Getting started

Day 3 today, so into the clinic yet again. I was really hoping AF would have turned up a day earlier, so I could have gone in to the clinic on Sunday on my Day 2, rather than blowing a massive hole in Q’s workday, but no such luck.

E. was, as usual, pretty fragile this morning. He hates changes to the routine, and he especially hates me disappearing first thing in the morning when he’s eating breakfast. He held it together though, and ended up having a lovely morning with his Daddy (as I knew he would).

The clinic was busy but not outrageously so, although I still ended up being there for over two and a half hours. I was called fairly soon after my ultrasound by my fertility specialist, but then I sat in one of his offices for ages before he came in, and then there was another wait to see a nurse.

Anyway. In the end we had an agreed upon plan: fresh IVF cycle, with ICSI. Another round of intralipid infusion. A strong suggestion that I should do some acupuncture, so I’ve taken the brochure of the individual who does it right at the clinic, and will discuss that with Q. Dr. L. thought I should try it out before booking a session for the day of the transfer, in case I hated it. He said he hates it “because I really don’t like needles”, to which I replied, “well, I guess since I’ve started coming here I haven’t had that problem”, which made him laugh.

He is a really good guy. I ended up in tears in his office (yet again), and when he asked me why I was crying, I told him that this was our last shot.

“I’m going to do my very best,” he told me, and stood up to give me a hug. “I’m going to do everything I can.”

We’re aiming for a retrieval on the 18th of December, to allow for a five day transfer of blastocysts on the 23rd.

I took my first birth control pill this morning. He has me taking them until the 2nd of December, which moderately stressed me out this morning as I didn’t think that was leaving enough time. I just went and looked back at our cycle in August 2010, however, and it was an identical timeline- last pill on the 2nd, and I was in the clinic again on the 4th, so my period must have started immediately after I stopped the birth control. I also took a day or two longer than expected to hit the point where I was ready to trigger, so retrieval was on the 18th, and the transfer was on the 23rd. That means that even if it takes a couple more days this time around to get my period, we should still be on track. And if we’re a day later, and we have to transfer on the 24th, that will be ok too. I just don’t want to be dealing with an embryo transfer on Christmas Day.

I am still debating stopping the birth control pills one day earlier than we set up today (and starting the Lupron one day earlier as well, since I’m meant to start it seven days before stopping the birth control). As I was leaving, my fertility specialist said, “So we’re looking at transferring around Christmas, right?” and I agreed, but didn’t say to him that it has to be BEFORE Christmas because as of Boxing Day we’re going to be travelling to visit family. So I might adjust things slightly just to make sure we have enough wiggle room. Part of it is it’s been taking forever to get my period with these FETs- this time it didn’t start until a full week after the last PIO shot. But the Lupron/birth control combination is different.

Ok- question for my readers: do you remember how long it took to get your period after stopping birth control pills while on Lupron? I find it hard to believe my twenty-four experience from August 2010 is the norm.

I have a few things to think about. My clinic now has an embryoscope, which is apparently a special incubator with a low light that allows them to take pictures of the embryos every few minutes and create a time-lapse video of their development. This is meant to help with selecting the embryos to transfer as they can see which ones have been developing normally since the very beginning. I am tempted by this, but I’m not sure the cost ($750) is worth it, as it’s a very new technology. They’re the first clinic in Canada to offer it, and they’ve only had it for two weeks. I’m not sure if my fertility specialist was so excited about it because he thought it would be a good option for us, or because he just loves having all the latest technology available.

The reason why I am tempted to pay the extra for the embryoscope is we’re probably going to end up in December facing the decision that I have been dreading since we first started trying for a 2.0, and the one I was so hoping our FETs would let us avoid.

E. is the product of a two embryo transfer.

I don’t know if I can stomach transferring two embryos again.

I honestly don’t know at this stage if I would rather have E. end up as an only child than end up with a twin pregnancy. It’s something I have to think a lot more about in the next month, and talk about with Q.

I do know that right now the idea of a twin pregnancy scares me half to death.

Maybe it seems ridiculous to be worrying about this possibility when we’re not even into the IVF cycle yet, and we have no idea how many embryos we’re going to end up with, or what their quality is going to be. But that’s where my head is, and that’s what I’ve been fretting about in the back of my mind for months, even during the two FETs.

I don’t want to have to make this decision.

I don’t want to get a negative result from a single embryo transfer, and then spend months wondering if we could have changed the outcome by transferring two.

But I also do not want a twin pregnancy.

So. I’m doing the research (or, to be more accurate, asking nicely if my sister can do the research for me), looking into the statistics, weighing the options. We can’t make a final decision at this point, but I think I really need to sort out my feelings about the whole situation before we’re given a report on our embryos.

I see my endocrinologist tomorrow for my usual biannual appointment, which means I’ll be able to get his advice on adjusting my synthroid dose to deal with the birth control and then the stims. This is assuming the man actually gives some reasonable advice and isn’t just rude, which is always a tall order with him.

I e-mailed my supervisor today to tell him he wouldn’t be getting a draft of my dissertation in mid-December like we’d originally planned, and suggested that we meet in December to discuss a new timeline.

Full steam ahead.

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3 Comments

Filed under 2.0 IVF, Anxiety Overload, Medical issues, Medications, Money Matters, Second Thoughts, Thyroid, ttc

3 responses to “Getting started

  1. It’s so exciting to be moving forward, but it must be terribly overwhelming to face such big decisions. With respect to the embryoscope- the cost is steep, but what will you regret more- spending the money, or not spending it and wondering if you should have? How many to transfer is a bit more of a tough choice, since you have to consider which of the two options scares you more- a twin pregnancy versus transferring one and not succeeding at all. Neither option is particularly palatable, and I don’t envy you. Sending love and hugs, and hoping like mad that this one works!

  2. Nity

    One cycle it I went in for an u/s 3 days after I stopped BCPs with no period. The other cycle I just started spotting and went in 4 days after I stopped BCPs. I don’t quite remember my Lupron cycles (as we stopped those due to my high stimulation). For us, it was a period or x number of days. I believe I usually reached x number of days and didn’t get my period.

    With the transferring 2 vs. 1: that’s really a personal choice. The last two times they have been very insistent to give us the choice, max 2, min 1. We have always opted for 2. But I think you can dictate your choice. At least you have a bunch of time to decide.

    BIG HUG.

  3. Funny — I just learned of the time-lapse idea when I was watching this video regarding PGS (which, as you know, is what I am doing now):
    http://www.nyufertilitycenter.org/news/2013/dr-jamie-grifo-present-reprogenetics-2013-symposium-registration-open-patients

    I think the time-lapse approach is interesting, and though not cheap, a heck of a lot cheaper than PGS which is not covered by insurance here in the States.

    I wish I could help you re: Lupron protocol but this new center I’m at doesn’t do Lupron (I used Ganerelix) and I can’t remember how it worked with H’s cycle timing-wise.

    I fully understand re: the angst over twins. I was preparing myself for that decision in case we needed to transfer, and I’d pretty much decided to transfer two but that was in no way an easy one to get to. Does it help you to think about it in terms of what you might regret more? That’s how I do it these days — which way will fill me with the least regret in retrospect?

    None of this is easy, and that sucks. I am sorry we’re not those women who can just POAS and do a happy dance. But we will both get through all of it and I’m sending you every positive vibe for what’s ahead. xo

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