Beatrice's first haircut

Beatrice's first haircut
Originally uploaded by jonnycorcutt

It's been a while since we posted anything... everything is fine other than us not getting access to our blog here in Syria since Blogger is blocked. However, seems I can post from Flickr, so here we are.

As you can see, Beatrice is growing fast! She's now on to three word sentences (but her favourite expression is "zelf doen" meaning she wants to do everything herself) and is well on her way to being potty trained, pretty much going without nappies during the day now.

But the big news is... Flo's pregnant again! We're now mid term with the due date around 9th September. After years of trying to get pregnant back in Holland, we went for ICSI treatment here in Damascus (we were advised by our GP that they didn't even do ICSI treatment here) and we got lucky first time with only a single egg! So moving to Damascus has been proven very worth while.

We found a specialist here in Damascus who used to be a professor at Nottingham University in the UK. We found out about him through Flo's friendship with a European lady living over here who's married to a Syrian; her daughter had been treated by the specialist and she kindly passed on his details. The hospital is very basic and the bedside manner and general care is poor, but we're prepared to overlook all that given the outcome!

One year ago

Today is a special day. Not only because this is the day that both my maternal grandmother and my second cousin (her great granddaughter) were born, but because today one year ago we had two embryos put back. The result is sleeping soundly next to me at the moment.

Our gorgeous little girl
- who prefers sleeping in her parents bed, snugly between the two of us
- who is always in a good mood in the morning
- who loves getting undressed and having a bath
- who doesn't like getting dressed so much, despite all the pretty clothes she has
- whose hair at the back of her head looks like she had a hair cut already
- with amazingly long Bambi legs
- whose tiny little fingers like fiddling with my t-shirt or my bra when she is nursing
- whose face lights up when she sees her daddy
- who giggles so much that we sometimes think life is one big joke we are not getting

She brings so much joy to our lives, it is amazing to see her grow and become more aware. Of herself (hey, I have feet!), us and her surroundings. We are extremely lucky to have her with us and I am forever grateful for the extraordinary act of kindness of one woman that helped us make our dream come true.

12dp3dt and yet another symptom: disbelief!

8dp3dt or rather how this is a long long overdue post

Erm, I couldn't decide on the right title for this post. Heck, I couldn't even decide whether I would actually write this post.

You know what it feels like when you have not spoken to a friend for ages and you feel slightly guilty about being so sluggish at keeping in touch. And the longer you wait, the harder it feels to pick up the phone. Then when you finally come 'round to it, it turns out that your friend felt the same and is loving your call. There was a bit of that. So much has happened over the past months and I didn't know where to begin or what to write. Call it blogger's block.

A lot of preparation has gone into this cycle. How nice it was not having to worry about my ovaries behaving, but just concentrating on making my lining receptive for the embryos. How hard it was to sit back and trust that a bunch of other people are doing what they need to in order to get you pregnant. And then you have to think constantly about how weird your life is, which is just tiring.

The down-regulation was not a particularly pleasant experience. The nasal spray brought me in a menopausal state and made me very weepy. I got weepy thinking about everything that could possibly go wrong. The donor might not respond well to the drugs, my lining might not thicken up enough, none of the embryos might make it to day 3 or it might simply not work. Egg donation is not fool proof anymore than normal IVF is. And I even got weepy about being weepy!

You can imagine my (and Jonny's!) happiness when I could start the other drugs, the ones to build up my lining. I felt so much better, I was relieved! The donor responded well to the drugs, my lining turned out to be a perfect 10 mm, the sperm was good enough for ICSI and three of the embryos made it to day three. So last Saturday we transferred two embryos that our clinic characterized as "good quality". One six-celled and one seven-celled embryo. We would proudly like to present the first pictures of our two lil' ones:



And here we are: 8 days past a day 3 transfer and I still feel good, if slightly nervous. I try really hard not to analyse every twinge, ache and pain. And I am not doing a very good job at it. Cramps a few days after the transfer, sore breasts, lower back pain. In a good moment I associate the symptoms with pregnancy, in a bad moment I think that my period is looming. Maddening!

