Embryo Transfers

First decision we had to make with our embryos was when to transfer them to Fertility Associates as they were created and stored with Fertility Plus. We decided to transfer them while we were waiting for the ECART decision so they are ready at the clinic when approval comes through. After a bunch of calls, emails, and forms later our 6 precious embryos were with Fertility Associates about a week before the ECART decision was shared with us.

Next came more screening, consent forms (Part A), and appointments to discuss plans and what to expect. Part A of consent form is tied to ECART approval expiry date and the signatures need to be witnessed by the clinic. There was a lot of information about what to expect, and what the plan is. A lot of which we did not retain but will be repeated again throughout the process.

We did not have to wait long for day 1 of our surrogate's natural cycle. She called the clinic to inform them and the clinic's protocols leading up to a transfer started. As Intended Parents, that meant another form (Part B) consenting to the cycle and thawed embryo replacement. For our surrogate it started with collecting medications for the luteal phase of the cycle with progesterone and any additional medications prescribed by the doctor. Blood tests and ultrasound scans are used to make decisions on the cycle and when/if embryo transfer will take place. We learned about uterine lining thickness, and what quiet ovaries were. Next, we got a go-ahead with a tentative transfer date! We pinched ourselves and were absolutely ecstatic that we might actually be parents in the near future. This was as close to being parents as we have come so far. Despite taking years to get to this point, it felt like it was moving at flying speed all of sudden and we were so excited at the possibility.

The next day was unforgettable, so much can happen in 24 hours at lightning speed. We were quickly reminded that we were still living in the times of the covid-19 pandemic. Our surrogate's child tested positive the morning after the scan. Unfortunately, a positive covid-19 case in the household meant we could not continue with the cycle. This was a different kind of roller coaster feeling than what we experienced in the earlier part of the journey, from the high of the transfer schedule news only a day earlier to the low of the cancelled cycle.  The pandemic got us. We quickly switched gear to making sure the surrogate's family is looked after and figuring out next steps with the clinic. We moved back into the waiting phase.

It was challenging to stay positive and the wait felt like a lifetime. In reality we were at day 1 of a new cycle only 4-5 weeks later. Unfortunately, this time we tested positive for covid-19 2 days after day 1 of the new cycle. We couldn't join our surrogate at the clinic for scans leading up to the transfer, luckily this didn't affect the cycle. Ultrasound scan and blood test were good and we could attempt another transfer. We felt excitement, nervousness, and confidence covid-19 was unlikely to put a damper time this around.

In the morning of the transfer, we met our surrogate and her support person to chat before the appointment. Full of nervous energy we sat and the surrogate and support person went through to the procedure room first to get ready for the transfer. We'd join her for the transfer shortly. We waited in the waiting room for the call to take us through to the room. The wait felt like an eternity and we thought surely any time now they will come and get us. We started to wonder if they transferred the embryo without us in the room.

Suddenly, we had a phone call and the call was coming from inside the clinic with the caller ID. They know we are at the waiting area, why are they calling us? Or do the medical staff not know we are here? We picked up the call and heard 4 devastating words, embryo didn't survive thawing. We sat overwhelmed with emotions from the news. We knew success rates for embryo transfer, but we had not considered chances of a frozen embryo not surviving the thawing process. Up to 10% of embryos do not survive the freezing and thawing process. We had a few minutes to process this information before the surrogate joined us in the waiting room. Our surrogate and the support both looked how we felt. We were disappointed, sad, frustrated, and overwhelmed. The clinic was thawing another embryo and that would take some time. It was a lot to process but knew we will be back at the clinic in the afternoon for another attempt. We all took time to walk, eat, and de-stress separately in our own way.

We started a lot of googling and wondered if the next embryo would survive the thawing process. Our minds wandered and questioned was it the embryo transport between the clinics? Was it different protocols used by clinics? Was it freezing? Was it thawing? Was it just a chance? Could we have prevented or mitigated this issue? We've done a lot of just-in-time research and thought maybe we should have done more research.  Before we could get too far down the rabbit hole, we received a call from the clinic with the news that the second embryo has thawed successfully and we are going for the embryo transfer. The 4 of us went back to the waiting area. Hope came back.

We lost any sense of time and we waited nervously. We were called into a private room with an embryologist who guided us through information about the second embryo and the morning's event with the first. We then joined our surrogate, her support person, doctor, nurse, and embryologist in the procedure room.

Ultrasound guided embryo transfer uses a full bladder to help visualise catheter and makes the uterus in a more accommodating angle. We heard that the transfer process is generally very quick. However, that wasn't the case for us. They had challenges getting the catheter in place which caused a lot of discomfort for her and we felt terrible. It seemed like a very long time had passed but at last they successfully transferred the embryo. We were full of hope again. Four of us left the clinic and went to a cafe for a snack and to talk through the roller coaster of the day it had been.

Back to the waiting period, again. The longest 10 days to wait for hCG level blood test to find out if there is pregnancy. We started googling what are the signs and symptoms to look out for after an embryo transfer. It was no help. They listed a series of symptoms but all concluded that presence or absence of any of the symptoms does not indicate pregnancy and best to wait for the blood test.

Day 10 has finally arrived. The day turned out to be a very stressful day. We started with a family medical emergency, John had to rush my mother to the emergency department at Auckland hospital and I was meeting them there. Our minds raced, was she going to recover? Is this going to be a cliche exchange of life like you see in a TV show? How were we going to get through it all? Chaotic scenes at the ED but my mother got admitted quickly and treatment started. Then my the rang, the clinic popped up on caller ID and I picked up to answer, still at my mother's bedside in the ED. I think I've uttered a total of 3 words during the call, OK, OK, Bye. It didn't take and there was no pregnancy. Back to the start again. In some ways, the distraction of the ED has softened the devastation of hearing the news. We were preoccupied with the health of my mother, we didn't have time to feel. My mother was now on the mend and was discharged later in the evening.

We knew this was a possibility but once the stress of the ED visit passed we felt waves of sadness. Sharing the news with immediate family and close friends was difficult, and we experienced the sadness again, and again. We stayed in touch with our surrogate, she was doing OK and we arranged to meet on the weekend. We spent the day at the zoo with kids and talked about the cycle and when we would be all ready to try again. We all decided we'd try the very next cycle possible. We were back at day 1 the very next day after the Zoo.

We had hope again but we were much more cautious. We decided not to share the news of this cycle outside our immediate family. Duphaston was recommended as extra medication for the cycle and she would need to take it for 10 weeks. I was overseas for work and only John could attend the scan appointment this time. We got the greenlight for another transfer.

Four of us met before the appointment and were back at the clinic once again. The transfer appointment started well with the embryologist letting us know the embryo thawing was successful and it was looking good. Embryologist explained the conditions of the embryo and showed us the photo of the embryo. Our 4BB embryo looked more like a "textbook" embryo than the previous 4BA embryo. We had a different team for this transfer and it was with our surrogate's doctor at the clinic. It felt more relaxed this time around, maybe due to having been through the process before, maybe due to more familiar faces in the room. The transfer went smoothly. It was a whole new experience compared to the previous attempt. Back to the now all too familiar waiting period...