embryo transfer | Laughter Through Tears

Pitch Drop Experiment Vs. The Two Week Wait

My post yesterday about the mysteries of IVF reminded me of another great Radiolab episode that helps put the torturous wait for our pregnancy test results in perspective.

It could be a lot worse.

It could be like the Pitch Drop Experiment.

Nine days of waiting feels like a really long time, especially when a healthy chunk of retirement savings rides on the outcome. The wait is painful and and requires great patience. However it doesn’t begin to compare to the patience practiced by the late professor John Mainstone.

Sadly, the revered researcher went to his grave without ever seeing the results of his test. Those results are due at any time now, and were estimated to arrive last July.

But still, we wait.

John Mainstone Watches and Waits

The experiment began under the supervision of another scientist in 1927. Eighty-seven years later researchers are still longing to see the results, making my 9 days pale in comparison. However just like my pregnancy test, the wait will end in a fraction of a second creating a mesmerizing moment where time that has lagged dramatically slingshots into high gear, moving at the speed of light toward what comes next.

The contrast is fascinating.

What is this intriguing and insanely lackadaisical experiment?

Pitch is a substance that is technically viscous, however if you hit it with a hammer it will shatter. The experiment is all about attempting to observe the substance’s liquid like properties and take note of what happens in the moment in which pitch drips out of a glass like a viscous substance should.

To accomplish this, a sample of pitch was heated and poured into a funnel shaped glass. Once the pitch settled, a process that took three years, the bottom was cut from the funnel.

Then the wait for the pitch to release a drop commenced.

Slowly but surely, the pitch began to stretch and prepare to drip. Over the last 87 years it has lazily dripped 8 times, an average of once every 10.87 years. However, the drops have never been observed. The experiment began before it was feasible to use cameras to monitor the pitch and the researchers consistently missed the fraction of a second they patiently anticipated.

Capturing that moment is exceedingly difficult. How do you observe something that happens anywhere from every 8 to 13 years but in a blink of an eye?

At one point, professor Mainstone was monitoring the pitch at a time when it was crazily close to dropping. He went to get coffee and when he returned, the pitch had dropped. Imagine his frustration! I am sure it was far worse than a two week wait, especially considering the experiment had to have grown to feel like “his baby.”

The last time the pitch dropped, there were was a camera on it but it malfunctioned.

Seriously, this poor dude was doomed.

Today the pitch has three cameras trained on it and there is a live video feed on a special website set up by the School of Mathematics and Physics at The University of Queensland where the experiment began.

Click to go to the live feed of The Pitch Drop Experiment

There are people hopelessly addicted to watching the live feed, wanting desperately to see with the naked eye what no other human has ever seen live. I too was sucked into the obsession when I first learned of the Pitch Drop Experiment, but soon realized that you could waste your life away by devoting it to following the imminent drop.

This is another way the experiment is like a two week wait. You can obsess about it non-stop, but it won’t make the moment arrive sooner. Wasting your time and energy thinking about it is pointless, but its amazingly difficult to avoid.

Thankfully there is no chance I will wait for nearly a century for my results.

So Dr. Mainstone, I tip my hat to you for your patience, fortitude, and resolve. I am so sorry you will miss it, again.

Personal Update: Feeling more pregnant than ever. With Spork I didn’t have much morning sickness but I was so exhausted every day I came home from work and would fall asleep on the couch before dinner. Its way too early for real pregnancy symptoms, but I did feel that tired yesterday. I am hopeful Blob has stuck and is already putting his Mama to the test!

How Old Is Blob? And Other Confounding IVF Questions

I am 5 days past our embryo transfer, which means Blob is 11 days old.

Or is he?

Blob was conceived on November 11th of last year. Technically he has been on this planet as a viable life for 4 months.

After Blob was whipped up in a Petri dish, our precious little ball of cells grew and divided for 6 days before an embryologist removed all of the fluid from him and flash froze him. In an instant, he stopped growing. And stopped living?