According to the doctor and embryologist, we have every reason to be positive and optimistic. Which we are. And I am so grateful to have this opportunity for success and I really apreciate it that we have made it this far. I just wish that time would go a little bit quicker! Five days to go until the blood test...

When Do You Know?

When do you know it is time to move on to donor eggs, one of my friends asked me? When do you decide to make that next step in the infertility journey? Well, I find making decisions hard enough when they don't concern life-changing events. Give me a choice of tea or coffee in the morning and I need to think hard. And oh, the horrors of a restaurant menu with 20 different starters or main courses (choice stress!)... On the other hand, I am quite quick to decide on what I like for our house and also with clothes I generally know what I want. And desserts. Dead easy: something with chocolate of course!

The decision of moving on to donor eggs probably fell in between very easy and impossible in terms of decision-making. We had talked about it before, childishly joking who we'd like our donor to be. After all, one has to joke about very serious things! When we had our evaluation after our third ICSI, we asked our doctor about it. Who dismissed it rather abruptly, especially since we mentioned egg donation abroad. Infertility tourism, anonymous donors with weird diseases and no doubt even weirder personalities, we were stabbed with the speech. We were not to involve them in this hideous crime we were planning and just had to learn to live with being childless.

Building our family through donor eggs did not feel like a crime though, if maybe a little unconventional. And remaining childless didn't sound like a nice option. I know that donor eggs are certainly not for everyone, any more than adoption or even IVF is. But after 3 failed ICSIs and talk of very small percentage chance of conceiving with my own eggs, we were ready. Ready to seriously consider it as an option for us to build our family. One night over dinner we decided (as you do) to go to Spain for an intake in a clinic there.

It turned out that donor eggs would definitely be our best option. And I must say, it was fantastic to hear a doctor say that you have a 60%+ chance of getting pregnant, as opposed to less than 5%!! So we tried to figure out how we'd integrate it into our lifes and our future children's life. We discussed anonymous donation and whether we would tell our future children.

We carefully tried the idea on our closest of family and friends and they were wonderfully supportive. There was no judgement, no difficult questions about things we so painstakingly worried about ourselves. They just wanted us to be happy and for our future child to be healthy and happy. They reminded us that a child is more than it's DNA, that we would still be able to see Jonny's groovy characteristics, that it was a great opportunity for us to get pregnant and have a baby. To give life. Wow.

And in being so sweet and caring, our family and friends made it possible for me to make peace with the the loss of my genetic link with our baby. It helped us in the process. Because that is exactly what is was. There is not one point in time I can pinpoint and tell that is when we decided. At one point it just felt right and we were comfortable with the idea of donor eggs. The decision was made. Spain sounded like a pretty good place for doing some baby-making to us!

I have been cupped

And it is not some form of internet stalking and it has nothing to do with coffee tasting... It was actually Part 1 of the Crash Preparation Course for the uterus. Make the embryo a happy home!

Cupping is an ancient art found in many cultures to relieve pain. The idea behind it is that stagnation in the body is removed by bringing toxins to the surfaceto be released through the open pores. Or belly button in my case. It is supposed to increase blood flow into the area of cupping.

So my belly was cupped to help the blood flow in my abdomen. Good blood flow is a factor in implantation of the embryo. Cupping in traditional Chinese medicine involves placing a glass cup on the skin with a vacuum heated by fire. A quite spectacular sight I must say.

It felt quite strange because the suction was enormous. It was intense but not painful. And I could actually feel the blood being drawn into the stomach area, warming all parts of my belly.

The cup left a bit of a mark, but no bruise, making me look like Gwyneth . Although there is no evidence for its efficacy, it was good to have the feeling to be doing something, to be in control. And I did feel quite chilled afterwards. Uh. warmed.

Our infertility story

When we didn't get pregnant soon after birth control, I remember telling my sister I feared there was something wrong with me. She said that was normally a typical male fear and we both laughed it off. Tests confirmed it was not me, but Jonny's swimmers. They were a bit slow and deformed. And there were not that many of them.

