Embryo on Board

A few years ago, I was doing my household cleaning when I flipped on the TV and started searching for something mindless to serve as background noise. I stumbled upon a marathon of I didn't know I was Pregnant! Like driving past a car crash, I soon found that I couldn't look away. I was drawn into watching episode after episode while the hoover remained in the closet. Props to the mostly unknown actresses who deserve Academy Awards for portraying someone going through the pains of labour, without realising that it is labour. I know it always gets asked; how can one seriously not notice any changes of pregnancy? In the sketches that I saw, many women had been diagnosed with PCOS and were told they could not get pregnant. A few others were in their mid-40s and figured they were too old. One very thin college age girl, I suspect was really in denial. Her pre-med roommate delivered her baby in their dorm room, thus nailing her admissions essay and interview. It was interesting to see the follow up with the real women and their surprises. Without any prenatal care or pregnancy precautions, they delivered healthy babies. My work seemed so obsolete.

In contrast, if this FET works, I'll be aware of my pregnancy from the moment it started. I'll remember that I went swimming that morning. It was raining and I love swimming in the rain. The sky may be throwing it down, but it feels so peaceful in the pool. California has been in a serious drought and we really need this rain. I'll recall that it was a (6) 1-2-3-4 and (4) 4-3-2-1 Individual Medley set. Man, she is pushing the yardage! I'll remember what I had for breakfast. Gluten free Rice Chex with almond milk, thanks to a great suggestion from Amanda at Beloved Burnt Toast.

I'll look back and recall that my transfer was postponed. We had just crossed the Bay Bridge when I received a call from New Girl explaining that my RE had a complication with a surgical case. (There was a possible perforation during a hysteroscopy and he needed to perform a laparoscopy. All was okay and he was hopeful that the surgery corrected her Asherman's syndrome.) We went to a nice spot for lunch and enjoyed the opportunity to walkabout like tourists in San Francisco. I was really glad that I decided to take the day off, especially as I have been fitting so much of this process around my work schedule. I had a really busy morning on the day of my D+C and I was almost late for my procedure. It felt good to be prioritizing my family, at least for the day.

There was more than one way that I benefited from this delay. At the time I received the call from New Girl, it was 30 minutes before my appointment and my bladder already felt as if it were about to burst. Husband has always complains about my small bladder capacity, and I may have a bit of an overactive bladder. In particular, if I know I can't go to the bathroom for a while, it really seems to drive the urge to void. The second time around, I waited until 45 minutes before my transfer to start drinking water. I only drank about half of the required amount, but it adequately filled my bladder and I was much more comfortable.

The embryologist reported that our embryo thawed well and was hatching spontaneously, which apparently is good. The transfer procedure itself went very smoothly, although the tech wasn't too proficient with the abdominal ultrasound. I could tell my RE was a touch frustrated, but I resisted the temptation to maneuver the wand myself. I've noticed that there is so much variation in the protocols between different clinics. XYZ is very no frills. They employ a non-sterile set up, and they don't offer  Valium or any other pre-meds. During my first transfer, I was so upset about the embryo report and I left a mess of loose ends as I rushed out of the office. I could have used the Valium for those reasons alone, but especially as I was so tense that it was hard to keep still during the procedure. Perhaps I was fatigued from so many laps of butterfly during our morning set, but I felt much more relaxed during this transfer. Not that I'm subscribing to the 'just relax' theory, as I know it won't make a difference... I once had a patient who described that she and her husband had been trying to get pregnant for 3 or 4 months without success, but then "we relaxed and it happened." I informed her that she was within timeframe for normal fertility, but I was really tempted to ask, "So, how exactly did you 'relax' and can you teach it to me?"

I'll remember what I was wearing on the day I may have been impregnanted; it was a shirt that read 'Swim Hard or Go Home'. It caught my RE's attention, and although we commented that it seemed more figurative for our IUI treatments; such a sentiment is my mantra for this FET. Either go the distance and produce our take home baby; or forever hold your peace with a BFN. I don't want to take another trip through the in-between territory with another miscarriage. I'm not sure we could go through this again if I were to miscarry for a third time. I also wore the It's a Marathon, not a Sprint necklace that my mother gave me. Someday when I recount these stories to her, I'll want her to know how her spirit was with me during my treatments.

How will I remember what I felt on the day I may have become pregnant? I wish I could say that I was consumed with more excitement than fear. I still can't shake the notion that my crappy stimulation yielded a tainted batch of embryos. We had the same embryologist as we did for our previous transfer. (Much to Husband's delight as he thinks she's hot....) It was nice to feel that we had some continuity, as she claimed to remember us. She reported that the selected embryo received top grades, and the other was still considered good; it just didn't score as high as the transferred one. Although my RE's description was that it barely met criteria, she acknowledged that they don't keep any embryos if they don't think they have the potential to produce a baby.

As I always like to plan my next steps in the event of a failure, this information is making me revisit the options of FET#2 versus a fresh cycle. I can appreciate why my RE recommended transferring both fro-yos. It would have been much more efficient in terms of time and money to see if none, one or both would stick. Yet, this time I was determined to hold my ground and insisted on a single embryo transfer. Neither my RE or the embryologist tried to change my mind. There is a lot to consider. Another FET is a walk in the park as it merely involves two monitoring visits, one blood draw and one scheduled transfer with a price tag of a few thousand dollars. A second fresh cycle would be much more consuming, as it involves every other day monitoring with an unpredictable retrieval date at a projected cost of twenty grand, plus meds. I feel as if I'm revisiting our decision to pursue so many IUIs, when we were hoping that spending $3K would save us from spending five times that amount. The difference now is that we would only be delaying another fresh cycle by only a month or two, and the cost of a second fresh cycle seems really steep whilst we are still paying off the first one.

Then again, maybe I won't have to make this decision. Can the fact that I am engaging in potential retrograde thinking be considered optimism?