Hope is made of steel
But heart is made of dust
Won´t you tell me that your real
My Hope is made of steel”
– Northcote

Today, my hope is made of steel and my heart is made of dust.

Hope is a funny thing. Someone I respect dearly told me it’s a funny thing. When we hope, we live in a future that hasn’t happened. We aren’t grounded in the moment, we aren’t full present in our experience now. But hope is also really important. Without it we wouldn’t strive for anything. I think hope, when done right, is a great motivator. Hope can also crush you when your heart is let down.

My biggest fears in this journey have been loss. It’s one thing to hope for something that hasn’t yet happened, but to grieve for something that almost happened or partially happened is really difficult to navigate. I’ve been trying so hard to live in the moment, day by day, and take all of the ups and downs that go with that. I felt a bit jaded with our Jan 31 transfer given our history. 5 previous embryos that didn’t pan out as we had hoped. But every time you give it another shot, hope manages to creep in even if you fight it.

The first pang of hope happened when I went in for my transfer and I saw our microscopic 4BB day 6 embryo on the screen in front of me. I was alone in the procedure room with the doctor and nurse, and the doctor told me “it looks like your embryo is hatching!”. I looked at the screen and instead of one circular blob, the embryo had started it’s way out of it’s shell. This is a crucial step before it’s ready to implant. I suspected then and there that this embryo might be different.



I did the transfer and felt no pain, no pressure. I saw the flash of light on the ultrasound screen once it was inserted into my uterus, and that was it. It was in there and everything else was up to chance.

I headed home like nothing had happened, since we had been through this a number of times before.

The day after my transfer I took my last HCG shot, and it was that day I began testing out my shots. The hormone is the same as the pregnancy hormone so my goal was to test until it was negative.

Most transfer cycles I feel all kinds of rogue symptoms due to the meds and probably due to my hyper awareness, despite having them not work. At 3 days after this transfer I had some really brief sensations of dizziness and nausea (maybe 5 mins worth). I also got stomach sick, which is not uncommon for me given I suffer from IBS. After that I didn’t feel anything really. tired, heartburn, but that’s about it! I was pretty sure nothing was happening.

On day 7, something else happened. My test was darker. It was supposed to be lighter. I chalked it up to urine dilution and continued as normal.

On day 8, it was even darker. Day 8 was Thursday and my bloodwork wasn’t until day 12 (Monday). I called my clinic because I knew I was going to lose my mind, to see if I could do an early beta test. They didn’t really want me to do it but issued a requisition so I could go to my own lab for bloodwork. There would still be HCG in my system from the shots. I am very type A and made a spreadsheet of what my possible levels could be based on the half life of the medication (29 hours +/- 6 hours for anyone wondering), and I calculated that my HCG would be be between 4-46 but most likely around 17-25 given the averages I found.

I went for my bloodwork on 9dp5dt and the result was 75. Usually on day 9, they hope for around 50, day 10/11 they hope for around 100. I was right in the middle, but still on the low side. I calculated my actual HCG was estimated around 50-63 given the chart. This means I AM PREGNANT! Cautiously so.

This morning my tests confirmed it. My tests were the darkest yet. I felt SO much relief seeing that. Anything can happen from here. We have lost one pregnancy at 5 weeks (today is 4w2d), as well as a pregnancy between 7-8 weeks. So although I am thrilled, I am cautious. I want to protect my heart, but I also want to feel all the joy in this moment in case it’s the last time I get to experience it (due to success, or due to failure). I want to try and enjoy it day by day, hour by hour. I’ll always envy those people who find out they are pregnant weeks into it, and don’t have to question all of this. Or those who have a successful live birth on their first pregnancy. Loss is something that robs you of the joy in your experiences.

So for today, I am pregnant. I’ll be repeating this to myself daily for as long as I am able.

We are now awaiting our beta result on Monday (bloodwork is just 16 hours from now, but I probably won’t get the results until late afternoon or Tuesday. This blood test is everything. It will tell us whether the pregnancy is viable or not, at this stage. It’s the only real way to confirm it until later on after 6-7 weeks. We’re hoping for a beta HCG of approximately 150+ on Monday to signal that it’s healthy – however our clinic may have a different benchmark. I should have a maximum of around 10 of the shots left in my system so it will be negligible and not alter the result much. Nervous but hopeful. But scared.

I’ll update you all as this journey processes for better or worse. Thanks for being along for the ride.

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I’ve been taking a hiatus from posting on social or writing here as I grappled to wrap my head around the news we got in December. I won’t be updating on the recall stuff for a while as we figure out our plan of action, but in the meantime I’ve been hard at work prepping to transfer one of our two frozen embryos.

A recap, we did a retrieval in Nov and ended up with 2 frozen embryos – 1x Day 6 4BB and 1x Day 7 3CB. We waited in December to get to a point where we could begin our FET#5 protocol. The culmination of a lot of things have come together this time around. We did a biopsy in October of 2023 to shed some additional light on things that could aid in successful implantation (half our issue, the other half being embryo quality). That test resulted in a really intensive protocol for this FET.

My cycle started the first week of December and I was then on a mission to pinpoint ovulation using OPKs. I normally ovulate a bit later, on cycle day 15-20 on average. The holiday break was likely going to throw a wrench in our plans, and we’d have to skip a cycle. But it turns out I ovulated late on December 27 and we managed to scrape by the closure. The first step in our FET preparation came with a endometrial scratch (almost the same as the dreaded biopsy we did in Oct – ouch is all I can say) which was to take place in the luteal phase of my cycle PRIOR to the transfer cycle. I went in on January 3 for this procedure. Then, waited for my period to arrive to signal the start of the transfer month cycle. I had a bit of bleeding leading into my actual period and I wasn’t sure if it would actually come as normal or not. But, after 3 days of spotting, I got my full flow. It was go time.

This protocol is not for the faint of heart. I have dubbed it the Kitchen Sink Protocol for good reason. I immediately started on Estradiol pills. I took 2mg, three times a day for the first 6 days, then I added two vaginal Estradiol pills for a total of 10mg a day. Normally my lining is very thing, even on this dose, and takes 25+ days to get where it needs to (a minimum of 7mm for most clinics). I planned a little getaway to visit a friend in a different city 1200km away thinking I’d be in the clear for at least a couple of weeks. I went in for an ultrasound the day before I left on cycle day 8, and it turns out I was nearly ready! I was shocked. They scheduled me to come back in the day after I returned from my trip, 6 days later. I was ready to roll.

