2.0 IVF Day Seven- Whoa there, eggies!

Hit the clinic super early this morning to make sure I could get my bloodwork and ultrasound finished before my intralipids infusion, which was scheduled for 8 a.m. The nurse in the IVF suite was just about to start my IV when I had a phone call from Q., who had an incredibly angry toddler on the other end who needed to speak to me, since apparently all the conversations we had the day before about me going in to see the doctor very early didn’t sink in. They’d just spent thirty minutes searching the house, with E. absolutely certain that Mummy was still in bed sleeping, even when Q. pulled all the covers off.

The intralipids infusion was finished by about 9:45. I ended up feeling like I was going to fall asleep again, just like last time. Maybe it has something to do with all that fat going in to my body- the nurse wondered if it was the equivalent to eating a big Thanksgiving dinner. There were a couple of other ladies in there at the same time- they were both pregnant. Nice to get reminders that things do work there.

Went back over to the main part of the clinic and managed to see my doctor really quickly. My follicles are zooming- the lead follicle was measuring 16 on one ovary and 15.5 on the other. This seemed a bit too fast to me, and I think my doctor thought the same, as he changed my meds to 150 iu Gonal-F and 225 iu Repronex for today and tomorrow. I’ll go back in on Friday and Saturday for sure. The retrieval is likely to be Monday or Tuesday of next week, so that is definitely faster than the August 2010 cycle, but I don’t think it’s too fast if we make that timeline, as my cycle in August 2010 was longer than expected. Obviously since it worked I would have been happy to repeat that pattern again here, but we can at least say with confidence that we’re not going to be dealing with an embryo transfer on Christmas Day.

Dr. L. repeated his advice to eat lots of salt and drink lots of Gatorade- minimum one litre per day to be exact.

I am feeling pretty miserable now. Really sore through the abdomen and just generally lacking any emotional fortitude. We had a terrible night last night where E. freaked out so much at Q. trying to put him to bed that Q. had to come downstairs and get me to take over because he was getting too angry, and then he was so angry he didn’t want to say goodnight to E., which upset me so much that after I had put E. to bed I ended up sitting in the bathroom crying. Then E. woke up at 9 p.m. vomiting all over his crib, at which point I deeply regretted letting him eat the entire punnet of raspberries that had been all he was interested in eating all day (along with rice crackers). Q. is so stressed about work- he is supposed to be writing a chapter for an edited volume this month, but E. being too sick to go to nursery school has completely blown a hole in his plans, so now he’ll have to take work with us when we travel after Christmas to see my family. Definitely a night where I found myself wondering why we’re putting ourselves through all of this to try to expand our family, given some days it seems we can’t even cope with one.

Deep breaths. One day at a time.

Twice as nice?

I have spent a LOT of time mulling over the big issue with this IVF.

One embryo or two?

I realize that this may look like I’m getting ahead of myself. We haven’t even started stimming yet, let alone hit retrieval or transfer. We don’t know how many embryos we’ll have, or what quality they’ll be, or even if we’re going to make it to blastocysts.

Rationally I know that, and I understand that, in some ways, investing all this time and emotional energy in this issue  now is putting the cart before the horse.

But at the same time, it’s an important decision, and if I leave it until the moment where we HAVE to make the decision, I won’t be able to give it the thought it deserves.

E. is the product of a two embryo fresh transfer.

To me, that is the biggest reason for doing this again. This is what worked. We’ve had quite a few cycles now of things not working- eight other embryos in five other transfers have not worked, to be exact.

So there is the temptation to do the same thing again.

It’s also more than likely that a two embryo transfer would produce a singleton, just like with E. My sister did some research for me and discovered that, in my age group, a two embryo transfer that produced a successful (i.e., live birth) pregnancy resulted in a singleton 80% of the time.

And, of course, the odds of achieving any pregnancy are better with a two embryo transfer than with just one, although I’m getting the sense that just how much better is now quite heavily debated.

If we had insurance coverage for procedures, if cost was no issue, I would gladly do an elective single embryo transfer.

But we don’t, and it is, and we’re running out of options.

