Geriatric ovaries, which was only written a week ago, now seems decades ago. It would seem that my old girls came through in the end. The scan showed 17 follicles chilling out in there with 13 at a really good size! After that, things progressed really quickly.

Here is me on egg collection day:

Rocking the hospital gown and can I just say my hair is on point!

8 mature eggs were collected, which is not bad. ICSI would be performed that very afternoon and then we would receive a phone call from the embryologist the next morning. Start popping those vaginal pessaries twice a day I was instructed. Discharged.

Things were looking hopeful. With 8 potentials, we could dream that I would fall pregnant on this round and then have some babes left over to freeze. This would save me going through all the needles, vag scans and more egg collection procedures for the next try.

It was exactly 10:00am when we got the call. Joy and I were still in bed, he was watching the news but not really watching the news. I was reading a book but not really reading the book. Several times, I had checked that my phone was off silent and that it was still working. Joy did his toilet routine in record time for fear of missing the call. I hadn’t left the bed.

Only two eggs were fertilised out of the 8 the embryologist informed us. Very quickly, our dream was put to rest. It’s still ok, it’s not bad I remember us telling eachother. It is still better than one or even worse, none.

Noone really talks about this part. The part, where you have to wait 24 hours (17 if you minus sleep time) for a 5 minute call to tell you if your embryos have survived another night. The fact that we had only two remaining, made me possibly lose my mind a tad bit. I became obsessed, reading up anything about embryo quality. I knew what fragmentation meant and how many cell divisions should be happening by day to indicate a good quality embryo. I was desperately trying to predict their chances of survival. I didn’t get anywhere by the way or feel any better.

The embryologist called the next day at 10:28am. Both had survived. But one was growing slowly and the other had stopped growing. So the clinic advised that I come in that same afternoon to pop both embies in to my womb. It is a really low success rate, the embryologist warned us.

In the IVF world, the days following fertilisation of an egg are important. Today was day 3. Now the ideal day for a transfer to happen is really day 5 as this has statistically shown better live birth rates. But, day 3 transfers do happen when one or both of the following criteria is met: A) the embryo quality is not great (that’s us) or B) if there are not many embryos (also us). So we were ideal candidates for a day 3 transfer.

The transfer itself is bloody awful. No sedation, full bladder with legs up in stirrups. The Dr also tilted the bed angle so that I felt like I was sliding headfirst off the bed while my vag and ass was up in his face. And just incase the Dr couldn’t see all that was going on, he also shone a light directly on to my private bits. Lovely. But, at least I didn’t pee on him. Once done, my consultant took his gloves off, washed his hands and simply said ‘good luck’ before disappearing out of sight. Presumably out one of the doors, I wouldn’t know as I was still hanging upside down.

The embryologist then handed me a pee tube (once I was dressed and the right way up) with the instructions to test in 14 days and to self isolate until this time. Continue popping those vaginal pessaries too she says.

So now we wait. Joy, myself and our two poorly embryos.

I have my scan tomorrow, or rather later today. It is 2:03 am after all. I am on day 35 of IVF injections and besides some emotional lability, bruises and several pin pricks in the belly, I think I am surviving so far.

Like everything else, our fertility clinic shut down during covid days and our treatment was put on hold. It didn’t bother me at the time, probably because I was too caught up in work to fully process the implications of having delayed treatment at my age.

And then, the fertility clinics started opening up again, but now at a slower pace due to the socially distanced rules introduced. To put things into perspective, instead of 4 embryo transfers a day, they were only carrying out 4 embryo transfers a week. In my mind, I thought that our chance for treatment this year was next to none. So I was suprised when I was invited to start treatment at the end of July. At the first appointment, the nurse handed me a bag which contained several needles, my very own sharps bin (to dispose the used needles in) and drugs. Lots of drugs.

I don’t mind the actual injecting part so much, the needle is so thin that you barely feel more than a pinch.

No, my biggest fear was that I would be a slave to menopausal symptoms. If you remember, the first drug puts you into a mini menopausal state. Of course, me being me, I had researched menopausal symptoms on the internet, and of course, the internet being the internet, it only threw up horror stories. Stories of women who had headaches for 10 days straight and no amount of pain killers could relieve it. Stories of women having chemical depression and then found sobbing uncontrollably in the bathtub by their other half. One woman got sent home from work because, as she put it, ‘got told she looked like shit’.

In hindsight, I probably should have seeked a more balanced view. But I didn’t, so I spent that first week very fearful that I would turn into the hulk.

In reality, it really is not that bad.

I can only recall a few incidents at work where I had to work extra hard to supress my rage, and only once where I had to go sit in the bathroom until I calmed my farm. There were a couple of days where I had the most horrendous headaches, but they could be relieved with paracetomol. Oh and I did cry more easily over cute dogs/rabbit videos on face book.

Things seemed to be progressing smoothly. My follicles were growing and my womb lining was at a good thickness level. I was even getting used to the vag scans. Joy and I were excited. But on my next scan, I was told that the follicles were growing slower than expected. This meant that there were no eggs ready for the scheduled egg collection.

