Sunday, July 22, 2012

Insurance

My mom and I made a date to see Magic Mike today, both of us hampered by partners in pain and on drugs.  Mom has been stuck with my dad during knee surgery and its aftermath, and I have the great pleasure of sharing in Heather’s reproductive process, so this is kind of a caretaker’s-day-out situation.  Don’t tell Heather; she thinks I’m just doing it for my mom.
 
What’s funny is that I anticipated a tremendous amount of drama in deciding about PGD.  Like just about everything where IUI/ICI/IVF is concerned, it’s an emotional and uncertain choice.  You don’t know for sure, but you find an angle that makes slightly more sense; inevitably, it’s the exact opposite of the angle your partner has chosen, and you battle it out furiously.  Everyone’s trying to be rational, but I guess in a way you’ve worked so hard to make a decision that you cling to even the hint of one.  Once you can halfway justify something—testing/risking embryos, changing to a cheaper sperm bank, changing donors, changing doctors—you’re relieved, and anyone challenging that relief, even if they make a good point, is a hostile force. 

The stakes, obviously, are ridiculously high, but you try to keep your shit together and not say anything like “If you don’t finish that goddamn pineapple, you’re never going to get pregnant!”  Inferences are made, though.

This idea, then, of a choice between miscarriage/failure to attach/deformity/cancer and losing the embryos that give you any sort of chance at a child at all…  Even if you kind of pick a side-- I myself leaned towards PGD, while Heather leaned away-- you can't actually be confident in it.  Neither one feels good.  I was terrified of how that argument (um, "discussion") would go, apprehensive Friday and most of Saturday about the decision we'd need to make today, but it turned out to be simple.

Heather stopped at my desk, said that she thought we should do the test if four or five of the embryos were still in good shape, but skip it if there were three or fewer.  That seemed very reasonable to me, so we fist-bumped and were done.

This morning, the lovely Jennifer, an embryologist who led our initial IVF class, called to ask what we'd decided.  She said we had five embryos still, but only two were grade B and three were grade C.  Or something like that; it wasn't great news so what I kind of absorbed was that we were on shaky ground losing any to PGD.  We said as much to Jennifer, who agreed, saying that in this circumstance we might want to go forward without PGD.  Both Heather and I nodded, feeling that was the right decision.  Done.

What accompanied that decision, of course, was the question of embryo quality and selection.  Grade A embryos, Jennifer said, were above average, grade B were average, and grade C were below average.  The secret underground element to choosing tomorrow's embryos is that the Nashville folk won't freeze grade C embryos.  (FYI, I have now seen both "embies" and "follies" mentioned in fertility forums, and I just cannot take these ladies seriously.  I guess maybe when you want a baby that badly, you start babying even cell clusters.)  If we choose the best embryos for transfer, the others are lost and we won't have another chance; why on earth, though, would we hedge our bets if it's at the potential cost of this cycle?

Heather, unable to sleep, dove into the internet.  We're swirling around in stories of women with grade C embryos that made it, or grade C embryos that turned to grade B overnight...  And Jennifer said, as we've heard from others before, that they don't like to be too firm about any of the embryo cell counts because they can change so rapidly.  So all I'm thinking is that we'll wait to hear more from them tomorrow.  We're leaning towards implanting three, if none can be frozen, but IVF is a doctor's world, not a patient's, so in some ways I feel like it's a question of feedback from them rather than research by us.

My mom called to confirm our date and said that her favorite neighbor family was thinking positive thoughts for our procedure tomorrow.  I'd told them about baby-making before, so it's plausible that they asked my mom, but I like to think she's excited and she brought it up.

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