Wednesday 5 March 2014

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?

21 comments:

  1. I've been thinking of you a lot. Continuing to send many thoughts!

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  2. I REALLY hope you won't have to make that decision, friend! Thinking of you and sending lots of good thoughts your way!

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  3. I'm glad that you had such a relaxing transfer, not that it will likely make a difference--I'm in your camp on this one--but it does make for a more pleasant memory. When I think about how much money we've spent so far on this I shake my head. I really hope that this is the last dollar you spend on getting pregnant.

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  4. I really hope you won't have to make that decision. The fact that your embryo was already hatching is a great sign! However, I am totally the same way and I felt that focusing on my next steps helped me to relax more about the results of my current transfer.

    I didnt' want to proceed with my IUIs because I felt like they were a waste of a (comparatively small amount) of money with low chance of success. I wanted to put all our money towards adoption. Andino felt strongly that we should finish out what we started. So I guess if I were in your shoes I'd do another FET before a fresh cycle but that's just my two cents.

    Wishing you the absolute best of luck :)

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  5. I'm glad that the transfer went well and that you were relaxed, even if your mood makes no difference on the outcome. I would likely do another FET before a fresh cycle as well- lower costs, not as many drugs, not as many appointments, etc.

    I'm crossing everything that I have for you!!

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  6. I am sending you good thoughts. Every time we decide to keep trying, it takes courage. Kudos to you for finding the courage.

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  7. Right after I got married, I was unemployed for about 4 months. I can't even tell you how many hundreds of episodes of "I Didn't Know I Was Pregnant" I watched - and yelled "how can you not know?!" at every single one.

    I'm hoping you don't have to make any of those tough decisions - both for emotional and financial reasons, and that this is one that sticks!

    (Also, can you get that patient of yours to teach a class on "Relax to Get Pregnant"? I know a few of us that would be interested in her fool-proof method.)

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  8. I was wondering if it could be considered clinically relevant to ask her about how she relaxed, but all I could think about a friend on mine who didn't have an orgasm until the age of 25 after accidently ingesting some pot brownies...

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  9. I have been sucked into a marathon of "I didn't know I was pregnant" I can only buy it in the cases where women truly thought they were unable to get pregnant. Then you could dismiss any symptoms, I guess. But, how are there so many women out there who don't get a big belly? Or any belly? So not only do you get pregnant on accident but your pregnancy is so easy you don't even notice? Argh.
    Anyway, congrats and good luck with your newest resident. Hope he/she sticks around for a good long time.

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  10. I also think it's fascinating to remember every detail around the transfer when so many women claim to have no idea they are pregnant for months or even up until labor in the case of the TV show. I haven't watched it in years, but my theory was that for the majority of the women on the show, pregnancy was the LAST possible thing on their mind (not that any of us have any clue what that is like) and they apparently need a better diet if they thought the baby moving was "just bad gas."

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  11. thinking of you! glad today went smoothly!

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  12. Sending tons of hope and good wishes for the embryo transfer! As for the TV show...yeah have no words.

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  13. I can't even with the "I didn't know I was pregnant" shows. I just keep thinking what idiots these women must be, although I suppose there's always a possibility that a well-informed, otherwise healthy woman might not notice 9 full months of pregnancy. *snerk* I'm glad to hear that your other embryo is not bad quality like you thought, but also echoing other commenters in hoping you won't need it.

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  14. Excited for you and hoping for the best news ever.

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  15. Good luck! Hope you get your BFP this time around!

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  16. I'm totally in agreement that clinics don't keep embryos that don't have potential to make a baby! Forget the grading and all that stuff, because so many supposedly less than perfect embryos result in a healthy baby. Fingers crossed for good news for you! Oh, and btw....that show you speak of is nuts! I thought how can these women not know they're pregnant, until I watched....yep, I totally believe it now, but wow! Talk about the flip side of the coin! haha!

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  17. I'm glad everything went smoothly, despite the delay, and that it was good to take the day off. Fingers and toes crossed that this is a healthy embryo that happily implants!

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  18. Glad you're enjoying the Rice Chex/almond milk combo. I definitely won't tell you about the Cinammon Rice Chex, which are also GF but with like a billion times the sugar. I wish no one had ever told me about them. Seriously. Addicted.

    I think about that all the time - not only that we knew the second we were pregnant, but also that we have a picture of our 5 day old embryo still hanging on the fridge. We still do! Should that go in the baby book? Is that weird? #IVFworldproblems

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  19. Good luck Jane! I'm sending lots of positive thoughts your way. I'm hoping that not only does the little bugger stick around but that he has a proper set of chromosomes to boot!

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  20. Sending positive vibes your way for these two embryos!

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  21. First time commenting, but I read your blog daily :)

    Wishing you lots of luck on this transfer. Hoping you finally get your take home baby!!

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