Plus, my body hasn’t exactly proved itself to be all that welcoming to those little balls of cells. E. is, let’s remember, my only pregnancy. We’ve transferred ten embryos (six Day 3s and four blastocysts) and only one of them stuck (that chemical pregnancy from the FET in October 2009 really doesn’t count given my initial beta was so low it was practically zero).

Every time I start to try to wrap my head around a twin pregnancy, however, I start to freak out.

In June a pair of articles on Babble garnered a lot of attention. They were written (anonymously) by a couple expecting twins. They used IVF to try to give their son a sibling. They hemmed and hawed and finally decided to transfer two embryos. They weren’t expecting, nor did they want twins, but that’s what they got.

Their articles were brutally honest. The reactions from the public were just plain brutal.

Admittedly, they didn’t always express themselves in a way that would encourage readers to empathize with their situation. But when I read the articles, especially the one written by the mum, I understood where they were coming from. I could see the anxiety, the fear, the sense of having lost control over the life that they thought they were going to have. I found another article written just this week, whose author also gave voice to some of the fears that I harbour, especially those concerning having to ignore the needs of one child to meet the needs of the other, something that I would face the moment I had two children, but something that would be even more heightened with the arrival of two babies simultaneously.

It’s easy for people to judge when they haven’t had to resort to IVF to get pregnant. Most people don’t even have to consider the issue of twins. Even mothers who end up with twins in a natural pregnancy haven’t had to weigh the decision whether to transfer one, or take the risk with two.

I know there are women out there who could go into a first ultrasound, see two heartbeats, take a moment to be overwhelmed, and then just be filled with gratitude for the two lives they were growing.

I’m not one of those women.

Everything about twins scares me. The high-risk pregnancy, when my pregnancy with E. and my experiences with my midwives had helped so much to heal the wounds of infertility. The fourth trimester, when I escaped PPD by the skin of my teeth when dealing only with one baby and with a husband who largely worked from home so he could be there for mental health checks much of the time. The whole first year, which, now that it is long behind us, has really driven home to me how much I prefer toddlers. Someone on my birth club the other day was commenting about how she longs for another baby, and I just found myself shaking my head. I want another child. Another baby? I’ll deal with that, because I’ll have to, but honestly, if I could outsource child rearing for the first fifteen/sixteen months or so, and get them back when they’re walking, sleeping through the night, down to one nap, and starting to really communicate, I’d be seriously tempted. I make no apologies for this either- the birth club has taught me that some people are just best suited to some phases of children’s lives. There are some mums on there who adore the teeny tiny baby phase and then there are a few of us who have really come into our own with toddlerhood.

Plus there are the associated financial costs of three kids rather than two. I don’t think the couple should have phrased it in terms of wanting to take their kids to Disneyland, but three university funds rather than two is not a small difference. We’d have to buy a car. It would be another ticket to see Q.’s family every couple of years. Maybe this sounds shallow, to worry about having to buy a car or about airline tickets, but it’s the sort of thing I think about. It’s the reality of how our life would change. I think it would be naive not to think about these sorts of implications.

Plus there would be the impact on my career. Twins would basically ensure that my career would be over before it started, as we would never be able to afford to have them in any sort of full-time care that would allow me to do anything in the academic world beyond very occasional contract teaching. (Daycare in my city, especially for the under 2s, costs significantly more than our mortgage payment.) You don’t recover from that sort of career path, and the first few years after your PhD is finished are your one chance to land a permanent position (assuming one even exists). I’m sure eventually, once they were in school, I’d be able to scrape together some contract teaching, but the reality is we’d be a single income family for a lot longer than expected.

Plus there is the added strain on a marriage. I’ve written before that Q. and I, while not struggling, have had to work harder at our marriage since having E. I know having a second child would add another whole layer of pressure, but I have to think that adding twins would be a giant atom bomb. I worry about how Q. would react to the financial pressure of being the sole provider, while at the same time becoming a father of three. I worry about how we would both cope with the sleep deprivation- that was one of our biggest sources of tension when E. was little and he could have been so much worse. I worry about how I would find the support that I would need, when we have almost no family in the city.

