KEEP IT IN THE PHAMLY

There are three main ways that gestational diabetes seems to be managed:

1. Not at all - pregnant woman ignores medical advice, goes rogue and eats whatever she wants and doesn't test her blood glucose levels.
2. Diet-control and exercise - Moderating blood glucose levels through balanced meals and snacks, with moderate movement/exercise after each main meal to help process the blood glucose.
3. Diabetes medical intervention with insulin injections or Metformin pills, or a combo of both.

So far, I have been on Option 2: Diet control and movement. On bad days, I wish I could do option 1 and indulge in hot chips and ice cream without the crippling guilt I know I'd feel after. On exhausted days, I consider asking my diabetes team to stick me with multiple daily needles already so I can be less strict with my diet. Then I remember that I am doing option 2 for baby and get back to it!

Going on insulin, I'm told, risks placental deterioration while taking Metformin pills passes through the placenta and impacts baby's insulin production and growth. Both are safe enough to be used on pregnant women, obviously, but diet-controlled is what the medical teams prefer if you can to avoid further medical interventions that come from going on medication. Diet control doesn't always work especially towards the end of your pregnancy because of wild pregnancy hormones produced by the placenta.

I am writing this at Week 30 when the placenta starts to kick up its insulin-resistant hormones so I may write about insulin and metformin experience in future. But for now, I am diet-controlled.

I went from two meals a day, and an afternoon snack of fruit to:

1. 3 main meals a day - breakfast, lunch, dinner - 30g-45g carbs
2. 2 snacks - 2-3 hours after breakfast and lunch - 15g-30g carbs
3. Supper right before bed - 15g or less carbs

I focus on low-GI carbs that take longer to break down into blood glucose, and adding lots of veggies and protein will also help slow the conversion to glucose. Some women find it easier to go low-carb because there's little to no risk of spiking your blood glucose levels (BGLs), but my dietitian recommended 175g minimum a day for baby's development so that's what I target.

I have this with low GI brown rice that's not pictured

For those on diet control, this generous Melbourne dietitian is a godsend - Robyn Compton shares her GD expertise and I couldn't have figured out my new, balanced diet without her. Even my hospital dietitians recommended her to me after I'd found her through an online support group: https://www.instagram.com/gestationaldiabetes_dietitian/ The hospital dietitian's few pages of info on carb portions and whole foods vs processed foods is not enough to build meal plans for however many months until baby arrives. But with Robyn Compton here to save the day, I have plenty of meal and snack options from here until I deliver.

The Gestational Diabetes Australian Support Group on Facebook is also really helpful:  Lots of women sharing their personal experiences and supporting each other through this often baffling diagnosis and treatment. I don't normally have a good time with Facebook groups because I find people get catty, judgemental or sarcastic when they're allowed to post anonymously. But this group is full of pregnant women who genuinely care and are trying their best to navigate the murky areas of gestational diabetes management.

I also binged the Gestational Diabetes Club podcast by nutritionist, Helena. There is one particularly helpful Q&A episode with a GD educator that I wish they'd recorded a couple months earlier when I was starting my GD learning. It's super helpful: https://open.spotify.com/episode/1AaAKDKl7kOC1hOWQzzoLh?si=e0a1418b664b452b  

I've found my 'safe' meals after about 4 weeks of a crash course on how my body processes different food combinations. I'll occasionally try something new now I'm 11 weeks into my new diet but often I don't want the anxiety of eating something different and waiting two hours to test my BGLs to see if it's within limit. My diet is getting boring and I have another 9-11 weeks to go if baby arrives around the estimated due date, but better safe than sorry. I talk Baby Pham through our daily menu each morning so he's prepared for yet another bland day of eating.

I have a few 'cheat' meals coming up for Babymoon and over the holiday season where I'm pretty sure I'll spike so I want to avoid having too many spikes now. Consistent spikes over time is the real danger to baby whose body then gets used to producing more insulin to compensate for my high glucose diet so I don't feel so bad about the odd cheat meal I have coming up in the next couple months.