Now came the fun part (sarcasm), My protocol from that day forward has been pretty intense (I am currently still in the thick of it). I started taking Prometrium suppositories the following day (6 suppositories a day – 2 in morning, afternoon and evening), and also introduced progesterone in oil injections (worst, 1.5″ intramuscular needles for those who have forgotten) which are currently every 3 days. I am down to 2 oral Estradiol pills a day, morning and night. That’s all standard issue every time.

In addition to this, I have added the following:
– 81mg Aspirin a day
– On days 4,6 & 8 I take a HCG injection (Ovidrel) in the morning in my belly
– I take a vaginal priobiotic suppository daily (VagiCare)
– I have to have intercourse on the day before and after transfer
– On the day of transfer I begin another injection called Fragmin (basically heparin) in the belly in the morning. I take this until either negative beta bloodwork, or until 12 weeks if our cycle is successful (in addition to the Prometrium, Estradiol and Progesterone in Oil).

Our transfer is also taking place on day 6 vs day 5, due to some results that came back from my ERA results suggesting I should have an extra day of progesterone.

I have also completely cut caffeine this cycle, cut back sugar and have been eating a cleaner diet. Add in Brazil nuts, beet juice and pomegranate juice.

Phew.

So here we are. After 5 embryos lost, 2 miscarriages and 3 Egg Retrievals, to say I am jaded is an understatement. I still have hope, but its minimal. More so, I have a resilience that just keeps me moving forward. Once you have been on the track for a while it’s easier to stay on it than take a break (in my opinion). I’m not sure I’d have in it me to continue if we stopped now. In my head I already have the next steps planned out for when this fails. But if it doesn’t fail, I’ll be over the moon. Managing expectations at this stage of the game is crucial for me though.

I thought back this week when I was walking around a baby store for a friend – two years ago almost to the week we began this journey. Prior to that, my hopes were so high. We went window shopping for all the baby stuff we’d buy. I made a baby registry to keep track of it all. I had boughed a fancy electric bassinet online. Some sleepers (thank god I stopped there). Now, I won’t even let myself go there in my mind. If we have success again I am really afraid the process will steal all the joy from the experience, but of course I’ll be grateful every single day.

Our transfer is scheduled for Jan 31. Because of my HCG injections I won’t be able to test at home, and have to wait an excruciating 13 days for my results. I’ll have all my fingers and toes crossed that our rainbow will appear through the clouds.

The post Frozen Embryo Transfer #5 appeared first on .

After about a year of trying to conceive, a failed IVF transfer and a few embryos on ice, I decided to call in the experts, and by experts I mean a really reputable naturopath dealing with fertility patients. Why a naturopath and not my GP you ask? Because in my part of the universe (British Columbia, Canada), there is a health care and housing crisis and you may wait for years for a family doctor. So, Naturopath it was. Not to mention, most GPs will not support the use of supplements because they aren’t FDA or Health Canada approved or monitored for quality control – I learned this recently, apparently supplements can completely lie about what’s in them (within reason) and get away with it. Shop at your own risk.

Not everyone believes in supplements, and that’s totally fine. I don’t in a lot of cases, however in the case of my infertility, I am of the mind that it cannot harm my odds. Especially those backed by science. So here I’ll do my best (as a person who failed science in high school) to break down what science I found around taking these mysterious pills.

Currently my IVF supplement list is as follows and has come from a few sources – I have found scholarly articles and studies on some of them, my naturopath suggested others, and the book “It Starts with the Egg”, which is highly controversial, recommended a few others. I didn’t take this book as gospel by any means but it has helped break down some of the science for me.

Also note, some of these are good for pregnancy as is, or trying to conceive, while others benefit blastocyst production and the endometrium for IVF/Assisted Reproductive Technology patients.

• Daily Prenatal Vitamin (not brand specific, although I am currently taking Materna because it also contains a small amount of Iron and I need as much Iron as I can get without taking a hefty supplement (IBS be damned).
• Fish Oil/Omega 3-6-9 – I am taking 1000mg of this a day. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9308390/, https://www.fertstert.org/article/S0015-0282(19)30810-6/fulltext)
• CoQ10 in the form of the readily absorbed Ubiquinol – a very large dose during egg retrievals of 600 mg a day, split into 3 doses a day of 200mg each. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870379/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6210096/)
• Active Folate – Methylated Folic Acid 1mg (also more readily absorbed than regular Folic Acid) (more so for regular pregnancy should it occur, but it could also help IVF https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172634/)
• L-Arginine – MASSIVE dose of this for egg retrieval – 6000 mg a day. It can get costly. I find the capsules to be the easiest to stomach, but you can also consider a powder supplement mixed in liquid, but it is BITTER. I mix with a ton of lemon or lime juice and water when I do the powder. I try to do capsules whenever possible though. I also try to mix this throughout the day to make it easier to handle. (https://academic.oup.com/humrep/article/14/7/1690/2913125, https://pubmed.ncbi.nlm.nih.gov/32977253/)
• Vitamin E – 400 mg (https://www.imrpress.com/journal/CEOG/48/2/10.31083/j.ceog.2021.02.2207/htm, it is also good for sperm quality (https://pubmed.ncbi.nlm.nih.gov/34671676/)
• Zinc 15-25 mg (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8599883/, also good for male fertility and immune response)
• Vitamin C 1000 mg (Great for post FET https://www.longdom.org/open-access-pdfs/effect-of-post-embryo-transfer-vitamin-c-supplementation-on-the-outcome-of-invitro-fertilization.pdf, https://egyfs.journals.ekb.eg/article_170463_2d039f08729155c6101049ea92985f35.pdf)
• Women’s Probiotic – I take Renew Life Ultimate Flora Women’s Extra Care Probiotic because it has a really good mix of the flora you want for your lady bits, and it is a large dose at 50 billion. (the studies are mixed on this, but I take it as a just in case, and for my IBS and gut health. Some doctors will actually recommend a vaginal suppository of probiotics specific to the vaginal flora to help balance bacteria, mine included. This dose is a ten day of FloraSAP and it is taken before FET).
• NAC (n-acetyl-l-cysteine) 600 mg (https://egyfs.journals.ekb.eg/article_170463_2d039f08729155c6101049ea92985f35.pdf, https://www.fertstert.org/article/S0015-0282%2804%2901904-1/fulltext)
• Vitamin B12 200 mcg (https://raf.bioscientifica.com/view/journals/raf/4/3/RAF-23-0015.xml)
• Vitamin D3 2500 IU (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8969598/)
• 81mg Aspirin (low dose – NOTE – check with your doctor before taking this, and absolutely advise any medical professionals that you’re taking it as it can effect your procedures (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5604627/,
  
  This is also a really good article on a number of supplements and their uses for fertility: https://academic.oup.com/humupd/article/13/2/163/661418

A caution for those taking supplements for egg retrieval and FET – consult your fertility doctor because some of these supplements should not be taken during pregnancy or in preparation for it. Some may simply have no effect, and there’s no need to take them once retrieval has been completed (or IUI!).