I don’t know. He was sure enough alive when they warmed him up a few short days ago.

Even more confounding, our daughter Spork was over a year old before she was transferred and I became clinically pregnant with her. While Spork is advanced for her age as any child of ours would be (gag), she is still very much two years old, not three.

All this ocassionally makes me ponder when life begins. I sporadically question when soul and spirit develop if I think about it too much.

I try not to think about it too much. Infertility adds enough uncertainty to a couple’s life without having to perfectly resolve feelings on the universe and life’s purpose.

Image: Don McCrady via Flickr

My mind first started swirling with these universal questions when my wisdom teeth were removed as a teenager. Going under and then instantly waking up with no sense that any time had passed made me question where the identifiable inner “me” went for that 30 minutes or so. I experience the same thing when I go under during egg retrieval.

It’s freaky deaky Twilight Zone stuff.

Image: Allen via Flickr

If I had more time and energy, I would explain what scientists are learning about the “block box” experienced when a patient is down for the count. Maybe someday when I am feeling less pregnant I will “nerd out” again and tell you all about it. Until then a Radiolab podcast I recently heard does a fine job of beginning to peel back the layers on the mystery of anesthesia.

If you have never heard of Radiolab, it is the best podcast out there for amateur geeks like me. If you carry a dweeb gene you should definitely add it to your Stitcher favorites.

Click to navigate to Radiolab and stream live audio of “Black Box”

Now back to IVF.

These are just a few of the many reasons why IVF can be so controversial. It touches on some ultra- sensitive subjects. Embryo freezing is the tip of the iceberg. There are other touchy topics like embryonic research, the morality of gender selection, selective reduction of multiple pregnancies, embryo destruction and donation, and now the over-blown and largely misunderstood concept of designer babies.

Speaking of gender selection, my clinic already knows whether Blob is a boy or a girl. They won’t tell us until we are 12 weeks in order to avoid possible legal and moral issues associated with gender selection. I tried to convince my nurse to come out for a couple of giant margaritas so I could pull it out of her, but she swore that only the embryologist knew.

I tried but he wouldn’t talk.

Image: Bradley Gordon via Flickr

All we want is a healthy baby, but of course there are those on the fringe that push the moral envelope of Assisted Reproduction Technology (ART). Debating IVF issues is not my agenda. If you wonder why, simply read the title and subtitle of the blog. Heated spiritual and moral arguments don’t fit with my mission.

I just like to think about it all from time to time.

Personal Update: As I mentioned, I do feel pregnant. I am bloated and have tightness and subtle aching in my lower abdomen. I am totally exhausted. “The ladies” are a little bit sensitive. These are all good signs, but could also be the high levels of hormones or the start of PMS. Oh Saturday! How I long for you…

Prodigious Progesterone

It’s a slow news day. Day two after transfer is creeping slowly along like most days between now and the blood test will.

That means its time for me to get all nerdy on my readers again and explain a bit more of the science behind this miraculous process. In previous posts I’ve described the role of lupron and estrogen. Both hormones are pretty awesome and make it possible for Blastocyst Blob to grow into a bonafide baby. However now an even more captivating hormone is in play.

Prodigious Progesterone.

If all the IVF hormones and drugs were characters in the movie Grease, Progesterone would be Danny Zuko. It’s one slick dude and most definitely the leader of the pack.

Image: John Irving Via Flickr

For the last several weeks my reproductive system has been in a holding pattern. The lupron injections stopped ovulation. The estrogen patches and pills helped build the uterine lining. Theoretically this could have gone on forever with no effect or change, but of course that’s not the point.

Once the lining ultrasound scan and blood work checked out okay we added our final drug, progesterone. That is when things really heated up in this radical game of chance.

Blob needs a perfectly prepared endometrium in order to nestle in and grow into our bundle of joy. For this to happen, my lining must be receptive and ready for him to implant. Amazingly, there are only a few short days in which Blob and the endometrium can make a love connection. Progesterone starts the clock on this critical time frame.