More than enough to do ICSI though. A form of IVF where the sperm is directly injected into the egg cell. Only a small obstacle to what we both wanted: our own baby. But what is a month treatment on a lifetime. Little did we know back then.

We were so excited and began our first ICSI cycle in the summer. Okay, it was a little bit uncomfortable having so many people involved in the baby making process. And taking so many hormones wasn't doing me any favours. But hey, we were going to get pregnant! Finally! After two weeks of drugs we had five follicles. Three fertilised and two were put back. On day three we transferred. Two Grade C embryos. This was it. We would be a mummy and a daddy.

The two waiting weeks flew by! Why on earth did anybody ever call those waiting weeks difficult? Technically I was pregnant, I just needed the pregnancy test to confirm it. On testing day there was still no sign of blood loss, so I was surely pregnant. Right?

Wrong!

One lousy pink line. That is all the test showed me. My world collapsed. Looking back at our journey so far, I can say that this day I lost a part of myself. It hit me so hard. I don't remember how I told Jonny, I just remember sobbing. Sobbing like I never had before. The rest of that day and much of that week is just a blur. I cried until there were no more tears and then I just sobbed with dry eyes. I got angry and I was in a bad place. A very bad place. I was angry at my body, angry at Jonny and angry at the world. I accused Jonny of not being there for me and he had no idea how to be there for me. We drifted apart.

We eventually found each other again and we started preparing for the next round.

I cut my caffeine way back, took more and different vitamins and put us on an organic food only diet. We tried a new protocol at a new hospital. This time only three follicles. But luckily two of them fertilised and were put back. We had a chance! A good chance with two good looking embryos. Could it be this time? Would we be lucky the second time around? I was between hopeful and gloomy for the whole two waiting weeks. It wasn't to be.

This time I was more upset about having to tell Jonny. I know how much he wanted to be a father. How could I tell him that it didn't work- again. That my body left us in the air- again? I saw the pain in his face when I told him. And we just held each other. For a very long time. And then we prepared for the next round.

We started with a detox- his and hers. More vitamins and I spent half my wages on accupuncture and now we only ate healthy food. No more tampons for me thank you, only organic cotton pads from now on. I took every advice in Zita West's book very serious. It was my pregnancy bible. I had to feel like we Did Everything We Possibly Could have to make this work. It was up to the lab assistants to help nature the last bit.

Same protocol and only one follicle. One lousy follicle. All that drugs wasted to produce what your body produces naturally anyway. We cancelled the cycle.

Then the hospital said it was enough. I was now officially a low responder. With only a 5% chance of getting pregnant with ICSI, they said we'd be better off having sex. Same chance. A second opinion abroad confirmed the low chance. But we were not ready to give up yet. We were still young. We were healthy. We had every chance to beat the statistics. If only we could convince the hospital. Reluctantly they agreed to do cycle selection. We just had to come back every cycle and pick the best cycle to start the treatment.

But there never seemed to be a best. My FSH continued to be high, there was only a low number of follicles each month and my veins started protesting at the amount of needles they saw. Suddenly it was enough. Enough of poking my unwilling ovaries, pumping my system full of hormones, giving blood to vampiring nurses and waiting for the right month.

So in May this year we decided to stop our own IVF- yes, I've been sitting on that story for a little while... We are moving on to donor eggs.

And we are so very happy to be moving again! We are so happy to have a life line!

A chance of one in 4.7 billion

No, not the chance of us becoming pregnant... ;-)

Gmail has this great service: it shows google links that match words in your emails. In my case a newspaper article came up: only ten hours apart two sets of sixtuplets are born in the US. Six babies. In one go. Wow.

Dots for inspiration...

Last Friday I went to the hospital. It was day three of the cycle, so check-time. They checked the number of follicles and the FSH level. Two squashed ones on the left and two on the right. FSH turned out to be too high (in case you are interested: 11.1).

Overall, not the best conditions to start treatment this month. They aim for eight to ten follicles for IVF/ICSI and a low-ish FSH (in case you are really interested: below 9).

Of course the number of follicles does not necessary correspond with the quality, but the more the merrier (but too many is also not good). With a certain number they can carefully handpick the best looking embryo. And hopefully that grows into a healthy bouncy baby.

