After the Sadness

It’s tough to know in advance how you’ll respond to these things. You’re always in uncharted territory, even if the territory has been trodden by countless others. You can read all the books and blogs you want, but when you’re in the forest, you’re in the forest. The map is never the territory.

As a wise friend of mine said, grief has its own half-life. It also has its own process. Denial had worked for me in the past, so for a while I hoped for a miracle. But when that didn’t work, there was no Anger or Bargaining. Just waves of sadness and frustration. Then we were able to accept that this is the road we’re on. It didn’t quite take the turn we had hoped for. But life is still very good.

I’m not saying this loss is easy. It never is, especially when you’ve invested six months and many thousands of dollars into the outcome. We had just begun planning an exciting year only to find the most exciting part retreating into the mist, and we have no idea when or if we’ll ever find it again. Another month? Another year? Another life?

Still, losing embryos at 5 1/2 weeks isn’t in the same ballpark of grief many couples have gone through. I read about one woman who conceived twins after five years of trying only to lose them at 20 weeks to a prematurely dilated cervix. (I refuse to use the grossly judgmental term ‘incompetent cervix.’) Another woman’s seemingly healthier twin passed away shortly before birth, and the other little girl died after spending sixteen months in the hospital. I’ve never been in either of those forests, and I hope to God I never find myself in them. (Thankfully both women went on to survive the grief and have healthy children.)

I’m also glad I’d done my research and knew miscarriages weren’t anything particularly rare or exceptional. I was well aware pregnancy was always a hope, never a guarantee. A lot of women are totally blindsided since it’s talked about so rarely.

We were able to send tissue for analysis, and a few days ago we got the news that Nymeria was a chromosomally healthy boy. It’s tough news in two ways. One, in another quantum iteration, he could actually have become a child. Two, it gives us no easy answer about why the pregnancy failed. But it’s also reassuring in a way. It’s our first confirmed genetically normal embryo. We can make ‘em! Now we just have to make one stick.

Nymeria’s namesake is a female dire wolf, so I was thinking about retroactively changing the embryo’s nickname. Conveniently, there is one more living male dire wolf on Game of Thrones. Unfortunately its name is Shaggydog and, well, no. I asked Ahmed what we should call him, and he said Nymeria was a fine name for a boy embryo, too. So now it’s a male Nymeria I imagine running among the clouds.

His gestational sac grew just fine, and that’s what gave us the positive pregnancy tests. But the embryo stopped developing early on for some reason. It’s a condition known as a “blighted ovum,” though it should more accurately be called a blighted embryo. It happens in up to 10% of pregnancies, but in most cases—about two-thirds—the embryo is chromosomally abnormal.

No one knows why it happens to genetically normal embryos. The official diagnosis seems to be “bad luck,” though there may be causative factors, such as our horribly stressful trip home, the subchorionic hematoma our Tulsa doctor found, or my thyroid hormones getting way out of whack. My TSH should have been below 2.5, and it stayed reasonably close to that in Turkey, but it somehow got all the way up to 6.2 by the 18th day of gestation. It had never been that high before.

I was never told that the elevated estrogen during pregnancy can wreak havoc with your thyroid levels, or that the effect is even more pronounced during IVF or a frozen embryo transfer because estrogen levels are inflated even higher. I also wasn’t told that the embryo in the first trimester depends entirely on the mother for its thyroid hormone supply, so if the mother’s levels aren’t sufficient, it can cause serious problems. I had to find all that out by doing my own research, and it was too late by the time I understood the situation.

The elevated TSH might also have been the reason I felt so “down” after getting back from Turkey, over and above the normal pregnancy tiredness and travel stress.

As for the second gestational sac (Summer), it was most likely chromosomally abnormal and simply reabsorbed, a phenomenon called “vanishing twin syndrome.”

So yeah—that’s two pieces of bad luck. The good news is, if it happens once, it’s not any more likely to happen again unless I do have some kind of autoimmune or blood clotting issue or a polyp or something. My uterus was tested earlier this year for anomalies, and none were found, but polyps can be missed, and they can grow quickly. It’ll be heartbreaking if we lost a potential kid for something as common and easy to treat as a polyp.

Part of me doesn’t want to be too sentimental about the loss of a particular embryo. After all, there are effectively, if not literally, an infinite number of biological children Ahmed and I could have. (Even identical twins growing in the same gestational sac are two different people.) We lost one of those possibilities (before he even really got started), but that leaves infinitely many more, and we only plan on having two or so (God willing). Who’s to say which two should get that vanishingly rare chance?

But another part of me wonders what that particular boy growing at that particular time would have been like. I can only picture a mini-Ahmed but maybe with a few of my features: lighter hair, attached earlobes, asking endless questions and driving people crazy. I hope he has a good life in that other quantum iteration.

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It’s Over

My hCG (pregnancy hormone) level was 2,000 on Thursday, which was on the low end of the range of probable viability given previous levels. It should have gone up to at least 5,000 by today (Monday). Instead, it dropped to 310. Which means that, barring a true miracle, the second embryo — Summer — seems to be on the way out.

I’m still pregnant, but barely, and not for long.

We don’t know what went wrong. Both embryos may have been chromosomally non-viable (about half of embryos on average are chromosomally non-viable, so two in a row isn’t exactly unheard of). Or Ahmed and I may have some kind of rare genetic imcompatibility. Our IVF protocol might not have been optimized for our individual situation. (It’s a huge guessing game for the most part, since the human reproductive system is so wildly complex.) My immune system may be overactive and attack the embryos. Or it could just be a string of bad luck. I’ve seen people have longer such strings.

Or can a miscarriage of one twin endanger the other? Can the powerful Doppler ultrasound we did after the first miscarriage have possibly pushed the rattled second embryo over the edge? Do I have some kind of previously undetected borderline clotting or bleeding disorder? What about my thyroid levels? Would more precise control have made a difference? What if I’d had zero caffeine instead of very little (well below the recommended 200mg or less per day)?

So many questions. I wish we at least had some answers.

Sadly, once we’re no longer pregnant, insurance kicks us to the curb for anything related to trying to have kids. So it’ll be costly to find out any answers, if it’s even possible.

We’re letting the news sink in a bit before deciding what to do next. It may involve a West Coast road trip (Grand Canyon, California, Oregon), or we may just lie low for a while, exercise a lot (at least I can play soccer again), be as healthy as we can, and try naturally for a few months.

We still have the three embryos on ice in Istanbul (day 3 cleavage stage embryos), but it’s pretty rough (and expensive) to keep going through this. It’ll be a lot more rough, and a lot more expensive, if those three don’t work out, either.

I just don’t know. Hopefully things will be a bit clearer in a few days (or years).

