My VERY long update, 4th IVF Summary, and Dr. Tortoriello Rave!

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Daisy21
My Little Loves

Member since 6/10

1133 total posts

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My VERY long update, 4th IVF Summary, and Dr. Tortoriello Rave!

This is going to be a super long post, so I apologize in advance. I don’t even know where to start because I have so much to say. For those of you that don’t know me, I’m going to give a quick synopsis of our story. If anyone is really curious, I can attach links to my previous IVF journals.

We have been trying with the help for a RE for a year, and I literally just turned 28 yesterday and my DH will be 28 in a couple of months. I have PCOS, so we went straight to the RE because I knew I didn’t ovulate on my own. After our first timed BD cycle, through a semen analysis, we learned my husband had a zero sperm count. We went to see the urologist and found out my DH has CBAVD(Congenital Bilateral Absence of the Vas Deferens). This is basically a mild form of cystic fibrosis and our only option for biological children was IVF with ICSI. Fortunately, my husband has sperm and he’s been through 3 TESE procedures where they extract tissue that contain sperm. In the meantime, I also learned that I am homozygous for MTHFR C, heterozygous for 4G polymorphism, and have low protein Z.

We were very aggressive from the start because we knew IVF was our only option. We did cycles in October, January-February, and April. We exhausted all of my IVF coverage through GHI and were left with my husband’s $10,000 cap through Oxford. I knew we were on borrowed time and money. That being said, I know we are very lucky to have this coverage. After three failed cycles, we made the huge decision to switch doctors. A lot of factors were considered when we were making the decision. First, I have to say that I truly respect and admire my previous RE. I think he is a wonderful man and doctor that helps many women, but I don’t think he was using the best protocol for my situation.

I’m not mentioning the doctor by name, but many of you know who I was seeing. I think it is important for me to explain why I made the switch. I feel like it may help someone. Again, this was just my own personal experience. I went through 3 IVF cycles and was told after each cycle that our biggest problem was my husband’s sperm. I spent a good month researching donors and we were planning to do a split cyle with both donor sperm and my husband’s. It was very emotional, but we were willing to do anything to have a healthy baby. My third cycle was so bad that we never used the donor sperm. The next issue that I think was significant was my estrogen levels. In one cyle, my estrogen went above 9,000 and my other two, it was above 6,500. To be honest, I never knew how dangerous this was. It’s really not healthy to have estrogen levels get so high, but I didn’t really know it at the time. I also assumed this was the only way I could stim. OHSS was avoided because of Lupron trigger, but it still was not healthy to have my estrogen get so high. I now also truly believe that this had a huge impact on my egg quality. At the follow-up consult to my third cycle, the doctor discussed using the exact same protocol that clearly had not worked before.

After this, I was still not really ready to switch. While preparing for my third cycle, I made a consult at another doctor because I knew it was time to get a second opinion. Even after the consult I was not sure I wanted to switch because I was so comfortable and afraid to move. At one of the first appointments at the new RE, I was shaking because I was so nervous about making the move. It ended up being one of the best decisions I’ve ever made.

We switched to Dr. Tortoriello at SIRM in NYC. I liked him because he did things similarly to my previous RE and addressed similar issues. He does all sonos himself, he addresses immune issues, and creates very personalized protocols. The office is VERY organized, but I did not feel like a number at all. At the consult, he told us that he did not believe that we needed to use donor sperm at all. He didn’t think the sperm were the problem. He immediately addressed the estrogen level and suggested a totally new protocol. He described my PCOS as “brittle” and explained that my hormone levels greatly impact my egg quality. He never said a bad thing at all about my previous RE. I ended up using a variation of the estrogen priming protocol. This is generally used for lower responders, but he was adjusting the meds to suit me. I always produce a ton of follicles because of the PCOS. I was on my way and trusted him from there. If anyone is interested I can be more specific about the meds I used.

