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Friday, September 26, 2014

Embryo Transfer (7th IVF cycle)



Transferred embryo (Grade 2AA)
                                   


Embryo transfer to Rita 

Embryo transfer TO MANJU!


Let me explain. When I told Dr. Malpani that I will do one more ovarian stimulation cycle he said, “Manju, I suggest that you transfer one blastocyst to your uterus". He also said, “If that doesn't work, we will transfer the supernumerary embryos, we freeze, to Rita". Until that day nobody was able to convince me for having an embryo transfer again. I was adamant that I cannot go through another pregnancy. But, when my Dr said so, I didn't have any second thoughts. He is my Dr and if he says so, there must be a valid reason behind it. We all have a person in our life whom we admire and respect a lot, whom we look upon as our inspiration. He is one such person for me and I immediately agreed to what he suggested. But, I was not as optimistic as Dr. Malpani was. I thought, first let the stimulation start, let my ovaries respond to the drugs; let me produce eggs and embryos! After seeing my AMH value I became even more pessimistic. I was not even sure whether I will have embryos which will grow to blastocyst stage and whether we will have blastocysts to freeze. If I am left with less than 3 blastocysts, there is no point of transferring them to me. I was very confused. I thought, let me decide whether to transfer the embryo to my uterus or not after the day 5 fertilization report. As you all know now that I had 7 blastocysts at the end, we decided that I will have one (two?) transferred to my uterus. The happiest person about my decision was of course my husband. His positive spirit has always amazed me. His only complaint was that, I didn't budge to his words and when Dr said so I listened to him. But he was like, “atleast you listen to someone’s words in your life!” :)

Dr. Anjali asked me during one of my scans, "What have you decided regarding embryo transfer, how many embryos are you planning to transfer?" I had no answer then, I told her that I was very confused. I said, "Ma'm, sometimes I think I want to transfer two, sometimes one and sometimes nothing at all". This is how my mind was until the very last moment.

The day of embryo transfer came. I went to the clinic. My mind was unable to decide between how many blastocyst to transfer - one or two? I am 36 years old. For my age, chance of having aneuploidy in the resultant blastocyst is more than 50%. If it is so, 3 (minimum) of my 7 blastocysts might have chromosomal abnormality. If that is the case, isn't it wise to transfer two instead of one? On the other hand, I was scared to death of another twin pregnancy. After going through so much, I couldn't understand how my heart was greedy to even think of transferring more than one? Human mind is strange, it forgets pain so quickly! I thought, Dr. Sai will be there, Dr will be there, I will ask them both before coming to a conclusion.

In the clinic, we both entered our allotted room; I wore that wonderful hospital gown and waited eagerly for my turn :). I was also very eager to meet Dr. Malpani. I had met him only for 5 seconds during my entire stay there. I find embryo transfer stress free when he performs it. He keeps on talking something funnily and I forget that I am laying there in the most uncomfortable position, allowing people to poke and prod my private parts. If I am not comfortable during such procedures, I could feel my vaginal muscles tightening, my legs shivering uncontrollably. Sometimes because of getting so tensed, I get cramps in my leg muscles too; if that happens the whole ET episode could become very painful and scary. 

First, we were lead to the embryology lab. Dr. Sai was waiting for us. He showed us our embryos. He also showed the one which will be transferred to me. He said, “this is ahead of other embryos in its growth, so we decided to transfer this to you". I slowly asked him, “Dr. Sai, can I transfer two embryos, will it give me a better chance of success rather than transferring one?" He couldn't give me a conclusive answer. Who will suggest me something after knowing my history of twin loss? I said him, "Ok, I will ask Dr. Malpani, is he in his room? Should I meet him there or can I ask him when he comes for embryo transfer". He said, ask him when he comes to the embryo transfer room. So, I entered the ET room and saw Sister Mary and Vinayak (he works as an assistant). Both are very nice people. On seeing them I felt much comfortable. I just sat there on the ET table and started chatting while they were getting ready with the necessary items for embryo transfer. Vinayak asked, "can I call ma'm" and I looked at him shockingly!

