IVF Post-Mortem and FET Prep

Super-Secret Post
Concerning end of cycle 38 and beginning of cycle 39 (November, 2014)

Uh…. Hi. Welcome back. Again, I’ve had to reconstruct a lot of details in the present to fill in the sparse notes I have from back in November.

The debrief for our IVF cycle had two sides to it. On the one hand, our appointment was so soon afterwards that we wasted no time at all before starting a frozen embryo transfer (FET) cycle. Since I was on a medicated protocol, I needed an injection at Day -7, and the day we met with the doctor was Day -7. The cycle “between” treatment cycles wasn’t even a wasted cycle as a result. We would be squeezing in the transfer before Christmas. Yay! Something working out for once!

The other side of the coin was that the doctor told us the cause of our embryo die off… which I promptly filed in the back of my head since I was too busy being so happy about the timing having worked out!

We figured we were statistically guaranteed one embryo would make it through thawing given that we had two and they each had a 90% shot at survival.

I miscounted and thought we had exactly enough time for a frozen embryo transfer before the Christmas break with our pregnancy test likely falling on Christmas Eve. We were sent home with no instructions except to call on Day 1 of a new cycle.

Then my period didn’t come and didn’t come. I had some symptoms like my chemical pregnancies and the clinic wanted to check what was going on, so in I went for bloodwork. I was terrified because, before the shot on Day -7, we asked the doctor if it would be counterindicated if we were pregnant, and she said yes. When I got my blood drawn to check for a pregnancy, the on-call doctor said that if I were pregnant at that point, it would be too late to worry about anything.

The test was negative of course. It was a bit neat that they could tell my period would be along soon. It did focus my attention on how I really can’t read my own symptoms anymore, from a combination of lack of data to the fact that we keep screwing with my biology so I can’t even use old data sets anymore.

It came the next day, 4 days late. I called it in but after 3pm on a Saturday so didn’t get a call back until the next morning — at 8:05am on a Sunday, waking us up.

“Do you have your schedule?” the nurse asked. My work schedule? “Uh, I don’t really have a schedule.” “I mean the schedule we gave you.” “… I didn’t get any schedule from you. Any paperwork at all.” “Oh I see… The doctor gave you a shot last time. Ok. Can you get some paper and a pen?” “Sure. … Ok ready with paper and a pen.” “Ok so you know the medication you have at home?” “No. I don’t have any medication with me.” “….. Oh. Ok. We need you to get to the clinic right away. Has your husband learned how to do the intramuscular injections yet?” “No.” “Ok. Please come in this morning.”

A rushed shower, breakfast, and bus trip later we picked up the schedule and the medication but didn’t have an appointment to learn the IM shots for another couple weeks. And because of the delay of my period starting late, the schedule was shifted so that the follow-up blood test would land while we were out of province visiting family at Christmas.

Later that day I had a major breakdown unlike anything I’ve ever experienced before. I wonder now if the four day delay in starting my estrogen supplements was to blame, but I ceased being able to function, and decided I would go to the hospital in the morning if I wasn’t better. I woke up feeling like myself the next day.

[Later I learned that suicidal thoughts are indeed a reported side effect of Lupron. I need to let my doctor know in case someone cares to track these kinds of things.]

Mostly the full impact of our last result from the doctor had settled in in my mind. My eggs, previously uninspected and only evaluated through inference, were found wanting.

The working theory is that the act of stimulation and creation of so many mature follicles spread quality too thinly across a high quantity. If that’s true, then stimulating my ovaries far less (say, to prepare 2 eggs) may have better outcomes for egg quality and therefore embryo quality.

In short, when I asked the doctor if we knew enough now to reevaluate the practicality of aiming for four children, she said that I will likely need to do a round of IVF for every pregnancy.

The fact that IVF won’t act as a way to stock up on embryos has changed our entire outlook. We no longer have our parachute plan of action; we don’t have a guarantee; there’s no drastic measure I can take that will be enough for sure. If we average one baby per IVF attempt, we’ll also spend way more money than we anticipated and I’ll have to put myself through way more… and now that I’d been through an IVF cycle I knew just how much more.

Our dreams of having four children are now foolish fancy.

It had taken awhile to sink in because it had been delivered along with the good news that we’d be able to squeeze in the first FET before Christmas (which now wasn’t quite true either).

Once I’d started to internalize that, and the hopes of being able to work get to the same outcome we always wanted even with this detour were dashed, the familiar self-pity and unfairness sunk in along with it. The knowledge that others are getting pregnant by accident, or neglecting children, while loving families are left unfinished because of bad luck… I’ve never experienced anything else like it.

But for now, we had two frozen embryos to try first.

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