We are staying with a friend of my husband’s who lives in a fancy suburb on the north shore of Chicago.  The house is … kind of a mansion.  (A little one).  It’s beautiful but formal; there is so much marble and wrought iron it’s kind of like staying at the Art Institute.  I was intimidated at first but finally got used to it.  The man of the house isn’t home much so I don’t have to worry that we’re imposing.

The cycle seems to be back on track.  At my last check, another long trip down from Rockford on Friday, my uterine lining was looking better (9.something) and my levels were up too.  So my doctor and coordinator are relaxed, I don’t have to get monitored again, and we’re set for doing the transfer Wednesday.  This is just one day later than originally planned.  It’s the day we leave, our flight is at 1:25, so that promises to be a mad rush.

I had a talk with a wise and dear friend last night, and we agreed that just transferring one has its benefits, since coming here – “having to” come here – and visit lots of friends and hang out in hip city places – isn’t that bad.  The next round of IVF for my clinic is in September since they’re on the batch system.  Another advantage of coming back to do another cycle is that my hsuband is back on his commuting schedule come September, so anytime I come to do a cycle is one week we don’t have to be apart.  The plane fares have weirdly fallen to very cheap levels, so I can fly easily & cheaply in the fall.

The other problems of transferring one (and not getting a positive on this cycle) are still there.  Our insurance coverage will probably max out on this cycle, so that’s money.  And I don’t have any place in my PPO to get monitored now that the Bad Clinic has probably put out a contract on me by now, and we may sue them.

The Bad Clinic,  by the way, has dodged calls from Blue Cross for two full weeks now and the whole situation has been escalated to “Provider Relations.”  I’m trying to figure out who to complain to, aside from Blue Cross, since they garbled every piece of data and never sent results on the same day, and actually held some results back completely.  Maybe ASRM?  I would hope the accrediting body would want to know of fraudulent billing and mild malpractice.

It occurs to me that if my Blue Cross maxes on this cycle, it won’t matter if I go to an in-network clinic for the next cycle; I’ll be self-pay anyway.  That’s a good point.

There is one piece of data that I need, and if you have any information about this please pass it along.  The question is: after having one baby, are you more likely to conceive the next time?  I always assumed yes.  But is that really true?  We all know women who had multiple miscarriages and then had a bunch of kids, the miscarriage issue seemingly resolved.  We are always told of infertile women who finally had a spontaneous pregnancy and then more babies after that.  The impression is that there was one pregnancy that “broke the seal” or something, and that woman’s problem was resolved.  I’ve always heard that a first pregnancy over 40 was highly unlikely, but less unlikely for a woman who’s already had a few kids.

Now i’m not so sure.  If a woman has some kind of infertility and it resolves enough for her to have one kid, then why would she not be able to have more?  Her fertility doesn’t increase with each kid, necessarily; she is fertile enough to have one, and therefore fertile enough to have 3 or 7 or whatever.  It sometimes seems like those unfortunate women who get pregnant six weeks after delivering a baby are “extra fertile,” but maybe they were just misled by not having had a post-delivery period, or thinking that breastfeeding is a perfect birth control.

Medical info and statistics muddies this question by the fact that after each pregnancy the woman is older, and therefore faces declining fertility.  Secondary infertility can often be attributed to this.

And, as every infertile knows, well-meaning friends always want to tell us about the over-40 pregnancies and post-miscarriage success stories.  But nobody wants to mention the many more who suffer, miscarry, and/or never conceive in silence.

If there is some medical reason why I’m more likely to conceive with the same batch of embryos than I was before, then absolutely, we only transfer one.  But if that’s just a myth, then transferring two is still on the table.  We’ve always transferred two, and never had more than  one take.  Even when we had losses due to ectopic and miscarriage, it was only one that implanted; the second one just quietly never took.

But…  even if it takes me two or three more single embryo transfers to hit the jackpot, and we have to buy more plane tickets and pay out-of-pocket for everything because Blue Cross is maxed, that probably doesn’t begin to compare to what we’d have to spend with twins.  Extra babysitting, and lots of it.  NICU, maybe.  And the incalculable cost of having a special-needs child, made more possible by the prematurity that almost always comes with twins.  The also-incalculable cost of damage to me, even if it’s just more knee and foot injuries incurred by me becoming Jabba the Hutt due to twins pregnancy on top of being 50 lbs. overweight.

Are you sick of my flippy floppy agonizing?  I am.  I usually dissect my choices into neat slices of data, risk, and intuition, and pull the trigger either way without dragging things out.  This one is tough.