Progesterone changes the lining, making it slightly thinner and replacing the triple layers seen on an ultrasound with a white cloud-like appearance. Whether in natural pregnancy or through assisted reproduction, progesterone gets in the game 5 or 6 days before implantation begins. Administration of progesterone for IVF is timed when ovulation when ordinarily occur in a natural cycle. In a natural cycle it is secreted by the corpus luteum and eventually by the placenta.

During the five and a half days prior to transfer of the embryo, progesterone helps the endometrium develop tiny little finger-like structures called pinopodes. Those pinopodes typically appear 5 to 7 days following ovulation, right around the time the blastocyst hatches from its shell and begins to excrete enzymes which will allow it to attach. The fingerlike pinpodes are only present for two to three days and it is theorized they must be present for implantation to occur.

If you research implantation, you will find many studies show the window can be as much as 6 days or even more, but its solely a function of not being able to pinpoint exactly when all these necessary steps take place. The true implantation window is likely equal to the life of the pinpodes. This time frame has to be matched with a blastocyst that is hatched, healthy, and ready to go.

If the blastocyst is too slow to develop, game over.

If the blastocyst develops, hangs out, and then dies before the lining is receptive, game over.

Image: Mykl Roventine via Flickr

This sliver of an opening is occurring inside me right now. For me to meet Big Blob someday, at this moment I need to have pinpodes that are closing in on Blob who has re-expanded and continued to grow to the point where he is burrowing in and about to excrete enzymes.

If Blob doesn’t make it, the absence of HCG will tell my body its time to begin the process of shedding my lining in which would normally occur in a week or so.

Isn’t it mind blowing that anyone ever gets pregnant?

Isn’t progesterone one bad mamma jamma?

Progesterone for IVF is also like the young and spunky Travolta character in that it can be a little oily.

Image: Thom Wong via Flickr

There are three ways to administer progesterone, by pill, vaginal suppository, and injection. The pill metabolizes inconsistently so only the suppositories and the injectible are used in IVF. The injectable is progesterone suspended in oil and astutely called “progesterone in oil” (PIO). I am taking both because my doctor likes to hedge his bets.

The PIO injections are hands down the most painful in IVF. Intramuscular injections, progesterone shots cause bruising and soreness in the hip area where administered. Many women need to ice the area prior to the shot and comfort the target area with a heating pad and massage after. This process helps alleviate some of the discomfort.

Endometrin (a disolvable insert), Crinone (a gel), and Progesterone in Oil

Side effects of progesterone are pregnancy symptoms which are experienced when taking the hormone at high levels whether pregnancy occurs or not. This totally messes with the mind of a hopeful momma wannabe as she ponders continuously;

Is it pregnancy or progesterone???

These side effects include bloating, abdominal pain, nausea , breast tenderness, headache, drowsiness, mood swings, irritability, and vaginal discomfort. Of all the drugs it mimics pregnancy the most, but for me at least it seems to balance the effects of estrogen and I feel better when I am on it.

Outside of its reproductive role, progesterone boasts many other riveting attributes. Progesterone relieves water retention in cells which is why some of my bloating from other drugs subsides for a short time when I begin taking the hormone. Most interestingly, progesterone inhibits the breakdown of the feel good neurotransmitter serotonin. As a result, the hormone has been proven to successfully treat addictions like nicotine and cocaine. The hormone is also being tested as a treatment for multiple sclerosis, certain skin disorders, and cancers.

Finally, it appears a reduction of progesterone is associated with cell death and scientists theorize administering the hormone could slow the signs of aging. Yes! Its a well deserved upside for those of us who have been on and off the hormone for years.

Our eggs may be getting older and we may not easily get pregnant, but at least we get to sip more than our share from this hormonal fountain of youth.

At least there is that.

Image: Sarah Veale via Flickr

UPDATE- This post was written yesterday during my long wait at the airport. Today we are three days past transfer so Blob should already be nestled in tightly. Now he should be dividing into two layers that will eventually become the baby and placenta. Unless of course he divided into two identical twins or is a little on the slow side. I am feeling a little crampy and bloated which could be a good sign. Unless its just the progesterone.

