I was working from home to be sure to be there when it arrived and our office is right next to the front porch. My heart sank when I heard the thump. That whole day, I had felt uneasy, and that sinking feeling when the package arrived affirmed that I really wasn't ready for all of this. I felt guilty and sad. Since we kicked our infertility battle into high-gear with IVF about a year and a half ago (when we got tested and diagnosed), I always thought this part would be exciting and hopeful. I'm feeling none of that. On the contrary, I've been feeling dread and anxiety over the choice. In fact, since coming back from my business trip in early February and scheduling the official date of transfer (March 29), there have been several moments of doubt and internal renegotiation about what we are about to do. A psychological fight-or-flight response to my fear of all of what we've done so far failing and my fear of giving up on my ovaries.
The past couple of months and particularly the last few weeks have been as hard for me as the hardest weeks of 2016. It's been as hard as when we went from 5 to 1 embryos in round 1, as hard as when we had completely failed rounds (rounds 2, 3, and 5), and as hard as starting round 4 after so much bad luck and lack of success. And I hadn't even started the transfer protocol / medicines yet...literally only the date has been scheduled and I haven't even started the uphill march yet. I kept thinking, "It could be rescheduled in a heartbeat. Why am I feeling such panic? Shouldn't I wait until we get started to freak out?"
The feeling has moved from terror to panic to depression to cautious hope and back again a multitude of times. Starting the medication has helped a little. There's some amount of commitment and action in taking my estrogen pills and applying and wearing the estrogen patches. When I went in for the March 3 baseline check, my scan was done by the other RE in the office (not my usual one, but one I see fairly often). He asked how I was feeling about getting started, and my reply was, "Terrified." He chuckled and said, "Well, it's been 3 years...time to jump out of the airplane. It gets easier once you're through the door, plus you can't ride in the plane forever." While an odd metaphor for IVF transfer, I get his point, and tentatively agree.
I'm now a week into the estrogen patches and pills. The patches are stickers the size of a quarter that I stick below my belly button and replace every 3 days. So far, I've found they don't stick too well on their own, and need an additional tegaderm / sticker / dressing on top of them. Other than that, they've been pretty easy. The pills (Estrace, 2mg) are the same ones I've taken in the past for estrogen priming. They dissolve under my tongue (as opposed to swallowing them), and they have traditionally caused some pretty heavy nausea for me. Previously during retrieval rounds, I only took 1x day, but now I'm taking them 3x daily - 6am, 2pm, and 10pm. It hasn't been terrible so far, but there have been some rough days.
This estrogen course will go for 17 days before I'm instructed to add in progesterone injections (on March 24). Those will continue (1/day) through the transfer and on until scans and tests either prove that we have failed or through the 10th week of pregnancy (sometime mid-May). This 50-some-odd shots are to be given intramuscularly ("IM"), usually in the upper-rear / lower-back area. So far all my shots have been subcutaneous ("Sub-Q"), meaning just in a pinch of fat / skin (usually in the stomach region). The IM shots have a 1.5-inch needle that goes all the way into the muscle where the medicine, which is an emulsion in oil, is then injected. This oil is fairly viscous, and has been known to cause lumps, bruises, and soreness at the spot of injection. Getting my game face on for this part.
Overall, I'm feeling a bit better about the whole process...better than I felt during the "jumping out of the airplane" talk. I have to admit, it was pretty rough for a few weeks. The stress / anxiety is there because it's such high stakes for us, but the stakes are high because science is actually giving us this small chance for success. Without this whole process, we would have next to 0 chance of getting pregnant naturally. Still, it's hard to face the real possibility that the 3+ years we have spent working on it up to now, particularly all the effort, time and expense of the last 16 months, could realistically end in failure.
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