I know I'm doing this a little out of order (writing about the transfer before I write about the retrieval), but it just feels right for where we are now. I have jotted down notes about the retrieval day experience, so I'll be sure and remember the main bits.
As you know, Wednesday, we had an appointment to have two of our embryos transferred into my womb. I woke fairly early (around 6 I think), but felt like I got a much better night's sleep than I did the night before the retrieval. Michael decided he would go in and work a few hours, then meet me back at the house around 9 and we would get to OHSU by 10. On Tuesday, a nurse had called and told us to be there by 10:30 so we could meet with the embryologist before the procedure. I mentioned that my acupuncturist was going to do a pre and post treatment with us, but she didn't make any adjustments to our time to be there. I guess someone was going over our chart again later that day because another staff member (Deborah, I think it was), called back later to confirm I was having acupuncture before the transfer and said that in that case, both Jelena and I needed to be there by 10. So I emailed Jelena at 3:30pm on Tuesday with the change in time and she let me know that she had a patient scheduled at 9 Wednesday morning, but she hoped to leave her office by 9:45 and be at OHSU by 10. And she was!
Michael and I got there about 20 minutes early (traffic on Hwy 26 is so unpredictable that we have gotten in the habit of giving ourselves plenty of time when going to OHSU) and hung out in the waiting area until Jelena arrived. We only waited a few more minutes before Deborah (who has done many of my blood draws and assisted during the ultrasound visits) escorted us back and took my vitals. I was very pleased to discover that my weight was only 137 pounds; we don't have a scale at home and it had been awhile since my last official doctor's office measurement. I was surprised it was under 140. :)
She also checked my blood pressure and heart rate (both fine) and then showed us to the room where the transfer would take place. She told me to get undressed from the waist down and get on the table and both Jelena and I questioned her. I told her I thought we were meeting with the embryologist before the procedure and she said that no, it would be after. Jelena said that I would probably be more comfortable (I think she meant warmer), if I kept my pants on during the acupuncture and I agreed. Deborah told us basically that we could do what we wanted and she left. Jelena wasted no time getting needles in place. She said the pre and post transfer acupuncture points were pretty much a set pattern of points and that I had had all of them at one time or another. Then she dimmed the lights and left me to relax. Michael had found a golf magazine out front and was busy reading it while I rested with the needles in place. I spent that time talking to our embryos, visualizing all that we would show them and the people they would meet once they were born. It left me feeling very peaceful and optimistic. Jelena came in about 10 minutes into it to check the needles. She adjusted them until I could feel them again and then left for another 10 minutes. I did have to send Michael to go get her from the waiting room to adjust one of the needles in my left leg as it was very intense, but other than that, it went really well.
Once Jelena had taken the needles out, it wasn't very long at all before Deborah came back and checked my bladder. I had been instructed to drink 20-24 oz of water before the procedure so that I'd have a full bladder. Apparently, it helps the doctor see the womb better when he goes to place the embryos inside. She said it was fine and then asked if it was okay for a resident and medical student to come in with Dr. Lee while the procedure was performed. I said sure. When Dr. Lee came back he verified who I was (name, DOB, age), just as Deborah had done when she first showed us to the transfer room, except she had also asked me what procedure was going to be done that day--I guess just to be very, very sure no mix-ups were made. Then we talked about the number of embryos to transfer and I told Dr. Lee that Michael and I had decided on transferring two. The chances of success are better with more than 1 embryo being transferred (Eileen had 2 transferred and is currently pregnant with a singleton), but we were nervous about transferring any more than that as neither of us thought we would be able to "reduce" a pregnancy--not after all we've done to get to this point. I think generally they encourage transferring more than 2 embryos once a woman is in her forties, but for my age, two is still the norm. Dr. Lee did tell us that all four embryos were growing well (about 7 or 8 cells with little fragmentation) which I had assumed since we hadn't gotten a call from them earlier in the day saying not to come in.
I signed the paperwork okaying the transfer of the two embryos (funny that it was only me that signed off on both the retrieval and transfer procedures whereas Michael had signed with me when we went through our initial consent paperwork way back when we first began the IVF cycle).
Then it was time to get down to business. There was a little sliding window in the wall that opened into the lab and the lady working in there was named Deb. She would be the one preparing our embryos in the catheter for placement in my womb. She did the final check to verify my identity, announcing my name and date of birth. Then she waited while Dr. Lee got everything set up and ready on our end before the embryos were prepared for transfer.
