anxiety, fertility, IVF, ovulation, pregnancy, running, single mom by choice, SMC, trying to conceive, ttc, two week wait

the science

It’s a quiet Tuesday evening at home. The light is beginning to wane, and the fog is so thick that I can’t even see the hills. Big puffs of fog roll intermittently down my street. I’m getting used to this phase of not doing much… Just talked myself out of doing work tonight since it can all just simmer down and wait until tomorrow. I also decided not to start my taxes (again). We can’t be driven by the to-do list every hour of every day. Am I right?

Last night was IVF orientation class at UCSF. I got to meet my Patient Navigator, the woman I eventually need to talk to about the financials. Maria from the front desk was there and gave me a hug. The auditorium was full of around 80 people considering or beginning IVF treatment, all roughly my age, all likely having been through the ringer on this already. I walked in and took a seat in front so I wouldn’t be too tempted to peoplewatch and make up stories about what each couple was going through. A woman my age sat next to me–I eyed her wedding ring. Why wouldn’t her husband be here? I felt solidarity with her, and annoyed that he felt he had something better to do.

Dr. Cedars, who I believe had the longest wait when I first called UCSF, got us started with a PowerPoint slide of all the physicians on staff, including, yep, Dr. Tran. I gazed at his photo fondly. She went through all their background info and areas of research (they really seem like a bunch of pals), and then we covered the basics: pre-conception testing, various protocols, the retrieval process, the transfer process, success rates. I knew a lot of it already (it’s amazing how much medical knowledge you can retain when it’s about you), but it was good to hear it from start to finish. I learned that the uterus is actually “potential space” and when it’s empty it’s flat like a pancake with the sides touching. Also, the ovaries aren’t really hanging way out on the sides like a Georgia O’Keeffe painting; they are usually hanging next to the vagina, just millimeters away. Closer to the opening, making the retrieval process not as terribly invasive as one might initially think.

Dr. Cedars says she is more conservative than her younger colleagues who recommend that the only thing you should not do between transfer and pregnancy test is skydive. She no longer recommends bed rest but forbids anything bouncy (which actually brought tears to my eyes as I considered abstaining from running at such a stressful time). She doesn’t want the uterus to contract for any reason–the Valium for transfer day is a muscle relaxer to prevent cramping when the catheter is inserted. She also forbids fish oil (which I’m currently taking) and herbal treatments because they can supposedly cause your blood to not clot well. She said to stop the fish oil when starting stims.

Then we moved on to Dr. Rosen, the lab director, for a bunch of amazing photos and videos from the embryology lab. We got a virtual tour of the lab, with its super-pure air (pushed through 5 filtration systems), incubators with each shelf dedicated to one patient at a time, and these futuristic-looking machines were the operator sits holding a joystick in each hand–ostensibly to guide the needle into the egg and inject the sperm.

The ICSI needle is 1/10 the diameter of a human hair, and the egg is about the size of the period at the end of this sentence. (Probably smaller, actually.) This video game requires some serious precision. About 75% of their IVF patients do ICSI.

I was just reading about how they dehydrate the embryos so they don’t burst while frozen, and apply antifreeze (cryoprotectorant) so they don’t shrivel. It sounds so sad! Don’t tell my kid. Assisted hatching is something they do for women older than 38, since their eggs’ shells can be too hard. The methylprednisolone, whose purpose eluded me when my meds box arrived, is a steroid hormone with immunosuppressive potency, potentially helping the hatched embryo survive in the new environment of the uterus. For some reason not explained in my handout, it helps them implant better. (Did I sound like a med student until that last sentence?)

Suddenly, regular conception or even IUIs  seem practically irresponsible for how much they leave up to chance!

The last slide was a photo of a newborn with an extremely scrunched-up face, and the caption said, “A Healthy Singleton.” Which is the goal. And, honestly, all of the above science doesn’t necessarily feel all that connected to actual pregnancy and birth. I guess that’s why you get nine months.

It occurs to me just how action-packed this blog is going to get in the coming weeks. First, the baseline ultrasound. Then the play by play on stimming–watching for how many follies grow with ultrasounds every other day. I am already anxious about the successful injection of the HCG trigger 36 hours before retrieval–the timing has to be exact. Then: retrieval, the daily fertilization reports until Day 5, the two-week wait for the genetic test results, and then gearing up for the transfer cycle (I don’t even have that calendar yet).

We won’t know anything definitive for two months but MAN will we be busy. And by we I mean me.

 

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6 thoughts on “the science”

  1. I have stumbled across your blog today, you are a brave and inspirational woman. Good luck with your ivf journey. I will be following and looking forward to reading when you eventually get to hold your healthy singleton 🙂

  2. I read this with fascination. Looking forward to an action-packed blog in the coming weeks, but more than anything, the ultimate goal: that healthy singleton.

    Love,

    Wig

    PS: It funny talking to young, female college students already thinking about how to handle the career-life-baby-partner balance at age 18! Years beyond them, and with me and other friends still figuring out paths at 40 or so, its actually hard to give sound advice (especially since my own path has been imperfect). Wig, what would you tell an intelligent 18-year-old honors student who wanted your advice on how to plan ahead for career and family?!

    1. Wig, I’m glad to hear that young women are considering this early! I just watched a Ted talk by Sheryl Sandberg (now author of Lean In, which I am reading), in which she talks about her undergrad experience where all women were focused on pursuing their careers, most assumed they’d have families, and no one was talking about how to combine them. At all. I also don’t remember anyone talking about it back then. While I am clearly not the person to give advice on finding a life partner in time, I would advise young women at this point to freeze their eggs young. That’s what I would tell my daughter. The technology will get better and better an will at least be something to fall back on if things don’t work out as planned. Beyond that, I really don’t know what the answer is–I don’t know any examples of moms who have it all perfectly balanced. It’s a tough road (especially in the US), and unpredictable and individual. I’d say: be yourself, follow your dreams, don’t settle for a non-partner, and freeze your eggs.

  3. I’ll pass that on. Freeze your eggs, follow your dreams, and open your options. In that order. Ironically (or maybe not since its a best seller), I got my amazon package with Lean In just yesterday! I read the first few pages (the scene in which she was requesting pregnancy parking), but then actually had to do some leaning in in real life, somewhat inspired just having the book on my bedside table: Firmly and unapologetically requesting clarity on my annual travel budget with someone who is generous and flexible, but not always transparent.

  4. yay, good luck! You will probably want to stop running about day 5 or so of stims. By then, your ovaries will be bigger and bouncier and will hurt. I suggest converting to swimming or some other less bouncy activity. During the 2ww, I mostly hiked and walked, but did sneak in a little swim here and there. No running though–I hear you, but it’s worth it!

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