I have just received an email about my blood test results. I think it was just a basic full blood count but it has come back normal and, apparently this is a VERY good sign!!! Certainly it has cheered Dr Romana up immeasurably and she says that this makes going ahead with the implantation much more likely!! Who knew a full blood count could be so significant? I am so pleased - I know we're not out of the woods until tomorrow morning but I don't think she would have sent such a positive email if she had serious reservations. Could it possibly be that things are actually going to work out OK? I am sure it has been an epic battle between Archie's guardian angel and my malicious little army of gremlins - but it looks like Archie's angel might be taking serious casualties! For the second time today - 'Guan yersel!'.
I am going to start with the good news because, in the big scheme of things, it is by far the most important consideration. While we were at the clinic today Archie brass-necked it like a pro and asked after our embryos. The response? ALL five are still with us and doing well!! Isn't that wonderful? I know we still have 24hrs to get through but there's being cautious and there's being a complete killjoy - for all five of our little embryos to have made it this far is not unheard of but it is statistically unlikely and it is well worth a mini-celebration! We are incredibly proud of them - which is a complete nonsense because they're about as far from being self-directed, sentient beings as it is possible to be and still exist at the same time, (and if any of then hadn't survived we wouldn't have been the opposite of proud), but emotions aren't renowned for their logic and, rightly or wrongly, it's definitely pride that we feel. 'Gaun yersel' as they say in Scotland.
I wouldn't normally broadcast my urinary exploits but I was delighted when I woke in the middle of night and had what, after days of low pressure dribble, felt like an ordinary and reasonably substantial pee. In fact, by the morning, the reduction in bloating was so significant that I tried to persuade Archie that a trip to the clinic was unnecessary. As it happens Archie is very good at ignoring me while simultaneously appearing to be both sympathetic and attentive - it is a gift he has refined into an art over the years. In the taxi I worried out loud about wasting the doctors time, citing the fact that the pain was now comparatively insignificant - Archie, held my hand and applied the aforementioned tried and trusted technique. Walking from the taxi, through the building, the discomfort began to return more persistently but I was still pretty optimistic - I felt so much better than the previous morning.
The nurse weighed me and took my waist measurement, (I never weigh myself so I was unable to tell her whether it was more or less than normal - but it doesn't really matter - they will use it to make a comparison tomorrow morning). The reason they take these measurements is because they are an easy means of detecting excessive fluid retention. If either of them went up overnight it would not be a positive thing. I apologised to Dr Romana for the possibility that we might be wasting her time, explaining that things were vastly improved - but her response was to commend Archie for emailing and bringing me in. She said that if I hadn't spent the past 24hrs lying down then the embryo transfer would, without a doubt, have been cancelled, (Archie, being a saint, had the good grace not to look smug). It was all sounding fairly positive until she scanned my ovaries and then there was a slight but detectable change in her tenor - I got the impression that she was a little surprised by their size. She mentioned that it was unusual to get OHSS after a harvest of only 7 eggs but confirmed that at the moment I have it to a 'moderate' degree - there is also some fluid in my abdominal cavity. My first inane thought was 'thank goodness you didn't check yesterday'! She didn't say the transfer was off, she said that we would assess the situation again tomorrow and make a decision thereafter - but I would be lying if I didn't admit that she looked a little relieved when we asked some questions about frozen embryo transfer. Before sending us for a blood test, the results of which we will get this afternoon, she briefly hazarded the possibility of transferring only one embryo, (presumably because, if one takes it will produce hcg but nowhere near as much hcg as two), but it was said in a 'thinking-out-loud' capacity and we didn't push because we know that, until tomorrow, everything is speculative regardless. In the meantime I am back on the couch, drinking water like a woman possessed.
I realise that the latter part of this account hasn't betrayed any great emotion, which is the antithesis of how I would normally eulogise happenings of great personal significance - but I cannot afford to start crying at the moment - every drop of liquid counts. Archie and I will have to talk about what we're going to do if the situation is the same or worse tomorrow, whether we'll risk a transfer of one or two regardless - or whether it would be wiser to wait and find the pennies to fly back.
I will let you know whether the blood test offers any enlightenment.
I wasn't going to post again today, but having spent some time mining google for information regarding mild/moderate OHSS and whether it's safe/advisable to go ahead with IVF regardless, I thought I would document my findings - which basically amount to a complete lack of clarity. Whenever someone posts in a forum saying that they have symptoms of OHSS and asking whether they should go ahead anyway, they get a barrage of 'don't do it' responses from people who went ahead with it and got very sick. That being said, some of these people then go on to say that they survived the OHSS and delivered healthy babies... and some, very sadly, go on to speak of heartbreaking miscarriage - but these posts are not sufficiently scientific for me to conclusively ascertain whether the OHSS and the miscarriage were linked or whether they were just a set of tragic co-incidences. As it is I am still hopeful that I will wake up tomorrow and the situation will have resolved itself overnight... (I am closely related to a rather fetching ostrich), but for the benefit of people considering IVF tourism I feel like I should address the issues regardless of whether or not they give us more than a day or two of worry.
As I mentioned before OHSS will be exacerbated by pregnancy, so if you have mild, (or even no symptoms), before implantation then the overwhelming likelihood is that they will get worse. This may amount to weeks of discomfort and inactivity or, it may result in being taken into hospital because the water being collected by your follicles eventually floods your abdominal cavity and lungs - which necessitates medical intervention to regularly drain the build up and replace the fluid/vitamins etc. that are bypassing your system. Another consideration is that, if you implant two embryos and both of them take, then the flood of hcg will be double the ordinary influx, considerably aggravating any possible case of OHSS. If the doctor advises, or you decide, not to go ahead, then you will have to wait at least a month before you can transfer any frozen embryos. So for people considering travelling to Europe for IVF, OHSS is a real consideration that you might want to preempt with some thought. I wouldn't for a minute advise that you let the possibility stand in the way of trying, since your statistical chances of developing OHSS to any kind of detrimental degree are not excessive - but you should definitely give the issue some thought so that you are not entirely blindsided by the eventuality. Up to this point, the only thing that we thought might prevent an embryo transfer was a lack of embryos - so, as a very good friend of mine used to say to me - 'learn from the mistakes of others, you won't live long enough to make them all yourself'.