Sunday, February 7, 2021

Hurry Up And Wait (And Deliberate)



After a hellish month due to my baby’s breathing issues, I finally received a new embryo transfer date, for late February. Though the health drama had been giving me second thoughts about moving forward, once I saw the treatment calendar, I was all in again.

I giddily booked my travel arrangements and scheduled my ultrasounds. I refilled my prescriptions. I calculated the due date and corresponding astrological sign of the potential baby-to-be. I brainstormed new names. I attached to the idea of her. I let myself feel hopeful again. 

Then I received another email from my treatment coordinator. She’d forgotten that I wasn’t on birth control. (Of course I wasn’t…because she told me to stop all medications in December!) The embryo transfer date was null and void. I would have to wait for my next period and reschedule. Again.

I lost it. I went full Karen on the clinic manager. (Again.) I threatened to pull out of the contract, demand my refund, and pursue treatment elsewhere. Of course, I didn’t want to do that, because it wouldn’t get me pregnant any faster.

A nurse called to talk me off the ledge.

“There’s still a chance you could keep the transfer date,” she said. “When was your last period?”

“December 26,” I told her. And that one, as far as I could tell, only happened because I stopped all the fertility meds when my previous transfer was canceled.

“Are your periods regular?”

“They haven’t been,” I said. I explained about my missing period in the fall and the Provera I had to take to get it back. There had been nothing “regular” about my cycles since…oh…2019, before I got on the infertility treatment roller coaster.

“We need to figure out if you’re growing follicles,” she said. “Because if you are, your body might be releasing hormones that could interfere with the medication protocol.”

I didn’t know the details of my follicular count, but I knew that in the past, it had been puny. The nurse reviewed my last baseline ultrasound and my SIS and confirmed there wasn’t much happening in the follicle department – but was that because I had been on birth control? Or because I was old?

“One advantage of being a seasoned woman,” she said (and, yes, that was the term she used), “is that we don’t grow many follicles. So I think we should do an ultrasound, see what’s going on in there, and if it’s not much, then we could potentially go straight to Lupron and stay on track for late February. What do you want to do?”

It was a risk, diverging from the tried-and-true protocol that had worked when I got pregnant with a donor embryo the first time, but at this point, I was feeling desperate. I had re-entered West Coast IVF’s program back in August and I still hadn’t had a transfer. I didn’t want to wait anymore. I wasn’t sure I could.

“Let’s try,” I said.

And so, the following Monday, I trekked to Dr. Baby-Maker’s clinic, where I once again submitted myself to another baseline ultrasound. As the sonographer readied the machine, she asked about my infertility journey so far. I told her all about the tooth ordeal and the canceled transfer in December. The tone of her voice indicated she truly felt sorry for me. Pity was nice, I guess, but what I needed more were answers.

The sonographer quickly found three small follicles (nothing to write home about) on the left ovary. As for the right? It was playing hide-and-seek. The sonographer maneuvered the wand in a thousand uncomfortable positions and she simply could not find it.

“I think it’s right behind this bowel activity,” she said, indicating what looked like a pulsing tube on the screen. Basically, I think she was saying that I was full of shit. (‘Cause that’s not mortifying.)

She dug around a little while longer, then (I think) gave up, grabbed a screenshot of something oval-esque, and called it an ovary for the report’s sake.

“I’ll send this off to California right away,” she said. “Hopefully you can get going already.”

I had my doubts, but later that day, I received confirmation from the doctor that I could start Lupron and keep the February transfer date. Hooray!

My treatment coordinator soon called to make sure my concerns had been addressed. Since she asked, I told her that there was one other unresolved issue: I felt uncomfortable with our backup embryo option, the one that included an egg donor who had a relative with schizophrenia and an unclear family history of mental retardation. I wanted to see more profiles – specifically those with proven fertility.

To make things easier, I told her I was open to any race. It was something I’d been thinking a lot about over the past several weeks. White couples adopted BIPOC children all the time; why would this be any different? It would be challenging, of course, and my husband and I would have to educate ourselves and immerse our child in her culture, but we were willing and eager to do so if it meant a healthier baby.

Within hours, I had a new backup profile in my inbox.

This profile had already been successful for another West Coast IVF patient. Unfortunately, that was about all that it had going for it. The egg donor’s family has a history of obesity. The sperm donor’s family had a history of high blood pressure, stroke, pneumonia, melanoma and breast cancer.

I didn’t hesitate to turn that one down. There had to be better options. And since I’d complained, the clinic seemed more willing to offer them to me.

The next backup profile arrived – and I fell in love with it.

The egg donor was athletic, articulate, and creative. Her favorite movie: The Princess Bride. Favorite book: The Great Gatsby. Favorite season: spring. And her health history was impeccable. The sperm donor was fit, entrepreneurial, and clearly had a sense of humor (“Love dogs, think fish are hilarious, cats are demon creatures”). His personality absolutely burst off the page. His family health history wasn’t flawless, but there weren’t any concerning patterns.

