Another Thanksgiving, another recipe

Thanksgiving in the time of fertility treatments: not the easiest time to feel thankful. There is a lot to be grateful for, most notably having access to healthcare that actually allows me to blow a year of my life banking embryos. But it'll be easier to feel gratitude once the banking is over. For now, saddled with this headache, I've got to keep the drinking to a minimum. As such, this year's new recipe was a non-alcoholic mulled wine, which actually turned out good enough that even the booze drinkers were helping themselves.

Thanksgiving 2024: good friends, good food, and a third consecutive year without moving (after moves during 6 of the first 7 years we were together). Overall, we've got a lot to be grateful for. I'll work on the gratitude stuff once I'm out of the fertility trenches.

I promise I won't be one of those nightmare bloggers with a five paragraph story before getting to what actually matters, so here you go:

Non-alcoholic mulled wine

Ingredients (for 4 servings)

• 750 ml bottle of non-alcoholic red wine - we grabbed the non-alcoholic Chateau Diana Merlot
• 2 cups of water
• 8 cloves
• 6-9 blackberries
• 1 cinnamon stick
• 3 star anise
• 1 sliced orange
• 1/8 - 1/4 cup brown sugar (to taste)

Instructions

1. Mix all the ingredients in a saucepan and place on medium-high heat just until the wine begins to boil.
2. Reduce to low heat and simmer for 20-30 minutes.

Easy! And it's flavorful enough that several people even asked if there really wasn't alcohol in it. A nice little fertility-journey-inspired success.

Not totally broken

I did a thing! I sneaky ran a 5k 5 days post-op. In a year where my body's felt generally worthless, today it showed me it's not totally broken. In fact, after having actually respected doctor's orders and not run for the past two months, I did better than I'd expected. (You're not supposed to run while taking fertility stim meds nor during the first two weeks post-egg-retrieval-surgery, which means no running at all while back-to-back cycling like I do.)

Initially, I'd signed up for this race as a way to reclaim my body post fertility treatments. So much for that. But the registration fee was non-refundable, so I figured I'd find a way to be a finisher. I'd been prepping for today with a whole lot of morning power walking with Lily, much to her chagrin. Five days ago, on the morning of my latest egg retrieval, I heard a nurse tell the patient on the other side of the curtain to abstain from all but "light" exercise including "walking or a gentle jog." The seed of an idea took root, and I obviously had to test how gently I could possibly jog today without feeling any sorts of scary pain. It turns out, respectably so. I didn't give it 100%, but I ran in a focused style to ensure minimal gut jostling and I came out the other side with no ovarian torsion and a solid finish time. It was so nice to get to be proud of my body for once in 2024.

Not too bad for five days post-op.

Capable

Today I was capable. I dragged my behind to another egg retrieval, the most seemingly hopeless one yet. From getting the news mid-baseline-appointment that we'd lost all my embryos from the previous cycle and having my doctor suggest we cancel this cycle due to poor initial indicators, to having some last minute rallying of the follicles only for hope to be dashed by dropping estradiol levels forcing me into a premature retrieval, all while bearing the news of this past week's election results, I'm amazed I rode the emotional rollercoaster all the way into today's surgery. With a heavy heart, I negotiated special terms to today's retrieval to cut our losses by electing not to fertilize (and save on the out-of-pocket costs) if we retrieved fewer than five mature eggs. I wasn't finding much hope to hold onto.

Having awoken at 3am today, I peaced out of our condo around 4:30am and walked all the way to the clinic just because I couldn't bear waiting around anymore. The universe did its best to cheer me on with an inspirational sign in the window of a car parked around the border of Emeryville and Oakland telling me I was capable of more than I know. Shout out to the random car owner who felt folks might need a cheerleader. After a quick pre-sunrise tour around Lake Merritt, I headed into my clinic to face the music.

What followed was confusing and hopeful and hard to digest. We got eleven eggs, ten of which were mature. That's good, really good by my body's standards. I don't trust it. There have been too many dashed hopes and disappointments this cycle for any of this to make sense. But I was capable of making it through today, and I'll get up tomorrow, and in three days I'll begin priming for cycle number 7.

Cycle 6: heavy on the heaviness, light on the hope, but we made it through.

Civic duty: check

Following along with the blog this year, you'd be forgiven if you thought my non-work life consisted of little more than doctor's visits, timed injections, operating room appointments, pubmed searches, and anxious waiting. Indeed it's been hard at times to live outside the scope of my fertility journey. But occasionally I still enjoy, or at least remember, to be a normal human being, like last weekend when Nico and I did our part to postpone stop the impeding collapse of American democracy, this time with two voices instead of just one thanks to Nico's naturalization!

Election 2024, well underway.

Now to try and breathe easy as a woman banking embryos in a world where Republicans are out to outlaw Nico and my unique chosen journey to a family of our own. Even our fertility clinic sent us a reminder to "vote for what's important to us." Ouf.

