IVF in the city of light

It’s difficult for me to wrap my brain around the fact that we are already on our fourth full IVF cycle.  When we started this process I knew it would be challenging, but I could never have imagined that my dream of becoming a mom would still feel so far from reality after five years of trying to grow our family and four years of often all-consuming infertility treatments. 

We had our fourth egg retrieval on Wednesday after an extremely busy and tiring week of stims, blood draws, and ultrasounds.  We decided to do our last funded IVF cycle with a team in Paris.  Last year after our first two full cycles and nine transfers we decided we needed a fresh outlook on our dossier.  We made the decision to work with an experienced, but somewhat boastful RE here in town who had the tremendous advantage of offering early morning appointments for which he was always on time.  This seemed like a godsend as running between work and appointments and sitting in waiting rooms for hours on end had become exceedingly stressful for me.  While the logistics of that cycle were relatively easy, it turned out to be tremendously challenging working with a RE who ended up just not the right fit for us as the cycle advanced.  That left us on our fourth cycle in search of yet another fertility specialist team. 

This time around I decided it was more important for me to find a team I really felt comfortable with and to forgo the convenience factor.  I don’t necessarily feel that the RE we chose to work with in Paris is more competent that the other RE’s we’ve worked with (even though you can tell she is a pretty smart cookie), but her outlook on our situation, here bedside manner, her network, and the plan proposed by her and the clinic’s embryologist correspond to my gut feelings and what I feel I need right now.  One major inconvenience of working with an up-and-coming Parisian RE, apart from the 400km commute, is that she is super busy and not always very responsive when it comes to emails and phone calls.  It takes a little, or rather a lot of getting used to no longer having a direct cellphone number where I can call/text my RE in case of urgent questions and having all my emails answered exclusively by secretaries.  The other major disadvantage of changing RE’s for our fourth cycle is that I am just a little fish in her big sea of patients.  We don’t have the baggage of past cycles to strengthen the patient-doctor bond that I feel often translate into a doctor investing just that little extra time and energy, which I greatly appreciate and find reassuring.

My elven days of stims were a whirlwind, which left little time for emotions other than pure exhaustion.   The cycle corresponded with a continuing education course I was attending in Paris, which was great because it meant I didn’t have to take time off work, but also made things extremely busy and tiring.  I had blood draws almost every morning in a specific laboratory in one corner of Paris, my training session in another corner, and my ultrasounds after the training session in yet another corner of the city.  I felt like I spent most of my week underground in the subway and hardly noticed I was in one of my favorite cities in the world.  I triggered on Monday and decided to come back home before our retrieval on Wednesday. 

My plan was to go to work on Tuesday because I had already been away for a week and I didn’t want to cancel even more therapy session with my little patients.  When I stepped off the train on Monday afternoon I was flooded with a wave of grief and sadness that had been pushed aside by the rush of the previous week.  I sobbed as I walk into our empty apartment, feeling shattered and alone.  I so desperately wanted to be walking into an apartment full of children’s cries and laughter.  And to be able to attribute my feelings of utter exhausting to sleepless nights with a newborn rather than draining medical interventions.    The thought of going to work the following day, where I would have to find the energy to take care of my little patients, was overwhelming.  I mustered up the courage to call my family doctor to ask for a sick note for the next day.  Throughout this whole process of fertility treatments, I have found it extremely difficult to put myself first, ahead of my little patients, ahead of work, ahead of perceived obligations towards friends.  I’m trying really hard to accept that it is ok and indispensable to put myself first, but god is it hard.

On Tuesday evening my husband and I took the train up to Paris and on Wednesday morning we hopped on the subway headed for the fertility clinic at 6am.  The check-in process was a stressful and disorganized, but once we were up on the day surgery floor the auxiliaries and nurses were relaxed and friendly, which was a blessing.  I had requested to be with my husband for the specimen collection and the nurses were super cool about this, unlike during past retrievals.  I was getting ready to head up to the laboratory with him, when the nurse casually said that we could just do the collection in my room.  It was much nicer than in the little collection room we’ve used for past retrievals.  There was a big window looking out onto the rooftops of Paris (cue the sappy music) and a real bed.  The one inconvenience was that the door didn’t lock, so we had to put a chair in front of it and hope for the best.  The husband of one of the other women scheduled for a retrieval actually mistook my room for his wife’s just as we’d made ourselves presentable.  My husband and I both burst out into a relieved, holly shit that was a close call bout of laughter after the man sheepishly closed the door.  I do seem to remember reading somewhere that men who watched erotic videos containing one woman and two men produced the highest quality specimens (something to do with survival of the fittest), but I’m not so sure this would have worked in real life.

Thankfully the egg retrieval went smoothly and I came out of the general anesthesia gently.  My RE came by quickly while I was in the recovery suite to let me know that she had retrieved 12 oocytes.  It all went much quicker than past retrievals and we were discharged quite early, so we decided to have lunch in Paris before taking the train home.  We had a yummy makeshift picnic on a bench at the Trocadéro gardens looking out onto the Eiffel Tower.  As silly as I feel writing this, it actually felt kind of special and romantic to be in Paris with my husband for our egg retrieval.  The positive energy generated that afternoon was wonderful and much needed.  It’s those little things that make this process endurable.  Our train ride back home was easy and I even had some energy left over to go to work on Thursday and Friday.

When the lab called on Thursday, we had 8 little growing embryos and this morning we’ll find out how many have grown into strong blastocysts.  This has never been the part of the process where things have gone wrong for us, so I’m not feeling too anxious.  It’s the implantation part where we have stumbled time and time again in previous cycles.  We went into this cycle knowing it would be a freeze all cycle, which was good because my estrogen ended up being over 4000pg/mL at trigger.  Right now I’m feeling relieved and thankful that we’re giving my body and mind time to recover before jumping into our 11th transfer.

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