When I’m in the middle of an IVF cycle, the monitoring appointments mean I do a TON of driving (I’m fairly certain I added about 1,000 miles to our car in the course of 7 days between driving to Albany for acupuncture, Tallahassee for weekday appointments, and Jacksonville for weekend appointments), which is both an opportunity for me to do lots of car singing (so.many.musicals) and lots of thinking, since I attend all of the appointments by myself because my husband has to work.
During one of the drives home from Tallahassee last week, I started thinking about how I’ve been approaching IVF. When we first started it more than a year ago, I put my faith in science because science means proven outcomes. I had known the odds of success were low due to my age, but IVF had worked for other people and so it could also work for us. That first retrieval, when they were only able to retrieve such a small amount of eggs, and then none of the resulting embryos passed PGS testing, dealt a deep blow to my “science will work for us” thinking process. From that time on, I approached IVF as something we could try, but without much hope that it would actually work. I didn’t think of it as a pessimistic outlook as much as I thought of it as (a) a realistic outlook and (b) a way to keep myself from being thoroughly crushed over and over again.
Each cycle of IVF brought with it new side effects from the massive amounts of hormones I was injecting into myself. During the first cycle, I completely lost my appetite. During the second cycle, I added deeper despair and anger. During the third cycle, which took place after surgery to have a giant fibroid removed, I felt a teensy bit more optimistic, but I stopped sleeping through the night (which, if you know me, is not something that normally happens to me). This fourth cycle brought with it more exhaustion, more despair, a loss of appetite again, and strong, strong RAGE. Rage at stupid emails, rage at not being able to fit a glass in the kitchen sink, rage at having to deal with everything yet again, and despair at knowing this whole process was probably futile.
And that brings me back to my original comment: all the driving leaves me with time to think about a lot of things. During one of the drives, it occurred to me that I was thinking very negatively about the whole experience. Now, to be fair, injecting multiple needles into my stomach twice a day, missing work on only 2 or 3 days notice to get to appointments (and trying to catch up from that missed time), doing 5-hour round-trips twice a week, and becoming more physically and emotionally uncomfortable as the cycle progresses seem like a lot of good reasons to think negatively. But, I wondered how things would change if I thought differently. Could I even think differently about IVF after so many failed outcomes? I mean, I spend 90% of my work time being a project manager, which means dealing in reality. How could I change my instinct to think realistically (statistically, there is a VERY slim chance IVF will work with my eggs) and instead think optimistically (maybe it will work this time since the doctors are seeing more and larger follicles than they’ve seen in the past, and that should mean more eggs at retrieval)?
I’m not saying I succeeded in thinking positively and optimistically about this round of IVF. But I did let a teeny speck of hope in because I seemed to be responding to the stimulation meds better than I have in the past, and retrieval was going to be earlier than it had been for the previous three cycles. And instead of leaving appointments thinking that this will never work, I left thinking that maybe, just maybe, we’d get a good batch of eggs at retrieval (and wondering how in the world I was going to get all my work done within end-of-month deadlines).
The last three cycles, I was on stim medicines for 14 days, with retrieval on day 17. This time, although they thought last week the retrieval would be on day 13 or 14, it ended up being on day 16 (the weekend appointment that my doc thought would be the last before the trigger med turned out to be the second-to-last appointment because the follicles needed some more time). That meant retrieval was this morning. My husband and I drove to Jacksonville last night after working all day, and by this morning, I was in the normal “I feel so uncomfortable and bloated and it’s hard to move” pre-retrieval feeling. That helped me forget I hadn’t been allowed to eat or drink anything since 7pm the evening before, especially since we didn’t have to be at the doctor’s office until 10am instead of the normal 7am retrieval (it was a busy retrieval morning).
I filled out the usual anesthesia paperwork. The nurse took me back to have my vitals taken, the anesthesiologist inserted the IV into my upper wrist (ouch), and they went over all the procedural things, which I knew by now after three attempts, and they knew I knew, but protocol is protocol. With each retrieval, I’m less and less nervous because it’s almost routine now, and honestly, I really love that I get an oxygen thing in my nose because it’s such a delight to breathe easy after year-round allergies. After they started the “sleeping time” meds through the IV, I was out in under 10 seconds.
As I was woke up briefly from the anesthesia haze while the nurse was checking my blood pressure post-retrieval, I asked her how many eggs they’d been able to get. I was still trying to remain a teeny bit optimistic given the number of follicles I had when I went in. I heard “two” at which point I let myself sink back into the sleep from the meds hoping that I had heard wrong. As I slowly came out of the haze for real, I asked the nurse again about the quantity of eggs, and she said that they were really sorry, but they were only able to get two and were not sure why, but she’d make sure the doctor came to talk with me before I was discharged (the doctor didn’t know, either). With that number confirmed, my hope was crushed once again.
Yes, I know it only takes one good egg/embryo to make a baby, but previous experience and statistics say the odds of success are not high. Those two eggs were fertilized today, and IF the fertilization works (we find out in two days on Sunday), then the embryos need to continue to grow to blastocyst stage (we’ll find out on Friday but we’ve usually lost 1-2 embryos at this stage), and then, IF there are any embryos left, they get biopsied and sent for PGS testing (the stage where we usually lose whatever embryos are left). If, by some miracle, we have an embryo that passed the testing, then I can start the prep for the transfer (the process that failed right before Thanksgiving this past year).
So now we’re back to the waiting to see if anything will come of those two lone eggs, and I’m back to my pessimistic outlook on it all.