So there we have it, the 700 pills I take a day. I recommend doing the research yourself to decide if any of these are right for you or not. At this stage in our IVF journey I’ll take any help I can get so I was willing to use the kitchen sink approach.

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We set up a call with our doctor, who might I add now feels like a member of our family more than a member of our clinical team, to review the results. I can’t stress enough how having continuity of care impacts how I have felt about treatment. I feel supported in such a different way, where my doctor knows my face and my situation.

Anyway, the results you’ve all been waiting for (hah, I feel like I am the only one anxiously awaiting these)…

EndomeTrio:

ERA Test:
We have found out that I am “pre-receptive”. Here’s an excerpt from my clinic on what the receptivity test does:

“The rationale for the test is based on the fact that the endometrium will only allow the implantation during a finite time frame known as the window of implantation (WOI). If the embryo is delivered to the uterus too early or too late, when the window is closed, implantation cannot occur […] However, until the ERA test was developed, there was no meaningful way to measure it in any given individual. More importantly, the ERA was actionable: if the endometrium was found to be non-receptive a plan to optimize receptivity was provided.” (Source)

Pregnancy can’t occur if:

• the window of receptivity is missed
• the embryo isn’t mature enough
• the endometrium is not expressing the correct genes or is not in a receptive state

The idea of a window of receptivity exists in both natural conception and IVF.

In my particular case, a very specific window of transfer/implantation has been recommended – between 141-147 hours of progesterone. This means my endometrium wasn’t ready on the day of biopsy, and additional progesterone is recommended (so an ideal transfer would take place approx a day after the normal transfer date of day 5 for most frozen embryos).

Here’s a really good article that explains receptivity and how to interpret your results if you do the ERA: https://en.e-stork.com.tw/article/view/71

EMMA Test:
The EMMA test came back recommending vaginal probiotics for 10 days prior to FET. I have taken these before, but not every time. The recommended probiotic is Flora SAP.

ALICE Test:
Nothing found

UtimPRO
This test was the beast. This one is not done routinely, but due to my implantation failure and recurrent miscarriages, my doctor recommended I give it a shot. I don’t know anyone else personally who has had this test, but the findings were very interesting. Once again, I am happy to try anything and everything at this point in my journey.

I didn’t see the report directly, but given the recommendations I was able to draw a few conclusions.

1. Heparin was recommended for my FET. This likely indicates that a clotting disorder may be a factor in my repeat failure. Here’s a good study on use of Heparin in Assisted Reproductive Technology (ART): https://academic.oup.com/humupd/article/14/6/623/631770

2. Endometrial biopsy prior to FET was recommended (AKA scratching). SUPER excited to do that again (sarcasm). Scratching can enhance the receptivity of the uterus to the embryo. It’s not a guarantee, but it ‘can’ assist. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294834/

3. Addition of HCG – HCG can aid in the implantation of the embyro,

Experiments have indicated that hCG influences the level of hormones in the uterus and even within the embryo itself around the time of implantation. hCG may also influence cells involved in the immune response of the uterus to the embryo, allowing the uterus to accept the embryo.

Here are two good studies on adding HCG during FET and the outcomes.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9289495/
https://www.fertstert.org/article/S0015-0282(19)31176-8/fulltext

4. Addition of Seminal Plasma (basically intercourse one day prior to and one day after transfer)

“Seminal fluid contains several proteins that interact with cervical and uterine epithelial cells inducing active immune tolerance.” (source)

Studies are conflicted, but here are two that demonstrate benefits:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979547/
https://www.iris.unina.it/retrieve/handle/11588/698105/212311/Saccone_et_al-2019-BJOG__An_International_Journal_of_Obstetrics_%26_Gynaecology.pdf


After reading all of the above, I am assuming that there’s a suspected immune response happening during implantation of an embryo in my uterus.

So how do I feel about this? Relieved to be honest. For the first time in our IVF journey, something actionable has come about that gives us hope. So many people have success in IVF during the first or second retrievals, and although my egg quality and our blastocyst production has taken a hit recently, this testing has made me feel more in control of my outcomes. Will it work? Who the hell knows.

The moral of the story here is that embryos are precious and everything should be done to ensure the ones we have actually implant. I am not sure why these tests aren’t offered more often before transfer, especially after subsequent failed implantation or miscarriage. I feel that I was over confident after our first egg retrieval, thinking “we made 7, we can make more easily!”. That wasn’t the case.

Going forward I feel more confident that any embryos we do create (fingers crossed), will have the BEST shot of survival. That we’re doing all we can on our end to make this dream a reality. I always tell my IVF friends, ADVOCATE ADVOCATE ADVOCATE for yourself in this process. Be it in asking for a test, pushing for a second opinion, making your wishes known. So many of us pay out of pocket for this, and we should use that power to do everything we can to achieve the outcomes we can for our future. You’re in the drivers seat, so don’t just sit there in the parking lot waiting for change to happen.

PS – I’ll be adding all of the studies I link to in my blog in my Resources page, once I have some time to organize them! If you know of a study that is informative that should be included, feel free to comment below!

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We decided after our biopsy cycle to move ahead as soon as possible. On Oct 3 we began to plan for a new Egg Retrieval with our new clinic. One hail Mary to see if we can create embryos again, this time on a different protocol altogether.

So far we have sank tens of thousands of dollars into this endeavour. It’s like playing the lottery, but not knowing if there’s actually a prize to be won or not. I have counted many things I could have spend my money on, but didn’t. Many experiences I have not had or had to forgo because of treatment and the dream of bringing home a baby of our own one day. It puts me in a bit of an ethical dilemma every time we forge ahead and put more investment into this. This money could be spent in a lot of ways, either on our future or by using it to help others. For now, we have made the decision that this is still important to us, and although sometimes we feel guilty about using our funds this way, I know people who toss their money out the window in worse ways, so that gives me a bit of peace in the decision. (for those wondering, 3 cycles will put us at about 70k CAD without any transfers – bye to my salary for a year).