Our fertility and pregnancy experience

Not fun fact: There isn't a national standard for diagnosing gestational diabetes (GD), as stated on the Royal College of Pathology Australia's website and also by my gestational diabetes educator. She opened our education session by stating, "This won't help you ladies, but if you were having your baby next year you may not have been diagnosed with GD because they're easing the diagnostic levels." Great. Just great!

It gets dumber. Each hospital has varying blood glucose limits and guidelines. So you can be in the same city as another pregnant GD mumma and get different medical advice. For example, I am trying to keep my levels within:

1. Fasting - 5.0 or under

2. 1 hour after meals - 7.6 or under (only if I know ahead of time I can't test at 2 hours then I should test at 1 hour if I can)

3. 2 hours after meals - 6.7 or under

Other women's fasting numbers range in the 5.3-5.5 range that I've seen. Some women are told to test at the 1-hour mark, while others are told to test at 2 hours. Gestational diabetes guidelines are a bit of a joke, yet it impacts many pregnancies in Australia. I can see why they're loosening the GTT gestational diabetes diagnosis guidelines because it puts more strain on pregnant women who are already struggling with all the quick bodily changes. Though, let's face it - the motivator for diagnosing fewer women with gestational diabetes is probably the cost to the healthcare system. The number of appointments I had scheduled more than doubled when I was diagnosed with GD. 

Anyway, it's 2023 and they haven't changed the Glucose Tolerance Test (GTT) gestational diabetes diagnostic ranges yet so I am being treated for gestational diabetes. You can read about my GTT experience and results for a bit of background.

In my early pregnancy, I was counting down to Trimester 2 in the hopes that I'd feel less nauseous and fatigued. Though, once Trimester 2 arrived so did my gestational diabetes diagnosis. This has taken over my pregnancy and overshadowed sciatica and pelvic pain that seem like molehills compared to the mountain I'm now climbing learning how my body's insulin and blood glucose levels relate to the foods I eat, the exercise I do and stress factors like work, hot weather and poor sleep.

I'll be honest. Gestational diabetes management has put a huge dampener on my pregnancy. I can't sit back and enjoy not feeling nauseous for a few months before reflux and indigestion take over in Trimester 3. Instead, I have a tonne of daily logistics and duties to try and prevent my glucose levels from spiking and causing baby harm. I am juggling 3 meals, 2 snacks and 1 supper each day and testing my blood glucose levels (BGLs) 2 hours after every main meal, and my fasting level first thing when I roll out of bed. This is the most discipline I've had around body and health since... well, ever.

The diet isn't really a diet. It's basically healthy eating with a balance of protein, veggies, fruit and carbs that is recommended for all adults. The difference is I actually have to follow it strictly because straying into simple carbs and highly processed foods like white bread or hot chips spikes my blood glucose levels. Why is this bad? Because if I can't keep blood glucose in check, then my baby overproduces insulin to compensate for my high blood glucose levels. Why is that bad? Because insulin is linked with weight gain in adults and babies leading to macrosomic babies.

Why is big baby bad? They may be harder to birth vaginally, though I've heard of plenty of women birthing big babies who didn't have GD so I'm not worried about that. The main problem with having a big baby in our medical system is the hospital policies. They will want to induce you early (Week 38-39 at my hospital) instead of letting you go into labour naturally when the baby is good and ready to come out. What if they don't want to come out until Week 40-41? Women in my GD support group also seem to feel pressured into elective C-Section to avoid risks. In case you can't tell from my language, I plan to decline offers of early induction or elective C-section unless a good medical reason arises such as I develop preeclampsia or placenta deterioration or baby has health issues. I'm not scared of trying to push out a big baby.

