Future Imperfect

I am burying it, as deep as it can go.

I am shying away from conversations with people who know, because I don’t want them to ask how I am doing. I don’t want to be reminded of what has happened.

It’s when I’m reminded that I start to cry again.

The only place I’ll allow myself to engage with what happened is here.

Here I feel safe.

Here I can work through my emotions without interruption, in my own time, when I am ready.

I know I should probably be trying to process what has happened. I know it is not healthy to bottle things up inside.

My jaw is already sore because I’ve started unconsciously clenching it again.

I am so quick to anger these days.

I have so little patience for E., my most beloved son, when he gets silly or defiant and pushes my buttons.

I should be letting myself grieve, letting myself cry, letting myself do what I need to accept it, and, in time, heal.

I’m not ready.

The problem is it’s not just about this baby.

If it were just about this baby, this loss, I could stand to think about it, to confront it rather than hide it down deep, as far as it can go.

I’m not ready to engage with what I’m afraid this loss means.

A friend who had a miscarriage before she had her second son sent me an email where she told me that she knew how awful it was to have to replan a year when you hadn’t wanted to change the plan at all.

I feel like I’m not just having to replan the next year, but replan my whole life.

I’m so afraid that this loss marks the end of any chance we had at becoming a family of four.

I know, I know- we have one frozen embryo- a blast- waiting for us at the clinic.

I don’t know what grade the embryo is, and it probably seems premature to discount it.

FETs don’t work for me though.

Fresh transfers?

Three out of four blasts implanted (the two Day 3 embryos we transferred with that very first IUI/IVF conversion cycle in May 2009 I’m discounting because my thyroid was too high. They never had a chance.), although, of course, only one of them ever turned into a baby.

FETs?

Zero for six.

And two of them, in two separate transfers, were exactly like this frozen embryo: a blastocyst that hadn’t quite made it to blast status by the time of the transfer, and was frozen on Day 6.

Late bloomers.

Late bloomers that did nothing in my womb.

I can’t see how this one is going to be any different.

And so, while it’s true that this loss does not, in itself, mark the END of our attempts to expand our family, I am so very afraid it marks the end of our hopes that we might succeed.

We’ll transfer that last embryo.

Of course we will. We won’t leave it alone in the dark.

Probably in the summer. We’ve reverted to our original plan to go and visit Q.’s family in the middle of the year, so we won’t start anything at the clinic until after we’ve returned.

But after that? When it fails? (I can’t even bring myself to write ‘If’ because of course it will fail. FETs fail with me. It’s what they do.)

I don’t want to look at what comes next.

By the time we are through with that final FET, we will have spent as much of our own money (or possibly even a bit more- I’ve lost count) on failed efforts to bring home a 2.0 as we did trying to bring home our first baby.

In December, Q. and I agreed that this would be our LAST.RETRIEVAL.EVER.

When we found out that only one embryo was frozen, and we’d had another terrible attrition rate (70%), I freaked out.

All I could think about was: one more chance.

Everyone told me to let go of the anxiety about the future, to concentrate on the current cycle.

I did.

Yet here we are again.

One more chance.

And not even one I believe in.

2.0 IVF 13dp5dt- Happy New Year

So here’s the thing.

I have thought, for a week now, that I’m pregnant.

Two things have done this: the fact that my face massively broke out, and the insane bloat/fullness in my abdomen.

I have refused to breathe a word of this to anyone, not even Q., because I knew that it could be from progesterone and holiday eating and I couldn’t bear to get it wrong again.

I didn’t get it wrong.

The clinic called.

Beta was 835.

Repeat beta and an intralipid infusion on Saturday.

I’ve called my midwives already.

You guys. I’M PREGNANT!

2.0 IVF 12dp5dt- One more day

Beta is tomorrow. It would have been today if we’d been home.

I thought about testing but decided against it. I don’t want to spend more money only to get one line. Plus I did a pretty good job of not thinking about it while we were away (except for the early mornings when I woke up before everyone else), and I didn’t want to wreck that. It was clever to put the tww over Christmas- I just wish I hadn’t stimmed so quickly that the tww started on the 20th and not the 23rd. I was pretty stressed over that weekend what with the major weather event and the frozen embryo report, and it was only on the 23rd, which I spent baking cookies with E., that I was able to consciously relax and just focus on Christmas.

Oh well. Maybe that was already too late. There’s nothing I can do about it now.