Ideally your ovaries show a dotty pattern (my words, not theirs...)at the start of a (non-surpressed) cycle: lots of small follicles ready to have a few shots of growth hormone! So for inspiration I wore my new dotty knickers. I am planning to wear my new dotty bikini a lot when we go away on holiday next week!

A short break

We are quite open about our infertility treatment. At work the frequent trips to the clinic during office hours need some sort of explanation after all. Some close colleagues know we have had IVF and that we are currently in limbo land. I leave out more details though. I wouldn't dream of talking about the thickness of my endometrium, the state of my ovaries or number of follicles... That somehow doesn't make good coffee machine talk.

Close friends, family, fellow bloggers, support fora, mailing lists we all need for the moral support. So we share our story. On this blog and in real life. In between, during and after treatments. And it is wonderful to be able to talk about our emotions if we need to, great that people don't feel akward about asking us what is happening and nice that others share their story with us too. It is sweet that people hope for us and sympathise with us.

Last week somebody enquired about when I would have my period next. Admittedly that felt a bit weird. I mean... Just for a second or so. I don't really mind, because after all when my next period comes we go the hospital again. And maybe maybe we can start the treatment again. And maybe maybe maybe I will get pregnant. And have a baby. Or two. How lovely would that be!

But it felt weird. Okay, out with it. I think I have ovulated. So within two weeks we go back to the hospital to have my blood tested and determine the number of follicles present. If all is in the limits than we can start. We thought we were getting the hang of all this and being very organised for once. And then all of a sudden it struck me, I'd forgotten something! A quick peek at the last few months in my diary and a few hasty calculations confirmed that our planned city break is, well let's put it this way, rather bad timing.

We'll just have to wait and see when my slightly erratic period actually arrives. And what the blood test shows and if there are more than a few follicles waiting to join the game next month. And if so, if we can fit the possible egg retrieval around our planned holiday. You can't say we don't keep it exciting!

Positivity

This morning we returned to the hospital for a consultation with our gynaecologist to hear his interpretation of the results of the recent tests that Flo has undertaken.

He started off a little scathing, since he wasn't too happy that a registrar had performed the ultrasound last week, but after making his point he settled down and started to get to the point. Although the results of the last ultrasound weren't great, with only three follicles observed, he concurred that Flo's results for the hormone tests were consistently (over a two month period) "fair". We've kind of become accustomed to his parlance and quickly translated the term "fair" as meaning "average" or "typical". Coming from a position of "poor" and "borderline", this felt like a little triumph in my mind.

So, hormone levels look OK, number of follicles looks is a bit low, but the overall outlook is "fair". The gynaecologist actually seemed to encourage us to commence a "natural cycle selection" protocol, indicating that the rate at which Flo is currently liberating egg cells may be in a temporary trough and could at any time pick up and return to "normal". He stressed on several occassions that, although it's statistically preferable to have lots of eggs, he's had several successful attempts with women who have only produced a single egg and gone on to give birth.

So... now we start natural cycle selection. On the third day of Flo's menstrual cycle, her hormone levels will be tested and an ultrasound will be performed. If the hormone levels look good and there's a reasonable amount of good looking follicles (three seems to be the magic number), then let the ICSI commence! Otherwise, we wait 'til the next month and try again then.

Well... it's good news. But at the same time, it's a bit disappointing since we feel that we've just lost six months while the hospital convinces itself that it's worth continuing to treat us. But let's be positive... it's good news and even better, our gynaecologist now seems to be enthusiastic (well, as much as he can be) and fully supportive, despite the "natural cycle selection" protocol being "a bit of a hassle" (his words).

Therefore... next update in a months time!

Dealing with emotions

My last post was very factual. So much so, I got a comment about it. It is a lot easier to describe what actually happened, than writing how that made me feel. But I'll give it a try!

I sort of knew the blood tests would be okay. Partly based on the first result a couple of weeks back, but mostly because my periods are fairly regular and I have NO symptoms whatsoever that make me think I would be pre-menopausal.