What I am scared of is what could happen after birth if I don't control my BGLs and baby gets used to over-producing insulin. Once bub is earthside, they'll no longer have my blood glucose passing through the placenta to them, and could end up a severe blood glucose level crash, end up in NICU and we won't have skin-to-skin time in our first days together-apart. I want to do everything I can to be able to hold my baby even if it means going on insulin injections or taking metformin tablets. There's only so much you can do to manage your BGLs with diet and exercise. If my placenta decides to produce lots of insulin-resistant hormones as my pregnancy progresses, then medical intervention will be the way forward. 

So... this fear is how I am getting through the monotony, strict schedule and firm diet of gestational diabetes. Any time I've slipped up like eating mango, or having a late meal, my BGL has spiked to remind me to get back in line. On days when I don't feel like jabbing my finger for the two hundredth time or meal prepping yet again or eating another hard-boiled egg for supper, I either say my affirmation out loud or loudly in my head, "For baby!" I'm doing it all to give Baby Pham a chance at being as healthy as possible.

My dreams of an easy Trimester 2 before I got extra bloated in Trimester 3 is long gone. I'm now dreaming of Trimester 4 once baby is out and I can bite into a banh mi. Soft, fluffy, crunchy white bread and all the things I don't currently eat for risk of salmonella or listeria - deli meats, raw egg mayo, liver pate. Oh man... I haven't told The Phamly yet but whoever visits me from Brisbane's southside first has to bring at least two banh mi for me and maybe one for Boyfriend Pham.

I have roughly another 250 finger jabs to go before our due window. Sigh... For baby!

Our fertility and pregnancy experience

The glucose tolerance test (GTT) is a stress test on your body to see if your insulin is managing your blood glucose levels well when you consume 75g of glucose syrup on an empty stomach. All pregnant women are offered the GTT around Week 27-29 when the placenta produces more of the hormones that cause insulin resistance. High risk women like me who have a family history of Type 2 Diabetes and Chinese-Vietnamese descent are given the GTT around Week 14-16 once the placenta has formed. From what I've gathered, women who had gestational diabetes are given the GTT in Trimester 1.

If you're going for a GTT, make sure you follow the preparation guidelines carefully so you don't accidentally skew the results and get misdiagnosed. Your pathology lab should give you an info sheet specific to their testing requirements, but here is a general guide if you want to learn more: https://www.healthdirect.gov.au/blood-glucose-test

The irony is I was working in a product team building a pathology booking system when I got pregnant. Pregnant women are treated like pin cushions we are sent for so many blood tests in Trimester 1. I went from researching what pathology patients need to being a regular pathology patient.

The GTT is a 2 hour+ test. When you arrive, usually first thing in the morning as you need to fast for 8-12 hours. If you fast for longer, your body may do a glucose dump and cause you to fail the fasting blood glucose level test and be diagnosed with diabetes, pre-diabetes or gestational diabetes depending on why your doctor sent you for the test and your medical condition.

Some people abhor the test and feel sick from the glucose syrup. I was thankfully not one of these people. After my fasting blood vial was taken, I sipped my 75g of glucose in a 10 minute window without issue. The pathology collector set a timer for 1 hour from my fasting test and at the one hour mark, another blood vial was taken. Another 1 hour timer was set and at the 2-hour mark from drinking the syrup, my third blood vial was taken and after checking I was feeling OK, they sent me on my merry way with cotton balls taped to both arm nooks. They rotate arms for the GTT so one arm gets pricked twice at the fasting and 2 hour mark, and one arm gets pricked once at the 1 hour mark.

I failed my GTT at 16 weeks pregnant, and have been diagnosed with gestational diabetes due to my 1 hour test results based on the diagnostic criteria below, as I had a 10.7mmol/L result. My fasting and 2 hour results were fine.

International Association of the Diabetes and Pregnancy Study (IADPSG)

• 0 h ≥ 5.1 mmol/L
• 1 h ≥ 10.0 mmol/L
• 2 h ≥  8.5 mmol/L

Our fertility and pregnancy experience

When people say you're glowing in Trimester 1, it's the sheen of sweat that is reflecting light off your nauseated forehead. The good news is that for some of us, including me, this sweat does actually become a glow in Trimester 2 once you stop feeling sick all the time and are instead flushed with the 40%-50% extra blood circulating around your body, making you feel overheated, and putting you at risk of varicose veins, high blood pressure and other fun, potential pregnancy symptoms.