UPDATE: It’s not fun to talk about this in public. The only worse thing I can imagine is for it to happen and not to tell anyone and just pretend everything is perfectly fine / normal.

Thanks for sharing in the excitement of my first pregnancy, short-lived as it was. (It felt like an eternity.) Here’s hoping it’s not my last.

May 23 (the due date) will always be Summer and Nymeria’s unofficial birthday. Godspeed, kids.

Nymeria’s Sunset

Yesterday around 2pm I started having unmistakable symptoms of a miscarriage. They weren’t severe, though, and only went on for several hours (as opposed to a few days) and then stopped.

Afterwards I still “felt” pregnant, though that doesn’t always mean much. My suspicion was that I’d had twins and had lost one of them, though of course I was scared there was only one there in the first place, or that I was losing both.

While it was going on, I went outside and just looked at the blameless blue sky with green trees thrusting into it and yellow butterflies flitting through it. Internally I pleaded with at least one child to stay and see all this.

We’d nicknamed our two embryos Summer and Nymeria, with Summer being the slightly stronger-looking embryo. Of course we’ll never know which one was lost, but we called the lost one Nymeria. A singleton would be due near the beginning of summer next year, so it fits.

I don’t know if there’s any meaning in the universe beyond what we give it. I do know humans are incredible meaning creators, and that’s a miracle in itself. We tell ourselves all kinds of beautiful stories to make this universe seem more homelike and intelligible to our small, emergent minds.

As I felt sure I was losing a sesame-seed-sized embryo — a potential child — I told myself Nymeria was too wild a spirit to be tethered to this limited flesh just yet. She still needed to roam the skies for a while. Or maybe she was protecting me, or protecting her sister/brother. Twin pregnancies can have terrifying complications. Maybe she sacrificed herself to save us from something much worse.

Probably it was just chromosomal abnormalities. But it’s nice to think in these pretty stories. (As long as you don’t make policies based on them.)

There were wild clouds all over the sky during the sunset, but instead of turning fiery pinks like normal, they remained a subdued grey, as if in mourning, except for one pink cloud just below a brilliant three-quarter moon. The sky was happy, after all, to have its daughter back. And I was honored to have carried that spirit for even a little while. We poured out some grape juice for her and sent her back on her way.

We hope Summer is brave enough to chance this crazy beautiful world.

The next day we had a doctor’s appointment that was supposed to be a routine prenatal. Instead we’d be finding out — in cold, hard, clinical terms — if we were even still pregnant.

Our doctor began, of course, by congratulating us, not knowing anything had changed. We filled him in, and he pretty much confirmed we had lost one of the twins and took us in for an ultrasound. We saw a gestational sac right away — I was still pregnant after all — along with some pooled blood that might be a chorionic hematoma (a relatively common complication that usually resolves by itself but can sometimes cause problems). The gestational sac was irregularly shaped, which the doctor didn’t seem too happy about.

We later got our hCG blood levels, and they were on the lower end of the expected range. Which means there’s hope. But it’ll be touch-and-go for a while.

We’re trying to take it easy and hope for the best.

Good News but WTF

Ever since I got back from Turkey, I’ve felt down. The awful trip home put a bad taste in my mouth. I’ve been jet-lagged as bad as I’ve ever been in my life, and to top it off, ragweed is at all-time record highs in Oklahoma. I’ve been sneezing and blowing my nose and generally feeling gross. I somehow felt “more pregnant” before the bad trip home. Afterwards I didn’t feel much of anything.

When I started getting The Tireds in the afternoons again (a fatigue unlike any other I’ve experienced) and feeling nauseous in the mornings, a little hope perked up. But of course that could just be the progesterone supplements mimicking pregnancy symptoms.

My doctor in Turkey told me to wait until September 18 to test – the 18th day of gestation, or four days after my cycle was due. (The extra progesterone would stave off a new cycle anyway, so a missed period wouldn’t mean much.) I’m amazed I held out until September 15, but that’s when I couldn’t take it anymore. I needed to know, one way or another, and I knew pregnancy tests had a high degree of accuracy by the 15th day of gestation.

I dreamed early that morning that I took two different types of pregnancy tests, and they both came back as huge in-your-face positives. As I was realizing it was a dream and waking up, I tried my best to hang on to the dream. It seemed cruel to have to face the uncertainty again after such a lovely dream.

It was almost 6am when I woke up bursting to pee. I collected the pee in a cup, sucked up a dropper full, and placed three drops on the test strip to see if there was any hCG (human chorionic gonadotropin, a hormone produced by a portion of the placenta after embryo implantation) in my system. The liquid washed across the strip, and the reference stripe immediately turn a dark purple. But there was no whisper of color whatsoever on the line that would indicate a pregnancy.

I felt gutted. Like all my insides had been scooped out. All that was left was a thin voice of denial: “Maybe it’s a bad test. Maybe I tested too soon after all. Maybe the embryo implanted late. Or maybe…”

I looked at the test again. A faint line was starting to emerge. I hadn’t realized you have to wait and let the line develop like an old-timey photograph. I knew the instructions said to wait three minutes, but I thought that was to build suspense or cover the company’s ass. I’d never had a positive pregnancy test before, so I had no frame of reference. They’d all started blank and stayed blank.

The line was pale but it was unmistakably there. I knew enough to know that any line at all, no matter how faint, was a positive. But I hadn’t realized the line would be so faint on day 15. I didn’t know the hCG numbers at that point were only in the low hundreds, and would (hopefully) double and double again in the coming days until it was in the 10,000s. So I kept squinting, willing the line to get darker. When it stopped developing and was still pale, I google-imaged “15 dpo pregnancy test results” (dpo = days past ovulation) and saw that I was in the normal color range.

That’s when I finally started to get a little bit excited. Except that I had been so devastated a few moments before, it was hard to recover quickly. I slipped back into bed to wait for Ahmed to wake. He did around 7am, and I led him into the bathroom and showed him, anticipating his excited response. But he just stood there, seeming paralyzed. Of course, I realized, he also didn’t know that a very faint line was good news. So I told him, and he hugged me tight.

Needless to say, we did not sleep again.

We didn’t tell anyone yet. False positives are rare, but they do happen. Chemical pregnancies, or very early miscarriages, are common, and so are miscarriages (or ectopic pregnancies) in the first trimester in general. Around 20% of pregnancies are thought to end in miscarriage. That’s why most people don’t announce pregnancies until around week 12, when the chances of serious complications or loss drop into the single digits.

I knew I’d announce earlier than that, and if (God forbid) something bad happens, I’ll just be honest about it. It’s part of life, and the fact that most people don’t talk about it can make it pretty lonely when it happens to you.

