Expectations: The World’s Worst Game Of Telephone

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Two weeks or so after the retrieval, we’re finally adjusting to the disappointing outcome and the slim margin of error between us and another round of IVF. The day Charlie starts his period, he calls the IVF clinic in Tucson to schedule the transfer of our first embryo (the highest quality of the three). The IVF coordinator, who has been our main point of contact with the clinic throughout this process and whom we’ve come to think of as a personal friend, tells him they prefer to wait one full cycle between retrieval and transfer to let the system recover from all the medications and stress of IVF. No one has ever mentioned this to us before–we thought we’d have a chance to get pregnant in February, and after a year and a half of trying, we’re not thrilled by the prospect of waiting another month. Besides, if a March transfer is successful our baby will be born at Christmastime, which Charlie would prefer to avoid. “Isn’t there any way we can do the transfer this cycle?” he pleads with the coordinator.

Reluctantly, she agrees to schedule an appointment later this month, provided that Charlie will get an ultrasound as soon as possible and make sure he has no ovarian follicles larger than two centimeters in diameter. (Larger than that would indicate a risk of getting ovarian hyperstimulation syndrome during pregnancy.) After Charlie promises up and down to make an appointment in the next two days and let her know the results immediately, the coordinator agrees to tentatively schedule his transfer for the middle of February.

It’s worth noting that we already have travel plans for mid-February. As you may remember if you’ve been within earshot of my screams of glee in the last six months, Sleater-Kinney, my favorite band in the known universe, reunited in December 2014 after a hiatus of nearly a decade. At the beginning of 2015 they released a new album and began a world tour. We bought tickets to see them in Denver, but after ten Sleater-Kinney-less years, that wasn’t enough for me. Through some combination of cajoling, sweet-talking, and possibly bribery (I may have sworn to watch every romantic comedy Charlie wants to see, without complaining, for the rest of our natural lives), I managed to convince him to road trip to Omaha so that we can see them play two nights in a row. Now there’s a new twist: After driving to Nebraska and back in the span of 36 hours, we’ll need to turn around and get on a plane to Tucson. “It will be an adventure,” I say. “Why do I ever listen to you?” says Charlie.

Charlie calls the monitoring clinic in Denver to schedule his ultrasound, but they haven’t received the necessary paperwork from the clinic in Tucson, so he has to contact them again and have it re-sent. This whole two-clinics-in-two-different-states thing has essentially been the world’s worst, slowest game of Telephone, where no matter what you do the message that arrives is never exactly the same as the one that was sent. Then we find out that the IVF clinic has accidentally ordered a pelvic ultrasound, which is much more detailed and time-consuming–and about four times as expensive–as the follicle count ultrasounds Charlie has had before. We ask them to re-submit the orders without the word “pelvic,” because we can’t afford a $250 ultrasound and plane tickets to Arizona in the same month.

When Charlie arrives at his appointment, the Denver doctors say they still haven’t received the new orders. At his insistence they double-check and find the paperwork on their backup fax machine. Having one fax machine in 2015 is baffling enough, but two? With two different numbers? What purpose does that serve besides psychological torture?

This time, the person who performs the ultrasound is a new intern, who hasn’t had much experience with the snatch wand. She isn’t very gentle, which is uncomfortable for Charlie’s recently-stabbed-with-needles vagina. Finally, however, she confirms that Charlie’s largest ovarian follicle is eleven millimeters, comfortably within the Tucson clinic’s guidelines, so the transfer is on.

Charlie looks at plane tickets and decides that the cheapest option is also the one that sounds the most ridiculous: we’ll take the earliest flight from Denver to Phoenix on a Tuesday morning, rent a car, drive to Tucson, go to the transfer appointment, drive back to Phoenix, and fly back to Denver the same night. I’ve heard rumors that for some people, getting pregnant is romantic.

Charlie has to start taking estrogen supplements to build up his uterine lining so that it will be well prepared for an embryo to implant. He’ll also need to begin taking progesterone just before the transfer. When you get pregnant the low-tech way, with an egg that was just released from an ovarian follicle, the follicle curls up and becomes what’s called a luteal body, which produces progesterone to support the developing embryo. However, since Charlie won’t ovulate before the embryo is transferred and thus won’t have a luteal body, he’ll need to take progesterone daily during the transfer cycle and, if it’s successful, until the tenth week of pregnancy, at which point the placenta will take over progesterone production.

For some people, progesterone supplementation involves a daily intramuscular injection of progesterone in oil. We’ve heard that it can leave tender, painful bumps under the skin that last for days, so we’re super relieved when the IVF clinic prescribes vaginal progesterone suppositories instead. They have to be kept in the refrigerator and taken at the same time each morning and night, which means more weeks of arranging our evening schedule around Charlie’s medication protocol, or going out with a cooler full of drugs at our side. And although these hormones are cheaper than the medication for the retrieval cycle, they still cost enough to put a serious hurt on our social life (which is fine, since Charlie isn’t allowed to drink right now anyway).

But no matter the expense, inconvenience, or exhaustion, we’re convinced it will all be worth it if we end up with a baby of our own. We’ve come much too far to back out now.

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