My early pregnancy symptoms in brief:

1. Sore boobs - a constant dull ache and they keep on growing
2. Sleep deprivation - I used to sleep like a log but no more
3. Frequent peeing - including at night, which added to lack of sleep
4. Fatigue - the most tired I've ever been in my life. Pulling all-nighters and 6-day camping music festivals have nothing on pregnancy fatigue
5. Gas - constantly bloated and gassy. Farting myself awake was a fun, new experience
6. Nausea - constantly needed plain carbs to settle my belly
7. Pimples - a smattering of hormonal pimples along my chin line
8. Sciatica in both legs - this is why they recommend sleeping with a pillow between your knees to alleviate pressure on the hips during pregnancy. Learned the hard way. D'oh.

I only vomited twice and that was before I knew I was pregnant. The first time I threw up was during a Diablo 4 gaming session. I don't normally get tension headaches but Boyfriend Pham does so we assumed I'd just been tense at the computer for too long. The second time I threw up was the night I found out from the GP via an email that we were pregnant. I went out to dinner for Girls Night, ate pho, had indigestion all night then finally threw up in the morning and took the next day off work.

This is what I craved early on:

1. Breakfast - must have cereal as soon as I get up to combat nausea
2. Oranges - 3kg bag nearly every week
3. Bananas
4. Kiwi - out of season so that was an expensive phase
5. Strawberries
6. Vegemite on toast
7. Eggs and toast
8. Plain crackers
9. Crackers and cheese
10. Hot chips
11. Cheese and butter sandwiches, later I craved pickles and cheese sandwiches
12. Vinegar - on salads mostly, but sometimes I'd drink a mouthful
13. Could not stomach red meat for 2+ months

Of the girls night crew, I had the worst Trimester 1 experience. In hindsight, I think it was the gestational diabetes / pre-diabetes because my pregnancy cravings were all high GI, mega blood glucose spiking foods like plain cheese sandwiches with butter and white bread, or plain hot chips soaked in tomato sauce. Fatty foods made me feel sick, flavoursome foods like curries made me feel sick. I somehow managed to not throw up, though, even when I thought I might. I was mega nauseous and plain carbs seemed to be the only thing to settle my stomach. But then I'd feel tired and exhausted after food and need a nap.

Our fertility and pregnancy experience

Our 2cm bean at 8 weeks.

For someone trying to get pregnant for a number of years, I sure was oblivious to what pregnancy actually entails. I knew that you did an at-home pregnancy test and then should get a blood test to verify any positive results. And then...?

I went to my regular general practitioner doctor (GP). He is very considerate and attentive when diagnosing general health problems but he is not an antenatal specialist so wasn't across the nuances of early pregnancy. I've since come across a checklist that would have been handy for both of us to know and work through together.

I am in Queensland, Australia and at my first public hospital midwife appointment, I was given a printed version of the Pregnancy Health Record and told to take it to every medical appointment from now on. Pages 12 to 13 are a handy breakdown of what you'll be chatting to healthcare professionals about during the different weeks of pregnancy. https://clinicalexcellence.qld.gov.au/sites/default/files/docs/clinical-pathways/pregnancy-health-record.pdf

A summary of my pregnancy scans and tests up to Week 20 (the halfway mark!):

1. Blood test to verify pregnancy.

2. Blood test to check immunities and potential risks if not immune.

3. Scan 1: Early pregnancy scan to check embryo growth. My GP recommended week 8-10 to also get bub's heart rate. 

4. Scan 2: The "Week 12 Scan" is a Nucheal Transparency (NT) to check the fetus' growth.
   
   This one is a biggy because your baby has developed vital body parts and functions and the remainder of your pregnancy is further developing what's been established. The risk of miscarriage dramatically drops if your baby has all its bits and bobs in order.
   