Plus there is the impact on E. He is such a sweet, gentle, sensitive soul. I worry endlessly about disrupting his ordered little existence with the arrival of one baby, let alone two.

Etc. etc. etc.

I don’t think thinking these things makes me a bad or a selfish person. I have the right to feel anxiety about the possibility of such an unexpected (and enormous) change in our lives. I’d be worried about some of the same things even if there was only one baby on the way.

I kept reaching a stalemate: the fact that E., the only transfer that worked, was a two embryo transfer, vs. my abject terror at the thought of a twin pregnancy.

And then my birth club had a post one morning from a mum who was ready to try for a second, but her partner wasn’t on board, and she was asking the other mums how they knew if they wanted another. At first the conversation just pissed me off, because I’m pretty sensitive to pregnancy/baby talk on there right now, given some days it feels like EVERYONE else is either pregnant, has already had a baby since our May 2011 littlies, or their May 2011 baby was their last one. But then a couple of posts really hit home. One mum, when describing how her husband felt, really highlighted how I felt about the prospect of twins- the chaos of infancy, the extra financial costs- but then described how she viewed it: more love, more cuddles, more of life to share. And then two mums said they visualized what they wanted their dining room table to look like in twenty years.

THAT got me.

In the short term- pregnancy and birth and the first year- I cannot face the idea of twins. Even in the medium term the idea freaks me out. I’ve basically decided that the first four years would largely be an exercise in survival and if we made it out the other side with our marriage still intact and all three children healthy with no one suffering pyschological damage, I’ll call it a win.

But when push comes to shove, when I picture us sitting at our table two decades hence, and it’s a choice between dear sweet E. sitting there by himself, or the happy chaos that comes with three, it’s a no brainer.

I don’t want E. to be solely responsible for us when we hit our dotage.

I don’t want E. to be by himself if we don’t make it to our dotage.

I don’t want E. to miss out on having nieces or nephews of his own.

He will spend the rest of his life only seeing half of his family every two years (if that). I have no idea if he will ever have cousins who live close enough for him to count them as real friends.

I still have to talk to Q., but I know now how I feel about the situation.

Fuck it.

If we’re lucky enough to be given the choice, I’m voting for two.

Gearing up

I took my last bcp on Saturday.

Ironically, given the situation, I had less bleeding on both Sunday and yesterday than had been the case for the entire previous week. But by late yesterday afternoon I figured it was ok to go in to the clinic this morning. My sister (bless her heart) came over to play with E. for the morning. They built a blanket fort, did lots of drawing, and just generally had a great time. E. was in good spirits, even though I bolted out the door very soon after he woke up.

Q. and I are going to have to figure out how we’re going to organize things for this cycle. I got in to the clinic at 8:45 a.m., which is getting towards the end of cycle monitoring hours (they run from 7:00 to 9:30 a.m. on weekdays). I got out at 11:30 a.m.

RIDICULOUS.

Partly it was because we were starting everything up, so it took a while to get all the medications together and go over all the instructions. Partly it was because the ultrasound techs were short-staffed so they were running a bit behind. Mostly it was because I’m convinced my f/s forgot about me and screwed up his rotation through his offices, as he dumped me in a room and then left me there for THIRTY-FIVE minutes, and there would have been only two more people in front of me. It’s possible he dashed off to do an IUI or two, but he’s done this before. It’s the downside of my clinic being so busy.

Anyway, Q. is going to have to look after E. any morning I’m in at the clinic. I next go back in on Sunday, and I’m *hoping* he can then next see me the following Wednesday, as E. would be at nursery school, so it won’t interfere with Q.’s schedule. But there will come a time where we’re going to have to decide whether it makes more sense for me to leave for the clinic long before E. wakes up (which means Q. will be guaranteed a hysterically weeping child), or wait until after E. wakes up, which will blow Q.’s entire morning. If I get to the clinic right for the start of cycle monitoring, I hopefully would get back home again by 9:30 or so.

You forget how much time this process takes until you start doing it again.