**Disclaimer: Some details follow that you might not want to read--esp. if you are a guy--women's health stuff.**
A catheter (long hollow tube) was inserted through a speculum and passed through my cervix, just until the tip of it entered my womb. It took a couple of minutes to get the placement right because he said my womb was transverse and rotated (?), so he had some manuevering to do to get where he needed to be with the catheter. This part didn't hurt--what was excrutiating was the doppler that Deborah was holding down quite forcefully over my very full bladder. I began taking long, slow deep breaths (and tried not to think about what was happening in my body, because I was afraid I would panic and move), which probably, now that I think about it, only caused her to press down harder in order to keep my womb in view. Michael rolled himself over on a little stool and sat by my head, holding my hand. Once again I squeezed it very hard (as you will read about when I get down to writing about the retrieval), but again, not from pain from what Dr. Lee was doing, but pain from feeling like my bladder was about to burst.
As he was working, Dr. Lee was explaining things to the resident and the student, illustrating why he did what when. He got in position and called through the little window to Deb in the lab that she was okay to get the embryos "loaded." I stopped thinking for a moment about my bladder and whispered to Michael, "Load 'em up!" I knew Dr. Lee was referring to getting the embryos ready to go inside a smaller catheter.
I got a little worried when he called out to her to hold on a minute--not sure if I moved or what happened, but a few seconds later he told her we were good to go again. She announced quite loudly that she was going to bring the embryos through the connecting door (I wondered why she didn't pass them through the window, but maybe it would have been too awkward). I don't think she opened the door very wide--just enough to pass the catheter through. Then Dr. Lee fed the small catheter through the one that was already in place leading to my womb and he basically injected the embryos inside. He tried to show us on the monitor, pointing out a sac of fluid that was just barely visible. I thought I saw a couple of tiny white specs inside the fluid, but I was probably imagining it. I asked it that was it and Dr. Lee said that yes, we were done. Deb was back inside the lab at this point and I could see her through the window, her face framed by a hairnet (the lab is a clean room so the staff wears protective clothing to keep as much dust, hair, skin cells, etc. contained as possible). She called "Good luck!" and smiled. I thanked her several times, not quite believing we were done with the transfer.
Dr. Lee removed all the tubing and speculum and then Deborah and the resident each took one of my arms and got ready to pull me up higher on the table. I asked if I should help and they said no--they didn't want me tightening my abdominal muscles. They slid me up on the table and then Dr. Lee and company left after wishing us luck and telling us to take care.
Next Deborah said I would need to come back in on August 15th for my blood test (the blood test) to determine if we had been successful with the transfer. I scheduled an 8:45 appointment time that day, thinking that Michael and I would both take the day off, and maybe go to the coast or something to take our minds off of it.
I still needed to get my post-transfer acupuncture treatment, but even if I didn't have it scheduled, I would have had to rest on the table for about a half hour before getting up. Deborah offered me the use of a bed pan so I would be more comfortable during the acupuncture and I agreed to it, having no prior experience using a bed pan. After she left the room, I wondered aloud to Michael how it would work since I would be lying down. He teased me and said, "You get to pee in that bed." I begged him not to make me laugh, since I knew it was important to stay as relaxed as possible.
When Deborah came back, she had me lift my hips (careful to use my legs only), and she slid something under me. Then she told me to pee and left the room. I tried, but immediately felt liquid going up my backside. I kept trying after that, but just couldn't. It was like my bladder had gone suddenly shy. She came back in a couple of times and I told her it just wasn't working. Finally she had me lift my hips again and pulled the pan higher up my back and tucked an absorbing Chux pad around the front of the bed pan. At this point, I was still embarrassed and afraid of getting urine everywhere, but had to go so badly that I didn't much care. Finally I peed and it just kept coming--I think I filled the pan to the brim. At least my bladder felt about 100 times better by the time Deborah came back in. She removed the pan, slid a fresh Chux pad underneath me, and sent Jelena in to do my acupuncture.
I wasn't as comfortable getting my post-transfer treatment as I was getting the pre-transfer treatment--maybe because I was missing my pants. Besides that, the room was just on the chilly side anyway. Even Michael mentioned it, and if he's cold, you know it's cold. :)
I think Jelena let me rest with the needles in for close to a half hour. At one point, Deborah stuck her head in the door and told me that when I was done with the acupuncture, we could leave. I think it was a little after 12 when we finally headed out, me moving gingerly and very cognizant of my new "transfer patient" status. Michael and I headed home, after some inital confusion remembering where we'd parked. I think I convinced him to stay home with me instead of going back to work, as I felt like I needed someone to wait on me for the rest of the day. Deborah had told us that I wasn't to lift anything until the next day, and I didn't want to be home alone and not able to get what I needed.
I ended up sleeping for maybe a couple of hours once we got home, then had a little lunch and spent a few more hours in bed reading. Later we locked Chloe in my green room (so she wouldn't try jumping in my lap), and watched a movie downstairs (Tron) before bed.
It had been quite a day and I felt like I'd been through the wringer by the time it was over. I was happy and relieved we'd made it to the transfer, but also scared silly that I would move the wrong way, or accidentally lift something too heavy and ruin our chance at becoming parents.
I kept reminding myself to surrender, that I am doing the best I can, and that really, most of what happens next is out of my control.
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