I was looking forward to starting the treatment again. There is something strangely exciting about sticking needles in yourself (in a non-junkie sort of way!). It is a we-are-going-to-make-a-baby-feeling! It is a we-are-doing-something-we-are-going-somewhere-feeling! And maybe a baby will come of it!

That feeling was taken away when we were told to do more tests. How many tests can you do in five years? Yes, five years. That is how long we have been trying for a baby. "Well, another month is not that long then" the nurse said. Although it felt a bit insensitive and matter-of-fact, it is true. It just feels so long.

So my feelings? A bit of everything. I was pleased with the good results. I was upset by not being in control. We depend on the doctors in this process. No matter how much jumping up and down I did, the outcome would still have been the same; we wait. That was disappointing. I was upset with myself for not handling it better. The jumping is slightly tiring after all...

The doctor visit

Last Tuesday we went back to the hospital for the results on the bloodwork. We did not see our own doctor, but we did get the results of the bloos tests. The good news is that my tests all came back fine. Beautiful FSH, E2, progesterone and prolactin levels, the works. What does it all mean? Okay, a quickie hormone lesson, part 2.987.

You make the hormone FSH which stimulates your ovaries to produce follicles. The ovaries also produce estrogen which helps prepare the body for ovulation. Other hormones cause ovulation to occur. The follicle that releases the egg will begin to produce progesterone, which further thickens your lining, preparing your body for pregnancy. My body does all of the above.

The doctor seems to think I just don't have a lot of eggs and/or that they are not very good quality. In the next cycle he wants to check the amount of follicles and do another FSH test. Again. And then maybe maybe maybe we can start the cycle selection in June.

We were a bit confused. We thought we could start another treatment if the results were okay. The doctor apparently wants to get a few test results in a row that say the same thing. I will ask next time we see him. Meanwhile we have to practise our patience for a bit longer and comfort ourselves with the idea that IVF works better in the summer.

IVF update: a slight delay

Some things are predictable. When we lived in Dubai we could organise a BBQ three weeks in advance, having the absolute certainty that the weather would be good. Having said that, we have been absolutely spoiled with lots of sunshine here too and could have planned a BBQ the whole last month. Spring has sprung!

Other things cannot be predicted. My cycle for example follows it's own rythym, not to be disturbed by our agenda. I anticipated our next appointment in the hospital being too early: I wouldn't have had all the blood tests yet. And since they are vital to discuss our next treatment, this morning, I called the hospital. Our next appointment is on Friday 18 May.

Curious as I am, I enquired whether the first results were in. The nurse was a bit reluctant to tell me, saying she could tell me the number, but not interpret it for me. Fine, fine... :-) My FSH level was well within range, so that was good news. Now we'll just have to practise some more patience. I predict three weeks exactly.

Just passing time

Infertility is a bit of a waiting game. Waiting for medical appointments, waiting for cycles, waiting in the hospital and of course the dreaded two week wait. Although admittedly patience is not one of my virtues, it is not the waiting that I mind that much. It is the insecurity. There is no take-baby-home-guarantee at the end. That is difficult.

All we had to do now was waiting for my next period. That was easy. During this cycle I have to go to the hospital to draw blood on three different days. Tomorrow I will have my day three baseline FSH level and my estradiol level determined. As a general rule, the lower the readings, the better.

Then some more waiting for the results. We have another appointment with the gyneacologist on 3 May. Based on the combined results of the blood test, he will decide the best course of action. Will that mean some more waiting ahead or will we be able to start our next round of ICSI soon? I really hope the latter.

Hope is what keeps us going. Our attentive readers will have noticed that the Hong Kong fortune teller predicted that we will have a baby boy next year. We always thought that we would have a boy, although we would be equally happy with a girl. We would just love to prove him right!

A beautifully tailored protocol just for us

The last (and only) time my FSH level was tested, we were told it was elevated. This generally indicates a low number of eggs left in the ovaries. However, the FSH level can vary from cycle to cycle as Jonny pointed out in his last post. Since there is nothing you can do to make more eggs, our best chance to get pregnant would be to start the treatment in a good looking cycle (lowish FSH, good lining and a few follicles) and use a different drug protocol.

