Ladies in waiting: How do I wait?
The Time Period Between the Transfer and the Blood Draw for BHCG
For many women undergoing IVF, there are ten days of the cycle which are hellish: the time period between her transfer day and her pregnancy test day. Although there is no label for this time, all women know what it feels like. It is a vulnerable, fragile time that drags on and on, often dragging their mood with it. For few women does the time just fly by. This is a time where the promise of pregnancy feels so attainable, more so than it has ever felt in the past.
But will the promise be kept?
In IVF treatment, in the best of situations where there is an expert reproductive endocrinologist and a healthy woman, a pregnancy following transfer will occur in 65% of the cases. It is virtually impossible to augment this number. For many women who have failed other reproductive procedures, such as IUI with its 16% success rate, a promise of a 65% success rate is as high a success rate that they have ever been promised.
But a 65% success rate also means that 35% failure rate.
I tell my patients to go into this time period between transfer and the blood draw for beta HCG with 65% optimism and 35% pessimism. For some women it is hard to hold both optimism and pessimism at the same time. This was the case for Amy.
The Story of Amy
Amy was a 35 year old who had been undergoing fertility treatment for nine months. At each appointment with her reproductive endocrinologist, she was energetic, gregarious, and friendly to the staff. She considered herself to be the cheerleader for her reproductive endocrinology team. She was proud to be part of this team and felt that her ebullience and enthusiasm would ensure the success of her IVF treatment. She felt sure that she would have a 100% success rate. During the 10 days between her transfer day and her pregnancy test day, she woke up every morning with a smile ready to embrace the goodness of the day. She looked forward to the pregnancy test – and talked about her optimism openly on social media - feeling certain it would be positive. She told me that she felt that putting her optimism out into the universe would increase her success rate. On the day of the blood draw for BHCG, she was devastated when the test was negative. She told me that she felt “shame” at her “naivete.” She was also angry at her reproductive endocrinology team which she felt had failed her. She refused to go back to her doctor and decided to take a break from fertility treatment.
The Story of Briana
Briana was a 38 year old fertility patient who came to see me after three failed rounds of IUI and one failed IVF transfer. During the time period between her second transfer and her blood draw for BHCG, we worked on holding her optimism and pessimism together in tension. The optimism did not take over her mood, nor did the pessimism. She felt steady emotionally as she went into her blood draw on day 10. She knew that she would be elated with a positive test and saddened by a negative test, but she also knew that she was emotionally ready and resilient enough for another round of IVF if she did not get pregnant this cycle.
