No food or drink after 9pm tonight

I read something recently which said that in order to be A Good Blogger, you can’t treat your blog like a personal diary. You have to ~ask questions~ and ~draw your audience in~

I’m sure that’s sound advice, but I have seen so many generic Five Reasons Why You Should Never Do A, B or C and How Can You Make Your Noun Verb Harder/Better/Faster/Stronger? posts out there that I think I’ll stick to my diary-style blogging for now. Hello, reader!

This week has seen a lot of going back and forth to the clinic for injections. Every morning I dutifully took my Letrozole and then every other day a stab in the arm to try to boost the number of follicles that will theoretically produce an egg. Initially I wasn’t sure if it was the post-covid-booster period being worse than usual or a side effect of the medication, but given that my uterus still feels uncomfortable and I have low-grade cramps almost all the time, I think I’m going to say it’s the meds. On Wednesday (yesterday) I went back to the clinic for a consultation/checkup where they did another ultrasound, another blood test, and I had a chat with the nurse before seeing the doctor.

“Do you think you’ll be wanting a general anaesthetic for retrieval this time?” she asked.

I hesitated. It wasn’t an option last time, and I had almost forgotten that it was possible this time round. I absolutely hated egg retrieval. For me, last time, that experience was worse than giving birth. It was so traumatic. I still have flashbacks, and I have honestly been dreading it ever since we decided to go through IVF again, especially with the knowledge that my ovaries are too useless to produce many eggs. There’s no way the risk of general anaesthetic is worth it for maybe one egg, maybe none… right? But the thought of going through that procedure, but then getting no eggs, and having to go through it again if we wanted to try to push for stimulation a second time…

She flipped through my chart. “From the ultrasound, at least, it does look like there are more developing follicles than last time,” she said.

Still, I am not getting my hopes up: last time it seemed as though there were several follicles but actually some were empty/contained no eggs. If I were to go under a general anaesthetic, how much longer would it take? How much more would it cost?

A couple of hours extra, and about ¥10,000 more. That’s much less expensive than I was imagining. A lot less. And you say I’d still be able to go home around lunchtime? Hmm.

Do you know what egg retrieval entails, my friends? Skip this paragraph if you are at all squeamish. The doctor places a device with a needle inside your vagina, through the vagina wall and into the ovaries. They check its location using ultrasound, and once it’s inside the ovary the needle pierces each follicle and sucks out the fluid inside, including the eggs. I had a local kind of anaesthetic last time and it did not stop the pain. It hurt, very deep inside. And of course, you can’t move, because that makes things a whole lot worse! so you’re just lying flat on your back on a big operating table with your legs spread out, trying to bear it for the few minutes that it takes. It really does only take about five minutes, maybe as many as ten if you have tons of eggs (not that I’d know!) but although it takes comparatively little time, almost three years on the memory of it is still very fresh in my head. I clung on to the nurse’s hand the whole time, with tears flowing freely from my eyes and into my hair (and ears, yuck). It hurt for days afterwards. Other people have different tolerance levels for different things! I will readily have another natural birth without any painkillers! But egg retrieval is my line, my limit.

So yes, okay, yes, knock me out. I know it’s higher risk – I’ve had a general anaesthetic 7 times in my life so far! – but I can’t be awake for that part again.

Well then! With that decided, I spoke with the doctor – mostly just discussing times and schedules, and he gave me the results of the various tests they’d had done. Once that was clear, it was back to the nurse for another injection, and time to receive the medicine that I would need to take home and give myself that night.

Thing The First was a self-administered subcutaneous injection, to be done at exactly 9pm. Any later, any earlier, and it would mess up the timing for egg retrieval – this is called a “trigger shot” because it boosts the maturing eggs in their follicles, a last spurt – as it were – to encourage as many as possible to be ready to be vacuumed up on Friday morning. I’d done this last time too, so it was familiar. 9pm marked T minus 36 hours.

Thing The Second was a nasal spray, which was new to me! We hadn’t used it previously. Luckily, squirting stuff up my nose was much easier than stabbing myself in the stomach. One spray in each nostril, at 9pm and then at 10pm, so four pumps in total. Okay. That part is also done.

The nurse also gave me a letter of agreement to sign, which involved reading 30-odd pages of a .pdf document stored on the clinic website all about the IVF process, the risks involved, the success rates, the storage options, and so on. I thought it was quite funny to be given a fancy booklet in English on how to administer the injection but then suddenly a whole long document full of kanji – surely, if you expect me to read this one then I can probably also read the other in Japanese too! Still, no problems, document signed and ready, used needle in the little sharps box they provided, nasal spray stored in the fridge for up to a year just in case we ever end up needing it again…

The final two things I received were a sample pot for my husband’s ~sample~ which needs to be provided/collected on Friday morning (“Any time after 5am!” said the nurse. “If it’s against your skin it’ll be the right temperature!”) and a bottle of special oral rehydration drink to be consumed between 9pm on Thursday (tonight!) and 6am Friday (tomorrow!) morning. A lot to take home; my bag wasn’t quite big enough. Another expensive visit.

For the last few days I’ve been wobbling between anxiousness, bitterness, and numbness. Anxious, because what if there aren’t any eggs after all? What if the eggs are no good? What if something goes wrong? I’m 35 in May and while I know it’s not the end of the world, the likelihood of successfully getting pregnant and carrying a child to term drops dramatically from 36-40, even without underlying issues.

And then bitterness, because all of this, all of these appointments and scheduling with my husband, and the money just to have the chance at having a baby while some people really do just screw once and bam, pregnant. Oh, despite knowing logically that there are plenty of people out there in infinitely worse circumstances it’s very, very hard not to feel bitter. It’s nobody’s fault, but I hate it anyway.

And then numb, again, falling back on the practical. If there are eggs, will any be fertilised? If any are fertilised, will they start to grow? If they start to grow, will one stick? If one sticks, will I be able to keep it? And you look too long at any statistics and oh, oh, it’s hopeless. It’s impossible. We’ll never have another baby. Our daughter was a miracle, too miraculous, we won’t possibly be that lucky again. Surely.

Today has gone on forever. The waiting is endless! Hurry up and be tomorrow!