It will be at least another day and probably more before Blob is producing enough HCG to turn a pregnancy test positive.

Not that I am thinking of testing…. I am not thinking about that at all. Nope. Not happening. Really. It’s not. Never.

Knocked Up

It’s done!

And yet it begins.

“Blob” as we are calling him (or her) is now resting peacefully at home, preparing to burrow into my lining and take root for the next nine months. It was a harrowing, exciting, and ultimately pleasant experience which began with our wondering whether we would be transferring Blob at all.

Blob’s First Baby Photo

Yesterday at the top of Breck’s Peak Six, I picked up a call from the clinic asking if I could come in right away for a cautionary ultrasound. It seemed the doctor was concerned about my cyst and the pain from the night before. Rather than blow our day of boarding we opted to arrive very early this morning to check on the status of my temperamental reproductive system. Until about 7:30 this morning we feared we would be coming home empty handed (or in this case empty “uterused”). Luckily the lining, ovaries, and vitals all checked out fine and we continued with the embryo transfer.

Our first hurdle overcome.

Next up was the transfer.

Because our ultrasound and lab appointments were at the break of day, we had time to kill before the 11:45 transfer. We spent it at Target where I picked up these groovy lucky socks. These socks were so perfect they jumped into my shopping cart and I was wearing them before we left the parking lot.

Fertility green and orange with the luck of the Irish thrown in for good measure.

So far the knee highs worked their magic.

Ease of transfer is one of the many critical factors that lead to enhanced odds of success. A fundus (top of the uterus) touched by the catheter used to transport the embryo is a lousy precursor for implantation. Much effort goes into making sure the depth and shape of the uterus is understood before the procedure so the doctor can avoid the edges. It’s like that game of Operation we played as kids, except on a fuzzy black and white ultrasound screen with no buzzers to tell you when you screw up.

Image by Mykly Roeventine via Flickr

The doctor gracefully guided our little bundle of cells to the exact right spot without a single hiccup. Dr. S navigated Blob to the sweet spot with the precision of a fighter pilot landing on a aircraft carrier. What makes this feat more impressive is the embryo can barely be seen by the naked eye. Try landing that in a tiny little spot on a computer screen with only a bit of guidance from an ultrasound tech.

Way to go Dr. S.

Catheter releasing Blob in the perfect spot

Another hurdle overcome.

Blob was a busy little fellow this morning and hatched completely out of his shell prior to transfer, earning a final grade of 6BB. When the lab flash froze him after genetic testing back in January the embryologist graded him a 5BB. He’s overachieving already.

You can see the incubator holding Blob who is waiting in the background while we prepare for transfer

Blob’s incubator in the background

You may be wondering, what the heck do those letters and numbers mean?

Embryo grading is a complicated process, but essentially this means Blob was at stage 5 when he was frozen. This is the final blastocyst stage right before he hatches and burrows into the lining. The letters are grades for the inner cell mass (ICM) and the Trophectoderm Epithelium (TE). The ICM is a clump of cells that will eventually become a baby. The TE will grow into the placenta which will replace all the hormones I am taking between 7 and 10 weeks.

6BB is a good quality embryo. 6AA would be perfect. Both are fully capable of becoming future Rhodes Scholars.

Blob as a Rhodes Scholar

Typically an embryo reaches stage 6 on the fifth day after fertilization. Blob started slowly and took six days to get there. This is the main reason Dr. S gave Blob slightly lower odds than other genetically normal embryos. However, Day 6 blastocycsts like Blob fair much better with a frozen cycle like ours. This is due to the surprisingly short window in which the lining is receptive. Unlike in a fresh cycle, in a frozen cycle the doctor can control the timing of the lining receptivity and match it to Blob’s developmental stage, increasing the odds he will stick.

