Friday, December 31, 2021

Fresh Embryo Transfer 1 - 15dp5dt (a day late)

Yesterday was day 15 since our transfer of a five-day-old embryo, and it was our third round of betas for this cycle. I was cautiously optimistic after the beta was 38 at 7dp5dt, then I was a bit nervous when it was 151 at 13dp5dt, meaning it was doubling every 72.34 hours (whereas the expected doubling time was 48-72 hours). My doctor brought me back 48 hours after my last blood test (that is, yesterday morning) to check how things were progressing. Before I headed to the hospital, I took a home test when I first woke up--in trying to conceive (TTC) world, that's known as first morning urine, or FMU)--and it was still positive. I promised myself I would not look at my patient portal until at least 1:30 pm, and I stuck to that.

As it turns out, my watch has a stress feature. When I checked a few times yesterday morning, I was hanging out in the medium- and high-stress zones. My watch also has a feature that will walk me through breathing exercises (inhale, hold, exhale, hold, repeat...) so I did a few of those to try to stay cool, calm, and collected. It sort of worked.

When I logged into the portal at exactly 1:30, I had an update: 272! I had already done some calculations at home to figure out what the number would be if I was still doubling every 72-ish hours, Thus, I knew the number I wanted to see was a minimum of about 240. I hopped over to Betabase to calculate the doubling time and was pleased to see we'd moved from 72.34 to 56.53 hours; that seemed promising. Until I heard from the fertility clinic, I didn't want to get too far ahead of myself. However, I felt like I could breathe a bit easier. The stress level on my watch dropped, too! How fascinating.

My nurse called at 2:13 pm, and the first thing she asked was how I was feeling. I was honest and said, "Well, I already peeked at my results, so I'm feeling pretty good." She told me that my RE still wants to keep an eye on the progress since the numbers are low. I agreed to come in on Monday for another blood draw. As I was sending out update texts later that afternoon (after Richard was awake and had heard the news), a friend said, "How many tests are they going to do before they let you relax?" which is an excellent question...but we also agreed that the frequent updates are a silver lining (at least as long as the news stays good.)

Not that there's any normalcy or standard in all of this, but a person who has a 28-day menstrual cycle would be expected to ovulate about 14 days before their next period. (Here's an article about why pinpointing the ovulation date can be confusing.) After estimating when they ovulated, people who are TTC track time in days past ovulation, or dpo. In IVF world, it seems (from reading message boards and such--I haven't read anything super scientific) that retrieval day and ovulation day are roughly the same. 

With that in mind, a person with a 28-day cycle would have missed their period (expected at 14 dpo) around 15 dpo. I've been thinking about when a person becomes "actually pregnant" and coming up short. Thus far, the day after a missed period seems reasonable. My 15dp5dt is approximately 20 dpo, so we have cleared that hurdle. Most people who are just looking for a missed period would have received a positive test by now and felt pregnant, so why not me too? I even said, "I'm pregnant" aloud to myself in the car yesterday, and it felt kind of real, kind of fake. I'm hoping that the numbers continue to increase and that I'll find myself able to celebrate and not feel like a pregnancy impostor. 

With repeated blood tests, it's difficult to settle in and enjoy the moment, but I'm doing my best. Still, it feels incredible that we have made it this far. I think the affirmations are helping! I have also been writing down five things I am grateful for each day. It's helping to get my mind right for sure. I'll be praying, keeping my fingers and toes crossed, saying my affirmations, and doing my breathing exercises until I get the next round of blood results. Join me!

Something that made today great: Good girl talk before bed :)

Time I woke up: 8:15 am

Tuesday, December 28, 2021

Fresh Embryo Transfer 1 - 13dp5dt

Welcome back! 

I left off two weeks ago, which was the day before our transfer of one embryo five days after our egg retrieval. We transferred the embryo on December 15, and everything went as expected. This time, we got our fries from Whataburger instead of McDonald's. After a good, salty breakfast, I went back to sleep and rested most of the day.

From our fourth retrieval (fourth??!), we had two eggs that were mature and fertilized, but only one was suitable for transfer. The embryologist watched the second one through day 6 but determined that it was not a candidate for freezing and testing. Although I wondered what happened to the second embryo when we went for our transfer, I didn't ask any questions and just figured it stopped growing. When my RE called the day after the transfer to let me know that the second embryo was not going to be frozen, I wasn't even sad because I had already counted it out.

With the holiday and my travel plans, my RE had me come in last Wednesday at 7dp5dt--that's seven days after the transfer of a five-day-old embryo--for bloodwork. My RE called while I was at lunch, which made me nervous because he's the one who calls when the news is bad. Sometimes, however, he calls when the news is good, too. In this case, it was the latter: my beta came back at 38. My RE seemed excited to share this news and confirmed that a beta of 38 on day 7 is better than a beta of 25 on day 10. He scheduled me to come back for another blood test when I returned from my holiday travels, so I went back this morning.

I did not take any pregnancy tests with us on our trip. After the experience with the chemical pregnancy in November, I did not want to be aware if my HCG levels started to drop. Even if the news was good, I didn't want to hyper-focus on whether or not the lines on home pregnancy tests were getting darker. I held out on taking a home test until this morning after I got back from the doctor, and the test was still positive, but I had no idea what the levels would be and had no basis for comparison.

Generally, at this point in a pregnancy, HCG should be doubling every 48 to 72 hours. Being the math nerd that I am, I had already calculated that with six days of growth, the result today should be between 152 (if doubling every 72 hours) and 304 (if doubling every 48 hours). Around 12:30, I started checking my patient portal for updates. Finally around 1:30, my results were posted: 151.35. While I waited for someone to call, I hopped right over to Betabase, a website I discovered while prowling forums about beta doubling rates, and calculated what this meant for me. The result? I'm doubling every 72.34 hours. 

While this was just outside of the 48- to 72-hour range if we're looking at four significant figures, it does round down to 72, which is normal. This was the kind of information I was simultaneously glad to have but not thrilled to know without guidance from my RE. Fortunately, I didn't have to sit with my imagination (or furiously Google things) for too long.

My nurse called at 2:22 pm. Since it was my nurse, I knew things couldn't be too bad. I thought the low numbers might send up a red flag or merit an adjustment to my medications, but she told me to keep doing what we have been doing and come back Thursday for another blood test. My nurse did admit that 151 is low, but the increase is a good sign.

I have heard pregnancy and childbirth described as liminal spaces, but I feel like I'm stuck once more in some weird transition between "pregnant" and "not pregnant." After the first beta following our FET, I ordered a book of affirmations called Conversations with my Belly by Tina Azucena. The book arrived after I already knew the fate of our embryo, but I pulled it out tonight to read through a few. Admittedly, I feel a little silly reading them aloud to myself (or sometimes to Scooter), but at this point, I'd stand on my head in my underwear in public if I thought it would help. The book has many excellent affirmations, but here are a few I like for this moment. I also appreciate that many of them are applicable to parts of life besides pregnancy.

