May Cause Hope

I’ve been pretty quiet throughout this IVF process because I felt so unprepared. I had big plans that involved IVF shirts, IVF socks, IVF bracelets (merchandising! merchandising!) and then suddenly we were doing it and there wasn’t much going on beyond a myriad of emotions. The shots were bearable (Menopur burns – use an ice pack beforehand, Ganirelix left me sore) and the retrieval went smoothly (beyond my swollen abdomen and shuffling-walk I developed). I was even pretty textbook in my stim cycle – ten days of injections, estrogen levels around 1900 day of trigger, 10 out of 15 follicles expected to be mature. Everything looked good. I began to dream about shopping for baby clothes and I pinned announcements and I hoped – which means it was the perfect time for everything to go to shit.

The day before my egg retrieval my RE called to “discuss a few things with me” (another bad sign), and I waited to hear how they discovered I already ovulated or how they can’t find my uterus on my ultrasounds anymore. Instead, she brought up my progesterone levels to not say that I ovulated, but to say that they were “kinda high”. 2.19 level high. If you take this search to Dr. Google, as I most certainly did, you’ll soon learn that a lot of practices believe you have lower success rates if your progesterone is high before trigger day – and high for some means above 2, over 1.5, or even anything higher than 1. I raked my mind and can guarantee that this progesterone cutoff was not mentioned during our IVF bootcamp when we discussed everything that could possibly go wrong. So, my uterus was getting ahead of herself and would then be in a different stage of my cycle than a 3 or 5 day embryo would be. Hell of a time to decide to be an overachiever.

My uterus made up for it though, by making sure that she then underachieved on my lining. A measly 6mm (triple lined)  after being flooded with estrogen (and yes, the estrogen boobs are back – silver lining), and the belief that “this is the best I’ll get”. So we’re just going to go ahead and ignore the fact that on most of my baseline scans my lining was still above 7mm, which means I clearly get there eventually. It’s just a matter of when. Most clinics refuse to follow through with a transfer unless it’s over 7mm, or sometimes 8mm – even 9! But I’ve been hearing for months now how “studies show that lining might not even matter that much”, to which I say “seriously?” You’re also supposed to have the thickest lining you’ll ever have during a stim cycle, which I guess you can say 6 is an improvement from the 3 and the 5 I had during my last IUIs. I was told that regardless of the toxic uterus and anorexic lining, we should move forward with a fresh transfer, and that if we decided to do a FET instead, it would mean months of canceled cycles as they attempted to genetically engineer my lining to thicken up on command. It sounded a lot like being told “this probably isn’t going to work, but we’re gonna do it anyway!”

But what about my embryo? Were they really asking me to sacrifice an embaby in the hopes that I’ll be the one in a million who beat the odds and tells stories for years to come about my ‘miracle baby’? Because miracles don’t happen to me. Either does luck. Or most good things in general (heeey pessimists!). If I’m going to face the unlikely scenario, it’ll involve things like attempting to grow babies in my tubes, and being the first of my family to experience infertility. Instead of dreaming of baby booties, I switched to imagining that when we went in for transfer I’d have to whisper “I’m sorry” to the little embryo that I set up for failure. Like mother like embryo, aye? The RE who did my retrieval (who, OF COURSE was so severely pregnant that I almost barked out a laugh when I saw her. Shouldn’t pregnant women be banned from these places?!) also thoroughly recommended a fresh transfer. For anyone who might be facing this same issue (though I’m usually on my own with these things): she said there aren’t enough studies done to prove that slightly elevated progesterone means pregnancy won’t occur, and that she’d be insisting on a full-freeze if my levels were higher, like 6 or something crazy. She also said that if they ran that same blood work over and over again – it’d probably come up with different results each time. So I was essentially being told they don’t trust their own results, which was supposed o somehow make me feel better. Apparently my RE has seen successful pregnancies with similar conditions, and when I tried to wrangle an odds-of-this-working percentage out of her I was told that if she thought this would decrease my odds of success by even 2% – they wouldn’t do it. But…they literally have to be lowered if you’re not working with ideal conditions, right? Where’s the logic in this?