While our overachiever was quick to break out of his shell, he was slow to expand. If you have ever taken a balloon from a warm place out into really cold weather you know it shrivels up and loses its fullness until warmed again. Embryos are the same. They compact when frozen and then begin to expand when warmed. We are slightly concerned that Blob didn’t expand more prior to transfer, but encouraged that he is still developing. Most important, every last one of Blob’s cells survived the warming process.

A final hurdle overcome.

Post transfer I remained on bed rest for an hour before being wheeled to our car. We are now at the hotel where I will spend today and tomorrow at a 45 degree angle, able to rise only to powder my nose. Butler Bill enjoys this part of the process because it is the time he is most involved in IVF. I enjoy abusing my personal butler and make the most of being cared for by the love of my life at this sensitive stage.

If you look hard enough you may be able to see all the way to Blob through those nostrils.

If you look close enough you may be able to see Blob through those nostrils.

Butler Bill will bring me food, water, and medicine for two solid days. I will read, watch stand-up comedy, blog, goof off on the internet, meditate, and try not to obsess about possibilities. I am allowing myself only a half hour with Dr. Google to see what I can learn about slowly expanding embryos. After that half hour I am firing that negative jerk in order to relish being pregnant.

Pregnant.

In the IVF community we describe this part of the cycle as being PUPO (Pregnant Until Proven Otherwise). I am so done with the uncertainty implied by “until proven otherwise.” This mama has decided she is straight up knocked up. I plan to prove it on March 22nd.

Our countdown begins anew…

Making the Most of It

We made it.

We are finally in the same state as the 100 celled baby we are taking back home on Saturday.

Even though real romance is a no-no at this stage in the process, we are making the most of it by tagging on two days of snowboarding prior to transfer. This is our fourth trip to Colorado for fertility purposes and we are infusing some fun and sport into the journey. On the last trip we ventured to Vail. Now we are giving Breckenridge a go. We both love boarding and are paying for the flights, so why not? Especially since I hope to be done with boarding for the next nine months.

We discovered a rustic mountain lodge only a few miles away from Main Street and were upgraded to a mountain view suite without even having to play the “we are here to get pregnant card.” Sweet.

We arrived just in time for some grocery shopping and a leisurely dinner last night. We hit up the local Safeway to pick up a prescription, beer for Bill, and water for me. Turns out the labs from Sunday yielded low estradiol levels, again. Now I am on four estrogen patches and also talking estrace orally twice a day. Holy estrogen overload!

Once again, this shouldn’t be an issue as long as we fix it by Thursday morning. The lining is nice and thick and my progesterone levels are right where they should be to make a cozy home for baby.

When the clinic called to relay the need to pick up more meds, we also learned that Bill has to have blood work done prior to transfer. They want to make sure he hasn’t picked up any communicable diseases before they send us home with a baby. The sadistic side of me is eagerly anticipating him getting poked too. Its only fair.

But today we put all the meds, labs, and procedures in the back of our minds as we enjoy two pristine days on the slopes.

Breckenridge is crawling with people, its one of the busiest weeks of the year. The first board rental store we stopped at was completely sold out of boards and bindings for Bill. We start the search anew today. Worst case scenario, we will buy new ones. Both of our boards back home are more than 10 years old and its past time. Still, the trip to Breck is stretching our already taught budget and we hope to score rentals.

Despite the crowds and not having a reservation, we consumed a delicious dinner without having to wait. Tonight we aren’t risking it and made reservations at an upscale, gluten-free, vegetarian restaurant. Simply perfect for our pre-baby making meal.

I booked an apres ski couples massage in the hotel spa today. Between shredding the hills today, the massage tonight, and the clean dinner I am doing the best I can for my body and should be toxin free by Thursday.

As far as how I am doing, physically I feel amazing. Stopping lupron has done wonders for me. Emotionally, I continue to feel unusually optimistic about this cycle.

On the plane yesterday I meditated multiple times. I visioned all the cells in my body breaking apart and joining with all the matter in the universe, including all the cells of our chilly little embryo. Then I imagined bringing those cells back into me. It was beautiful. I feel as though my body is calling our baby home. I have felt this way before, but this time is more profound.