For body:
  • I trust my body.
  • I am capable of carrying, nurturing, and sustaining the life inside me.
  • I am confident in my ability to nourish and grow my baby.
For mind:
  • In this moment, my mind is free to feel grateful.
  • I choose positive thoughts.
  • In times of uncertainty, I call myself back to balance.
For fear:
  • I let go of the need for control. I accept things as they are.
  • I give myself permission to trust my body.
  • I am confident that my body will work efficiently during this pregnancy.
For spirituality:
  • I have faith in myself and my ability to have a healthy pregnancy.
  • I choose to have faith in God and all the love that He brings to me and my baby.
  • I am grateful for the generous blessings I have received and am receiving.
As my friend Bob would say about running and racing, you've got to get your mind right. Rather than fretting and worrying for the next day and a half, I will focus on relaxing and being strong mentally. "Relaxing" might translate into "taking excessive naps," but that's okay. 

Something that made today great: A walk and [decaf] coffee treat with Ellen!

Time I woke up: 6:45 am

Tuesday, December 14, 2021

IVF Cycle 4 - Retrieval and Fertilization

The last few days have been incredibly busy, but I am finally making time for an update. Let's start with Friday.

After triggering on Wednesday night, the retrieval went as expected on Friday morning. We retrieved three eggs, which is what my RE expected. I'm unsure what happened to the other three follicles that were on the ultrasound (Were they empty? Was there an egg in there that just wasn't mature?) but Richard spoke with the RE after the retrieval, and Richard said he seemed satisfied. Pretty quickly, I decided that the other three were ones that would not have made it anyway and committed to thinking of the eggs we recruited as a "quality over quantity" matter. Funny enough, I heard someone at AFA two weeks ago say that "We were going for quality over quantity" is what many fraternities say after they did not have a good recruitment. (Who knew infertility and fraternities had so much in common?) I thought we had a pretty good shot at having three eggs fertilize, which would be excellent.

That afternoon, our nurse called to give me instructions for the medications we would be adding. SHe also let me know that someone would call on Monday to schedule the transfer if there was something to transfer. Friday night, we started the pre-transfer medications, which included four days of methylprednisolone, two estradiol tablets daily, and one progesterone in oil (PIO) shot daily. I was out of town on Saturday night and did my own shot, but otherwise, Richard has assumed the role of shot giver.

Saturday morning, the embryologist called with our fertilization update. I was asleep with my phone on silent, but they left a message to let us know that two of the three eggs had fertilized. While not the three I'd hoped for, I had also read that transfers of three embryos have lower live birth rates than transfers of three embryos, so I felt reasonably good about this news.

Monday was our next big milestone because I was going to find out if and when we would have our embryo transfer. Typically, the nurse calls with updates between 2:00 and 2:30, so I didn't worry much in the morning. To an extent, I am getting better at not worrying since these things are out of my control, but I still worry sometimes. Our nurse didn't call until 2:54, so the minutes between 2:30 and 2:54 were not particularly peaceful for me. Even knowing (and personally witnessing last week) that Monday can be a busy day at our clinic, I started to worry that we had nothing to transfer, and our doctor would be calling after 4:00 with bad news. (Our RE is the one who delivers the bad news.) When the phone rang at 2:54, I was somewhat relieved to see our clinic's name instead of our RE's name, and I was more relieved when I heard my nurse's voice on the other end...but I was still quite nervous. However, she let me know that we had one embryo to transfer and that I should show up at the clinic at 9:45 am on Wednesday with a full bladder for a transfer at 10:00 am.  


I asked our nurse if we just had one embryo, and she said, "For now," which I was unclear if that meant, "Your one could go away," or, "Your other one might catch up and be sufficient for transfer." I decided not to inquire in case it was the former--less to worry about. 

In the same way that fraternities that had a low turnout during recruitment tout the "quality over quantity" line, something said often in [in]fertility world is, "It only takes one," which is true. The question is will this be our one, and that remains to be seen...but we certainly hope so. I feel at ease about the procedure, and I am surprisingly not concerned about the fact that our embryo(s?) will be untested before the transfer. Hopefully my body will take over, and we'll have amazing news in a few weeks. That's the dream anyway!

Something that made today great: I got a few responses to my dissertation recruitment e-mails!

Wednesday, December 8, 2021

IVF Cycle 4 - Stims Day 8

A year ago, I had laparoscopic surgery to check for endometriosis. My OBGYN found and removed some endometriosis (stage 2 of 4), but what raised a red flag for him was that my ovaries weren't looking as round as expected for someone my age. With that, Richard and I took a referral to our RE, and I have since had more people, wands, and devices up in my lady bits than I would expect in a year that didn't involve getting and staying pregnant. Also, there's been quite a bit of bloodwork.

Today, we finished ovarian stimulation for our fourth IVF cycle. But before I recount the events of the day, let me back up first. Here's what a typical appointment has looked like for me at my clinic:

  1. Arrive/check in (which is a non-event because the staff recognizes us at this point)
  2. Wait in the big waiting room
  3. Have the blood draw
  4. Empty my bladder (optional/if needed)
  5. Wait in the small waiting room
  6. Have the ultrasound
  7. Wait in the small waiting room again
  8. Talk to the nurse about next steps
  9. Pay (if there is anything to pay) 
  10. Leave 

Today during step 6, we noticed that there were more follicles on the ultrasound, which I thought was good news after our conversation on Monday. Two more appeared on the right, and the one on the left was still there. That brought our total to six follicles.

Despite the fact that I just named ten steps, our appointments are generally pretty quick. Sometimes we're in and out in 20 minutes. I mentioned that Monday was not one of those times, but it turned out that today wasn't either. We waited in the small waiting room for longer than usual. In contrast to Monday, however, the office was not swarming this morning. So of course I let my brain take over, and I started to worry during step 7.

Then during step 8, our nurse told us we were going to have to have the conversation we'd talked about on Monday. I was a little puzzled by this since we were looking at more follicles today. I guess part of why we had to wait longer today was that our nurse and RE had to consult. Our RE came in shortly after we sat down in the nurse's office. To make a long story short, of the three options I described yesterday, Option 1 ("Go forward with the retrieval as planned") won.

What happens next, however, looks different. 

Our RE told us that we might want to shift our focus to trying to achieve a pregnancy rather than trying to bank more embryos. Certainly, we'd been prepared (and hoping) for a pregnancy when we did the frozen embryo transfer in October. What he offered up was proceeding with the egg retrieval but attempting a fresh transfer next week. As the name suggests, a fresh transfer is different from the past where we biopsied and froze embryos while we waited for the testing. Financially, the choice of attempting a fresh transfer makes sense: there are extra costs (over $3000--one day I will get into the finances of IVF) involved with the biopsy, cryopreservation (freezing), testing, and storage that we avoid with a fresh transfer. We still have one euploid embryo in the freezer that's frozen in time at the age of 32, I am still under the age of 35 (a big deal in [in]fertility world), and I'm not knocking it out of the park with follicles this cycle. Our RE said this is the path he would recommend but told us to take some time to think about it.

