So how does it feel to go back to the fertility clinic?

Mostly, it feels too far away to worry about. I haven't yet been reunited with the phlebotomy table* or the ultrasound room. I don't have a calendar of events. (I haven't actually had a period for over two months**.) Nevertheless, I am struck by one, particular feeling: a vaguely sinking one.

I thought we had two decent blasts from the last cycle, and I thought they were frozen individually, which would have given us more and better-looking options. We don't, and they're not - they're ok-to-freeze-but-not-waste-a-whole-two-straws-on blasts. And suddenly, I remember: everything has to be just a little bit harder than it should be.

It's never the end of the world, or at least it hasn't been for us***, so far, but it's never quite as good as you'd like it.

You never ovulate on time.

Your protocol doesn't yield the ideal number of eggs.

Or if it does, fully half those eggs aren't mature enough to ICSI.

And of the others, nearly half don't fertilise, or don't grow.

And you lose a couple more in the freezing.

And your thaw rate is below average, nevermind optimal.

And you get horribly sick during your luteal phase, which is a bit spotty.

And your beta isn't great, and it doesn't double well.

And your ultrasound - if you get there - is measuring behind dates.

And along the way, you get just about every unpleasant side effect, and at least three minor procedural complications.

Just a little bit harder. Just not quite as smooth. And with each step, you have to ratchet down your expectations just one more notch. Just one more notch. If you're not careful, it's the slow road to abject despair.

Nealy three years ago, I quipped that if I started titling my posts Just A Little Bit Harder Than It Should Be, pretty soon nobody would be able to tell one from the other. Then I went on to have a cycle where I couldn't collect the drugs when and where I'd planned, couldn't get plane tickets on the dates I needed, didn't ovulate on time, didn't have a good percentage of mature eggs, didn't get the expected number of decent embryos, got struck down by a horrible case of diarrhoea during a spotty luteal phase, had a marginally ok beta with a poor doubling time and embryos measuring several days behind on ultrasound, had a spotty first trimester, and lost one twin, after we'd seen the heartbeat. Just a little bit harder than it should have been. But ultimately (I try to reassure myself, desperately, over and over) every bit as successful as we wanted.

How does it feel to go back to the clinic? In a word, it feels deflating.

But I suppose we'll just have to wait and see.

*I always had to lie down.

**I'm toying with the idea that maybe my cycle is in a spin because I weaned the Prata Baby. I had been perfectly regular for twelve months until I did that, then all of a sudden... nothing. I know breastfeeding is supposed to suppress fertility and weaning should reinstate it, but this zag-not-zig is just the sort of malarkey my reproductive system likes to pull.

Or maybe it's the decreasing daylength after all.

***Although it has been the end of the world for a number of our embryos, at various stages of development.

I've been asked how it felt to go back, and I'll get to that, but I need to write this post first, for reasons which will eventually become obvious, if you're prepared to hang around that long. It's about taking kids to the clinic.

Before PB came along, my opinion was that parents should make reasonable efforts to avoid bringing their kids to fertility clinics. I always went on to say, however, that I understood that sometimes these things just have to happen, and that probably hurling actual firebricks at either the parents or offspring involved was taking your hurt feelings just a smidge too far. (Silent glaring and the odd foot "accidentally" stuck into their strollerway is almost certainly enough.) Here, on the other side of the fence, I maintain this view.

PB came to the clinic with us the other day. I expect it will be the first and last time. This is because, in future, Mr Bea will not be required to come along, and I will go alone, like I used to - how in hell do couples ever organise to both go at that notice, anyway? - leaving the Prata Baby home with his Dad. In the future, you see, my appointments will be before Mr Bea's usual working hours.

In the future, it will also be more desirable to leave The Prata Baby home, because my appointments will be during the hours that FS sees the bulk of his appointments, before he skips off to the day theatres to start retrieving eggs or popping back embryos. They will be during the hectic, morning rush-hour, when the clinic throngs with activity, and toddlers would get severely in the road, both physically and emotionally. In the future, my appointments will involve blood draws and vaginal ultrasounds - neither of which are child-friendly scenarios.

On this occasion, however, my appointment was in the middle of the day, when nobody much is around, except the pregnant people waiting to see the obstetrician next door. Mr Bea's presence was required. The only other babysitting option was my MIL, and she would have had to madly rush halfway across town from her usual Thursday morning business, then she would have commenced a deep and particularly vexing course of maternal worry that would have continued forever and ever, until the end of treatments, and possibly beyond. Given all this, I decided it was reasonable to bring The Prata Baby to the clinic, this once. In fact, I decided it was unreasonable to expect us to do it any other way.

We came upstairs immediately before our appointment time. We were in the waiting room for less than two minutes, and we saw one other patient on the way in. She was a fertility patient. She came out of FS's room, went straight up to the desk - which placed her with her back to the waiting room - paid, and left. I'm not sure she even noticed the toddler tucked around the corner, near the toy box, quietly looking at a book. When we came out of the room, there were two obstetrics patients in the waiting room. They both smiled at PB and said hi, then Mr Bea took him downstairs again whilst I paid and finished up.

Sometimes, it's hard to see where the other person is coming from - especially when your world is in crisis. Sometimes, it's just as hard to remember how you used to feel once the crisis is behind you. In this case, I think I've managed alright on both counts.

