FET #5, the night before

This cycle has flashed by strangely. I haven't done acupuncture, and my wheatgrass intake has been quite erratic. I still got scanned with the best lining I've had since pre-Small Boy, so that's nice. I think it was the fruity pills.

I feel... quiet. Very quiet. Usually I'm frantically consulting auguries by now, but I haven't looked at a single set of entrails.  This is the last round for a while, at least. If it's not going to work, I don't want to know it quite yet.

Her Indoors can't come with me to the transfer tomorrow, as she'll be trapped at work. I actually feel fine about that. I'm not sentimental about the process at this point.  I'm just going to go in, have a couple of embryos transferred to my uterus, continue with my life. It sort of matches with the quiet I'm feeling now.

Well, that's done.

Accomplished in the past week:

1) Re-elect President Obama;
2) Pass marriage equality legislation in my state;
3) Transfer embryos to uterus.


As you can see, I've been busy.

All kidding aside, it's been an odd few weeks. I've been tied up in knots upon knots about the election. It's not something I like to think about, but for the past 15 (fifteen. FIFTEEN) years we've been coping with the fact that Her Indoors is not an American citizen. We've patched temporary visas together legally so far, but with very little sense of security. If Obama manages to do something about DOMA during his second term, things could change for us in an earth-shattering way. I knew there was a zero percent chance of anything like that happening under a President Romney, so... I was pinning a lot of hope on this election. Not to mention the whole marriage equality thing which was/is incredibly important to me. So between one thing and another, the past few weeks have been a blur of anxiety and hopefulness.

On that subject: I have had major lining-related setbacks in the past, so I was pretty nervous about my lining check on Nov 5. I was delighted when they found my lining to be 8.79mm -- this is not rockstarish (back before Asherman's, I used to produce 11-14mm) but it's comfortably above the 8mm cutoff that my clinic uses. Previous cycles had settled down around 6.5mm. I know there are a couple of others out there struggling with lining issues, so here's a summary of what might have made a difference for me. There are details regarding vaginas below, but I figure anyone grossed out by that probably isn't reading my blog.

What I did

• Delestrogen shots instead of estrogen pills. I think this made a big difference for me. With my last two FETs we piled on the pills in hope of fattening my lining. This gave me a pounding headache, constant nausea, and a skimpy lining, though my E2 was >1000. Delestrogen, on the other hand, has given me physiologically reasonable level of 294, no side effects, and a decent lining. Totes worth the butt-shot every third night.
  
• Viagra. The doctor at Big Shiny Fertility Factory doesn't believe in Viagra to improve lining. I do. Rather than attempting to argue the point, I just quietly procured a passel of off-brand 25mg pills from an obliging Indian pharmacy and tucked one Up There four times a day from the start of estrogen to the first day of progesterone. Since the relevant study was done using suppositories, I first tried an elaborate scheme to construct suppositories with a pill-crusher, microwave, and cocoa butter inserts. This was tremendously messy and tremendously tedious. The next thing I tried was simply stuffing one into the relevant tract. Worked beautifully, with minimal muss or fuss. A tip to anyone trying this at home: it worked even better when I inserted it with 1ml of Preseed, the kind that comes in the tube with the applicator. Most effective method was to draw up 1ml of the Preseed, turn the applicator with the open end facing the ceiling, draw the plunger back a bit more, and balance the pill on top of the lube.
  
  Incidentally, I chose the Preseed not because I was afraid of some other lube damaging embryos or whatever, but because Preseed is pH-neutral, has no glycerin, and (most importantly) had just the right applicator to fit a Viagra pill into. $20 at Target.
  
• Vitamin E. For this I didn't actually follow the study protocol of 600 mg/day; I used Dr. Marsh's protocol of 1000 mg/day. Dr. Marsh is an Asherman's expert who's seen a lot of scrawny linings. I really believe this made a difference for me, maybe as much as the Viagra -- when I had my post-surgery hysteroscopy during an unmedicated cycle I had a pretty great lining (9 mm) and I wasn't taking anything but the Vitamin E then. But I typically do worse on exogenous estrogen, so I am glad I did both the Viagra and Vit E.

What I didn't do

• Acupuncture. I totally believe it can be helpful, but I was so busy that I just didn't get to this time round.
  
• L-arginine. I started out taking 6g a day (12 pills!). After 4 days I had rotten heartburn and decided to just give it up. Plus, its mechanism is basically the same as Viagra's (although it's taken orally), and I was afraid of Overdoing It.

Transfer was smooth. The receptionist said "Good luck, ladies!" as we walked in, which pleased me. We may be lesbians, but we're still ladies, dammit. Gauged the water/bladder fullness pretty well; I was uncomfortable, but not in agony. Was not offered a picture of the embryos, which was a bit disappointing, but which I have to admit is sensible. Blastocysts were fair quality upon thaw; I've not too fazed, though, considering the fact that my only take-home baby has come from the worst-quality embryo I ever transferred. Pretty is as pretty does, you know?