This suggestion was a bit surprising to us for a number of reasons, first and foremost that we'd literally never discussed a fresh transfer. Also, this was the same physician who told us about a month ago that we'd need to do the endometrial receptivity analysis (ERA) before attempting another transfer. Well, that specifically meant a frozen transfer, not a fresh one. (And it's entirely possible that we missed that critical F word when we talked last month.)  To keep it simple, our RE explained that my body is already doing a lot of what we were trying to achieve with the transfer medications, and my uterus and lining look great. (My RE actually said that we have a great car and just need something in the driver's seat, hahaha.) Pending bloodwork (primarily that my progesterone stayed under about 1.5), he said we could try the fresh transfer.

On November 21, I wrote, "Looking at the calendar, that meant that another actual transfer before the end of the year was not in the cards." I think God is probably laughing right now. While another frozen embryo transfer before the end of the year was not in the cards, we unexpectedly have the option of a fresh transfer. This is just another instance of something I didn't think of as an option becoming our reality; I have had at least one of these in every cycle but the second one.

Our nurse called back this afternoon to confirm that we could go ahead with the retrieval on Friday. Specifically, I would need to administer the trigger shot at 9:30 tonight for a retrieval on Friday morning at 9:30. Something different about this cycle is that we did our evening stim shots instead of discontinuing after the morning shot. I think it's because my biggest follicle is currently a 20, compared to 25+ in other cycles on the day of the trigger shot.

Looking to the retrieval, the quantitative researcher/data analyst in me wanted to detect a pattern. I took a look at my handy spreadsheet of IVF cycles and saw that we had a monitoring appointment on day 8 during our third IVF cycle. As it turns out, the six follicles I have right now look a lot like the middle six follicles I had in the third cycle. In that cycle, we retrieved seven eggs, and six were mature and fertilized. Although every cycle is different and I'm only comparing with one other cycle, this piece of information made the situation seem less bleak. What we need next is to have a higher (or at least the same) blastocyst rate than our third cycle.

So, the next few weeks are filled with possibility and lots of steps. Here are a few things we're hoping for now:

  1. That the follicles I have stick around and and are retrieved on Friday
  2. That the retrieved eggs are mature 
  3. That the mature eggs fertilize after the retrieval
  4. That the embryos make it to day 5
  5. That the transfer goes smoothly
  6. That something sticks
  7. That I have a healthy pregnancy with a live birth

As always, please join us in hoping and praying for the best possible outcomes. 

Something that made today great: More follicles + confirmation of the egg retrieval

Time I woke up: 7:00 am

Tuesday, December 7, 2021

IVF Cycle 4 - Stims Day 7

Richard and I returned to our RE's office for bloodwork and an ultrasound yesterday. This was our first check since the ultrasound we had on November 26, and we were on day 6 of stims. I think it's been a while since we had a Monday appointment, but the clinic was swarming! I guess everyone had some sort of appointment after not going in over the weekend. Our RE saw us instead of our regular ultrasound tech or the physician's assistant. Rather than watching the ultrasound screen, I chatted with my doctor about the podcasts I listened to while driving back from Dallas this weekend. He reported that although my right ovary had three follicles growing--a 12, a 14, and 16--there was not much going on with my left ovary. 

When we talked with the nurse, she wanted to get a pulse on how we might want to proceed if there were still only three follicles when we returned for our next visit, which she expected to be Wednesday. If we didn't see any new growth, the three options would be:

  1. Go forward with the retrieval as planned
  2. Convert the cycle to IUI
  3. Cancel the cycle completely
The idea of this conversation was not to blindside us if we weren't seeing more follicles at our next appointment and needed to consider options 2 and 3, which is considerate of our care team...but it still didn't feel good. I learned from thinking through this that my arbitrary number of follicles where I feel comfortable is apparently four. We retrieved four in our first cycle and managed to have one blastocyst. Even though that one turned out to be highly aneuploid, it could have been four seemed significantly better than three in my head. (This is all disregarding the third cycle where we retrieved seven, had six mature/fertilized, and still only ended up with one blastocyst that was, again, highly aneuploid.) 

After three failed IUIs this summer and years of trying to conceive without intervention, Richard and I were not thrilled about option 2 or 3. While doing an egg retrieval requires anesthesia and higher costs than IUI, we have already sunk so much money into medications and monitoring for this cycle that option 1 seemed like the best choice. Knowing that our numbers will always be low, it seems like a waste to stop at this point.

When my results were uploaded to my patient portal yesterday afternoon, there was one little 9 mm follicle listed on the left. I'm not sure if someone else took a look at the ultrasound and decided to count that one or what. So, that put us at four follicles, which somehow feels like it comes with much better odds than three follicles. Four is still low.

Needless to say, yesterday's appointment was yet another reminder that our follicle counts will probably always be low, and we will continue to need to have these difficult conversations and make expensive decisions. In the infertility world, a phrase that gets tossed around a lot is, "It only takes one," and it's seeming more and more like we need to set our sights on one euploid embryo per cycle. This is a strange place to be because some people retrieve so many more eggs than that, but others do not respond to it's all a bit of a crapshoot.

Somewhat surprisingly, I'm doing well with this latest batch of news. A friend sent me a devotion about trusting God the other day, and it made me feel totally seen.
Trusting God can feel hard when our life doesn't look anything like we thought it would.

But can you imagine how much less anxiety, fear, angst, and heartbreak we would have if we truly trusted Him?

I don't mean just saying we trust God because it's the Christian thing to say. I don’t mean just singing words of trusting God because it’s in the praise song. I mean having a marked moment. A real live moment we can point to and remind ourselves that we declared we will trust God with this suffering. With this disappointment. With this situation. 

Okay, ouch. Talk about getting called out...but also it's all fair and true. I think I might've finally had that marked moment of shedding some of the anxiety and heartbreak because I didn't cry yesterday, and I didn't worry (too much) while I waited on my results and the nurse's afternoon phone call. 

When the nurse called, she told me to continue our same medication protocol and return to the office on Wednesday. Richard believes my left ovary will rally before tomorrow morning, and I'm doing my best to mimic his hope and enthusiasm. As long as we have the same or more follicles tomorrow, I suppose we'll be looking at an egg retrieval in the next few days...but I will update about that tomorrow when we know more. Join us in hoping for more follicles tomorrow and a smooth retrieval later this week.

Something that made today great: The Junior League holiday social was fun!

Time I woke up: 8:40 am

Sunday, November 28, 2021

IVF Cycle 4 - The Beginning

 It's almost been a month since I had the bloodwork appointment where I was a little pregnant. In most ways, the month has flown by--on top of my regular work and school routine, other things such as travel for conferences, the LSU/Arkansas football game, travel for fun, and Thanksgiving have kept me busy. What I haven't been doing is going to any of the races I signed up for in November. I've also decided I am done drinking alcohol for a while, which hasn't been a huge change in my day-to-day routine but has been surprising for some people in social situations. However, as many of my friends will attest, I love a good mocktail as much as I love a cocktail.