Last night Q. and I signed our consents and made decisions about whether we were happy for discarded biological material (eggs that didn’t fertilize, follicular fluid, etc.) to be used for research purposes (yes) and whether we wanted one of us to be able to use any leftover embryos if the other had died (no). We also decided that we wanted to use the embryoscope, provided my f/s could assure me that using this new technology meant that the embryos wouldn’t be disturbed. This did indeed prove to be the case- they have six chambers in the incubator, so our embryos would get their own spot and their perfect environment won’t be disturbed by other clients’ embryos being added or removed. We decided this perfect environment was worth the $750 price tag. This is the last time we are going to do IVF, and we had a lot of attrition in our embryos between Days 3 and 5 with the cycle that brought us E. This new incubator might help them develop. I guess an added bonus will be the fact that it gives the lab techs the ability to see which really are the perfect embryos, but if our cycle goes like last time that will be irrelevant- we only had two embryos that had made it to blast by the day of the transfer, so if we get that result again clearly we’ll just be using them.

I asked my f/s to check my TSH again and should get a call about that this afternoon. All the extra blood tests he ran came back normal, although my AMH has dropped from 37 to 20, which is not unexpected given I’m three and a half years older.  It still indicates a ‘medium ovarian reserve’, so he didn’t seem too worried about it. We spent quite a long time looking at the calendar. He felt my estrogen was a bit on the low side this morning, so eventually he decided I would start stimming on Thursday. This is going to make it really touch and go to make sure we get everything done before Christmas, so I could use some good vibes for responding well. The LAST thing I want to be doing on Christmas Day is an embryo transfer.

He’s starting me on 225 iu Gonal F and 75 iu Repronex. I told the nurse to treat me like someone who’d never done it before, so we walked through every step. It should be straightforward, but it is always stressful when so much rides on you doing the right thing at the right time. I’ll go back in on Sunday to see how things are progressing.

I’m not going to lie- I’m dealing with a lot of anxiety about all of this. I’ve been sleeping really well lately, but the last three nights I woke up at 5 a.m. and then couldn’t get back to sleep. On Sunday I spent E’s entire nap surfing Pinterest for ideas for E’s room (as we’re probably going to move him into the room that is currently my study when we transition him to a bed, whether we’re having another baby or not)- an anxiety displacement activity if ever I saw one. It mostly served its purpose as a distraction, except for the point where I realized that the mattress I want to buy E. (which is made by the same company that made his crib mattress) is really quite expensive, and while it would have been easy to rationalize purchasing it if we weren’t spending all this money on the IVF, it’ll be harder to figure out where that money will come from in our current situation.

That gets to me a lot. I think there is a big part of me now that doesn’t believe we’re going to end up with a 2.0, in which case we’re basically about to flush thousands of dollars down the toilet. And while money obviously isn’t everything, there are so many other things we could be doing with it- things that would have tangible benefits for the child we DO have. I know if the IVF doesn’t work we’ll at least have the peace of mind that we did everything we could, but I wish so much there was a way to get that peace of mind without emptying our savings account.

From here on out my focus is the IVF cycle. Any dissertation work I get done will be a bonus. I’ve basically just shelved the chapter that still needs significant work- I’m not going to even look at it until January. Instead, I’m plugging away at the notes in bold I’ve left to myself in the other chapters (they usually say things like “get this reference sorted” or “add the example with the guy with sixteen kids who’s excused from munera“). They are not sweeping changes, but they have to be made, and every one I do now is one fewer I’ll need to do when I can actually focus on my work again.

When I get overwhelmed, I just remind myself that, no matter what happens, this is the very last time I’ll be stimming. This will be my last retrieval. Whatever we get from this cycle, whatever the outcome, we’re done.

Deep breaths. Take it one day at a time.

All in

I saw my fertility specialist this morning. I took the office manager’s advice and went in around 11:15. It was so quiet today that I didn’t even have time to go to the washroom before I could hear him calling my name to go into the office.

He was focused and thoughtful and not in a rush. He did have a new medical student with him, which made it even more annoying when I (predictably) started to cry, despite all of my best efforts not to, but I’m sure he’s seen it all before.