Egg Retrieval 3.

As soon as I got a bleed from my mock cycle, about 3 days before I stopped the medication, I called the clinic for my cycle day 1 (CD1). Just like that I was on another adventure. The nurse immediately faxed my prescription to my pharmacy and we were off to the races.

This time I am set to do priming for 35 days. A mix of Androgel (testosterone) and Estradiol, followed by a week of provera to induce a period. I am currently on day 26 of this priming.

On October 31 I head into the clinic for injection training (not that I need it at this point, but it’s protocol), and to pick up my stim medications. I’m scheduled to start those on November 11, the day I begin my Christmas mini sessions of all things (hah!). Last year I also had to do stims during my mini sessions. I was SO bloated and so exhausted. This time it’s just day one of stims so hopefully I’ll feel fine for a few days before the side effects kick in full force and the bloating begins.

My protocol for Egg Retrieval #3 is as follows:

Day 1-5

• Aspirin 81mg mg, Take two tablets of Asprin 81mg daily, for a total of 162mg.
  Saizen Inject 0.5 mL (1 mg) subcutaneously
• Rekovelle 12.00 mcg subcutaneously
• Menopur 225 IU subcutaneously

Day 6+

• Cetrotide 0.25 mg subcutaneously
• Rekovelle 12.00 mcg subcutaneously

Trigger day (TBD)

• Dual trigger TBD dosage

The medication types are similar to retrieval 1 & 2 but the priming, constitutions and dosage differs quite a bit.

Technicalities aside, I am somehow feeling hope again. I think nearly a year of trying to conceive naturally and coping with the ups and downs of testing, to be let down again and again, has set me up to be able to handle the emotions of IVF – it isn’t the case for everyone, but I somehow have been able to compartmentalize this part of my life and hold my grief and frustration simultaneously with hope. One day, maybe that won’t be the case. It does get harder each time we have a loss or a failure, but over time our path becomes more clear and as we get more answers and results (or lack thereof), I think we will begin to feel confident in the directions we are taking.

IVF has been a very reactionary process. As much as I’d love to plan ahead and say “I will only do X number of retrievals, put $X into this”, you truly don’t know until you’re faced with that very moment and the emotions that come with it. As logical as you want to be, the hope for your future, the vision you have for your life, the person you become through the process (and god has this process changed me) will dictate those next steps as you reach those individual markers or decisions in your journey.

Today, the way I feel is that if this cycle fails we may try the donor egg route, which is a whole other path and life for us if that’s where we end up. But that’s something we will only know when the time comes to make the call. It will also be a hard route, knowing I’ll have to grieve the loss of my own fertility (if it was ever there to begin with, who knows). The loss of a biological connection, the loss of a stage of my life. But I am so damn ready to enter the next stage. A stage that doesn’t involve endless limbo with my body failing me.

So for now I’ll stay in the realm of hope. I’ll do everything in my power to make this cycle count and to give it my best shot, because that’s all we can do when these things are so very out of our control.

The post A new plan appeared first on .

In September 1st my period came again and we started with a wonderful new clinic. I was nervous to make the switch. It meant new blood work, scans and building a new relationship with a new team (let’s be real though, there wasn’t much of one at the last clinic). I’m not sure I would have had the energy to keep going with the first one anyhow. It’s like kicking a relationship until it’s last breath. It felt like it was just time to call it. I felt like I deserved better. 

I called the clinic on cycle day one and we discussed then and there what our next steps would/should be. Did I want to forge ahead with a retrieval and get moving asap? Absolutely! But we decided before we made any more attempts that it would be smarter to do some further testing. 

We started with my AMH levels, last tested in April of 2022. My initial levels were 9.6 pmol/L, but now in September 2023 they had dropped significantly to 5.1 (for those on the ng/mL scale, it went from about 1.34 to .78). This officially put me in DOR (diminished ovarian reserve) territory. Scary stuff. Your AMH can fluctuate but I took this seriously. Going ahead, and looking back, it was becoming harder to get quality eggs and embryos. Our time was running out and the embryos we could get were becoming rare and precious. 

We decided with our new doctor (who is wonderful BTW) to do a mock cycle before doing another retrieval. This would delay our retrieval by 2-4 months but it would be instrumental in ruling out and identifying any barriers to carrying a healthy pregnancy.

Mock cycles are often debated in the fertility community. Some doctors are all for them, and the myriad of biopsies that can go alongside them. There is mixed evidence, or maybe just not enough evidence to convince all doctors of the value of these tests, but I wanted to take the kitchen sink approach. We were still very much in unexplained infertility territory, so anything that could explain what was happening was welcome.(I’ll link to some relevant studies below in case you want to read them)

Four endometrial biopsy tests were recommended as options with one strongly urged over the others. I decided to do all of them. 

EndomeTrio (3 tests)

ERA (Endometrial Receptivity Analysis)

The ERA test checks the receptivity of the uterine lining to find out if it is lining is receptive to embryo implantation at the time of a normal transfer. The test could indicate a different amount of progesterone in preparation for future embryo transfers. (The ERA test resulted in a 73% pregnancy rate in patients with implantation failure) 

(https://www.igenomix.co.uk/genetic-solutions/endometrio-clinics/#:~:text=The%20ERA%20test%20evaluates%20the,personalised%20embryo%20transfer%20(pET).)

ALICE (Analysis of Infectious Chronic Endometritis) 

ALICE detects the bacteria causing chronic endometritis (CE) and identifies the most common bacteria causing it and helps clinicians to recommend appropriate antibiotic and probiotic treatments.

EMMA (Endometrial Microbiome Metagenomic Analysis) 

EMMA evaluates the uterine environment at the microbiological level by analyzing it’s  microbiome. It can indicate whether the uterus has the optimal microbiome for embryo implantation.

UTIMPRO (strongly encouraged by our doctor)

UtimPro is a biopsy that analyzes the immune profile of your uterine environment and response to foreign cells (embryos, etc). It tests for natural killer cells and it can indicate a very specific customized protocol for individual patients. 

To do a mock cycle, you basically proceed as if you’re planning on doing a frozen embryo transfer. I started on Estradiol on day one, and similar to a FET, my lining was monitored throughout my cycle. I did 5 appointments with my friend Wanda, and it took a little while to get to the needed 7.5mm minimum uterine lining thickness required for the biopsy. I introduced progesterone on day 28 (pretty normal for me as I struggle with thin lining issues) – both as suppositories and intramuscular injections. My biopsy finally took place 6 days later on October 3rd. 

