Thursday, March 12, 2015

transfer day mishaps and more.

I'm not someone who puts a whole lot of stock in bad omens. That said, it's not like I don't recognize them, either.

We left for our transfer about five minutes later than I wanted to, which is to say: not really late at all. But we started to hit traffic pretty early on. Thick traffic. Traffic that made my GPS tell me we were going to be 6 minutes late, then 8, then 10. I tried not to stress. I cranked up the volume on the audiobook I've been listening to. It was Gone Girl. Not the most uplifting choice, but still.

When we finally emerged from the traffic, which had been caused by road construction, Mr. Hope was so engrossed in the audiobook that he was driving about 10 miles an hour slower than he normally does. Which is to say: really fucking slow. At times, he was doing less than 60 on a 55 mph stretch of road. While we were running late. 

I said, "I should've just driven."

He said, "Maybe you should have."

It was a little tense.

When we get to the clinic, we wait. Long enough for all the pre-transfer water I pounded to start to build up in a semi-painful way. Eventually they call us back and we go over the post-transfer meds instructions with the nurse. Next, the embryologist comes in.

She hands us the picture of our two embies and right away I know something is off. The one on the left is kind of uggo. There looks like there's fragmentation and the cells don't seem very uniform. The one on the right looks a little better but it still doesn't look like the two we transferred last time.

The embryologist starts telling me that the embryos are still quite compacted and that they'll continue to expand in my uterus. Then she says, "Any questions?" 

She hasn't mentioned grades. So, I ask about them.

The uggo is a B-. The other is a B.

I am confused. The embryo we had leftover from last cycle was an A when it was frozen. What happened? Which is which?

It's the uggo that used to be my A. The one on the right is the new donor's. I find out that it had been frozen in 2010. 

I ask about variances in grading. Most of the women in my FB group get grades like 5AA or 3AB. She explains that my clinic grades them differently, that they characterize the trophectoderm (the outer cells that eventually form the placenta) as "fair" or "good," and not with a letter. Then she says (sounding mildly annoyed), "The only reason I gave that a B- is because some of the cells look damaged from the thaw."

"But it's still viable or we wouldn't transfer it," she tells me. "Any other questions?"

I feel like I should note that even though she seems mildly annoyed and/or uncomfortable, she's not unkind. She is the second embryologist I've meet who seems like she just doesn't like talking to people. She's probably an introvert, as am I, and is sitting in this cramped conference room thinking, "Can I just get back to my little lab now, please?"

At any rate, here's what I am thinking:

  • Last time we transferred two Bs.
  • I got pregnant with a B.
  • I miscarried with a B.
  • I cannot deal with another miscarriage.
  • This cycle isn't going to work.
  • Why do I know all of these people who get A embryos and I keep getting Bs?
  • Do I need to get my embryos from some other place?
  • Is it time to switch clinics?
  • How much money will that cost?
  • I can keep hemorrhaging money.
  • Will we ever be successful?
  • Will I ever have my baby?

These thoughts all occur inside of the thirty seconds it takes from me leaving the conference room and going into the changing room to put on my hospital gown. There was a quick kiss to Mr. Hope in the middle, too.

(Later, when researching embryo grading on Google, I read several things that say Grade AA embryos are extremely rare. Yet, I know SO many women who've transferred them. I think, "Could this be a case of grade inflation? Are their clinics grading on a curve?" I don't know the answer, but it does make me wonder.) 

Inside the changing room, I see that they haven't pulled the larger size gown for me. I say something to the nurse. She goes to look for one but they don't have any. They've always had them in the past so I'm confused. She says, "Just put this one on and you can wrap yourself in the blanket." 

I say, "Really? That's so humiliating!"

She says, "No, it's not. I'm the only one back here today."

I clarify: "It's going to be really uncomfortable."

"I know," she says. "I'm sorry." Then she eyes up my t-shirt. It's one of Mr. Hope's that I decided to wear on a whim, so it's baggy and long. "Just wear your t-shirt," she says. "And wrap the towel around your waist."

This is a good compromise. After I get my hairnet on I take a selfie and send it to Mr. Hope. 

In the room, there is more waiting. We're now about 20 minutes behind schedule. I have to pee badly. The nurse asks if I want to let a little out. I say no, then change my mind. She gives me a cup with a line drawn on it and tells me I can't let out more than that amount. I end up letting out half of what she tells me I can let out, feel like I can handle the remaining pressure, and go back onto the table.

Finally, Dr. Smiles arrives. He doesn't seem as cheerful as he normally does. I think, "Is he unhappy with the quality of my embryos, too?" 