Whenever I am told bad news, I never feel anything at that moment in time. Instead, I joke to ease the tension, I take care to note what it is being said and then I leave as if stoic. I am not a stoic person by the way, rather my brain is simple and cannot process emotions, thoughts and incoming external information simultaneously. I am that annoying person who has no questions when asked, but will then come back the next day with a million questions. For now, they wanted me to increase my dose of menopur and have a repeat scan to see where we are at. Not a big deal.

It wasn’t until we were half way home that I started to process it all and then panic. I had a ‘holy shit what if I have no eggs and this whole thing fails because of me’ moment. I started obsessively searching the internet for reasons for egg collection failures, and one really stood out to me. Aging ovaries. I started to beat myself up about my chilled attitude towards this whole baby business. If I had been less chilled, more active then maybe we would have started everything earlier when I was younger or before covid had hit to give us a better chance. But I didn’t, and now here I am with geriatric ovaries, panicking that the Sarkar line will end because of me.

The good thing that I have found about growing older, is that I have become wiser and kinder to myself. I have become better at recognising when my mind starts to behave like an asshole. Like in this instance. It is no good beating yourself up about decisions made in the past, because they were made in the past with the information you had at the time. Fertility issues tend to not loudly reveal themselves, so we had started trying for babies when I was 34. Which is not such an unreasonable age to start trying for babies if there are no fertility issues to delay things. How could we have known? And how could we have known that covid would rudely interrupt our IVF plans, delaying things even further? So I tried to put those unhelpful toxic thoughts to rest as quickly as possible. Instead, I found comfort in the fact that medication adjustments and delays in the IVF treatment cycle is not all that uncommon.

Next, we wait for this scan today and hope for the best. Now all there is to do is to just quieten down this nervousness and get some beauty sleep for my ever ageing ovaries.

We met our fertility consultant on the Monday last week. He was running late by nearly an hour, so we didn’t see him until 20:30 that evening. By this time, I was already yawning my head off after being awake at 5:45 am and then enduring a crazy day at work.

First, we talked about Joy. The scrotal support has now retired after a good job done and things are healing well. To all of Joy’s friends, sadly, Joy had threatened divorce if I posted a picture of him wearing his scrotal support. So I compromised…

Next, the Consultant tells me to wake up as it is now my turn. You are going to want to listen, he says, as he takes out a flip chart with pictures and diagrams.

The IVF Long Protocol

It starts when the red lady knocks.

On day 21 of my cycle, I come in for a baseline vag scan*. I then start injecting myself daily with Buserelin, a drug which cuts the communication between the brain and my ovaries. In other words, I am put into temporary menopause and yes, I will experience all the symptoms that come with menopause. To my husband, friends and colleagues, I apologise in advance.

When the red lady comes knocking the second time, I go in for another vag scan. This time to see if my womb is ready for the second daily injection, Menopur. This is the drug that will stimulate my follicles. If I’m not lucky, they will tell me to come back later and I will have to endure yet another vag scan to see if my womb is behaving. If I’m lucky, I will immediately commence the menopur, which now means having two daily injections to the fatty part of my bum. Come to think of it, is lucky the right word to use?

After a week of the two injections, can you guess what will come next? You guessed it. Another vag scan. This time to see if the follicles are stimulated enough. If it isn’t, they will tweak the dosage and ask me to come back later. If my follicles are behaving, and I hope they will be first time round, I will then have a third injection called Ovittrell, aka the trigger shot. This is what matures the eggs inside the follicles. Within 36 hours, I will be back for the egg collection procedure, which thankfully, they will knock me out for.

Are you still following this? Is this all making sense to you? Asks the Consultant. Probably because I looked overwhelmed and stupid. I think so, I say. But in hindsight, I think I was a deer in headlights. A very tired deer in headlights.

ICSI will now take place, where they insert a good strong swimmer into a good quality egg. Once the egg turns into an embryo, I will be back for the final procedure, the embryo transfer.

Now this is the one that worries me.

I will not have any sedation or be put to sleep. Instead, I am instructed to have a full bladder to enable the Consultant to do an external ultrasound. This means he will be pushing the scanner down on my full bladder while I have a speculum* and thin tube up my vag.

The procedure only takes about 10-15 minutes, he says, as if this is no time at all when you desperately need to pee.

Has anyone ever peed on you? I ask, thinking I am probably going to pee on him.

Only twice in my whole time doing this, he says proudly. Yep, I think to myself, I am definitely going to pee on him.

Then, it’s daily vaginal suppositories for two weeks, twelve weeks if you’re pregnant and you’re done! He finishes and closes his flip chart.

VAGINAL WHAT NOW?! AND FOR HOW LONG?! This is what went on inside my head. But outwardly, I controlled my panic and calmly asked him to explain.

The suppositories release the hormone progesterone, which helps to optimise the conditions in the womb, to help the embryo stick. It is about as big as a tampon and you insert it up, daily. And he said it, just like that, like it was no big deal. He even did the motion with his finger, just a quick upward jab of the pointy finger.

Later, I spoke with a friend who has lived through the IVF long protocol. On the subject of vag suppositories, her nurse had told her that if it leaks out the vag, then insert it up the ass.

Honestly, I wouldn’t wish IVF on my worst enemy.

*Vag scan: form of ultrasound where they insert a dildo shaped scanner up your vag to check out what’s going on in there.

*Speculum: tool which spreads your vag to enable procedures like pap smears or embryo transfers.