The embryologist phoned me to let me know I had been scheduled for a day 4 embryo tranfer.
I was prepared for this eventuality, and not happy with it. Neither was I planning to go ahead with it.
“Can I ask a question?” I interrupted her as she was discussing the time I needed to arrive at the hospital.
“Sure.” she said uneasily.
“Why am I having a day 4 transfer?”
“Um, well,” she started. “Unfortunately you had your egg pick-up on a Tuesday and that means a day 5 transfer would take place on a Sunday. And we don’t open on Sundays.”
Ah yes, but of course. Never mind what’s best for the patient who is paying thousands of dollars for treatment. The clinic doesn’t open on Sundays. Makes perfect sense.
“”But why am I having a day 4 transfer?” I asked, undeterred. “I mean the embryos are taken out of the incubator on days 1, 3 and 5 aren’t they?”
“Yes….” she said.
“So they were taken out on day 1 to check for fertilization.” I said. “Then they’ll be taken out on day 3 to check for progress, taken out on day 4 to pick the best embryos for transfer, taken out on day 5 to check them again and then taken out to freeze on day 6. What happens to embryos when they’re taken out of the incubator?”
“They’re placed under stress.” the embryologist said. “It has a very small impact on their quality.”
“Right.” I said, happy she was proving my point. “And you’re going to take my embryos out of the incubator four days in a row. That doesn’t seem like a good idea to me, unless you can definitively tell me that there’s evidence to suggest a day 4 transfer improves pregnancy rates compared to a day 3 transfer. Of course I want the best possible chance to get pregnant, but I’m also very mindful of our other embryos. I want to freeze as many as possible and give us as many chances as possible to succeed.”
“Well actually,” the embryologist said. “It’s much harder for us to pick the best embryo on day 4 than it is on day 3. On day 4 the embryos are going through a transition stage and it’s almost impossible to tell which ones will come out of it looking the best.”
“So you’re actually recommending I go with a day 3 transfer?” I asked.
“I’m not allowed to recommend one day over the other,” she said. “But between you and I, if I was you I’d be going with a day 3 transfer. Put two embryos back so you give yourself the best chance at pregnancy and also help your other embryos in the incubator at the same time.”
“Ok that’s great.” I said happily. “Let’s set that up.”
There was silence on the phone for a moment.
“You’re always so smart…” the embryologist suddenly said, in a faraway voice.
You guys, I think I’m getting a reputation at the clinic as someone who likes to interfere with my treatment plan. I don’t know whether that’s a good thing or a bad thing…
As it turns out, Doug wasn’t available to have time off work for my day 3 transfer so instead I elected to take my mother along. The transfer was to be at 11.45am on Friday morning, and it was going to be with Doctor Eventi. That same replacement doctor who had turned up half an hour late to my egg pick-up.
“This doctor is supposedly fantastic.” I explained to mum as she drove to the hospital. “But after my egg pick-up fiasco he has one last chance to prove himself. My own doctor isn’t anything to write home about, but I’m certainly not transferring to this doctor if he isn’t any better.”
My admission time was 11.30am, and my full bladder was just starting to become painful when we arrived at the clinic. The worst thing about embryo transfer, other than the nerves, is the fact you need to have a full bladder for the guided ultrasound. This time around I had stupidly polished off 150ml more water than I was supposed to. 150ml is no big deal unless you leave it sitting in your already full bladder for an hour.
At 12pm, fifteen minutes after my scheduled transfer time. a nurse came out to ask me how I was coping.
“My bladder is stinging, but I’m managing ok.” I said. “How far away is the doctor?”
“We aren’t sure. ” she admitted. “I’m sure he’ll be here soon.”
At 12.30pm, a huge 45 minutes after my scheduled transfer time, they started ringing the doctor’s phone but he wasn’t answering. I was furious. I couldn’t believe he was late again! And this time he was super late.
The embryologist came out and showed me photos of my embryos to save time. Of the seven embryos that had fertilized, we had a grade 1, a grade 2, three grade 3s and a grade 4 in the incubator. The grade 1 was perfect looking and actually developmentally quite ahead and sitting at the day 4 stage. The embryologist was very happy with it. The grade 2 embryo was nicely compacted and also right on schedule, but had some fragmentation. They were the two chosen for transfer.
“Don’t worry about your other embryos.” she said. “From memory last time you had a grade 3 embryo on day 3 and it ended up coming good and was frozen on day 6.”
“Yes that’s right.” I nodded, feeling confident.
At 12.45pm, an entire hour after my scheduled transfer time, the nurse took me into the theatre and started prepping me. She dressed me in one of those sexy backless hospital gowns and had me up on the table ready to go. She said there was nothing else they could do other than wait.
The pain in my bladder was so terrible that I was sure I was going to end up with a bladder infection, and I was concerned about my embryos who had already been prepped for transfer an hour ago.
“All I can say,” the nurse said. “Is that if you pee on the doctor during the transfer then it will be entirely his own fault for keeping you waiting!”
