The IVF 2-week wait

Published January 27, 2014 | By Greg Hodgson-Fopp

This is part 3 of my attempt to describe the IVF Process as it applied to us. Part 1 – Before The Magic Happened and Part 2 – Transvaginal Aspirations are to be found earlier up the blog chain.

At this point in the process, I almost feel like it isn’t really my story to tell anymore. The involvement that Matt and I had, and all the decisions we had to make and things we had to arrange were in the past by this stage. Once the process of implantation had occurred, I felt like it became Natasha’s story, and her journey. It almost feels inappropriate me writing about it.

The first Family Photo of the twins

On the day our implant was scheduled, I sent Natasha a long and probably incoherent e-mail letting her know how much we had wished we could be there with her, and to let her know we were thinking of her non-stop and wishing her well. She had her parents there with her on the day, so she wasn’t going into the great unknown alone, for which I was extremely relieved and grateful. After the medical bit had been completed, she was happily out and sending us messages from the car pretty much immediately. As I think I mentioned, we heard from her long before the poor staff at California Fertility Partners had time to write up their reports and scan in the images to send us.

Speaking to her while she was in the car on the way home, she was inspiring. Although she was nervous herself, she actually did a really good job of calming me down. She told me that while she’d always felt nervous about going to the fertility clinic, this time she felt really good about everything and her calmness had a knock-on effect on me as well.

And so once she was home, we began the most nerve wracking part of the whole process. To see if it had worked.

To say we had a lot riding on this was the understatement of the century. We had used 2 of our 4 fertilized embryos. The process and procedure had involved months of hormone injections for Natasha that would have had to be started again, putting her through all of that again to have a second round. And that would also mean Matt and I going through the emotional roller coaster of trying not to get our hopes up, while secretly daring to hope as well.

Home Pregnancy Tests

In normal IVF, where the woman carrying the child is also the egg donor, there are some cross-overs from the egg aspiration medication and the possible results. So there are strict rules about how soon you can use a home pregnancy test before the results are definitively reliable and not a by-product of the injected hormones.

We were having none of that. We told Natasha to test as often as she damn well liked!

The next 5 days were pretty tense for me. Matt and I were chatting to Natasha a lot, and I was over-educating myself on the process as my way of coping. I think it’s fairly safe to say that I now know more about home pregnancy kits than most gay men have any reason to. I was aware of what they test for, how it’s produced, how it occurs naturally in the female body and so forth.

The take-home from my research was that the Home kits test for the presence in the urine of something only a placenta makes.

So – the only reason for this particular hormone to show up in a test is if there is a placenta somewhere attached to that bloodstream or system.

Unfortunately, home pregnancy kits are blunt instruments, and being so, quite imprecise. They are designed to be used once a menstrual period (or two) has been missed. In normal usage, women don’t use home kits until they’ve had some reason or inkling to suspect that they’re pregnant. So the level of detection in these home kits is tuned to that. A home kit is perfect for detecting a pregnancy that has progressed around a month since ovulation. They’re pretty much fool proof at that part, but a lot less so earlier in the process.

We were now hoping they would detect a pregnancy that was technically no more than 5 days progressed, and of course, the additional tension wasn’t making either Matt, Natasha or myself any less forgiving of these uncommunicative chemical testing pens.

Too Faint to Call

My reading convinced me that detecting anything before the 5th day after implantation was scientifically so impossible that it wasn’t worth even getting my hopes up. So I spent a tense and fraught weekend, knowing that even if everything was proceeding perfectly according to Dr. Ringler’s carefully laid plan, there would be no positive home kit test until Monday at the earliest (the 5th day after implantation).

On Monday, while at work, desperately attempting to concentrate on things that suddenly didn’t seem all that urgent, I had a few facebook messages from Natasha. The home kit had changed, but the line it formed was incredibly faint, and so it didn’t really match what the Home kit instructions said was a “positive”.

It was at this point that I was very glad of my extensive reading of the science behind how these kits are manufactured and what they’re testing for. Knowing that they were not designed to be used this early, and knowing they were an extrapolation of how a litmus test works, I knew that a faint line simply meant that the pregnancy hormone was present, just not in as strong a concentration as the test was designed to look for.

The only way that hormone gets into the urine for the test to pick up, is if it’s made it into the bloodstream. To make it into the bloodstream, considering it’s made in a placenta, means that one (or, as we know now, two) of the blastocysts had hatched from their shell, floated over to the uterine wall and embedded. At that point the placenta dips it’s little microscopic tendrils into the wall of the uterus to borrow it’s food and nutrients from the bloodstream (and in doing that, pass on it’s pregnancy hormone, which triggered changes in Natasha’s body as well).

So even a tiny, faint line at 5 days was reason to hope.

