Two down

I made it through the second retrieval surgery today—with a 14-day injection window—and came out even better than last time. I woke up without any of the grogginess and got the news that we got 9 eggs compared to last month's 6. While hard not to feel a little disappointed after my left ovary's follicular rally earlier this week, it's still a better starting number.

50 injections to get us to today's retrieval and celebratory coffee cocktails!

I'd like to celebrate but I'm busy bracing myself for the next cycle, wondering if my doctor's even going to approve said cycle, and tackling the rest of today's tasks. How quickly life-altering activities can become routine: our future child may be getting conceived in a quiet laboratory over in Oakland and here I am tackling some frivolous to-do list.

Seventeen

My body is doing weird things and I don't know how to internalize it. My second IVF cycle kicked off the same as last: antral follicle count of 9. Those follicles looked nicely synchronized and they were a bit chonkier than the teensy dots we saw on my first cycle's baseline day. Yay!

Technically, everything that's happened since hasn't been bad. From my first monitoring appointment, I had 11 responding follicles - a happy surprise and big improvement over the 2-ish that seemed to be responding at the start of my first cycle.

For a while, everything felt like it was "on track." I knew how IVF looked and how I could expect to feel. I knew what my version of "optimal" looked like: maybe all 11 follicles would keep growing, maybe they'd all grow in sync, maybe I'd slide into the standard 8-12 day stimulation cycle that my clinic says is standard. (Last cycle, I'd fallen just outside the "normal" window with a 13-day cycle.) Things started going sideways over the weekend, when I somehow had maintained the 11 follicle count despite losing two on one side. (How do you even lose any??) From there things just got weirder.

On the one hand, I'm now rocking a minimum 14-day stimulation cycle and it may just keep going. I'm anxiously checking my phone for the latest news, and highly cranky that my surgery may fall on a weekend, robbing me of my hard-earned day-off to just chill after enduring a full cycle of poking, prodding, stabbing, and draining just to get way fewer gametes than a man can emit with a few minutes of fun.

On the other hand. I've climbed all the way to 17 follicles, thanks to my heavy-hitting left ovary bearing 13. On its own, it could be fabulous news—it certainly isn't bad—but those follicles aren't synching. Now my team is trying to figure out how to optimize the number of eggs we retrieve, and I have to accept that half of them may be throw-aways.

I hadn't realized how much I'd internalized that 9-to-11 antral follicle count as a part of my identity. I'd alternately mourned and celebrated—I'm past my peak but it's not too late!—and baked that into how I see myself. Now I don't know whether to celebrate that my body is surprising me with a bigger egg reserve or mourn the fact that I can't properly tap into that reserve. All the while I need to maintain focus in a competitive and completely male-dominated workplace where pretty much none of my coworkers could understand this experience. So, you know, a regular Wednesday. Hooray.

We're on the board

Just a week away from egg retrieval round two and we finally got the score from the first round. It's official: we're on the board with one healthy embryo in the bank. It's kind of all sorts of miraculous and somehow a little disappointing at the same time.

I'd been so busy preparing myself emotionally for the euploid (chromosomally normal) versus aneuploid (not compatible with life) outcome that I hadn't spent a moment worrying about whether we'd get a boy or a girl (the latter having just one fourth the risk of autism compared to the prior). Nicolas and I had no problem agreeing on our preferred biological sex, so to me that question was closed: we'd be having a girl. Either I was going to be a girl-mom or not. My brain simply hadn't inserted boy-mom as another possible outcome. Now this is incredibly stupid, but my brain only has so much space and the Neuralink clinical trials have been eating up a lot of it. The rest has been consumed by "oh my God, is this going to work??" and "can you believe we're even doing this??" without having a moment to ever fathom the most normal of becoming-a-parent questions: girl or boy?

I'd assumed there'd be more emotion, but I just feel like a box was checked - no more, no less. Maybe it's because I know I'm not yet half-way through the IVF slog. Maybe it's because I spent the day battling some gnarly software bugs that were essential for our implant manufacturing. Maybe it's because passing this hurdle still leaves some tough odds: an embryo with this guy's score has only got a 50% chance of a successful implantation and a 42% chance of live birth. With those numbers, I don't know how much I have to wrap my head around just yet. But this is good. I just didn't think I'd have to be telling myself that. 

And then there was one

That's it, no more Petri dishes filled with our maybe-babies anymore. Now all we have is to wait and to prep for cycle number two. There is one little hope sitting frozen while we await its genetic screening results - which at my age put it at a perfect coin toss of being our first healthy embryo or the last one in the discard line from our first cycle.

The final report - leaving us with 50/50 odds that we may have just banked our first healthy embryo.

