Like so many other people, I cannot believe that the calendar says it's mid July. I recently overheard Co-worker making some calls to schedule the one year check up for her twins and sort some details for their first birthday party. Seriously, can she not take care of these tasks on her day off? "OMG! I can't believe they're already a year old!" she loudly exclaimed, just in case we weren't already eavesdropping. It was two years ago this weekend that I hosted Myrtle's baby shower. "I know in my heart that I'll be hosting a similar event for you very soon!" she wrote in her thank you note. While it feels as if the time just evaporated, as little Myrtle is only two months away from turning two years old; this is not exactly soon.
It feels like it were merely weeks ago, when we were ushering in the New Year, and I was waiting for AF to arrive, so that we could start the prep for our first FET. It was exactly six months ago, but in Infertility Time, that was only 2 FETs and a fresh cycle ago. Infertility Time operates in strange ways. Sometimes it flies by so quickly. I still won't be pregnant by the time I reach another phantom due date, although I'm grateful for the delay as I don't want place any additional burdens on our next embryo.
Then there are moments in Infertility Time that creep slower than a snail's pace. The two week wait feels more like a two month wait. Minutes are like hours when you're anticipating a call with your beta results. Forty-eight hours between blood draws seems more like a fortnight. The time between your final beta and first ultrasound might as well be a year. Yet, the most enduring delay is determining ovulation, just so you can plan the next step in the process.
My previously unpredictable ovaries have now achieved some consistency. I'm officially a long distance follicular phase cyclist. Earlier this year, I went to my primary care doctor to follow up on my blood pressure issues. I lied and made up a date when the medical assistant asked me for my last menstrual period. It was much easier that the alternative explanation; No, there's no possibility of pregnancy. I know it's in your protocol to run a test for anyone who is more than 28 days from her last period, but I didn't ovulate until day 20, so my period is still over a week away. Plus my Husband was on the east coast when I ovulated, but it wouldn't matter as we've got this infertility thing going on. Please don't humiliate me by requiring a urine test. I know you are only doing your job, and I'll only cause more attention if I argue. It's easier for us both if I lie...
Waiting for the little happy face or egg symbol on the Clear Blue Fertility Monitor was stressful enough when it only involved scheduling coitus, now I'm just trying to coordinate my endometrial biopsy and future transfer date. Additionally, I need to take some time off in August to complete an online CME course. I have to work around my other colleagues's vacation requests and Co-worker's baby bonding time. I know maternity leave in this country is absymal compared to the rest of the world, but she took four and a half months last year and now she gets an extra six weeks. I don't begrudge her at all for taking every minute that is entitled to her; it's just that I'm very bitter as I don't have a baby and her absence makes my work days much longer. Slaving away at the grindstone while she's excused for baby bonding just seems to imply that she is special and I am not. It's also tough to see her mother post on Facebook, "Spending quality time with the twins while their mother enjoys a lucious spa day!" (sounds more like baby abdandoment rather than bonding) Fortunately, I have a bit of flexibility with my course, so hopefully I'll be able to transfer during that week. Maybe I'll be able to fit in a spa treatment as well.
Hopefully, of course is the operative word. Despite the fact that my CBFM was medium on CD 10 and I had some misleading cervical mucus, there was no indication of an LH surge by CD19. As endometrial injury prior to FET is a relatively new practice, there isn't a consensus on when it should be done. One meta-analysis that I read notes success rates were highest when the biopsy was performed 3-4 weeks prior to transfer. Accordingly, my RE advised the procedure to be done on CD 19 or 20. I checked my progesterone level, just in case my monitor was inaccurate. It came back at 0.2 ng/ml, I hadn't even begun my luteal phase. This could lead to a gap of five weeks or more between injury and transfer. I sent an email to my RE with these details, and he agreed it would be prudent to wait until I had confirmed ovulation. Although, I think he's just indulging me with the plans for a scratch, so I suspect my concerns over a "premature cytokine release" induced an eye roll or two.
CD 21, CD 22, CD 23... still "medium". Waiting another 24 hours just to test again feels like I'm waiting an entire month. If I had started the prep with my post retrieval period, I could be resting from my transfer right now. In addition to my insistence on roughing up my endometrium, I thought my body deserved a break after such a high count egg retrieval. I briefly considered using a Nuva ring, which would have coordinated my withdrawal bleed, but after 12 days of injectable gonadotrophins, going au natural seemed like a good idea. C'mon Jane! I thought you were smarter than that! Now I appreciate that I probably still had higher circulating levels of estrogen which inhibited production of FSH. Probably the nicest thing I could have done to Si and Am after the way they came through for me, would have been to suppress my hypo-pituitary axis.
CD 24 and no sign of impending ovulation. Ugh. It feels like it will be forever until I'm finally able to transfer, and yet at times forever feels too soon. Like someone with good intentions for a New Year's resolution; post retrieval I refined my eating habits, hit the gym, the pool and my running trails and actually lost a few pounds. Maybe this time it's for real. That's the other scary aspect, I'm dreading receiving my beta results. That potentially life changing thirty second voicemail that could forecast waiting for more beta draws and an ultrasound or waiting another month for the next opportunity to transfer embryo #2. Another month...it might as well be a millennium.
Logically, I must acknowledge that there may be some good news resulting from that phone call, which is also a bit daunting. I might actually experience a pregnancy with a good outcome, and I'm not sure I know how to handle that. I've become so proficient in dealing with disappointment. I'm now anticipating that my transfer may be around the third week in August at the earliest. I'd be receiving beta results in early September, four months after I started the Lupron for this IVF cycle. If it sticks, I could be 8-9 weeks by the time I visit my parents in October. Still too early to announce, even with a known euploid embryo. Had I transferred with my first opportunity, I could have been 14-15 weeks, lightyears ahead in terms of pregnancy security. While it's not ideal, I'll accept that scenario to the alternative - prepping for transfer of euploid embryo #2 before the three year mark of our first (unintended) act of unprotected intercourse. Alas, time marches on.