Bonne Chance

One of the things I really like about my clinic is that they only give you instruction sheets for as far as you have gotten.  So, your stims sheet will only go to retrieval.  Your retrieval sheet with only go to transfer. And, your transfer sheet, will go to beta, the end of the line.  It really helps to compartmentalize the process and not get you ahead of yourself.  And, there are so many instructions on each sheet, it would be three pages easy if they gave them to you all at once.

Today I got the post-transfer sheet complete with the date of beta day*. 

And I got embryos.  Oh, did I get embryos. Four to be exact.

Yes, you read that right. We went from three to four – although, if you want to be nit-picky, we went from two to four, two being how many we transferred last time. 

After my acupuncture session, I headed over with the full, but not really uncomfortably so, bladder to the prep area where Mr. X was waiting.  The embryologist came out and spoke with us about how many contenders were left standing.  Of the 7 from Sunday, three had arrested (as had the four cell, but we weren’t really expecting a robust future there).  We had three beauties left and a nice looking fourth that while not at the level of its three counterparts, was still better put back than left to the freezer, which it probably wouldn’t have made it into.

Dr. Salsa and the embryologist both agreed that given our history, it was not that aggressive to transfer all four and see what sticks.  It also means that we had none left to freeze, but for some reason, that doesn’t bother me.  I think alot of that is because I specifically asked the embryologist if I should be concerned about the quality of the embryos that we were going to transfer since there were no others that made it and he said no. 

So, four it was. No bladder drama either this time, which was a real nice change from last time.  And, I wore the wonderful earrings that my friend made for me. On the left side, it said “Bonne” and on the right it said “Chance”, good luck, which some how sounds so much more encouraging in French.

Bonne chance, little four. 

image: scene’s

*I must disappoint those of you who want to know the date.  I share all kinds of things here, but that is just one thing I cannot bring myself to divulge.

Transferring, Please Hold (It)

I vividly remember the last time I had to pee so badly that it physically hurt. It was in 1997 or 1998, when I was a junior in college.  We were walking home to the dorm after a particularly marathon-esque night of imbibing.  Now that I think about it, there were probably at least five buildings on campus between the (off-campus but right next to the edge) bar and our dorm that would have been unlocked in which I could have made a mad dash to a fluorescent-lighted throne with my name on it.  For some reason, though, I had to wait until we got to the dorm and it was Torture.

My friend tried to distract me by having me tell him a story, and I played along, walking fast but gingerly. But, in reality, I was still just as cognizant of the fact that the dam was going to burst, sooner rather than later and I really didn’t want it to burst in front of my friends.  In the end, we made it to the dorm with nary a drop spilled and I was able to give my eternal thanks to the builders of that 10-story cinderblock menace from hell for having the wherewithal to install a bathroom on the first floor. 

Fast forward, eleven or so years, and once again I had to pee so badly it hurt.  Only this time, there was no booze to be blamed. No seal had been broken and drinking had continued.  All that had happened was that I was swigging water like I was on a desert island in a desperate attempt to actually completely fill my bladder. 

~~~

Ever since I had known that we would probably have embyros to transfer, I began to think about what special thing I wanted to have with me at the transfer, especially since my most special thing, Mr. X, wasn’t going to be there. The powers that be sent him to the northeast yesterday and he won’t return until tomorrow.  My mind kept coming back to one item that just made me smile: a pair of turtle socks that Mr. X game me for Christmas a few years ago.  It’s rare for him to pick out clothes for me and so these were extra special because he had chosen them. And, they are just so darn cute.  I knew what I needed to wear so that I could feel him with me even if he was far, far away.  And they really helped.  Thanks, little turtles.

~~~

Once I had gotten dressed, walked the G and dispensed with the feedings of the various animals, I began to swill the fluids that usually run right through me: tea (decaf, of course) and water. I also had some grapes (so juicy!) for breakfast.  About an hour later, still not getting that ‘gotta go’ feeling, I headed out the door with my glass of water in hand and made my way to Dr. Salsa’s office for my acupuncture treatment before the transfer.  I was swigging at stoplights and taking a slurp on boring stretches of road.  I still didn’t feel much need to go when I got there and I began to worry that maybe I wasn’t drinking enough, after all I had peed when I got out of bed.

I needn’t have worried. By the time she came back to take out the needles, it was getting uncomfortable.  By the time I was ushered back into the procedure area, it was really uncomfortable.  And, adding insult to injury, I had to change into my gown in a bathroom.  There was the toilet, pristine and white and untouchable.  I grabbed my iPod and walked as best as I could to the bed before getting in and trying not to think about how I was now sweating because I had to pee so badly.

I listened to a podcast of Car Talk because I needed distraction from the agony going on down below.  By the time I was in the room with the ultrasound, I was almost writhing in pain. My legs were shaking and I was spewing four-letter words.  I was on the verge of tears when Dr. Salsa appeared and I had a glimpse of hope that relief was going to be coming soon.  And it did, in the form of a catheter that he inserted and placed in a bed pan and I can easily tell you that I have never felt so good as when I was literally peeing in the face of my RE. 

After this relieving interlude, my bladder was still full enough that they could do the ultrasound visualization on my belly, but I was blissfully comfortable.  I was so comfortable, in fact, that I didn’t even feel the catheter for the transfer. It was the smoothest transfer I have ever had – even of my 6 IUIs. I couldn’t have asked for anything better.