I’ll stop here to say, by this time I had met with my actual doctor either on zoom or in person 5 times in one month. He was also the one to personally do my scans and my biopsy. Seeing that smiling familiar face made all the difference. Technically the appointments were the same, but patient care was worlds ahead with the new clinic. From the receptionists and nurses to the clinic itself and their professionalism and timeliness. It made the experience better many times over. 

The biopsy was…. Not fun. Not going to sugar coat it. Because of the things being tested, the biopsy only allows you to take Tylenol as a pain killer and is fully unmedicated otherwise. I managed to convince them to give me a Ativan to take as I tend to have a sensitive cervix. The procedure requires them to use the speculum, and sometimes a cervical clamp, and insert a tool into the uterus to scrape the lining. It’s as gross as it sounds. The doctor told me it would hurt and I prepared myself. He told me I could swear at him if I needed to, that it would last 10-15 seconds and I’d have some severe cramping. The nurse offered to hold my hand.

They went in with the pipette (the tool for the biopsy scrape), and I was surprised it didn’t hurt more to be honest. It did suck, very much. But I tolerated it and they applauded me for handling it better than most do. Once the procedure ended, the cramping stopped. It turned to mild tenderness, and I spotted a tiny bit following the procedure. After that, I was good to go.

The test results take 2-3 weeks on average for the EndomeTRIO and 4-6 weeks for the UTIMPRO.

The doctor put me on Estradiol again for 5 days, but I began bleeding 3 days later for my next period. All in all, I think it was worthwhile. The overall cost was around $3400 CAD including meds, the time it took was 33 days for the cycle, and the recovery was almost immediate.

Now, we wait for those juicy results.

Studies on the above mentioned tests:

The Uterine Immune Profile May Help Women With Repeated Unexplained Embryo Implantation Failure After In Vitro Fertilization (2016)

Comparison of the Effectiveness of Endometrial Receptivity Analysis (ERA) to Guide Personalized Embryo Transfer with Conventional Frozen Embryo Transfer in 281 Chinese Women with Recurrent Implantation Failure

Is Endometrial Receptivity Assay (ERA) Useful in Patients with
Repeated Implantation Failure Undergoing Single, Autologous Euploid
Embryo Transfer?

The Endometrial Microbiome and Its Impact on Human Conception

Characterization of the Endometrial Microbiome in Patients with Recurrent Implantation Failure

The diagnosis of chronic endometritis in infertile asymptomatic women: a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology

The effect of chronic endometritis and treatment on patients with unexplained infertility

The post The Biopsies appeared first on .

Since going through this I have become a FIERCE advocate for women’s rights and abortion rights. I always was pro-choice, because I truly believe women aren’t out there in droves trying to abort babies late in pregnancy. I never thought I’d have an “abortion”, but that’s what a medicated miscarriage is classified as.

I didn’t mention this in my past post, but let me lay out how that week went.

On February 22, 2023 I started a full-time job. I am a photographer full-time, but knowing we wanted a baby, knowing the costs of IVF and how fixated I was on fertility, I wanted a distraction. I also wanted maternity leave one day. I applied for jobs and took on this job before I knew I was pregnant, but hopeful it would happen. By the time I started I knew I was pregnant.

My first day I went into the office to meet everyone in person. My interviews had been on zoom, so this would be the first time. That day was the first day I started bleeding. While I was trying to focus on the job, I was panicked about whether I was losing this baby.

As time went on, juggling a new role that was more challenging than it ought to be and juggling a guarded pregnancy was hard. At the time, was a solely remote position, at the very least so I got to work from home. I found out on Friday, March 10th that we had no heartbeat. Before starting work for the day at 8am. I came home, told my boss I got some bad news, he pressed a bit about what, and I told him family stuff. He told me to take it easy that day, I’d continue to work at my own discretion but I may not be all there.

I called my clinic and they had the doctor call me back to discuss “options”.

I had 3 options.

1. A natural miscarriage, which may or may not occur – if it did not, I’d have to consider option 2/3 anyway. It could take a while, it might not happen at all. We already knew our baby was gone for a week at that stage, so infection was also a risk the longer the tissue stayed in my body.
2. A medicated miscarriage – I’d take one medication day 1, a second medication day 2, and the miscarriage process would begin ideally within 12-24 hours.
3. A D&C (surgical removal of the pregnancy). More invasive, more concrete.

I decided on option 2. The determining factor for me was speed, I wanted it gone. I didn’t want to be pregnant anymore. I would have to wait for a D&C, until there was time in the surgeon’s schedule. It could be with very little notice. If I took medication one immediately that day, I could start the miscarriage on Saturday, with hope it would be finished by Monday so I could work again.

The clinic sent me to a very specific pharmacy in my area. This is where we learn about reproductive rights…

Abortion is legal in Canada. We are VERY lucky to be given the choice. Did I want an abortion? No. Did I need an abortion? Likely yes. Whether the baby was already gone, or whether a defect would cause them suffering, I would have chosen to forgo the natural miscarriage. In any miscarriage/abortion, it’s possible for tissue to be retained by the body, and it can cause all kinds of issues. Option 2/3 both are the most helpful at removing all the tissue. Option 1 often requires 2/3 anyway to remove it all. Sometimes 2 or 3 don’t get it all either, and another method has to be used.

Despite being legal, very few pharmacies stock the medication. Mifepristone, when used together with another medicine called Misoprostol, are used to end a pregnancy through 9-10 weeks gestation on average. It’s controversial. I had NO IDEA how hard it was to acquire, even with the doctor’s prescription and sign off. We learn new things every day.

My husband went and picked up the medication for me while I finished work for the day, and as soon as he came home I started the process.

My medicated abortion experience was hard, but predictable (thank baby jeebus). It was both the worst pain of my life and the biggest relief of my life.

Trigger warning again – graphic descriptions/loss.

I took day 1’s dose. This medication is a progesterone blocker. It stops supporting the pregnancy, in preparation for a clearing of the uterus. That was all good.

On Saturday, day 2, I took Misoprostol. I had read stories of people’s experiences on Reddit and online forums. I was scared but ready. I surrounded myself with the essentials:

• Heating pad
• Advil
• Tylenol
• Snacks
• Gatorade
• Netflix
• Adult diapers
• Bucket for vomit

I took the pill and within around 4 hours I started cramping, as expected. The cramps built up over the next two hours. Tolerable still. But medication helped. I kept a hot pack on my abdomen to ease the discomfort.

