A little over a year ago, DW and I embarked on our very first IVF. It was a special IVF, as it was a reciprocal IVF, and we were amazed by how science could allow my wife to carry embryos with my biological genes in a pregnancy. If you’ve followed our journey since last year, you know that for unexplained reasons, she miscarried twice. She had all of the immune testing that I had, with the exception of the natural killer Th1/Th2 cytokine ratio. All of her results were normal. Later, in September, I miscarried a blighted ovum. It has been heartbreaking for both of us, but hers seems to be a silent one, as we have moved our primary reproductive efforts to me. I try to honour her role and contribution to our journey, but realize that it is nearly impossible to fully do this because she is in essence “being benched” for the time being. She deserves so much more than that, but due to her age, our financials, and the unexplained nature of her infertility, this is the best that we can do for now. I know however, that my wife will be an amazing mother to our babies, and I am so lucky to have her as my partner. All you non-gestational parents out there, share your awesomeness with us.
For days now, I’ve been waiting to hear from our fertility clinic about our next steps, and finally, we have a plan!
We will be doing another round of IVF.
I bombarded our RE with some questions, relayed by email through his nurses. Of course, his answers were super vague and generally unhelpful, but provided some reassurance.
I have copied and pasted them below:
1. Why do you think that none of the seven day-five blastocysts were
It can be either embryo— genetics vs
random bad collection—– or it could be recipient issues.
2. What is your opinion on how my body responded to the stimulation cycle?
The response was good
3. Any changes he would make to the stimulation cycle this upcoming round,
4. Would he recommend that we do PGD/S testing for chromosomal issues or
He wouldn’t recommend either.
5. Does the clinic do PGS on day 3 or day 5?
We do pgs on both day 3 and
day 5 embryos. We can do PGS testing on either day 3 or day 5 embryos.
6. If we do PGS, does that mean that we cannot do a fresh transfer (and all
have to be frozen for FET)?
If bx is done on day 5 embryos then those embryos are frozen. This is what is preferred. We are able to do a day 3 bx and then proceed with a fresh cycle and transfer would happen on day 5.
So what I gather from this is that he does not think that there is an issue with our embryo quality (pathology testing of embryo in September 2014 miscarriage was of a chromosomally normal female), and even though we are willing to shell out the dough for PGD/PGS, he doesn’t think that we need it. In fact, because he doesn’t recommend it, the clinic’s plan for me is not to to PGS. I have mixed feelings about it, as embryo quality is one of the major factors that affect IVF success.
Now, some of you may be surprised that we are sticking with the same clinic, but after a lot of thought and consideration, we decided that it was in our best interest to continue with them for several reasons:
– continuity of care- they know what worked/didn’t work for us last time.
– familiar with their system- I know who to call when I need whatever, and have realized that if I need to talk to the nurse asap, I just need to flood the nurses voicemail line with messages.
– the RE is open-minded enough to treat me aggressively for the immune issues, which if we started at a new clinic, would want to put me through the ringer before being satisfied that I need all of the intralipids/steroids/blood thinners.
– proximity- the clinic has 5 locations, 2 which are within 15-20 minutes of our home and work places.
– we got a good lot of quality blastocysts the last IVF. Carrying was the issue.
There is one uncertainty that I feel we just need to live with, and that is the quality of the clinic’s embryology lab. On one hand- we got 7 good day-five blastocysts in the end, but on the other hand, none of them worked out for us. The fact that we got 7 blasts makes me think that their lab is good enough to support their development to day 5, but with none of them working, it leaves me to wonder if it’s them (lab), or us (uteri). Anyway, it’s something we kind of have to roll with, and I will never get an answer to that question, so I should just move on with my life.
I am currently on
day 8 day 9 of my current cycle, on no meds, and on day 21 I start taking Lupron again. As you know from above, the plan is to do the long Lupron protocol again. Last time, they started me on a 200IU dose of Gonal-F, went up to 250IU for a few days, and then back down. In total, I stimmed for 14 days, which is on the long end of normal, but I think the Lupron over suppressed me a bit, and 200IU is quite low of a dose of stims.
Last year, the pain of the egg retrieval had me swearing that I would never do IVF again… And here we are, a year later, seemingly in the same place we were last year. We aren’t- we are more desperate, more jaded, but hopefully also little wiser (immune issues). While we are doing the same protocol again (the results were good), I won’t be on BCP’s at the beginning of this one (unlike last IVF- anyone with experience doing IVF without BCP? Please share your experience in the comments below), and we will be fully armed with the intralipids/prednisone/fragmin/aspirin that we weren’t last year.
So yeah, F$&K presents! We are buying ourselves IVF for Christmas!
Happy holidays to you and yours!