At 1.00pm the doctor strolled casually into the theatre.
“Oh hello!” he said. “You’re already all set up in here? How unusual!”
“Yes we’re trying to be quick.” the nurse said grumpily. “You haven’t been answering your phone.”
“My phone?” he said flippantly. “Oh I lost it.”
Well, great. The guy is an hour and fifteen minutes late while I’m sitting in the waiting room with a full bladder because he lost his phone. Happy days.
“Well Sadie,” he said, turning to me. “The other day at your egg pick-up I was late and you were very cross with me weren’t you?”
“Yes.” I agreed. “I was.”
I was honestly in so much shock I didn’t even have it in me to complain about the fact he was once again late.
“This is the first time we’re properly meeting isn’t it?” he asked.
“Yes.” I agreed again.
“But look at you! You’re just a baby!” he gasped. “How old are you?”
“I’m 27.” I replied.
“27 is too young for IVF!” he said. “Why do you need IVF?”
“I have endometriosis, PCOS, adenomyosis, hyperprolactinemia and blocked tubes.” I said through gritted teeth. “And this is my fourth cycle of IVF. I’m not a baby.”
After that I think he got the idea that I wasn’t really in a mood to chat so we got started with the procedure.
“I always have to remind Doctor Holiday that I have a long cervix so you need to use a longer speculum.” I told him as I lay back onto the bed with my legs in the stirrups.
He began with an internal examination and cleaned the crinone build-up out with saline. After that, we were ready for the transfer to begin.
“Actually I disagree.” he said. “You have a normal length cervix and we will use the normal length speculum.”
So he inserted the instrument and started opening my vagina. I have vaginismus so it was excrutiatingly painful, particularly with my over-full bladder. I was gripping my mother’s hand so tightly it was starting to turn purple. After a minute Doctor Eventi stopped and assessed his work.
“It looks like you were right Sadie.” he said. “We do need that longer speculum after all!”
Just like that! No concern for the pain I was in, or apology for the fact he had ignored my advice and now I was paying the price for it. The nurse rolled her eyes so violently I thought they were going to fall out of her head.
When Doctor Eventi finally got the second speculum in place, my body was starting to go into lockdown. My pelvic muscles were trying to shut up shop so desperately that even with the speculum holding me open he couldn’t get the catheter inside my uterus.
“Your internal organs seem to be resisting…” he frowned, pushing harder to try and get the catheter inside me.
In the end he had to go and get a different type of catheter and wash my cervix with saline again just to force his way inside. Then the two embryos were loaded into the catheter and ready for transfer. The nurse was scanning my belly so we could see a clear image of my uterus on the screen.
“Where is the catheter?” Doctor Eventi asked, looking at the ultrasound screen.
“What do you mean?” asked the nurse.
“I can’t see it in there. Where is it?” he frowned. “I’m going to poke it around and you just shout out if you can see it on the screen.”
Let me tell you if I hadn’t already been lying down I would have fallen over in shock. The man who I was trusting to get me pregnant, the man who was pocketing thousands of dollars of my hard earned savings, didn’t even know where the catherer was. He had apparently lost it in my uterus.
“There!” my mother said. “I see it in the top corner of the uterus.”
“Ah yes!” the doctor nodded. “Good work Sadie’s Mum. It looks like it’s in a pretty good position so I’m ready to insert the embryos now.”
I couldn’t believe it was up to my friggen mother to find the catheter for the doctor! And I couldn’t believe he was being so flippant about the whole thing. A pretty good position? You’d better be damn sure it was in the absolute perfect position if you’re playing with my health, my emotions and my bank account.
As he was completing the transfer, the doctor began to laugh. “These embryos look so healthy. What will you do if they both take? What will you do if one splits and you end up with triplets? You might get triplets you know!”
What kind of stupid question is that? If I get one baby I’ll be ecstatic. If I get two babies I’ll be completely over the moon. If I get three I’ll be completely freaked out, but also thankful. Did he expect me to say that I would selectively abort a baby if we had triplets? That I would adopt one out? I mean honestly what an idiotic thing to mention.
Thankfully, before I had the chance to say something biting or witty I was informed the procedure was over and I was allowed to get up and run to the bathroom. That was much more important than wasting time having a go at the doctor.
“Well congratulations and good luck!” the doctor said. “I’m sure you’ll do just fine because those embryos looked great.”
On the way home from the hospital I called Doug to let him know how everything had gone. He was completely furious with the treatment I had received, but also happy with the final result. We had two beautiful embryos on board, and four more still alive in the incubator who were going to bake for a few more days. Everything was falling into place.
“Doug what will we do if neither of these embryos implant, and none of the other embryos freeze?” I asked quietly.
“Don’t be silly.” my husband said. “That’s not even going to happen. You’re 27. Your embryos looked great. We’ll get many chances. We’ll get pregnant. This is going to be our year! I can feel it!”
If only wishing made it so…
(to be contined AGAIN….only one more part in this long-winded saga, I promise!)
(You can view Part One here)
(You can view Part Two here)