But the first few days are the most tenuous, and we wanted to keep it between ourselves a little while longer.

The next morning I tested with a different kind of pregnancy test, and the result was much stronger. The second blue line was unmistakable. It felt so weird and wonderful to keep acing these tests – effortlessly – after failing them for so long. Again I left it on the counter in the bathroom, but this time I fell asleep before Ahmed woke up.

Ptest

He told me later that he almost had a heart attack when he saw it, because he thought it was supposed to have a plus-sign instead of just a second line. Luckily the directions were printed on the test itself, so he figured it out quickly.

Later that day (day 16 of gestation) we went to the hospital to get a blood test to confirm our pregnancy once and for all. I was jabbering to Ahmed about what different hCG levels meant (according to my distinguished internet research) – how a couple hundred would be fine and 400 or more might just mean twins.

We were called in quickly, and my blood was drawn by a nurse. When she asked how I was, I said, “Hopefully pregnant!”

We went to lunch at Miss M’s, where we ran into my step-dad and talked about Istanbul travel and Tulsa real estate. When we got back to the hospital, my stomach was tingly. Home pregnancy tests are highly suggestive, but blood tests are definitive. This would be it: whether we were officially pregnant or not.

I went back to the lab to look for the nurse who’d done my test, and she beamed a huge smile and pointed me back to the front desk. It seemed from her demeanor that it was good news, and my spirits lifted.

We signed something at the front desk, ripped open the envelope, and unfolded the report.

There was no hCG level listed at all.

Instead it said: “Reference Range / Units: Negative.”

test3

The bottom dropped out of our stomachs. We were too stunned to react. We just stood there, staring at it, like it must be some kind of joke. But it was there in black and white. It was all over. Definitively.

Finally Ahmed tried to hug me, but I shrugged him off. No. Something wasn’t right. Why had the nurse smiled at me like that? She didn’t strike me as a sadist. And how could we have had two false positives on two totally different types of pregnancy test? One false positive was almost unheard of. Two was simply ridiculous. And as far as I knew, hCG levels could not drop from “strongly measurable on a home pregnancy test” to zero in a matter of hours.

Totally numb — and once again totally in denial — I marched back toward the lab and stopped the woman who had directed me to the front desk.

“We literally had a positive pregnancy test this morning,” I said. “How can this be negative?”

She said cheerfully, “Oh, it’s positive!”

“Uh… wut?”

“See here where it says AB Positive? That’s your result. Don’t pay attention to that other part.”

“That other part” looked an awful lot like where the result would be expected to be. I assumed “AB Positive” meant something about my blood type, even though my blood type is A positive.

“Why does it say negative? And why isn’t there an hCG level?”

“Oh, we didn’t test for the level. We just tested to see if there’s hCG in the blood or not. The ‘Negative’ just means we don’t have a reference range for that.”

I looked out the glass door, where Ahmed was still trying to collect himself, and I wanted to punch everyone in the hospital. How could they do this to people? What if I hadn’t already taken two different pregnancy tests even though I wasn’t technically supposed to? What if I wasn’t a busybody control freak who “asked to speak to the manager” when I got a blood test result I didn’t like? What if we’d just gone home and cried our eyes out and I’d drunk a bottle of vodka and stopped all my medications?

How about this: “Reference Range / Units: NOT F***ING APPLICABLE.”

Thank God for denial, is all I can say. I was shaking I was so angry, but there was nothing to do but run out and give Ahmed the good news. He almost collapsed with relief.

We were both too agitated to be excited as we drove home.

I’m sure it’ll sink in once we’ve calmed down.

But yeah. At least for now, we’re officially, if cautiously (and furiously), pregnant.

Our Horrible, Terrible, No Good, Very Bad Trip Home

Quick note: There is still no news about whether we’re pregnant or not. This is just the story of our journey from Istanbul to Oklahoma on September 10, 2015, recorded for posterity. Fair warning: It is chock full of profanities.

InO

It started innocuously enough. Lufthansa, the airline we were flying with, announced a strike the day before our flight. I hoped they’d be done with it by the day of our flight – and in fact, our flight from Germany to the US was on schedule. Unfortunately, our flight from Istanbul to Germany was canceled.

We called Lufthansa, and they apologized and booked us for an even better flight at a more reasonable time with only one stopover instead of two. Turkish Airlines was going to fly us to Chicago, and United would fly us to Tulsa. Score.

After a leisurely breakfast with Ahmed’s sister on Thursday morning, we arrive at the airport two hours early for our 1:40pm flight. We even think about sitting down and having coffee somewhere before going through security, but I say, “Naw, let’s just get it over with so we can relax.”

By now I’ve been in Istanbul for five months and overstayed my three-month tourist visa. But that isn’t really my fault. The Turkish government had just rolled out a new system for granting appointments to extend tourist visas, and I tried for weeks to go online and get an appointment. Each time there was an error and it said to try again later. Finally we went to the ministry itself, in person, but they wouldn’t even let us in the door.

“Go to the website,” they said.

“The website doesn’t work,” we replied.

“Try again.”

“What if it still doesn’t work?”

“Just keep trying.”

So we tried and tried and tried and FINALLY one day it worked and we were able to get an appointment… in November. Long after we were going to have left. Ahmed said he read somewhere that that was no problem. As long as we had the paper that showed we had an appointment to try to get an extension, it should be fine.

Sigh… I should have learned my lesson in Russia.

So anyway, at the airport, Ahmed goes to the Turkish citizens’ line for passport control, and I go to the ‘Other’ line. It’s one of those long, windy lines with lots of switchbacks, but finally I’m at the window, and the guy looks at my visa and says, “You overstayed.”

“Yes,” I say, and explain briefly what happened.

“You have to go see the chef,” he says.

“The chef?”

“The chef du controle.”

The Turks have a long history of French influence, and you can find many French borrowings in modern Turkish. Luckily I’ve studied enough French to know this probably means the Big Cheese of Passport Control. “Where is the chef?” I ask.

“That way,” he says, pointing in a vaguely diagonal line over the heads of the people crowded in lines and toward the enormous hangar-like check-in lobby.

“Where exactly?”

“Go that way and turn left.”

“I’m sorry, I don’t know what you’re talking about.”

“Just go that way and turn left.”

“Where? How far?”

“Just go that way and turn left.”

At this point he’s starting to get angry, so I just start walking in that vague direction until I find a small booth that seems like hopefully the right place (even though it’s not really where he said it was). I hand over my documents, explain again, and the man says, “Go to the police.”

“The police?”

“Yes.”

“Why?”

“You need to be punished.”

“Punished?”

“You need to pay.”

