Tuesday, November 2, 2010

Waiting

Infertility is all about waiting. Waiting, waiting, waiting. Most of the time by a phone.

First you wait for results to your workup. What's wrong? What else is wrong? Why is nothing showing up wrong? Then that wait gets replaced with the wait to get started on your treatment. When can you get on the schedule? When will you actually get the chance to put your plan into action? Then you wait for medication to kick in. This is a twofold wait. When will your ovaries start bubbling up with new follicles, and when will your body start displaying any number of side effects? This part of the process can take what seems like forever. For a Clomid cycle, you take the pill days 5-9 and have your first monitoring appointment around day 14 or so. Then, depending on what they see, you come in again after another couple days. And then another day or two, and then possibly daily depending on how slow or quick you respond. With injectibles, it can go really long. I had a cycle where I was on injectibles for 17 days. They monitor you much more closely on those medications because of the risk of hyperstimulation and too many follicles to proceed with IUI (depending on the clinic you go to, you can be cancelled or switched to IVF if you make more than 5, because the chances of having high-order multiples is so high). I was in the office every 3 days, and then every 2, and then every day.

And, every day you go in they take blood. Every time they take blood you receive a phone call sometime in the afternoon letting you know what your estrogen levels are and whether or not you have to come back or if you can stick a fork in it 'cause you're done. You become a slave to your phone. Missing the call is not a disaster, because they will leave a message, but taking the call could be your only shot at talking to a live person that same day, depending on the timing. My clinic is AWESOME about getting back to you if you leave a message on the nurse line, but then you are just a slave to your phone a second time. I carry my phone with me in my pocket, even at school, when I am expecting these calls. I quell any dirty looks with "I am expecting a very important call from my doctor regarding some test results." That usually stops people from thinking I'm some slacker with my phone out while I'm teaching! Hopefully you get the call that tells you you can take your trigger shot, which will release your eggs from the follicles so you can have the IUI two days later. After you take the shot (at home, given yourself, not by any licensed medical practitioner unless you happen to be one), you wait for your procedure. After the procedure, you wait for two weeks. The longest two weeks of your life. The dreaded Two Week Wait. Then, if you didn't get your period at the end of the two weeks, you are REALLY pasted to your phone. Because then you go for bloodwork in the morning and expect your most important call. The call that either starts with "Congratulations!" or "I'm so sorry."

If you're doing IVF, the waiting (like everything else) is more intense. You have the same wait to get started--ironically, the thing you desperately want NOT to see at the end of a cycle is the very thing you need to get in order to start the cycle. Your period, Aunt Flo, monthly visitor, Martha, red flag of freedom or despair--whatever you want to call it. It calls the shots. You have all the waiting for stims (injectible medications) to start and for stims to take effect, but this time when you take the trigger shot it is to ripen your eggs, not to release them. Then you have your egg retrieval procedure and wait to see how many eggs were in your haul. For me, the time between the trigger shot and retrieval was really stressful--I was terrified that my eggs wouldn't cooperate and that they would release on their own (which would cancel the cycle). I couldn't wait for the doctor to tell me how many eggs they retrieved. They tell you a rough number when you are loopy from the anesthesia, but then you have to wait for the call from the embryologist to tell you how many were truly mature enough to attempt fertilization. This wait was the third hardest wait because you can have eggs retrieved, but then not have them be mature enough or good quality enough to try fertilization. Then, the second hardest wait: waiting for the call from the embryologist to see how many embryos you have and their quality. Having eggs fertilize does not guarantee that you will have good embryos to transfer, which makes the call scary until you get your stats. Then you have the embryo transfer and the two week wait begins (thankfully shortened in a way since it is 2 weeks from fertilization, not transfer). You get two weeks when you don't have to have your phone in your pocket on vibrate so you don't miss an important call. (Those two weeks are difficult for other reasons, but that's for another time). Then the day of your blood test comes and you are a wreck, just a wreck, waiting for that phone call. This is the call that will tell you if all of your money, time, discomfort, and emotional distress resulted in a pregnancy, or if you are once again waiting for your period to arrive so that you can give it another go. I got my call at 1:27 in the afternoon and had to wait until after 5 when Bryce got home to listen to it because I did not want to get the news by myself. The little green voicemail light flashed at me all afternoon long. Now that was a long wait.

The waiting doesn't get any easier the further down the infertility road you go--I had to wait for a call just yesterday regarding my test results for the refund program. I sat through a haircut with my phone in my lap and then put it on vibrate so that I could at least feel it go off since the blow dryer was so loud. I took a phone call mid-blowout because I was waiting for those results, so that I could find out how much longer I have to wait before I can get started on my next IVF cycle. It doesn't get any easier, but I am sort of getting used to it. I just want to trade in all of these stressful waits and phone calls for a nice, long, 40 week wait for my healthy, happy baby to arrive. At least I will have plenty of practice with waiting!

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