Nor can I do anything about the chair that I lifted on the second day after the transfer and carried upstairs so that we had a way for E. to climb into his crib by himself without me having to lift him. Q. weighed the chair afterwards, and it was just under my clinic’s magic twenty pound weight restriction, but I had nothing but cramping afterwards.

Nor can I do anything about the fact that on the 23rd, after walking with E. down to the streetcar stop rather than getting the stroller out, because I know it weighs more than twenty pounds, and having E. climb up the steps himself rather than carrying him like I normally do, and having him climb down the steps himself instead of me picking him up like I normally do, we then walked to the dollar store where I promptly picked him up and put him in the cart so he could help me choose wrapping paper. It didn’t even occur to me what I’d done until we were finished shopping and I was trying to lift him OUT of the cart and his boots got stuck in the spaces for his legs, and I suddenly realized that I’d ended up lifting my toddler despite my oh-so-careful plans to make sure I wouldn’t. Cramping again after that. Then nothing.

I tried. I tried so hard to do what my clinic told me to do. And I still ended up, yet again, doing things that now hang over my head, things that I can’t help but wonder whether they might have swayed the balance, even though they are things that most women would do without a moment’s hesitation.

I wanted this to work so badly. I worked so hard to try to get my head around the possibility of twins, to make my peace with it, to accept it, to eventually even welcome it.

I did everything I could, and tried so hard not to do anything I wasn’t supposed to. But in the end I can’t make it happen. It’s not up to me. I can’t wish it so.

I’m preparing for a negative. I’ve got nothing to really sway me either way, but it’s just easier to try to start expecting bad news than to get blindsided.

2.0 IVF- 9dp5dt- Oh, shut up

December 24th
Body: Psst.
Me: What?
Body: *looks furtive* Wanna overanalyze?
Me: No. I’m busy. *goes back to wrapping presents*

December 25th
Body: Psst!
Me: What??
Body: C’mon. Wanna overanalyze?
Me: No. We’re busy. *goes back to opening presents, skyping and eating nice things.*

December 26th
Body: PSST!
Me: WHAT?
Body: Let’s overanalyze! You know you want to!
Me: NO. I’m busy. *goes back to talking non-stop to her toddler for three and a half hours to keep him from melting down in the car during the seven hour journey that should have been four so Q. can concentrate on driving (since he won’t let her drive because “That’s stressful and you’ve got the twins to think of”).*

December 27th, 28th, 29th
Body: PSSST!!!!!
Me: AUGH!! Fine! What do you want??
Body: You cannot tell me you haven’t noticed. All that bloating. All that sensation of fullness.
Me: Yes. I’ve noticed. You’re not fooling me. It’s called progesterone. I’ve been fooled by it before. Not this time.
Body: Yes, yes, ok. But this time is different. You have to admit it’s different.
Me: Yes. It’s called PIO shots meet Christmas holidays. It’s FOOD, body. Overeating for a week doesn’t mix with a digestive system currently functioning at the speed of a snail.
Body: But you’ve had to think about it and tell yourself this, no?
Me: Oh fuck off. I’m going back to reading Longbourn.

2dp5dt- it wasn’t a fluke

I was on my birth club yesterday, trying to explain why I was so twitchy about the clinic not calling. I explained my 77% attrition rate between day 3 and blast last time around, and how it should have been around 50-60%.

“I’m sure last time was just a fluke,” one of them said.

It wasn’t.

The clinic called this morning at 10 when we were in the car, off to visit friends.

I knew it wasn’t great news from the moment she started with, “Well, you had ten eggs that fertilized.” I already knew this. Then she told me that we decided to go to blast (yes, I knew that too), and that we transferred two on Friday (yep, I was there) and that we didn’t freeze anything on Friday (yep) and that we pushed four embryos to day six (uh-huh- this is not news).

Then there was a pause.

“One embryo was frozen,” she told me.

“Ok.” I said. “Thank you for the report.”

I hung up. I relayed the news to Q.

We were both quiet for a little while.

“One is better than none,” I said at last, trying to put a brave face on it.

It is. It certainly is. One is better than none. One more chance is better than the road ending right here with this cycle.

But it’s not what I was hoping for.

And it means that despite the better technology and the embryoscope, we still had a 70% attrition rate with our embryos.

There probably is something wrong with my eggs.

“Maybe we should have only transferred one,” I said to Q.

“But the fresh cycles get better results. And that was what worked for us.”

We’re holding on to that now. Nothing has worked for us- absolutely nothing- except a fresh cycle where we transferred two early stage blastocysts.

That’s exactly what we did on Friday.

It’s our best shot.