We were failed

The fifth embryo banking cycle seemed like the great redemption cycle. After a totally failed, all-aneuploid cycle number four, I can back with a vengeance, retrieving the most mature eggs ever, and churning out a full four cryopreserved embryos including my first-ever day-five embryo. (Women of advanced maternal age, such as myself, tend to have slower-growing day-sixers. Generally, a day-five has better odds of being genetically normal and a stronger overall metabolism.) Sounds like time to breathe a little easier, maybe give ourselves a pat on the back, huh? You'd think.

Instead, we lost all of this cycle's embryos. The laboratory that handles the biopsies, the final step to determine which (if any) embryos are good to go, mishandled all but one of our samples. The only one they didn't botch was the day-six embryo with the worst morphology and it was, unsurprisingly, aneuploid. As for the rest including my little pride-and-joy day-five embryo? They're all still sitting in a freezer with an "untested" status. The actions required at this point to learn if they are healthy will all but destroy them, decimating any chance they'd have of being born.

And for the service of stealing our fifth cycle, we were charged $950. Just to add insult to injury.

Casually offering a re-biopsy as though that doesn't all but eliminate the embryo's chances of being born. Cool. We just stole an entire IVF cycle from you, no big deal, yeah?

The cherry on top? My doctor casually mentioned how "it was too bad how that cycle turned out" while she had an ultrasound wand up my vagina and was dropping the news that the sixth cycle I've just begun is poised to be my worst cycle yet - only eight little follicles all looking mighty surpressed. She even offered to cancel this cycle, in case things couldn't get worse.

Sometimes I wonder if the universe isn't trying to tell me there's an off-ramp from my hare-brained idea that I should become a mom.

Survived (thrived?) another round

I'm home, my short-term memory is fully recovered, and once again I wasn't even inclined to crack open the bottle of norco. Five cycles down, one to go. I survived. You might even say thrived: for the first time we had fabulous follicular synchrony. The majority of my follicles hit maturation size together. There wasn't a single runaway abandoned to go after a more-numerous-but-slower-growing cohort. My stimulation cycle made its "normal" time frame debut. (Normal means 8-12 days, with 11 being considered optimal. I, on the other hand, have rocked 13-14 day cycles on my first four go-rounds, but enjoyed a privileged 11-day stim cycle with a total of just 29 injections and 5 blood draws this month.) And in case it wasn't enough to enjoy fewer injections and a shorter cycle window, I even got the largest number of eggs yet: 12 fully mature MIIs that got fertilized in a laboratory this very afternoon. Another tiny miracle of science that I have the extraordinary privilege to access. You'd think I'd be sitting pretty.

And yet.

And yet.

None of this means anything. Yet. Because I've lived through the crappiest stim cycle with a measly five mature eggs and came out the other side with a healthy euploid embryo. And I've lived through a strong, highest-estrogen-level, ten-whole-mature-egg cycle that yielded nada.

I've finished my part of embryo banking cycle #5. It's all in the hands of the embryologists now.

It's time to buckle up for a few weeks of emotional roller coaster waiting for the final embryo report from this cycle while I start slathering on the testosterone: come Wednesday, the hormonal priming for cycle 6 goes into full swing. With the clock ticking on that 2024 insurance maximum out-of-pocket having been met, there's no privilege of waiting for one cycle's results before diving into the next. Once again, one more time, here we go.

A story that isn't done

I've been thinking a lot about the importance of stories in human existence. Stories are how we make sense of the random series of events and experiences that form the course of our lives. It's how we define our family, our nation, our collective history. It's how we sell a CV filled with various professional experiences that we cobble together to pay the bills and hopefully find some meaningful way to contribute to society.

I tried to sell myself on the story of being the future mom who accepted the data that told her that four euploid embryos and one low-level segmental mosaic were sufficient: that odds of 199 out of 200 are squarely enough to feel confident that motherhood is secured, that it's time to move on and not agonize over the tiny reserve of eggs withering away before we thaw out our five little hopes of creating a biological family. But that's not my story. I realized I couldn't stop my fertility journey on so much heartache. The decision has torn me up and left my intestines in knots. What about our bank account? What about the odds that I now endure multiple failed cycles?

Once again, there's comfort and sanity in the stories we tell ourselves: I'm not a woman who failed IVF but a fertile woman who has created five viable embryos and who's on a mission to make a few more. I'm not someone just embarking on embryo banking but someone who's already successfully banked what most doctors would call enough for two children, and who's circling back for a couple of bonus cycles while enjoying the benefits of having hit her annual out-of-pocket limit.

We can't know what the last chapter of the IVF journey will look like, and to be fair that final bits won't come until we've implanted in years to come. All I know is I can't live with the narrative that I gave it anything less than all I had. And what I've got is two more cycles, two more tries for another frozen miracle who might one day make me a mom.

Get those seat belts back on: this ride isn't over yet.