Fertilized Embryo Transfer

In the morning, Leah is nervous and has to pee.  She's under instructions from FTC to arrive with a full bladder.  A full bladder elevates the uterus into a position where it can be seen through a traditional ultrasound instead of the "wand of knowledge" transvaginal probe.  Lisa, a foxy nurse we've never seen before, leads us in.

I remember the other nurse--Paulette--from the egg retrieval.  She walks us through the "administrative packet."  We nod through the details and remember none of them.  I'm holding Leah's hand and Leah's trying to hold her bladder together.  Paulette and Lisa lead us back into the recovery room where Leah changes into a gown and I'm given a gauzy "bunny suit" and paper slippers to cover my shoes.  I'm sure there's some science behind all of this, but it seems like the most casual nod to the sterile field.  Leah rides a wheelchair into the "scary room." 

That's what Nurse Paulette calls it, anyway.  It's an operating theatre, with an enormous lantern suspended over the bed like the Sword of Damocles.  But the lamp is off and the room is dark as Leah climbs onto the bed.  She winces when she changes position.  The room feels larger than it is because there's only the bed in the center--and the chair next to it I plop myself into next to it.  The surgical supplies and ultrasound machine are pushed against the walls.  There is a door across from the one we entered that I assume leads to the embryology lab we've never seen. 

Nurse Paulette and Nurse Lisa wait with us.  Nurse Lisa stands next to the phone for reasons that are unclear.  While we wait, Paulette and Leah make chit chat.  Leah can lay on her side if it takes some of the pressure off her bladder.  I think that with a young nurse and an old nurse, this is in very many ways the opposite of an exorcism. 

Dr. Tao, the embryologist, comes in.  He speaks quickly and with a thick accent, but the nurses focus on him and their attention draws and narrows Leah's and mine.  Dr. Tao says that one of the good embryos survived the thaw, and the second didn't survive.  They're going to transfer the remaining good embryo, and the fair to good embryo they also thawed.  Dr. Tao sweeps back out of the operating room and into what I'm not pretty sure is the lab. 

Once Dr. Tao leaves, the nurses sing his praises.  They say that he designed the catheter that will be used to transfer the embryos.  They tell us that when the embryos are transferred they'll be between two tiny bubbles that keep them in one place.  Leah rolls to her other side and grunts a little bit. 

Dr. Rychlik takes forever to arrive.  Besides Leah and I, no one is nervous, but everyone else is getting impatient.  The nurse pages Dr. Rychlik over the intercom, and apparently his car has been spotted in the parking lot.  Nurse Paulette puts up the stirrups and Leah places her stockinged feet in them.  Nurse Paulette says that we could have done the procedure three times in the time we've been waiting.  Leah does a horizontal pee-pee dance in the stirrups.  Dr. Tao peeks back in and the nurses ask him to explain how he designed the catheter.  Apparently he only designed the tip and doesn't have much more to say about that.

The procedure takes two minutes.  Dr. Rychlik sweeps in wearing scrubs and rolls the ultrasound machine to Leah's bedside.  The gel should be warm by now, he says.  Dr. Tao quickly follows behind with the catheter and its tip nestled between his fingers. 

On the ultrasound, I see Leah's English-saddle uterus and Dr. Rychlik compliments the quality of the lining that has developed.  The catheter might be a little uncomfortable, and we can see it enter her uterus on the screen.  The embryos show as a bright white oval on the screen.

Leah has to say on the bed for another minute to rest before she gets up.  Nurse Paulette is holding her hand.  The procedure can make a patient hypertensive, she says, but that's not a bad thing.  They also want the uterus to squeeze around the embryos.

"To hug the embryos," I ask.

"That's right," Paulette says.

There's no rest room between the operating room and recovery, so Leah gets dresses again before she can pee.  We walk out into the summer day not quite knowing how to feel.