October 26, 2012

B. had her first ultrasound today. I got a text from her a couple hours ago saying that the doctor heard a heartbeat! That means the pregnancy is now considered “viable”. We’ll still probably wait to tell most people until the end of the first trimester, but we may begin to increase the number of people that know.

Also, the doctor only mentioned one heartbeat. B. didn’t ask about that distinction, but I’m sure the doctor would have said something if he or she had heard two heartbeats. I consider that to be good news! It’s possible that both hearts were beating at the same time, and the doctor will check again in a few weeks, but it seems likely that there is only one baby.

B. still has to drive two hours to get to a local IVF clinic for these appointments. I hope that soon she can start going to her OBGYN in the city where she lives. I also hope this means that future appointments will be covered by the additional insurance policy we bought.

October 25, 2012

I discovered an interesting fact today that I had missed in my 34 years: When a woman says she is 8-weeks pregnant, that is the time since her last period. It is not the time since conception.

Two weeks ago, I signed up for an online service that sends you updates on your child’s development in the womb. Two weeks ago, our embryo was the size of a poppy seed; last week he or she was the size of a sesame seed. (I’m looking at bagels differently these days.) This week, our baby is the size of a lentil and I literally found that out while eating leftover lentil soup. In the future I’m not going to open those emails while eating lunch, at least until the baby grows to be too big to fit in my lunch bag.

But I realized there was a problem when I entered our due date (we don’t have an official due date yet, but I counted nine months from fertilization). The website kept telling me that we were two weeks further along than I thought. At first I manipulated the due date so that the development chart showed the right number of weeks, but then the due date was way too early.

So, I Googled it. “How do you determine how far along your pregnancy is?” I asked. Every response detailed the fact disclosed above. Of course, that’s not relevant to our situation. B. has been on ovulation suppression drugs for months.

I should have started with the IVF sites because I finally found that a good rule of thumb to convert an IVF pregnancy’s development (in terms of weeks pregnant) to the scale normally used is to add two weeks to the date of conception.

So we’re six weeks into this thing and not four, like I thought. That means that the ultrasound B. is having tomorrow will determine the viability of the pregnancy; we don’t have to wait another two weeks. That makes me both more excited and more nervous.

October 16, 2012

To keep myself from worrying too much about our embryo gestating over a thousand miles away, I went on a mission today to calculate its chances of survival. (I know that may sound grim to some, but I respond well to statistics; unlike Han Solo, I need to know the odds.)

It is true that we have passed the largest hurdle – successful implantation of the blastocyst on the uterine wall. The chance of a failed IVF cycle was 20%. Since a blood test confirmed the pregnancy last week, the chance of miscarriage has fallen to 10%.

As previously mentioned, the pregnancy isn’t considered “viable” until 6-weeks after fertilization. If we make it past that stage, chance of miscarriage will fall to 2.5%. We probably won’t announce the pregnancy to the general population until after the first trimester. At that time, the chance of miscarriage or still-birth will have fallen to 1%.

I’m generally reassured by these odds. I’ll feel a lot better in three weeks, though.

(The source for these statistics was www.americanpregnancy.org and www.pregnancycharts.org . I tried to take into account B.’s age and the fact that she has had successful pregnancies, with no history of miscarriage.)

October 12, 2012

It’s official. B. is pregnant with our baby. We are expectant (not just intended) fathers.

I got the call from the IVF clinic yesterday. I was at my department’s annual “End of Audit” party (I work for a non-profit and we are audited every year). I checked my phone just before I sat down for dinner and saw that I had a missed call from the IVF clinic.

I left my drink and my coat at the dinner table and ran (as casually as possible) outside. I tried calling the clinic and got a “This number is no longer in service” message. (I don’t know what that was about. Can a business have an outgoing-calls-only line?) I hung up and didn’t know what to do. I didn’t want to go back into the party without knowing what the clinic had to tell me.

I decided to stay outside for five minutes and wait for them to call back. I thought they also might have tried our home phone, in which case they would have gotten a hold of Alberto. But in less than a minute they called again.

The nurse on the other end of the phone played it cool, like an American Idol judge telling a contestant he’s made the Top Twelve. She had a somber tone as if she was going to deliver bad news. But she got to the point faster than Randy Jackson. She started talking more quickly and raised her vocal pitch until she finally said, “B. is pregnant!”