Or rather, the cycle selection method forces us to use the antagonist protocol instead of the most commonly used agonist protocol. Since the GnRH agonists surpress the GnRH surpressors, it cannot be used during cycle selection. Or in layman's terms: the most commonly used IVF meds mess with the hormone levels necessary to determine when to start the stimulation.

Agonists are given before starting stimulation and antagonists let you start stimulation without suppression. Although they work slightly differently, the outcome is the same. They both stop the pituitary gland from making LH. LH prevents ovulation. Meaning it prevents all the carefully stimulated follicles to pop and flush away before the puncture. Antagonists do this in a matter of hours, whereas the agonists take a week or so - they make it the pituitary gland overproduce, then it shuts down.

The antagonist protocol permits a simplified and shorter treatment cycle than agonists. That is the good news. During a good looking cycle, I'll stimulate for a few days and when the LH starts to rise, we'd add the antagonist to the daily injections. Done and dusted in just over a week. All we need now, is to get that good looking cycle! Bring it on, body!

IVF update: good news from Voorburg

On Friday afternoon we returned to the hospital at Voorburg to discuss the next steps of our ICSI treatment with the gynaecologist. We went with open minds following our latest insights from our trip to Gent and we happy to see that the gynaecologist followed suit.


Flo's menstrual cycle is back into its regular swing following the last treatment, which is good news since this offsets the problems with Flo not producing many eggs during each treatment. The gynaecologist gave Flo a quick ultra-sound scan and commented on her having a perfect uterus, another good sign. While Flo was putting her clothes back on, I asked the gynaecologist whether Flo had any more cysts and as he started to give me an explanation about the difference between a cyst and a follicle with an egg, Flo came hopping back into the room frantic to hear what he was saying. Apparently, a cyst is just a follicle without an egg, so it's quite common to see them. The problem only arises when the eggless follicle becomes too big, but in Flo's case it was looking OK.

Although making a point that our chances of successful fertilisation are lower than normal given that Flo is likely to produce less than ten eggs during stimulation, he was optimistic that, given the right protocol, we could still have a reasonable chance. He agreed that the protocols that we'd tried to date were not the best given our specific circumstances and he proposed a cycle selection and an antagonist protocol.

Cycle selection means we do some blood tests at the start of each menstrual cycle and only commit to stimulation and treatment if everything is looking good. Of course, looking good is a relative term and what this means is that Flo's uterus and ovaries are in good condition (no cysts and enough follicles) and that Flo's hormone levels are looking good. The really encouraging news was that the gynaecologist stated that, if things look consecutively sub-optimal for a few months in a row, that we stop for a few months and then take another look later to see if things have changed. The idea being that fertillity cycles, with peaks and troughs and that the time that we're doing the test may be in a natural trough. So coming back in a few months may give the body time to peak again.

Another thing that suprised us was the gynaecologist's willingness to try the antagonist protocol, despite the fact that it may mean carrying out the actual ICSI procedure during the weekend. Previously, he had stated that the hospital lab does not operate at the weekends which is one of the reasons that they prefer down-regulating, since it gives them more control over when the puncture will be performed and they can time it to occur during the week. He was now stating however that, although they prefer not to use the antagonist protocol, but in our case it was obvious that this was the best treatment and that, if the lab had to come in and work during the weekend, then so be it.

So, we couldn't have hoped for a better consultation really. We're getting what we want plus the gynaecologist is fully supportive of the procedure. So the next step is to perform some blood tests at the start of Flo's next menstruation. Unfortunately (well, sort of), we're probably going to still be on holiday at the start of the next menstruation, so we'll have to wait until April before heading back for the tests. But after waiting this long, another month is not going to hurt and I think going away for a much deserved holiday will only have beneficial effects for body and mind and set us in good stead to get back into the baby project!

Gent's a Go

Yesterday afternoon Flo and I headed off to Gent's University Hospital for our scheduled appointment with the fertility clinic. The journey turned out to be quite treacherous, since we're currently suffering from heavy rain and strong winds in the Netherlands, so driving conditions were pretty tricky!

