Sunday, December 27, 2020

A Kind-Of Christmas Miracle

The much-anticipated embryo transfer has been canceled.

The deciding factor was yet another visit to the dentist, where Dr. DeVille’s boss finally dared to show his face and confront the mess that is the hole in my mouth. He tapped my teeth and did the “ice cream test” (not as tasty as it sounds) and poked around before deeming the extraction site infected. He prescribed another round of antibiotics, this time amoxicillin (because penicillin is for lightweights – my words, not his). I was instructed to take the antibiotics for 10 days, which meant I’d be medicated through the new year. If the pain didn’t go away in a week, he said, I should see an oral surgeon.

I contacted my treatment coordinator at West Coast IVF to inform her of my current medication status. I had hoped that we could simply delay the embryo transfer a week (do endometrial linings hold up that long?) but nope. She said we would have to cancel. Upon the resolution of my oral ordeal, I could reschedule.

Six weeks of fertility medication wasted. A baseline ultrasound for nothing. Airfare refunded and hotel reservation erased. Fantasies of a fall baby now crushed.

All because of one fucking little tooth.

I thought I would be bawling and inconsolable upon cancelation of the embryo transfer, but what I felt was closer to resignation. I was tired of playing “beat the clock” with my body. I knew canceling was the right thing, even though it broke my heart. That afternoon, I took the baby out for an extra walk. We’d had very mild weather for December in Minnesota, and I wanted to soak up the fresh air before a forecasted snowstorm came.

As I turned the stroller towards our home street, the sun was setting, everyone's Christmas decorations were lighting up, and the song “What a Wonderful World” came on Spotify. I cried a couple of tears because, all things considered, it was a wonderful world and I have a wonderful life. I was about to celebrate my baby’s first Christmas. There was so much to be thankful for. And yet, precisely because the world is so wonderful, I felt that aching absence of our baby-to-be. I just wanted her to be here already, to share the holidays with us.

Instead of paralyzing me, the cancellation of the embryo transfer mobilized me. I was determined to heal, no matter what it took, so I could get another transfer date on the calendar. I called the oral surgeon and bullied my way into an appointment the day before Christmas Eve. At that appointment, a very young, sweet assistant with a glittering engagement ring took a 3-D image of my mouth and listened to me recount each traumatic procedure and dental visit I’ve had since the extraction. Then she asked me to swish with some awful solution that tasted like semen. Then the oral surgeon (a DDS and an MD, because why be one kind of doctor when you can be two?), who resembled a huskier version of actor Damien Lewis, embarked on solving the mystery of my mouth pain.

At first, he thought a whitish hook shape on the 3-D image was an errant nerve ending that had somehow been left behind after the extraction. But then he texted Dr. DeVille’s office – apparently, they’re on a personal-cell-phone-texting-basis – and looked at some more X-rays and declared it an “aberration.” His next best guess was that the prior clearing out of my dry socket was insufficient and that perhaps food or debris had been left behind. He hesitated, but finally said, “If I were you, or you were my sister, I’d recommend going in there, cleaning it all out, and starting the healing process over from square one.”

“Oh, man,” is all that came out of my mouth when I heard that.

Those first few days, post-extraction, were so hard – liquid diet, no movement, sleeping propped up, narcotics ‘round the clock (if I was lucky enough to get them). I really didn’t want to go back to that place. I wasn’t sure I could come out of it again.

The oral surgeon understood my disappointment. He said I could wait and see if the pain resolved on its own. But if I didn’t want to wait anymore (I’d been doing the wait-and-see approach for three agonizing weeks after all), he was willing to do the procedure – called “debridement,” which sounded to me like a wedding on horseback – for the price of an office visit. He even threw in IV sedation and bone grafting – to prevent another dry socket – for free. He also outlined his extensive post-op instructions: medicated mouthwash, a syringe to clean the site with saltwater, antibiotics, five days sans exercise, etc., which Dr. DeVille’s office could use a few pointers on. (Their after-care was basically: don’t disturb the site for 24 hours, take Advil and Tylenol, and cross your fingers!) The oral surgeon even gave me his cell phone number in case I had any questions or concerns later. All I could think was: where was this guy when I had the tooth extracted? I’m confident that in his care, I could have avoided three weeks of misery. Lesson learned: spend the extra money and go to the experts the first time. (If you can get a referral.)

The assistant brought in the consent form for the debridement procedure. It was all pretty standard – but then I got to the section on IV sedation. As nice as it sounded to check out of reality for a while, especially while my mouth was being excavated, the risks went from tolerable to terrifying. Nausea, vomiting, headaches, heart attack. Worst case scenario: you could die. My danger signals started going off.

A perky receptionist came into the room and said that if I fasted until the late afternoon, I could come back and get my procedure taken care of right away. I felt overwhelmed and weepy and afraid. So I told the truth: “I don’t know if, emotionally, I can do another procedure right now.” She totally understood and encouraged me to call my husband to talk it over with him. I did, and my husband said I should give the antibiotics a few more days to work, to rest over Christmas, and if I was still in pain, I could come back on Monday morning and go under the knife (or whatever scary instrument they use).

I heeded his advice, because I remembered one thing this tooth trauma taught me: don’t schedule procedures in the middle of the week – especially before a holiday – because if something goes wrong in those early days, you’ll be shit out of luck.

I scheduled the procedure for early Monday morning. Then I cried and prayed for healing. I was not optimistic that my mouth would repair itself in a mere four days. But I decided that Christmas Eve was a good time to test myself. Could I be off pain medication? How long? Initially, I made it 12 hours, my longest stretch without pain meds in over three weeks. I enjoyed a lovely Christmas dinner with my family – roasted turkey breast, Brussels sprouts with bacon, stuffing – and on Christmas morning, I woke up, amazed that I hadn’t needed to take any pain meds overnight. I got on the treadmill and while I could still feel my mouth pulsing, it wasn’t painful. So I tried running. One mile, then two. It had been weeks since I did any heart-pumping cardio, so I slowed down to a walk, but it seemed like another sign that I was on the mend.

I dressed the baby in a frilly red-and-black checkered dress and we all gathered in the living room to open presents. The baby learned to crawl just in time to make a beeline for the Christmas tree and is an expert wrapping paper ripper. (She also has several newly cut teeth as I'm losing mine. Ha.) Every year, we all write one another heartfelt letters; this year, my letter made my eldest cry. (Aw.) My husband and I referenced the same dreams for the future in our missives (and, yes, another baby is still one of them). His gifts for me were bittersweet, as they were safety items for my embryo transfer trip, like sanitizing wipes and latex gloves. 

It was a simple and lovely celebration. And I endured the entire day without pain meds. While the awareness of a tender, gaping hole in my mouth has never ebbed, I almost (dare I say it?) feel like a sliver of my old self.

To what do I owe this rapid turnaround? (Not counting the three-plus weeks it took to get here.) The wonders of antibiotics? The cessation of infertility drugs, especially estrogen patches? Mind over matter? A Christmas miracle?