I started smiling inanely at this stage. Which was incredibly annoying to everyone around me. It was also annoying to me, because if you think it’s early to tell people when we did at 9 weeks, you really, really don’t tell people that you might be having children when you’re at the 5 day mark. That tiny little line lifted my mood and broke the back of some of the built-up tension that I had been feeling that I hadn’t even realized was there.

In years to come, when making embarrassing speeches at their weddings or birthdays, I will be able to genuinely say that from that first faint line on a litmus test I was lifted up knowing they were on their way into the world.

Repeated, still faint

On day 6, Natasha repeated the test and the test result was pretty much the same. A faint line, not as strong as the instructions said to look for. We had all secretly been hoping that within 24 hours that faint line would have become a super strong dark line, and so everyone was pretty tense for this 24-48 hour period.

On that day, despite the science telling me not to panic yet, and that still “Any Reading is a good sign”, I was tense and irritable. I couldn’t really focus on what I was doing, and I was prone to drifting off into my own thoughts. I was useless at work, unable to stay on the treadmill at the gym, and constantly checking my phone to see if there were any messages or updates. Hormones staying the same level would not have been a good sign, but the home kits just aren’t designed for the kind of precision that would be needed to detect a change between day 5 and day 6.

So while I had no reason to think anything was wrong, I also had no reason to think things were going right. It was a thoroughly unpleasant 24 hours to say the least. Chatting to Matt and Natasha helped a lot. I did feel like the three of us were in a sort of holding pattern for those 2 days. I know Natasha was talking to her sister at the same time (who has a medical background) and we all just tried to get through the day.

The 7th Day

On the morning of the 7th day after implant (there is a shorthand for this in use in the IVF community, but I’ll spare you), the morning test that Natasha did came back very strong positive. I think you could hear the collective sigh of relief of all three of us in three different time-zones. At that point, we could be pretty sure that at least one implant was successfully attached to the uterine wall, and was happily slurping away at Natasha’s poor bloodstream for it’s nutrients, while feeding her some of the hormones it makes to bring about changes in her body to suit it’s needs. Which, when you put it like that, does sound a little creepy.

It was at this stage that I think I told Natasha that I had an inkling it was twins for the first time. Matt and I had been discussing the possibility since the very beginning, but since there was no basis in thinking it was anything more than me projecting my fears, I hadn’t mentioned it to Natasha. We let her in on the fact that we’d registered a domain “The T-Word” which we were going to use if it turned out to be twins. I think it’s quite telling that we didn’t bother to think of a name we would call the blog if we just had one baby. Maybe “Who’s The Daddy?” (I suspect that might be taken).

We decided we couldn’t wait until the scheduled appointment to confirm pregnancy and so a few arrangements were made and Natasha was able to go in and get a blood test earlier. Withing another 24 hours, the blood test had confirmed what we suspected, she was definitely, provably pregnant.

High Levels means… what?

I might have mentioned a couple of times so far – the hormone being detected by all these tests is produced by the placenta. We could tell from Natasha’s very first blood tests, and the fact that she was reading positive on home-kits a few days before she really should have been, that her levels were higher than expected.

At this point, the science on the internet failed me a bit. The levels of “normal” that are acceptable for this particular hormone are really wide. You can have crazy-high levels and it’s perfectly normal. You can also have really low levels and it’s also still perfectly normal. Every woman and every baby is different and the OK ranges were very wide (like “300-2400″) for the stage of progression.

There was no real reason to suspect twins, but still, I was deeply suspicious.

To me, the most logical conclusion for really high levels of a hormone in the bloodstream being produced by a placenta was… two placentas.

This was further reinforced by the follow-up blood-tests. They were also off the scale towards the high end. By the time of the second blood-tests, I had pretty much convinced myself that we were having twins already, which is why it didn’t really come as a surprise when we later found out.

The utmost respect for those undergoing IVF

Now that we’ve been through the process and we’re comfortably sailing towards our birth date, I wanted to stop and say how much respect I have for those other couples who have been through IVF. I think this is one of those things that you don’t and cannot understand until you do it. The stakes are so high, there are so many unknowns still, and the human psyche is fundamentally geared to want this so badly, that there can be no roller-coaster which is rockier. The highs are higher, the lows are lower and there is no getting off once you let yourself start to hope you might have children.

For us, with the science we invoked, and the situations created we had the numbers and good chances of success. I can only imagine how much worse it must be for people trying to conceive late in life, or with a situation where their bodies place impediments on the process.

Before we went through it, I never really understood how invested I would get in the success or failure of the process.

If this is some inkling of what parenthood is like, then I’m in for an emotional ride.

What next?

Now that the last two busy weekends are out of the way, next post I intend to start answering some of the other big questions people ask me. Like “What the F–k were you thinking?”, “How do you find a surrogate?”, “How do you choose an egg donor?” and of course – “Who’s the Daddy?”