Only two more days and we will be reunited with our baby and will hopefully be done with trips to Colorado for “medical purposes.” While we appreciate writing off the travel expense on our taxes, the next time we come back we hope it is as a family of four.

There still may not be much room for romance then, but that will be okay with us.

Its Not How Far You Fall

Image by John Kollege via Flickr

I missed an opportunity to mark a special moment yesterday morning and it didn’t register until I was reviewing my protocol last night. I took my last Lupron shot yesterday morning.

NO. MORE. HEADACHES.

Too bad I can’t have a nice glass of red wine to celebrate.

I begin taking progesterone at bedtime but I don’t inject anything until Sunday (I will leave how I take progesterone to your imagination for now).

So today is a completely shot free day. Yes!

I love having little reasons to be happy in IVF. The roller-coaster ride of attempted conception has many loopty-loos and inverted twists, but is mostly made up of enormous hills and heartbreakingly rapid drops. No matter how hard you try you can’t smooth them out. But we still try. Its human nature to try to eliminate pain, even if it is impossible.

Whether its IVF or any other uncertainty in life, we make valiant efforts to protect ourselves and develop a variety of coping and defense mechanisms to help. We say things like:

“I have to stay grounded.”

“Hope for the best and plan for the worst.”

and of course the mother of them all:

“I don’t want to get my hopes up.”

I am one of the world’s worst offenders. Only three days ago Bill and I settled on Plan C and I immediately posted about it with the excitement of someone who had found the Holy Grail.

Why do we even need a plan C at this stage? If this transfer doesn’t work, Plan B will take at least three months and potentially even half a whole calendar year. Is it really necessary to have a back up plan in this situation?

Nope. But we have one anyway.

We do it for many reasons. Humans evolved this behavior because it has real life benefits. In days of old, when we fought for survival or chased prey it made sense to anticipate outcomes and prepare alternatives. These days its a useful skill in business negotiations and competitive sports. Professional pool players do well to “look six shots ahead.”

With infertility, some planning makes sense. For instance, We aren’t ready to buy the pontoon boat Bill has his eye on. Not yet. That wouldn’t be prudent until we know what is next and how it will affect us financially. Plan C is expensive. But its more than just pragmatism. Thinking ahead also provides a momentary sense of relief when the decision is made, giving the elusive feeling of control in an otherwise uncontrollable situation.

Planning has value, as long as its kept in check.

But hope? Hope is another thing altogether. There is no sense in losing hope or muffling it in a futile effort to protect ourselves from being hurt.

I have seen little value in “not getting my hopes up” in the two different ways I have approached IVF.

First I tried gathering as much information as I could, considered statistics, worried about outcomes and worked my tail off to keep my emotions in check. I feared and obsessed about low odds and potential losses.

As hard as I worked, when it didn’t work it hurt like hell.

Next I bought into The Secret approach. I tried visioning a cycle filled with good news and a baby in my arms at the end of it. I worked to cultivate full trust in the process and embraced all the highs along the way.

As hard as I worked, when it didn’t work it hurt like hell.

There was no measurable difference in the pain at the end, but there was a gigantic contrast in my mood and the ease with which the process was navigated in the second approach. I savored the peaks, holding my hands up in the air and screaming with pleasure. When I plummeted to the bottom I was washed over with pain. But I pulled myself together and continued the ride.

This time I am struggling to have faith in the process and let myself believe it could work. I meditated at acupuncture today, fervently willing my mind to give in to the possibility that I will be pregnant in a week. I couldn’t get quite there as hard as I tried. My human brain won’t let me after 6 failed cycles.

I continue to try. While I may not be able to fully believe, I am committed to enjoying the high points and making the most of our conception experience.

So today I am embracing the excitement of this part of my cycle. I am excited to throw the lupron in the trash. I am excited to be done with work for a full week, able to wholly focus on preparing for transfer. I am excited to enjoy my daughter this weekend before we leave on Monday. But mostly I am excited to be nearly three weeks pregnant on Thursday when our little snow baby comes back to me.