I don’t know, but I am so grateful to feel like for once, real healing seems to be underway. I pray it is permanent.

My hope for this hellish experience is that, just like when we had to cancel our Minneapolis IVF cycle because of that mystery bump on my arm, this dry socket nightmare and subsequent embryo transfer cancellation will turn out for the best. Maybe it would have been too dangerous to fly right after the holidays. Maybe my body needs more time to recuperate before procreating again. Maybe the baby needs extra attention right now that I couldn’t give her if I’d gotten pregnant this month.

A reason why might only be visible in hindsight. And so, I wait.

They say time heals all wounds; that better not be just an adage.

As for rescheduling that embryo transfer? I'll keep you posted...

Sunday, December 20, 2020

The Center Will Not Hold

Be careful what you pray for. You just might get it.

Cut to Friday evening, me on my knees in my bedroom, begging God for a sign about whether or not to go ahead with the embryo transfer.

Two-and-a-half weeks post-tooth extraction, my mouth was still throbbing and I was still popping Advil and Tylenol every six hours. I had spent that afternoon shuttling my husband to and from a colonoscopy. It was the final of a trio of appointments he wanted to take care of pre-transfer. The first, with an ENT for snoring, was utterly unhelpful. (Flonase and a wedge pillow? Google could have told us that.) The second, with a urologist, got canceled – after which, his symptoms mysteriously vanished. And now the colonoscopy, which required a brutal combination of semi-starvation and an onslaught of laxatives for 24 hours prior – and after all of which, the results were inconclusive. My husband would have to repeat the procedure in three months.

The night before all this, my baby had woken up crying. She’d been constantly congested for two months, which the pediatrician said was seasonal, then strep. But the stuffiness didn’t subside after 10 days of antibiotics, so I took her to an ENT. He said her adenoids were slightly enlarged, but because he generally didn’t operate on babies under nine months old, we should try a steroid nasal spray instead. That had proved totally useless. Now, she had so much mucous in her nose and throat, she could hardly breathe. This made her panic and cry, unless she was upright, so I spent much of the night going back and forth from the bed to the rocker.

So by Friday, I was overwhelmed and exhausted and just imagining bringing another human being into the world felt absurd at best and irresponsible at worst.

My husband, surprisingly, did not feel the same way. When I picked him up from the colonoscopy, he seemed to not only be back to his boisterous, optimistic self, he also dropped this bomb as I pulled into the driveway: “I’m OK with another kid.” He said this from the backseat of the car, where he was entertaining our restless baby.

Since my tooth extraction, I had felt his enthusiasm for the next baby waning. At one point, I dared him to say I should cancel the transfer, but he couldn’t. (I suspect that’s what he’d prefer but he loves me too much to stand in the way of what I want.) Part of me wanted him to say it because I have been feeling increasingly ambivalent about – and equally unable to cancel – the transfer. It was like being in a miserable relationship and waiting for the other person to break up with you because you didn’t have the balls to end things.

But, now, he was on board with another baby and I was wary. Idling in the driveway – because we’re never alone anymore and have no opportunities to talk about Big Life Decisions – I expressed all my fears, which are primarily financial and/or health-related.

He said he had those fears, too, plus another one: the deteriorating state of our relationship. We haven’t had sex in weeks, and even before that, I can’t remember the last time I enjoyed it (second trimester of pregnancy, probably). Personally, I’m at a point in my life where I could never have sex again and that would be just fine with me. The feeling is not mutual, however. Even if we could set sex aside, we barely have any intimacy anymore. No more morning coffee chats, no leisurely walks or lakeside runs, no Sunday church services. The closest we have to "together time" is watching an episode or two of The Office in the evening while rocking the baby to sleep. And because of his snoring, my husband has been sleeping on the couch.

“I don’t think it means anything about us,” he said about our sleeping arrangements. “But I don’t like it.”

I was kind of OK with not sharing a bed with him, because I was still sharing a bed with the baby. I’m a light sleeper, and I can handle interruptions from one bedmate, but not two. The sleeplessness had been so bad before he moved to the couch that I'd made worthless threats to get my own room and let the baby and my husband figure out their own sleeping arrangements.

My husband asked if I’d noticed the distance between us. Of course I had. I just didn’t know what to do about it. We’ve been in crisis mode all month. Just making sure everyone is showered and fed and fulfilling their household and professional responsibilities has been daunting.

“I miss us,” my husband said.

I guess I miss us, too? But more than that, I miss myself. Somewhere in the pain and aftermath of the tooth extraction, I lost who I used to be. Now I often feel like a bitter, angry, singed version of myself, just going through the motions, just trying to get through one more day.

So there I was on Friday evening, on my knees, pleading. “Please, God, guide me. Speak to me. Let me know what Your will is. If I’m not meant to go forward with the transfer, make that clear to me.”

That night, about an hour after the baby and I went to bed, she woke up screaming. It wasn’t a hunger scream. It was a pain scream. I changed her diaper. I tried a bottle. She wasn’t having it. She wailed and wailed. I tried suctioning her nose and got some mucus out, but now she was so upset that the amount of mucus she produced overpowered what I was able to suck out. She started choking again.

I went downstairs, where my husband was retreating to the basement to watch a movie with my younger teen, seemingly oblivious to what was going on. I was going to chastise him for being unhelpful, but when I opened my mouth, what came out was: “I think we need to go to the ER.”

Which we did. We raced to the closest children’s hospital and my husband dropped us off at the entrance. I was asked to fill out a sheet with my baby’s name and her symptoms. I wrote “choking on mucus” in the hopes that it would get us to the top of the queue, but in the grand tradition of emergency rooms, nothing was treated like an emergency.

Though a green stoplight on the wall indicated the wait would be under an hour, I later realized they probably never updated it. The baby was calm for maybe 10 minutes, but then she saw a young dad and his 7-year-old-ish daughter in face masks hanging around the aquarium and she freaked out again. The pain wailing ramped up, and by the time we were ushed to a desk by a triage nurse, the baby was inconsolable. Halfway through the intake (which was near impossible to do through masks and over the sound of crying), the baby threw up a ton of mucus all over my coat.

Finally, we were taken to a room. A nurse came in and said she would suction the baby’s nostrils out. I held the baby’s arms down while the nurse hooked up a loud, scary machine and shoved tubes in her nose. It looked like some kind of torture device. I started crying, the tears dripping inside my mask. When her nasal passages were finally clear, the baby calmed down.

But then we had to wait. And wait. And wait. It was almost two hours before a doctor arrived, and when she did, she performed the usual ear, nose, and throat inspection but didn’t have any revelations. She suggested another nasal spray to dry her up for the night, followed by an X-ray to check how large the adenoids were.

The X-ray was another round of trauma. My husband and I were outfitted in lead aprons. (“Any chance of pregnancy?” the tech asked me. Loaded question.) My husband held the baby’s head and I held her arms. The tech strapped her torso and legs to a plastic board. Then the X-ray tech went behind the wall and took the pictures. The baby was wailing again, and by the time we finished the X-rays, she was all full of mucus because of the crying.