Despite staying busy, I haven't been quite able to shake the grief that's followed the chemical pregnancy from our first frozen embryo transfer. I know these things take time, and I also know that I'll never be exactly the same after experiencing this loss (and the [in]fertility journey more broadly). It seems like I get a little closer to normal every day, but some days are definitely tougher than others. As evidence that I can still smile and have fun, here are a few photos from The Office Experience that Brooke and I went to in Chicago. (If you're a fan of The Office and are going to be in Chicago between now and January 17, go check out the experience! We loved it.)

Brooke and me in Michael's office

Enjoying the Finer Things Club--I'm smiling under the mask

I was supposed to go back to the doctor on November 19 to prepare for our fourth IVF cycle, but when I looked forward in my calendar, I realized I was going to be out of town for the Association of Fraternity and Sorority Advisors Annual Meeting during the late stims/possible retrieval portion of the cycle. I want to attend the annual meeting for a number of reasons, including hopefully promoting my dissertation study, but I also didn't want to lose a month. Fortunately, when I realized this was going to be an issue, I called my nurse and got approval from my doctor to stay on the Nuvaring for an extra week. With everything pushed back a week, I went back for an ultrasound and bloodwork on November 26. Everything looked as expected, so we start Lupron injections tomorrow at 5 am. Full stims will start on Wednesday.  

I'm approaching this next cycle with a mix of emotions. Our doctor told us when we first started seeing him that we might not hit the right cycle (I forget his exact words) on the first try. The second cycle was the best by far (two euploid embryos as opposed to zero), and I'm hoping we will see similar (or better!) results from this time around. I remain grateful that this is something we are able to attempt multiple times, but I also can't help but wonder why Richard and I--or anyone else for that matter--would have to endure such a long and difficult road to (hopefully, but still not guaranteed) biological parenthood. I probably won't understand on this side of Heaven. We will continue doing everything we can and then hoping for the best. Please remember us as we embark on our fourth round of ovarian stimulation and (hopefully) egg retrieval. 

Something that made today great: Video chatting with Ashley, Emma, and [briefly] Brittany
Time I woke up: 11:45 am

Friday, November 12, 2021

FET Cycle 1 Wrapup

It's been two weeks since my last update, so I guess it's time for another one.

When I left off, I'd just gotten the news that my first beta result was 25, which was a gray area, or "a little pregnant." This was not the news we'd hoped for, and despite wanting to not stress out all weekend, I stressed out all weekend. On Friday night, I took a home pregnancy test for the experience of seeing what a "little pregnant" test looked like. Something just felt wrong all weekend. I met my friend Megan for late lunch/early dinner on Sunday afternoon, and I could barely eat. On Sunday night, I decided to try another test, and the second line on the test--the one that separates the "pregnant" from the "not pregnant"-- was all but gone. In two short days, our pregnancy faded away. The test from Sunday is still sitting on my bathroom counter with the second line barely there; it is simultaneously a reminder that I was once pregnant and a reminder that I'm not pregnant anymore. I probably need to throw it away.

After consulting with another friend who's had a failed transfer, I decided to message my nurse and ask if I could come in for bloodwork on Monday instead of Tuesday to save myself the waiting and the progesterone shots I would have needed if the pregnancy has been viable. This is probably a bit dramatic, but I felt like I was on a death march. My nurse responded early on Monday morning, and I went in at 9:00 for the bloodwork. 

The nurse called Monday afternoon to let us know that my HCG had dropped to 5, which is considered negative. She told me I could discontinue the medications I was on and wait for my period to start. Looking to the future, she said that before we attempted another transfer, my doctor wanted to do an Endometrial Receptivity Analysis, or ERA. There's more information on this website, but to put it simply, I will do a mock transfer cycle (complete with the meds and shots) but not actually transfer an embryo. Instead, they'll take a sample from my endometrium (uterine lining) to see if we actually timed the transfer correctly, if I need more days of progesterone, or if I need fewer days of progesterone. Looking at the calendar, that meant that another actual transfer before the end of the year was not in the cards.

For those keeping count at home, though, the other issue is our number of euploid (normal) embryos: we're down to one. Regardless of when we do the ERA, we knew we'd have to make a decision about whether to go for another retrieval or try to transfer the second embryo. This was something we wanted to discuss with our doctor, but we also wanted to take some time to process what had just happened and what was about to happen. We called back on Wednesday and scheduled a time to talk with our doctor on Friday.

Meanwhile, I had to decide whether I wanted to cancel my plans to attend the Association for the Study of Higher Education (ASHE) conference in San Juan, Puerto Rico. I wanted to go, but I was nervous about what would come next. Ultimately, Richard agreed to travel with me, so I canceled my flight, booked a new one for both of us, and scheduled Scooter for boarding. I also made the decision to go ahead and tell my supervisors what was going on. Truthfully, I'd been minimally productive at work since Friday afternoon's news--I completely threw in the towel and took Monday afternoon as personal time--but my supervisors were supportive and encouraged me to do whatever I felt I needed. I tried (with mixed results) to do what was critical and put everything else on hold.

After I learned that I was going to miscarry, I thought a lot about what that would be like in an unfamiliar place compared to in my own home. I pictured myself bleeding and sobbing while I wondered if the baby had come out yet. Regardless of where it happened, I realized it was going to be rough. Even the fact that I could prepare for the moment felt strange. I've reflected a bit, and I think it was better to know what was coming than to be caught off guard. I worried that it would be painful, too. It was like a different version of the same death march I had been on, but at least there was an end in sight. 

I started bleeding on Thursday. While I found myself wondering if I'd just flushed what could have been our child down the toilet, I never cried. It was slightly more painful than my regular periods, but I managed the pain with over-the-counter meds. I was oddly at peace, and I truly think it helped that so many people have been praying for us. I also appreciated the change of scenery and the fact that Richard was there with me.

We talked with our RE on Friday morning about next steps and determined that we would go for a fourth retrieval before attempting another transfer. Despite everything we've been thrown this year, Richard and I are still hopeful that we will be able to have children using my eggs and his sperm. Our doctor had several anecdotes about couples going through IVF and then getting pregnant naturally, which is a lovely thought but one that feels completely out of reach at this point in our process. With our desire for multiple children and only one normal embryo in the freezer, another retrieval seemed to make the most sense. I'm not getting any younger. So, we're at the beginning of IVF cycle 4.

Coming home from the conference was a bit of a challenge. I have felt very left behind as we continue down this road. I'm also learning that I feel the best when I am totally distracted. I want to think about conferences, work, and anything but [in]fertility. I don't have the energy or emotional bandwidth to work at the level I would like, but I've mostly been working until I'm tired enough for bed. This is effective for me in most ways, but I also realize that there is now a volatile can of emotions just waiting in the wings to explode. Below is a picture of me presenting some of my dissertation research (as research-in-progress) at a [different] conference this week. I think I look happy and proud. I love my dress, and my hair and makeup were on point too, despite the number that the New Orleans humidity did on my curls. But when I zoom in on my face, I see how tired I look and how much hurt is in my eyes. I have tried to bury this immense grief because I can't shake it off. The best I can do is suppress it.