Anyway. We looked things over. He agreed that my ratio of embryos to blastocysts from that IVF cycle in August 2010 (17 embryos on Day 1, 17 embryos still growing on Day 3, 2 blasts transferred with 6 potential ones to freeze on Day 5, only two more blasts frozen on Day 6) was “lower than we would expect given the other factors”. His best guess, which is mine too, is that the PCOS means I make crappy eggs. There’s not a whole lot we can do about that, although he says that in general they have better luck with embryos these days than in 2010 because the technology keeps improving. He says he’d probably tweak a few things with the IVF protocol this time around, partly because of the embryos, partly because I’m older (and so, of course, is Q.).

He feels that he has already run every single possible test to determine other problems with me or with Q. He was happy enough to run most of the auto-immune ones again, and I was happy to pay for the ones not covered by OHIP, but that’s really just an information gathering exercise. If any of my results have changed, it won’t alter the protocol- he’s already put me on all the medications they recommend for those sorts of situations. Q. and I both need to update our bloodwork since it’s been six months since our last round, and he’s requested that Q. provide another sperm sample so they can make sure everything is still ok on his end.

We looked at the calendar.

“We’re still in semester until early December. Can we do a retrieval and transfer as close to Christmas as possible?” I asked.

His face lit up. “Yep. Absolutely. Great idea! Just come back in on your day 2 and we’ll get you set up.”

So.

Looks like we’re doing this again.

It’s impossible to say anything with 100% certainty in this game, but I really feel like this is it. Doing this IVF is going to stretch us financially. Another cycle will make things really difficult.

Plus I could rationalize to myself that with just two failed FETs it’s possible we ended up on the wrong side of statistics. We were unlucky, nothing more. I don’t know that this same argument would hold much weight if we go through another entire round of IVF (plus any associated FETs) and still come up empty. I think then it will be easier to call it quits.

I hate the idea of doing another full IVF.

I hate the idea of spending this much money on something so tenuous, money that we could spend on the life we already DO have with E.

I hate the idea of the drugs and the stimming and the retrieval.

But I hate the idea of walking away more.

I reminded myself yesterday that in December 2009, after the last of our FETs from that first IUI/IVF conversion cycle failed, I wanted to quit. I was done. Q. wasn’t, and he convinced me to try again, argued that we had to give a full, long protocol IVF cycle a chance.

That last cycle was the one that brought us E. (I looked at my chart while I was waiting for my doctor and discovered for the first time that E. was either embryo #7 or embryo #13, as they were the two that grew the fastest and were chosen on transfer day.)

He wouldn’t be here now if we hadn’t pressed on past that first point where I really wanted to stop.

2.0 deserves the same chance.

So I made another decision today.

I’m going to tell my supervisor he’s not getting a full draft of my dissertation before Christmas.

I’ve lost probably five of the only full day each week that I have to be in library this semester to trips to the clinic, because it also happens to be the only day where I can go without having to drag E. with me, as Mondays I’m at his nursery school in the mornings, and Fridays I’m teaching.

I’ve been refusing to work after dinner, refusing to work when I wake up at 5:30 in the morning and can’t get back to sleep. I haven’t always been as efficient as I could (or should be) when working during E.’s naps. All of this has been a very conscious deliberate strategy to control my anxiety and my stress levels. But it has also meant that progress on the dissertation, although it continues, has been slower than it needed to be to meet that deadline.

I probably could get a full draft to my supervisor by mid-December, as we agreed in early September, if I absolutely went for it over the next six weeks.

But it wouldn’t be easy.

And I just can’t rationalize commiting to another round of IVF when I am also openly planning to arrive at the start of that cycle stressed and exhausted and burnt out from what is basically a self-imposed deadline.

I’m still moving along at a good pace with the dissertation. I’m still on track to finish on time (and by that I mean at the same time I would have been expected to finish if I hadn’t had a baby and taken six months of maternity leave, so I guess that’s technically finishing early). I’m the one who decided I wanted to have a draft finished by Christmas. I wanted to have that off my plate before the holidays. It was a good plan, but I underestimated how much time and mental energy the FETs were going to eat up.

