding a baby in my arms are gone. I call my husband. I can’t even get a word out, all he can make out are hysterical sobs and immediately knows that I’ve had the call for the results, he asked me “are they both no good?” and I mutter a tiny “yes” again he asks “both of them?” “Yes, both of them” I reply. Anyone that knows me will know that I absolutely hate crying. I'm so embarrassed and mortified if anyone sees me cry. For this reason I have to leave work and I sit in my car completely grief stricken, bawling my eyes out, sobbing and screaming for at least half an hour before I can even bring myself together enough to drive home, where I just continue to cry on and off for days. I’m completely devastated. I withdraw myself completely and try to make sense of what I’ve just heard. So many questions are running through my head, what does this mean for any future embryos? Does this mean that our last frozen untested embryo would also be no good? Do these results represent all the past embryos and explain all those failed transfers? Are we genetically incompatible? What next? Will we ever be parents? Will I ever hold my own baby? All these questions constantly run through our heads backwards and forwards, they keep me awake at night and will remain unanswered until we can see our specialist to discuss it further in a few weeks. The biggest question for us though is "is this the end of our journey?" That’s all for now.

The aftermath of receiving the results on our genetic testing has been a really dark time.

Apart from our miscarriage, this has probably felt like the biggest setback in our journey to become parents. We were feeling completely hopeless and lost, we felt like we didn’t know where to turn next.

We made an appointment with our specialist to discuss the results in more detail and what course of action we were left with. We had so many questions and information that didn’t make sense to us. The two embryos that tested abnormal, what exactly did the abnormalities mean? Were they reflective of all our embryos, past and future? What about the one frozen embryo that couldn’t be tested? Are we incompatible together? Are we carriers of some genetic condition? Are there more tests we can have? Is there any point moving forward, wishing for our own biological child? Is the next step donor eggs or embryos?

Our specialist explained the following things. Each embryo has 23 pairs of chromosomes, 46 in total. For someone of my age (younger than 34y/o) they expect that 30-50% of embryos will be abnormal.

Of our two embryos, one was missing chromosome 11 & 12 and one had errors in chromosome 9 & 10. These are different and spontaneous abnormalities. She had already conducted all the tests on us individually to rule out all possible/testable genetic predispositions. Therefore these results relate only to these two particular embryos; they are in no way representative of past embryos or future embryos. Whilst it is unfortunate that both of our tested embryos had abnormalities, it was only two embryos. They may have been the only two with abnormalities of all the embryos that were produced from this cycle. There is no reason to think that our last embryo that is frozen has any abnormalities at all. She recommended using our last embryo and then if needed, having another stim cycle and trying again as there is no reason why we wouldn’t get normal embryos from the next cycle. Same answer as every other time- try again.

When I left this appointment I cried, a lot. In reality I was expecting something more like, “this is the end of the line for you guys, next step; donor embryos or eggs.” I probably should have been happy that we weren’t at that stage as yet, but I wasn’t. For me, this just felt like Russian Roulette. It’s easy for other people to just flippantly say “go and try again” when they are not the ones who are suffering the grief, heartache and loss, over and over. They also aren’t the ones having to come up with all the money for another stim cycle. All this money I feel like is just going down the drain to no advantage. At times like this, a quote keeps coming to mind from Albert Einstein “Insanity: doing the same thing over and over again and expecting different results.” Going back and trying again and not doing anything different each time, to me certainly feels like insanity.

For now we will use our last frozen embryo but I can’t say at this stage if we will go ahead with another stim cycle. The thought of this makes me feel completely overwhelmed. I’m not sure I have the energy to go through this again, I’m not sure it’s in me any more. Perhaps the time has come to move on.