My (Long!) Story

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bookworm
Two Little Rosebuds

Member since 8/09

2106 total posts

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My (Long!) Story

I'm posting this because many women have FMed me or posted to ask. It's super long because, well, this is what happened. I just want to put the info out for those who are interested. Please don't hesitate to FM me with follow up questions! Chat Icon

In February of 2013, my 4th IVF cycle ended in another unexplained failure. At that point we had already started adding any bells and whistles we could find to help us. We were being treated by an RI based in Chicago and doing co-culture at Cornell with Dr. Davis, who (like the RI) was famous for solving hard cases. It was always the same outcome for me: even though I am dealing with premature ovarian aging (started treatments at 31) and would never get a ton of embryos (usually around 7) I would always have 2 that looked picture-perfect on day 3, and since I did not have an overwhelming number of good embryos, I was always a day-3 transfer. With the failure of round 4, we started seriously considering donor eggs, but I also had generous insurance coverage for IVF that had not run out yet, so we decided to embark on a hail Mary effort and spend the remainder of that coverage to (at least) get some answers.

Step One: Sometimes if you have good-looking day-3 embryos that fail, it makes sense to look at the sperm because genetic problems with the sperm don’t affect embryo development until after day 3, like a pretty 8-cell embryo that falls apart by day 5, for example. We had the DNA fragmentation run on DH’s sperm (his samples had always been just okay against count/motility/morphology measures) and it came back as borderline problematic. We consulted @ Cornell with Peter Schlagel (hands-down best urologist in the country) who recommended extracting sperm from the testicle to skip over a lot of the damage that happens in transport. I will spare you the science of this, but FM me if you want to know more.

Step Two: In our investigation of DE, I had a conversation with Marna Gatlin, who is the head and founder of PVED (Parents Via Egg Donation) and she basically introduced me to the reality that there are no ‘great’ labs in the LI-NYC area. They range from bad to okay, and the only clinic around here where I would even consider growing fragile DOR embryos is SIRM. This reality can be very plainly observed in SART data when you look at outcomes for donor eggs cycles. Cornell, for example, who has a great reputation, was getting 55% success rates (compared to 65% @ SIRM or 75+% @ RMA-NJ or 85% @ CCRM) and there’s just no excuse for this when they’re dealing with 22 year-olds. When the eggs are the problem, giving your embryos the best chance all comes down to lab, whereas if you don’t have an egg quality problem, you are probably doing just fine @ your local clinic. That is how we ended up in Colorado. Without a doubt, when I compared my embryology report from the CCRM cycles to those from my failed cycles, our embryos did dramatically better in the super-lab. It was kind of shocking, actually.

Step Three: My doctor at CCRM changed my protocol dramatically, and from that point forward I became a MDL flare girl with HGH. I had never done this protocol before, and I will say that my cycles at CCRM yielded much higher (healthier, normal) E2 levels for the number of mature eggs retrieved. **Note: cycling out of town is not as impossible as it sounds because I did the vast majority of my monitoring at LIIVF, who then faxed my results to my regular nurse/doc. I actually thought cycling in NJ was easier than cycling @ Cornell.

Step Four: Because of my RPL, DOR, new questions about DH’s sperm and, in general, my quest for answers, we decided to grow out to blast and do PGS (test them to see if they had the right number of chromosomes) to see if the embryos were really as good as they seemed on day 3 and to ferret out whether we needed donor eggs. We banked cycles in Colorado (stim, retrieve, fertilize, freeze, repeat) and ended up with 3 chromosomally-normal blastocysts. This came as a complete shock. I was waist-deep in egg donor research (really in a very dark place about that) and fully prepared for the embryos to fall apart by day 5, game over.

Step Five: The joy of this news quickly faded into looming questions about why. Why, if I make normal embryos at 34, did my IVF cycles fail at 31 when it was easier to get lots of eggs. These why questions were not well answered by my doctor in Colorado, who is a brilliant scientist but who grew exasperated with these question and never really answered them. I started to consider GC (my cousin had volunteered to carry for us) because I had already done 2 rounds of immunology treatments (IVFs 3 & 4) only to fail. I had worked so hard for these embryos that I was terrified to sentence them to death in my uterus. This is how we ended up at RMA-NJ with Dr. Scott (amazing, most perfect doctor I have had in this whole experience because he is a hardcore data-guy who is also human and takes the time in the consult to really explain the rationale behind his recommendations). He introduced me to the concept of synchrony and the havoc that IVF stims wreak on the timing of lining receptivity and embryo development, which is why some women (me) will never get pregnant on a fresh transfer. Again, I’ll spare you the science of this, but FM me if you’re interested. As a DOR girl, I never had leftover blastocysts for an FET, but since we did the freeze-all cycles with PGD, FET was our next step and there was a chance it could be the silver bullet to solve our problem.

Step Six: I had my frozen embryos from Colorado shipped back east to RMA-NJ so I could plan the FET with Dr. Scott in his comparably amazing super-lab. We also cycled there to get two more chromosomally normal blasts just in case (1) my FETs failed and it turned out I really did need a GC or (2) my increasingly faltering ovaries were not willing to make babies in a few years when we’d come back for baby #2. My FET was really simple – just some Estrace to thicken the lining to about 10, then the addition of PIO. I worked with them to add vitamin e, baby aspirin, and dexamethasone in lieu of the RI protocol I had previously used. They gave me Medrol and antibiotics for a week around the transfer, plus a vaginal antibiotic gel the night before. They gave me a special progesterone suppository a few hours before transfer, and I had laser acu in my transfer room immediately before and after. I transferred one of my CCRM blasts the day before Thanksgiving so I could relax for a few days, but that was really it.

Step Seven: Babykins implanted with a beta of 72 that doubled in 2 days, and yesterday we heard the HB, 113 bpm. We still have 4 chromosomally normal blastocysts in the freezer for siblings because I AM NEVER DOING IVF AGAIN. I had a very healthy and permanent break-up with my ovaries.

Message edited 12/28/2014 9:43:56 AM.

Posted 12/28/14 8:55 AM