Back to the room we went. I paced the floor, bouncing the baby, trying to get her to calm down. Time moved so strangely. Despite the late hour, I didn’t feel tired, but my husband kept falling asleep on the couch. This made me mad, that he couldn’t even be present in the simultaneously terrifying and utterly bored state we were in.

At the three-hour mark, we still didn’t have a read on the X-ray or a treatment plan. My husband started roaming the halls and bothering nurses until the doctor came in. I was unclear on what the X-ray showed, other than the baby’s adenoids weren’t huge (which we already knew). Still, the doctor said we should follow up with ENT and schedule an adenoidectomy.

By the time we were finally released, the baby was so exhausted she started wailing again. She cried the whole way home. I drove as fast as I could, wondering what the hell just happened. “We sped to the ER to get help and now we’re speeding home because the ER was of little help,” I thought. Other than getting the snot sucked out of her, did we just cause her more upset? Should I have just put her in the bath at home and gotten her to calm down instead? Why can’t I make good decisions? Why does healthcare suck? Why do bad things keep happening? When is this fucking awful year going to end?

I silently screamed, “WHERE ARE YOU, GOD?!” at the black sky.

Back at home, I removed the baby from her bunting. Her onesie was soaked through with sweat from all the crying. I put on her pajamas and I could sense a shift in her, like, “Oh, I’m home. These are my pajamas. I’m going to bed now.” She had a few sips of juice and fell into a deep asleep.

I, however, was wide awake, my mind racing. What did this all mean? Had I asked God for a sign and this is what He did? Practically suffocated my baby? Why didn’t He just make my endometrial lining too thin? Or cancel my flight? Or close my clinic due to coronavirus? Why this heavy-handed, hurting-the-people-I-love tactic?

Before I finally succumbed to a nightmare-filled sleep, I set an alarm for Saturday morning because I had yet another appointment – to get my fucking throbbing mouth checked again. I returned to the emergency dentist who loved trying-to-be-cool country music because he seemed to be the only person who understood my pain.

His take: my dry socket had been very bad, and though it was showing signs of healing now, he was not surprised that I was still in pain. “No one knows how to cure dry socket. We just manage it,” he said.

I explained that I was feeling frustrated and impatient with the pain because I was going through infertility treatment, and had a transfer scheduled soon. I needed to be off pain medications by then. 

“I know this isn’t your area of expertise, but should I cancel the transfer?” I asked. 

The dentist was dumbfounded. He clearly had no experience with infertility.  

“Am I going to feel better in a week?” I asked, trying to phrase my question in a way he could answer.

“I’ve had patients who take up to four weeks to recover after dry socket treatment,” he said. In other words, I was barely halfway through the healing process. “Can you wait a few days and see how you feel and then decide?”

Well, sure, I could. But at this point, the pain feels like a part of me. I’m afraid it is never going to end.

A hygienist walked me out.

“Good luck on your transfer!” she said. “I hope it all goes well!”

“Thanks,” I mumbled, feeling more and more convinced that the transfer wasn’t going to happen.

“Do you have any children now?” she asked.

For some reason, I said, “Yes, two. They’re older.”

I don’t know why I said that. It just came out. I guess I thought if I said, “I have three,” she would look at me like, “It doesn’t sound like you need infertility treatments!” or “And you have to have another one?!”

It struck me that maybe I was being greedy, that no one “needs” four children. And yet, in my head, I’ve conceived of it as: I have two daughters, and now I am going to have two more. In my mind, they come in pairs, not all at once.

That night, the baby once again had trouble sleeping. She kept waking up crying, which made me cry because I was so exhausted. I tried a new electric nasal aspirator and it was useless. My husband ended up rocking the baby to sleep as I lay in bed, worrying. Then I constructed an elaborate pillow arrangement so the baby could sleep with her head elevated but without putting her at risk of suffocation (I hoped). As I lay there, wondering if I would ever sleep again, I said, “Fine, God. You win. I’ll cancel the transfer.”

But then we all slept. And morning came. And here I am – torn and conflicted and arguing with reality again.

On the one hand, adding another kid to the mix right now seems insane. On the other hand, I’ve come this far, my lining is likely raring and ready to go, my travel is all booked, so why not just go ahead with the transfer? It might not work anyway. And if it does, I guess I have nine months to figure out how the hell I’m going to juggle everything?! 

If I do back out, what is my excuse? The tooth or my baby’s adenoids? Am I postponing? Or canceling and asking for a refund? I don’t know if I can tolerate the ambiguity of just putting it off until I feel better. Because who knows when that will be? 

Do my emotions matter here? Because if I cancel, even if my brain “knows” it’s the right thing to do, I will be devastated.

One more question: Is faith in the fearless plowing ahead or in the thoughtful pause?

And how the fuck do I get any answers?

Wednesday, December 9, 2020

A World Of Hurt

Remember when I said my body was all healthy and raring to go for another embryo transfer? Yeah, I spoke too soon. (Which is part of the problem with blogging – I suspect it invites calamity to keep things interesting.)

See, there’s this tooth. No. 19 for those in the know. I had a root canal on it in my teens, a crown put on it in my 20s, and for the past few years, it had been bothering me for a day or so every few months – just a mild, achy sensation that I couldn’t exactly pinpoint. I didn’t think too much of it because I’d had a root canal, after all – how could I possibly have any sensation left in a tooth with no nerves?

Clearly, I didn’t understand dentistry well enough. (Though as I’m learning, neither do the so-called dentists.) Finally, one night in November, this troublesome tooth woke me up, throbbing. I popped a couple of Advil and decided that was it, I was going to take care of it. With the transfer looming in December, I didn’t want any future dental surprises while pregnant.

Cue insane circus of trying to get a referral to – and an appointment with – an endodontist. When my efforts proved fruitless, I called a dentistry chain that advertised itself as affordable, offering a free exam and X-rays for new patients. This was attractive to me because I haven’t had dental insurance in at least a decade. They could see me right away, so I went. After an unnecessarily long and involved appointment, the dentist there, who we’ll call Dr. DeVille (for reasons that will soon be clear) said that it looked like there might still be some nerve left on my tooth and that I should see an endodontist to have the root canal redone. (Bangs head against wall.) I asked if I shouldn’t just have the tooth extracted instead and she said no, that wasn’t necessary. Oh, and by the way, I had a cavity. (My second one this year. WTF?!)

The endodontist Dr. DeVille referred to was available to see me the next day, so I went. The office was so fancy – white leather seating, massive flat-screen TV, fireplace, silver statues of animals – that I didn’t even feel like I could afford to sit in the waiting room.

The endodontist was nice, but he seemed young and inexperienced and after reviewing even more X-rays of my tooth, he said he could certainly redo my root canal, but he wasn’t confident it would be successful. And if it wasn’t, then I’d be looking at nerve surgery and a type of filling I’d never heard before (something about from the bottom up). The cost for these procedures? $2K. Each. Ouch.