I looked up the sperm donor’s ID on the Facebook group for the sperm bank. Picture after picture of babies made from his genetic material came up. The sperm donor’s genes were clearly the dominant ones in all of his offspring – but his genes and my family's looked nothing alike. The kids were adorable, but it would be obvious to everyone that this baby wasn't “ours.”

I was concerned about how this baby would handle questions about her origins. I thought of a line from the children’s book we have about donor conception that goes, “To make a baby, you need a seed from a man, an egg from a woman, and a nice warm tummy to grow the baby in.” I imagined our future child stuck having many interactions like this:

Random Person: Are you adopted?

Future Child: No, I’m donor-conceived.

Random Person: What’s that?

Future Child: To make a baby, you need a seed from a man, an egg from a woman, and a nice warm tummy to grow the baby in…

It seemed unfair to subject a child to incessant questioning, not to mention racism. And yet, I could feel the good vibes from this profile. It also had one current pregnancy, a better track record than our chosen profile, which had a negative pregnancy test and a chemical pregnancy to its name.

I had to ask myself: Did I want the fantasy of a baby (who might look like my husband and me) or did I want a flesh-and-blood baby (who would definitely not look like either of us)? I could clearly imagine myself with the baby from our chosen profile; I wasn’t sure I could see myself with the new one. (Though I know I would love any baby put into my arms.) 

The clock was ticking. My coordinator needed a yes or a no. And she needed to know which profile was primary. If I chose the new one to be my primary, I would have to give the old one up (because the new one had multiple female embryos available, so I wouldn’t need a backup). 

My husband was firmly on the side of the new profile, his reasoning being: if we’re going to do this, we want it to work. My younger teen agreed. My older teen and I were waffling. We didn’t want to let go of the old profile. But what if the transfer with the old profile failed? I’d be kicking myself for months over wasting all this time and money. 

I wished for the impossible (of course I did): that we could transfer one of each and let fate decide, but I was pretty sure the clinic wouldn't allow that, and I didn't want to risk twins. (Imagine explaining twins genetically unrelated to us and one another!)

Ultimately, I let myself be persuaded by reason. The new profile had the best chance of success, so that was the one I was going to choose.

But on the morning I was supposed to send back the confirmation form, my printer refused to print. I tried once, twice, three times. There was still ink in the cartridge, but the text wasn’t printing clearly. I signed up for a free trial of Adobe and tried to e-sign it, but the document wouldn’t let me edit a section of the document where I needed to print my name. “Is this a sign?” I asked aloud to no one in particular.

If it was a sign, I ignored it. I ordered a new ink cartridge, got it installed, printed off the confirmation page, and signed it along with my husband before the day was done.

“We’re sure about this, right?” I asked him.

“I’m done discussing this,” he said. (All this deliberation had begun to sour him on the whole endeavor. Topic for a future post...)

I emailed the signed confirmation form to my coordinator. So that was that; we were letting go of the old profile and would be transferring a female embryo from the new profile in late February.

Only a few minutes after sending the confirmation, my treatment coordinator responded, confused. Did we want the new profile as the primary? Or as the backup?

I stared at the message for a long time, unsure how to respond. It felt like all day, the signs were saying, “Don’t let go of the profile you love.” Now she was giving me another chance to change my mind. Should I take it?

I typed up my email response, with two lines: “Primary” and “Backup.” I copied and pasted the profile numbers – the old one for primary, the new one for backup. Then I swapped them. But I couldn’t press “send.”

I tried to imagine how I would feel months from now, pregnant or not, if I let the old profile go. Even worse: what if someone else got pregnant with that embryo? What if I saw a picture of that baby in the West Coast IVF Facebook group? Would I feel like she should have been “mine,” just like I did with my baby’s only full genetic sibling who was growing up halfway across the country? (I would give anything to have had another embryo from her profile available. Then there would have been zero deliberation; only celebration.)

Something in me again said, “Try.” I had to give the embryo I wanted most a chance. If the transfer was unsuccessful, the new profile would still have an embryo ready and waiting. (Though the age gap between my baby and her little-sister-to-be would be close to two years at that point.)

I told my coordinator to keep the old profile as the primary and the new profile as a backup. And then I told myself to stop deliberating. (‘Cause that works.)

This process revealed traits in me I didn’t recognize – and didn’t like. I used to be so decisive and now I seemed so wishy-washy. Also: why, after I pushed and pushed to get what I wanted (in this case, a backup profile worthy of being a primary profile), did I reject it once I got it?

And, most pressing: now that preparation for the next transfer was underway, why did I suddenly feel so ambivalent about moving forward at all, with any profile? 

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