Today began with a few attempts to extract blood from my veins, resulting in four puncture wounds (two vines if which bore fruit, two of which steadfastly refused). After the vampire routine I met with Dr. Braverman for a sonogram and a discussion of next steps in this FET cycle.
My lining today was essentially the same as it was on Friday. I was disappointed by this but Dr. Braverman was not. He cited a Cornell retrospective study showing no substantive difference in transfer outcomes where uterine lining was between 6 mm and 8 mm or more in thickness provided it demonstrated the trilaminar pattern. Dr. Braverman showed me my beautiful trilaminar lining.
We then talked about transfer dates and whether to transfer our 5-day or our 6-day embryo. Dr. Braverman looked at me and detected the storm brewing behind my eyes. He asked if I was opposed to the possibility of twins. He said that I have been through so much and with all of the travel and related stress I have undertaken to complete this cycle he really wants us to have the best shot at having one live birth out of this. He recommended we transfer both embryos (if both survive the thaw) so long as twins are not out of the question for us. If they are, we will choose the best quality of the two embryos to transfer this time around.
I was surprised to hear the suggestion but realized I should not be considering that Dr. Braverman is not working with your average IVF patient. Also, he reminded me that there are no guarantees. There is no guarantee either embryo will survive the thaw. There is no guarantee they are of good quality. After all, we already blew threw our best embryo in my cycle this May. There is no guarantee that the immune protocol in its current incarnation will work; it may need some tweaking. I may need laparoscopy to diagnose and remove endometriosis. There are entire worlds of what ifs to explore if one is so inclined.
I am not so inclined. I hate the what ifs. What ifs can go to H-E-double-hockey-sticks.
There are so many opportunities to fail. Or to win and then lose. Again.
As best I can recall it was during this moment – when we began talking about transferring two to maximize our chances if one slipping by the minefield of my immune system – in which the watershed broke. Dr. Braverman gave me one of those “you are going to cry on me, aren’t you?” looks and – foolishly – asked if we were okay. The dam gave way and out rolled the flood of tears and sobs that stained my face and shook my shoulders intermittently for hours to come. He said he recognized that look because he used to think it was him. I am sure he has used that line often.
He invited me to call him once I had time to think over what he had said. Among other things he said the risks of a twin pregnancy are no longer substantial if there is no history of uterine abnormality, serious autoimmune diseases such as lupus or serious third-trimester complications (toxaemia, for example). I have a history of cholestasis of pregnancy. He said that is manageable and not something that would ward against transferring two. He again said I could call if I had any questions or wanted to talk about this.
I don’t know that a telephone call is necessary. Maybe for the LP. He has more anxiety about transferring two than I do. After today’s discussion with Dr. Braverman I feel okay about an all-or-nothing approach. I cannot help feeling that the subtext of what he is saying is that he is not confident this will work, at least not if I transfer one at a time. If he goes to Vegas, I bet he blows a lot of cash. This man is a gambler.
What *is* necessary for me is to figure out the web of lessons today holds. I have a strong sense that this was a teaching moment and I have only scratched the surface of what all I am meant to learn from my emotional meltdown. Azulito sees an opportunity to teach me something. What? I don’t know yet.
One thing I have learned already is that I feel like a sham. I am concerned that I have been attempting to delude myself (or you, dear readers) about how afraid I am, how devastated I am by all of our losses and the fear that I will never have another successful pregnancy, how exhausted I am and, among other things, how lonely I feel sometimes in all of this.
I have chosen courage. And courage is what I try to manifest, for my own sake and when I share my experiences with all of you. Yet inside there is an ocean of tears itching to pour across every leg of this journey and a school of fears looking for a conduit in those tears.
Who knew that creating life – and letting go one’s creations when their time to hold a physical place on this plane was not fleeting – could be so terrifying and painful?
I ought to have known. I have been to the land of loss and fear before. Yet this time feels different.
I am alive to my vulnerability and to the vulnerability of Gertrude and Alice, our two remaining embryos. I am mindful of the educated guess our reproductive immunologist has made and we have embraced in following his protocol. I stuff down but know well the risk that a certain percentage of frozen embryos perish when thawed and others fail to implant or flourish even when chromosomally normal. I know that our chance of success if we transfer two is only slightly greater than our chance of failure regardless of how many we transfer, although the spread is greater the fewer one transfers.
I know so much. But I do not know how to tend to my feelings, fears and needs, it seems. Ostensibly, I have sold myself and others a bill of goods. Today I woke up (okay, I did not really sleep last night – a fact I admitted to Dr. Braverman at the start of my time with him today, noting this made me realize I am quite anxious about this cycle and this morning’s appointments) feeling unsettled. Yesterday, too. A storm has been brewing.
It may be the hormones. It may be the steroids. But behind the medications lies a woman – a mother – with a seemingly bottomless well of need for calm, reassurance, hope and faith that we have a real shot this cycle. Today I became mindful that a good-sized chunk of me does not know how to believe that.
I am dead scared. I am so scared I am afraid to admit how scared I am. I am afraid to own the depths and magnitude of this fear. At times it feels larger than life.
Where does this leave me? I feel as though I am or have been a con artist, shamming you into believing I had it together. Trying to sham myself into believing thar. And now we all know that is not true. It is not true at all.
The truth is, I am afraid. I feel tiny, vulnerable and exposed. I feel shaken, not stirred.
What does that mean?
Am I unable to believe this cycle will work as I did in May? It may mean exactly that. I may not be able to reacquaint myself with the innocence I have lost. Although this is our first cycle using an immune protocol (and an aggressive one at that), it does not engender the marvel and illusion of previous firsts.
I do not – cannot – blindly accept that this will work simply because I will it to. I can manifest an outcome and engender confidence until the cows come home. That trick has been played. I don’t believe in miracles happening in my lifetime anymore. I got my one miracle and I am fearful that asking for more guarantees me ongoing loss. This makes no sense. It is not rational. Bu this is how my phrenetic brain seems to work.
What lessons is Azulito trying to teach me today? A friend suggested I ask if Azulito wants to bring a friend along for the ride (vis-a-vis the two-embryo transfer recommendation). That suggestion opened up a world of possibilities for me.
Why wouldn’t I ask Azulito for some guidance about what to do?
Why am I so out-of-touch with how much stress I am and was under about our recurrent losses, this cycle and what happens if it fails (especially if it fails because my womb kills both Gertrude and Alice in one fell swoop)?
Why do I worry about everyone else’s needs and not realize the deep needs brewing inside myself?
This is a recurring theme for me. Has Azulito come to teach me that? I am inclined to believe so. And now I am deeply curious what other lessons lie behind today’s tearful breakdown in Dr. Braverman’s office. I am going to follow my friend’s suggestion and try to ask Azulito directly.
As for what is next, if all goes as planned my transfer will be Tuesday, October 14th. I will start progesterone on Thursday, October 9th. On Friday, October 10th I will be back in Long Island for my last weekly Intralipid IV (after this they are to be done bi-weekly if I get and stay pregnant). On Monday, October 13th I will have a final sonogram with Dr. Braverman to make sure my uterine lining looks good before Tuesday’s transfer. My first beta (hCG blood draw) will be October 22, 2014 (8dp5dt).
In reflecting upon this past weekend’s stay in New York, I would like to extend my heartfelt gratitude and tremendous appreciation to the women who made an effort to meet and spend time with me this weekend and today, those of you who introduced me to others close to you (or not so close in some respects, until this weekend) by whom I have been moved and inspired. You know who you are. From my heart and spirit to you and yours: thank you. I feel truly blessed.