A few days ago a friend asked me how I was doing, so I gave her an honest answer: I’ve been an emotional mess, especially this week. Two weeks ago, I was told to start taking three estradiol pills (estrogen) twice daily. Those pills alone start to mess with my emotions (I just about started sobbing during the MasterChef Junior episode where the kids get a visit from their family members for inspiration/encouragement). Five days ago (Tuesday), my husband and I drove out to Jacksonville in the late afternoon for an early-morning pre-transfer monitoring appointment the next day. This is the appointment where the doctor checks to see if my uterine lining is thick enough to proceed with the planned transfer. The first time we were prepping for a transfer (last November), the doctor found a polyp/cyst and the transfer was delayed, so this time I was a bundle of nerves and kept waking up from stress or anxiety or some combo of the two, worried that this transfer would also be delayed. As many people do, I mindlessly scrolled through Facebook on my phone trying to bore myself back to sleep. Instead, I learned that a friend of ours — someone greatly loved by the community — had died Tuesday night after battling cancer. Learning about this news while trying to create a new life was strange (that’s not quite the right word, but I can’t think of it right now). So my husband and I went into the appointment Wednesday morning extremely saddened by this news (his was a normal reaction, mine was heightened by the hormones I was on).
Amazingly enough, my lining was just thick enough (the clinic’s threshold is 6, and mine was 6.2), which meant the transfer was on, and the eggs would be thawed and fertilized the next day. And then the doctor asked: Do you want to transfer one embryo or two? Ummm … I thought that was something he’d tell us. When I told him that, he said it was our choice, but that the odds of success are 40% with a single embryo and 60% with two embryos. Of course, two embryos also creates a greater likelihood of twins and complications. The doctor said that he’d indicate we were transferring two, but we should discuss it and if we decided we’d prefer to transfer only one, to call the clinic. We left the exam room wondering how to decide between one or two embryos, and with instructions to add the other pre-transfer medicines (two progesterone suppositories twice daily and progesterone injections every other morning) and to wait for my husband to be called back to provide his part in everything.
We sat in the lobby area for longer than I thought was normal before the nurse came out and asked that both of us go back into an office with her. Alarm bells immediately went off in my head because my husband’s part in this does not take place in an office with a desk, and definitely not with anyone else present. As we’re all walking to the office, the nurse says something to the effect of “sorry it took so long to call you back, but it turns out your eggs were never shipped from the egg bank.” My response: I’m sorry, did you just say the eggs were not shipped? It turns out that I was supposed to call the egg bank once I had a transfer date to schedule the shipment, except nobody ever told me that. The long wait time in the lobby was because the nurse had a frantic call with the egg bank, and was able to get the eggs shipped out for arrival the next day, but since they’d deliver too late in the day to start the thawing process, she also had to check with the embryologist to see if my husband’s sperm could be incubated for 48 hours instead of 24 hours, otherwise he’d have to return to Jacksonville the next day. Thankfully, the sperm could still be collected that day as planned, and would still be perfectly fine to use for fertilization when the eggs were thawed two days later. However, the egg arrival delay meant that the transfer would be delayed by a day, so I’d have to start my additional medications a day later as well.
We were sent back to the lobby to wait for my husband to be called back to provide his collection, and then we had to wait some more while they checked the sperm to make sure everything looked good. We were told that would be a 15 minute wait. It was 50 minutes. We finally got on the road home two hours after we had expected to leave the clinic.
The next day (Thursday) I heard from the nurse that the eggs had arrived, so we were all set for fertilization on Friday, and that I’d get a call from the doctor on Sunday with the two-day report. Thursday I also had my acupuncture appointment to continue prepping for the transfer from that angle, and I learned that she would be on vacation the following week and unable to provide me with a post-transfer acupuncture session. I mean, I totally understand that people are allowed to take vacations, but that timing is really awful as there have been studies that show acupuncture right before and after a transfer increase the likelihood of success. I tried to hide my dismay as she used a pen to indicate pressure points I should press on the two days prior to the transfer.
On Friday, my new “do your medicine” alarms went off at 7:45 am and I started the additional medications — the intramuscular progesterone injection (my husband has to do these since I can’t reach behind me), the two suppositories twice daily — and continued the three estradiol pills twice daily. So … chock full of hormones. Then on Saturday, we went to our friend’s memorial service (lots of tears and laughter), and Sunday morning I waited for the doctor to call with the two-day report.
That call finally came, and it wasn’t exactly the news I was hoping to hear. Of the eight eggs in the donor egg cohort, seven survived the thaw, and all seven fertilized. However, of the seven fertilized eggs, only three had divided enough to “be on track” where the embryologist wants them to be on day 2. The other four eggs were still single cells. The doctor stressed to me that it didn’t mean those four eggs should be counted out as they still might start dividing, but that it was unusual to have such little activity on so many donor eggs. Normally they’d call us the morning of day 5 (Wednesday - transfer day) to let us know if the transfer was still on as scheduled — meaning at least one of the fertilized eggs had advanced to the blastocyst stage — but since we have to drive in the night prior, they may try to call us on Tuesday, although she recommended we plan on coming anyway because things could change overnight.
And that’s where we are right now. I’m hopped up on hormones and trying to remain calm, cool, and collected. The whole one embryo or two embryos might be a moot point if only one of those three on-track eggs makes it to blastocyst stage.