One or two

If you had asked me 10 years ago about my future family, I more than likely would have said that I would be the mother to twins. Twins run in my family in every generation. My father is a twin (identical). My aunt (his older sister) has twins (fraternal). Twins go back several generations on my father’s side. I always assumed I’d be the next one to have them. I accepted it as my fate and moved on.

During the post-mortem on my first (failed) IVF cycle with our RE a few weeks ago — in which he said that my cycle was absolutely textbook perfect minus the lack of pregnancy (not as comforting as it might sound) — he asked whether we would like to move forward with a one or two embryo transfer for our second cycle. As soon as I opened my mouth to answer, my RE jumped in with the laundry list of complications that are more likely in a twin pregnancy. Increased risk of preeclampsia, gestational diabetes, low birth weight… yep, check.

For these reasons, as well as the perceived quality of the embryos we currently have frozen (Anna, Elsa, Olaf, Kristoff and Anakin, you may recall), he recommends another single transfer. And while this is his recommendation, he is open to transferring two because of the practical and logistical factors involved with IVF.

I left the office that day with my husband — me headed back to work and him home — and said in the parking lot, I don’t know what to do. This surprised him, mostly for the resigned to twins reason above. And honestly, it surprised me a little, too.

One of the very (very, very) few positives of medically assisted reproduction is that I have some small amount of control over having twins. In the future my 20+ year old self envisioned I did not. Our odds of having twins with a two embryo transfer is about 25 percent, per the RE. That seems somehow more significant – heftier – now when I have the option, technically, of choosing a singleton pregnancy and child.

I’m struggling with a few things as I try to make this decision (presently my husband has allowed me to make the choice). Perhaps most seriously with the practicality of caring for and raising two children at the exact same time. I’m not naive – that shizz is hard. That shizz is expensive. I ask myself if I could be a good mother (or perhaps more accurately, the kind of good mother I aim to be) to two as to one. The questions I ask myself are honestly exhausting.

Residing on the other side of the fence, of course, is the part where I’ve tried for three and a half years to have a baby and create my family… I can’t possible say, oh, I only want one at a time. Nope. Give me all the babies!

I don’t really see myself coming to a resolution on this any time soon. Overthink, much?

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When your heart keeps breaking

Going into my first IVF cycle I didn’t understand just how high my hopes would be. I thought, as long as we come out of this stim cycle with frozen embryos, I’m good. And we did.

But I’m not good. I got my period several days ago and have been stewing ever since. I went through the stages of grief. Spotting is normal during implantation and this is only a little more than that… Then my period would all but stop and I’d feel relieved and silly that I overreacted. Then, hours later, more red.

Little 3AB didn’t stick around and that sucks. It really just sucks. I’m angry that for what I’ve put my body through over the last several weeks I don’t have much to show for it. I’m still waiting. How am I still waiting?!

How has this thing that happens for a majority of the population — often by accident — not happened for me after three and a half years of time, money and effort? I’m angry. I’m sad. I don’t understand it. I can’t understand it. I can’t let it go.

I’ll focus on the positive — a future Frozen Embryo Transfer (FET) — later. I’ll dust myself off and gather the pieces… later. For now my heart is broken again. It’s my new normal and I hate it.

Signs

I’m kind of a superstitious person. Sometimes. Okay, much of the time. I don’t think I’ll break my mother’s back if I step on a crack in the sidewalk, but if I notice the crack I’ll probably avoid it.

My biggest source of superstition is numbers. Specifically dates. I hold a lot of significance in birth dates, death dates, milestones and the like. Before my husband and I were engaged, I’d talked him into committing to a specific wedding date — July 5th (happy anniversary, love!). My lucky number (and birth date) is seven, and his five. I also would have accepted May 7th as a wedding date, but in 2013, that fell on a Tuesday. Joining two significant numbers together into an important date of unity felt very special. I was not in love with getting married on the hottest day of the year in New York City, but some things were just more important.

Each time we’ve used medical intervention to conceive I’ve found that the expected due dates fell on the birthdays of very important people in my life. The first was my brother’s birthday. The second was my best friend’s (also the day before my aunt’s, who’d died the year earlier). I will never forget them. They’re tattooed on my soul.

When we arrived at the embryo transfer last week, I was on the look out for signs. The date that we’re expected to find out if 3AB “takes” will be during a significant week, but not the specific date. I wanted more of a connection.

I got it.