So, how many embryos were sent down the fun chute? Two beauties. As of this morning, these two were the real over (ova?) achievers of the group and were apparently raising their little hands going, “ooh, oh pick me!” to the embryologist. The other three are still doing well, but were not as enthusiastic. We’ll know tomorrow if they developed enough to be frozen.  I’m going to fight the urge to pass judgments on the success of this cycle if the other three do not in fact make it to the deep freeze of the nitrogen tank.

As for whether this will work, I’m not thinking much past tomorrow.  There’s a stack of books that are waiting to be read, beautiful weather to be enjoyed and animals to be scratched and loved on.  If there was anytime to just be, it would be now. 

image top left: Mark Kempe

Putting a Number on Hope

Boiled down to its essence, inferitility treatment is a numbers game.  Everything about the process is quantified – number of follicles, number of sperm, percentage of motility, dosage of medication, size of cysts, size of follicles, number of eggs retrieved, number fertilized, number transferred, HCG number, number of heartbeats, heartbeat rate, measurements of the fetus, days of pregnancy,  number of miscarriages, the list just goes on and on.   And, statistics loom large with every decision, from how many IUIs to try to how aggressive to be in the number of blasts that are transferred during IVF.  Numbers are everywhere in infertility, often making a clinical process seem even more cold.  

You would think that there were some areas that were immune from being quantified, such as feelings.  Ah, if only.  When I was filling out the questionnaire for the acupuncturist last week, that last wall fell with this question:

On a scale of 1 to 10, with one being the lowest and ten being the highest, how would you describe your current level of hopefulness towards attaining your fertility goals?

Rather than treat this as one of those quizzes in Cosmo where you put down the answer that you know gets you the most points and proves that you really are boyfriend material, I knew that I needed to answer the question truthfully.  Much like you are instructed to blurt out the first thing that comes to mind in a Rorschach test, I circled the first number that came to mind:

4.   

I used to have hope of probably around 7.  If I could pinpoint that moment when my hope dipped below the magic halfway point of 5, though, it would be when I learned that my second miscarriage was also a monosomy, after we had been assured that it probably wouldn’t happen again.  I lost a lot of hope in that fiasco and most of it has not returned.  I don’t know if it ever will.  Like money, you learn not to put too much hope on the line lest you lose it all.

I have no idea what the acupuncturist will do with this information.  Like the rest of the questionnaire, it may go unread.  But, I thought it was interesting that of all of the things that we have left in this journey of infertility that have not been reduced to numbers, couldn’t they have left hope alone?

image: velo_city

Pins and Needles

You would think that once I realized that things were not as they should be reproductively wise, I would enlist all manners of assistance to get knocked up and stay that way.  On the Western side of the equation, that has been the case. I was popping Clomid within eight months of starting to try to get pregnant and I had a full RE workup a little over a year after we started trying. But, West is not the only game in town.

East has quite a few weapons in the arsenal.  None of those weapons, however, were in my infertility tool kit. Why was this?

The people I have known in my life who turn to Eastern medicine have done so as a last resort, not as a first option.  It didn’t help that what I did know of it involved sticking needles in strange places. At that point in my life, my dates with needles were few and far between, the fewer the better.  In other words, I had no positive experiences to view Eastern medicine as a serious and worthy compliment to Western medicine.

And then I became infertile.  My opinion of Eastern medicine, however, did not change, partly because Western medicine did get me pretty far.  Acupuncture probably wouldn’t have cleared out my tubes, but darned if that laparascopy did the trick!  And, then I got pregnant.  And, I miscarried.  Then I got pregnant again, and I miscarried again. With the same chromosomal abnormality.

It was at that point that I began to look at what we had been doing to see what we could do differently to change our outcome because even though we had been given a diagnosis of Bad Luck, I wanted to see what we could differently to possibly counteract whatever was causing things to go awry.  I began to seriously consider acupuncture, having read a lot about its benefits with IVF, and general well-being.  Dr. Salsa recommended it, something Dr. Uterus never mentioned, and Dr. Salsa had even partnered with an acupuncturist so that they would work out of his office.  It couldn’t have been any easier to get acupuncture treatment.

And yet I still hesitated.  That little part of my brain* kept saying, “this is the last step to you declaring that you are a desperate infertile!”, obviously a throw back to my original opinions about Eastern medicine.  Then my cycle started getting out of whack and I reached the point where I wanted to do something, anything, that did not involve more hormones to get things moving back in the right direction.  And, it wouldn’t hurt that acupuncture has been shown to help with IVF, which we are on schedule to do in the spring.  So, I made an appointment and I have now had two sessions.  I will have two a week up until it’s IVF time and then one on the day of retrieval and two on the day of transfer. 

So far, it’s been interesting. Some of the sticks hurt, others don’t. Once the needles are in, she leaves me for 30 minutes to sleep, which so far I haven’t been able to do.  I’ll stick (ha!) with it, though, because even if it has few to no physical benefits, the mental benefits of knowing that I am doing something toward our goal and that it is something new, are worth it. 

*The little voice has completely changed her tune, by the way. She’s now convinced that acupuncture will magically fix everything.  I’m going to have my hands full beating down her expectations and remaining realistic. 

image: run dorkas run