And if it fails, we’ll have six months or so to start to get our heads around the idea of E. as an only child, and then we’ll have one more chance to change that future.

But I’m not going to lie- it’s looking a whole hell of a lot closer than it did a few weeks ago.

2.0 IVF- 1dp5dt- Disappointment

My clinic didn’t call today.

That’s the first time they’ve ever missed a really important call like this. I called around 4 p.m. and left a message, but I find voicemail is a bit of a black hole there. I’ll call again first thing tomorrow- at least the advantage to dealing with a clinic is they’re open seven days a week!

This has, of course, led to some ridiculous anxiety-driven thoughts along the lines of, “THEY DIDN’T CALL BECAUSE THERE WAS NOTHING TO FREEZE AND THEY DIDN’T WANT TO GIVE ME BAD NEWS, SO THESE EMBRYOS CURRENTLY FLOATING AROUND IN MY UTERUS ARE OUR ONLY HOPE AND WHAT IF RATHER THAN BEING JEDI TWINS THEY’RE ALREADY DEAD??”

Even I can see that this is unlikely. The nurses at my clinic spend every single day giving people bad news- that the beta was negative, that the eggs didn’t fertilize, that the f/s didn’t find any sperm, that it will be a day three transfer. They’re hardly going to shy away from a phone call because it might upset the patient.

Much more likely is the fact that we’re currently experiencing a bit of a weather event in my neck of the woods, and a number of the nurses live outside the city. I bet they were busy and short-staffed today, and my doctor probably ran two hours late as per usual, and my chart just slipped through the cracks in the chaos.

Still.

I would like to know where we stand. If for no other reason than to help me get back to sleeping through the night again.

Last night was the third night in a row where I woke up in the wee hours, but well before 3:30 a.m. (which is usually the danger zone for my body deciding that I’ve had enough sleep and should just get up), and then tossed and turned in bed for a couple of hours before finally drifting off again. Last night was particularly disrupted: we had E’s coughing fits (we discovered last night he has croup again), combined with our cats deciding that they both wanted to sleep on the bed, and the resulting territorial standoff which required much meowing and clambering on us, combined with E. wheezing so badly from the croup that we had to check on him (and then I had to check on him again when he stopped wheezing so loudly we couldn’t hear him any longer from our room down the hall).

No one was bright eyed and bushy tailed this morning. Except maybe the blast twins, but it’s hard to tell with them, being but tiny bundles of cells floating in my uterus.

2.0 IVF- Transfer Day- Déjà vu

Yesterday Q. and I worked through our options while he was making dinner. We agreed that if we had four blasts or more we’d transfer two and freeze the rest. If we had three or less we’d transfer one and freeze the others. We wanted to maximize our chances on this cycle, but also hedge our bets against failure, because I wasn’t emotionally ready for our 2.0 quest to be ended without warning in early January.

What we didn’t do and, in retrospect, should have done, was discuss our tactics if we had a repeat of E’s cycle in August 2010 where we had two blasts ready to go and more still developing.

That is exactly what we got.

My f/s appeared in the transfer room, 90 minutes later than scheduled (not bad by his standards- I love listening to the nurses talk about him. One was telling another patient: “I’ve learned that the more you ask him, the longer he makes you wait. So you try not to ask him until you have to say, ‘They’re leaving!’, and then he comes. All the other doctors work on our time. He works on his own time.” He also managed to give everyone the slip for a few minutes- he’s had a doctor shadowing him for months now and this doctor, plus everyone else, had absolutely no idea where he was.)

He looked at the embryologist’s report. “Let’s see what we’ve got. One, two, three, four, five, SIX! How many do you want to transfer?”

“Two!” I said with confidence, pleased to have a clear answer.

Then he started qualifying.

Turns out we had two blasts ready to go (one more advanced than the other) and four more late bloomers that were still developing. Of those four, two were “very very close” and the other two “still had some work to do”.

I vascillated.

I doubted.

And then I screwed my courage to the sticking place and told him to transfer the two blasts.

“Just like E’s cycle,” I told myself.

In August 2010 we had six embryos still thinking about becoming blasts at this stage. Two of them did, and were frozen. I’m hoping that because the technology has improved we might get two again.

Four would be enough. Enough for two more chances. Enough to know that we really did do everything we could to expand our family. Enough for closure when the time came.

So here I sit, pregnant until proven otherwise with twins, yet still in the retrieval waiting game mindset.

At least it will kill one day in the tww waiting for the clinic to call tomorrow to tell me whether my gut instinct gamble paid off.

