The Numbers Game

Wouldn’t you know it – all of our trials and tribulations on the path to pregnancy weren’t over yet.  (Remember we’re gay, so adversity and drama is an integral part of life for us.  That’s why gay guys love Judy Garland so much.)  At any rate, our surrogate has a proven track record of fertility and both the nurse and reproductive endocrinologist said that she has a “beautiful uterus” (much to her embarrassment).  I imagine that it’s like a guy being told that he has a beautiful prostate.  (Errr, OK… thank you?)  So our surrogate began hormone injections, which right there earned her my undying gratitude because – seriously – have you seen the size of those injection needles?  #shudder  Even though I’m gay, you’d never catch something that large and sharp near my ass.  I’m just saying.

The first shadow fell with the first lab results, which came in four days after our surrogate’s period started and three days after she started Delestrogen injections.  Her hormone levels were within desired ranges, but there was some fluid build up in her uterus as well.  It turns out that fluid build up is an occasional reaction to hormone injections, and that fluid in the uterine lining is statistically shown to deter pregnancy.  But our endocrinologist had our surrogate continue hormone injections, saying he would monitor the fluid and order an extra ultrasound a week later (hoping fluid levels would go down or at least not rise).  But a week later, even though our surrogate’s hormone levels had continued to progress within target levels, it turned out that the fluid in her uterine lining had also increased.  So our endocrinologist cancelled the cycle and embryo transfer for that month.  I won’t lie – given our history, that was a major blow.  (And not in a good, S&M kind of way.)  Wild reactions ran through my head: it was only 2.3 freaking millimeters of fluid, after all!  But as our endocrinologist explained, given the time and effort that was being put into this endeavor, he wanted conditions to be as perfect as possible.  And although uterine fluid can be drained, it’s usually done when found during embryo transfer and not when detected earlier – because of the risk of disrupting the uterine lining.  Damn him and his impeccable logic!

So the doctor scheduled another cycle for the following month, putting our surrogate on Provera for a few days before her next period.  It was a really bad time for all of us: for my husband and me the big question was whether the uterine fluid would reoccur again.  Because if it did, we were faced with the possibility of needing to be re-matched with a new surrogate.  That thought was almost unbearable, because we were already so emotionally attached to our current surrogate and her husband.  And, to my huge frustration, no one seemed to have any hard data about the statistical probability of uterine fluid occurring two cycles in a row.  Talk about uncertainty!  But it was even harder for our surrogate: she not only felt (needlessly) guilty about letting us down (in her opinion), but her husband had recently developed major health complications.  Despite the problems in her family, however, our surrogate was determined to push forward.  I was incredibly moved by her commitment and determination.  And my husband and I also realized how much integrity she and her husband have, because they certainly didn’t have to tell us about his medical issue.

The next few weeks were obviously the most painful yet in this journey.  To come so close and still have all this uncertainty was just flat out crazy.  This time, the doctor started our surrogate on a lower dosage of Delestrogen, gradually raising her dosage instead of starting off with a full dosage.  And, although it may not seem miraculous to medical professionals, it felt like a miracle to us because it worked.  There was no fluid in her uterine lining this time, and we were full steam ahead to embryo transfer!  Even though our endocrinologist delivered the news with extremely scientific stoicism, I couldn’t stop trembling after his phone call.

So we’re ready to go, with transfer scheduled and travel arrangements for our surrogate and her husband made.  In other words, it was the perfect time for another issue to introduce itself.  We had fourteen fertilized eggs, frozen at the 2PN (two pronuclei) stage – or when sperm and egg combine into one cell – but found out five days before transfer that three didn’t survive the thawing process.  Yikes.  Apparently embryos are not frozen immediately anymore but cultivated for a few days (our egg harvest was three years ago), so the survival rate is better now – but that’s small comfort to us.  And then, at two days before transfer, we were told that two of our embryos were not growing within normal parameters (they should have grown to between four and eight cells by then).  So we’re down to nine out of fourteen original embryos.  Yikes times two.

I have to confess that my masculine pride started to rear it’s ugly troglodyte head about now, because more of the embryos that I had fertilized were dropping than my husband’s.  The thing is that, although my husband is an undoubtably masculine guy,  I secretly view myself as the more “butch” one of the two of us.  And if, by some fluke, only one of us had the testosterone to sire children, my assumption was that my seed would prove to be tougher than his.  I know, I know – I’m a complete idiot and neanderthal, and it’s not a competition.  Now that I’ve mentally processed those reactions, I am once again in the place where biological parentage is not a big deal.

We had a great dinner with our surrogate and her husband the day before the transfer, but the numbers got a little more scary the next day: only two embryos had progressed to the blastocyst stage and were ready for transfer.  Which is actually perfect, because we only want to transfer two – but it’s still unnerving.  So the transfer happened, and our surrogate allowed us to be in the room during the procedure (which began with a disturbing large, phallic shaped ultrasound wand).  We saw our babies magnified on a television monitor and then transferred into the womb where they’ll hopefully grow for the next nine months.  You can call this a sterile and clinical procedure if you want: for us, after over three years of waiting for and working toward this moment, it was a beautiful moment that I will never forget.

A nurse took our surrogate down to our car in a wheelchair a half hour after the procedure and, as we were in the elevator all together, a woman spoke to our surrogate in a nosy way that only senior citizens can get away with.  “What happened to you?”  After only a moment’s pause, our surrogate replied: “I got knocked up by two men.”

The next day we got the final count from the lab: of the fourteen embryos we started with, three ended up growing into blastulae (including the two that were already transferred).  So the remaining embryo is frozen again.  I’m told that the remaining embryo has a 97% percent of survival because it was frozen later in development, but only 21% of the fourteen embryos we started with made it that far.  So the sense of security I had when we had a whopping fourteen embryos is gone now.  And if you’re someone who always has at least one back up plan, this is an unsettling place to be.  We only have one embryo left now – and if we lose either of the two that were already transferred, our plans for two children is seriously compromised.  Especially since we would like our children to have the genetic bond of a biological mother in common.

All this brought me to the realization that life is incredibly precious, in all its rare fragility.  Human life, hell life in general, is a miracle – even if the population of China is exploding.  What I didn’t realize until now was how many failed attempts at pregnancy (intentional or not) there must be out there.  It’s a numbers game.  Which I guess makes for a lot of happy people having sex without getting pregnant.  Roll the dice – I’m hoping for double fatherhood!

Our two little embryo blastocysts

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