I rather feel like I’ve bigged up this Plan so I hope you’re not disappointed by it. Basically, The Plan came about when I went to see my consultant to have the post-unsuccessful IVF debrief — or the “what the fuck went wrong chat” as I’m pretty sure I’ve seen it called on other blogs.
Anyway, I sat in front of my consultant and said, “So, we had one grade 1 embryo and it failed to implant. And I understand that there may be many reasons for this, but what can we do minimise the likelihood of these being reasons why the same thing doesn’t happen again?”
And that was when she told me about something called an ERA test. ERA stands for Endometrial Receptivity Array and, very briefly, it’s basically a test that lets you know whether you’re putting the embryo back on the right day, when the endometrium is at its most receptive. Because research suggests that while IVF is standardised to do it on a certain day, for up to 25 per cent of women, this could be too early, or too late. (You can read all about it here should you so desire…)
My consultant was at pains to point out that this is an expensive test (it’s £1200, but then in my experience, pretty much everything in IVF is “about a grand” — sperm, ICSI, embryo transfer etc etc) and not something that she’d normally recommend after just one failed implantation, but because my frozen eggs are at a premium, we want to give them as much of a fighting chance as possible. And, as she put it, “what would be a disaster would be if we defrosted the rest of your eggs, created say two embryos, they failed to implant and then we did the test and found out that we’d been putting them in on the wrong day all along.”
And that was kind of the point where, although I said I’d go away and think about it (and look at all the PubMed papers and all the rest of it), that I made my mind up. So I consulted my coterie of brilliant others — my biochemist brain who did some research on my behalf and concluded that on balance it was probably worth it; my non-scientific but eminently sensible sister who said “given your cycle is shorter than the standard 28 days doesn’t it stand to reason that you might be in the 25 per cent?”; and the one who knows me inside out and knows that in my head “knowledge is power” and knew that, me being me, as soon as I knew that this test was available, I couldn’t NOT do it — and, to be honest, I would probably have ignored them if they’d said don’t do it, and done it anyway, but it was nice that we were all in agreement.
So that’s The Plan. A dummy cycle (as in one where I’m not trying to get pregnant but doing everything, apart from the transfer as if I were) — this time with 6mg oestrogen daily from day 2 as well as the progesterone pessaries later on in the cycle too (no, I don’t really know why, presumably because my consultant thinks that this will be another way to improve likelihood of success next time around, rather than just using progesterone— which I don’t mind apart from the fact that the oestrogen appears to be making me fatter, and more prone to tears, both of which I could kind of do without) — and then a biopsy of my womb to “analyse the expression levels of 236 genes linked to the status of endometrial receptivity, using RNA sequencing.”
I mean, modern life is amazing and all that, but every step I go down this road, whether it’s acupuncture, dietary changes, hormone tablets and pessaries, thyroxine adjustment, personalised windows for transfer, whatever…. makes me simultaneously more and more astounded that anyone gets pregnant ever, more and more resentful of the 20-odd years I spent desperately trying NOT to get pregnant, and, if I’m honest, feeling like more and more of a freak for not being one of those people who merely have to see a cock to wind up pregnant. (Although in my defence, what with there being no cock AT ALL in my particular scenario, getting pregnant without IVF could be more of a challenge for me than for most.)
I also do realise that The Plan is, again, another way that I’m trying to control an uncontrollable situation, but I’m justifying it because it will — I hope — give me a certain amount of peace of mind, because, well, two-fold, if I’m meant to be staying as relaxed as possible about this whole process, for me that means dotting Is and crossing Ts, (yup, that’s the sort of fucked-up shit that relaxes me.) And secondly, if this doesn’t work, I don’t ever want to look back and think that I didn’t throw everything I had at it.
But that’s just me. It always has been. I’d always rather fail at something — a project, a relationship, a job — having given it my all and known there was nothing more that I could do. Always been frustrated when someone called a halt to something, or didn’t even give a chance to something, when I thought there was still potential…. I don’t know if that’s daring greatly or flogging a dead horse, but it’s just the way I am. And, I guess, fundamentally, there’s only a certain amount of mindfulness and letting go I can do when I’ve spent the best part of 40 years being me.