Sure, I could choose to say “I am excited to maybe be nearly three weeks pregnant on Thursday.” But it won’t make it any sweeter if I am pregnant, nor will it lessen the pain if I am not. I won’t know the outcome until March 22nd. Until then my hopes will soar.

Whether you fall from 10,000 feet or 1000 feet its going to hurt like hell when you hit bottom, but at least from 10,000 feet you feel like you are flying for awhile.

Friends in Low Places

Image by Treacle Tart via Flickr

Like Garth Brooks, I have friends in low places. Or at least one friend.

Don’t get me wrong, my friend Kristy exemplifies class and style, it’s just today she was literally in a low place.

Low meaning that she was sandwiched between a pair of stirrups below my waistline. She was there holding a wand while looking up at a video monitor to assess the size and pattern of my endometrium.

Kristy and I met and instantly became friends almost three years ago at a pre-natal exercise class. Everyone who meets Kristy instantly becomes her friend. She is a sweet social butterfly who never met a person she didn’t like and you’d be hard pressed to find someone who didn’t like her. Our kids were born only a month apart. We quickly formed a small play date group that gets together to drink a beer and let the kids run wild.

I love our little clan and Kristy is the glue that holds us all together.

Before I met Kristy my local monitoring was done by a hometown infertility specialist who partners with more remote clinics. She was nice enough and always willing to come in on weekends, but I never connected with her. So for baby number two I switched to Kristy for monitoring at the local hospital.

Trans-vaginal ultrasounds take a friendship to a whole new level. Moments like that shared among friends connect you for life. I remember how nervous I was the first time I went to see her. I am sure she was the quintessential professional, but I felt a little strange.

Fast forward a handful of scans and we gossip and carry on as she inspects my innards like we are knocking back brews on my deck in July.

Switching to her was a great decision and not only because she is a friend. Kristy is excellent at what she does. You may not realize it, but follicle monitoring is tough stuff. Its difficult for the tech to count all those tiny circles across the surface of our imperfectly round ovaries. Kristy is a whiz at this, arguably as good as techs at clinics that do it all day long and able to carry on a conversation at the same time (I’ve seen more than a few who can’t).

As good as she is, the best part is the friendship and that hit home today. After I left the appointment the obsessing began and we had the following text exchange:

Me: You are sure you saw three layers, right? They weren’t as obvious to me this time and we won’t check again before transfer.

Kristy: Yes, three layers and measuring 9mm

Me: Is it okay if I use your name in the blog? You might want to read tomorrow.

Kristy: I always read your blogs, your writing is funny and informative. Even though we don’t have infertility in common its good because it lets me know how you’re feeling and how my patients are feeling.

See what I mean? Sweet, right? I regularly freak out and text after appointments and she is always there to talk me down. You can’t get that from a stranger. She lies about my writing being funny and informative. She loves her patients and wants to understand how they are feeling. (Side note- this his smart on her part because Kristy can get pregnant by merely thinking about having a baby. A mutual friend and I are throwing her a small “sprinkle” for baby number 2 on Sunday.)

All of this is great, but here is where she did me in, where she sealed her fate and got stuck with me as a friend forever. As I am leaving she says to me:

Oh! I forgot to tell you, I wore my orange underwear for you today.

If you have read Orange Panties and Green Toes you know why that makes her the best friend and sonographer ever.

Thanks Kristy, it worked. Everything looks good and we are go for launch. Unfortunatley they increased my estrogen but that’s on the lab and not ultrasound. I guess we need to talk the phlebotomist into wearing orange panties too.

Now please just let me drink out of your glass on Sunday…

Waiting- Part 1

Image: Denise Curran via Flickr

For many, waiting is a as much a part of trying to conceive as sex. When sex is removed from the equation for the couple trying to conceive through IVF, waiting becomes the single most frequent conception act. Waiting, just like its more provocative cousin, can come in many flavors and is done throughout the IVF odyssey.

