Egg retrieval

A normally stressful event was made somewhat easier by having our RE make an unscheduled appearance to do Mo's procedure today. He retrieved 12 eggs! Mo has been fairly uncomfortable (but very relieved) and resting most of the day. She will update on the fertilization report as soon as we get word tomorrow. We are very, very pleased.

More news soon.

Will

Cycle day 13 update: Trigger day

Will just gave me the HCG trigger shot and we're set for an early retrieval on Sunday. I can't believe we're here already.

Things have brightened since my last cycle update. There are now 7 large follicles and several smaller ones visible on ultrasound, so we are cautiously optimistic that things will go well on Sunday.

My RE did our ultrasound Thursday and said he will try to come in and do my retrieval himself, even though he isn't on call. We are thrilled and touched. Our IVF center is quite large, known for its clinical excellence but not necessarily for being a hand-holding kind of place, so his willingness to come in on his day off is especially meaningful.

We will keep you posted. Thanks, as always, for your warm wishes and thoughts.

Fingers crossed and full speed ahead.

Mo

The fate of the frozen embryo

Today's New York Times yields yet another infertility article, this one on the difficulty former IVF patients face in deciding what to do with leftover frozen embryos.

According to the article, more and more couples are struggling to decide what to do with remaining frozen embryos when they want no more children. They are choosing to do everything from freezing the embryos indefinitely (at a not insignificant cost) to donating them to other couples (rarely) to donating them to research to saying prayers over the petri dish when the embryos are thawed and destroyed.

It's difficult to know what one would do in this situation. Given our struggle to produce a single offspring, I find it almost impossible to imagine that our problem could some day become the potential for too many children. And we have learned very well, through hard won and bitter experience, that an embryo (even several embryos) does NOT equal a baby. Not even when you actually get pregnant with said embryo.

At the same time, we do not see these embryos as just a piece of cultured tissue. They represent the potential for human life. And in that way, they are (the words are loaded but I don't know better ones) somewhat sacred.

Will and I personally entered the frozen embryo debate when we met with the RE to tell him we wanted to do another fresh cycle this time (while having six embryos frozen at the 2PN stage from our last attempt).

I believe the RE's exact words were: "What do you want, a library of embryos?"

Ouch.

I suddenly felt like the RE thought we were aiming to collect vast quantities of our genetic material to keep in jars in various rooms in our apartment. Just to gaze at.

His words surprised us, and definitely gave us pause. After reflecting, we explained our reasoning (to ourselves and to him) thusly: that we want multiple children if possible - gosh, a whole family of them if we could. That we worry I am headed into premature menopause because of my chemotherapy treatment almost a decade ago for lymphoma. That we can actually afford another IVF cycle right now because I have - just for this year - a very generous insurance policy that has a special arrangement with my IVF center. We reminded him that we are Irish Catholics (lapsed and mortally sinning Irish Catholics because we're doing IVF, but still.) That for us, a family with several children would not be a bad thing. We'll be grateful for one, mind you, but a whole passel of kids would be fine too.

But reading the Times story today made me realize for the first time another major factor underlying our decision to do a 3rd fresh IVF cycle: keeping six embryos on ice gives us a sense of continued hope. These embryos dull the full keening urgency we feel about starting a family. Their existence gives us a sense (falsely perhaps) that as long as we have them, we still have the potential to be biological parents.

This article also made it clear that it will be much more complicated than we ever imagined should we someday encounter circumstances that compel us to not use these embryos and instead have to decide their fate. What would we do then?

It's a decision I hope we never have to make.

Mo

Cycle day 10 update

Today's ultrasound was kind of a bummer. I had the fellow I am not so fond of again today and when she did the scan, it was clear that there was only ONE large follicle on my right ovary, and just a few decent sized ones on the left.

This is a significantly muted response compared to my previous two cycles (where 21 and 9 eggs were retrieved, respectively). Needless to say, since going in this morning, I've been trying not to get discouraged. The fellow did say that it's possible some of the smaller ones could grow enough to contain a mature egg ("That happens sometimes," she said, chipper and clueless, while I tried to suppress my urge to growl audibly at her).

Despite the substellar follicular development, my lower abdomen is extremely crampy - much more so than with the previous IVFs. Very curious. Based on the way my belly feels, something is going on in there. Maybe it's not follicles under construction, maybe my body is putting in a line of new condos or something.

In other news, Rocketman's ship landed safely last week in South Dakota and the results are in. Sperm chromatin was normal (which was a huge relief), motility was lowish, and morphology was abysmal. All in all not so different from previous testings. And nothing that's too major since we will be utilizing a petri dish (and perhaps ICSI).

So I know that none of the information gleaned today is terrible, but I left the IVF center feeling slightly glum and rather less hopeful about the cycle. Fortunately, my feeling one way or another should have just about zero impact on the outcome, as long as I can rally myself for my injections and make it to the retrieval on time.

I keep trying to remind myself that I don't need a legion, I just need a few good eggs.

But any words of wisdom from you guys would be most welcome.

Mo

Infertility math

Yesterday I read the cover story in the New York Times Magazine by Alex Kuczynski about her use of a gestational surrogate to become a mother after 11 IVFs and four miscarriages.

One of the things that hit home was her brief description of "the terrible, wishful math of infertility." I'd never thought of it that way exactly, but I immediately recognized myself. And I recognized my penchant for Infertility Math.

I have repeatedly calculated how old I will be when I give birth if I get pregnant on X attempt, which is a continuously moving target. I also calculate where I will be in my academic training and career…along the lines of "If I get pregnant now, I will be on my internship… applying to post-doctoral fellowships… interviewing for post-doctoral fellowships…on a post-doctoral fellowship (probably true if I get pregnant this cycle)…on the academic job market," etc.

One of my most grueling versions of Infertility Math is computing the age and developmental stage our baby would be at if we hadn't miscarried the first time. I only do this with pregnancy no. 1- by the second and third losses I'd learned to not calculate due dates that might come back to haunt me.

With that first pregnancy, Will's older sister was one month farther along and now has a child (truly, a lovely child) who is a continual reminder of the fact that our baby is not here. Try as I might to NOT do this, when I am at my sister-in-law's, holding her beautiful son, it is almost impossible to not start the dreaded calculations in my head, subtracting one month from her baby's age and imagining what our daughter would be doing and how our lives would be so very different if she had lived.

Then I catch myself, and I stop.

Until the next time.

Similarly, watching friend after friend get pregnant and deliver, and then some of these friends get pregnant - how is it possible? - a second time, has become yet another barometer of loss. A painful reminder that Will and I are somehow out of step with time.

The holidays engender a particularly treacherous form of Infertility Math. Just yesterday, Will and I bought our tree and were securing it in its stand in the living room. Before I could stop myself, I reflexively thought, "This will be our last Christmas without a child."

Which would be fine, except that I think this every year.

And we don't have a child.

And (breath hitches in throat) I don't know if we ever will.

Infertility carries us along on a continuous cycle of hope and loss…followed by more hope. Hope that I can soon be a mother, hope that Will and I can seal our union with an oh-so-beloved child, hope that we can put this chapter of grief and loss and longing behind us and move forward into the future.

And at the same time that hope carries us into dangerous territory - dangerous and terrible and wishful territory - a landscape of unmappable days, of the uncharted and unknowable future.

That's the rub of infertility. And the peril of Infertility Math.

Mo