After giving our history and medical background to the trainee doctor, we had a good, long chat with the fertility doctor. She was very frank with us. She said that, taking account of all the information that she has, she is inclined to agree with the opionion of the doctors at Voorburg that our chances of success are less than average. However, she went on to say that we're still young and we have time on our side and that she would not recommend stopping at this point unless we either can't afford to continue or don't wish to subject ourselves to further stress that is inevitable with the treatment.

She agreed that Flo appears to be what is referred to as a "poor responder" to hormone stimulation. In order to have a reasonable chance (30-40%) of the treatment being successful, Flo needs to produce about eight eggs during the treatment cycle. Since Flo only seems to be producing about four or five, this straight away reduces the chance of success. However, given that we have been successful in the past up to placing the eggs back, she thinks it is worth continuing.

In Belgium, it's standard practice to have six fertility treatments sponsored by the government, giving an overall rate of success of over 90%. In the Netherlands, the government only sponsors three attempts, giving an overall success rate of around 80%. This alone gives the Belgians a much more positive outlook on fertility treatment and they are far more willing to continue treatment for longer. As a result, the Belgian hospitals are far more relaxed about success rates and are not phased by league tables (showing which are the most "successful" fertility clinics in the country).

The doctor thought that our chances of success were around 20%. However, after the trainee doctor examined Flo with an ultrasound scan, around seven or eight follicles could clearly be seen (along with another small cyst on the left side), which was encouraging so early in her cycle. So it appears that Flo's fertility cycle is a little bit tempremental, peaking and troughing. Therefore, the timing of the treatment could well be critical and so it will likely be worth us waiting until Flo appears to be in a peak before starting an ICSI treatment.

The Belgian doctor advised that, given that Flo does not respond well to stimulation, there is very little risk of her hyper-stimulating. She therefore advised using the full dose of hormones and very small doses of down regulating drugs. Interestingly, she was very suprised that our last treatment was cancelled by the clinic, since, given that it was obvious that Flo was a poor responder, it would have been worth continuing the treatment for another week since delayed responses are often observed in women with conditions similar to Flo.

So, the bottom line is that they'd be more than happy to treat us in Gent. However, it's quite a drive, so it would be easier on us if we could at least have some of the ultrasounds done at a local hospital. Ideally though, we'd prefer to continue treatment at Voorburg. With the additional insight and confidence that they've given us at Gent, we're looking forward to returning to Voorburg to see if they propose continuing with us and to see if they are prepared to be flexible with the treatment that they offer us. It's strange, but, given the experiences that we've had and from talking with a few informed people, we seem to have formulated our own idea of what treatment we want. Unfortunately, doctors don't like being told what to do and don't like their conclusions being questioned... least of all by their patients!

Well... let's see what they have to say when we return to Voorburg next month. At the very least, we now have a plan B. Personally, I'm now much more confident and enthusiastic about continuing to chase our objective to have our own child.

We finished the day with a nice meal at Grade, a restaurant featured in one of Flo's magazines. The food wasn't anything special, but the ambience was nice and the company was excellent! It gave us time to unwind and debrief one another of the day's events.

Panorama: the baby-making boom

There is a program about IVF on television tonight. Panorama is a current affairs program on BBC and tonight they examine claims that some couples are being sold over-priced, unproven and unneccessary treatments. It is on BBC one at 20:30 English time, so 21:30 Dutch time.

Taking the baby project to Belgium

We have a plan. We are taking the baby project to Belgium. In January we have an appoinment at the university hospital in Gent. For a second opinion and maybe even to do the treatment there.

It is a little bit out of the way. But after getting the kitchen in England and the cats in Friesland, we think nothing of making our baby in Belgium.

I chose the hospital in Gent because they have experience with treating low responders. In general Belgian hospitals are more technically advanced and they are willing to try out more and different things. That might just be the right approach for our case.

To get in the mood we have another "matinette" at breakfast. Little thin slices of chocolate, that Belgians eat like we eat our hagelslag. But posher. There is a certain joie de vivre about the whole breakfast experience.

It feels good to have a plan. And it is almost January.