Archive for the ‘infertility’ Category

The Wide World of Frozen Embryo Transfers


Oooo, I know! I know the benefits of transferring a 5 day blastocyst!

A few months ago, some of you may have read my post, “IVF 101.” As my husband and I are getting ready to embark on a FET (or Frozen Embryo Transfer), the questions have again started to surface. 

So, what is a FET? Many people wonder if it is related to In Vitro Fertilization, how the embryos are frozen, and why anyone would do something so weird in the first place. So here is your answer – the fertilized eggs are kept in your freezer. I keep mine in an old popsicle box. When you are ready to use them, you thaw them for 24 hours and……yes, I am totally kidding. 

Frozen Embryo Transfer can be the result of a couple things. First, and in my case, you have gone through an IVF cycle but were unable to transfer the fertilized egg or blastocyst. This is usually due to ovarian overstimulation. If you cannot transfer right away, you need to freeze the eggs so you can use them at a later time when you have a better chance of success. You may also have to do a FET if your last transfer was unsuccessful, or you are using a donor egg. There are other reasons, but you get the picture. 

The Freezing 

When it comes time to freeze, you will have either fertilized eggs (embryos) or blastocysts. A blastocyst is a five-day or older embryo that has started to experience cell division. Should they need to be frozen, they are paired up in twos – like at the Ark – and placed in a little cryopreservation tube. This process will cost you a good amount of cash, so go ahead and ask to see the pictures of your embryos before freezing if possible. Also make sure you know how many you have and what each one is graded (meaning quality). It’s nothing weird like naming them or anything, it is just being an informed patient. You worked really hard to get these embryos, so make sure you are comfortable with what is happening. 

When it is time to freeze, the tubes are placed in cyclinders of liquid nitrogen, which keeps them in a static state. They remain alive, but the cells will not continue to divide until they are thawed. It does take some time to get used to the concept, because theorectically you could freeze some eggs tomorrow and thaw them out in ten years time to implant. 

This is NOT how you will freeze your embryos.

 Your mind will start to think about all sorts of philosophical, scientific, religious, spiritual, hypothetical circumstances and scenarios at this time. It’s normal. After all, you are most likely still pumped with drugs. So to clarify, these are embryos. Yes, they are amazing and beautiful, but they are not little humanoid creatures. Just saying. Some people are not sure. WE ARE NOT FREEZING BABIES HERE, PEOPLE. This is not that out there. 

OK. Moving on. 

The Transfer 

Once you are ready to attempt conception, you will begin preparing your body for implantation. For some people that mate normally this consists of a nice dinner at Ruth’s Chris and one too many cocktails. In your case, its time to dust off your trusty dusty needle kit. Yep – you are back to about 4 weeks of shots and pills and shots and pills and blood work and ultrasounds and shots. Oh yeah, and pills. Basically what you are doing is allowing your uterine lining to grow thick and healthy. Without this, and without sufficient progesterone, your embryo will be unable to implant and sustain itself after transfer. And that would just be sad. So you go through a much easier yet still needley version of what you did when you grew all the eggs in the first place. 

Once your uterine lining looks good and your blood work looks good, you are a go! By the way, the normal “compliments” that you used to revel in are not so coveted now. Instead of “cute shoes” (you will be living in flip flops and slippers) or “have you lost weight” (you are going to get some chunk, so just go with it), you now light up when you hear “Your lining looks great!”  

I love you, healthy uterine lining!

At this stage the embryologist will review the egg’s quality with you and choose which tube to thaw. I am actually not sure how they do this, I imagine they just set it out on the counter and head to Starbuck’s, but I have not asked. The morning that you come in for your transfer you will decide how many babies-t0-possibly-be you will transfer. Single Embryo Transfer is becoming quite popular, and if we have a very healthy one we may go this route. Regardless of how many you have decided to use, you will come in that day on valium. This is not so that you agree to go ahead and put 6 back because, hell, they’ll be adorable. This is so that when the embryo is being introduced into the womb you will not cramp. If you cramp, you may actually hurt the chances that the embryo can implant and begin to grow. Think about it – when you are settling down to go to sleep at night, exhausted, and then your spouse hugs you REAL TIGHT you cannot get comfy, right? He may even push you out of the bed. With valium, your body just responds better to a skinny straw being threaded into your itty bitty cervix. 

The Wait 

By this point, you have gone through a lot. In my case, it  took about 6 months to grow the eggs, get them out and fertilized, get them frozen, and prepare my body for our upcoming transfer. Once the embryo / embryos are in, you just have to chill out and take it easy for a couple weeks. I think that AVOIDING the home pregnancy tests would be wise in this case. Often times they take intially, but just as in nature, don’t last more than a few days. So it is better to just bite the bullet and wait for the blod test at the doctor’s office. You can avoid possible heartbreak this way. Either way, having it not work is hard regardless. Nothing about this process is emotionally easy. 

I hope that clarifies what FET is. There is no scary little man in a florescent, sterile lab. Oh wait, yes there is. Sorry. But he’s there to help your embryos grow, so if people ask you about this weird Frozen Embryo process, let them know the deal. 

Peace and Love, 

Sarah

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Selective memory is my red bull!


Well hello there, Stranger! I feel as if I am coming out of a deep and contemplative hibernation, and am now seeking to rejoin the ranks of society.  

Is my hair OK?

I hope people still read this – if you are reading this I love you! I think I got tired of waiting for new developments and realized that, if the inspiration does not strike, don’t post anything. And since no one pays me to do this, I can do what I want. Fabulous.  