I resisted the urge to shout or cry or whoop out there in front of the restaurant (I may have performed a little hoping dance) but obviously I was excited. I may have said that over and over to the clinician on the line. I got all the relevant details from her and then called Alberto with the news. It's cliche to say that we "breathed a sigh of relief", but that is what we actually, audibly did.

Now, it’s not like we can quit worrying. Realistically, I probably won’t quit worrying for the rest of my life about this child. The pregnancy isn’t considered “viable” until six weeks has passed from the day of conception. But we’ve cleared the biggest hurdle in the process. As time goes on, the risk of miscarriage will rapidly decrease.

The next milestone is in three weeks when an ultrasound can detect a heartbeat. Keep us in your prayers!

October 11, 2012

I’m at work, but I’m barely getting anything done. I got up from my desk a couple of minutes ago to walk around outside for a while. I can’t shake the feeling of suspense. This is much more nerve wracking than a job interview.

B. went to her local clinic this morning to have a blood test that will end our Two Week Wait. Either we will be pregnant or we will have to start the process over again. She will need to have hormone injections for two months and then we will travel to the IVF clinic in December for Round Two. Besides the delay, Round Two costs $10,000.

Please let her be pregnant.

We had a little bit of good news last week. B. texted us during the day on Saturday to say that she had taken a home pregnancy test. The results were positive, but the pink line she was looking for was very faint. I have no idea whether that indicates uncertainty about the outcome of the test, how soon after implantation she was taking the test, or some other hormonal glitch caused by the embryo transfer. The IVF nurse told us that there are a higher number of false positives with IVF and we need to wait until the blood test.

So we’re trying not to get our hopes up too much.

I thought that we would have heard by now. I thought that the lab that did the testing would do it in-house and that it wouldn’t take very long. I know B. has concluded her appointment because the charge has already shown up on our credit card.

I’m trying to remain calm, but it’s not working. I know we will hear soon. Just a few hours more.

October 2, 2012


Possibly (hopefully) the first picture of our child(ren).

October 1, 2012

We are at the beginning of the famous “Two Week Wait”. That’s the term the fertility blogosphere uses to describe the period between an embryo transfer and the blood test that confirms pregnancy. Most couples confronting the two week wait face worse odds than we face. Infertile couples that seek out IVF often have underlying factors that don’t apply to an egg donor and gestational carrier with demonstrated fertility and a biological father with sperm that has been tested and is presumed effective. But that doesn’t mean we’re not going to be stressed out for these two weeks.

On Friday, we traveled to the IVF clinic so that we could be present for the transfer. Our attendance wasn’t required – I’d already performed my end of the deal – but we wanted to be there to see B. again in person and for moral support. We didn’t realize we would also be able to watch the procedure.

B. arrived just after we did. She didn’t even have time to tell us about her trip before the nurse entered the waiting room and called her name. As B. got up, the nurse looked past her to us. “Are you Jonathan and his partner?”

We looked around to see who she was talking to.

“This is Philip and Alberto,” B. said.

“Oh, okay,” the nurse said. “Come with me.”

We followed her to a consultation room, but I was thinking, Who the hell is Jonathan? These people better not transfer Jonathan’s embryos into our carrier.

The nurse left us in the consultation room and went to get some paperwork. B. told us about her drive. She came with her boyfriend and their two kids, who were waiting back at the hotel. They were able to spend the previous day in New York City and they had a good time.

When the nurse returned, she held out a clipboard and asked, “So which one of you is Jonathan?”

Honey, there is no Jonathan. Go find the paperwork for Philip and Alberto.

Before we could say anything, she checked the clipboard again. “I’m sorry, Philip, which one is Philip?”

I raised my hand and took the clipboard. She gave paperwork to B. as well. “Are you two going to be present for the transfer?”

We turned to B. The nurse assured her that it would be modest. We would remain above the neck and watch the procedure on the ultrasound. The whole process would take about five minutes. B. said she felt comfortable with us being in the room.