Despite my sadness, there are several positive things that I can say about all of this. The failed embryo transfer and chemical pregnancy have absolutely affirmed the strength of my marriage and the dreaminess of my husband. The years of trying have been difficult, but this year especially so. Richard assures me that he's going to love me no matter what, and we're going to get through this. Even if I already knew all of that, it's good to hear again. Similarly, I have felt lots of love and support from friends and family in the form of Facebook messages, Facebook comments, text messages, and calls from family and friends. There are so many people who have offered sympathetic thoughts and words of encouragement while I've been down in the dumps. I'll also give myself a little bit of credit and state that even though I don't feel fully like myself, I'm pretty darn strong, tough, and resilient...and that's pretty cool. 

So, time marches on, and we're moving forward with it. I picked up a Nuvaring from a CVS in San Juan last Friday, and our fertility medications will deliver on Tuesday. I return to the RE on Friday for an ultrasound and bloodwork, and I think we'll get our calendar for this cycle at that appointment. I never thought I'd be a repeat IVF-er, but my hopes are high for the upcoming cycle. Please remember us as we prepare for whatever is next.

Something that made today great: I had a lovely dinner out with family tonight. 
Time I woke up: 9:00 am

Friday, October 29, 2021

FET Cycle 1 - Update 6 (10dp5dt, Beta 1 Day)

 Right after my transfer, I posted on social media that I was Pregnant Until Proven Otherwise, or PUPO. Today, beta day, was the day I could drop the UPO and confirm pregnancy. As I have said repeatedly, nothing—especially a live birth—is ever guaranteed with IVF, but today’s beta test was the next step along the journey.

I was a few minutes late for my 9:15 blood draw, but there was nobody else in the waiting room. I was called back shortly after I sat down. The draw was quick, and they told me they would call with results in a few hours. The clinic closes at noon on Friday, so I figured I would not have long to wait. I watched the clock and was not very focused on my work. At 12:14 pm, my doctor called. He asked if it was a good time to talk, and I told him I needed to go wake Richard. When Richard was ready, our doctor told us that my beta was 25, which is a gray area. It’s lower than desired at this point, but I am technically pregnant. I tried to put a positive spin on the situation by saying, “Well I’m more pregnant than I’ve ever been,” which my doctor agreed was true. The next test (because of course there’s a next test) is to see if my beta is at increasing. So, I go back on Tuesday (14dp5dt) at 7:45 am to see what the situation is. The expectation is that the beta should double every 48 to 72 hours, which would mean I hope to be in the 60-100 range by the next test. Sometimes it takes babies a little longer to get going, which I totally understand as someone who’s not an early riser and is tough to get going. (For those who are wondering, when the issue isn’t just being slow to grow and the levels fail to rise, this becomes what is known as a chemical pregnancy—this article covers the topic. I’m not ready to discuss this possibility.) In the meantime, we hope, pray, rest, and try to be happy.

Upon receiving this news, I had two reactions at the same time. As I reflected on them later, I had to laugh at how graduate learning has molded my way of thinking but hasn’t made me completely stop flying off the handle when I initially receive disappointing news.

Reaction 1 (the more dramatic one – skip over this one if you’re not one for colorful language):

Everything I ever learned in the public school system about pregnancy was fucking bullshit. It’s not as simple as “pregnant” or “not pregnant.” How the hell can a sperm can fertilize an egg, and a person could still not be pregnant? Fuck the entire system and all of the structures that fail to educate people about how to take control of their fertility and just tries to scare people out of having sex. I hate everything.

Reaction 2 (the one I’m prouder of):

The more I learn, the more I realize how much I don’t know. I can learn a lot from this experience. How can we more adequately define pregnancy (or are we already doing the best we can)? I thought this would be a simple “pregnant” or “not pregnant” situation, but it’s more of a dimmer switch than a light switch you flip on or off…and it’s looking pretty dim right now. I was never guaranteed a viable pregnancy, and I will not be guaranteed a viable pregnancy even if the beta does increase, so really I would have been waiting for the next thing—whatever that was—regardless.

Truthfully, I knew in my heart that being PUPO really meant being a little pregnant. I had lunch with some friends last Sunday and opted for a mocktail with my meal since I was PUPO. I explained to them that the sperm had fertilized the egg, and the embryo was in my uterus, but we were waiting and hoping it would implant and grow. Saying that aloud and typing it just now does truly feel ridiculous. In a poll, even of educated people, I think most people would agree when the sperm and egg meet and are in the uterus, a person is pregnant. There’s so much we take for granted and expect bodies to do when in fact, it’s difficult for some bodies.

The good news in all of this is that we now know I am capable of becoming pregnant. I have wanted this and hoped and prayed for it for years. Another thing I’ve learned from (a) graduate school and (b) working in positions where I had to hold young people accountable is that you have to ask the questions you’re actually trying to get an answer to. As I’ve asked and dreamed of being pregnant, I didn’t specify how pregnant I hoped to be. I have learned to pray for a viable pregnancy ending with a live birth, but I never said anything about betas. So really, I got what I asked for. In the future, I’ll ask for high betas.

I’ve been jamming to Tom Petty and James Taylor tonight, and Tom Petty says in “The Waiting” that the waiting is the hardest part. I’m not sure that’s exactly true, but it’s definitely a part. Please remember us and pray for us through this next chunk of waiting time.

Something that made today great: The higher education student association had a mix and mingle on Zoom today that was pretty fun!

Time I woke up: 8:15 am

Wednesday, October 27, 2021

FET Cycle 1 - Update 5 (8dp5dt)

Oops, I definitely didn't realize that two weeks had passed since my last update. I am now 8 days past a transfer of one thawed 5-day embryo (with transfer day being day 0), which is referred to in the lingo as "8dp5dt."

Since my last post, we started the PIO shots. Overall, they are going well! We have received several tips that have made the process a little better for us (at least I think they have--we didn't have a control for this experiment). Warming the oil (either in a cup of warm water or in our armpits) helps thin the oil a bit, and going for a walk or easy run after has been helpful for my muscles. Admittedly, I have gone back to sleep more days than I have gotten up and moved. I definitely notice the difference when I don't's that way with other parts of my body and exercise, too. 

For comparison, I included a photograph of the needle Richard uses to inject the PIO compared to the one we use to inject Lupron. Since starting down this road, I have learned that a larger needle gauge means a smaller hole in the needle. Whereas the Lupron syringe (also commonly known as an insulin syringe) is a 31 gauge, the PIO needle is a 22 gauge. I think the Lupron needle is 5/8" long, compared to 1.5" for the PIO. Fortunately, the worst part is piercing the skin with the needle. The actual injection is not bad, and I eat a piece of chocolate every day when it's done, which is good. What might present a new challenge will be if I am actually pregnant, as I am traveling to a conference next week and will have to do my own injections or find a conference buddy and get really close with them really fast...but we aren't there yet.

