Sunday, January 25, 2009

Mel’s Show & Tell — Frozen Embryo Transfer, Step by Step

For Show & Tell this week I thought I go over the steps of my frozen embryo transfer in plain English. Recently I have given my URL to people who don’t necessarily know how assisted reproductive technology works. So, I thought it would be helpful to explain what these next few weeks will be like.

I started a drug called 1upron last week on day 21 of my cycle. The reason for starting that day is that I should have ovulated by then. This is checked by an ultrasound (not so affectionately known as the dildocam) of my ovaries, where they look for a corpus luteum (an empty egg follicle) and a blood test. I inject the medication with a small, subcutaneous needle into my abdomen. No big deal. Stings for a half second, and I get a little itchy at the injection site, but that’s all. Its purpose is to shut down my ovaries, since we’re not using them for this. This is called the suppression phase of the cycle. Not all frozen embryo cycles are done with suppression, but it gives us more flexibility in timing the transfer.

After 14 days of 1upron injections I will go to my local clinic for another ultrasound and blood work to make sure my ovaries are suppressed. (Not anticipating that my poor, old girls will have a problem with this.) Then I stop the injections and start taking estrogen pills to build up my uterine lining. After 10 days of estrogen, back to the clinic for another date with the dildocam and more bloodletting. Hopefully, I will have a nice, fluffy lining. A soft bed of tissue for and embryo to dig in and stay for the duration.

Following a good lining check I will start progesterone. This is in the form of capsules inserted up my hoo ha. Some doctors prefer intramuscular injections of progesterone in an oil suspension. These are LONG, BIG GAUGE needles in the tushie. They need to me long to get into the muscle, and they need to be thick needles because it’s an oil suspension, so too thick to push through a thin needle. There have been many studies that show that vaginal progesterone is just as effective as a HUGE needle in the ass. I know there are exceptions to this, but I am relieved not to have to do it.

A few days after the lining check I will fly to the frozen tundra for my embryo transfer. I’m disappointed that Angrycanrn will be out of town, but I have been emailing another blogger in the area and we hope to meet up while I'm there. An embryo transfer is usually an easy procedure. I know what to expect from my IVF in November. Before the procedure I will drink a good deal of water to fill my bladder. I think this raises up the uterus, making it easier to visualize on the ultrasound. Please correct me if I’m wrong about this, internets. Some people find the full bladder to be the most uncomfortable part of an embryo transfer. I have good kegals (for now), so not a problem for me.

Okay, so … on the table, knees wide apart. Ultrasound is external (no dildocam), so my abdomen is gooped up with ultrasound gel. The tech will get my cervix and uterus on screen. The dr will thread a catheter past my cervix into my uterus. The embryologist will pass a syringe containing the embryos to the doctor, who will inject them through the catheter into my uterus. We should be able to see them on the ultrasound screen. Little bright dots in my uterus. (I love them already.) The dr will withdraw the catheter and pass it and the syringe back to the embryologist, who will check them under a microscope to make sure all the embryos are where they should be and that none are stuck to the catheter or syringe.

I will stay on the table for a while, then they will tell me it’s okay to get up and pee. I’ll go back to the hotel and take it easy for the rest of the day. Of course, I will blog about it! Maybe I’ll give out my hotel phone number by email and some of you can call.

I’ll fly home a day or two later. This is when the hard part really starts. THE TWO WEEK WAIT. Not always exactly 2 weeks, but that’s the phrase we use to refer to the crazymaking time until the official pregnancy blood test. Many of us are home pregnancy test addicts. POAS (Pee On A Stick) junkies. I’m ready. I have a box of 2 lst Response tests, and a bunch of ebay cheapies that are supposed to be generic lst Response. This is THE MOST STRESSFUL part of the process. I will be wondering about every little twinge, poking my boobs to see if they’re tender, debating with myself whether I’m tired from the stress, from the progesterone, or because I’m PREGNANT! Of course I also have to behave as if I were pregnant, so no booze to calm my frayed nerves. Chocolate consumption will increase.