The nurse gave B. some instructions regarding medication and behavior following the transfer. B. was going to need to take it easy for the next 48 hours, not walking very far or lifting more than 15 pounds. She was not to swim or even take a bath (showering would be fine). Then for the next two weeks she shouldn’t exercise, but other than that her life could go back to normal. I want to assume “normal” means strictly healthy behaviors and an excessive concern for safety.

The nurse left the room to get us the sterile garments we would have to wear over our clothes while in the operating room. Very soon after that, the doctor came in with pictures of the two embryos he would transfer. Most people have to wait for an ultrasound to have the first picture of their baby, but we have pictures of our child(ren) when they were only 8 cells big.

The doctor asked B. how she was feeling and she said she was a little nervous. The doctor assured her that the procedure would be completely painless, but I don’t think she was concerned about pain. I think she was thinking about her responsibilities that were about to begin. Until that point, her obligations were to give herself daily injections of hormones, drive to the monitoring clinic once a week and speak to us on Skype. If the transfer worked, she would now be responsible for a human life.

The nurse returned with hairnets, shoe covers and a gauzy apron for Alberto and me to wear and took B. to a separate room to change into her hospital-type gown. We were given approximately 30 seconds to put on those items before another nurse appeared and hustled us out of the consultation room.

The operating room (do you still call it that if there’s no scalpel involved?) looked like a standard office in a depressing office park – drop ceilings, harsh lighting, beige walls, bland art. The exception was the gurney and stirrups in the middle of the room with an old-looking monitor attached to it. A frenetic Paul Simon song was blaring from hidden speakers. Alberto said the song reminded him of the bakery where he worked during college.

A different nurse entered with B. and got her situated on the gurney. She asked B. again how she was feeling. B. said she was fine, but looked more nervous than before. Alberto and I sat behind her and focused our attention elsewhere as they put her legs in stirrups and shined a spotlight beneath the sheet that covered her. I didn’t blame B. for feeling uncomfortable and thought that maybe it would have been better if we had waited somewhere else.

But then the nurse switched on the monitor and put the ultrasound wand up against B.’s belly. As the white lines that signified her womb appeared on the screen I realized that I was about to witness something profound. Not the moment of conception, that had already happened. I'm not even sure what to call it, but certainly it’s a milestone in the life of my child. A different kind of starting point.

The doctor came in and again asked B. how she was doing. He again assured her that the process would be painless, missing the point. He asked for something more calming to be put on the radio and the nurse switched on some dramatic classical music. It was the sort of soundtrack you would expect to hear as the Starship Enterprise soars through space.

The doctor set about doing something beneath the sheet that I ignored, concentrating on the monitor. After two minutes, a door opened in the back of the room and a woman came through holding a catheter. “B., Alberto and Philip,” she announced. The doctor nodded and she handed him the catheter. I was glad nobody mentioned Jonathan.

After handing the catheter containing the embryos to the doctor, the woman disappeared through the door again, her participation in this task apparently complete. I cynically wondered how much we had just paid for the woman to carry the embryos from the lab to the operating room and how one gets that job. Is the main requirement that you can walk without tripping over your own feet? (I’m imagining a Mr. Bean episode where Rowan Atkinson is hired in this capacity and hilarity ensues as he stumbles about accidentally impregnating things.)

We returned our attention to the monitor as the doctor guided the embryos to their resting place. On the ultrasound monitor, the tip of the catheter looked like a bright, white speck of light moving through the darkness. I’m not sure if the catheter had an actual light at its tip – wouldn’t that burn the embryos – or if it was some kind of material designed to show up as a light on the ultra sound. The doctor watched the monitor as he maneuvered the embryos into place in the upper third of the uterus. I don’t know how he picked the place where he finally set them down, perhaps it had good feng shui, but again, the whole process took less than two minutes.

Then he removed the catheter, switched off the spotlight and they wheeled B. out of the room. The doctor shook our hands and wished us good luck. The nurse led us to the recovery room where B. would have to wait for an hour before she could get out of the bed.

We waited with her in the recovery room and finally got to spend some quality time with her. She said that she had lain awake the night before thinking about how this could change all of our lives. I admitted that I wasn’t even thinking about that. I had been up worrying about whether the procedure would be successful.

And that’s still where I am. I think I’ve already done the thinking about how much my life will change when the child is born. For the time being, I’m spending all of my worrying just hoping we get good news in two weeks. It’s going to be a long wait.