6; Our Tentative Plan for IVF, or He’s Just Not That Into You Where He = My Doctor

So if you read my last post, it’s safe to say you know I’m insane. As does my doctor, who has (lovingly? Irately?) referred to me as his “penpal.” Why? Exhibit A:

Our latest love letter. Check out his extremely interested response.

I think I’m more into my doctor than he is me so this is middle school all over again, except fertility treatments are way more expensive than an extra Fruitopia at lunch that barely gets me a nod of thanks before said crush returns to four square (the recess game, not the app) after I spent a quarter of my goddamned allowance. Also, if you don’t know what Fruitopia or four square are, just…enjoy your youth.

As I discussed previously, I have something called diminished ovarian reserve, which feels like just as big of a middle finger to my femininity as you would imagine. Hey, you are curvy and have always had regular periods and gyno exams but did you think to check your eggs? You didn’t right? Haha, joke’s on you! But like I said, this doesn’t affect pregnancy rates, so we really don’t know what the deal is — hence my suspicion that it might be actually be the quality of my eggs vs. quantity, which is why I’m trying to make the genetic testing a priority.

Thing is, this PGS testing is done on day 5 embryos, which is called the blastocyst stage. It’s the final stage an egg has to make it to before it’s transferred into the uterus, and not many make it there. First is the retrieval, second is checking how many eggs you retrieved that are mature. Then, only the mature eggs are sent to the lab for fertilization attempt in a little petri dish. Sometimes, if you don’t have many eggs, the lab will use a procedure called ICSI, where they inject a single healthy-looking sperm directly into the egg instead of just sitting there and letting them do their thing. Our lab does this with no “extra” (lol) charge, thankfully.

After that, the number of eggs that make it to fertilization are monitored to see how many make it to day 3. This is the stage our doctor wants to keep open to possibly plucking the embryos from to transfer them freshly into my uterus, if it looks like I don’t have a good shot of enough embryos making it to day 5 (from what I’ve read, the live-birth rates between day 3 and day 5 transfers are pretty similar). But day 5 is what most doctors strive for, I believe — and my wish is that if we have enough embryos to gamble a day 5 growth and a good number that get that far (say, three or more, maybe), I want to have them tested, frozen, and then transferred later…like maybe in May or so.

The May thing had my doctor questioning my sanity — that was when I told him I wanted to not have a holiday baby if I could help it (obviously if I got pregnant naturally in those few months we would be overjoyed and not care about the timing at all). But also, I’ve read a lot of accounts from women who did a frozen transfer instead of a fresh one and they said it was so nice to have a break before transferring because they had put their bodies and minds through so much stress with the stimulation meds and retrieval surgery and couldn’t imagine having gotten pregnant directly after all that. Which sounds pretty damn reasonable to me.

My nurses know my desires and I really hope the doctor doesn’t err on the conservative side with my meds. I have a feeling he will try to in an effort to get me to do the fresh transfer, but the goal in my mind (and Josh’s, after we had a long and wine-filled discussion on Thursday night after our Hangouts Chat That Went Nowhere) is to get enough embryos to day 5 to test and enough chromosomally “normal ones” to freeze for later. And if that doesn’t happen and we need to make the day 3 fresh-transfer decision without testing, so be it. Shit, it’ll save us $6,000, so we’re not that against it. But that $6,000 could also save us a lot of heartache later.

As you can see, I have a very specific idea of what I want but am also completely willing to let go of control over what actually ends up happening. Like sure, my e-mail to my doctor was long, but I’m basically telling him I want a contingency plan if my ovaries end up proving him wrong come January. We’ve already discussed how my ovaries take after my personality in their Type A-ness — but maybe they take after the side of me that likes proving people wrong too.

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