I put on the adult diaper just in case.

About 7 hours after the medication it began. Cramps continued to build into what I’ll describe as borderline contractions. I started bleeding slightly and kept checking to see if anything major was happening. Bleeding got heavier, but nothing much greater than a period.

For some, the first dose doesn’t work, and they have to take a second dose after 24 hours. I was ‘lucky’ this wasn’t the case. At 7.5 hours or so, I started having excruciating cramps/contractions. Keep in mind, I am popping advil and tylenol on regular intervals at the max dose. Let’s just say it did not take the edge off.

I went into what I assume were full on contractions. I was sweating, I couldn’t wear clothes, I put a mat down on the bathroom floor but all my body felt like it wanted to do was sit on the toilet and poop out my insides. Nothing came besides liquid blood.

I sat on the floor again, for about 45 minutes. It ramped up. It was the worst pain I have ever felt in my entire life. Worse than the banana bike seat up the hooha at age 12, worse than a dental abscess that triggered my trigeminal nerve, worse than any IVF injection, any skinned knees or any period I have ever had. Worse than the car accidents and sprains. I sat doing cat-cow on the floor for what seemed like eternity, mooing like a damn cow (seriously). I pushed and pushed and nothing came, until suddenly I felt a gush, a release. The contractions returned to cramps, and there it was.

That thing I fought so hard to grow. That 30 thousand dollar piece of tissue. The visible gestational sac, about 3 inches long. Luckily, no fetus was visible, but I assume it was present in a few pieces of the tissue that were expelled (a few different things came out with different consistencies/colour). I knew from reading about the process, and what parts needed to be accounted for, that my miscarriage was done.

I went to bed, kept popping the pills and applying the heat. The next day I recovered in bed, my body was exhausted, like I had run a marathon. The hormones were FIERCE. Coming off the high hormones of pregnancy, and slowly losing them over the coming weeks was a trip. I felt waves of depression, which almost seemed like postpartum depression in hindsight, comparing this to what my mama friends have told me post birth.

I returned to work on Tuesday, taking Monday off because I just didn’t care anymore.

Slowly my thoughts began to look forward at what was next. We still had a normal embryo on ice, so all was not lost. The fighter could continue to fight when the time was right. We still had a shot.

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Pregnancy after loss is a beast, even if the loss was barely after finding out you’re pregnancy in the first place. My previous loss was so early that I didn’t really know it was happening, had it not been for my beta bloodwork telling me so.

When I got this positive, the feeling was not exactly excitement. It was a flurry of tests over and over until I felt confident it wasn’t going to to fade or disappear. I tested for maybe 10 straight days to watch the line get darker. After a while, it’s natural for the tests not to be able to accommodate the levels of HCG your body is producing, so you get the illusion of a lighter test. To combat this, there’s a theory that if you dilute your urine again, it will be more easily picked up by the pregnancy test. This was the case for me at a certain period – I can’t recall when, but I am guessing around 20dpo or so.

I would every now and again catch myself thinking, when we have this baby in 9 months, wondering what they would be like, who they would look like more. I wouldn’t let myself buy anything this time around though. It’s just different when you know how fragile pregnancies can be (god, I envy those people who never have a loss or significant struggle to conceive).

I am going to get really real and candid for a second. I have only shared this with 1-2 friends during this process. Many people who know me know that I have always been a bit of a black sheep. If you read my earlier posts, there’s a slight indication of that. But it runs deep.

Much of my ‘history’ has been pieced together through stories my family have told me – family I trust – and I didn’t know this until I was very much an adult in my 30s. My mom had me after having what I can only assume was an affair with someone while she was married. She wanted a baby, so I am told. Why I don’t know. I learned from a very young age that it likely wasn’t the “baby” she wanted, but the stability and security of a ‘normal’ relationship. My biological father enjoyed drinking. They weren’t super young, 26/28 when I was born. Technically, the divorce from my mom’s husband happened late, right around when I was born. I found this out through a divorce certificate I discovered in a box a number of years ago. Some drama went down, no doubt. My bio father wasn’t looking to have a baby. I believe there was deception involved, and I also believe abuse was a factor in my not really knowing him until I was an older child.

When I was around 2, I was “lucky” enough to have had my mother’s boyfriend take an interest in raising me. I spent a lot of time with my grandmother while my mom was off being a 20 something year old. But when I was 3, my “Dad” started to raise me more full time. His family took me in like their own, and to this day they are my primary supports.

I say all this because as much as I was “wanted”, I wasn’t. I was planned, but I wasn’t. My entire childhood, and life, I couldn’t picture growing up with a stable and secure life, with the nuclear family and with the ease that comes with secure attachments (a really good book on this is Attached, for anyone curious about the impacts of infant and childhood attachment). Nothing I have ever done has been achieved without taking the hard road.

I was moved around every 3-5 years of my childhood/teen years. I never had a “group” of friends, always lurking on the outside. I had lots of friends, but never truly fit in any one place. I couldn’t go to university when my peers did because my bio parents made too much money but refused to help me out, so I didn’t qualify for loans until I was 24. I never made university friends because I was 7 years + older than everyone else. I didn’t learn to drive until my mid 20s because nobody would take the time to teach me (my now ex bf graciously offered when I was 24). I’ve never been on a “family vacation”. Nothing has come without a fight, a wait, a challenge. This “fight” is a part of my soul.

When we got pregnant, I couldn’t believe it would be this easy. This simple. And in true me fashion, it wasn’t.

Trigger warning ahead: graphic descriptions.

At 5 weeks and 4 days I started bleeding. My periods are usually light, so this was scary. I passed some heavy tissue/clots. I was sure I was miscarrying this pregnancy and had passed it. I had some intense but brief cramping. I googled it, naturally. Cramps and blood isn’t good in combo. I called my clinic and I got in for an emergency ultrasound at the hospital the next day to verify whether it was gone. It wasn’t. The sac was there, measuring correctly. Why was I bleeding?

The doctors chalked it up to what they call a SCH (Subchorionic Hematoma), a collection of blood in the uterus that eventually releases. It can be harmless, or harmful. It depends on the type.

My clinic told me to go home, take it easy, and continue my meds (progesterone injections, those huge gross ones, and oral/vaginal meds). I did just that. I continued to bleed lightly, but it tapered off slightly.