   Before your scan, you need to do a PAPP-A blood test 4-5 days in advance so the radiology team can get a copy of the blood results before your scan.
   
   Optional NIPT genetic screening blood test that is not covered by Medicare. Cost ranges from $500-$700 from the few pathology companies I looked up in Queensland. NIPT blood test needs to be done up to 7 days in advance as it's a specialist test and may take longer to process. I opted to pay for the NIPT for peace of mind but to also learn the baby's sex (finding out the gender is an opt-in tick box on the request form, you don't have to find out if you don't want to).

5. Hospital referral from your GP - You need to decide whether you're going public or private and nominate your preferred hospital.

6. Hospital care options - You need to choose a maternity care option. I was offered shared care with my GP and hospital midwives, midwives only, or specialist care. I went with midwives only since I was a fairly low-risk pregnancy. That, and my GP seemed glad to refer me away from his care because I had questions he sometimes couldn't answer. I later got bumped up to Specialist Care with a little more involvement from the hospital's obstetrics team. More on that another time.

7. Scan 3: The Week 20 Scan is the last major milestone for the first half of pregnancy.
   
   The scan checks baby's growth and takes measurements and images of the baby. You can also learn the baby's sex at this scan if you didn't learn earlier. If baby is healthy and mumma is healthy then I'm told women are mostly left to their own devices until the Week 26-28 glucose tolerance test (GTT). Then don't continue growth checks until Week 32+ onwards.

Me? Unfortunately, I got diagnosed with gestational diabetes in Week 17. I did my GTT early because being part Chinese put me in the high-risk category. I will write about gestational diabetes another time though, because it adds a whole new dimension to my pregnancy experience.

My left ovary that gave us two frozen embryos and our miracle 'natural' pregnancy embryo.

Our fertility and pregnancy experience

Let's take a break from my IVF and pregnancy experience to talk about stupid home automation. We have lights and hub from the Phillips Hue range on a tech friend's recommendation. The Phillips Hue Bridge connects to and controls the Phillips smart bulbs - there are more advanced options with motion sensors, but we wanted to start with the basics.

I love the idea of home automation in theory. The reality is, that you probably need programming skills to set up actually smart home automation. The current settings and rule options in our "smart" lights remind me of clunky eCommerce store sales rules logic where a programmer built what they could and not what they should, limiting the options to end users like me.

We wanted to set up smart lights that would:

1. Turn on at sunset each day. Tick.
2. Fade and turn off by a certain time of night. Took 5 routines to set this fading effect up, but - tick.
3. Turn on when one of us comes home after dark. No tick.

I didn't think it'd be impossible to set the lights to only turn on when it's dark / after a certain time but apparently, it is. The option was to turn on the lights regardless of the time of day whenever one of us arrived home, or nothing at all. Our house is bright and we don't use lights during the day so we opted for nothing at all. Otherwise, we'd end up turning the lights off multiple times a day instead of turning the lights on occasionally when we arrive home after the fade and turnoff routines have run at night.

Hopefully, the software will improve over time. For now, we've settled with having dumb smart lights with limited usage and Boyfriend Pham just yells at Google to turn the lights on. I'm waiting for maternity leave to remove work apps from my personal phone so I can enable Google Assistant voice activation - currently, they're disabled for work security reasons and I'm too lazy to carry around two mobile devices so I sacrifice my right to Google voice. Dumb, smart me.

We decided to freeze our 2 viable embryos rather than do an immediate embryo transfer because I was so bloated from the IVF medications in March. Then in April, I had food poisoning, head colds and aching ovaries; it was just not a good time to schedule an embryo transfer because I wanted to be in good health to improve our chances of success. Even though I've heard from women who fell pregnant while they were sick as a dawg.

