I hardly know where to begin.
This IVF was dubbed a "short-cycle" protocol by my doctor, before we began. She also said it would be a lot easier on me, with less injections, etc. While meeting with her on Thursday, I told her "not for nothing, doc, but this has been the longest and most difficult IVF yet!"
It's been a crazy cycle. Even the nurses are commenting on how crazy it has been.
On day 9 of my cycle, that is the day I was informed that I only had 2 eggs, both on the left, and that they were both smaller than 10mm. The ultrasound tech basically told me that they would probably cancel my cycle. I assumed that she was correct, since I ordinarily trigger on Day 11 or 12, which was only a few days away and wouldn't give those follicles enough time to grow big enough.
Then that nurse called me with the brutal truth, or at least her assessment of my situation, that the 1st cycle was probably the best we'd ever see.
So I started to face the writing on the wall. I started to deal with all of these emotions welling up. And I started preparing myself for another cancellation.
Yet, cancellation never came. Again I would get a phone call, telling me to continue on my meds and report back for another ultrasound and blood test in the morning....
This went on for a whole week.
I don't know what is worse - getting cancelled unexpectedly, or being mentally prepared for a cancellation that never comes. At one point I even said to Anthony that I felt like this was just dragging out the inevitable. If we were going to be cancelled, then just go on and cancel us God dammit!
Wednesday's ultrasound (Day 15) brought a surprise. I now had 5 follicles, three of which were of good measure. I started to cry. Three! Maybe we wouldn't get cancelled after all, because after all three is better than two! I abruptly pulled myself together and slapped myself on the wrist...no allowing hope to creep in. Don't do that to yourself, Dawn!
Wednesday afternoon one of the doctor's called me directly at work. "Are you in a place where you can talk about this, Dawn?" she asked. I inhaled and said, "sure." I knew it was bad news. When the nurses call, you are still on track. When the doctors call, it is always bad news.
She proceeded to tell me the same thing that the nurse had told me the week before on the phone - that my body is responding poorly to the IVF meds. However, this time an explanation was offered up. "You just don't have a lot of eggs, Dawn. Even though you are young - 34 - your body is responding to IVF as if you are in your late 40's / early 50's with low fertility." She went on to say that this protocol they have me going through currently is one that they use on their most extreme cases - on women of advanced age who don't have a lot of eggs remaining. She said the fact that I have produced only 3 decent eggs tells them that I have an extremely diminished egg supply.
Remarkably, I felt very calm as she was telling me this. Partially, because I saw a cancellation coming for a week now and was prepared for it. And partially because I was feeling relief to finally, FINALLY, have some answers. To finally be moved from the "unexplained infertility" category to having an understanding of WHY we are not getting pregnant. It was because of me. Anthony is fine. I am not. At least we know now.
"What I suggest," the doctor went on, "is that we convert you to an IUI cycle. Rather than putting those three eggs through the trauma of removing them and putting them in an unnatural habitat (the petri dish), let's at least inseminate you and leave the eggs in there and see what happens."
"Okay," I replied. Whatever. It's all over.
**************
Wednesday night. The clinic calls with my instructions. I am to do my trigger shot that night between 6 - 8PM. Anthony is to be there at 9:00AM on Thursday to give his sample. I am to report there at 10:00 for the IUI.
Anthony is extremely stressed out because he has a huge, important meeting at work the next day at 8:30AM with clients and a total of 20 people involved. This IUI means that he'll have to stand up and walk out of a meeting that HE called, fifteen minutes into it. I apologize but remind him that we are victims of the schedule they set. He agrees that the IUI is the priority, but it just couldn't possibly be worse timing.
Thursday morning. I get a call from Anthony while I am on my way to the clinic that he did his part and all went well.
I arrive, and immediately my doctor wants to meet with me. "Good," I said, "because I want to talk with you too."
She told me, almost verbatim, what the other doctor had told me on the phone a day earlier. I must have a low egg count and she doesn't recommend that I continue on with IVF. To continue to go through it and expect different results is a mistake. She said we could discuss donor eggs, but I told her I wasn't sure. That perhaps we'd pursue an adoption and save the last 3 IVF's I have insurance coverage for to try again in a few years.
"Dawn," she said, shaking her head, "you aren't understanding what I am saying. Your fertility is declining every day. You cannot expect to try IVF again in a few years and get better results. This is it. You are all done."
I stared at her, finally understanding the gravity of what this all means.