Hopefully, by beta day (pregnancy blood test), I will have gotten clear positives on home pregnancy tests. I know it’s a possibility it won’t work. It will be agony if I don’t get pregnant from this transfer, but it won’t stop me from reaching my goal. We think I should have 2 or maybe 3 tries with these embryos. Can’t stop my multi-tasking mind from planning ahead.

A positive pregnancy test is the just first of many big hurdles to bringing home a baby, but it’s the biggest. Hope this transfer is the one!

Don’t forget to see what the rest of the class is showing.


Baby Smiling In Back Seat said...

Great explanation for the non-expert (that is, those of us who don't already do this stuff regularly ourselves).

One thing you left out that readers might wonder about is how many embryos are transferred -- both typically and in your case. We experts might also wonder if extra embryos will be thawed to make sure you have enough for transfer.

My understanding of the full bladder is that the liquid makes it easier to "visualize" the body because the ultrasound waves bounce off of the liquid.

I hope your expensive and cheapie POAS all come up positive!

Dora said...

Thanks, Cassandra. I left out the part about the embryos because the dr and I have not decided yet. These embies were frozen at an early stage. We'll need to see how they thaw and culture to decide how many to transfer.

Michelle said...

You did a great job of explaining! I am just so excited for you!

Kristin said...

Great explanation Dora. If you need someone to talk to, I'm always up for chatting and I have free calls to Canada.

Annie said...

That was a great explanation, thanks for sharing that. I am sending good thoughts your way and I hope this transfer becomes the beginning of many happy blog posts from you!

Megan said...

Great explanation. Thanks for sharing.

The Steadfast Warrior said...

Thanks for posting this. I knew the basics but this really helped me understand the process since I have no experience with ART.

Bella said...

Awesome details!! I never understood the full bladder part, so thanks! So excited for you!

Anonymous said...

Another thing to consider with regard to the number of embryos to transfer is the age of the egg donor. She was 23. My fresh cycle yielded twins and she cycled about 6 months later and the fresh cycle also resulted in twins. Both fresh transfers were done at day 2. You have some serious decisions to make, darling!

I'm only sorry I will be sunning myself in the south when you do your transfer..... But rest assured my thoughts and prayers will be with you and I will be proudly sporting my bracelet.

I can't help but envision thighs like J's on your little one!

JuliaS said...

Oh good wishes to you! Great explanation - simple enough that it would be easily understood by those who have no frame of reference.

princessoftides said...

Woo hoo, it's getting close! We'll have to go out for a good luck drink before you head to the frozen north :)

Phoebe said...

My FET protocol is a bit different than yours, but the idea is basically the same. Unfortunately, I will have to use the big ass needles this time around, but I'm beyond caring. Plus, I know that the shots are not the hard part of the whole process. I just have to keep telling myself that - "the shots are not the hard part, the shots are not the hard part..."

Good luck on making those hard decisions. I think I would do a SET under the circumstances, but that's just me.

areyoukiddingme said...

Sounds deceptively simple and straightforward! Here's to fluffy linings, good Kegels, and excellent news from the frozen tundra! Good luck!

AnotherDreamer said...

Awesome explanation!

I am getting sooooooo excited for you!

battynurse said...

Oh the fun of all the preparations. I ended up this last time doing the PIO and will likely do it for my donor egg FET. I just feel more comfortable with it since my first IVF I started my period 4 days before test day. It would be nice to just be able to do suppositories though.

Nikki said...

I think I'm going to send some of my non expert readers here for an easy explanation of what's going to happen with me as well very shortly!

And yes, how about both of us getting pregnant next month? :-)

Anonymous said...

Hey, Dora

I may have missed this part, but are you doing this in T.O.? Something you said on my blog gave me that impression. If so, I will be there from March 13-April 5. Does that match up at all? If so, let me know. I know how stressful this gets and if I can do anything to support you let me know. (Either in T.O. or otherwise.) You can email me at Lexie.Acquara at gmail dot com.

Xing all my fingers and toes for you.

Billy said...

Loved your explanation :-).