I’ve been a little quiet this week, but today I’m happy to
share an update about our gestational carrier journey. It’s been a week
(plus?!) of appointments, questions, flexibility, and changes to the original
plan. With the blessing of our carrier, I’m sharing a bit about what we’ve been
up to!
Initially, we planned to do our first frozen embryo transfer
to our carrier on Wednesday, June 5. In preparation for the frozen embryo
transfer, our gestational carrier took estrogen and had a monitoring
appointment to make sure her body was responding to the medications
appropriately. (Well, appropriately for a frozen cycle and per the clinic’s
guidelines – remember, every woman’s body is different and what is appropriate
for one might not be for another!)
After nearly two weeks of twice daily estrogen pills, our
gestational carrier made the trip to our clinic to meet me for our monitoring appointment
on May 29. At that appointment, our doctor was looking for a thick uterine
lining (more than 7 mm), no fluid in the uterus, no ovulation, and no structural
abnormalities (like a cyst). Structurally everything looked sound, but there
was a bit of fluid in the uterus at that first appointment and the lining wasn’t
as thick as my doctor would like. After reviewing the blood work on our
carrier, our doctor upped her estrogen dosage substantially to try to build the lining and asked her to come back
in 48 hours - which she graciously agreed to do.
48 hours later, we met for the second monitoring
appointment. The fluid in the uterus was gone (YES!), but the lining was
actually a bit thinner than it was at the first appointment. We discussed our
options, and we all agreed to delay the transfer and have our carrier continue
with the increased estrogen protocol for five more days with a recheck on the
day of our originally scheduled transfer (June 5).
On June 5, we met at the clinic again, and our carrier had
another scan and blood draw. The lining was a bit thicker, but it was still not
up to the minimum required by the clinic for a transfer. At this point, we had some
decisions to make. One option was to scrap the cycle - which would mean having
the carrier stop her medications and wait for her period to start a new round of
estrogen in an attempt to thicken the lining the next month. Another option was
to convert the cycle to a testing cycle, and complete an ERA (endometrial
receptivity assay) to test for uterine receptivity to receiving an embryo. We
decided that rather than “waste” the medications our carrier had so graciously
been administering, we would move forward with a test cycle.
The test cycle means that we will go back to the clinic and
the carrier will have a uterine biopsy in the next several days. It also means
that in addition to her estrogen protocol she is starting progesterone shots. The test cycle requires us to do everything
exactly as we would as if we were having an embryo transfer, but instead of the
transfer she will have a biopsy. The biopsy test result is timed (literally to
the hour) to correspond with her first progesterone shot, and the result should
tell us if she is “receptive, pro-receptive, or post-receptive” to receiving an
embryo during that time window. I’ll do another more in-depth post on the ERA
testing in the future, but for now know that our carrier is a trooper!
We are all feeling glad to use the cycle to gain a little
more insight into the best time for an embryo transfer. The delay does mean a little
more uncertainty about timing and when we will move forward, but for now the
risk averse side of me (and of our carrier) is focusing on the fact that we
will all feel more comfortable with a transfer once we have the information
from the test.
Thanks for the continued support. We've felt so much love from so many this week who knew the exact transfer day that we had planned. Though we didn't move forward with the transfer, we appreciate all of the prayers and well wishes, and we hope you will share them with us and our carrier again in the coming weeks for the biopsy, results, and (hopefully!) transfer!
Thanks for the continued support. We've felt so much love from so many this week who knew the exact transfer day that we had planned. Though we didn't move forward with the transfer, we appreciate all of the prayers and well wishes, and we hope you will share them with us and our carrier again in the coming weeks for the biopsy, results, and (hopefully!) transfer!