He puts in the wrong speculum. See, I always require the long, skinny speculum, not the standard one. The first transfer I had, I told him this. The second transfer, I reminded him and he barked, "I know what kind of speculum you use!" So on the third transfer, I didn't remind him and he used the right one. This time? No. And it hurt. 

I hear him ripping open the package for the right speculum. Then he inserts it but it hurts a little. It's stabby. It hadn't hurt the two transfers prior. I wince and he tells me to settle my bottom. I'm trying. There is some crankage and that hurts too. I feel the catheter. I haven't felt the catheter the past two transfers. What is happening?

He starts to pull the speculum out and I feel relieved. Then the nurse says, "He's got to reposition it, so he can get a better view."

I say, "Are you kidding me? Really?"

The nurse says, "I know, I'm sorry. He needs to use a stiffer catheter, too."

I say, "Jesus Christ, okay."

Dr. Smiles cuts in, "I'm right here, ladies. I may be dumb, but I'm not deaf."

This is him joking. He has a dry wit. It makes me laugh. 

I tell the nurse I might need a bedpan after. There's a lot of pressure and pushing on my bladder throughout all of this. I don't know if I'm going to make it. I ask if anyone's ever peed during the procedure. 

"It happens," the nurse says. "Not often, but every once in a while."

I promise Dr. Smiles I won't pee on him. "Thanks for that," he says in his trademark deadpan way of his.

He finishes up and leaves and the nurse tells me to lay on the table for 15 minutes. She asks if I need the bedpan. I say, "I'm going to try to tough it out." She tells me she'll check on me in a few.

When she comes back, I say, "How much longer?" 

"Nine minutes."

"Okay," I say. "I can wait nine minutes."

It is excruciating.

I start to pull my legs off the stirrups right at the nine-minute mark. Then the nurse comes back and I run across the hall to the bathroom to let it out. 

I'm feeling kind of numb as I get dressed. Nothing had gone right, or at the very least, right enough. In my head, I start mentally preparing for the next cycle.

I am convinced there will be a next cycle.

As Mr. Hope and I walk back to the car, I tell him that I do not feel confident in the least. I lay out my reasons why. I tell him about the transfer mishaps. 

I say, "What are we going to do?"

It's a somber ride home. 

When we get to the house, I immediately start making the Indian-spiced lentil soup that I refer to as implantation soup. Only, the lentils don't get tender enough, so it cooks forever. Finally hunger wins out. I think I darken the spices too much. The soup looks weird. It doesn't taste like it did the last time.

Another thing that didn't go right.

I check out a website that offers embryos. There's a set still available that was available in September. I've kind of had my eye on them. There are a lot of embryos in the set. The features match up. Why hasn't anyone claimed them? The donors are Jewish. That could be a black mark against them in the Christian-dominated field of embryo adoption. Also, they've been accumulating storage fees for years and they want money. It's probably a lot of money. I close the page.

I update my FB group. I update my friends. I feel flat. I feel defeated.

So, this is where I am. Terrified I won't get pregnant. Terrified I will and face another miscarriage. Terrified that I will never get my take-home baby.

I want to be hopeful. I want to be positive. Yesterday afternoon, when I felt a series of twinges that were like the implantation cramps I got last time around, I emailed Mr. Hope to let him know. He wrote back, "Maybe they'll stick around after all!"



  1. <3 I can understand wanting everything to go smoothly. I'm the same way! I had three AAs with an AB and three of the four died. I wish there was more rhyme/reason to this crazy process for people like us who need structure to reassure us. I never could just sit back and let things happen myself. I hope your twinges are right!!

    1. I think I'm where you were at this point in your current cycle. Like, I think I know things are happening, but I can't get excited. All I can think is, "Well, even if I get a BFP, it could be a chemical. Or a blighted ovum. Or another miscarriage." I hate that infertility has robbed me of so much joy.

  2. And what a rip off about the gown!

    1. OMG, I know, right? I had to ask once before but they've never NOT had them!

  3. Thinking of you, try to not to obsess too much about the grading. Perfect looking embryos fail to implant and average or poor looking embryos still make perfect babies. So much of it is misunderstood. You are PUPO! Enjoy!

    1. Working on it! It's so hard. Fear does such nasty things to your brain.

  4. Last time started off good and ended up bad, maybe this time by starting off bad things will end up good? Yay for twinges, burrow in there little embryos!

    1. You know, I'm a sucker for a good story. I love the one that starts off, "It never should've worked, but it totally did..." And then, of course, me being neurotic me, I think, "If you want that, it will never happen." Me = crackerhead.