Wednesday, August 3, 2011

You Can Really Only Trust The Blood

The two week wait sucks. It stinks anyway, because you have had a flurry of activity up until the waiting period, where at least every other day you got SOME kind of news. And then...nothing. In IVF, the first week of the wait isn't bad at all because you are still getting some informatioyon throughout that week--you are getting embryo reports, you are having your transfer, you are getting calls from the lab about your remaining embryos if you are lucky enough to have any, you have an estrogen check. It feels like incremental progress is being made and, if you are subscribing to the "celebrate today" philosophy, you actually have new things to celebrate (hopefully).

But the second week of the two-week wait is a long, desertlike stretch. There are no rest stops. There are no road signs telling you how close you are to the end of your journey. You are left in the dark, to contemplate what's going on (hopefully) in your body. Which is not necessarily a good thing. Because you are on progesterone. Yup, that big and scary inch and a half needle that goes darting into your gluteus maximus is full of progesterone, an evil drug that is totally necessary (your body has been messed with so thoroughly that you need supplemental progesterone because your body likely won't produce enough to support an early pregnancy until the placenta takes over), but likes to screw with your head. Because the side effects of progesterone completely and totally mimic all those early pregnancy signs you may have read about in books or while obsessively googling the internet.

2010 embryos. The one on the left is a slightly ugly 8-cell, the right is a 6-cell.
Supposedly, an embryo should hatch and attach within a day or two of getting to the blastocyst stage. At three days after retrieval, ideally an embryo should be 8 celled. At five days, ideally an embryo should be a blastocyst--a cluster of 60 or so cells that are not easily distinguishable from each other but rather look like a circular blob with two parts--the part that will be baby and the part that will be placenta. Our embryos were transferred at the 3-day stage (beautiful, all 8-celled embryos, not like the previous ones that were destined to swim with the fishes), but we also had two go to blast in the dish that got frozen--which was encouraging, because if they made it that far in a dish, surely they made it that far inside of me. And we used assisted hatching, which means that the embryologist made a tiny hole in the "shell" of the embryo (zona pellucida) to help it hatch once it made it to blast. This procedure is usually used on older women or women with egg quality issues. It was used on me because I have had two failed IVF cycles--nothing has ever implanted. So even though I don't have any visible egg issues, something is keeping those little babies from hatching and attaching. My theory is that my crusty PCOS eggs that sit half matured in their follicles don't like to hatch. And without hatching it's off to the septic system they go.

Anyway, since there is a timeline of sorts of when this attaching business will take place, you spend your entire second week of the wait examining your body and any signs that there is life brewing in there. The thing that stinks is that this is my third IVF, so I have two different cycles where I have felt two entirely different things and neither time was I pregnant. Thank you, progesterone. And, on top of that, I know a lot of ladies who have gone before me in this process and made it to the other side, and they share what they felt (or didn't) during their 2-week wait. Every body is amazingly different, but you hear everything from "I felt absolutely no different" to "I felt like I had PMS and was crampy...I was pissed because I was sure I was getting my period" to "I was nauseous starting a few days before the test." There's really nothing meaningful you can take from all that.

And then there's everything you feel during this time:

- extreme fatigue (at least one nap a day, sometimes two)
- sore boobies, boobies that seem bigger, boobies that seem a little veinier than usual
- headaches
- a feeling of nausea/upset if you don't eat at regular intervals
- the constant need to pee

Sound like early pregnancy to you? It's just plain cruel. I have had all of these symptoms before while on the Progesterone In Oil shots, and never have I been even a little bit pregnant. Not once. Last time I even thought I had a heightened sense of smell. I may have, but it was the hormone injected into my ass causing that, not a little nugget. So, this time I am determined to try to ignore it all. I hope, hope, hope that this time anything that I'm feeling is at least one and up to three (yup, that's right, three) embryos burrowing in for a cozy stay. But I know that it could all be a progesterone fake out. There is nothing but the blood test that can truly tell me if I am pregnant or not.

Yup, just the blood. Not even a pee stick is reliable--I know women who have peed on a stick the day before their test or even the morning of and been devastated by a negative only to have the blood taken and find that they were in fact pregnant. That blood test can detect levels of HCG, the pregnancy hormone, way lower than even your most sophisticated pee stick. And this time I am determined not to cave in and pee on one. Every single time I have given in and peed on the stick on the day of my test. It never ends well for me. The first time I had made it all the way to the blood test and was waiting for Bryce to get home so I could check the message that had been waiting on my phone since 1:25 in the afternoon. I caved and peed on a stick while waiting. It was negative. I was crushed but hopeful I would be one of the lucky ones whose stick lies. My stick was a Boy Scout. You would have thought I'd learned my lesson, but last cycle I peed on a stick the morning of the test. I was so sure that I was actually pregnant, all of my progesterone side effects were different and intense and I hadn't started spotting like I had the first time (although, spotting can be "implantation bleeding" and not a harbinger of period doom). I gleefully peed on a stick at 6 in the morning. I waited for that second line to appear. I waited three times the recommended time with tears pricking at my eyelids. I dismissed the negative as stupid internet tests that I'd gotten 20 for $3.99, cheap flimsy strips that I had to dip into a Mickey Mouse dixie cup of urine. But the crack in my positive attitude was there and it only widened throughout the day until, still somewhat sure that it was a mistake and my strip was a big fat liar, I picked up my call from my clinic at school. And was crushed to smithereens when the cheap and obviously faulty strip was telling the truth. So, while for some people peeing on a stick can provide early peace of mind and confirm a pregnancy before the blood test, for me it has been nothing but an exercise in masochism. No pee sticks this time.

I am also not picking up the phone. I am having Bryce be the one to hear the nurse on the other end. I have gotten the call enough times to know that you can tell which direction this call is going to go within 3 seconds. I don't want to try to sleuth out the tone of voice in the "hello" this time. I want someone else to hear "I'm so sorry" or "Congratulations!" and then relay it to me. In the interest of having this cycle continue to be different I think this is the way to go. Bryce is very nervous about it, but I think it's time we switched roles on this one. It is a tremendous burden to get the call. Your heart jumps into your throat the second you see the clinic name flashing on the phone. If I am lucky enough to be next to Bryce when he gets the call, I'll be able to tell which way it went pretty quickly. Unless he has one hell of a poker face, but I really don't think this will be the time for practical jokes. I am really, really jealous of the people who get to pee on sticks and then surprise their husbands with the news in a creative and fun way, instead of waiting with sweaty palms and butterflied guts for a call that could be the best news of our life or yet more disappointment.

It is torture waiting for the blood test and the subsequent call that are the only reliable way to find out if you are carrying the future in your uterus or you are headed down a path to more procedures, more drugs, and definitely immediate plunging into a bottle of some sort. You second guess everything. But this time, I am resolved to be a bit calmer. Even though each day the only thing I have to celebrate that's new is that there's one less day until my test, I really can celebrate my frozens. They will make it possible for us to have another go if we need it as early as the fall. This is the first cycle where, if all the juju deserted us and we are still on that dastardly first leg of this journey, we are for once not left empty-handed. We have two things to show for ourselves--we have frozen embryos for a (much cheaper and less invasive) frozen cycle, and we have proved that we can meld our materials and make some truly beautiful embryos. We are no longer peering down the fork in the road of donor material at this point. We can do it, we just need them to stick. Soon enough, the blood will tell us which way we are headed.

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