All of the monitoring went well and he told me he expected between 15 and 20 mature eggs. The day of retrieval was great. I was monitored super closely. As always the first thing I asked as I came to was, “How many eggs did he get?” The nurse told me more than 20 and they were still counting. My husband and I were totally giddy. We couldn’t believe they got so many with my great estrogen level. I went to the bathroom, came back and heard the nurse say something about 45. I asked her to repeat the entire thing and found out they got about 45 eggs. We freaked out. It was an amazing moment. It really was. He retrieved 53 eggs! 45 mature! And the best part, 38 fertilized with my husband’s sperm! The embryologist was there until 9:30 fertilizing our eggs. I was just amazed. My estrogen never went above 3,000 and besides being sore the day of retrieval, I felt great. When we found out 38 fertilized with my husband’s sperm, I cried. I couldn’t imagine that this might all work and we might actually have a baby of our own after all the tears. The other reason this was so great was our fertilization was so high, about 85%. In our past cycles, our fertilization rate was never above 50% and we used the exact same sample of sperm. I truly believe that the high estrogen level was negatively impacting the quality of my eggs. So in the end, it was always the eggs.

We got a good update on day 3 and transferred 2 early blasts on day 5. At this point I was already nervous because they hadn’t expanded yet. SIRM has high standards for cryopreservation and my embryos had to become expanded blasts to be frozen. The wait to find out if any of our embryos made it to freeze was pure torture. I felt like the fate of my transferred embryos was riding on whether the others made it. We ended up freezing 8, but 4 of those look really good. We have never been able to freeze any, so this was awesome for us.

I stayed on modified bedrest for about 48 hours. I ate my pineapple and tried to keep my womb warm. I did everything that I had read about over the past year, but I did this stuff with my other attempts as well. By the evening of 2dp5dt, I thought I was doomed. I truly did. I went to dinner with my mom and DH, and I was talking about adoption. I wasn’t going to give up after this round, but I also wanted to be realistic. I was waiting for cramps and didn’t really feel much. The next day, I woke up and didn’t feel much, but by the middle of the day I was crampy! I had light cramping all afternoon and evening. For the first time, I had real hope. I triggered with hcg, but tested out the trigger. The next morning, 4dp5dt, I woke up and tested with a wondfo. I thought maybe I saw something but thought I was crazy and went back to bed. I woke up a few hours later and tested with a FRER and another wondfo. There was a line! There was really a line! I didn’t believe it. I’ve never seen one that wasn’t from the trigger! Ever! I truly didn’t think it was real until about an hour later. I actually had plans to meet a few of the amazing ladies from LIF for lunch and showed them because I couldn’t contain myself. I was too nervous to be really excited, but it was still the most amazing thing. For the first time ever, I felt like I might be a mom. It all felt possible and worth it. I tested the next morning and the test was still really light, but I was able to confirm with a digital. My first beta was 8dp5dt and I got the call as I walking around Marshall’s with my Mom. It was 90. We were happy, but still so nervous because I knew the first number really didn’t mean anything. My next beta wasn’t until 12dp5dt and the wait was torture. I was truly terrified, but it came back at 555. We overcame another hurdle. I continued to POAS like it was my job. I literally used about 25 FRERs. I wish I was kidding. The line was always darker. Today was my first sonogram at Dr. Tortoriello’s and we saw TWO beautiful heartbeats. TWO. It was truly the most amazing day of my life. My husband was just in awe. I can’t believe that I can actually be pregnant. I truly thought there was something so wrong that I could never be pregnant, and it is OUR baby. We are beyond words and beyond belief that this could actually happen.

I also want to say that I had full intentions on posting a rave with a BFP or without. This is by far, the farthest I’ve ever gotten in the process and we’re forever grateful. I just want people to be aware that not every doctor is right for every person. I’m sorry I haven’t been posting much, but to be honest, I was emotionally exhausted and then too terrified to say anything about our great results. Dr. Tortoriello is one of the kindest and smartest people I have ever encountered. This is all because of him and we are forever grateful.

One of the most important pieces of this journey is this infertility board and the friends I’ve made. I think I might have gone completely crazy if I didn’t have this board. So, I thank you. I truly do.

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Message edited 8/22/2011 6:12:43 PM.

Posted 8/22/11 5:54 PM