Tumbling Through the Rabbit Hole...
Header image

One or two?

Posted by Haisla Sunday, 30 August 2015 0 comments

I can't believe how the time has flown.

This summer has literally just sped by.

I've started in my new job (after a very stressful three months of working long hours to try to bring my previous job to a tidy-ish conclusion) and have had the lowest stress levels in years. My new job is a doddle. For the first few weeks I felt like I was "cheating". It was all just way too easy. A nice office based job, enough time to do everything I was expected to do and (comparatively) short working hours. And I got paid for it..

I also had to make a major adjustment in terms of my identity, which for so many years had been tied up to my career. Who was I now that I wasn't that person who worked long hours, put up with a lot of cr*p, dealt with very difficult / dysfunctional people on a daily basis, all for a very worthy cause?

I had to get used to not being that very important person in the lives of many very unwell individuals, for not having to deal with their daily dramas and often self-inflicted emergencies. I had to realise that to quell my hunger for excitement I would now have to obtain my daily dose of drama from the TV, like normal people do. I thought I used to thrive on being the person who brought order to all that chaos, but I must say that I feel much happier working in a calmer environment. I can actually see my desk these days, a huge improvement from my previous job and hopefully reflective of my inner world, too.

I'm slowly learning what it feels like to have a work-life balance (yes, I know, it actually exists - for many years I thought it was one of those unicorn-like things). And in short, it's quite wonderful.

I'm sorry if this sounds boastful, but it's really not meant to be. I just feel like I was under some kind of a weird spell (call it workaholism if you will) and just couldn't see a way out - I thought it was normal. Which just goes to show what growing up in a dysfunctional environment can do to you - it warps your sense of normalcy. Now that I'm on the other side, I can only shake my head and wonder how I survived. I don't need to be Freud to realise that on some level I must have craved for the drama and chaos; it felt familiar, it felt safe. I was re-living my childhood, but this time I was in control. Perhaps I needed to prove something to myself. I'm sure my motivations weren't completely pure (as often is the case, - we want to rescue people, because ultimately we want to be rescued ourselves). I do hope (and I genuinely believe) that I must have done some small good in the last ten years. I don't think it was all wasted, but I did pay a heavy price, as did M.

It's only now that I've slowed down that I realise how much he did in terms of running our household. He did most of the cooking and grocery shopping. He did quite bit of the housework. I did some over the weekends, when I wasn't too floored with exhaustion. But in the evenings, because he always got home first, he would do what needed to be done. I feel really bad about this. I was just way too preoccupied with my work to see. M. would bring it up every now and then, but what could I do? I only had so many hours in the day. So I would just feel guilty. Not a great dynamic. But I married a good man, you know. Not many would have put up with such nonsense. But M. knew what he was getting into when he married me. He knew what my work meant to me and he was willing to make the sacrifice. So I'm grateful, so very grateful that our marriage has somehow remained more or less intact and I'm now catching up on being a better partner. And it's nice, it feels healthier. We're both contributing to our family life, no-one needs to carry most of the burden. And we have more time to have fun and just enjoy each others' company.

That all being said, I'm not surprised I couldn't get pregnant. All those stress hormones continually flowing around my body for so many years. Goodness knows what kind of long-term havoc they've wrecked on my system. Not that I believe in all that 'just relax' crap (advice so familiar to us in the IF community), but surely a constant cortisol overload is not beneficial for the body either.

Anyway, after a month of much lower stress levels and lots of dedicated baby-making (which is much easier when both of you are working 9-5, I must say!), we still didn't get pregnant. AF arrived today and with its appearance heralded the start of our first FET cycle.

So I'm finally getting to the title of this post; the one question that has been haunting me since my WTF appointment with our fertility doctor in July, namely how many embryos we should transfer.

I know that we are in a fortunate position to have any embryos to transfer at all and that in the greater scheme of things this is a frivolous first world problem. But frivolous or not, a decision has to be made and it could have some rather serious consequences..