I asked the endodontist what would happen if I did nothing. “It’s just a matter of time until it flares up again,” he said. “Then your face will swell and it will be very painful. But you could do nothing, for now. I don’t think it will give you a heart attack.”

At first, I thought he was joking. As in: it won’t stress you out. But then I went home and Googled. Holy shit. An infected tooth – even a latent, painless one – can cause a heart attack!

Given my Familial Hypercholesterolemia diagnosis, I knew I had to do something. Was it worth $4K to potentially save my tooth? Or should I just have it extracted, for a measly $338 at Dr. DeVille’s office? My husband had recently had two teeth pulled (at a different clinic), and after about a week of narcotics and soft foods, he was back to normal, running and chomping away on all his favorite crunchy snacks. It didn’t seem like that big of a deal. He was in favor of extraction.

Given how much we’d just dropped on our upcoming embryo transfer and the future costs of another baby, it seemed like a no-brainer. I’d get the tooth pulled.

Oh, but can anything in (my) life be that fucking simple and easy? Of course not.

I cried every day leading up to my extraction appointment. I had been hoping that someone along the way would say, "You're too young to lose a tooth!" But no one did. I really didn’t want to say goodbye to my tooth – especially since it had stopped hurting – but I also knew that I didn’t want to risk a dental emergency after getting pregnant – or even after the next baby would be born. There is no such thing as “taking it easy” when you have little kids. 

The extraction was traumatic. I was completely numb, so I felt no pain during the procedure, but it was as medieval as dentistry gets. At one point, the dentist (not Dr. DeVille; a colleague of hers) wrapped her arm around my head, pulled me into her bosom, and then used some kind of terrible tool to tug my tooth back and forth, back and forth. Halfway through the procedure, I thought about jumping up and saying, “Never mind! I want my tooth! Put it back! I’ll pay anything!” But I knew it was too late to change my mind. It will forever be one of the worst decisions I ever made.

Finally, the tooth came out. The dentist showed it to me. It had a little gummy gurgle of blood at the bottom of the root. “That’s the infection,” she said. “It’s out now.”

I thought the worst was behind me. (Ha!) Though I’d asked about antibiotics and prescription pain killers, the dentist swore I didn’t need either. (Huh.) She sent me home with instructions on how to “stack” Advil and Tylenol, which she swore was just as effective as an opioid. (Hahahahahahaha. No.)

For two days, I blended and drank all my food and popped the Advil and Tylenol on schedule. But the pain was starting to assert itself. I called the clinic and Dr. DeVille said that as long as my pain was constant, not increasing, I didn’t need to come in. She sent in a prescription for Tylenol with Codeine – but because of insurance issues, the pharmacy wouldn’t release it to me. Thanks to the opioid addicts of the world, there were a gazillion restrictions on pain meds and I had to wait a whole other day for Dr. DeVille to resend it to a different pharmacy, where I paid for it in cash.

I’ll try to spare you the minutiae of what turned into the second-worst weekend of my life (after my hospitalization for endometritis earlier this year). Suffice to say that the clinic’s 24-hour “emergency line” was bullshit. If I did get a call back (often, Dr. DeVille would text me instead, clearly as an avoidance strategy), she would just say that I should take more meds, that I would feel better soon, and that if I didn’t, I should go to Urgent Care (which I didn’t want to do because what do MDs know about teeth?). I asked multiple times for her to meet me at the clinic for evaluation, but she refused. I sent Dr. DeVille a picture of my extraction site, worried that I had developed a condition called dry socket (where a blood clot fails to form, or forms and falls out, leaving the bone exposed) and she blew off my concerns. I didn’t want anything to be wrong but I couldn’t ignore my instincts, either.

By Saturday night, I was in so much pain I couldn’t stop crying. I left the sleeping baby in my husband's arms and went to Urgent Care – where a doctor immediately diagnosed me with dry socket. (Thanks for nothing, Dr. DeVille.) I asked for a Percocet prescription, but of course the doctor, like everyone else, was a pussy when it came to prescribing narcotics. He wanted to try all his other options first. He shot me up four times with the weakest form of numbing agent I’ve ever had. It was no match for the throbbing in my gums. He filled the socket with paste. That did nothing. Finally, he printed off a Percocet prescription (because doctors can’t call these fucking things into the pharmacy anymore; thanks again, addicts) and I hauled ass to the only pharmacy within a 30-mile radius that was still open that late at night.

I arrived home at almost midnight, exhausted and in excruciating pain. I took the Percocet and some penicillin and got into bed with my baby, hoping I wouldn’t roll over on her in my drug-induced slumber. Yeah, well, no worries about that because I could barely sleep.

By Sunday morning, my mouth was not only still throbbing, my face was flushed red and swelling. The whole point of pulling the tooth was to avoid a dental emergency, yet here I was, toothless and having a dental emergency. I paged and texted Dr. DeVille and when she didn’t respond, I left her a tearful voicemail begging for an appointment. Apparently, she had had enough of me. She texted me saying that she was “referring” me to her boss, who was just as insensitive and who also refused to call me or meet me at the clinic. All he was willing to do was make sure I got an appointment on Monday. (Gee, thanks.)

Unable to stand the pain anymore, I found the only emergency dental clinic in my area that was open and took the first appointment available.

“They treat dry socket at Urgent Care?” the emergency dentist asked.

“Not very well,” I said.

“Huh. Did you hear that?” he asked his assistant. “Maybe I should start treating bladder infections here.”

He struck me as kind of a frat-boy type, though his music of choice was the kind of country that’s desperately trying to be cool. But I forgave him, because he knew his shit and took care of me. He told me that my nerves were going wild, like phantom pain. He got me completely numb, then scraped out the dry socket, put a medicated “pack” in, and sent me on my way. Though I couldn’t feel half my face for the rest of the day, I also couldn’t feel the throbbing.

Monday morning came and I was feeling somewhat better – by which I mean, I didn’t want to die. (I haven’t mentioned, but should, that in addition to reducing my diet to liquids and purees, the extraction also meant I couldn’t exercise. At all. So all my eating disorder triggers were being pushed at this point, too.) I had few coping mechanisms left. When I prayed, all I could manage to get out was, "Help me. Heal me. Please. I beg of you." When I meditated, I imagined my body being remade by God in heaven as the Bible promises it will be. Weightless, painless, free to move about as I pleased – and all my teeth in-tact.

On Monday afternoon, the dentist that pulled my tooth saw me again and said my healing was within normal range. I would be back to myself in, oh, about two weeks. 

“Two weeks?!” I thought. “Where was the warning?”

Another memo I didn't get: dry socket is more common in lower extractions. It's also more common in women taking hormonal birth control pills, which I was. Thanks for the heads-up! 

Had I known how awful this experience was going to be, I gladly would’ve forked over $4K to avoid it. I would still pay $4K now if there were any way to put my (mildly and rarely painful, if infected) tooth back in my skull. 

