Now What?

I lost 35 pounds before we attempted a second transfer. I heavily reduced the stress in my life. I waited until my favorite time of year to do the transfer. I had a positive attitude and called the embryos by their future names. On December 7th we transferred two of our frozen embryos. They were beautiful. I was beyond optimistic this time. I was doing everything right and statistically our chances were pretty solid. I’d never done a FET (frozen embryo transfer) before so this was my first experience of not taking a pregnancy test from the first day to test out the trigger. I managed to hold off til 4dp5dt. For the non-fertility obsessed, that’s 4 days past a 5 day transfer. By this point the test would have a good chance of accuracy. It was negative. Clearly, clearly, clearly no ambiguity negative. Our beta on the 17th told the same story. The FET didn’t work. 

So generally I’ve managed to keep my emotions in check throughout this process. Never having a lot of hope has made it easier when treatment after treatment fails. This time I had so much hope though. I was crushed. Full on sobbing daily for 2 weeks level crushed. Having a transfer fail a week before Christmas sucked beyond belief. I felt like skipping the holidays altogether. I had been giving myself intramuscular injections for almost a month just to have nothing work again. So disheartening. 

There’s this part in the infertility documentary One More Shot where Noah says that you’d think as the couple without children they’d be doing all these cool things and going on amazing vacations but instead they’re broke just trying to have a kid. Truest words ever. Every transfer is another $4,000 and our insurance coverage is nothing but a distant memory. $25,000 went fast. I have so many opinions about companies choosing insurance plans with a flat dollar amount of coverage for infertility that I could write for hours on just that. Instead I’ll just say it’s really shitty and move on. Point being, this is all so expensive. I want new floors.  I want to travel. I want to pay off debt. What we end up doing is chunking more and more money at this hoping to find a solution. Now that we’re on to a new year on the calendar with a new insurance carrier we’re not only paying fertility treatments out of pocket, we’re back to paying for all Kap’s diabetes supplies out of pocket until we hit our $3,300 deductible, (likely next month). There goes the floors. And the vacation. And the credit cards being at $0 balances. 

If you’ve made it through my depressing monologue, thanks. I needed to get it all out there. When my doctor called me after my failed beta, he shared that while he believed the FET failed due to embryo abnormalities he wants to do another biopsy on my uterus and another SHG to determine if my uterus is in any way impacting our ability to conceive. I agreed to call with my next menstruation to have these tests done. I’d also need to get my estrodial and FSH levels checked as our new insurance carrier requires updated bloodwork every 6 months. While agreeing to all that I also started doing a little more reading into the ERA test. 

The ERA (endometrial receptivity array) is a test that determines exactly when the endometrium is most receptive to an embryo implanting. When going through IVF, transfers are done after 5 days of progesterone supplementation as that’s when most women’s endomentriums would be ready. This fairly new test measures whether that’s accurate for an individual patient or if she needs an additional 12 hours, 24 hours, 12 hours fewer, etc. I had heard about the ERA on Matt and Doree’s Eggcelent Adventure podcast a year or so ago but hadn’t thought too much about it since. I began googling like a fiend. In a lot of cases of multiple failed transfers, this answered why they weren’t working. Obviously not for all of them, but in a quite a few, the ERA also led to a successful transfer. 

I, like a big chicken, asked my doctor for the test through the patient portal messaging system. My doctor is super smart and pleasant but can occasionally be slightly condescending and I couldn’t stand the thought of being told the test wouldn’t help me or that I needed to stay off Google. I sent him the message after having Kaptain edit it first. Yes, I had a 4 sentence message proofread. The next morning I saw I had 1 new message in my patient portal. I procrastinated on opening it because I was afraid I wouldn’t get the answer I wanted. A couple hours later I answered a call from the RE’s office and it was a nurse letting me know my doctor approved the test and we’d be doing it my menstrual cycle following the one where I’d be doing the other tests. She said they’d just gotten in 6 new kits to perform ERAs and would be ready for me. 

I’m conflicted about how I will feel if the ERA shows my receptivity is displaced. Likely pissed we wasted 4 embryos before making the discovery. Also likely relieved we did the test prior to using the last 2 embryos. Either way it does feel good that I advocated for myself regarding additional testing. It may be my receptivity is absolutely average but at least we’ll never have to wonder if it was just a timing issue. We will be able to say it really was likely just poor embryo quality. Along with that, better to find out now than later if we do end up going the donor embryo route. 

So donor embryos. Still very much on our radar. I’ve spent a ton of time looking into the process in the Czech Republic. Their law demands complete anonymity of donors, they do double donor (donor egg and donor sperm) and prices are really reasonable. The main downside is that the donors tend to all be Caucasian. While Kap and I don’t need to have a child that’s biological related to us, it would be nice to have a child that had some of the same racial makeup of him. Not a huge deal though so this still is the most compelling option if we go the donor route. 

And now we’re all caught up. Yes, I’m sad the transfer failed. Yes, I’m sad we’ve now spent 2 years of our lives focused on conception. But yes, I am so relieved to have a new plan of action. I am so relieved my doctor is supportive of an additional test. I am relieved there are clinics like those in Czech where I stand a much better chance of getting pregnant. All in all I am tentatively excited to see just what 2019 will hold for us.