The Dr seemed to be strongly of the opinion that since we had such high quality embryos (out of which one was transferred and seven frozen) and a successful outcome at our last transfer (i.e. a pregnancy, which sadly resulted in miscarriage) we should only transfer one.

I did point out to her, that however beautiful our previous blastocyst had been (at "five grade AA"), it had obviously still not been chromosomally normal as it had resulted in a miscarriage and not live birth. Ergo, we have no way of knowing (save for carrying out a PGD, which is way too late now) how many (if any) of those 7 frozen embryos are likely to be chromosomally normal. In fact even a PGD could not guarantee a 100% certainty as only a fraction of the chromosomes of each embryo are tested. She had to concede that this much was true. I also pointed out that since this was our last NHS funded cycle, we would have to take finances into consideration, too, when deciding on the number of embryos to transfer. Again she accepted that these were things we would have to think about, but warned that based on our previous cycle and my age, I would be at very high risk of becoming pregnant with multiples and due to the increased risks to mother and babies, she could only recommend a SET. She said that we do have the right to request for a double embryo transfer, as long as we are fully aware of the risks and make an informed decision.

One positive thing I took away from this conversation was that a FET at our current clinic (with our frozen embryos) only cost approx. £1,000 a pop, which is a fraction of what a fresh cycle would cost. I didn't think to ask whether that figure includes the meds, but all the same, it did make my heart feel a bit lighter.

No matter how cocky I may have sounded in pushing for a double embryo transfer, it doesn't mean that I feel by any means certain that that's the pathway we want to go down. In some ways I guess I just wanted to make sure that we have the choice.

I've researched the risks that come with twin pregnancies. I've researched the pregnancy rates between SETs and DETs. I've read all sorts of scientific articles, case studies etc and as a result of it all, I think I am slowly (and rather reluctantly I have to admit - I mean surely transferring two would double our chances!) veering towards a single embryo transfer.

I've had a few conversations with M. about this, too, and I think we are both pretty much on the same page. We'll do one more SET and then if this one fails or ends up in miscarriage, we'll do a FET privately (at the same clinic) and transfer two.. I think especially since we now know that the cost of a FET is fairly reasonable, we feel safer in the knowledge that we should be (financially) able to do quite a few of those if needed..  I'm just hoping that at least one of our frozen embies is chromosomally normal. I would hate to spend months and months doing FETs only to realise that we'll have to do yet another IVF on my even older eggies.

Another scary possibility (that has crossed my mind more than once) is that perhaps our embryos are perfectly fine and it is my uterus that is just immunologically hostile to anything attempting to implant in there. The Dr I had our WTF appt. was fairly dismissive about this theory (I know immunology-stuff is considered pretty 'out there' by mainstream docs, so I can understand her scepticism), so I'm only holding onto it ever so lightly. I guess we would need to suffer three or more miscarriages before the doctors at this clinic would even start investigating such avenues and I'd quite frankly rather not cross such bridges until we get there.

Maybe we'll consider some more testing should this FET fail, but again, I'd rather get through this first before starting to worry about such things.

All in all, things are therefore well.

I've emailed the clinic and am waiting for further instructions (I can't help but think of the 1980's series Mission Impossible - "Your mission, should you decide to accept it ... is to self-administer numerous subcutaneous injections, undertake much cloak and daggery, including secret / whispered phone conversations with your ER, attending many undignified appointments with a dildocam, all in the hopes of having a baby.." I almost wish they'd send us one of those little discs that self-destructs in 30 seconds with the instructions of what we are to do next. Receiving a voicemail / email just seems so very underwhelming for something as complicated and potentially life-altering as IVF/FET) ..

Anyway, I digress. As per our info leaflet, I'm expecting an appointment in the next two weeks, to start sniffing Buserelin on CD21 and to start taking oestradiol tablets approx. 26 days from today (on the next CD1). The transfer itself should then take place approx. 3 weeks later, in mid-October-ish. Much easier than a fresh cycle of IVF. I think there are one or two scans sprinkled in there, too, but that's about it.

Bring it on, I say, bring it on!