“How much?”

“Ask them.”

“OK. Where are they?”

“That way.” Again a vague point in a dizzyingly huge and crowded space.

“Where exactly?”

“That way.”

So I walk again, maybe two or three hundred meters, and ask someone, and they point me to the police. Keep in mind I’m rolling my carry-on with a heavy backpack on top of it, and as a potentially pregnant person, I’m really not supposed to be lifting or carrying anything, and I’m certainly not supposed to be stressed out. The reason I’m carrying most of our stuff is because it’s crammed full of supplements and drugs to support what we hope will be a pregnancy, and it would make a heck of a lot more sense for me to be carrying it than for Ahmed to be if someone stops us and asks us about it. Since I figured I’d be through passport control in five minutes, I wasn’t worried about it. But now I’m dragging it all over the place, through crowds, and it’s stressing me out and pissing me off.

Add to that the fact that my doctor had, to be conservative, put me on larger-than-normal doses of progesterone, a hormone that utterly robs me of my already tenuous ability to suffer fools and deal with bullshit. Not a good state of mind to be in when facing a full day of dealing with border control goons.

So I snake my pissed-off way through the (thankfully) mostly empty line to talk to the police. I have to wait a bit because someone is ahead of me and takes a while, but finally it’s my turn. I hand over my papers, explain yet again, and he hands it back to me. “I need a copy of your passport.”

“Um… Can’t you just make a copy?”

“No.”

“OK… How can I make a copy?” It wasn’t like I had a copy machine in my carry-on.

“That way,” he says, pointing me back to where I came from.

“Where?”

“Next to the café.”

“What’s next to the café?”

“You can make a copy there.”

“Where?”

“Next to the café,” he says, as if I’m an idiot.

This is fucking pointless. “Then I come back here?” I ask.

“Yes.”

“Will I have to stand in line again?” I ask, because sometimes if people make you go get something else, they’ll wave you back in since you already stood in line once.

“Of course.” Again, like I’m an idiot.

I don’t want to talk to this jerk anymore, but I also don’t want to walk all the way back to where I came from, ask around until I find the correct café, try to find someone who knows where the mysterious place is where people can make copies, figure out how much it costs, and figure out how to pay for it (I don’t have any Turkish lira with me).

I’ve already burned through forty minutes. The flight leaves in an hour and twenty minutes, and we’re supposed to be at the gate thirty minutes ahead of time, and I have no idea how long this is going to take or when or if it’s going to end, not to mention that even if it does end, I’ll have to go through the big passport control line again, followed by the security checkpoint, and meanwhile Ahmed doesn’t know where I am, and I have no way of letting him know, and I’m sure he’s freaking out, and I have no idea what kind of fine they’re going to slap me with, or if there’ll be some other ‘punishment’ as well, and if we miss this flight over something that’s NOT MY FAULT TO BEGIN WITH, I am seriously going to lose my shit. I’m kind of losing it already.

And all of that is, of course, entirely secondary to the fact that, if I am pregnant, this is not good for me or my embryo(s), and everything could be ruined by these thick-headed functionaries who have no idea of my situation and couldn’t possibly care less. And the stress of that takes all the other stress and ratchets it up by an order of magnitude. I really try not to let it get to me, and I really fail. At this point I almost wouldn’t blame a couple of beings, on their tenth day of gestation, from choking on all that adrenaline and jumping ship from this world. And that makes me feel really, really sad.

I soon see a storefront for Iranian Airlines, where a man is standing and looking very bored. Iranians are nice people, and I’m sure he has a copy machine. I walk up to him and say, “Excuse me, I need a copy of my passport to give to the police. Would you terribly mind just making a quick copy for me?”

“You can do that next to the café,” he says.

I nod slowly, and I must look like I’m going to cry, because he says quickly, “Here, give it to me. You just need one copy?”

I nod again like a little kid who’s just been told she doesn’t have to go to time out after all. He makes the copy in about five seconds, hands it back to me, and I give him my best grateful smile and thanks before heading back to the line for the police. I snake through the goddamn switchbacks again and wait maybe ten minutes to talk to the police again. They take the copy, look again at the documents, write a number on some kind of receipt, and say, “OK, now you have to go over there and pay.”

“What?! I can’t just pay you?”

“No, you have to go over there.”

“Where?”

“Where it says Information.”

“Where is that?”

“It’s over there. Why didn’t you just read it?” Again, like I’m an idiot.

Tears in my eyes (it’s now less than an hour until the plane departs), I stumble toward where he pointed until I find yet another booth. At least the fee is ‘only’ 233 Turkish lira. I hand over the receipt and my documents, and the man says, “Cash only.”

“Are dollars OK?”

“No, only Turkish lira.”

I take a deep breath to stop myself from strangling the man with his own tie.

“Don’t worry,” he says. “Just go to the exchange office. It’s right there.”

At least this one is within visual range. But I still have no idea when or if this shit is ever going to end. I feel like a rat caught in an endless maze. The poor guy at the exchange office must think I’m a nutcase. Through tears I ask, “How many dollars do I have to give you to get 233 Turkish lira?” Math is way beyond me at this point.

He taps on his calculator. “Eighty-two dollars.”

I hand it over, he gives me the lira.

I go back to the previous booth and hand over the lira. The man writes something on the receipt and says, “Now go back to the police and let them know you paid.”

I am too numb to do anything but walk back to the police line like a zombie, threading my way – yet again – back and forth through the switchbacks. The police look over my documents again, take my receipt, write me another receipt, and say, “Go show this to the chef du controle.”

I don’t have any heart to ask, “Then will this all be over?” I just turn to leave, but there are so many people in the way that there’s no easy way to get out with my bags. I’ll have to thread my way backwards through the switchbacks.

That’s when I finally have a panic attack. It’s funny the little things that tip the scales. I can’t do anything but stand there with my hand clutching my throat and breathe in and out, my heart pounding, waiting for it to pass. A man behind me asks if I’m OK, but I can’t speak. I hold up a finger to ask him to wait. After a minute or so I can breathe normally again. I thread my way backwards through the switchbacks and walk slowly and mechanically back toward passport control. I barely care anymore whether I miss my flight, but I know I should care.

Then I look at the long switchbacking line to get back to the passport control lines, and I just can’t. The coast seems clear, so I simply open up a divider rope and step through near the chef du controle’s booth, pretending like I know what I’m doing, bypassing the line entirely. No one stops me.

I get in line to see the chef, but he’s busy with some other guy who’s sweating bullets and obviously having an even worse day than I am. He begs the chef to have mercy, calling him “big brother” in Turkish, but the chef will not be moved. He begs and begs, and I’m rooting for him, but I’m also rooting for me to catch my flight, which is looking less and less likely. I still don’t know if the chef will even let me pass or if there’s some other punishment waiting. Meanwhile I know poor Ahmed must be absolutely frantic. I keep looking for him on the other side but can’t spot him.