Why am I telling you all this? Well, for catharsis, first of all. (My therapist isn't available until next week.) But this really isn’t about my tooth. Or rather, it isn't only about my tooth. It’s about how much one person can take.

One of the things I hated about this ordeal was that I felt like I was trapped in a cage of pain and I couldn't interact with the outside world, where everyone else was going about their business as usual. I couldn’t be present for my baby. There were many moments when I would just sit on the floor with her in my lap, but I was too preoccupied by my pain to read to her or sing to her or even smile at her. I just couldn’t be there for her in any meaningful way. The pain demanded my complete attention. I was a zombie mommy.

Normally, being in my body feels like riding a brand-new Ducati – smooth, sleek, fast (sometimes too fast). OK, it doesn’t feel that great all the time, but right now, my body feels like a rusty tricycle with a crooked wheel – slow, awkward, in need of repair. And I can’t trust it.

Rather than being in a joyful state of preparation for the embryo transfer, I am freaking out (a recurring theme). And because one freak-out begets another, I can’t help but wonder: If one little tooth could take me down this hard, why am I thinking about having another baby? 

I’m worried about how long my mouth is going to take to heal. I’m worried about the amount of drugs currently in my system. I’m worried about traveling amid coronavirus, especially if my immune system isn't strong. I am worried that I can’t handle any future health problems that might arise if I have two little ones depending on me. I’m worried that I should be prioritizing the restoration of my own health over trying to build another human being.

If pain is a message, what is mine trying to tell me? (Other than the government needs to lift restrictions on Percocet just for me, please and thank you.) Is this tooth saga a sign that I should not proceed with the embryo transfer? Should I delay it? Cancel it? Trust that in a matter of weeks I’ll feel better and this will all seem like a foggy, distant nightmare?

My husband keeps saying, “This too shall pass.” Of course it will. But will I come out of it all right? I keep telling myself, "Tomorrow will be better," but I don't fully believe it. I've been in a near-constant state of pain for a week now.

I wish I had a panel of infertility warriors, medical specialists, and competent dentists to consult. I wish I could trust my decisions. I wish I knew how to be patient – with my body, with other people, with adversity. I wish I didn’t have to blog these things to feel some relief. (How do you people who don’t write everything down do it?!)

Do you know the poem "The Guest House" by Rumi? It goes, "This being human is a guest house. Every morning a new arrival." Well, the guests in my house right now – pain, anger, anxiety, regret – are assholes and they need to get the fuck out. I have to tidy this place up and prepare it for a guest who actually deserves to be here. Because I should move forward with the transfer, right? Right?

Tuesday, December 1, 2020

Proud To Be Donor-Conceived

While in the midst of solidifying a profile for our second donor-conceived embryo, we received news: our baby’s only full genetic sibling, a girl, had been born. Her mother posted a picture of the sleeping cherub in her crib. She looked almost identical to our baby as a newborn. It was awe-inspiring but also hurt my heart to look at her. If only we had transferred two embryos, she could have been ours. My baby could have grown up with a twin. (Of course, this is assuming that both would have implanted and the pregnancy would have been healthy and resulted in two babies.) Aside from saying I was both overjoyed and jealous, it is impossible to describe what it is like to look at your child’s full genetic sibling who belongs to another family.

Despite the bittersweet nature of the news, I didn’t want to deny my baby a connection with her only full genetic sibling in the whole wide world, so I sent the mother all of our family’s contact information for safe-keeping. She did the same. Then I printed out the picture of my baby’s new little sister and posted it on the wall in her room. Every time we passed by the photo, I pointed at the little girl and said her name. I also added other images of my baby’s half-siblings (through the sperm donor) and every morning we cheerfully greeted them with, “Hello brothers! Hello, sisters! Love you! See you someday!” As the weeks passed and I saw the delight it gave her to look at their pictures, I decided to put together a photo album of all her genetic half/siblings stickered with their names. My baby loves flipping through it and seeing all her sibs.

At the same time as we were familiarizing ourselves and the baby with her genetic half/siblings, I was struggling with a huge elephant in the room: I still hadn’t told my parents about my new baby’s origins. (And yet, I had started a blog about it, so depending on how often they e-stalked me, if ever, perhaps they already knew?) I knew I needed to tell, out of loyalty to my daughter. I didn’t want her conception story to be shrouded in shame or secrecy. I believe how we became a family was miraculous, and I wasn’t going to hide it just because it didn’t follow the narrative of Where Do I Come From?

I consulted a Facebook group for parents of donor-conceived children (hi, my name is Erica, and I am a Facebook group addict) on how to tell my parents. Someone suggested writing a letter. I liked that idea, because I (obviously) express myself better in writing and it made the “conversation” a one-way statement of fact rather than a question-and-answer session. But mailing a letter seemed antiquated and too formal. Instead, I composed an email and sent a tailored version to each of my parents. It went a little something like this:

Hi Mom/Dad. We wanted to tell you this sooner, but since everyone seemed shocked when we announced we were expecting, we held off. Then there never seemed to be a “right” time.

When we decided to try to have a baby, we faced several challenges. We explored all the methods of having a child and ended up using a double-donor embryo (donor sperm and a donor egg) which was transferred into my uterus during an IVF cycle. The donors are anonymous, but we may explore finding them in the future if that’s what our daughter wants.

We are committed to being open with her and family members about her being donor-conceived. It just took us a while to figure out how to share the news.

We hope this doesn’t change your feelings about her. If you have any questions, please feel free to ask us.

I was prepared for an onslaught of questions. Instead, I received a “No problem. She’s still your baby girl,” from my mom and a “Not at all. Congratulations,” from my dad.

Huh. So that was a lot of fretting for nothing.

I want my daughter to be proud to be donor-conceived. But I still have questions about how to instill that pride in her. Being a parent of a donor-conceived child has shown me how genonormative our society is. People automatically assume families are genetically related and feel free to comment on them. Here are a few comments I've received so far:

“Where did these big feet come from?” – my mom, before she knew

“Does she look like her sisters when they were born?” – the pediatrician who examined our baby in the hospital

“Did any of your kids get this gorgeous hair color?” – my hairstylist

“I was hoping for a redhead!” – the photographer who took my maternity photos when we brought our baby in for a portrait session

“They’re like puppies – where the rest of the litter ends up is not your concern.” – a therapist (who I will never see again) about my daughter’s genetic half-siblings

When people make comments like these, I still haven’t figured out if I should launch into an educational lecture about donor conception or if I should just answer the question as truthfully as I can – i.e. “No, none of my children got my hair color” (which is, oddly, something I never thought about even with my bio daughters) or “Yes, she does look like her sisters at birth” (bio and social, strangely enough).

I imagine new conundrums will come up regularly as this is the first time I have raised a donor-conceived child. As those issues arise, I plan to blog about them. As for anything else? I’m unsure. This blog started as a way for me to process the experience of getting, and being, pregnant with a donor embryo. Now the blog has caught up to real time – so I don’t even have a proper teaser to end on!