We let April come and go. My cycle was warped from all the IVF hormones and my usual 28-day menstrual cycle was a whopping 39 days. We decided my next cycle would be our first attempt at an embryo transfer. I had progesterone meds stocked up in the fridge - it is used to thicken your uterus lining to increase chances of the embryo embedding successfully, and got my medication plan from the fertility clinic in anticipation. But then my 28-day cycle came and went. Then my new 39-day cycle came and went. I had spot bleeding the weekend V came to visit and that usually means my period will start a few days later. But it didn't.

Then one Girls Night, Little Sissy Pham suggested I take a pregnancy test. She'd given me the tests she had from when she got pregnant with Nephew Pham. That Saturday morning I peed on the stick and was shocked to see the little plus symbol. Part of me couldn't believe it so I read the instruction box and saw that IVF medications can mess with results. I went downstairs to tell Boyfriend Pham. We were both surprised and happy, but unsure. I wish I'd researched it further before I told him that IVF meds can cause a false positive, which dampened our celebration somewhat. But IVF hormones stay in your system for approx. 10 days. It had been over a month since I was on those meds so we were very likely pregnant and could have been less reserved in our happiness!

Anyway, I went to the GP and asked for a blood test to confirm. One evening while taking the train home together I read an email from my doctor. He'd circled something on my blood test results and had scrawled, 'CONGRATS!' And that's how we learned we were definitely pregnant at 7.5 weeks. The doctor was surprised I hadn't tested sooner, but honestly, I was so focused on the embryo transfer, and in denial because we'd been trying for years without success - why would I be lucky enough to get pregnant now?

I am so blessed that we got pregnant 'naturally.' I put that in quotes because I am convinced the IVF hormones helped our cause. The only other life change was Boyfriend Pham left a toxic work environment for a very supportive new workplace. Maybe it was a combination of both - my body needed the fertility hormone boosts and Boyfriend Pham needed less stress. Whatever it was, I am so very grateful for our miracle embryo. My spot bleeding from a couple weeks back had been the embryo embedding into my uterus lining.

Next up: Pregnancy scans, tests and holding my breath between key milestones, willing my little embryo to stay healthy and keep growing.

Our fertility and pregnancy experience

The egg and sperm collection process was straightforward. The hormone injections were physically challenging but it was the wait for viable embryo news that was mentally challenging because it's out of your hands at this stage. It's up to science and luck.

I had my egg collection on a Wednesday and flew to Melbourne that Saturday to visit Phamly because Little Sissy Pham wanted her son to meet the Aunty we lived with for 2-3 years to finish high school after The Phamly moved to Brisbane. I didn't need to be there, really, but Little Sis is sentimental and wanted me there so why the hell not? I was mega bloated still from the meds but the soreness was gone.

On Friday, I received a call from the clinic to say of the 19 eggs they collected only 8 were mature enough to progress. Boyfriend Pham and I had opted for ICSI where they inject the sperm into the egg rather than placing the egg into a culture with the sperm to naturally try and fertilise, because we wanted to control as much of the process as we could. However, of the 8 mature eggs, they only injected 2 successfully, another 3 failed to survive the injection because they weren't mature enough and were too soft. The last 3 eggs they put in a culture to fertilise naturally.

It was disheartening to learn less than half the eggs collected were usable and we only had 5 chances at a viable embryo. I kept telling myself that we just need one good one to proceed, even though, mathematical me knows our odds are better with more than one shot. And so, it was a blessing that I had an impromptu trip to Melbourne with my nephew and his parents to distract me. Our next update would be on Monday. The weekend days were fine because they were filled with family, travel and feasting, but when I went to bed at night I missed Boyfriend Pham and was anxious about embryo news.

On Monday, I missed a call while on my way to visit Little Sissy's friend and her new bub. I called back and got the happy news that one of the eggs had developed into a healthy embryo, and there was one more they were monitoring its development. Unfortunately, the other three did not fertilise. They would update me the next day. One out of 19 so far. Sigh. Still, I told myself. Better than none.