But then I do spot someone – Ahmed’s sister-in-law and her husband and their two kids. They’ve apparently driven in all the way from Izmit to say good-bye to us. I wave to them, hoping I don’t look as psychotic as I feel, but I can’t go to them for fear I’ll lose my place in line. After a while they realize they can enter the Turkish citizens’ line and come closer, so they do. I know only enough Turkish to shrug and say, “Visa problem.”

Finally the chef dismisses the sweating-bullets guy and brings his attention to me. He looks at everything, gives me another receipt, and tells me to go to Line 1, which is in the Turkish citizens’ section. Which makes no sense. So I say, “Bir?” (‘One’ in Turkish.) He nods.

Ahmed’s brother takes my stuff and helps me roll it toward Line 1. We hug and smile and say good-bye, and they hand me an eight-pound bag of pismaniye, a sugary sesame candy that’s a specialty of their region. I take it and the rest of my luggage and get into Line 1. It’s maybe thirty-five minutes ’til our flight leaves the ground. I crane my neck again and finally spot Ahmed in the crowd across the room. He’s craning his neck looking for me in the ‘Other’ line, never suspecting I’ll be in the Turkish citizens’ line.

I jump up and down and wave my hands, and he glances over and sees me, and his face melts in relief. He runs over to the Turkish area, and I shout to him that his brother’s family is here, though of course he can’t come back out and hug them because his passport is already stamped. They all wave to each other, and I get to the head of Line 1, and the agent takes my receipt and stamps my passport, and I’m finally through. I take the bags through security, and Ahmed and I are reunited at last.

“What happened?” he asks. It’s clear he’s been worried sick.

“I don’t want to talk about it yet. Let’s just get on the plane.”

The plane is about halfway through boarding when we finally rock up. We settle in and watch Inside Out (which is awesome!) on our little personal movie screens, then he watches Mad Max while I watch The Other Woman (a nice feel-good girl power movie) and a couple other forgettable films.

The flight takes almost twelve hours and arrives in Chicago at 5:20pm, which is 1:20am in Istanbul. Bedtime. Neither of us slept on the plane (though I tried), and we’re both pretty sleepy. We have a two-hour layover, and Ahmed has a Green Card, so we assume we’re reasonably safe. We do the automatic check-in-to-the-country thing (which I’ve never seen before), and his receipt comes back with a big black X through it.

Great.

We head to the passport control line, and I sail through, but Ahmed is told to follow some guy. We try to ask what’s going on, but we’re given no further information.

So we follow the guy. He takes us to a waiting room full of maybe two dozen people, nearly all of them of South Asian or Middle Eastern descent.

No racial profiling here, folks.

There’s no apparent order to who gets called. They seem to simply pick passports out of a pile at random. They call for Mohammed, Ali, Ahmed (a different Ahmed), Ali Mohammed, Jafar… You get the picture. Flying while Muslim. On the day before 9/11 no less. Blegh.

The clock is once again ticking, and we know we still have to get our boarding passes and go through security again since we’re switching from an international to a domestic flight. Twenty minutes pass, forty. Our flight is at 7:30pm, and it’s likely the last one of the day. We have a hotel booked in Tulsa, the idea being to give us some space to RELAX upon reentry. But that’s looking more and more like a pipe dream. Not to mention, they have the power to deport Ahmed without any kind of due process if they feel like it. And we have no idea if there’s some kind of actual problem or if this is just routine bullshit.

Finally Ahmed is called, and he’s asked a few inane questions by a border guard I’ll just call Meathead. Ahmed explains why we were in Istanbul and I pipe in, “I might be pregnant right now, and all this stress is really not good. And we’re very close to missing our flight.” I’m trying to appeal to the guy’s humanity. Can ya hurry it up a little, dude?

He just looks at me with dull eyes and says, “They’ll rebook you.”

I want to say, “First of all, you don’t know that. They don’t have to rebook for shit that’s not their fault. Second, for all you know, they won’t be able to rebook us until the morning, which means we’re stuck here all night. Third, you’re really just punishing innocent people with Muslim names for no reason, and it’s fucking pathetic. You don’t even care if we miss our flights, or what that might mean for some of us.”

Instead I say weakly, “Well, it still means we’ll be stuck here for more hours.”

Meathead continues staring at me dully.

I say quickly, “Anyway, just…” I barely stop myself from saying, “Just do your goddamn job.” Instead I indicate his computer as if to say, “Carry on, by all means.”

Poor Ahmed. He’s looking at me like, “You’re not helping!”

Belatedly, I shut my pie hole. (I like to think progesterone has the effect it does to help the Mama Bear instinct kick in – you don’t mess with Mama Bear, right? I like to think that because it’s nicer than thinking it turns me into a giant bitch.)

Two minutes later – the whole damned “interrogation” only took about five minutes, after making us wait an hour, fucking pointless bullshit – we’re running toward the trains to take us to Terminal 2E, which isn’t the normal United terminal, but the TV screens say that’s where our flight is. Whatever. We get there and go to the United desk. No one is there. We ask a passing guy with a badge where they are.

He says, “After 6pm there’s no one here.”

“So how can we get our boarding passes?”

“You have to go to Terminal 1.”

So we run to Terminal 1 (Chicago’s airport is huge, mind you – these are not short distances) and find a lone woman at the United desk. She informs us that we’re too late to check in. The system is locked out. I briefly explain our situation and ask if there isn’t anything she can do. She starts tapping on her computer and continues for some time.

I finally say, “May I ask what it is that you’re trying to do?”

She says, “I’m trying to book you for a flight tomorrow.”

My heart sinks. Tomorrow. Great. “There’s no hope tonight at all?” I ask.

“I’m trying to book you for a flight tomorrow so you can get through security and catch your flight tonight.”

My heart leaps. “Oh, thank you so much!”

She hands us our boarding passes and we sprint back to 2E.

The TSA guy at the security checkpoint looks at our boarding passes and says, “These are for tomorrow.”

“Yes, I know,” I say. “It’s a long story. But it’s fine. Please. We need to hurry.”

He continues staring at them. “But they’re for tomorrow. I don’t know if I can let you in.”

“We have a 7:30 flight tonight. It’s about to leave. A woman from United gave it to us so we could try to catch our flight. Please.”

He calls a supervisor over. “Hey, can I let these people through? Their flight is tomorrow.”