I don’t know what will happen next, but I hope you will continue the journey with me.

Friday, November 27, 2020

The Paradox Of Choice

No two donor embryo profiles are alike...which makes picking one near impossible.

But we were past that stage. Or so I thought. We’d signed on for what would likely be a blonde-haired, blue-eyed bundle of joy with West Coast IVF. I made my travel arrangements, scheduled my ultrasounds, and filled my prescriptions. I started drinking fertility tea and popping my prenatal vitamin.

There was just one problem. This was the last remaining female PGS-tested embryo from the profile, which meant that we needed to pick a back-up profile just in case the embaby didn’t survive the thaw on transfer day.

My treatment coordinator sent us a backup profile. The egg donor was a certified massage therapist and a respite care provider. She was older (32) and on the heavy side (BMI: 27). She had checked “yes” for a family history of Down Syndrome but didn’t specify who had it. Obesity seemed to be an issue on the maternal side of her family, too. She had prematurely graying hair and her periods had ceased. One thing she did have going for her: proven fertility. She had two children of her own.

The sperm donor, an aspiring firefighter, had some problematic attributes as well, like a marijuana addiction as well as a congenital heart defect and a respiratory birth defect in his family history.

I won’t go into further detail because who am I to criticize someone’s health history (I wouldn’t even be allowed to donate if someone saw mine). But it wasn’t just the cold hard facts that gave me pause. It was…the aura of the profile. Perusing it, I just felt…sad. There was no joy in it.

This profile was an immediate, unequivocal “no” for me, even as a backup. My coordinator understood my reason for declining, but stated that she was out of PGS-tested female embryo profiles…unless I was interested in a mixed-race profile. Was I?

Infertility will make you consider many a thing you never thought you would, and I suppose this was one of them. I say that not because I wouldn't love a mixed-race baby (I would love any baby to pieces), but because ethically, I didn’t know if I, as a white woman, should raise a child of a race or cultural background other than my own. I wouldn't want the child to miss out on anything related to their culture or suffer identity issues because of my white blinders or ignorance. On the other hand, my teens are half-Latinx (my ex-husband/their dad is from Mexico City), so I already had experience and a comfort level with raising bicultural children.

We talked this through over the course of several family dinners. Ultimately, we all decided, if it meant a healthier baby, yes we were open to mixed-race Latinx-Caucasian profiles.

So the coordinator sent us one. The profile one was better, vibe-wise. The egg donor was Latinx and worked in the criminal justice system. The sperm donor was a science whiz with Turkish and Russian ancestry. Both had proven fertility. But here, too, were some non-negotiables. Instead of checking “no” under “Mental Retardation,” the egg donor had left it blank. Was it just an error? Or an emission? She also had an aunt with schizophrenia.

The sperm donor’s health history was pretty clean, save for red-green colorblindness (a recurring theme, apparently).

There are no perfect profiles. I know this. I just didn’t realize how lucky we had been when we were preparing for the transfer of the embryo that became our new baby. Hers was the very first profile we were offered and there was an extra female embryo so we didn’t need a backup.

This time around, I loved our chosen profile, but I wasn't crazy about the backup options so far. I didn’t want to risk getting coronavirus by traveling to California in what might be the peak of the pandemic only to find there was nothing to transfer – or that there was, but that the embaby might not be healthy.

The whole backup scenario threw me for a loop and made me question if even our original profile was good enough. The egg donor was, after all, nulliparous. She had no baby-making track record. I pressed my coordinator again for information on the success of our chosen profile. She said there were “no current pregnancies or births” from it. 

“This is a fairly new profile and most recipients are looking for brown hair and eyes,” she told me.

Was she trying to be reassuring? Spin our profile more positively? Was there something she wasn’t telling me? Would the clinic really transfer an embryo that they didn’t think had a chance of becoming a baby?

Suddenly unsure of anything, I did what I do best (or at least, most obsessively): I crowd-sourced opinions.

A quick survey of the West Coast IVF Facebook group showed that many women had gotten pregnant from nulliparous egg donors. But when I mentioned that there had been no pregnancies from the profile and that this was the last (female) embryo in the batch, both admins chimed in, saying they would not accept the profile. What good was the “perfect” profile, after all, if it doesn’t get you pregnant?

I pushed my coordinator once more on our chosen profile. How many transfers had there been and what were the outcome of those transfers? Her answer sent my hopes plummeting. There had been two transfers: one BFN (big fat negative) and one biochemical pregnancy (the absence of an identifiable pregnancy on ultrasound despite a positive pregnancy urine test). Most biochemical pregnancies are due to chromosomal issues. But these were supposed to be chromosomally normal embryos. Was a carrier issue, like insufficient endometrial lining, to blame? If so, might my outcome be different? 

My coordinator said the previous cycle outcomes were not indicative of embryo quality, or how my cycle would turn out, but the seed of doubt had been planted. Cue freak-out. I didn’t know what to do. Should we move forward? Was this profile going to work? Was it worth risking coronavirus for? (Was any profile worth risking that?) Was God saying “wait”? I couldn’t tell.

I had already started the birth control pills (and was slogging through some unpleasant side effects, like breakthrough bleeding and depression) and was nearing my first baseline ultrasound, after which I would begin the heavy-duty fertility medication regimen. If we were going to back out, I wanted to do so before inundating myself with drugs. 

But I didn’t want to back out. I had already fantasized about getting pregnant in December and visualized the timing of each trimester up until the birth next autumn. I had pictured our blonde-haired, blue-eyed beauty 1,000 times. (Although I’ll admit that the Spanish name we all adored didn’t really fit my vision of her.)

I couldn’t ignore the fact that our egg donor had yet to produce a single pregnancy – her own or someone else’s. That did not bode well.

In a heartbreaking decision reminiscent of when I canceled our Minneapolis IVF cycle over a year and a half earlier, I emailed my coordinator to tell her we couldn’t move forward with our chosen profile. Was there any way we could keep the transfer date but find another match?

The short answer: no. She told us we were going back on the waiting list, where it would be six months or more before we saw another match.

I felt gutted. I cursed. I called the clinic manager and was told to email her my concerns, which I did, in a long, emotional message. I waited. No response. I spent a night crying like, well, a baby. I hate the saying "You don't know what you have until it's gone," but in this case, it was true.

By morning, I knew what I had to do: try. If I went back on the waiting list, the chances of me getting pregnant spontaneously in the next six months were next to nothing. If I took a leap of faith, however, and did the transfer in December, the chances of me getting pregnant with our blonde-haired, blue-eyed embaby were as high as 60 percent. 

As soon as the clinic opened, my coordinator called me to resolve our conflict. She calmly explained that the clinic would never transfer an embryo they didn't think would stick. She reminded me that everyone has different medical histories and therefore one woman's experience was not indicative of another's. She said it was very rare that anyone had to use a backup profile, but promised to keep an eye out for a better one. For my part, I apologized for all the drama. (Bless these poor coordinators having to put up with hormotional Karens like me all day). I recommitted to our original profile and transfer date.

