I'm all flustered this morning. We are meant to be tracking my endometrium lining and blood hormone levels in preparation for a transfer. The schedule given to us was for a lining check on the 23rd (tomorrow) and 26th (Friday) of September. In my mind, given that I had begun this cycle on the 12th, but had started spotting on the 11th, this struck me as very late to be monitoring a cycle.
Usually on a natural cycle, because you are not using any medication, you have to at least scan in the first week post menstruation to determine if you are accurately on-cycle. This is as versus a medicated FET transfer, where you take a Lucrin shot (or Depo-Provera) to shut down your own ovaries and then use medicines like Progynova and Estrogen to mimic a natural cycle, headed toward an embryo replacement or transfer.
But, I shrugged and followed the schedule, except that when I actually booked the appointment, I did it for a day earlier, on the 22nd.
Then, in setting up the appointment with Dr N, I was frustrated with the nurses, who bluntly told me that my appointment was 9.30am on the 22nd, as requested, but it depended on what time he came in from ward rounds and whether there were procedures that day. I understand that this is how fertility doctors and cycles are — unpredictable, but I thought, really? 9.30am on a Monday morning. But an hour or two wait, possibly. How does any working woman manage that?
I called up the public hospital, where the nurses were much more responsive and polite. They booked me in for the 23rd and 26th. Still, I had a nagging feeling. I wanted the appointment on the 22nd. I wanted to speak with Dr N for a proper consultation.
Looking back, I realized I booked the consultation earlier (Day 11 in the cycle) for one simple reason. I wanted to ovulate naturally and on time, on Day 13 or 14. If you ovulate on time, then scanning on Day 12 gives you a pre-ovulation scan.
Which is precisely why I knew it wouldn't happen. Because I wanted it to happen that way. And if there is anything I've learnt from 3 years of this fcked-up, frustrating-as-hell process, it's that every time you want something badly, it isn't going to happen. If you think it was easy, it's going to be hard. If you have numbers, you don't have quality. If you think you had low-stims, you'll get OHSS (google it).
Still, today was a mess. This past weekend was the Formula One race in Singapore, it is a street race that drags through the city and by the river, which meant that where we worked was a mass of barricades, cranes, grandstands, massive lighting and road blocks. If we had driven straight to my office, which is on the edge of the city, and my husband had taken the train to his office, we would have been there, all fine and well.
But no. For some reason, he decided the day after the race was fine and we should drive directly to his office, so he wouldn't be late. It took almost an hour, for what is normally a 20 minute journey. We were crawling along in traffic that was bumper to bumper, while I sat there, silently fuming at the masculine naivete that enables one to believe the scaffolding that took three months to build could have been removed since after the race ended at 1 am last night.
Finally, we managed to turn out, he walked the rest of the way to his office and I zoomed off to my work meeting over coffee, which I was already running late for. And then, at 9.50am as the meeting was wrapping, the clinic calls.
To tell me that I needed to start out, as I was third in queue and Dr N now had an embryo transfer at 11am, so could I reach there by 10.50am. Seriously? Why didn't they tell us this before? I ran up to the carpark and stood there, to deliberate. I could see the roads outside my office were also slow-moving.
And yet, something drove me on. Something ate away at me, that I had been hot earlier this week, more tired than usual, more emotional, more affectionate than usual. Fine! I got in my car and started to drive and by the time I hit the traffic, my blood pressure was already shooting through the roof.
I rushed all the way there, threw my keys to the expensive hospital valet and ran up the crowded lobby, pausing to empty my bladder on the way in. All I could think was, it's this late and I haven't actually even stepped into the office yet.
Sat at the couch. Waited as patient after patient went in. 10.50am came and went. I was starting to feel upset that I was clearly not going to get a substantial consultation. The nurse had the gall to ask me, do you have a full bladder for the embryo transfer. My nurse. The one who handles my case files.
I. am. not. here. for. an. embryo. transfer.
I am here for a lining check and I have already emptied my bladder, because this is the 100th time I have had a pelvic ultrasound, I silently said out loud in my head.
At 11am I was called in to see the doctor (this is why embryo transfers, by the way, never, never start on time — I've been on the other side of those stirrups, too). The thing about Dr N, when you see him, the whole world lights up. It makes you believe one day, you'll get that baby. One day, he'll actually deliver your baby. But is it worth the heartache of an overcrowded clinic and surly stressed-out nurses? I don't know.
He ran through the results and I can see he put a lot of time and effort into thinking about our experience. And then, the actual lining scan. First, he measured a 9mm follicle.
Then he saw, nothing, on the left ovary. He pressed and prodded and he finally said, I think this is a corpus lutuem. In fact, I see two corpus lutuems. You may already have ovulated, recently.
Riiight.
So I've ovulated two eggs in the last 24 hours and I have a 9mm follicle? Could that be any less conclusive? He sent the scans on to our transfer doctor and ordered an immediate blood test (the only real way to know if you've ovulated) and then another blood test tomorrow, followed by another scan the following day. Cheerful prospect. What this means, in theory, is that if the blood results corroborate the scan, we will have to move up our transfer schedule by at least 4–5 days.
And then he said, you know your lining — which was 9.7, easily within where it needs to be for a transfer in five days — is not trilaminar. It is a bit dense. If it is not perfect, we are not going to transfer. The embryos are very precious.
I was glad to get back in the car. Until I hit the real traffic, trying to get back into the city. I had no idea which roads were blocked and drove around and around in circles on three flyovers and in four barricaded areas, finally winding up nearer to home than the office, then having to drive all the way back in from an alternative route.
It was now halfway through lunchtime. It was taking me close to an hour, to drive the 6 kilometers (as the crow flies) between the clinic and my office, most of that time sitting in dammed up traffic across Chinatown. I had a light day at work, but had to jump into a two-hour corporate management meeting in Chinese right after lunch, of course, one that I was not prepared for. I was wondering to myself if linings grow, or embryos respond to road rage? Would it be fair of me to tell my doctor that half the stress in the entire process came from the creation of his clinic?
It wasn't just the traffic. It was that I was frustrated. I was exhausted. All I wanted was to work through the afternoon till 7.30pm and go for spinning class. Instead, I had spent close to four hours on the roads, in one morning. I was going to have to do this again tomorrow and through daily blood draws that might still end up in no transfer. I was tired, tired of this. Tired of a world so wrong, that I had to do things like this, every fcking month.
This is why it makes me laugh when people ask if I'm travelling for work soon. Or travelling for work, again. I think they don't realize the level of ridiculous that goes into just simple processes like daily scans and blood draws. They don't know you can't be expected to function on some inhuman, or superhuman level, where you could do the same for meeting schedules and flight tickets and hormone cycles and transfers.