She takes a look at our boarding passes, sees our frantic faces, and apparently puts the pieces together. “Yeah, after about 6pm it’s fine to let people through. Thanks for asking me, though!”

He finally lets us through and I announce to the people in line for baggage check, “Pardon me, but we’re about fifteen minutes from missing our flight. Would you terribly mind if we went ahead?”

Everyone kindly steps aside, and we put our luggage on the belt. But nothing is moving. A man is trying to push and pull a bag stuck in the machine, but it won’t budge. There are three more machines, and about six people standing around doing nothing, and I ask one of them, “Excuse me, can we possibly use another machine? We’re very close to missing our flight.”

The man working on fixing the machine says, “Just hold on.”

Five minutes pass, and it’s really like the Keystone Kops vs. The Machine. He keeps trying the same thing over and over again. It never works. Ahmed goes ahead through the metal detector to let the people at the gate know we’re on our way. I’m almost in tears again, and one of the agents says, “Come on through, I’ll make sure your baggage gets on the belt.”

Not really helpful. The belt is still not moving.

Five more minutes pass. Ahmed comes back, looking defeated. “They’re gonna close the gate really soon.”

We can’t do anything. Five more minutes pass. Finally they have the brilliant idea of just using another machine. Our bags come through and we sprint to our gate, which is not exactly close by.

Just as we arrive, a man emerges from the door to the walkway and shuts it. We can see our plane through the window.

I say breathlessly to the guy, “Hey, we’re here, sorry, TSA held us up. Is there any way we can get on that plane?”

“Sorry,” he says. “Captain’s orders. When the captain tells me to do something, I have to do it.” He says something about how even five minutes can somehow turn into overtime and cause delays and blah blah, but I’m not really listening. I collapse on the floor and just sit there, defeated. I give myself a few moments to let the sadness pass through me and then I stand up again.

“How can we get rebooked on another flight tonight?”

“That was the last United flight of the day.”

“Of course it was. What about on American or something? Can’t you rebook us to another airline?”

“You’ll have to talk to a United representative.”

He directs us to the right place, and we speak to a woman and ask if there isn’t anything she can do. She says there’s an American flight leaving in an hour, but she isn’t allowed to put us on it because United didn’t book our original flight.

“Is there any way we can get on that flight?”

“Since you originally booked through Lufthansa,” she says, “maybe they can do it?”

“Where are they?”

“End of the B corridor.”

It’s a long motherfucking corridor.

At this point Ahmed wants to just give up and get a hotel room.

I say, “Hey, we have forty-five minutes and no security checkpoints to get through. Those are the best odds we’ve had all day.”

So we run another mile or so to find the Lufthansa counter. No one’s there, but a large German man with a Lufthansa badge wanders by, and we explain our situation. He goes to the counter and starts tapping on the computer and talking to someone on the phone. He tells the person on the phone that we missed our connecting flight because our first flight was late. I don’t know if he assumed that or just said it to help us out, but we certainly don’t correct him.

He finally hands us two hand-written strings of numbers and says we can go to the check-in counter at gate H18 to get our boarding passes.

“And you should maybe hurry,” he says mildly. “It leaves in less than half an hour.”

We thank him profusely and run all the way back down the entire length of the B corridor, all the way to the H corridor, and all the way to our gate which is, naturally, at the very damn end of the long-ass H corridor.

(I had terrible shin splints the next day.)

Luckily there’s a ten-minute delay, and the plane is boarding when we get there. We’re home free. Finally.

Except the pilot hasn’t shown up. No one knows where he is. It’s burning up in the cabin (or maybe that’s just us, sweating from our half marathons), but the cockpit is locked so no one can turn on the AC. Twenty minutes pass. Forty. It’s not clear if we’ll actually get to Tulsa tonight. We start laughing. What the hell kind of day is this? Really?

Finally the pilot shows up, and there’s some kind of mechanical/paperwork thing, but that’s sorted out, and we’re in the air.

We land in Tulsa, pretty sure our bags must have come in on our United flight. So we walk down a semi-long corridor to the United lost luggage office and explain our situation. She tells us we have to go wait for our luggage at the American carousel before she can write up a report. Seems pointless, but OK. It’s now 11pm, which is 7am Istanbul time. We are wiped out. We walk all the way back down the corridor and wait for our luggage. It predictably doesn’t come, and we walk all the way back to the United office.

She asks for all of our information and enters it into the computer. Then she says, “Wait a minute, you came in on an American flight, right?”

“Yes. As we told you.”

“Then you have to file a claim with them, not us.”

“Then why the fuck did you waste our time, you dim-witted harpy from hell?” I don’t say. I want to, though. I’m kinda demented by this point.

So we walk all the way back down the corridor, back to American, and they take all our information yet again. Just our luck, some entirely new baggage tracking system had been rolled out just as our bags were being put on the plane in Istanbul. No one apparently understands the new system, so it’s not even clear what continent our bags are on.

Whatever. It’s almost midnight now, and we flag down a shuttle to take us to our hotel. Our room is sub-Arctic, with the AC going full blast, and I try to open the window, but it’s welded shut. I turn on the heater for just a little bit to keep us from freezing solid, and a toxic burning smell fills the room.

Choking, I call the front desk. As if it’s perfectly normal, she says, “No problem, I’ll get you booked into another room.”

The new room doesn’t have soap, but I don’t care. I wash myself with shampoo and pass out around 1am Tulsa time, which is 9am Istanbul time.

And that was our terrible, horrible, no good, very bad trip home.

Here’s the thing. If I’m not pregnant, I’ll never know if the stress of that day had anything to do with it.

If I am pregnant, it’ll just be one of those funny anecdotes about what we go through to have kids.

Here’s hoping it’s the latter.

Just to clear out some of the bad vibe cobwebs, let’s count our blessings here at the end, shall we?

  1. We did, after all, fly all the way from Istanbul to Oklahoma in less than 24 hours. That’s pretty amazing.
  2. The Iranian guy didn’t have to help me out, no matter how pathetic I looked. It was very kind of him.
  3. The United lady who tried to circumvent the rules and help us catch our flight didn’t actually help us catch our flight, but it was very sweet of her to try. And she did get us past the security checkpoint so that we could attempt the Lufthansa Hail Mary.
  4. The Lufthansa guy was an understated angel. He didn’t have to go right to the desk, tell a white lie about the cause for the delay, and get us free and timely tickets home, but he did. Bless him.
  5. Because we got the hotel room in Tulsa, we didn’t have to involve anyone else in our drama. We could just show up whenever and pass right out. That was a lucky break.
  6. Seriously: If you haven’t seen Inside Out, you should. Genuinely thoughtful and funny and gorgeous movie with a great and unexpected message.
  7. We did get our luggage back the next day (minus one wheel).
  8. We came home to a green and gorgeous Oklahoma September, and we made a huge pot of ginger curry chicken soup with wild rice and avocado. It was really good.

    kitchen

    P.S. Someone on Facebook asked, so here’s the recipe we followed for the soup.

