WTF Appointment Part Deux

Hi everyone,

As I mentioned in our previous blog, the infertility world refers to the appointment after a failed cycle as the “WTF” appointment. You discuss what happened in the cycle, how you would like to proceed, what your options are, how you are feeling etc. Let’s go in order, shall we?

What happened this cycle?: We implanted our best 6AA blastocyst, my lining was 11mm, and everything looked textbook perfect.

How would you like to proceed?: We are going to start another FET cycle with my next period, which should be towards the end of September or early October. My birthday happens to be October 2nd, and I can bet you $100 that I will get my period on or before my birthday. My body likes to be an asshole, so why not? Tentatively, our embryo transfer will be scheduled for 10/24. We will be traveling for our best friends wedding that both Dean and I are in, just before this on October 20-23rd. As a rule, I feel much better mentally when I am undergoing treatment for our IVF, and postponing definitely isn’t in our best interest. So, October is definitely a big month for us. This cycle I have opted to do the Progesterone-in-oil (PIO) injections instead of the suppositories for several reasons, but mainly due to the extreme discomfort  I experienced from the suppositories. I ended up very chafed and sore from the medication, even though I changed my panty liners often (read: every two hours). It was so bad that I actually was missing some skin on the outside of my vagina, which you know – NOT exactly the most fun thing to deal with.  It has been almost two weeks since I stopped that medication, and just yesterday is when I felt comfortable enough to say I am healed. A bruised butt and a big needle seems much more appealing to me at this point.

What are our options?: At this time, we have had one fresh and one frozen failure. Dr. Cass discussed doing a “mock cycle” that could assess if we are having issues with embryo implantation. Essentially, you treat it like a normal cycle (paying for and then taking the medication, monitoring, etc) but instead of an embryo transfer at the end, you have a small uterine biopsy to assess your uterine environment. If you were to google it, you will find various descriptions, but this is a pretty good one: “A mock cycle allows the doctor to ensure that the body, most specifically the endometrium lining, is capable of reaching levels that will support pregnancy and make implantation likely without the cost of preparing an egg that could potentially be lost to unfavorable conditions.  At the conclusion of the mock cycle medicines or dosages may be changed or fine-tuned in order to create optimum results in the real cycle.”

We neglected to do a mock cycle this time around, as I do not feel that there’s enough sample data in our situation to truly be concerned about having an implantation issue. Knowing what I know about the percentage chance of any treatment succeeding, as well as simply being at the mercy of your body, I am not quite ready to attribute our lack of pregnancy to anything other than bad luck. Next cycle, it is likely that I will feel differently.

How are you feeling?:

I am definitely still feeling the way that I was in my previous post, but it is a lot more palatable. During treatment, you form a very complicated relationship with hope. I have discussed this with other women in treatment, and they all understand exactly what I mean. You hate to be hopeful because if you are not successful that cycle, it is a much harder fall. And yet, you will still be taking pregnancy tests every single day with the hope that it will somehow show up positive. You even make all sorts of excuses and do some extreme mental gymnastics to convince yourself that you’re not out of the game. Logic brain kicks in somewhere and tells you, “Okay, you need to chill. This isn’t working out for you.” It is a literal tug-of-war between your emotions and your logic, often experienced within seconds of each other. Add in the extra bonus of being pumped so full of hormones that you feel like a horrendous monster, and you get a very exhausting situation. If anyone were to ask me what IVF treatment is like in one word, that would be it. Emotionally, physically, financially, exhausting.

As a rule, I do generally feel better when I am in treatment than I do when I am waiting around. Obviously, a failed cycle puts me at an extreme low. Dr. Cass knows and understands that I feel more in control when I am in treatment, and supported my decision to pursue treatment. As always, Dean is magnificently supportive. He thanked me this morning for being so strong and so brave for enduring everything I do. I can tell you that I rarely feel strong in the face of all of this, but after making the choice to voluntarily stick needles in my ass, I kind of do feel like a badass.

We will chalk today up as a win for the Johnsons.