The alternative is to shelve the whole process of trying for a 2.0 until next July, when we’re out of school and back from visiting Q.’s family, and just work like mad on the dissertation in an effort to try to defend at the end of the academic year. There are good reasons for this alternative timeline, but they’re not the ones that really matter to me when I sit down and think about it. What really matters to me is I’m getting older. What really matters to me is the age gap between E. and any potential sibling is growing with every month. What really matters to me is I’m already emotionally invested in this process, and the idea of giving up on it for another eight months, leaving us in limbo, is untenable.

I would rather have the dissertation take a couple of months longer to finish. In the grand scheme of an academic career, those months mean nothing.

Coming into our IVF cycle in a healthy state of mind could mean everything.

I keep remembering what my Dad said, about how it’s a better use of our money than going to the casino.

We’re gambling all right.

I just hope we get the big prize at the end.

No one is ever average

Because I work on the place of fertility in a historical culture, I spend a lot of time thinking about demography and statistics and averages.  When you are dealing with an infant mortality rate of 50% of any birth cohort before they reach age 5, the hard truth is that women in their lifetimes have to give birth five or six times in order to maintain a stable (with five births) or very slowly growing (with six) population. It takes that many children, on average, to ensure that each woman will replace herself with a daughter who reaches child-bearing age. It’s manageable provided you have a earlyish (late teens to early twenties) age at first marriage for women, and no reliable methods of family limitation.

My field doesn’t have the sort of evidence that other historians of other periods do. We don’t have access to birth records from villages. We can’t track the rise and fall of individual families. Only very rarely can we piece together a coherent picture of any family at all.

As a result, we spend perhaps more time than we should with the statistics, the demographics, the averages.

And we forget that the averages can only tell us what the population does as a whole; they leave no room for the individual hiccups of fate and (mis)fortune that change the makeup of families.

A scholar in my field who does recognize this failing wrote recently that, “Diversity is perhaps the most striking feature of ‘natural fertility’…birth and death rates vary dramatically, from family to family (the childless lie next to families of eight or ten or more), from year to year…from region to region.”

Enormous variation lies underneath that computer-generated calculation of five or six births per woman, variation that can’t be quantified or reduced to statistical averages.

It’s the same, I feel, for infertility.

I haven’t gone and done the research, but I would imagine that the majority of women with primary infertility who succeed in having a baby eventually are able to go on and have a second baby. But whatever the percentage is, the bald number masks the individual stories. It will lump together the ones who managed to have their second baby naturally, without medical intervention, with the ones who still needed help but were successful on the first try, with the ones who lost baby after baby before they got to bring another one home, with the ones who ended up pregnant with twins on a last-ditch, final chance cycle, with the ones who saw two pink lines from a FET, with the ones whose fresh IVF led to a heartbeat on an ultrasound monitor.

Equally, the statistics make no distinction between those who are not so lucky, the ones who make up the smaller number.  There is no room to distinguish the ones who exhausted current medical knowledge and technology to no avail from the ones who had to stop treatments because they couldn’t afford to continue, from the ones for whom time and biology ran out, from the ones who had the resources to continue but had to make the decision to stop for their own sanity, so they could build a life with the family they had, rather than continually engage in a (what-had-proven-to-be) futile chase for another baby.

Statistics don’t tell the whole story. They never tell anyone’s individual story.

The success rate for FETs among women who are under 35, using good quality blastocysts, is very close to 50%.

If everyone were average, one of the two FETs we did this fall should have worked.

One of those embryos should have become a baby.

I don’t know yet if we were just unlucky, or if there is another underlying problem.

I don’t know yet in which group I’m eventually going to belong.

I don’t know yet what the road will look like that will bring me there.

But I think we’ll do another IVF cycle.

We might have just ended up on the wrong side of the statistics this time around.

And ten years from now I don’t want to regret not having tried to change that.

Expected

Beta was negative.

That’s it then.

We do another full round of IVF, or we call it quits.

I really didn’t think we’d end up here.

8dp5dt

So.

I tested this morning.

It was a clear BFN.

I’d been debating testing and refusing to test for a couple of days, mainly because I didn’t really believe deep down that the cycle had worked, but knew that if I kept refusing to test I could at least keep on trying to believe it had worked.