The next day, Tuesday, we flew home. Our flight was delayed over an hour so we were stuck at the airport with a 1.5-year-old to entertain. Fortunately, our flight wasn't on time because while we were sitting in the food court trying to convince Nephew Pham that his Happy Meal box was the most entertaining toy in the world, I got a call from the clinic.

I remember this moment so clearly because Nephew Pham was watching me intently while I was on the phone and as I started to smile, he started to smile. By the end of the call, I was grinning from ear to ear and when I happily thanked the scientist for letting me know that we have 2 viable embryos, Nephew Pham read my emotions and started to cheer and wave his arms. It was such a happy memory. We'd doubled our chances for an embryo transfer, and Nephew Pham was cheering for what could be his future cousin!

Two out of 19 is not a great result, but we'll take anything we can get. I'm 39 years old and next year my fertility takes a statistical nose dive, which will make the odds forever not in our favour. I've had friends go through multiple egg collections with no embryos at the end of it. I've had friends who go through egg collections and get 5-8 viable embryos. Results feel random because there are so many factors that impact fertility.

Next up, scheduling an embryo transfer...

Our fertility and pregnancy experience

We had our first round of IVF egg collection in March 2023 after 11 days of not-very-fun belly injections for the wannabe mum. We had the option of doing the egg collection knocked out in the hospital or mild anaesthetic at the Life Fertility clinic. I opted for mild anaesthetic at the local clinic because I'm not particularly fussed by a pap smear, colposcopy or any other procedure that some women find invasive and distressing. Also, I am cheap and do not want to pay hospital and anesthetist fees unless I really have to.

On the day, I had to fast since nobody wanted me throwing up from the green whistle (anesthetic) I would have before the procedure. Boyfriend Pham drove us there since I'd be too woozy to drive after and he had to provide a fresh sample of sperm - double duties. I just had to rock up, strip off my bottom half, put on a medical gown with an open back and sit in a chair.

We arrived an hour before my procedure was scheduled, and Boyfriend Pham went first. When they called his name, another guy stood up and also approached the nurse. We were very confused since the guy's name turned out to be Ryan, which didn't sound anything like Boyfriend's name. The nurse took Boyfriend to a private room and checked his name and DOB a half dozen times to be sure she had the right person before he was left to produce sperm.

A half-hour later, it was my turn. I was taken to a second waiting area where my blood pressure was checked. The nurse then walked me through the post-procedural area where I saw a handful of dazed women in recovery chairs. I was quite happy to see them eating snacks. I was hungry. Then I was in the procedure room where there was a chair, screens, trays of medical devices and two friendly nurses. One was there to give me the green whistle and help me through the procedure. The other was there to assist the doctor. A scientist in the room adjoining popped his head in to say hi and let me know he'd be checking the eggs as they were collected.

When the doctor and his student doctor arrived, the nurse gave me the green whistle. I quickly started to feel light-headed and was soon giggling away. The doctor showed me the many follicles I'd grown on both ovaries. Once it was clear I was feeling the effects of the green whistle, the doctor applied the local anaesthetic. The injection hurt a bit but not much.; I barely noticed the procedure had started. The doctor started retrieving the contents of the follicles using needles. A nurse would take each tube to the next room where the scientist would check the contents for eggs and call out the count as we went.

Once the doctor was done and gone, the nurses packed up while I sat there for a little bit. I was still lightheaded but felt OK to walk so told the nurse I was ready to get dressed. They provided pads in case there was any spot bleeding but I'd worn my period undies so didn't need one. In the recovery area, I sat in a comfy lounge chair, applied a heat pack to my lower belly and stared longingly at the packet of potato chips I was given but couldn't eat because I was too tired.

At some point, the doctor walked through with another patient and called out that I must be OK because I was smiling. I don't know what I was smiling about - maybe dreaming of eating. After a short rest, I told the nurse I was ready to go home. She gave me a take-home heat pack and instructed me to take Panadol at home if needed for the pain. Boyfriend Pham greeted me in the main waiting area and I made him do a pit stop at a fish & chip shop where we dined in with my little heat pack and a funny walk. At home, I curled up on the couch and took some Panadol. I was a bit achey but it was similar to a bit of bad period pain. Nothing major.