To complicate matters more (or, more like: to make me try to schedule an appointment with literally anyone who could get me back on my anxiety meds ASAP), we didn’t do so hot on the fertilization front. I was so upset before retrieval that I should’ve just been happy when no one reported that my eggs came out black and rotten as I always feared due to my “bad vibes only” mentality. But we didn’t follow the typical egg-drop-out rates, and you know I hate when I don’t meet the stats. We had 17 eggs at retrieval, 9 were mature, and only 4 fertilized. Egg quality issue, anyone? If we had a five day transfer, that was like giving each egg their own day to drop off and stop growing. And don’t give me that “all you need is one” crap. The odds weren’t in my favor, I needed all the back-up embryos I could muster.

IVF is generally thought to be a diagnostic procedure, as well as the let’s-see-if-we-can-do-the-knocking-up-for-you procedure, so I shouldn’t have been shocked when something was discovered. But, really? Lining? That’s what’s going to take us down? I’ve had more dates with Wanda than I can count, and yet no one thought to pause for a moment and see if they could manipulate my lining before we got to IVF? Talk about putting all my eggs in their basket! And I have so many questions about this lining issue. Like, why don’t I respond to estrogen like everyone else does? Is it thickening up too late for implantation each month? Is it because of my years of birth control? Or FSH levels? Was my ectopic pregnancy supposed to be a sign that my tube is a safer place for an embryo over my own uterus?

Even with the ‘I swear this has a minuscule chance of working’ mentality, I felt like I had to practice what I preach and trust in the three RE’s who kept chanting “Transfer! Transfer! Transfer!!” So due to my ‘low’ amount of fertilized eggs, we decided to go through with the scheduled three day transfer of our very best embaby. The thought of wondering “what if?” after spending seventy days trying to buff up my lining for a FET outweighed the risk of this not working. Plus, we didn’t even know if any of our embryos would make it to freeze, so it was worth taking a chance.

I was told to come in with an uncomfortably full bladder, which I took way too seriously and resulted in me having to tromp through the hall with the blanket wrapped around my waist to ‘empty it a little’. Do you have any idea how difficult is it to slightly empty your bladder when you already feel like you kidneys are about to burst? I was so worried about peeing too much and disappointing everyone, that when I came back the RE who did my transfer told me he didn’t even believe I went to the bathroom at all. My husband laughed nervously in the corner as the RE began to prod my bladder and tell everyone (nurse, embryologist, mortified husband) how full it looked. I don’t think either one of us expected the transfer of our embryo to be all about pee. With the exception of trying not to pee on the table (where’s the pee pad when you need it?!), the transfer itself went smoothly. After IUIs and SIS’s and the brutal HSG – this was nothing. Well, that is until I lost all color in my face, began to sweat, and thought I was about to throw up my embryo (that’s how this all works, right?). A snack and some (MORE?!) water later, I was back to normal, but there’s also been a lingering fear that my body immediately rejected our embaby and I’ve been think-talking to an empty uterus for the past week. “I believe that you can do this. We’d really love it if you stuck around. Make yourself at home!” There have been no apologies for a poor environment, just an experiment in positive thinking in the hopes that I have a strong little embaby and that they decide to stay with us.

We weren’t given great odds to make it to freezing, so I was pleasantly surprised when I found out that two of the three embryos we had left kept growing and are now renting out a small apartment in the embryology lab. It’s hard to be completely positive, as I’m so used to being let down, because this is what history has taught me: you don’t get BFPs. And if I do? You don’t get to keep them. A side effect of my injections must be hope though, because I’ve started to believe that maybe, just maybe, I’ll get to meet all of these little embryos one day.

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