Beta is January 2nd.

2.0 IVF- And now for something completely different

There’s never anything to report on the fourth day.

My clinic called to tell me that I have to be there tomorrow at 11:45 a.m. because my transfer is scheduled for noon. I felt like saying, “Can I just come at 1 p.m. instead so I don’t have to wait as long for my doctor?”

So, as a means of breaking the tedium and the tension (because I do still spend almost every waking moment wondering what the embryos are doing), I offer E’s recent interpretation of a classic nursery rhyme:

“Hickory, dickory, plop.
The mouse pooed on the clock.
The mouse got a cloth and took it to the sink and got it wet
And the mouse cleaned the clock up!”

Potty humour. At 31 months.

2.0 IVF- Relief

The clinic called this morning at 8:45 a.m. as I walking E. to nursery school. It had been a stressful start to the morning. I woke up too early and couldn’t get back to sleep because I was so nervous, and E. woke up on the wrong side of the bed, so hangry he couldn’t even calm down enough to eat anything, and telling anyone who would listen that he was “planning to have a horrible day” at nursery school.

The nurse on the other end of the phone was calm, reassuring. They always sound so calm, no matter what the news is they’re delivering.

“I’m just calling because your doctor has already looked over your chart,” she said. “He’s looked at the report from the embryologist and has decided to go with a five day transfer.  We’ll call you tomorrow to confirm the time for Friday, but it will probably be noon.”

Thank FUCK.

I was so relieved I cried as soon as I had hung up the phone.

One more box checked.
One more hurdle cleared.
One step closer.

What was tormenting me, in the wee hours last night when I couldn’t sleep for fretting, was the realization that if we’d had to do a day three transfer I wasn’t going to get what I most desperately needed from this cycle.

Not a baby. A baby still strikes me as this amorphous wisp of a dream, that can’t even be given voice lest it vanish on the wind.

No, I’m talking about closure.

When our second FET failed and we made the decision to do one more fresh IVF cycle, a significant part of our reasoning was that if it failed we wanted to be able to say that we had done everything we could to make E. a big brother.  We wanted to give 2.0 his/her own chance, not just rely on the embryos that were left from E’s own cycle.

I realized last night that if our doctor had told us we had to go to a day three transfer, and it didn’t work, and anything that was frozen also didn’t work, I’d never get that closure.

E. was the product of a blastocyst transfer.

If we’d never got to blastocysts again, I would have always wondered what could have been. I would have remained unsatisfied with this cycle. I would have always believed something could have been different.

I would have come right up against the fact that money had become the deciding factor. If we’d done a three day transfer, and everything had come back negative, if we’d had insurance coverage for procedures, I’m sure we could have rationalized trying one more cycle in the summer. But paying out of pocket? Not a chance. We’ve blown through all the money we saved all last year for our shot at a 2.0, and then some. Fronting up for another fresh cycle would have been out of the question.

Now we’re one step closer to lining up all the variables to make sure that, no matter what the eventual result is, we can walk away from this cycle confident that we gave it our very best shot.

The next step?

Achieving an attrition rate better than the 77% nonsense that happened with E’s cycle where 17 day three embryos produced only four blasts.

If I could wish and make it so, I’d ask for four. Two to transfer. Two to freeze. Just like with E.’s cycle. Enough for a couple more second chances.

And now, we wait. Again.

2.0 IVF- Retrieval Recap

I figured I should post a recap of my retrieval experience, partly in case anyone stumbles across the blog looking for that sort of information, but mostly as a record for myself.

On Sunday we weren’t asked to be at the clinic until 11 a.m., but Q. and I went down there quite early so we could stop at a grocery store (as E. had eaten the last of his Che.erios and the WORLD.WOULD.STOP. if there were none for breakfast on Monday) and so we could pop into a store near the clinic so I could do the penultimate look for a particular Bruder dump truck and excavator combination. I have been looking for this for months now. I did find it once before in another branch of the same store (when I had E. in tow), but someone had stolen the excavator.

Anyway, given this store is a block away from the clinic, I’ve been going in every time I’ve had to do cycle monitoring to look. They’ve had Bruder logging trucks, and cement mixers, and cranes, and, on Friday, even a fire truck and a tow truck carrying a jeep, but not this set. E. already has the Bruder garbage truck. He loves it. He’s played with it every day for months now.

The thing with the Bruder trucks is their size. I don’t want more than two in our house. So even though I knew E. would like the crane, or the fire truck, or the tow truck, I kept refusing to buy them. I was holding out hope that this branch would come through.