The baby-making plan set, I began taking steps to help my new baby connect with her genetic half-siblings – and a brand-new little sister...

Monday, November 23, 2020

Are You My Embaby?

It never fails to astound me that when you commit to a course of action, God (or the Universe or the powers that be) conspires to help you. About a week after turning in all the necessary paperwork, labs, and medical records required to get on West Coast IVF’s waiting list for a PGS-tested female embryo, I received an email from my coordinator.

We had a match. And it was perfect.

The egg donor was an active member of the National Guard and a file clerk at a law firm who did flower arrangements on the side. Her favorite movie was The Lion King and her favorite book was The Glass Castle. Though a quiet, shy child, she was very physically active in her youth, participating in everything from cheerleading to dance team to gymnastics to swimming.

Her reason for donating? “I am in a same-sex relationship and know how it feels to want to be a parent, but not be able to get pregnant the old-fashioned way. One day my partner and I will have to get a sperm donor. I want to be able to help a couple become parents.”

The sperm donor was an only child pursing a degree in psychology (which is what I majored in!) who excelled at running (like me!) and bowling (not at all like me).

“I am an easy-going, funny, hard-working individual,” he wrote. “People enjoy being with me because I can always make them smile and have a good time.”

According to the sperm bank’s comments, the sperm donor was “very punctual and has great manners. He is disciplined and trustworthy.”

This sperm donor was from a different sperm bank than our previous sperm donor, and this sperm bank had a lot more information available. For a small price, we could see the donor's childhood photos, creative work, a recording of his voice, and results from a personality test. A quick search on the Donor Sibling Registry showed that he had produced at least two other donor-conceived children. He was also open to contact. This was a major plus now that I knew how important being able to track genetic relatives might be to the embaby in the future.

Both donors were young, fit, and healthy. The baby would undoubtedly be a blonde-haired, blue-eyed cutie. (Not that we cared. Hair and eye color were the least of my concerns.) The only medical hiccup: the sperm donor had red-green colorblindness, a genetic trait. A quick Google search revealed it’s more common in males than females, so I wasn’t too worried.

There was one other hesitation: the egg donor didn’t have any children and had never donated eggs before. How did we know that she was fertile? I emailed the coordinator to ask if anyone had had success with this profile. She didn’t answer.

I was so in love with the profile that I didn’t care. On Election Day, my husband and I signed the profile page that would reserve a female PGS-tested embryo for us and I mailed the check that would pay for the three-transfer package.

My coordinator confirmed receipt of our paperwork, then asked if there were any days I would not be available to travel to California for a transfer. Assuming we were speaking about spring 2021, I listed the birthday of one of my teens as well as the birthday of the new baby.

“I am looking to schedule this before the end of this year, so great to hear that you are available,” she replied. “I will prepare your treatment calendar and send it to you to confirm dates and appointments.”

Before the end of the year? She couldn’t be serious. This had to be a mistake. What happened to the doctor’s insistence that I have around two years between births? Or be on Crestor for six months? Should I say something? Or should I just let her schedule me?

I didn’t want to end up in a situation where I was propped on the table, ready for a transfer, only to have the doctor come in and say, “Wait a minute! I told you not until spring!” So I emailed the coordinator back and fessed up. Cue several emails and phone calls back and forth trying to figure out who was insisting on a spring 2021 transfer. According to a note in my chart, I was the one who wanted to wait, not the doctor.

Finally, a new answer came back from the doctor: he only required one year between deliveries.

OK…?!?! I knew I hadn’t misheard him. He said not until April or May of 2021. But if he was willing to do a transfer sooner, so was I!

I felt all the things: excitement about a transfer so soon, and around the holidays (which made it feel more special). If the transfer was successful, the baby would be born in autumn. This was a godsend because I was not looking forward to bringing a baby home in the dead of winter and being stuck indoors for the first three to four months of her life (which would have been the case if I’d transferred in April or May). My two donor-conceived babies would be only 16 months apart, almost exactly the same age difference between my teens. This was everything I hoped for!

But I was also afraid. Coronavirus was still raging – harder than ever, according to the news. Was flying to California safe? What about staying in a hotel? And the Uber rides to and from the airport? It would be incredibly stupid to end up with coronavirus in pursuit of a pregnancy when I could technically wait until a vaccine was available.

My husband, who had initially said that if we were going to do another transfer, we should do it as soon as possible (because we weren’t getting any younger and we were already in baby mode) suddenly backpedaled. December felt too fast for him. He thought he had six more months to make peace with the idea of another little one under our roof. Now, he had emotional whiplash.

To add to this dizzying time, my period – a real period, my first real one since the birth – came, which meant I could start on the birth control pills that marked the first step in my medication treatment calendar. The fertility train conductor was shouting, “All aboard!” If we were doing this, it was time to get going.

I started popping The Pill, and as each day passed, my husband and I got more comfortable with the idea of a December transfer. Though I’d already picked a biblical name for the next baby, a new one of Spanish origin entered my head one day – and it stuck. I shared it with my teens and my husband and they all agreed that that was the baby’s name. No deliberation necessary.

Just as I was starting to imagine what our next little baby would look like, my coordinator sent us another profile. She explained that there was only one PGS-tested female embryo from the profile we’d selected. She recommended having a back-up profile in case the one we wanted didn't survive the thaw. That way, all my ultrasounds, fertility medications, and travel didn’t go to waste.

It was considerate of the clinic to give us a back-up option. But instead of reassuring me that I would have an embryo to transfer in December, no matter what, it sent me spinning. Coupled with a new piece of information about our desired profile, it made me reconsider if the embaby we chose was really perfect for us after all…

Friday, November 20, 2020

O Aunt Flo, Where Are Thou?

My heart and my mind were on board with trying for a second donor-conceived baby. My body, however, was another story.

One of the first things you need to start infertility treatment is a period. It marks Cycle Day 1, and without it, I couldn’t schedule the saline-infused sonogram (SIS) that I needed to get on West Coast IVF’s waiting list for a match.

Dr. Baby-Maker had told me that at the two-month postpartum mark, if I didn’t have my period yet, I should take a pregnancy test. I didn’t have the former, so I did the latter, and it was negative. (No surprise.) By three months postpartum, I still wasn’t seeing red, and the pregnancy test again came up negative. Dr. Baby-Maker said I could make an appointment for four months postpartum, but reassured me that my period would probably come by then and I could just cancel the appointment.

Well, the four-month mark came and my period didn’t. Leave it to Aunt Flo to crash the party when you don’t want her to and to go off the grid when you desperately need her.

I trekked to Dr. Baby-Maker’s clinic. While I waited in the exam room, I could hear her and another woman discussing an egg retrieval that apparently didn’t go well, judging by the intermittent gasps. It made me glad I was skipping that part of IVF and going straight to the embryo transfer.

