Doubling up

The final results came in today and it's official: we've doubled our embryo count! (With another boy, of course.)

We can breathe a sigh of relief: cycle #2, albeit awfully disappointing, wasn't for nothing.

This second embryo has better odds than our first: given his grade at time of cryopreservation, he has a 65% chance of successful implantation and a 50% chance of live birth. With our two banked embryos combined, the odds of one successful live birth have now climbed up to 72%—not enough yet for me to breathe easy, but a more comforting number with which to roll into my third retrieval next week.

Time to start mentally preparing myself for a future as a #boymom. *knocks on wood*

What if my body was only my body?

I was reading an interview on NPR this morning in which the interviewee discusses her acceptance that fertility treatments wouldn't work for her. She's quoted as having found liberation in the thought "What if my body was only my body?" I was struck by how her journey, though quite different from my own—unlike me, she'd hoped to carry another life within her—converges with mine, meeting me where I've always wanted to be.

I got to feel like I owned my own body for a brief time, running a couple of miles on Friday and climbing the silks yesterday for the first time since mid-March. IVF cycle day 2 marked roughly the end of the safe window, a few days when my body was only my body in between healing from one egg retrieval and gearing up for the next during back-to-back cycling.

Tough as I'm finding this year's journey, there's a decent chance it may work. I may find myself in the unique position where my body will get to be only my body, and yet I may have the chance to be a biological mom, a privilege few cis-gender women in the history of our species have ever had. I'm thrilled and I'm scared and I don't want to start hoping too soon. But if, if... If this all works, I'm afraid of what people will say, of how our own families may react: the judgment, the discouraging words, the lack of support at a time when we'd need it most. I'm afraid that our child, if we're lucky enough to have one, might one day hate me for having made the choice to preserve a bodily autonomy that every father gets to enjoy by default.

Through those moments of doubt, I take comfort as did NPR's interviewee knowing that my body is only my body, a liberating thought indeed.

And then there was... one. Again.

Turns out my day peaked well before my clinic finally got around to delivering today's news. Give me the flowers on my walk with Lily or those snuggles with Chat and Furnie over this car crash of a medical call any day.

We started out so much more promising this time! On Monday, our day 3 report came in with double the number of embryos we'd had last time. I was so hopeful going into today - after all, the clinic explained to me that 40-60% of embryos make it from day 3 all the way to day 6. Sure, last cycle only 25% of ours survived, but with such low numbers last month, I wasn't going to extrapolate. And then we came out with half of last month's survival rate. Yes, only 12.5% (aka one lone survivor) made it out of this month's cycle. Cool, cool. Technically, our little trooper got graded with the most perfect score in every grading category, so you go little one! But we still have another two weeks to wait to learn if he or she is chromosomally normal. If not, it's automatic disposal per clinic policy. And so my fertility hell continues.

Okay, so disappointing news aside, here's something cool. This surviving embryo got scored on three categories:

1. Expansion stage, meaning how quickly it developed (that's the number). A score of 6, the highest possible, means this embryo "hatched." Did you even know humans did that? Apparently when we were a few hundred cells big, each of us had a shell that we had to hatch out of before implanting in our mother's womb. Mind blown.

2. The quality of the inner cell mass - what would grow to become the baby (that's the first letter). An A means there were many tightly packed cells.

3. The quality of the trophectoderm - the outermost layer of cells - what would grow to become the placenta (that's the second letter). An A means there are many cells forming a cohesive layer.

This is what the internet tells me that a 6AA looks like. It's not ours but I still think it's neat so I figured I'd share.

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.