Photograph of two syringes (one larger than the other with a longer needle) and two bottles of progesterone (one empty and one half full) on a black bathroom counter
A comparison of needles: PIO vs Lupron

Other than PIO injections, I had my last lab visit on Monday, October 18, and then Tuesday, October 19 was the transfer date. (Yay!) There is a risk (of course there is, there's always a risk) that something could go wrong in the thawing process, but our embryo thawed exactly as expected. Our doctor even called it "gorgeous" and gave us a picture as proof. While "gorgeous" is a different term from the "beautiful" word that I resist, it still makes me nervous to put much stock in those sorts of comments. Richard and I were not sure if the embryo looked more like him or me, but our doctor said the comparison is difficult to make unless we have photos of ourselves five days after the sperm met the egg, and technology has changed considerably since the 1980's. I guess time will tell. 

Although I'd talked with a few people who have been through the FET process, I was still a little unsure of what to expect. It was a short process and was not painful, but it shares many uncomfortable characteristics with a pap smear, including a hospital gown, stirrups, and a speculum. (But as a bonus, I got a warm blanket for this one!) Something different about this procedure is that Richard was able to be in the room with me. I think his presence helped keep me calm. Also different was that it felt a little like being on a medical or scientific TV show. The embryologist entered the room and asked me to confirm my name, date of birth, and what I was there for. (I got all three correct.) Then, a few moments later, she returned and said, "One embryo for Davis," and passed it to the doctor. I didn't get a good look at the container, and I kind of regret not paying better attention. Richard was able to watch on the ultrasound screen while the doctor inserted the catheter and put the embryo in. I didn't really know what I was looking at, so I looked at the ceiling more than the screen. In total, the procedure only lasted a few minutes. A moment after we finished, the embryologist returned and stated "all clear." In other words, the catheter was empty--no embryo left behind. Our doctor was satisfied with the transfer and said it went exactly as it should have. That was good news!

After the transfer, we went to McDonald's to pick up lunch and lots of fries, because it's IVF community folklore that they're supposed to bring good luck after the transfer. (Richard and Scooter ate fries as well for good measure.) I rested all day after that and made sure to keep my feet warm (more IVF folklore). I continued to take it mostly easy for the rest of the week. Richard was off all week, so we enjoyed having down time at home together.

Over the last few days, the waiting has gotten more difficult. I've increased my napping frequency once more, which could be a sign of pregnancy or could be a sign of estradiol and progesterone. Friday (10/29) is the day I go to my doctor and have a blood test for pregnancy. The test is referred to as the Beta, short for beta human chorionic gonadotropin (HCG). HCG is known as the pregnancy hormone because blood or urine tests measuring HCG levels can confirm pregnancy. The over the counter/at home pregnancy tests check HCG levels in the urine.

On Sunday night, my mom asked me, "Why do you have to go to the doctor for a pregnancy test? Can't you just take a test at home?" Those are interesting questions indeed. The short answer is that while urine pregnancy tests are 97-99% accurate, blood pregnancy tests are more like 99% accurate. A risk of a false result on an at-home test could be worrisome or devastating for many reasons. With a false negative urine test and a positive blood test, I could be thinking the FET failed when it didn't. With a false positive urine test and a negative blood test, I could be getting my hopes up about a failed transfer. People make different decisions about whether to test at home, and the choice is highly personal. Regardless of testing choice, the wait until the beta doesn't go away. 

My beta is Friday morning, so I am about a day and a half from the test and a little longer than that before we have results. I'm hoping that Thursday isn't too agonizing with the waiting. I have a few things scheduled that will keep me busy.

Something that made today great: I video chatted with Ashley and Emma and laughed about all kinds of silly stuff!

Time I woke up: 8:30 am

Wednesday, October 13, 2021

FET Cycle 1 - Update 4

Okay, we're gaining momentum! Richard and I went for our last ultrasound today, and my RE said things looked beautiful. I kind of resist using that word for anything fertility related after our beautiful embryo from the third retrieval turned out to be highly aneuploid, but at the same time, I know my doctor meant it in a positive way. My ovaries are chilling out (which is what we want before a transfer), and my endometrial thickness was 10. Research has suggested (this article cites 5 studies) that pregnancy and live birth rates are significantly higher when endometrial thickness is is greater than 9-10 mm, so I'm where I need to be.

After our ultrasound, our nurse gave us a small packet of instructions for before the transfer, after the transfer, and the PIO shots. She also told us the time for the transfer: October 19 at 10:30 am! Tomorrow's PIO shot has to be at exactly 10:30 am (something about lining up with the transfer time), but the other days can be whenever I want them. I'm happy to be able to work from home for the first one. I've been advised to go for a brisk walk to work my glutes after the shot, but I'm going to do it big tomorrow: Ellen is coming over for a pre-lunch run.

Toward the end of last week, I heard from a connection I met through an infertility group that her transfer was canceled because her endometrial lining was not where it needed to be for a transfer. After that, I was worried that we might not get to move forward on October 19 as scheduled. Thus, I was relieved to get the green light today. I was also surprised by how different I felt leaving our appointment knowing that my next visit would be the day before the transfer. It all feels really real, but in a good/exciting way.

A bright spot since my last update is that my body seems to have grown accustomed to the estradiol, and I have not had to take any naps in four days. I love naps, but it's nice to not need a nap to feel functional. I'm sure I'll take a nap or two this weekend.

Something that made today great: Getting our transfer time and instructions was pretty great!

Time I woke up: 6:45 am

Saturday, October 9, 2021

FET Cycle 1 - Update 3

We went back to the doctor yesterday, and things seem to be proceeding as expected. I started taking estradiol on October 1 (which was actually very early on October 2 thanks to pharmacy mishaps and airline delays!), and that has been mostly fine. I was notably more tired this week than I have been lately, but I traveled and ran the Oklahoma City Memorial Marathon last weekend, so I can't fully blame the medicine. As scheduled, we upped my estradiol from two tablets daily to three, and we added estradiol patches yesterday. We're not quite 24 hours into the patches, but so far they're a non-issue. All normal life stuff (showering, taking a bath, swimming, exercising) is okay with these, which definitely makes things easier. After 72 hours, I'll take these off and put two more on the other side of my belly...and repeat every 72 hours until further notice. I guess we'll see this week if the estrogen is to blame for my tiredness this week or if I've just been trying to do too much.

I have talked a lot about injections, but I don't think I have ever said much about the oral medications/supplements I take for fertility purposes. Some I've been on for a while, others I started when we started seeing our RE. So, here's a short list of what goes into my body every day.
  • Prenatal vitamin - started over-the-counter prenatals in late 2017/early 2018 and switched to a prescription prenatal in April 2019. I don't know that the prescription makes a difference.
  • Folic acid - 2 mg (1 mg 2x/day) - started this in April 2019
  • DHEA - 25 mg - started this in February 2021 when we started working with our RE
  • CoQ10 - 200 mg - started this in February 2021 when we started working with our RE
  • Vitamin D3 - 2000 IU - started this in February 2021 when we started working with our RE. I take the fruity gummy ones--this is my favorite part of the daily routine. 🙂
  • Baby aspirin - 81 mg - started this last Friday for FET prep, though I also took these during the second retrieval cycle
  • Estrace - 6 mg (2 mg 3x/day) - started this last Friday for FET prep. 
We're also still doing 5 units of Lupron once by injection; it's not yet time for the progesterone in oil (PIO). 