Finally, Dr. Baby-Maker came in, bright and bushy-tailed as always. We got right down to business.

“I want to get back on the fertility train,” I told her. “We want to give our baby a little sister.”

“Are you ready?” she asked.

“If I could transfer today, I would,” I said.

She seemed surprised, but happy to help. I explained that I was moving forward with the donor-donor embryo program at West Coast IVF and that I needed to schedule a SIS. There was just one problem: I was supposed to do it on certain days of my cycle, but how was I supposed to know when to schedule it if I didn’t have a period?

“I’ll put you on Provera for 10 days,” Dr. Baby-Maker said. “That will bring on a period. Then you can schedule the SIS. This could take two to three weeks until you’re all done.”

I couldn’t believe how well-versed she was in infertility. I mean, it’s her job, but still. Competent doctors are rare.

In addition to the labs West Coast IVF required for its program, Dr. Baby-Maker ordered a whole lotta bloodwork.

“I’m curious to see what your AMH is now,” she said. “I’d also like to check your FSH again. I imagine it’s higher than last year.”

“And what would that mean?” I asked, though I suspected I already knew. “Not…menopause?”

“Perimenopuase,” she said. “But if your FSH is over 30, that is considered menopause.”

The possibility of perimenopause wasn’t a complete shock. A few years back, I’d written a newspaper article about creative women coping with peri/menopause…and realized I had many of the same symptoms as they did. But post-pregnancy, I actually felt better than I did back then. I was now thinner, had more energy, and was rarely depressed. But I did still have some perimenopausal symptoms. One of them was high cholesterol, which made me wonder if I didn’t have Familial Hypercholesterolemia but instead was in menopause – not that I liked that idea any better. (Isn’t aging fun?!)

“Any questions?” she asked as we wrapped up.

“Is menopause going to prevent me from getting pregnant again?” I wondered silently. (Because one would think that it would make getting pregnant, well, impossible.) But I wasn’t ready to confront that situation yet. I would just have to wait on the bloodwork.

And the wait was worth it. Not only was my FSH in the normal range (11.3), it was lower than it had been pre-pregnancy! My estradiol, prolactin, and TSH were all normal, too. It was almost as if pregnancy had been good for me. I was all balanced.

The one bummer: my AMH was indeed lower than last time. It was 0.08, down from 0.24. But with numbers that low, and the fact that I wasn’t even going to attempt to procreate with my own eggs, did it really matter?

“Your labs are not indicative of menopause,” Dr. Baby-Maker wrote on my online chart. “I am OK with you going ahead with another donor embryo transfer.”

The Provera produced a period as promised, though as far as my periods went, it was pretty lackluster. It was two days long and mostly rust-colored (read: old) blood. On day six of my cycle, I went to Dr. Baby-Maker’s clinic for the SIS.

Unlike my previous SIS with Dr. Gerber at the Minneapolis IVF clinic, this one was performed by a sonographer and a nurse, not by a doctor – and therefore, was not the quicky, easy, and painless in-and-out procedure I’d had before.

The sonographer started with an abdominal ultrasound to make sure that everything was where it was supposed to be, anatomically speaking. Then she switched to a pelvic ultrasound.

“You’ve had these before, right?” she asked.

“Oh, lots,” I said.

And yet, this time, it was really uncomfortable. The wand felt twice as big as I remembered it and the pressure was intense as she examined each ovary. But everything looked normal, so she brought in a nurse to do the SIS.

There was a disconcerting moment as the two of them stood over the tray of tools and surveyed them all with perplexed expressions, as if they’d never done this before.

“Sorry,” the nurse finally said. “They gave us all new equipment.”

They futzed with the catheter for a moment and one of them mentioned a balloon.

“No!” I thought. “Not the balloon!” (I was still traumatized from my HSG.)

As they discussed which attachment the saline went in, I had a terrifying vision of them blowing up my uterus with air instead of saline. Could a uterus burst like that? For a second, I thought about bolting. Did they really know what they were doing?

They turned out the lights and put a hot spotlight on my lady parts. The speculum had a tight grip on me, though I didn’t feel the catheter or the saline.

The sonographer and the nurse both peered at the monitor. They didn’t say anything alarming, but they didn’t exactly reassure me, either. A couple of times, the sonographer said, “Oh, is that something?” and then a minute later, “No, I guess not.” It seemed like she was looking for abnormalities and was disappointed when she didn’t find any.

Just being in the ultrasound room brought back a lot of anxiety, reminding me of those early pregnancy days, watching the screen, holding my breath, trying to decipher shadows and light on the screen.

“We got some really detailed pictures,” the nurse said at the end. “You did really well.”

I wasn’t sure what that meant. It wasn’t like Dr. Gerber at Minneapolis IVF triumphantly declared that I had “textbook perfect uterus.”

I asked the sonographer if she could send the results to West Coast IVF.

“The doctor needs to review the images and write a report. It could be a few days. How soon do you need it?” she asked.

“No hurry,” I said in that stupid, Minnesota Nice way of mine.

“You aren’t transferring for a few months yet, right?” she said.

“Right,” I said, though I immediately realized that West Coast IVF wouldn’t put me on the waiting list until they received the SIS results.

Rather than reassuring me that I had checked off one more box from the onerous to-do list for West Coast IVF’s program, the SIS made me question if I was really up for another pregnancy. The procedure had made me uncomfortable, and resulted in hours of cramping afterward, and as we know, humans don’t like discomfort. Humans wants to be cushy and comfortable and stay with the status quo.

Part of me wondered: “What am I doing? Why am I messing with perfection? Maybe I should just leave well enough alone. Maybe my body isn’t up for this again.”

I wasn’t ready to give up yet, though. I figured the best way to fight the fear was to check out every angle imaginable of my health. Assuming a match was months away, I started taking care of things I’d been putting off, like dental work and gum surgery, as well as preventative appointments, like my annual mammogram. I met with a genetic counselor and spit in a tube for a 47-gene cancer panel (which came back negative on all fronts, though because of family history, I am still considered high-risk for breast cancer).

I also followed up with Dr. Cardio. After three months on Crestor (and, to my credit, some hard-won diet changes), my total cholesterol was down to 188! Out of an abundance of caution, I also requested a calcium score test, which is a CT scan of the arteries to check for plaque buildup. My score was a 0 (which meant no buildup). 

“My husband and I are moving forward with a donor embryo transfer next year,” I told Dr. Cardio, who was unusually chipper during our conversation. “I will be OK off Crestor for a year, right?”

“If it’s just a year, I’m not concerned,” he said. “You gotta do what you gotta do.”

And I was going to do it. My body seemed to be saying, “All systems go!”

By late October, West Coast IVF had all my paperwork, labs, and the SIS report. My coordinator confirmed we were on the waiting list for a PGS-tested female embryo. Just as I settled in for a long, six-month wait for a match, I received an email. West Coast IVF had news for me – and it was very, very good