    For stock:

    Sautee an onion and a half cut into chunks until translucent and lightly browned, add chunks of ginger and garlic, sautee a bit more, remove all from the pot.

    Lightly brown two pounds of chicken thighs (you can salt and season the chicken first, which we forgot to do, but it’s good either way), then add onions and stuff back in and cook on low (covered) until the chicken releases its juices (about 20 min).

    Add carrot chunks, celery chunks, bay leaves, parsley, sage, rosemary, cayenne, curry powder, and cracked pepper, cover with boiling water, and simmer for one hour. Remove chicken and cut into little chunks. Set aside. Let the rest of the pot continue to simmer for three more hours or so.

    For soup:

    Meanwhile dice another onion and a half plus about five carrots and five celery stalks. Sautee for a while in a second pot, then add finely diced garlic and ginger plus salt and cracked pepper (and a bit more curry powder and cayenne if you like, but keep in mind cayenne packs a punch) and sautee some more. Turn the heat off, add the chicken in, and just let it sit until about twenty minutes before you want to eat.

    At that point, strain the stock and throw the solids out under a tree for the rabbits. Pour the stock into the second pot with all the stuff in it, add finely-diced parsley, and simmer for 20 more minutes. Salt to taste.

    Add wild rice, sourdough croutons, garlic bread, and/or avocado chunks if ya like.

    Sounds simple when you write it out like that, but when you’re jet-lagged, it’s like climbing Mt. Everest. 😛 Totally worth it, though.

The Eagles have Landed

Summer and Nymeria — our first two gorgeous 8-cell day 3 embryos (named after two of the Stark dire wolves from Game of Thrones) — are safely in vivo after a clean, textbook implantation.

Now it’s up to God / Allah / Brahma / Tao / Muse / biochemistry / molecular biology / baby dust.

(And hopefully the GoT writers won’t do anything nasty to those dire wolves this season…)

(And to be clear, we don’t plan on naming the children Summer and Nymeria. It’s just their embryonic-stage nicknames.)

We took the ferry across the Bosphorus to get to Besiktas and our clinic and snapped a few photos of us on the way. I had seen a dolphin a few days earlier and thought I caught a glimpse of one today as well, but I couldn’t be sure. We did see lots of fish and jellyfish in the clear aquamarine water.

photo 1

photo 3a

At the clinic, we met with the head embryologist (who went to the same Turkish university as Ahmed, followed by Harvard Medical School), and he said at one point, “We put them in culture and watch them for a few days so we can look at their cleavage.”

Obviously he meant “cleavage” in a technical sense — the cells splitting, and then splitting again — but I had this image in my head of doctors ogling voluptuous little balls of cells, and it was such a stupid image that I had to struggle to keep from laughing, and then it was so stupid that I was struggling to keep from laughing that it got even worse. You know how it goes — giggle positive feedback loops can be a powerful vortex.

The high-powered embryologist paused to ask me what was so funny, and I didn’t want to tell him it was something so stupid, but I hate it when someone is laughing and won’t tell me why, so I told him.

He said, “Hm, I never thought of it that way…”

Anyway he was cool even though I was being a huge dork, and I’ve heard about studies that say people who laugh a lot on embryo transfer day actually have better odds, so I was OK with being a little silly.

My doctor, whom we’ve been seeing for five months, just took a new job far away from our clinic (a promotion of sorts to some kind of academic post), which would have been upsetting… except he fought a traffic jam to come ALL THE WAY back to the clinic in the middle of a work day just to do my transfer. We were so grateful for this, and he said it went smoothly and beautifully. Couldn’t have gone better.

Teşekkür ederim (thanks), Dr. Arikan.

He also showed us photographs of the embryos, and objectively speaking, they look awesome. You can’t really tell how good an embryo is by looking at it, but I’m sure it doesn’t hurt if they’re pretty enough to appear in a textbook.

Then there was nothing to do but rest for half an hour, go get a warm salty snack (lentil soup in our case), and then take the ferry back to Moda with a couple of potential new beings on board. Pretty surreal.

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We had dinner at a rooftop restaurant and watched the sun set over Old Istanbul, with thousands of seagulls wheeling in the breeze. There were brief fireworks over the Hagia Sophia, and I said to Ahmed, “That’s sweet, but they really should wait until after the pregnancy test.”

We’ll test in about two weeks to find out if one or both has stuck around.

May they live 100 years.

Meanwhile I’m cutting out tea and coffee as well as sugar, dairy (I have a mild allergy), and playing with stray cats just on the off chance that I might pick up toxoplasmosis (which I’ve probably already had anyway, since I played with plenty of stray cats as a kid) (and which I actually have a better chance of getting from improperly washed vegetables or improperly cooked meat — unfortunately I can’t just stop eating).

So, like, no tea or Turkish coffee in Turkey, plus no Turkish ice cream or baklava (or baklava with Turkish ice cream), or kittens…? It’s kinda like I’m not even in Istanbul anymore. :/ At least there are still the pretty sunsets and parks, and a few more ferry rides. We’ll leave for Oklahoma on September 10. Almost exactly five years after we met playing soccer in the Bronx. 🙂

I can't haz ur kittehs anymoar?
I can’t haz ur kittehs anymoar?

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IMG_0697

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It’s hard to say what our odds are. Odds don’t mean much when you’re just one couple. It’ll happen or it won’t.

Obviously, we’re not out of the woods by any means. But we’re in an exciting part of the woods. It’s fun to think of ourselves, just a little bit, as (kinda sorta) a family of four for at least two weeks. I already declined to climb some stairs today with the excuse, “Hey, I’m carrying three people! Well, one person plus sixteen cells…”

Once we know the results, we’ll adjust our emotions accordingly.

But for now we choose to be happy and hopeful. Why not, right?

photo 5

Good thoughts/vibes/prayers always appreciated. 🙂

P.S. Another thing the embryologist said was not to worry about any special diet or anything. He rolled his eyes and waved his hand and said, “You don’t need to eat pineapple or whatever.”

We laughed, because it was already too late for me. The internet says pineapple core has bromelain in it, which is supposed to help your blah blah do something something… I don’t remember, and I honestly don’t care, because I’m stoked for an excuse to eat a whole pineapple by myself (over the course of five days). I think of it like potato salad on the 4th of July, or a cake on your birthday. Pineapple for embryo transfer. A tropical party in your mouth. Score.