There's a lot of preparation involved in a process that offers no guarantees, but we're plugging along and hoping for the best. Someone I know from an infertility group just had their cycle canceled this week a few days before their scheduled transfer due to issues with the uterine lining, and that was a wake-up call that even this far in, things can still deviate from the plan. With only two precious euploid embryos, we definitely wouldn't want to move forward if conditions were not right. Still, we've been through so much this year (and in the previous years) that it would be devastating to have to abandon the mission and wait to try again. So, we hope and pray that my body responds to the medicines as expected.

We'll go back to our RE on Wednesday, and that is our last scheduled ultrasound before the transfer. I'll have labs on the 18th before the transfer on the 19th. I'm doing my best to keep calm, but I don't think it's possible to be completely at peace at this point.

Something that made today great: I usually write these at night...but so far today, it'd be sleeping as late as I wanted.

Time I woke up: 8:28 am initially, but I went back to sleep for a few hours after playing on my phone for a bit.

Thursday, September 30, 2021

FET Cycle 1 - Update 2

With just a few minutes left in September, we are now eagerly looking to October. It's Richard's birth month, but it's also (hopefully) our FET month! It's been a bit since I have made one of these boards, so I'm a little rusty. But...

Letter board that reads "Hooray, we have a transfer day! October 19"

At our appointment today, we got a new calendar complete with an anticipated transfer date of October 19 and a schedule of medicines (and medicine changes) to follow until pregnancy test day on October 29. I fell into the birth control/Lupron lull and forgot to stop taking birth control last Thursday, so I had two extra days of birth control. Fortunately, things still look fine, and I am going to pay closer attention to this schedule. Starting tomorrow, I'll be decreasing my Lupron from 10 units to 5 units daily and adding estrogen and baby aspirin to the regimen. I'm still two weeks out from the infamous progesterone in oil shots, but I'm currently so excited to be approaching a transfer that I'm not worried about big needles or thick oil going into my rump. 

Photo of medication schedule for Frozen Embryo Transfer

As much as I have worried and wondered about IVF in general, I really hadn't thought about the steps leading up to a transfer. It's definitely more complicated and lengthy than I anticipated, but if it gives us a better chance of a pregnancy and live birth, I'm all for any process. I have plenty to keep me busy over the next few weeks, so October 19 will likely be here before I know it! We also have two more appointments on October 8 and 13 for bloodwork and an ultrasound, so that will break up the waiting. Our focus will be following the schedule between visits and hoping that my reproductive system keeps looking the way it's expected to.


Here are some outtakes from making my letter board. When I lived in Natchitoches, Papa's Bar and Grill sold their Big C burgers for $4 on Tuesdays. One night, I went with some of my co-workers, and Susan convinced Mary Bess to order some 1 lb burger. Mary Bess agreed, though I don't think she ate the burger in one sitting. I completely forgot about it until I couldn't find my big "C" letters, so that was a fun memory. I then found not one but two big "C"s on my other letter board. 

Something that made today great: Taco Thursday/lunch catch up with Jennie today!

Time I woke up: 6:40 am

Thursday, September 16, 2021

FET Cycle 1 - Update 1

Well, it's been a bit!

I last posted after our first intrauterine insemination (IUI). IUIs have about a 15% success rate, and my RE was willing to try up to three of those. All three failed, which was not surprising but was a bummer. September is a tough month to not get pregnant because it means I won't have a baby before my next birthday (assuming a full-term pregnancy), but it was easier this year than the last few. If not when I'm 30, 31, 32, or 33, maybe 34...maybe.

After the third IUI failed, we talked with our doctor last Tuesday (9/7) about what was necessary to move forward with a frozen embryo transfer, or FET. We're now on our way!

As with my retrieval cycles, the first step in preparing for the FET was to take birth control. So, I started that last Tuesday. Since we are working with a limited number of precious euploid embryos--two to be exact--we want to take plenty of precautions to hopefully have a pregnancy that results in a live birth. Last December, I had laparoscopic surgery to check for endometriosis (and remove it once it was found). When we first met our RE in January, he explained that the laparoscopic surgery would buy us about six months before we would have to worry about the endometriosis returning. For those keeping score at home, it's been nine months since the surgery, so my RE wanted to check out my uterus for a status update before we went for a transfer. To do that, he recommended a saline infusion sonohysterogram, which is a fancy way of saying that he would inject some saline into my uterus and then look at it on the ultrasound to make sure everything was good. We did that this morning, and I rolled into the clinic in my traditional "This is terrible. Keep going" T-shirt and my good luck/friendship/happiness charms that I bring to almost every appointment: a friendship token from KT and a little squirrel from Cate. I held tightly onto them during the procedure. I have not had many issues with pain during the various procedures over the last few years, but this one was definitely the most uncomfortable of anything I have done so far. Not painful, but definitely uncomfortable. Fortunately, my reproductive system looked "very normal" according to my RE, so we are moving forward.

Tomorrow, my medications will arrive, and we'll be back to injections of Lupron. This is a different kind of Lupron from what I have had before, and we'll do it twice a day for two weeks. I'll discontinue the birth control pills next Thursday, and the Thursday after that, I'll go for an ultrasound and labs. Eventually, I'll start injections of progesterone in oil, or PIO, which is famous for being thick and requiring a large Pile it on top with the other medications, supplements, and procedures. Ha. 

Preparing for the FET is exciting, but I do feel more pressure than I did with the IUIs. If the first FET does not take, we will have to pause and decide if we want to try for another retrieval (or retrievals) or transfer the second one quickly. If the first one fails but the second one works, we would be out of euploid embryos, and I would be older. For now, however, I am doing my best to not think about that. Right now, we're going to give the first FET our best shot (no pun intended). 

I'll probably be mostly quiet between now and our next appointment on the 30th, as there will not be much to update.

Something that made today great: I had a dissertation homework party with Catherine and Diana, and it was so nice to catch up! (And we got our homework done!)

Time I woke up: 7:00 am

Friday, July 23, 2021

July and IUI

In fall 2005, my friend Ashley was dating a college boy, and she was able to get access to high school Facebook—yes, that was a thing—pretty soon after it came out. At that time, high school Facebook users could invite some allotted number of friends to join as well, then those friends could invite friends, and so on. Since that time, I have been a loyal and heavy Facebook user…until June 14.

I knew I spent way too much time on social media, especially Facebook. I’d made efforts in the past to reduce my Facebook consumption, but I always ended up reinstalling the app on my phone and getting right back where I started. Under the weight of our latest batch of bad news in June, however, I was completely crushed and needed to step away. So I did.

And I liked it.