Q. has pointed out that it is still early and that I don’t exactly have the greatest track record with HPTs. To which I have made the reply that at other clinics beta day would be tomorrow, and the HPTs that gave me the negative result with E’s cycle were from the dollar store. This one was a FRER.

I bought a two-pack, so I’ll test again on either Sunday or Monday for confirmation before the actual beta. But at least now I’ve got a couple of days to start to get my head around it all.

I didn’t ever really think, not deep down, not in my heart of hearts, that we would transfer both of our remaining blasts and still end up not pregnant. Deep down I was convinced that one of them would work.

But here we are.

Looks like we’re going to have some tough decisions to make.

Harder, but not worse (2.0 FET #2, 3dp5dt)

I can’t find the link to the post right now, but quite some time ago Bionic wrote about a particular evening with her (then infant) son, and how becoming a mother sometimes made her life harder, but not worse.

That phrase- harder, but not worse- has stuck with me ever since.

And I’ve realized this week that it is also true of ttcing for 2.0.

It is harder to manage the trips to the clinic, harder to balance the visits with our family’s schedule, harder to figure out who can look after E., harder still on the rare days when I have to bring him with me, and I try not to make eye contact with the miserable women who don’t want to have to look at him, while at the same time I wish I could just make a big announcement to all of them that “E. came from this clinic and it took us thirty-five months to get pregnant and he is an IVF/ICSI baby and sometimes, sometimes, it really does work”.

It is harder when it is time for the PIO shots again, when doing them in the morning means my muscles are less sore, but E. freaks out at being left downstairs, or freaks out at being left in his crib, and shrieks non-stop while Q. is trying to concentrate on causing me the least amount of pain, harder when we decide to just do them at night, and the last thing we do before going to bed is the PIO shot, which is hardly the sort of intimacy a couple wants.

It is harder during the two week wait, when I am forced to realize just how often I pick up my toddler in the course of a day because I am no longer supposed to pick him up at all, harder when we are at the park and E. wants nothing more than to go on the swings, and I have to distract him because last cycle I forgot and did put him in the swing and then wrenched everything when I got him out again and now always wonder if maybe, just maybe, I screwed things up right at that moment, harder when (as has been the case this week) he is ill, and wakes in the night, and cries, and doesn’t want his father, and doesn’t understand why I can’t get him out of the crib, or why we have to call in Daddy when it is time to go to bed at night.

It is harder, so much harder, after a failed cycle because I know now, I KNOW what these embryos, these tiny balls of cells become, I know what we are missing every time a cycle fails, and I know that these embryos were once in the same petri dish as the embryo that became our son, and that hundreds upon thousands of tiny details somehow aligned in the universe so that his embryo was transferred, and his embryo stuck, and his embryo stayed with us and grew and developed, and it takes my breath away that perhaps if even one of those factors had shifted, he might not be here, no child might be here, that we might never have become parents.

It is harder sometimes.

But it is not worse.

It could never be worse.

Because at the end of the day, no matter what the result, he is still here.

2.0 FET #2, Day 16: Pregnant Until Proven Otherwise

Again.

Today was a weird day. I didn’t sleep well- I got hit with some news late last night I wasn’t expecting, which led to a huge emotional meltdown (think me sitting on the couch wailing: “I’m a GOOD mum! I just want to be a mum again! Everyone else is getting pregnant!” while Q. gave me a cuddle and quietly thought about how much he prefers his wife when she’s not on a billion medications), which led to me waking up at 5 a.m. this morning and not being able to go back to sleep.

I decided to not even try to get any serious work done this morning, so after I dropped E. off at nursery school (the drop offs are just getting better and better), I made my way very slowly down to the clinic running a bunch of errands and walking the entire time. It was a crisp, clear fall day, and I was in good spirits, and walking just felt like the right thing to do.

On the way down I chanted, over and over, under my breath: “This embryo is OUR baby.” I repeated it right up until it was transfer time. I decided this morning to go whole hog with believing this transfer will work. It’s going to be a mindfuck of crushing disappointment if it doesn’t, irrespective of whether or not I’ve tried to protect my own feelings. And if my doctor is worried that something in my body is interfering with the embryo’s best chances for implantation, I feel I owe it to this embryo to be as all embracingly positive as I possibly can be. All morning I chanted my mantra and did belly breathing if I started to tense up.