Today I actually did have a rendezvous scheduled at my fertility clinic. We are finally (insert song of the angels here) ready to transfer one or two of our magnificent little frozen people-to-be into the womb! I have these little imaginings that inside me there is perfect and pristine mini-human apartment decked out with a comfy sofa, a year’s worth of formula, and a bad ass rocking swing, but no inhabitants. Kind of like when that guy woke up from a coma in 28 days later, but much less creepy and without the flesh-eating zombies. So I was really jazzed to go to my appointment today because I thought it would go something like this:  

Nurse Lady: Hello, it has been so long……Sarah, you look incredible!  

Me: Oh, aren’t you sweet!  

Nurse Lady: Everything looks great for transfer, let’s do it first thing tomorrow! And by the way, don’t worry about those sly little charges that come up. It’s just a joy to have you in the office. Now let’s get you pregnant!   

Of course, it was pretty much the opposite. A long protocal of lots of pills, more shots, confusion over which needles and syringes I need, and an ETA of LATE SEPTEMBER OR EARLY OCTOBER for transfer. Am I on that Bloopers show?  How did I forget all these steps?  

So, this gets me thinking….do we subconsciously elect to have selective memory? And if we do, do women do it more than men? Here is why I ask: My friends that have been pregnant tell me about “baby brain” during pregnancy – they sometimes lose the capacity to talk, walk without falling, tie their shoe, or count change.  One of my friends was so entertaining to her husband that he contemplated keeping her pregnant into possible perpetuity. (No, he’s not a sexist asshole, he was just kidding. Calm down.) These friends of mine have mentioned to me that this happens so that women do not remember the whole of the pregnancy experience – swollen feet, things you need Preparation H for, cravings for food that Andrew Zimmern would not eat, and so on and so forth. (Pretty smart thinking, God.) So what if this instinctual and automatic little memory glitch is something we learn to hone, like early man with his evolving stone tools? They just kept getting bigger and crazier and now they’re machine guns. Do we do this so that we can keep on enjoying the awesomeness of being a woman without focusing on the undesirable parts? But wait, men do it, too! Maybe somewhere along the line we all possess the ability to harness this temporary lack of recollection. Like Memento, but selective. You keep going to work every day, because the reward of a paycheck pushes away the fact that your desk chair has been broken since January. So I am going to proactively use selective memory to keep me going. Which is great because you shouldn’t drink Red Bull when your trying to procreate. 

And so I am done being crabby (well, for today anyhow) and am once again getting excited.  I hope all of your journeys are progressing well….keep me posted!  

Peace & Love, 

S

Keep Truckin’


Last summer I was really grateful to have been invited into a 48 hour film festival group by some friends. Hearing about the project, I was ecstatic because it was right up my alley – but I felt intimidated that I would be joining a group of people that I did not know and sharing my ideas openly. They didn’t know me – would they wonder where I came from and why I was invading their project?

It was not that way at all – these people were fantastic. I got to work on a film project with some trained professionals who opened their doors to me and allowed me to participate. And there were others like me, who just wanted to contribute. It was a memorable experience because it was open. What I mean is that it was welcoming and free. My friend introduced me as someone who acts and writes to a group of people who, for most part, actually went to film school, but they did not judge me. They gave me a place on their team immediately, and gave me a part in their film. I really got to see how it’s “all done” – the lighting, the filming, the editing and camaraderie. It was a blast – to watch people work so hard together just because they have a passion for what they are doing. For what they were collectively creating, and for all the effort and joy that was put in behind the scenes.

That was almost a year ago. I remember that I was trying to work out schedules at the time so someone would be home for my first fertility drug delivery. I was so thrilled to be moving to the “big gun” fertility treatment and was calculating when I would be due, how fun it would be to be pregnant over Christmas, how long before I needed to start shopping at maternity stores, etc. How time flies; now we have lived another year and undergone 3 IUIs and a partial IVF cycle. Not pregnant yet. So much for the best laid plans.

Back to the film project, it seems some of last year’s crew has disassembled. People have obligations and teams don’t just magically unite when you want them to. So my friends that brought me into the group last year decided we should still do it. After all, we have someone who can do the filming and editing, who actually went to school for it – we have someone who is organized and can see the big picture without forsaking the little ones, and we have someone who can write and act. We are pretty jazzed because we have decided to create something. We have decided to keep going even though it will be more difficult, and we are not even really looking at it that way. It gets me thinking, it’s the same premise with the fertility treatment. Here is where I am going to get a bit campy and cliche. Sorry. But sometimes there is a lesson to be learned in keeping your head down and forging ahead. (I know, I did not want to admit it, either.) When I was about 5, we lived in the same neighborhood as my grandmother. Walking to grandma’s house was always a joy -no doubt there would be a hot cup of cocoa in the winter and the basket full of toys she kept waiting for us grandkids. But she lived at the top of a fairly large hill – and my legs were those of an inpatient little girl. Getting up the hill, I used to dramatically drag my feet and whine to my dad, “I’m tired, I’m thirsty, I’m this that and the other…” And dad would remind me what was at the top of the hill and he would always say, “When the going gets tough, the tough get going, Sarah!” Reminds me of what my brother wrote in our guest book when we got married – “Congratulations. Keep Truckin’!”

I have had times since then when I have been really tough. Pulled through some scary situations. And other times when I just wanted to be 5 again and give up, which I did. And I know it sounds really cheesy, but your mother was dead on when she told you that if everything came easily you would not appreciate it as much. Some gifts just find their way to you, and others have layers of circumstance that you have to peel away, slowly, methodically, over time. You have no idea how the story will turn out, but it develops as you go along, regardless of what you thought you’d write.  So yes – it has been a year and I am still waiting. But I am closer – much, much closer. And while I wait, I can create in other ways. The best plots are the ones where you wait in suspense, and then you find your story revealed. And it’s better than you ever imagined.

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