Tuesday, June 22, 2010

The Dreaded 2WW

I went in for my transfer yesterday and I got some really bad news and a little good news.

The bad news first. Dr. Zed reviewed the results of this cycle and last cycle and the fact that both resulted in a high percentage of immature eggs leads him to believe that there's something inherently wrong with the quality of my eggs. His recommendation was to look into using donor eggs and although I respect his opinion, this is a really hard pill for me to swallow. I'm going to get another opinion at SI.RM in Sacramento and also probably do a phone consult with CC.RM.

There are a few things that I know after doing hours of research over the last few days. 1) I have very low estrogen levels throughout my cycle, hence, my thin lining, very light periods, and low estradiol value of 32 on CD 3, and 2) low estrogen can cause immature eggs. Scouring through the different message boards, I've found a few women in the same situation as me have their doctors prescribe them metformin even though they do not have PCOS.

Actually, I toyed with this idea in the very beginning of my IF journey, but a lot of the literature I read said that you had to be overweight and have cysts (hence, the "C" in PCOS). However, I didn't realize until now that lean PCOS can manifest itself in different ways and can be caused by other things. You don't necessarily need to have cysts or be overweight, the main factor is the hormonal imbalance of excess testosterone and reduced estrogen and possibly some insulin sensitivity.

Way back in 2001, I went on this highly restricted calorie diet and started to exercise excessively. I monitored my calorie intake and made sure it was always between 1100-1300 calories/day plus I exercised anywhere from 2-3 hours/day (once in the morning and once in the evening). I wanted to be skinny, really skinny. And it worked for awhile, but then I noticed that I started to gain weight and around my stomach and my periods started to get really, really light. Since then, my body has changed dramatically. I gain weight around my stomach (which I never did before) and my periods have always been really light (think: pantyliners for 2 days).

Up until I got married, I sort of maintained this diet/lifestyle, albeit a bit less extreme, but still calorie restricted and lots of exercise. I really think that my lifestyle has caused a hormonal imbalance. I haven't had my testosterone tested, so I'm not sure what that is, but I have some of the symptoms that have been listed for lean PCOS including hair loss/thinning, difficulty in losing weight, oily skin/acne, and irregular periods.

Ok, sorry this is getting so long, but what this led me to believe was that maybe the addition of metformin will help. All of the women on that board said that they had better egg quality with metformin. So, if this cycle doesn't work, I've already discussed with Dr. Zed about putting me on metformin.

Alright, so on to the somewhat good news...our 7-cell embryo, the only one that made it, had turned into a morula by the time we had a transfer. So, we had one 3-day morula to transfer. Typically, embryos are morulas by day 4 or 5, so the fact that this little guy had already grown to a morula is a good sign. We're hanging on for dear life to the one hope that our little bean makes it. PLEASE!!!


sienna said...

soo - that's AWESOME news that your embie was a morula on day 3!!! i'm sooo happy for you and so hopeful that this little bean sticks!!! you have a great chance, so i'm hoping you don't have to do any second opinions. *fingers crossed*!!

i've been on metformin for the last 3 months bc of pcos. i had to actually insist on taking it, since i'm "atypical". i actually don't have cysts, but i'm pco-like, so hence the diagnosis. i actually had to stop taking it last week bc something about taking it alongside synthroid was giving me that icky metallic taste in my mouth, so all doctors agreed that i should stop. i'm hoping it helps my egg quality this time, so we'll see how it goes. from what i know, it can't do any harm, and given everything you just wrote, it might really do some good, so i'm glad dr z was cool with it, should a next time be necessary.

sending you big hugs!!

sienna said...

ps - donor egg talk is way way way premature!!!!

Anonymous said...

your embie is such an overachiever! :)

i agree with sienna. not time for DE talk yet. get a 2nd and 3rd opinion. i think you're right - there's probably something off with your hormones. get your RE to dig into that more. it sounds like you're on to something.

but hopefully this is all something you won't have to worry about because now you're PUPO and you'll be getting your BFP soon! (i'm the forever optimist.) hugs!

Anonymous said...

I'm praying so incredibly hard that your morula turns into your long awaited pregnancy! All kinds of sticky vibes coming your way!!!

Lisa said...

I'm am so hoping that this is your cycle and that you won't have to worry about what's next. Hopefully, poopy diapers are next :)

Ashlee G. said...

I hope your little bean makes it too!!

Ashlee, ICLW #180

Low Fat Lady said...

I hope that your little one makes it and you have a quick 2ww. That is really interesting about your lining because I have identified the same thing in me just recently. I have always had a thin lining and increasingly light periods. I hope that after my sono tomorrow they will recommend something that will help with that. I didn't know it was related to egg quality though. Scary. I hope the second opinion is able to figure something out.

lis said...

i only have one ovary so that automatically puts me in the low fsh category. we had our first IVF minimal stimulation because we paid out of pocket. 5 great eggs/5 fert. this second IVF we were covered by insurance so the doctor added in more drugs to 'try and get a better ovarian response' IVF #2 yielded 7 eggs and only one fert normally=BFN. i have been reading that in women with low fsh/ovarian reserve minimal stims are better so i will certainly be doing that again next time. i am in the midst of a 2ww with a frozen embie myself. hoping yours is snuggling in for the ride and hope my comments help a bit.