I was out for a cliff walk on Saturday morning and hoping to make it home before the clinic rang with an update. Bit awkward trying to hang back or dangle discreetly from a cliff-face to get a bit of privacy.
(I took the precaution recently of changing the clinic’s entry on my phone to “Simon” so it’s not as obvious who’s calling. This casual lying and subterfuge gets a little wearing after a while. I even have a story ready about whacking my hand on a doorknob should anyone ask about the massive bruise on my hand.)
As it was, I was home when they called at about 2.30pm but didn’t get to the phone fast enough, so missed them. Fifteen minutes of suspense later, I finally talked to embryologist A, who had good news. All bar one were compacting nicely and we would have two to transfer at 12.30 on Sunday. She’d give me a further update in person the next day.
It being a Sunday, the clinic waiting room was practically empty today and also pretty damn cold, as they obviously don’t bother with heating. There was only one couple waiting, and the nurse told me later they had driven over from the other side of the country. When I was in for intralipids a week or so ago, one of the other women had driven four or five hours through the snow to get there. I’m so lucky to be a mere 15-minute drive from the clinic.
I’ve done the last few transfers on my own but my mother insisted on coming today, so I left her behind in an empty waiting room with Sky News on, some trashy magazines and the coffee machine all to herself. No disrespect to my Dad, but I think when you’re married to a 74-year-old man this qualifies as quality me-time. My mother seemed pretty content, at least.
My tried and tested policy of drinking only 330ml before transfer to avoid being in a cold sweat with bladder pain let me down last time, when I had to top up in the theatre, so I drank 500ml from about 11.30 today just to be sure. I still wasn’t feeling the bladder when they brought me downstairs to get ready but was afraid of making the rookie mistake of taking more on board only for it all to hit me in one miserable, sudden go as I waited to be called in. I chugged another small cup very reluctantly in the knowledge that at least there were unlikely to be the usual delays on such a quiet day. All was fine, and I could definitely feel the pressure when the nurse gelled me up to check.
Embryologist A came into theatre for a progress report. We had one excellent fragmented blast, exactly as they wanted it, giving me a 45%-or so chance of pregnancy. The other candidate was not so great – not fragmenting yet ie still a morula. If we had had only the morula, we’d have been looking at a less stellar 15% chance of pregnancy. Still 15% though.
I asked about the other four and, as of today, none of them was looking good enough to freeze, as not yet fragmented – morulas don’t survive the thaw well, A explained. That’s not to say that they won’t be fragmenting tomorrow and, so, they will keep an eye on them. No news will be bad news: if I don’t hear from the embryologists tomorrow, there are none to freeze. Otherwise, they’ll ring about lunchtime. I was a little disappointed but we’re not beaten yet.
Dr C, who did my egg collection, was there for transfer. He was super-informative and explained more about the process than anyone ever has before. It was a slight shame that the theatre nurse was obscuring the screen, despite literally bending over backwards to clear my view. Dr C showed me a small white area on the screen, the sweet spot where they want the embies to land. Above it, you’re looking at ectopic pregnancy risk. Below it, chances for the embryos are just not so good. He did a practice run to make sure they would land in the right spot and then released the real embryos, pointing out where his line was before doing so. They rewound to show me the flash of the embryos being released.
I asked if the embryos stay put or move around before implanting and he said a study was done in which they observed the embryos for about an hour and a half after transfer and they did indeed travel a little. Contractions of the uterus are not great news, apparently. I asked if this meant they discouraged women from having sex after transfer, and they do. This hasn’t come up, not surprisingly…
If the blast implants, this will happen within about 12 hours. Its mate, in contrast, will take 24-36 hours to burrow in.
Interestingly, if both embryos had been as high-quality as the fragmented one, I would have been given the option to implant just one, as the chance of multiples would have been high. I also would have had to sign a form to confirm I understood that risk (why did they not ask me to do this with my two two-embryo frozen transfers, I wonder?). As it is, we have a 15% chance of multiples and I still had to sign to that effect – though neither embryologist A nor Dr C seemed to think this very likely. As with A, Dr C gave me about a 45% chance of pregnancy overall due to our star player, which he said was as good as you can get, with the lagger contributing an extra handful of per cent in his view.
I asked Dr C about the other four and whether their slower fragmentation meant they were inferior quality. He said not necessarily. Embryos develop at the same pace for the first three days but after that their speed of development varies. So, if some of the others do fragment by tomorrow, they are by no means inferior to today’s blast.
All went well, as is usually the case with my actual transfers. There is one tweak with the meds: at egg collection last week, one of the nurses mentioned reducing the Omega 3 capsules from three to one after transfer because of a risk that they might contribute to miscarriage. This was news to me, and I’ve continued taking three after all four of my frozen transfers, but apparently it’s a new policy. I asked Nurse E today and she confirmed that I should reduce the dose. I do recall querying the use of both Clexane blood thinner and Omega 3 when all this stuff was prescribed for me initially but clearly they’ve changed their minds. Best not to think about that.
I’ll have intralipids on Wednesday and my test date is 20 February. I’m not sure this time if I’ll bother doing a home test, as the positive on the last transfer broke my heart. We’ll see.