Big Decision Time

All systems are go for the embryo transfer this week, and we’re pretty thrilled with how well things are going so far. But we’re faced with a big decision.

We have five lovely day 3 (8-cell) embryos on ice. Four look near-perfect and one is a bit behind on growth. But I’ve heard plenty of stories of the runt turning into a beautiful healthy baby. Sometimes it turns out to be the only viable embryo!

Embryo development, day 1 - day 5
Embryo development, day 1 – day 5

So here’s what we’ll have to decide:

(a) Thaw the two best-looking embryos and immediately transfer them (day 3 transfer), or

(b) Thaw ALL FIVE embryos, see which one(s) develop in the lab to day 5 (blastocyst stage, with about 100 cells), transfer the two best-looking ones (if two even survive), and freeze any leftover blastocysts again (if more than two survive).

Here are the benefits of the day 3 transfer:

  • The embryos aren’t in the lab as long — they’re back in vivo where they belong. Studies have shown that there’s no benefit to taking a specific embryo to day 5 vs. day 3. Meanwhile, I’ve heard bone-chilling stories of human errors in even the best labs in the world. While they are very rare, that doesn’t mean much if it happens to you. And since we’re talking about so few embryos, and everything it took to get them, a pretty extreme level of conservatism seems justified.
  • There’s conflicting evidence whether, even in the best lab settings, taking a group of embryos to day 5 provides much benefit. If you have fifteen embryos and want more data about them before choosing which one(s) to implant (especially if you only want one or two kids), taking them all to blast probably makes sense. You’ll end up with maybe six or seven blastocysts, and implanting two at a time, you’ll have a great chance to get pregnant quicker than implanting two “untested” day 3 embryos at a time, and without implanting three or four and risking triplets or more. But if you only have five embryos, you’re taking a much bigger risk, and losing even one potentially viable embryo is pretty tough to swallow.
  • If we do a day 3 transfer with two embryos, and keep the other three on ice, we’re guaranteed at least one more shot at parenthood if this transfer doesn’t work. If we put all five eggs in one basket, there’s a chance that not only will we have only one shot at a transfer — we may end up with zero. I’ve heard more than one story of a couple excitedly getting ready for a day 5 transfer only to be called on the morning of and told the embryos had all “arrested” (died) overnight. It’s possible they might have died anyway, and dying in the dish saved the couple the pain of a miscarriage. But as for me, I’d always wonder if one of them might not have survived if we’d done an earlier transfer.
  • If we did a day 5 transfer and were lucky enough to have more than two survive to blastocyst, we’d have to re-freeze any extras. Personally, I’d rather not subject the embryos to any more intervention than absolutely necessary. More than 95% of embryos tend to survive freezes and thaws these days, but each intervention adds more possibility for bad luck. Seems safer to just leave three in the cryo tank, either for another try for #1, or for a sibling down the road.
  • At least back in 2003, the sex ratio (male/female) for blastocysts was approximately 1.3, while the ratio was much closer to 1.0 for day 3 embryos. Which means, apparently, that lots of perfectly good female embryos were falling by the wayside on the way to day 5. Lest you accuse women of being finicky even in vitro, the egg controls growth and development until day 3. That’s when the sperm’s genetic contribution starts kicking in. Apparently there’s something about X sperms (as supposed to Y sperms) that isn’t so crazy about dish life. Of course, I’m not a trained professional, so there may be a totally different explanation. This is just mildly educated conjecture. And a lot of things have changed since 2003, so the sex ratios may be different now. But if those stats hold up, I’d hate to lose any potential daughters to the petri dish patriarchy. 😛
It's raining day 3 embryos...
It’s raining day 3 embryos…
  • I’d rather risk a miscarriage, and risk having to come back to Istanbul to do another (relatively easy) frozen embryo transfer, than risk having either zero or only one shot with these embryos, and I’d certainly prefer it to another IVF cycle.
  • I would probably choose to implant two whether it’s with day 3 or day 5 embryos, so if I go with two day 3 embryos, there’s probably less of a chance for twins. Overall I’ll be grateful for any pregnancy, but if I had my choice, I’d rather not take the (significant) risks of a twin pregnancy with my first.
  • It’s anecdotal, but I’ve heard several stories of women who were advised to go ahead and implant their embryos on day 3 because it was clear they would never make it to day 5 in the lab. In many cases, those “failing” embryos turned into healthy kids.
  • Emotionally speaking, thawing all five at once and waiting for phone calls each day about how many had survived would turn me into a nervous wreck just when I need to be in a positive energy state to welcome a new being into my own.
Hatching blastocyst. It isn't ours, but isn't it pretty? Like a galaxy being born.
Hatching blastocyst. It isn’t ours, but isn’t it pretty? Like a galaxy being born.

Here are the benefits of the day 5 transfer:

  • Many doctors argue that only the non-viable embryos die on the way to day 5, so there’s really no loss, and you end up with much more concentrated quality in the group that survives to day 5. It seems true that you do end up with a higher percentage of quality embryos. But no one is really sure if perfectly good embryos might die in the lab that could have survived in the body, and with only five embryos, “percentages” don’t mean a whole lot.
  • Of course, a day 5 blastocyst can still be chromosomally abnormal and thus non-viable (roughly half will be abnormal on average for any given couple), but the chances are less. So you can more confidently place only a single embryo and not risk twins (or only two and not risk triplets) — though with day 5 embryos, there is a slightly elevated risk of a blast dividing into identical twins (which carry even more risks than fraternal twins).
  • It can potentially save me from wasting my time with two dud embryos and save me an extra trip to Istanbul.
  • The doctor says our embryos look great, so it’s very unlikely they’ll all die before day 5. But we’re not a “representative sample.” We’re one couple. “Unlikely” won’t mean much to us if we’re in that unlucky category.

So I guess I’ve already made up my mind (after hours and hours of research, reversals, and soul-searching). But part of me wonders if I’m being too conservative — if I shouldn’t trust the lab techs and the experts and save time and money by gathering that extra data about what we have and choosing (hopefully) the best and just doing this once.

A big part of it, I think, is regret management. If I have to make an extra trip to Istanbul and things still don’t work out (or if they do!), I can know I did everything I could and didn’t take any unnecesssary risks. If we take the “easier” route and things go wrong, I think I’d feel a lot worse about that.

If all this embryo talk bores you to tears, by all means, go read something else. 🙂

For the rest — particularly if you’ve had any experience in this arena — I’d be glad to hear your thoughts.

UPDATE: If you read the next post, you’ll know (though you probably could have guessed!) that we went with the safer day 3 transfer, and we still have three embryos in cryo tanks. I feel good and confident that we made the best decision for us. Inshallah!