My next ultrasound was scheduled for 6w2d. I did not have high hopes. They wanted to monitor me closely, even though the norma was to do the first scan around 7 weeks. Two days before I started bleeding heavily again. More tissue and clots. I went to my ultrasound and I said to the doctor, “I’m prepared for bad news, so please be real”. He said, “we’re you prepared for a heartbeat?”

Holy effing shite. This threw me. I was floored. My heart skipped a beat. A HEARTBEAT? IT HAS A HEARTBEAT?

He explained that I was measuring a couple of days behind, which in itself is not a huge deal. But the heartbeat was slower than he’d like. He called it a “guarded pregnancy”. We’d want to be cautiously optimistic. It could go either way.

Nothing comes without a fight, I told myself.

I left the clinic elated that it was still hanging on. I was still pregnant. We could do this. If I could fight so could this baby.

The week passed, I passed more blood. Less bright coloured (a good thing indicating older blood vs. a new bleed). I was still scared to death.

We went together for my 7 week ultrasound as planned.

I listened to Tara Lapinski’s podcast, Unexpecting, recently and she put words to feelings and experiences I hadn’t been able to describe. In her podtcast she reiterates how in all her scans, she noticed the technician “seeking” before giving bad news. This was what I experienced.

Seeking. Measuring. Seeking. Seeking. Measuring.

The baby was there. It was measuring 6w2d (at 7w, not good). She said “theres no FHR”.

Ok, but what? What is FHR… then, my brain put the pieces together. Fetal Heart Rate. There was no fetal heart rate. (are you crying yet? Because I am…).

How the f&%! I held the tears back then, I don’t know. She said she was sorry. She left the room. I had no pants on. My husband was staring at me with sad puppy eyes. Unsure what to do or say. I told him to look away, I couldn’t handle being nude and having him stare at me with those eyes.

I got dressed, still holding it together. Doing that thing we as women are taught to do. “Stop crying”.

I walked out of the room in a daze. Walk through the waiting room. Get to the door I told myself. Just get to the damn door.

I opened the door and emotionally I collapsed. I cried and cried and couldn’t stop crying. I have never cried so much in my entire life. All of the feelings of black sheepery, having a hard go all the damn time, never getting a break, came flooding to me. All the hope was washed away by my tears. I got in the car, I had to get my husband to drive because I couldn’t keep my eyes open and dry. I cried the 25 minutes home. I sat on the bathroom floor and cried when I got home. For days, I continued to cry.

The flicker was gone. The hope was gone. Our baby was gone.

The post A flicker of hope – Pt 2 appeared first on .

My period came on Dec 20, right before their closure, but due to the holiday slow down, I had to go on birth control until Dec 27. This basically delays your cycle, forces another light bleed, and you can begin cycle day 1 again.

We were waiting to begin a new Frozen Embryo Transfer (FET) with one of our Euploid embryos.

FET prep varies depending on the clinic, but most of the protocols I have seen involve Estradiol (Estrace, Lupin Estradiol, etc.) for a number of days, basically shutting down your ovaries for that month. You take that for a couple of weeks or more, and they bring you in for a baseline ultrasound (we meet again, Wanda).

You become intimately familiar with this machine and it’s phallic ultrasound wand. For a FET you may go in for internal ultrasounds upwards of 4-5 times in a two week span. Early AM appointments usually beginning around 7am. You get really used to people being up in your business. It’s much like a pap smear, minus the speculum (I hate the speculum). It can be a bit uncomfortable if they have trouble locating your uterus or getting the right picture.

For the FET they are checking for uterine lining thickness, which is juiced up by all the meds you’re on. You eventually add progesterone suppositories into the mix, and for me I was lucky to have to take them 3x a day up the hooha for almost 4 weeks.

Along with many other people I know, I suffer with thin endometrial lining, so it takes a while to build it to the thickness they require for the transfer. Our clinic looked for 7mm and it wasn’t without difficulty getting there. If it takes too long, you’re at risk for a cancelled cycle, and you have to begin again on your next period start. It’s not an exact science, but it’s close.

In addition to the suppositories and the oral medication, a FET differs from a fresh transfer in one other way…

Progesterone in Oil – the bane of my existence. (PIO)

This was my first experience with PIO. Before this, I had to brave my fear of needles with subcutaneous injections – these are done around the bellybutton area and the needles are 1/2″ in length, and quite thin (27 gauge if you are curious). Scary for someone beginning to inject on their own, but all in all tolerable. Not completely void of pain, but I’d classify it as a mild and brief discomfort.

PIO was a whole other ballgame. PIO is thick, as it’s actually oil, so it requires a thicker needle. The kicker with PIO is that it is injected intramuscularly. This means the needle is also longer. 3x longer to be exact. 1.5″ of thick, scary pokiness. You inject PIO into the upper butt, almost on your lower back, directly into the muscle. Because of the location, I had to let go of my control-freak tendencies and let my husband help me. I’ll include my PIO workflow at the bottom in case anyone is curious and scared for their first poke.

My protocol involved taking 2 Prometrium suppositories 3x a day, 2-5 Estradiol orally a day (depended on time in cycle), and PIO every 3 days at a certain point in my cycle after thickness reached it’s minimum.

It took a while for me to get to the 7.5mm required, I was 5mm on CD20, and finally bulked up to 11.3 by CD27. I was ready to roll. They started me on PIO and my FET was scheduled, this time in my home city, 6 days later on Feb 19, 2023.

PIO for Beginners

For anyone staring PIO in the face, I HIGHLY recommend using an auto injector device. This was recommended on a couple of threads I read, and I am SO glad I ordered it. The shipping was fast and I got it in time to start my injections. It also helps if there’s a chance you might not have someone there to inject for you. Takes the guesswork out of needle depth, angle, etc. The injector I used can be found here: https://unionmedico.com/90-super-grip/. It’s not cheap and I felt sketchy ordering something from Europe, but it works like a charm. See photo at the bottom.