The big waits are obvious. The most mammoth is the wait between the time the embryo is transferred and the results of the Beta HCG pregnancy test. In our case, this wait spans nine intolerably long days. Time moves very slowly over the course of what is commonly called the two week wait. I’ve often heard women say it would be just fine to be unconscious during this time and awoken only after the results are received.

March 13th is the date of our transfer which means on March 22nd we will have the eagerly anticipated results. The date is circled on the calendar. The hope and anxiety are already building.

The torture of the two week wait is followed in magnitude only by the wait a couple experiences between the egg retrieval and the final fertilization report. Money, hope, health, and mental well being are all riding on discovering whether the eggs fertilize and grow to a stage and quality acceptable to transfer and make a baby. Being sadistic people by nature, we chose to extend this period at our new clinic by throwing a little genetic testing into the mix. The time it took from retrieval to receiving the call that we had genetically normal embryos to transfer extended over 3 weeks.

Waiting for the genetic results is further broken down into waits that are much smaller. We experienced almost immediate gratification after retrieval and waited only two hours to learn that 22 eggs were retrieved successfully. The clinic then called 24 hours later to tell us that 12 of those eggs were mature and 11 fertilized. These were minuscule intervals in comparison to what came next. For the next six days we patiently but eagerly waited to be told that 5 of those embryos made it to the blastocyst stage and were good enough quality to be genetically tested. Next we waited two and a half weeks to learn we had two genetically normal embryos and two that needed to be retested, therefore requiring yet another two week wait. Our embryos were on my mind every spare moment during this time. Ultimately we ended up with three genetically normal embryos. Our last is the one we will transfer in March.

The longest wait of all was this summer and fall while we waited to work through a long process at our clinic that would culminate in our embryo transfer just last month. We first called in June and were able to meet with our new doctor in July. This was followed by another month long wait to get on the calendar to visit the clinic for our work-up to make sure we had a green light to begin our cycle. By November my ovaries were finally percolating and we flew back to our clinic again for egg retrieval surgery. After retrieval the wait was another two months as we completed testing on the embryos. In the months preceding retrieval we used the time to get our eggs and sperm ready to do their life’s work. We each took different supplements, limited alcohol, exercised moderately and ate healthy. At my peak I was taking 19 different supplements a day and Bill took 11. At least it helped us pass the time.

Tiny little waiting periods pepper the whole IVF process. Since our failed cycle back in January I have waited three days to get my period, three more days to start birth control, another 13 days to start lupron, and five more days to once again stop the pill. Each step takes us a little bit closer to our fate, whatever it may be. Though small in terms of actual time, these steps feel gigantic. When they come early, it can be unequivocally thrilling. And that is what happened today.

If you read a Deeply Disturbing Fascination with Toilet Paper you know a little bit about the waiting for that happens for a woman who is getting ready to start a frozen embryo transfer or other cycle. Since Saturday I have been a devoted student of TP. Today I hit pay dirt and was able to call my clinic to check off a critical step that will take us to transfer. Two days from now I will begin estrogen patches that will prime my uterine lining. I continue administering lupron daily but cut the dosage which should help with the headaches and other symptoms. Sadly the bitchiness caused by lupron will only be replaced by the emotionality of estrogen. The end result for me is about the same. Say a little prayer for Bill who catches the worst of the mood swings.

My call to the clinic today was a full day earlier than we all expected. However, no changes will be made to the transfer date. The lupron I am injecting keeps my reproductive system suppressed and on schedule. The extra day may only serve to give my lining just a tad bit of extra thickness to welcome our embryo home. A nice, thick, cozy lining should help that embryo want to stay for the long haul. With a little luck we will then be waiting for doubling HCG levels, morning sickness to pass, a myriad of ultrasounds, and ultimately a scheduled C-section date.

Even though meeting today’s milestone early will have no impact on when we actually get pregnant, it is a rare event to have something, anything come early. I’ll take it.