"Which is why I cannot in good conscience proceed with an IUI cycle today."
More staring. "Huh?" I finally said.
"Dawn, this is your last chance. This is the best we're ever going to get. You've got three eggs in there, ready to go. An IUI will give you, at most, a 5% chance of becoming pregnant. IVF will increase those odds to 20%. This is your LAST chance, and despite what the doctor said yesterday, you are MY patient and I would like to try to still do an IVF cycle with you. If it is your last one, shouldn't we just go for it?"
I was stunned. Focusing on the wrong thing, I said "So Anthony didn't have to come this morning?" (no pun intended). I explained that he had to walk out of a very important meeting, etc, and she apologized and said she still hadn't made up her mind what to do with us when he was still there. She emphasized one more time that, if this is my final IVF cycle, she wanted to do absolutely everything possible for us. And she doesn't work in the Reading office (where IVF is done) on Fridays, but told me that she personally would go there in the morning as she wanted to be the doctor doing my retrieval. She wants to hand hold us through this until the bitter end.
Which I was thrilled to hear. My clinic has a team of doctors and whoever happens to be doing procedures on any given day is who does the retrievals and transfers. I have not yet lucked out and had my doctor do any of my procedures. Knowing she was going to go out of her way to make sure she took care of us meant so much.
I left the clinic and headed to work, head still spinning. I called Anthony and told him about his wasted trip, which frustrated him, but we also both agreed that we would much rather do IVF than IUI, especially if this is our last one.
I called my mother and broke the news, that once this IVF is over, we're all done. She cried and cried.
We went out to dinner with Anthony's dad and stepmother, and broke the news to them, and there was a lot of sadness to go around. Then I slapped Anthony on the arm when it suddenly occurred to me that he was drinking a beer. "What are you DOING? You have to give another sample in the morning, idiot! It is the last time ever, do you think you could not DRINK ALCOHOL?" Truth is, we all forgot. There is too much on our minds.
He didn't finish his beer.
So yesterday we actually had egg retrieval. For over a week I was expecting to get cancelled every single day, and we actually made it to egg retrieval. Before the procedure my doctor came in to see how I was feeling and if we had any questions.
I had one for her.
"If we are assuming that this is it for us..."
"Yes?"
"And the reason we are doing IVF is to just go for it and maximize our chances..."
"Yes?" It was clear she didn't know where I was going with this.
"Is there any reason in the world not to do ICSI? I mean, if this is our final chance, is there a good reason NOT to?"
She stood there for a minute, thinking about it. "Well, with three eggs I most likely would want to do ICSI, I guess it just depends on your insurance?" I looked at Anthony and with barely any hesitation said "I believe we are covered for it, but please do it regardless - we'll pay for it."
She smiled at us and said "I am so glad you asked that question. I am going to check now on your coverage but, yes, absolutely, we can do the ICSI. I will see you in there in a few minutes."
ICSI, for those of you who are not familiar, is when the doctor selects the very strongest sperm from the sample and actually injects it into the egg with a needle, as opposed to just putting sperm and egg in a dish together and hoping fertilization occurs naturally. Normally this is done when there is a problem with the man's sperm, but in our case we wanted it done because in our last cycle we didn't make it to transfer because we had terrible fertilization results.
So, we had the retrieval, I remember her putting in the speculum and them pushing the meds into my IV at the same time. Within seconds, the whole room swam on me and though I was fighting it my eyes closed.
I opened them a split second later (in reality, 40 minutes later) with Anthony at my side, brushing my face. I was not in the procedure room any more. Once again, retrieval was over. The doctor came in and said "Dawn, it went so well. Guess what? We got four eggs."
"Four?"
"Four," she said, smiling. One of them was apparently hidden and they weren't catching it in the ultrasounds. I was expecting three at the most and got four.
This has been the craziest cycle ever.
As I type all of this today, I am awaiting my fertilization results. If we have lousy embryos, like last time, we are officially all done. It is just unbelievable to me that we are here already. For as long as I have been at this pursuit of having a baby, I can't believe we are at the end of the road that gets us there via pregnancy. My entire future hangs on this one phone call.
This whole crazy cycle has been a series of tiny, tiny hurdles.
Now, all I am focused on is getting to transfer tomorrow. I just want one last shot at this. I want some embryos inside me. We'll focus on the next hurdle next.
All I want is to get to transfer.
The phone is ringing.......
