FET3 and PUPO

At my baseline ultrasound a couple of weeks ago, I saw a large black circle flash across the screen as the nurse tried to locate my left ovary.

Fuck. I cursed silently.

“Ugh, a cyst,” the nurse and I said in unison. She raised a how-could-you-tell eyebrow.

“I’ve had enough ultrasounds at this point to know that a large black circle isn’t a full bladder!”

The nurse said a cyst didn’t necessarily mean the cycle would be delayed or cancelled, but it depended on my blood test results.

My blood work showed my estrogen was 82. Anything over 100 would be too high for anyone, but an 82 was way too high for someone who had been on Lupron for 10 days. Perhaps the cyst was interfering with my estrogen levels, so we had to wait a week to do a second baseline ultrasound.

I didn’t care about the delay as much as I did about staying on Lupron another week. (Waiting a week meant I wasn’t cleared to start estrogen that night and start weaning myself off Lupron.) I was pretty bummed about having to buy more Lupron. At $500 for a two-week supply (the manufacturers are gouging the consumers on price because there’s a nationwide shortage—how very fucking convenient for them). For another, I was really not feeling like myself. Lupron made me feel very anxious and irritable. As for my reproductive system, I felt dead inside. I wondered if this deadness is what menopause feels like—Lupron shuts your reproductive system down and puts you into a temporary artificial menopause. (I’ll take monthly cramps any day…)

My anxiety has been based around the fact that my uterus seems okay, which leads me to draw the terrifying conclusion that our embryos have been damaged in the freezing process—a theory about our clinic’s vitrification method seems to be making the rounds on an online forum I belong to. (Also, why would our rockstar, super-fertile donor who has never produced fewer than 30 mature eggs have been asked to return for a sibling cycle?)

Lupron heightened these feelings. Some days I didn’t have the energy to write it all out, so I drew pictures with captions:

But, back to the cyst: another week on Lupron might resolve it. I called my RE’s assistant and flat out told her that $1,000 on medication for potentially up to several months was not sustainable. And guess what? There’s a compounding pharmacy in Arizona that will make luprolide acetate (the generic!) at ⅓ of the cost! So there’s my PSA for anyone else out there being gouged by the disgrace that is the current US health”care” situation…

At my second ultrasound, the cyst was bigger (say whaaat?) but my estrogen levels had plummeted to 13—slightly lower than they had been when I took Lupron in 2014 for the cycle that resulted in my daughter. As the cyst wasn’t affecting my hormone levels, I was cleared to taper off the Lupron (hurrah!), start the Letrozole (supposed to suppress endometriosis and aid in implantation), and start the injectable estrogen.

After only a week (or, three shots of estrogen), my lining was already at 8mm! In spite of a week-long delay caused by the cyst, we’d still do the FET on May 24 as long as a little bit of fluid had resolved.

I returned to the clinic the day before to check that the fluid had resolved, and it had! Plus, the cyst was G-O-N-E gone. To my surprise, the lining of my uterus had shrunk down to 7mm. The nurse explained this is good! Progesterone makes your lining compact, and therefore more receptive to an embryo. This is why you’re not seen for lining checks after you start progesterone. I had no idea! (Did you?)

All this brings me to yesterday: Transfer Day.

The embryologist was very happy with the embryo. She’s already hatching out of the zona pellucida (the ‘eggshell’) which they zapped with a laser to help the cells break out more easily. (The zona pellucida can be a little hard for an embryo to break free of after freezing.)

Here she is, the little beauty:

Transfer went smoothly. My RE couldn’t have been more pleased with how everything went. I fell asleep in the car on the way home (thanks, Valium!) and have been on modified bed rest.

Lucky me, I have my fabulous MIL staying with us to help me with V—I can’t lift more than 20 lbs until my beta on June 5. She’s cooked, cleaned, done several loads of laundry. Do I have the best MIL in the world or what?

She and DH have both asked me how I’m feeling. I know what they’re really asking: what is my intuition telling me?

I’m not sure what to say. I am more hopeful than I expected to be. I am more confident than I should be, given everything we’ve been through. Yesterday I had mild cramps hours after the transfer. Maybe it was something to do with that, or maybe it was implantation? This evening, there’s a burning sensation in my uterus that isn’t uncomfortable. I’m being careful not to get my hopes up, but sometimes hope is all we have.

Third time lucky, right?