Here are some things I did in my social media absence:

  • Went to Mexico for six days with Richard
  • Turned 33
  • Ate an enormous steak for my birthday
  • Visited my mom and sister
  • Reunited with my best friend group from high school, the BAKErs
  • Kept up with my running…sort of
  • Started a new job that is a-mazing!
  • Kicked off the new Junior League year and started my role as Chair-Elect for the Diaper Bank Committee
  • Lots of academic stuff – made good progress on my dissertation, worked on some manuscripts, and submitted several conference proposals
  • Read two non-academic (and actually kind of trashy) books

Here are some things I did not do:

  • Get pregnant. Well, maybe.

It’s possible that I got pregnant yesterday or today, but there’s no way to know just yet.

In a previous post, I mentioned that our RE suggested trying intrauterine insemination (IUI) before attempting to transfer one of our euploid embryos from the freezer. We jumped straight into that in June, and it failed. IUI has about a 15% success rate (this page from our fertility clinic estimates 10-15%, but some research suggests the success rate could be as high as 20% ). We’re trying again this month, and my RE will do up to three before moving on to transferring a frozen embryo. (One study found that 88% of pregnancies from IUI happen within three cycles, and 95.5% happen within four cycles.) If we don’t have success after three, I might beg for a fourth, but (a) I’m not sure my RE would agree, and (b) I might not want a fourth after three failed cycles. Of course, a better scenario is that we have success within three cycles and don’t have to cross that bridge (or even come to it).

Compared to IVF, IUI is almost a non-event. I take 100 mg of Clomid for five days, get a few ultrasounds and a little bloodwork, and when the follicles look good and ready, I do a trigger shot. For both cycles, I have had two good looking follicles in my left ovary (21 and 22 mm last time, 18 and 24 mm this time). Then, 35 hours later, Richard does his semen sample. The lab pulls out the best sperm (the ones wearing tuxedos), and an hour after that, what’s left is placed into my uterus using a catheter. The process is about as [un]comfortable as a pap smear and only takes a minute or two.

Within 24 hours of the procedure, Richard and I make whoopee without a catheter for good measure. (I chose that euphemism for sex from this list of historical euphemisms partially because it’s funny and partially because Macon—the city where I went to college—once had a hockey team called the Macon Whoopee.) Starting the night of the day after the procedure (that’s a mouthful) and every day until I get my period (which I of course hope I won’t), I have the delightful experience of inserting a progesterone suppository to help my uterine lining be all ready to receive an embryo. All in all, though, it’s pretty painless. Some aspects—I’ll let you guess which ones—are in fact the opposite of painful.

I don’t have anything particularly profound to say about my time away from social media. I think some people step away from social media and realize how much they were living through others or that they were not really living because they’re stuck on a screen. In my case, it’s not as if I was missing out on real-life experiences because I was spending so much time on Facebook. I lead a busy life, so I did not suddenly find myself with an abundance of time to fill.  

What I was missing, however, was the time to process and decompress. I thought I was processing as I was sharing our story—and I think in some ways I was—but I never let my brain stop working. I found that it was healthy for me to not know any time someone else got pregnant and not inundate myself with infertility-related content.

I have a lot of mixed feelings about the best way to approach the next steps with infertility. I know that we have another IUI and two frozen embryo transfers in our immediate-ish future, but I don’t know what we will do if those all fail. While I don’t want to think too much about that possibility, I also have to be realistic: this is a difficult path, and there are a lot of things that don’t seem to be working for us. Mentally, I’m in a place where I think I could take another cycle or even several more cycles of IVF if that became necessary, but I will need to seriously consider what boundaries I need to set and uphold.

Something I have discussed repeatedly with my therapist is that I have not put other aspects of my life on hold to try to get pregnant. Working on my doctorate, running, volunteering with Junior League, and traveling have all kept me busy when our attempts to have children have not come to fruition. The world keeps going, and I don’t want to be left behind.

At the same time, I can’t help but wonder if I might have had a different outcome if I had made motherhood my only priority. I’m a person with many identities, and I don’t think I can relinquish all of them to be a mother. I shouldn’t have to. The gamble here—and there are so many things that have felt like gambles over these last few months—is that if I never have my own children, I could be left wondering forever. I try not to have regrets, and I probably won’t as long as there’s even a tiny possibility that I’ll get pregnant. But once that door closes (if it closes), I have no idea how I’ll feel.

So, that's the status update. For the foreseeable future, I am going to continue keeping my distance from Facebook and other social media. I think I’ll get back to blogging regularly, but I’m still not in a good space for engaging on social media. No matter how happy I am for other people, it's still very painful for me to see pregnancy announcements and baby pictures, so I'm finding it best to avoid those things where I can.

Time I woke up: 6:45 am

Something that made today great: Junior League social at City Roots followed by an unofficial afterparty at La Carretta!

Monday, June 14, 2021

IVF Cycle 3 Wrapup

Since Richard works nights, I cook dinner around 4:00 during his workweek. This afternoon shortly after 4:00, the phone rang with a call from our fertility clinic. I guess I was distracted by the couscous I was boiling because my brain tripped up and declined the call. When I tried to call back, I got the answering service, which only forwards after-hours calls that are medical emergencies.

I waited a few minutes for a voicemail to appear, then I sent my doctor a text to see if he'd tried to call me. He replied, "Calling you in a sec," which commenced the longest four minutes I have experienced in a while. Somehow, I just knew it was bad news. It felt as if the bottom of my stomach had fallen out. Then, I reminded myself that our embryo was beautiful, so the news was probably good.

Finally, my phone rang.


"It's another high mosaic."

I was right the first time.

I talked with my doctor for a few minutes about how having two normal embryos in the freezer is actually pretty good. I told him it doesn't feel good at all, which he said he understood, but we've ultimately had relatively good results for my dismal (my word, not his) AMH level. We discussed the possibility of trying a few IUI cycles before attempting an embryo transfer, and I said I'd talk with Richard about it and let him know. Richard and I will most likely go ahead and try IUI, and we go for a scan first thing tomorrow.

I have a few people (mostly close friends and family) that I try to update about our progress before I post on social media. I can usually come up with a silver lining or at least something to say before I drop the bad news bomb, but I couldn't do it today. I'm over it. So, everyone got a variation of this message, the main variation being inclusion or exclusion of an expletive about the hole I want to crawl into.

There just aren't words to describe how much this hurts or how unfair it is. I am furious, sad, and numb. I feel a little bit like the vase of flowers from last week that's still sitting on our kitchen table. Some of the flowers have started to wilt, but I'm letting them stay anyway. Sometimes in life, we have to sit with the less beautiful aspects for a little while, even if that means our life doesn't look like we want it to. When we're ready, we can replace the old or unpleasant bits with new experiences, just as we can replenish a vase with fresh flowers. 

Continuing last week's theme of feeling the feelings, I'm giving myself permission to feel all of the feelings. This time, that includes taking a step away from social media and most likely blogging. I need time to deal with the ugly stuff. I'll be okay--I always am--but I need some space to process. Please continue to remember Richard and me in your thoughts and/or prayers.

Something that made today great: I'm making good progress toward starting my dissertation--including progress made over donuts and coffee with Tori today.
Time I woke up: 8:15 am