For the first time, when I got to the clinic there wasn’t a free cubicle. They were having a really busy day, so I had to sit out in the little waiting area for about twenty minutes or so before they found me a space. Once I was all set up, I sat in the chair and did some teaching prep. It was weird to be there by myself. My favourite nurse was on duty, as well as the old head nurse (who is supposed to be retired but seems to be in there every time I am), and they both know me well. I signed my instructions, confirmed I had all my medications (“You’re on practically everything!” said the nurse), and then waited.

Surprisingly, despite the really hectic day, they called my name at 1 p.m., only an hour after the scheduled time. I walked into the room, and that’s where all of my composure started to fade and my positive thoughts started to falter. It was harder than I had anticipated to be in there by myself, and I started to get a bit emotional knowing this was our last embryo. So much riding on one little ball of cells.

The head nurse and the u/s tech (both of whom also know me very well) weren’t happy about this at all, and convinced me to take an Ativan. “Honey,” said the u/s tech, “I hate having patients cry when I do the ultrasound, because crying contracts the uterus. It’s not what we want to see.” So I obligingly took the Ativan, and sure enough was a bit spacier (but much more relaxed) shortly thereafter, and then we all sat around for a bit longer to wait for my doctor to turn up.

He was having a chaotic day too. He had a med student shadowing him who didn’t inspire confidence- he kept getting in the way and shining the light in the wrong direction. My doctor had to send a text message before starting the procedure, and then his phone rang partway through and he had to get the ultrasound tech to answer it for him and take a message. Then he forgot to get me to sign the consents until after the transfer was complete.

But the important bit, the bit that mattered, was the blastocyst survived the thaw and it looked ‘good’ according to both him and my u/s tech, and the transfer to my uterus went smoothly.

I headed home soon after that, and told the embryo all about its first subway ride and its first ride on the streetcar, and then we counted the pumpkins we could see on our street. I mean, if I’m going to go crazy about this whole process, it might as well be crazy for a purpose, no?

Beta is November 4th- only 12 days to wait this time. I’ll test the morning of to make sure I don’t get blindsided like last time. And until then I’m going to do nothing but talk to the embryo, because, as I proved much to my chagrin last cycle, how I’m feeling on any given day really has nothing to do with whether or not the cycle has worked.

But still. For today, I am pregnant until proven otherwise. And if I can will that embryo into sticking, I am damn well going to try.

In dreams (2.0 FET #2, Day 15)

E. woke up last night. He went back to sleep at first, for about forty minutes, but then he woke up again and it was clear he was going to need some help to get fully settled. I went into his room, checked that his diaper hadn’t leaked, picked him up, and sat with him in the rocking chair for two minutes or so, just until he started rubbing his face with his bunny and flopping against my chest. Then I kissed him, put him back in the crib, and crawled back to bed. Given it was already 5 a.m. by that stage, I didn’t like my chances of falling asleep again, but, in the end, I did.

I had the most convoluted dream.

In the dream we were planning to go to Australia with my mother and my two sisters, and I kept freaking out because it was going to interfere with trying to have another baby, and I had to have another baby, because we didn’t want E. to be by himself, and what if something ever happened to E., how would we go on living? And then, in the dream, I felt this enormous rush of relief because I realized (as one does in dreams, where a complete shift in the dream reality seems perfectly normal) that we already had two children, that there were two little boys running around our house, not one, that we were taking both of them with us to Australia, so it didn’t matter at all- we didn’t have to try again, we didn’t have to worry, we had our family. In the dream I can remember shaking my head, bemused at my own silliness, wondering why on earth I was so concerned about this when our boys were right there.

And then I woke up. And the worst part of it, the very worst part, is it took me a moment to disentangle myself from the web the dream had woven. For a very brief moment, that second little boy seemed like a lived reality and not just a dream.

May it be so.

Transfer day tomorrow.