My embryologist, whom I’d met before but somehow never made the connection, shares a last name with my family. It’s the name of my mother, brother and stepfather. The moment that I read her name embroidered on her scrubs, I felt warm. I literally stopped her mid-sentence and told her she shared a named with my family and that that was such a wonderful gift to me on a day when I was feeling scared. This isn’t a very common name, particularly in the South.

I immediately perked up and held that warmth during the procedure.

My husband asked me after, while I was changing back into my clothes, why I hadn’t further explained the name significance to the embryologist. I knew I could fully form the words without crying. My stepfather died very suddenly five years ago. He was so important to me. I couldn’t say that out loud then, and at that moment I don’t think I would have wanted to. Because I didn’t feel sad when I saw her name and felt the connection – I felt happy. I felt like he was showing me that this was going to be okay. He swooped in with the support that he’d given me throughout my childhood and early adult life.

Thanks for the sign, Dad.

IVF: TWW

Right now, there’s a blastocyst swimming around in my uterus looking for a cozy spot to park and grow. I picture it a little like Dory in Finding Nemo, actually, but I biologically know it doesn’t really swim. The embryo we transferred on Wednesday was a grade 3AB, which I’m told by the many, many trained professionals that have seen my anatomy in the last week, is great.

The transfer went smoothly and was not at all painful like my egg retrieval. Some discomfort and pressure with a very full bladder, but a cake-walk, relatively speaking. It took about 10 minutes from start to finish and was fascinating to watch on the ultrasound screen. On the grainy screen, my husband and I watched the entire process as my doctor put little 3AB in where he/she belongs.

Now, we wait…

I’m relieved to have the injections over, and certainly grateful for the end of the pain of my Dark Willow ovary. Every other time I’ve been in this TWW limbo has been me white-knuckling through the anxiety of the wait. And while I’m certainly eager to see if 3AB is successful, I feel mostly relief that I have my first IVF cycle behind me, regardless of the outcome. 3AB is in there now and I just have to keep it as safe as I can.

While 3AB swims around looking for that warm and inviting spot, Anna, Elsa, Olaf, Kristoff and Anakin are now on ice. We were able to freeze five embryos. Two more of good quality (two more 3ABs), and three more of good/fair that appeared likely to survive the freezing and thawing process. When I texted my sister-in-law  about this process, she sent me a gif from Frozen, and the embryo “names” were born. Its become an amusing inside joke, and one I’m sure I’ll repeat pretty regularly over the next few decades. I’ve denoted Anna and Elsa as the two superior embryos, only because they were frozen together, but I’m personally pulling for Olaf to make it to my uterus next time. If only because it will be endlessly funny to call him Olaf in utero.

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Visualizing the possible

First, a fun fact*: An enzyme in pineapple could help an embryo implant into the uterus. I’ve been eating pineapple like it’s my job.

*I’m using “fact” quite liberally here. I mostly find this bit of information fascinating, and I happen to like pineapple (at least for now).

My acupuncturist recommended that I come in for a treatment 24 hours prior to my embryo transfer. As I lay down on the table, she explains the points she’ll hit to get my blood flowing well to my uterus in advance of tomorrow’s “big day.”

Before she leaves me with a dozen needles sticking out of various points on my legs, hands and tummy, she tells me to visualize what will happen tomorrow. Picture a perfect embryo entering a warm home and finding a nice, cozy spot to implant. If I’d thought about it too much, it might seem silly to picture this in my mind, but it certainly can’t hurt.

Then before she closes the door to the room, she says to picture what is to come in the months ahead. A healthy, growing bump; a happy mama to be. Visualize what I could look like in four, five months as the leaves turn. A Thanksgiving with a big, full belly (and lots of pie just for me… mmm… pie). Then picture laboring my child and holding him or her in my arms for the first time. The moment my husband sees his son or daughter. The hair color. The tiny but strong grip on my finger.

Imagining my child was very difficult for me to do. After three and a half years of waiting and two miscarriages, I don’t allow myself to picture a future with a baby with blonde hair (my husband’s) and green eyes (mine). It’s simply too painful to fathom that being real anymore.

As I lay there, I imagined my brain knocking down walls. I allowed myself to inch closer to visualizing this little person – half me, half my husband.

I left the room after my treatment very definitively wanting to take a picture tomorrow of me, my husband and our IVF nurse. If this is successful, I’ll hang that photo in the nursery in some months of the people that made my dreams come true.

If tomorrow doesn’t take, I’ll be glad to have a photo of us filled with hope for that little blondie with the green eyes, even if we have to wait longer.