Drawing it up/pre-injection:

• Lay out all your stuff (needle, syringe, alcohol swab, tissue, injector if you have one, sharps container)
• Turn on a heating pad, or warm up your hot pack
• Wash your hands
• Swab the top of your PIO vial
• Swab anything else (end of syringe, needle attachment, etc.)
• Attach the needle to the syringe, ensure it’s secure.
• Pull back the syringe to your dose line (mine was 1ML) with air
• Pierce the top of the vial, inject the air into the vial
• Tip upside down, and draw back your dose of PIO. (I always take more than I need, give it a few flicks to remove air bubbles, and plunge the access/air into the vial)
• Remove the needle from the vial
• Re-wipe the top of the vial with the alcohol wipe
• Heat the area you’ll be injecting into for 10 minutes approximately (see image below for ideal placement – check with your clinic if you’re told otherwise or not sure. Some clinics recommend using the upper thigh, but I have heard this hurts more).
• I also put the syringe somewhere warm to warm the oil, like an area below the heating pad, in my bra, etc. It shouldn’t be too hot, but warm enough to reduce viscosity.

• After 10 minutes, I swab the area to inject with the alcohol pad
• I get any remaining air out of the syringe, and load it into the injector
• We steady ourselves to ensure no movement occurs, and inject the needle at a 90 degree angle to the skin.
• PIO takes a little while to plunge due to it’s thickness, go slow and it will hurt less. Avoiding movement or shaking also hurts less.
• When the plunger has been fully plunged, pull the needle out and wipe the area with a tissue or swab.
• IMPORTANT: Massage the area for approximately 2 minutes vigorously, down into the muscle. This helps distribute the PIO and will prevent pain in the days to come.
• Heat for another few minutes, then stretch those muscles for 2-5 mins to further distribute the meds.
• Discard your needle in the sharps container.
• Voila, you’ve been jabbed successfully.

The post Frozen Embryo Transfers appeared first on .

After the egg retrieval, you begin to play a new waiting game. You’ve done your part, and now it’s time for the eggs and sperm to do their’s.

Immediately after the retrieval, they look at how many eggs are mature. We got lucky and 13/13 were mature. Usually the attrition for this is around 60-80%, meaning on average, people with 13 eggs would end up with 8-11 mature eggs.

From there, the eggs are fertilized. They use one of two methods (there are other methods that are much less common), either standard IVF or ICSI (I described this in an earlier post, but in short standard lets the sperm decide to fertilize, and ICSI is an injection of sperm INTO the egg itself). On day 1 post retrieval, so the day after, you get your fertilization results.

Usual attrition for fertilization is also 60-80%. By now, most people will have 5-8 fertilized eggs. We miraculously got 13.

The next part is the hardest wait so far. If you’re doing a fresh transfer, you find out on 4 days post transfer whether any embryos made it to the blastocyst stage. The blastocyst stage requires a certain number of cells and for the cells to arrange in a particular way. We were lucky to have all embryos growing as hoped on day 4, so we got scheduled to come back for our embryo transfer the next day on day 5. We were hoping to PGT-A test our remaining embryos for genetic abnormalities (an additional cost, and involving a biopsy on day 5-6 before freezing).

From here, the wait can get tangly. Lots of embryos make it to day 3-4. We in the infertility community fittingly call the next few days the hunger games.

We went in for our embryo transfer feeling so very hopeful. We got a photo of our little embryo that would be transferred and it was so cool to see a picture of it. It was of one of the highest possible grades (grading takes into account the ‘look’ of the embryo, and in lieu of genetic testing it is the one marker they use to decide which embryos to keep and which to discard).

The transfer itself is a lot easier than the retrieval. Following the retrieval you immediately switch gears and start on progesterone suppositories (in my protocol anyhow), and you come back on day 5 for the transfer. This involved another trip across on the ferry for us and another night in hotel that same night. You really don’t get much notice, but for us it was the ‘off-season’ from tourist season so not too difficult to find a spot affordably or to get on the ferry.

We arrived and usually the transfers themselves are completely unmedicated. They had me take Ativan one more time just to ease my muscles in case I reacted to the catheter due to some cervical pain/cramping I had previously with my Saline Sonohistogram.

This appointment was a piece of cake. I donned my hospital attire, and my husband was allowed to be present for this procedure so he donned his own set of whites over his clothes. I wore my socks again for good measure. He, of course didn’t even have to take off his shoes. He just put some booties over them and went on his way.

They walked me into the same OR I had my retrieval in, and it was just sheer luck that it was the same doctor (I still had never met my own RE doctor at this point. More on that later.). I laid on the same bed, had the nurses lift my gown – and my husband got a wonderful show.

This is where I point out that I am NOT comfortable with my body. We joke that I am a never nude like Tobias on Arrested Development. I have always had issues with body confidence and being comfortable in front of others. I changed under my bed coverings until I was 10 years old (no abuse, just paranoia), I refused to change for gym class with other classmates for many many years, often going so far as to leaving my clothes at home and getting detention because I was uncooperative. I wouldn’t shower when we went swimming unless there was a private shower stall. This was never addressed in a healthy way, because teachers and parents don’t talk about that stuff. Not in our generation anyway (Millennials). After some tragic experiences as a teen regarding consent, I reverted even further into my cave of discomfort with my body.

Let’s just say the IVF journey has taken all the fear and dignity I have when it comes to my body. There is was, out there for a room full of strangers and my husband to see. Not to mention his first experience seeing people poke and prod between my legs. I can only imagine how uncomfortable that is for a partner. He had never been present for my other exams, and there were many, so by this point I was used to it. It got to a point where I didn’t even try to cover myself anymore. What was the frigging point.

The transfer went off without a hitch. The catheter and the speculum didn’t hurt, and when they inserted the embryo into my uterus, a little flicker showed up on the ultrasound screen. This is NOT the embryo, but an air bubble that accompanies the embryo to confirm placement. An embryo at this stage is microscopic (.1-.2mm), but they print off a little picture of your “flicker” for you to hold on to.

It was done in a flash and I walked out with the strangest feeling. I was now Pregnant unless Proven Otherwise (PUPO! – I’ll note that the fertility community says “Pregnant until proven otherwise” which I don’t love, because there’s almost an expectation of it being proven otherwise, so I prefer my saying).

Now the next most excruciating wait of my life was to come. The “Two Week Wait”. This is a bit of a misnomer for IVF though because technically the two weeks starts the day after your retrieval. At this point on day 5, I was already 5 days into that wait. So we awaited our bloodwork 9 days after retrieval to tell us if this little blob decided to stick around or not.

The only solace we got in that time was that we would be getting our final blast update on day 6-7, telling us how many made it to biopsy & freezing.

All in all these 9 days have tended to be THE most hopeful and ignorantly blissful part of IVF. We got to pretend we were pregnant, we got to feel all the myriad of emotions that come with maybe having a baby. We got to imagine a future with our little 4AA embryo. Finally we had hope.

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