There were a few wins, enough to justify carrying on: we now know that I definitely have eggs that can be successfully fertilized and can grow to blastocyst stage. And we now know more about how my body responds that my doctor can use to better tailor the next cycle to my unique profile. If this is a numbers game, we just need more numbers, and the only way I'll be getting that is by cycling more. At the same time, it's hard not to get down on myself. Was it horribly arrogant of me at 37 years old to think I could change lanes and decide to go the bio parenting route? And how will I keep up the pace at work while walking a journey that might take the rest of this calendar year?

I'm exhausted, overwhelmed, distracted, disappointed, and very much needing to get back onto my work laptop.

So far so good

We're down to 4 healthy embryos at Day 3: Cleavage stage. The embryos are progressing exactly as we'd been told to expect, but that doesn't make it any less terrifying. I've already been warned of the anticipated 50% drop-off from now until Thursday when we'll get our final growth update. Any embryos that have made it that far will undergo biopsy and cryopreservation, and then we've got to survive another two whole weeks before getting the biopsy results.

Our embryos' Day 3 report

It's insane to me that I'm supposed to just go to work and be a productive human being while our future child(ren) may or may not be progressing through the first few days of their existence. I understand that any traditional conception would leave the parents completely in the dark for this stage, but I don't think I was mentally prepared for these natural uncertainties. Nicolas and my future hangs in the delicate balance of an environmentally-controlled Petri dish. It's dizzyingly surreal.

Quite the news to mark seven years of marriage!

A small miracle

Today, a small miracle happened. For the first time since they were formed back when I was in utero in 1986, some eggs left my body alive. Six of them, to be exact. And of these, five were mature and got to be introduced to the most attractive hand-picked sperm cells from my favorite human. How amazing is that? Somewhere, right now, in some hidden lab in some fabulous petri dishes, the very first cell divisions of my future children may be happening.

Survived 33 injections - and not so much worse for the wear!

I'm scared to write any of this down because our next update is coming in less than 24 hours. By tomorrow, all the possible futures of those little petri-dish maybe-babies could go up in smoke. The only thing in my control is my attitude for retrieval cycle number two, which starts in just two days. That round of eggs is finally awakening after nearly four decades of slumber, and it's in my power to ensure they get exposed to the most well-rested, nutrient-rich, and stress-reduced environment possible. But right now those poor gals are being robbed of their good night's sleep by my curiosity over the happenings in a lab in downtown Oakland.

Made it to egg retrieval and fertilization day!

Holding on to two things at once can be incredibly hard: though tomorrow may prove this cycle's efforts were for naught, today was a small miracle. I got a taste of a world where a human life can be conceived in a lab. It's an extraordinary step towards women staking the same claim to bodily autonomy as men, where two humans can each enjoy creating a biological family together without one of them having to profoundly compromise their physical well-being. (Of course, in a world where the external uterus is still relegated to animal research and is only currently being developed to help preemies, a woman must still sign up for the nine month ordeal, but in a place like America where this is thoroughly regulated, that woman doesn't have to be mom: she can be someone who's signed up voluntarily, who's passed physical and psychological screenings, who's had a proven track record of uncomplicated pregnancies, who'll be guaranteed good medical care, and who'll be compensated fairly for her efforts.) What a remarkable future.

It's ironic in a time where women's reproductive rights are so endangered that I am getting to explore such privilege. But, despite the legal and political challenges ahead, as someone who believes profoundly in the potential good in new technologies, I'm so excited for what the future could hold for the women of our children's generation.

Turns out

Off to a good start, physically. Mentally, on the other hand...

Turns out that an egg retrieval cycle is tough - really tough - only not at all in the way I’d anticipated. My body feels fine, perfectly fine, other than the sleep deprivation. I haven’t gained weight. My injections haven’t really hurt or bruised; they weren’t even stressful. My blood draw yesterday went beautifully. But I cannot get out of my head.

It doesn’t make sense that I’m so stressed about how my follicles may be progressing. (Some are, some aren’t.) My heart isn’t set on a baby. More than the outcome, the uncertainty around it is keeping me up at nights and killing my daytime focus. Nicolas and my life path will be profoundly impacted by these retrievals, one way or another. It feels like it’s all on me, yet it’s so out of my control.

I can take all the prenatal vitamins, track all my health metrics, read every article, and listen to every MD who made a fertility podcast, but no amount of studying will help me ace this test. I am so out of my depth. This egg retrieval exercise forces me to grapple with my own mortality: I’m playing with a biological system that’s on its last leg, the first in what will be a steady procession of them. Aging feels so abstract and impossible until you actually start to live it.