Now obviously, having the Prata Baby there coloured my view of the clinic and the appointment, which is why I wanted to go through this first. Next post, I'll get to the D&Ms you asked for.

The appointment went like this.

First, we went through our file with the nurse, who did a quick audit of our embryos. Six two-day-olds and two blastocysts - all frozen in pairs. The FS asked if we'd like to do a single or double transfer, and we said we'd lean towards a single, but since they're all frozen in pairs, if we ended up with two on the day we'd transfer them both rather than discard the "leftover". And then he said, really? they usually do freeze them singly, because we like to promote SETs. They only freeze pairs if they're not good enough to fly solo. Let me look at your file... oh... well... don't worry, we get a lot of pregnancies from all types of embryos. But what we'll probably do is thaw out some day twos and grow them on a bit and then see, just in case. But we'll also note down that if we have one decent embryo, that'll do, and we won't go crazy thawing lots more to ensure that we have a double transfer.

Then he said how is my cycle because isn't it a bit screwy, and I said well, not really, only when it sees you coming. For example, it has been like clockwork for over twelve months, set your calendar by it, except for this month, when it has decided to get, yes, screwy. I am on day I've-lost-count-maybe-fifty-something. (I've actually accrued enough years' worth of data now to suspect that I'm only seasonally polyoestrus, because I really don't cycle much from mid-Autumn through to the winter solstice, but then otherwise I am pretty much ok, unless I'm living near the equator, in which case I'm fine all year around, but I didn't mention this because it sounds whacko which, as an interesting aside, is how I get by February if I'm living in the UK over winter.) Anyway, to his credit he didn't make me do a pregnancy test, he just asked me what sort of protocol I'd like to start out on when I begin my next cycle.

Not much has changed. He still recommends a natural cycle for those that naturally have textbook cycles. He said I might like to choose a medicated cycle, though, which involves a protocol of the usual - basically oestrogen, followed by progesterone. Then I said, what about the OI cycles we were doing last time? and he said, we did what? oh right, flick flick flick, yes, so we did, I wonder why...? but everything did work very nicely didn't it, except that one time when we bumped the dose up and started a bit early and got too many eggs... so yes, if we did the same thing as we did those two times and look, you actually did get a bit pregnant, which is encouraging, isn't it? And I said that, all other things being equal I would stick with what I know, and he confirmed that all things were indeed equal - that the real reason they usually don't use OI with puregon is because (given that ovulation is not required for an FET and that women respond to such a wildly different range of doses) it's easier to take over the whole cycle than to tweak the FSH so you ovulate only a single follicle, and that as long as the oestrogen is right and the lining is good and the progesterone is afterwards what they'd like to see it is all the same, which I can understand, and so since, in our case, we seem to have figured out how to manage an OI/FSH cycle with approximately as much accuracy as a fully-medicated cycle and more than a natural one, that was that, except for the bit where we all laughed and said how my ovaries will probably respond completely differently to the FSH nowadays and therefore throw it all out the window.

And then I asked about clexane, and he said why the hell not.

And he wrote down FET, 1-2 embryos (from day twos), OI with FSH, clexane.

And then he said call me on day nine of your next cycle, and I said we were going to wait til after our July ski holiday because I don't want to be pregnant on the ski fields, and we laughed, and then I said no seriously though, we're going to start after the holiday, and he said fine, whenever, he's away for a week in July but after that he's all mine and I said good.

And then we left.

No wait - first we signed some new paperwork and paid more for our consultation than I remember paying several years ago.

Then that was that, til August.

I have a new referral letter. It says that my GP is sending me back into the capable hands of my FS, because I am "ready to have another baby". I keep getting stuck on that line. It's not exactly what's going on.

Not that I haven't spent a great deal of energy thinking about timing, but I haven't spent much of that energy pondering over pregnancy, birth, or newborns. Instead, I've been thinking about being ready to try. I've wondered whether I'm ready to face treatments again, whether I'm ready to drag myself into the clinic at fuck-o'clock in the morning, endure repeated blood draws and self-injections, and make nice with the dildocam. Whether I'm ready to live, once again, the hurry-up-and-wait, plans-on-hold lifestyle that ART treatments demand. Whether I can handle the emotional tension of a cycle whilst staying adequately and appropriately engaged with the child I have now. I've thought about whether I can bear to open the can of worms that using up one's embryos might bring - once we start again, will we be able to stop at a sensible point, or will we get sucked, by degrees, down the vortex of I've-come-this-far-and-I'm-not-leaving-without-a-baby? I've wondered how our finances will go, with the burden of treatments, which cost - by the by - more in a month than our last little addition, and that's with excellent insurance coverage. And of course, somewhere in this, I've considered the possibility that the treatments might actually work, but to be honest, I've quickly dismissed it as being the least of my worries.

Am I ready for another baby? Truthfully, I haven't bothered answering that question. If it works out that way, I'm confident we'll cope. If it doesn't? Well, that's what concerns me.

Then again, this time I have something I didn't have before - and I'm not talking about the Prata Baby, although he is also here, it's true. What I have this time is experience. I am not bewildered, or fearful. I am not lost or anxious. I am stronger, and less brittle. I have learnt so much about coping, and recovering. I don't know yet if this will be enough to see us through, but perhaps it is enough to begin with.

I have a new referral letter, and an appointment on Thursday. I think - and I hope - we are ready.

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