So now... we wait. And I eat pineapple, out of a sense of tradition and ritual. And bathe in the knowledge that, positive or negative, BFN or BFP, come Jan 1 we can get freaking married, and come Jan 20 we'll be watching President Obama up there on the podium. I've gotten two out of my three wishes for November. I'm hoping for a hat-trick, but no matter what happens, it's been a stonking good month.

5 DPO: Transfer day

They thawed the two vitrified embryos. Both of them survived.

I'm gobsmacked, and grateful. I dunno if they found the right button on the microwave or what, but I'm happy.

They both made it through in good nick, too, 4A. No, I don't know what happened to the second letter, and I wasn't in the mood to ask, so I didn't. I'm a bit of a skeptic on blastocyst grading now, anyway -- I miscarried a 4AA, and my little 2BB is running around in his wee sneakers right now.

So far, so good, I can't ask for anything more. I'm in with a chance, as good a chance as anyone's. Now -- I wait.

4DPO: a.k.a. the day before transfer

I've swallowed the doxycycline, the methylprednisolone.  The progesterone in oil (well, thankfully, in ethyl oleate) has been sunk deep into my gluteals each evening by my lovely partner. Transfer is scheduled for 8:30 a.m. tomorrow.

Nothing to do now but wait, wait for my uterine lining to be synchronized, wait for the embryologist to (please) coax those little frozen things into life.

Tonight we will drink a toast of pomegranate juice, and wish the Tiny Frozen Americans a safe journey from the dark frozen underworld into our world of light and sound.

Transfer day: another dose of mixed news

Good: the spotting, which was only slight, stopped entirely!

Not so good: I had 16 good-looking embryos on day 3. As of today, day 5, I had a couple of mediocre-looking embryos. First round we transferred one 4AA. This time the best we could do was 2BB. No one knows why, of course.

We had such good results the first time that I was barely worried about the embryos between days 3 and 5. Since worrying is how I stave off disaster, obviously this happened because I failed to worry properly. This mistake will not be repeated.

It was pretty upsetting to sashay in there, full of confidence, and get the news. But just because the chances are somewhat reduced doesn't mean that they're zero; babies are born all the time from less-than-perfect embryos.

Well, it is what it is. It's all over now but the waitin' and the hopin'.

Compacting Embryo On Board

Out of the four survivors, three were still chugging along. Two 8-cell grade 2, one grade 2 "early compaction".

No grade 1s this time. Last time I had 7 8 cell grade 1s on day 3, so who knows why the quality was down this time. Compacting is good, though, slightly ahead for the timeframe.

There was zero chance of going to 5 day. We transferred the compacting embryo. It's odd for me to imagine because a 3-day embryo needs 2 more days before it is ready to implant; right now, it's not attached to my uterus, it's just... hanging out in there.

I dearly hope.

Beta August 20, stick-peeing commences next Friday, August 15.

O.O

4AA

One 4AA partially-hatched blastocyst, hopefully burrowing into my endometrium right now and not into my underwear. Made it back to work in time for my 3pm meeting. I don't believe in that bed rest stuff.

Things I didn't like about today:

1. No cute embryo pics like other people have posted on their blogs. Although I guess they all look the same -- I could just right-click one of someone else's. Here! Behold Junior:
2. RE did not use ultrasound to guide the catheter for the transfer. One of the few clear results from studying IVFs is that clinical touch (no ultrasound) is inferior to ultrasound-guided transfers . I'm not happy about that at all, and it may be what prompts me to leave a doctor I otherwise like very much.
3. The paperwork the RE brought out was all filled out for the transfer of two embryos, despite having mentioned in every single conversation on the topic -- including our initial IVF consult -- that we only want to transfer one. When we stuck to our guns he gave us the "this is your best chance" spiel, although he did add "whatever choice you make has to be right for you." Additionally, his presumption of two gave the embryologist a heart attack, since she had to toss #5 in the freezerator at the last minute to get it started in time.
4. Never learned the embryologist's name, never talked directly to her about how the embryos were doing.
   

Things I did like about today:

1. The fact that we have 5 embryos on ice, with more hopefully joining them tomorrow;
2. The transfer room was very homey, not like a hospital, just a room with a fancy split-legged Laz-E-Boy;
   
3. The transfer was painless and relatively swift;
4. RE warmly shook our hands and wished us luck at the end;
   
5. Lying in the twilit room afterwards, holding hands with my darling, stroking each other's faces, dreaming of all that could be;
6. It's over, everything went well, it's over, it's over, it's over.

So yeah. Nothing to do now but keep shooting up the progesterone, and wait.