The Deafening Silence

It was little Myrtle's birthday just over a month ago. I selected a present that would be fun, educational and easy to ship cross country. "Is this a gift that you would like to have wrapped?" the sales clerk dutifully asked me. I knew it was a routine inquiry, but it just seemed to remind me that I wasn't making a purchase for my own child. I looked at the selection of wrapping paper and acknowledged that I didn't have any at home. Whatever she would charge for the service was justified by the fact that I wouldn't have to buy some cutesy wrapping paper that would just sit in my closet.   Plus, I figured this would help earn me points for being the good Auntie Jane.

It started to dawn on me that I haven't been that good a friend to Myrtle to support her during her first year of motherhood. I've kept my distance in order to protect my own feelings. I tend not to ask too many questions and I haven't been too available for her to discuss her experiences. A few days after the birthday, I called Myrtle and invited her to talk about little Myrtle's first year. Myrtle recounted the terrifying days of little Myrtle's ICU admission after birth, which was followed by many frustrating sleepless nights once they brought her home. She described that over time she started to gain confidence and felt more comfortable in her new role. She's enjoyed watching little Myrtle's personality blossom as well seeing her reach her developmental milestones, which recently included her first steps without assistance. "People are starting to ask me when I'm going to have my second baby..." she noted (apparently, this happens after the first baby reaches the one year mark) "I'd like to have another one... I'm just not sure if I'm ready yet."

I know there is no handbook or manual for how to deal with your friend who is infertile, but I'm sure if there were; there would be a chapter on not causally discussing your plans for a second child. It was just so striking how she could discuss the possibility with such confidence. There was a part of me that wanted to advise Myrtle that time is passing for her and she may not get knocked up straight out of the gate again. Yet, selfishly I fear that if I give her such a warning, she'll go off the pill and be pregnant within a month. Although Myrtle has no known biological limitations; the three of them are living in a shoe-box sized one bedroom condo, and their prospects for moving to a larger house are restricted by the fact that her husband is only getting part time work through a temp agency. Then again, it still seems more plausible that he could find a permanent full time position and they could move to a less expensive area.

I haven't spoken to Myrtle since I started this IVF cycle. During my IUIs, she couldn't understand the concept of having ultrasound monitoring to track follicle development. How could I explain the process of controlled ovarian hyper stimulation, oocyte retrieval via a needle inserted into my vagina, intercytoplasmic sperm injection, fresh versus frozen embryo transfer and possible chromosomal testing? Lentil once commented, 'why do I bear the burden of needing to provide education just because you don't know your science?' Seriously, there is this thing called the internet that lets you learn all kinds of stuff. Is it too much to expect her to Google IVF? Or maybe read the infertility primer I wrote up for her last year?

However, reading about IVF on Wikipedia only details the process when everything goes according to plan. It doesn't explain the situation of a poor response, disappointing fertilization rates or the unexplained BFN that follows a transfer of perfect looking embryos. Even my Ob/Gyn colleagues are also seemingly unaware of those situations, as their experiences involve caring for the success stories resulting from IVF.

I know it is not intentional and merely coincidental, but Myrtle always seems to send me an update on her baby just at the time when I've received some disappointing news. As I was walking out of my RE's office, upset over the prospect of only having 6-8 mature follicles after twelve days of stimming, Myrtle texted me a photo of little Myrtle. I probably should have sent a one line response to acknowledge that I received the pic, but instead I chose to ignore it. A few hours later, Myrtle nudged me, "did you get the picture that I sent?" Yes, Stan's Dad, I saw your bloody photo...
"Yes, she's adorable" I wrote back and I informed her that I had just received some information which indicates that IVF may not work. "Sorry to hear you got bad news about IVF." she replied "Is there some other treatment you can try?"

Now, I don't know if this was Myrtle's way of asking the 'have you considered adoption' question, or if she really thinks that science and progress may have other methods beyond IVF available. (I suspect the latter) I thought about explaining the option of donor eggs or embryo adoption, but I replied that we still are reasonable candidates for IVF (at least we were at that time) but it may take more than one cycle. Besides, as I was now reminding myself, we weren't out of the game with this cycle just yet. I was merely in the holding pattern waiting for my retrieval and the fertilisation report.

In my groggy post retrieval state, I heard my RE say "twelve". He was able to retrieve a dozen oocytes. As we were getting ready to leave, the embryologist announced that eight were mature. Even before I started my stims, I projected I would produce twelve eggs, and he was spot-on with his forecast on their maturity. I would have been ecstatic (pun: egg-static) to have 9 or 10 mature eggs, but I was very happy to be on the upper end of his prediction. Husband looked online and found that the lab has an 87% fertilisation rate, so he thought that would translate to 7 fertilised eggs. I estimated that we'd have a 50-75% fertilisation rate, which would yield 4 to 6. Well apparently, I am really good at predicting this shit, as we ended up with five fertilised eggs. Now we await the next match report. I have no conjecture on what it might bring, but I'm preparing for a fresh day 3 or day 5 transfer and possibly having nothing to freeze.

As intended, I did go swimming the day after my retrieval. I felt fine as I started my first warm up lap until I went into my flip turn. The process of crunching my lower abdominals combined with pushing off the wall sent me into agony. I think I screamed underwater. I finished the workout, but it was really uncomfortable and I was truly miserable. Alas, some things you have to learn the hard way. Such as discovering that you should have done IVF a year ago.