I asked Vinayak, “Isn't Dr around?". He said, I don't know but ma'm said she will come to do the transfer. I was about to cry, my face was becoming grim. I told Vinayak, “will you please look whether Dr is in his room, if he is not going to do the transfer, I will not undergo this embryo transfer at all”. I know it was not very nice on my part. Vinayak looked at me as if his eyes would pop out. I actually ordered him, “go and look whether Dr is in his room", my intention was not to order, but, then, that was how I could react. He left the room. Sister Mary was listening to all this silently and she spoke. “Manju, ma'm will be upset if she hears this. She does embryo transfers very well. Do you know that women come from many different places in order to have embryo transfer done by her? She does embryo transfers equally good" On hearing this I felt guilty. True, how will ma'm feel if she hears what I said. How stupid I was! But I couldn't accept that Dr will not do the embryo transfer. I thought, “he didn't even care for me the least”. I wondered whether he even remembered that I have my embryo transfer on that day! I brought with me my children's foot prints (they gave them to me in the clinic after their birth) to show to him, I wanted him to hold it for some time, he only transferred them to my uterus and above all he is my Dr whom I shared my happiness and pain during my twin pregnancy. He was patient and kind enough to give me a shoulder to cry on during my very difficult times. It was hard to accept that he will not do my embryo transfer this time. It was very hard to accept the fact that my last chance for meeting him was no more viable. He didn't even wish me good luck! I remembered a patient e-mail where she asked whether Dr. Malpani will treat patients like me who writes blog like a VIP, I thought sarcastically, "yea, he does!" Vinayak came back. He said, " Dr is not there, only ma'm is there."

Dr. Anjali came. I always say that she has lucky hands. I think that expression is very unfair, and it somehow underplays her talents. She is the most talented person around. Several years of experience and her dedication has sharpened her skills a lot. Since Dr. Malpani is net savvy people know him better than Dr. Anjali, but, she is the best in the clinic :) The first question I asked her, as soon as she entered the room was "Ma'm, where is Dr?". She said, "He is busy nowadays, he went somewhere out". From that moment onwards till the embryo transfer all I did was to cry. Not just tears I was sobbing!

Dr. Anjali asked me, "Manju, how many embryos do you want to transfer?" I asked her, " how many should I transfer, can I transfer two?" She was not able to suggest me something too. She said, “you must decide". I was baffled. Lying down with legs on the stirrup and trying to think logically was not an easy task. I looked around and said, "I will ask my husband, where is he?" Normally, when Dr. Malpani transfers the embryos, Rajender will be with me. I wondered why he is still not there. Dr. Anjali told me “I don't want husbands inside the embryo transfer room". Even at that moment I actually appreciated her. I always felt that Rajender was more tensed than I was during embryo transfers. Instead of him trying to keep me calm, I have to hold his hand tightly to give him some assurance that all will be fine. Even after coming out of the embryo transfer room, he will be replaying several times in his mind whether all went well. He would say, “I saw some blood in the catheter after transfer, is that OK. Doctor was taking long time, he was moving something here and there, and would he have done it correctly?” His questions and doubts are enough to send me to a panic mode destroying the joy and peace of having a little embryo inside. So, Rajender was not available too to get an answer for the most important question - should I transfer one or two embryos? My mind was racing, I had only few minutes to decide, I was angry with Dr. How to decide, I had no clue! And, then an idea flashed inside me.

Vinayak, was near my eyes reach. Sister Mary and Dr. Anjali were preparing my nether region for transfer. I called Vinayak. He looked at me with little fear, “what is this stupid woman going to order me now was the question in his eyes” :) He was tensed. I showed him two of my fingers and said (ordered!) touch one of the two. He was totally clueless. He blinked for a moment and touched both my fingers. I really went mad for a moment, that's my last effort and he is trying to spoil that too. I said, "Vinayak, touch only one". People in that room were looking at that drama. He reluctantly touched one of my fingers. I calmed down. I looked at Dr. Anjali and said very confidently, "ma'm please ask Dr. Sai to bring only ONE embryo".

Dr. Anjali proceeded to transfer the embryo. She realized that I was crying. She asked me several times why I was crying. She was saying, “See, at one point we were wondering how many embryos you might get; now you have many. I thought you will be so happy and smiling today, why are you crying?" I gave no answer; all I did was to cry dutifully. Dr. Anjali asked me to breathe like the way when we do pranayama. She said, “I must see your stomach moving up and down”. All I did was to sob. She asked, "aren't you happy Manju?" I couldn't answer. She asked this for few times until Sister Mary interfered nervously. She said, “Oh, she is happy, heyna Manju”, she asked. I realized I am behaving stupidly. I said, "yes ma'm, I am happy". Dr. Anjali before transferring the embryo asked me to visualize it. I could see that she was saying a little prayer when she pressed the piston of the embryo transfer catheter. The transfer went on smoothly. I didn't feel any pain or I was not in a mood to feel what was going down there. She did it very carefully and with so much ease. After the transfer I thanked her amidst tears. I could see a very frustrated look in Dr. Anjali's face (due to all my tears!). She said, "I have to leave now, I will meet your husband and then leave"

After Dr. Anjali left, Sister Mary was telling me, “during transfer you were crying, because of all your sobbing I could see the cervix moving up and down". I just gave a blank expression. She said again "do not worry ma'm did the transfer very well". I was still on the crying mode. Vinayak on seeing this was trying to console me. He said, "There was a patient, her name is Manju too. She now has twins after many failures. This time all will go well for you" This further increased my sobbing. He was near my head. He kept his palm on my forehead and said, "Don’t cry Manju". That was such a compassionate gesture. I felt instantly better. I told him with smile on my lips and tears on my eyes, “if I do not get pregnant, for sure I will come and kill you, you are the one who said that I must transfer only one embryo".