Sunday I dragged Q. inside. “We just need ten minutes to see if we can find the truck for E.,” I told him.

I scanned all the shelves. I’ve learned that stock turns over incredibly quickly in this store (largely because they sell things far more cheaply than anyone else). I pulled out boxes to look behind them. Logging truck. Crane. Fire truck. Cement mixer. Tow truck with jeep. Garbage truck. Giant excavator.

“They have a lot of them,” commented Q., looking a bit overwhelmed.

I sighed. “There’s one more spot to check,” I told him. I circled back to where, on Friday, I’d found two enormous flatbed trucks with backhoes. They would have been perfect except they were SO big I really didn’t want to bring them into the house. Plus they were a lot more expensive.

The two flatbed trucks were still there. But so was one more box- a box with a dump truck and a mini excavator priced at the (ridiculously inexpensive) sum of $35.

I may have cheered.

I didn’t even hesitate for a second. I grabbed it, showed it to Q., and said, “E. is going to lose his mind on Christmas morning.”

That was pretty much the highlight of my day.

After that we wandered over to the clinic, where all the nurses in the IVF suite commented on our giant truck. Q. went off to do his thing, one of the nurses came in to take my blood pressure and get my IV hooked up (she wasn’t at all pleased at what the IV for the intralipid infusion had done to my right arm), and then we just chilled out for an hour or so.

I think it was around 12:30/12:45 when my f/s turned up (the retrieval was scheduled for noon but he is always, always late), and they called my name first. I went to the ‘loo (massively awkward with an IV attached) and then we headed into the OR. The nurse walked me through what would happen, and then she started up the drugs. I remember that my legs suddenly got really heavy and that I was feeling a bit dizzy. Then my f/s came in, started getting ready, realized I was still feeling more than he would like, and ordered more drugs.

That’s the last thing I remember until I was back in my cubicle. Q. says I actually fell asleep during the retrieval, which is a new one for me, and not really something they wanted to have happen, so he and the nurses kept having to remind me to “take deep breaths, Turia!”. Q. was sent off to buy the Dostinex to guard against OHSS. Apparently I had a lengthy conversation with one of the head nurses about taking this pre-emptive measure. I don’t remember this at all.

We stayed in the cubicle until 2:30 or so, when the nurse came to take out the IV, and I told Q. I felt well enough to go home. We went downstairs and hailed a cab. Arriving home we learned that E. had refused to take a nap, but he seemed to be in good spirits and had absolutely loved spending the day with his Auntie C. He’d made a snow globe, and a bunch of vehicles out of bits and pieces from the recycling, and had read stories, and had a blast. Q. snuck the giant truck upstairs, and I crawled onto the couch and stayed there for the rest of the afternoon/evening.

I am so so so glad Auntie C. is staying with us for this week, as it was a life saver to have her able to entertain E. That meant Q. could keep an eye on me, and make dinner, without E. getting riotous or stroppy. At one point Q. and Auntie C. forcibly bundled E. (who was protesting mightily) into his snow gear so he could go play in the 20-odd centimetres of snow that had fallen over the last day. Once he was outside, as predicted, they all had a marvellous time.

Once I got onto the couch, I felt well enough to eat, so I ate some white bread, and then a whole wheat roll. Then, when I still felt ok, I ate some pretzels and some rice crackers. When they seemed to settle well enough (I was still completely starving by this point, having eaten nothing since 9 p.m. the night before), I ate some of my sister’s granola. I think that was the straw that broke the camel’s back, as shortly thereafter I realized I had better go hang out in the ‘loo for a while, and sure enough I puked my guts out.

For supper I drank around a third of a mug of miso soup and then ate some french fries. That stayed down, and by the late evening I was feeling much much better, although I was still very sore and uncomfortable. I went to bed early, around 9 p.m. Poor Q. had to come up to give me the first PIO injection and he had a terrible time with it. I realized this morning that we were using a 25 gauge needle, which is what they tell you to use on the instructions, but if you’re using castor oil, which is even thicker, you have to use a 22 gauge needle. No wonder he was struggling so much to get it in!

Monday I felt much more human. Still sore and still massively bloated, but no longer nauseous. I felt well enough to go do my duty day at E’s nursery school, and then went and got (another) poutine for lunch. It is perhaps the one good thing from this whole mess- being under doctor’s orders to eat terribly.

Now it’s a waiting game. I don’t know what their cut off for blastocysts is.

I hope we make it.