One more thing worth mentioning is the anaesthetic makes you mega constipated so make sure you have poop-friendly foods like prunes.

All up we retrieved 19 eggs, which I'm told is on the higher end of the scale. Though, what matters most is the quality. That will come in my next post about the wait for embryo news.

Our fertility and pregnancy experience

After spending 2022 trying to figure out why we weren't pregnant, we started this year trying to make viable embryos.

2023 did not start off well for me. In January, I had my initial IVF appointment and had to get some blood tests. In February I had a hives breakout that wiped me out and then because my immune system took a beating, I immediately got a cold as soon as I started to overcome my allergy symptoms, followed by a bout of food poisoning. The worst part was, during the initial appointment, my new fertility doctor was baffled as to why my previous doctor put me on thyroid medications when my blood results showed I had normal thyroid function. Serenity now! 

I had to delay my egg collection because my blood results came back with a high level of a stress hormone, which was explained away by my allergies but we still had to wait until I was well enough to begin the IVF medications. The nurses sent my script to a specific pharmacy in Spring Hill, Brisbane. I could either pick it up in person or have it couriered. I opted to go get it and I'm glad I did because the pharmacist ended up stepping me through the injection process. I still watched instruction videos but I always feel better with in-person demos. 

There would be 10-12 days of injections depending on my cycle and when the doctor was available for consultation. Keep in mind when reading the below that there are different types of IVF hormones and doses - it's all catered to your specific needs so don't read this as a standard medication plan - it is what was best for me.

I had 11 days of Ovaleap 600IU injections to grow my follicles and increase the number of eggs to increase my chance of having some healthy eggs. I did not enjoy the injection pen. It had a sliding mechanism that made it go from 1 to 100 in speed, and the sudden shot of fluid into the belly hurt. This one gave me bruising most of the time.

From days 8-11, I started a second injection of Ganirelix / Orgalutran 250mcg to stop my eggs from being released from their follicles. This medication came with a slightly bigger needle tip but thankfully was a regular push syringe so I could control the speed at which I injected myself. By now, I was very bruised and tender so while I don't think this one bruised me, I was achy overall from the pen injections.

I am grateful my cycle meant I could get my scan on Day 11 and I skipped the last day of injections. On Day 11, my doctor did an ultrasound to confirm the meds had worked a treat and I had many follicles on both my left and right ovaries. He booked me in for an egg collection two days later. The night of the scan I injected myself with 2 syringes of Decapeptyl exactly 36 hours before my collection was scheduled.

Even though I dread the thought of doing another IVF round, the bruising and tenderness were probably the best of the side effects from the hormones. I experienced every common side effect listed on the warning labels and the severe and rare side effects as well. My symptoms ranged from standard bloating and gas to redness, soreness then my favourite: hives on my chest and neck. I contacted the clinic about the hives and ended up taking antihistamines and an ice pack. After the first couple of days, my body adjusted and the hives went away.

The scariest side effects were on the night of Day 8 when I first injected the Ganirelix. I injected myself at 7am each morning, and by 3pm that day I was feeling nauseous and bloated. By 6pm I was short of breath and had developed huge cankles to the point where when Boyfriend Pham came home, I got up to greet him and he said, 'Whoa, I think you should sit down.' So I did. I sat back on the couch and elevated my legs and pondered whether this was the rapid weight gain that I was meant to seek immediate medical help for.

I decided that if I went to emergency now on a Friday night and I wasn't in immediate danger then I'd wait around for hours while people with more urgent health issues were seen before me. So I would go in the morning after some sleep. I'm glad I did because I woke up to find my swollen legs and ankles had started to deflate. The next injection of Ganirelix didn't have the same side effects so I assume my body had just needed a bit of time to adjust to my new hormone levels.

As always, if you have any questions about my experience, feel free to email me via the email icon top-right if you aren't comfortable commenting. 

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