Ten minutes I was there in the transfer room. Sister Mary and Vinayak made me feel so comfortable with all their pep talks. Sister Mary never fails to ask me a question whenever we meet, "your husband seems to be a very nice person, isn't he?" :) Previous time she even said, " when I fist looked at you, I thought you were proud but after talking to you I understood that you were not like that" :) Thank God! Mary Sister goes on talking and talking, she talks in Hindi, I reply in English, language doesn’t really matter!

I was allowed to go to my room after 10 minutes. Rajender was eagerly waiting for me. If he sees my tears he will panic, so I wore a smile on my lips. I told him that everything went on well and lay down. I said that ma'm did the transfer and that is why he was not allowed in the embryo transfer room. Before telling him that Dr was not there, tears once again appeared. He said, "please do not start again Manju, atleast not now". He looked at me for some time and said, "who knows I am not there in the transfer room and that might be your lucky charm". I looked at him angrily, didn't want to respond. I just closed my eyes. I thought, "Where will this decision of mine take me to? Why can't I have a crystal ball to predict my future?"

After half-an-hour I was ready to go. Rajender wanted me to rest for some more time but I wanted to leave. I said good bye to everyone. When I was about to leave, Shonali told me, “Manju, you should never come here again". I was very thankful for those words. I knew she meant well. With a heavy heart I came out, I thought, "I will never ever talk to Dr again, and if this embryo doesn't implant then I will see" :(

Where did my decision take me to? Will it lead me to happiness and bliss or to sadness and grief once again? Keep reading!

23 comments:

  1. Wonderful!! God bless u.

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  2. Beautiful. Twist. :) may god be with you

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  3. Remember Manju- I was really adamant about transferring one for my FET. That cycle worked for me!

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  4. What a twist in the end. Good luck to you. And do update us soon.

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  5. Good luck Manju!
    All the best to you and your family.

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  6. So happy to read this Manju. Take care of yourself!

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  7. Very happy to read this Manju! I really think this is your time now :) You are in my prayers!!

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  8. I am so glad you transferred an embryo to yourself. Nothing to do with Rita, she seems a lovely lady as well. I just wished you would give your body one more chance. You will continue to be in prayers dear.

    MM

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  9. Very happy for you and a decision well-made! All my love and all the Best!!! **HUGS**

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  10. Hi Manju, I am looking for a consult regarding an IVF project in India for single women. Could you email me directly at fertilitysf@gmail.com? Any help would be greatly appreciated (I know you're busy!).
    Thanks again!

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  11. Manju, what was ur ET on the day of transfer?.

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    1. You want to know the date of my ET? Why? :)

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  12. Hi Manju, ET- Endometrium Thickness dear. I meant Endometrium lining.

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  13. This comment has been removed by a blog administrator.

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  14. I'm ur blog follower. All your blogs are full of knowledge, strength and emotions. Being in this infertility journey, can easily relate to everything you mention. I sincerely wish you, all good to u n ur hubby from the bottom of my heart. May you soon have ur dream coming true. God bless.

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    1. Thanks a lot for the kindness! I wish you too lots of good luck and may your wishes come true soon. Please do write to me if you think I could be of any help.

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  15. Hahaha Manju! Technicalities and seriousness of the subject aside, I was in splits reading this post. You are a talented writer. You should write a novel :-). Keep it up lady! And seriously, that's a pleasant surprise! Proud of you for doing it. Cheers, Anjani.

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    1. Anjani :(

      What's there to laugh ? It did hurt so much. No one understands :(

      Thanks ! :) Pray for me. Novel? I can write only an autobiography :D

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  16. Aaaaaawwww, Manju! Didn't mean to offend u, sorry. Totally know what u go through. Been there so many times, had that awkward moment when u are sitting in the most uncomfortable position and a team of people staring at your private part, that too under flood lights. It's just my habit of finding something funny in all situations and moving on. Was only trying to be cheerful :). My bestest wishes are with you, God bless you with loads of happiness in the form of a healthy baby in your arms soooooooon!

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    1. Not a bit offended :)

      Anjani I know about you and I admire you for tackling even the most difficult situation with a pinch of humor. I wish you write a blog too!

      Thanks a loooooooot and wish you the sameeee :) Love u.

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  17. Hi Manju!!
    Wishing you very best for your future ahead. May you succeed this time.
    Can you please share the stimulation protocol which you used in this ivf?
    What do you think made the difference which resulted in so.many excellent quality blastocysts?

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    1. Thanks a lot! Can you please read the previous posts, I have discussed the protocol there. If you don't understand please write to me again.

      I did nothing special. Good quality blastocysts are due to my clinic's good embryology lab and excellent embryologist.

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