When we met with our RE in early January, our goal was to plan out our next IVF cycle. We looked at all of the past failures, test results, embryology reports, etc. to figure out what we could do differently this time around to finally bring home baby #2. I flat-out asked our doc what the hell was going wrong in the pipeline.
And that's when he said it, "You have a really high arrest rate." Arrest rate? Surely, I shouldn't have to worry about an arrest rate until these embryos are at least 18 years old, no?
He went on to explain that, although they are able to harvest an abnormally high amount of eggs during my retrievals (thanks, PCOS), a large portion of our fertilized embryos simply stop growing. He went so far as to say they look beautiful up until day 5; then they just arrest.
Safely assuming our embryos aren't out drinking in public, urinating in the subways, and vandalizing cars; what else could possibly cause this high arrest rate? This was our next avenue for exploration.
Let me give you an idea of how high our arrest rate actually is. During our last fresh IVF cycle, we had 35 eggs retrieved, 26 fertilized, and only FOUR made it to day 5. Of those four, none implanted. This is a problem, for sure.
My husband and I opted to undergo genetic testing to see if there's any recessive diseases that we're carrying. If we are carrying something, and likely passing it on to our embryos, we would have the ability to test those embryos for the disease BEFORE going through the transfer process. It would mean a big cost savings and, more importantly, an emotional cost savings as well.
We'll meet with the geneticist on February 1st to get the test results. I'm torn. Part of me wants to be completely normal, especially for the sake of the daughter we do have. I want her to never have to worry about passing a disease onto her child one day. But another, very tiny, part of me wishes that they would find something to explain this mess.
Before you do an IVF cycle, before any shots or pills or surgical procedures, the doc makes you sign an encyclopedia-size pile of consent forms. These forms are designed, I can only assume, to protect the clinic in the event of a mishap, complication, or misunderstanding.
What's so striking about these consent forms though, and our willingness to sign them, is they quite blatantly state that the odds are this procedure will not work. And it's also possible that something will go wrong in the process, either now or eventually down the road when we figure out what all of this hormone manipulation actually does to us. Infection, vaginal bleeding? Bring it on. An increased risk of uterine cancer? They'll have a cure for that soon, right?
Yet, we still sign. I still sign. Heck, most of the time, I don't even bother reading the consents anymore. I may have very well initialed away our home or our beloved family pet this afternoon. But it's worth it. Why? Because we have an opportunity to create a life--an honor that trumps all other risks or likelihoods. I consent to weight gain, blood clots, and the dangerous accumulation of fluid in the abdomen if it means I might, although unlikely, have a baby at the end of it. I consent.
Looks like it's just about time--time to start another round of In Vitro Fertilization. I'm excited; I really am. I'm hopeful and pretending to think positive all the time. I'm optimistic knowing that I've done just about everything my reproductive endocrinologist has asked of me. I've lost weight (slowly), started an exercise program (Zumba!), lowered my cholesterol and blood pressure (without meds); I've cut back on carbohydrates (sad face), got my thyroid levels in order (thank you, Synthroid), and started seeing a therapist to address stress from previous failed cycles (I feel that...). I've cut from every corner of our family budget to save up for another round of this. I know this cycle is going to be a success. It has to be because it's the last cycle. It's our last chance to give our daughter the sibling she's been asking for.
Amazingly, when she started really talking at two years old, my daughter's first sentence was, "I want a baby sister." It stung. We had been trying since she was six months old to give her that sibling. We thought we would strike while the proverbial iron was hot, and by "iron," I mean uterus, and by "hot," I mean a comfortable 98.6 degrees. We thought it would be so easy. Our first IVF cycle was a gleaming success. No complications. Textbook results through the entire pregnancy, in fact. We had no reason to believe that anything would get in our way of another beautiful child. Seven failed cycles later, however, we were struggling to hold onto hope.
Through all of the failures, I started asking serious questions--Did my doctor really know what he was doing? Was there something I did wrong? Why didn't God intervene? Is there a God at all?--and not-so-serious questions--Are we all just part of the Matrix? Has my uterus become a black hole, a break in the time/space continuum with the sole purpose of swallowing embryos? Is this because I didn't eat the pineapple?
For those of us who've struggled with infertility, and even those who simply wanted to ensure a successful natural cycle, pineapple--pineapple core, to be exact--is a familiar ally. It's magic. The pineapple alters the flavor of your uterine lining and entices the little embryo to implant with the promise of pina coladas, pineapple upside-down cakes, and Hawaiian luaus if it promises to stay put for the next nine months. No, I'm making that up. The real reason we eat pineapple is for the bromelain, an enzyme found most concentrated in the pineapple's core, which may have an anti-inflammatory effect on the uterine lining and help encourage implantation.
With all of my cycles, I laughed at the thought of chomping into the not-so-pleasant core of a pineapple. I mean, it can't really be true, right? Why not blend it up with an eye of newt and one strand of hair from a wild unicorn? But here I am, about to start cycle eight, and guess what--this time, I'm going to eat the freaking pineapple. This time around, I'm keeping my uterus as horizontal as possible until my embryos stick. I'm not reaching for anything above eye level. I'm not even going to inhale the caffeinated scent of coffee. I'm taking Vitamin D supplements. I'm even doing laser acupuncture. And, most importantly, I'm writing this.
I'm writing the story of my final fresh IVF cycle (and hopefully a frozen cycle to follow if we get enough embryos) because I've been doing this for too long not to. I've learned too much about myself, my relationship with my husband, and the miraculousness of our daughter to just let this go by and only vaguely remember what it was like in ten years. I'm writing this to share because I know "infertility" is a dreaded word, but it's also the name of one amazing community of women and men who have a special, nuanced perspective on life and its foundation. And I'm writing this to create something so that even if I don't walk away with a baby in the end, I have a story to share one day with this precious three-year-old who just wants a baby brother or sister.