So you have created the embryos and you’re ready to put them back into your uterus. This is a surprisingly simple process but you have some choices to make.
Oh, and did you think you were done with medications? Hahahahahaha.
You might have the choice between a “fresh” IVF cycle — meaning, they don’t freeze your embryos before transferring back into you, so they pop one back in six days after surgery (something I cannot fathom) — and a frozen IVF cycle. Almost every clinic does frozen cycles because it allows you time to do genetic testing and with modern technology, fresh and frozen cycles have the same success rate. A fresh cycle wasn’t even given as an option for me and honestly my uterus and surrounding environs felt awful after my egg retrieval so I can’t imagine transferring an embryo back in so soon.
If you freeze your embryos, you can pretty much transfer whenever you want. I chose to do my first available cycle, which started about a month and a half after my egg retrieval.
For the transfer, you might have the choice between a “medicated” IVF cycle or a “natural” IVF cycle, which essentially translates to, do you want to stick yourself with needles some more or do you want to do vaginal suppositories instead. My doctor said they have a fairly equal success rate, and I definitely understand the immediate jump to be done with needles, but here are some things to consider that might make you choose medicated (needles):
Do you need to do the transfer on an exact date?
Do you want to be 100% sure you see your specific doctor?
Does your vagina get irritated easily with creams?
Are you hesitant to “leak” twice a day when the suppository comes out and do you have underwear you don’t care about?
Is having sex or oral sex throughout this process important to you? (See: leakage)
On the other hand, if you travel often, it may be easier to get suppositories through airport security than needles and vials.
With all things equal, I will generally choose the “not sticking myself with needles” route, so I went with a natural cycle. However, I’m not sure I made the right choice. I really didn’t have trouble with needles and the suppositories are quite frankly, gross (I luckily did not have any irritation which a lot of people report).
Since embryo transfer means a new set of medications, that means another round of “Thank God I have insurance” for the suppositories and trigger shot.
$2,131 - How much Freedom billed my insurance
$1,355 - Self-pay price
$55 - How much I had to actually pay
Is it sad that this actually seemed kind of cheap after all the other costs?
Which embryo do I transfer?
When I received the genetic testing results, there was big bold text in the email — DO NOT OPEN IF YOU DO NOT WANT TO KNOW THE GENDER. So, I believe you can just tell your clinic to transfer the healthiest embryo and be done with it, or you can choose to transfer a particular sex.
As a control freak, I obviously chose the second option. A lot of people have asked me how I made this choice, so although it is an intensely personal decision, I will share my process.
I think, if I were trying to conceive naturally with another person, I would have wanted a girl. However, when I was looking at quality of life for my child, it seemed clear that men currently have a lot of advantages in this world — and why wouldn’t I want to make life easier for my child? Men get paid more, men are less often the victims of sexual assault, domestic violence, and eating disorders, the government has fewer laws regulating men’s bodies, etc. The challenge I will have in raising a boy is to make him not an asshole, and I feel fairly confident in my ability to do that.
(That said — while I made this particular choice, I will fully support however my child turns out to be in terms of sexuality/gender identity, etc.)
Also, at the risk of sounding like a crazy person (although I know at least one other single mom who felt this way), when I got the genetic testing results back, there was an embryo I felt a special connection to. I knew that was my child.
That’s all nice but please tell me about the transfer
The transfer itself is super easy but first you have to do some prep work on your uterine lining so it is nice and thick to receive the embryo.
On day two of my period, I had to go in for an ultrasound and blood draw to check my levels. They also did a saline ultrasound to double check that everything was okay with my uterus and a mock transfer to see how I’d tolerate the procedure (I didn’t even know they did this until I read my appointment notes).
I was put on Femara/Letrozole for a few days and had to do Menopur inserts (vaginal suppositories of progesterone) twice a day. I also had to do another trigger shot (but a different one — Ovidrel) to induce ovulation. I had one appointment to make sure everything was going according to plan and then we did the embryo transfer five days after ovulation (remember that the embryos are frozen at five or six days old!).
So, the embryo transfer. It was nothing — very similar to an IUI. I had to go into the surgery portion of my clinic, but I didn’t take pain meds or anything. It’s literally just putting the embryo in a catheter, transferring it into your uterus, and then checking the catheter to make sure it went in. I’ve heard some clinics will let you watch the transfer on a screen, sadly I did not get to see the magic happen.
My favorite part about the procedure was immediately after when my doctor told me, “Congratulations, you’re now three weeks pregnant.” Actual picture of my face at that moment: 😳
And the rest is history
Two weeks after my transfer, I was scheduled for a blood test to confirm the pregnancy. I had lunch with my mom that day and she said I was insane for not taking an at-home test before the official test, but I figured it wouldn’t show up as positive. Late that night, around 12:30 a.m., I realized I had one at-home test left so I figured, what the hell, and took it. It was positive!
Honestly my reaction at the time wasn’t excitement or happiness — it was, “Oh my God.” I’d been so focused on completing all the steps that I had kind of lost sight of what this was all for. Seeing the positive pregnancy test was a big shock, and I had a little mini-spiral about my future with a child. Unfortunately, since it was 12:30 a.m., none of my friends were awake at that time to share the news with and I had a very sleepless night.
The official test confirmed the news the next day, and approximately 37 long weeks later I gave birth (I honestly didn’t believe I actually had a baby until he was about 8 weeks old). That’s where I’ll end this journey for now. I think there are enough blogs out there about pregnancy (it sucks) and motherhood (tbd but probably sucks) — I just wanted to talk about my specific experience of trying to get pregnant as a single woman.
(Also, if you are a sarcastic person like me and want a book about the realities of pregnancy that does not mention the word “miracle,” check out There’s No Manual by the founder of Reductress.)
I’ll leave you with one final note: While I hope my writing about this has been helpful to you, publishing it has also been immensely helpful to me. I didn’t tell anyone about my IUIs, but once I moved to IVF I started talking publicly about my “journey,” and I’m so glad I did. While I didn’t find anyone who went my exact path, I was able to connect with people who froze their eggs, who underwent IVF, who had a baby with IUI, who struggled with infertility — and they all made me feel less alone and more comfortable about the process. (One group in particular I can personally recommend is Resolve, an infertility support group.) There’s a world of help available out there if you ask for it — something you will learn soon enough as a new parent.
I’m obviously happy to talk about this or connect with anyone else going on a similar journey! Feel free to get in touch on the contact page.