Sunday, May 22, 2011

Happy ICLW!

It's been awhile since I've participated in ICLW, so for all the new visitors...Welcome, and here's a little recap on my infertility journey. Warning: It's a long journey.

It's been 2+ years since my husband (Doc) and I have been TTC. When we started TTC, like most newbies, I assumed I'd be knocked up within months, but six months passed and I could tell that something was not quite right. My luteal phase was short. I had very light, 2-3 day periods. No existent cervical mucus.

So, I tried the alternative, natural methods first. Went to acupuncture, took delightful tasting herbal meds, started yoga, reduced exercise, gained weight...But all for nada. So, then I went to a local RE who does everything except IVF and with her we did two rounds of IUIs (a clomid and a letrazole cycle). I responded, but again we got the BFN.

After those three rounds, the RE was out of options and we were still unexplained, so she suggested we move on to IVF. She assured us we'd be pregnant in no time. Doc's sperm analysis was top notch. I was still relatively young (34). I responded ok to the meds. All the physiological stuff was a-ok. It was a no-brainer...on to IVF.

So, Doc and I bit the bullet and with hope in hearts we went to a local IVF RE who had the best stats in the Bay Area. We started with an antagonist protocol because I had done the clomid challenge and had just barely squeaked by. It seemed things went fairly smoothly. The only cause for concern was that my follies took a little longer in growing. But, by day 13, I was ready to trigger and I had 9 good looking follies for retrieval. Good news was I had 9 follies retrieved. Bad news was out of those 9 follies only 3 were mature and only 2 fertilized. We transferred 2 ok-quality embyros on Day 2 and got a BFN.

The doctor was stumped. He had only encountered this one other time and really didn't have any answers as to why this had happened. He suggested we stim for another day or two and do away with BCPs, which may have oversuppressed me in the beginning of my cycle. Doc and I thinking that this was just a fluke decided to give it another go.

Although we liked IVF RE #1 just fine, we decided to go with another well known local RE. He suggestion was to do a microdose lupron protocol with estrogen priming, but when I asked him about the extra day or two of stims, he said that it would not help to produce mature eggs and it would only cause the eggs to be overmature. We trusted his opinion and went with him and the result was almost identical cycles. We had retrieved 11 follies, but out of those 11 only 3 were mature and only 1 fertilized, so we had only ok quality 3-day embryo to transfer. Another BFN.

At this point, we obviously knew it wasn't a fluke and something was going on with my eggs, so we went to the best and headed to CC.RM for what we thought was our final cycle. We talked to our doctor there and decided that we'd push to blastocyst no matter how many embryos we had and we'd also push for CCS (if we had enough blasts). If this was going to be our last cycle, we really needed some answers. I knew that CC.RM's lab was excellent, quite possibly the best in the country. If we pushed to blast and we had zero embryos make it, then we knew there was quite likely an issue with egg quality and then at least, we'd have some closure.

Our third IVF cycle went very similar to our last two IVF cycles. We did an antagonist cycle, but this time we stimmed an extra day, growing my follies to over 20mm and letting my estrogen rise to over 3,000. We also did a double HCG/lupron trigger. We retrieved 9 eggs, 5 were mature and 4 fertilized. Of those 4, we had only 1 perfect 3-day embryo and that made it to blastocyst by day 6. We froze our one 4AB blastocyst and decided not to do CCS.

After this cycle, we decided to give CC.RM one more try. Our fourth IVF cycle was the same protocol but this time I also added in saizen. I reacted the exact same way and they let me stim for an extra day. At retrieval we got 11 eggs, 5 were mature and 4 fertilized (one extra fertilized late, but it didn't make it past day 2). Of those 4, we had 3 make it to blastocyst -- 4AB, 3BB, and a day 6 5BB. We decided not to do CCS because on day 5, when the decision needed to be made, we had only 2 blasts.

So, now this is where we stand...We have four blasts on ice and we'll be transferring two (4AB and 3BB) in a FET sometime in August or September. All I can say is that it's been a very long journey and it's changed me a lot. I'm not the same person I was two years ago. I wish I could say that it's made me a stronger, better person, but I can't confidently say that. I just know that my life will never be the same.

Wednesday, May 4, 2011


We had our $108 15 minute call with Dr. Sur last week to discuss next steps and to pick his brain a bit. In summary, he said that he didn't think this cycle really differed all that much from last cycle even with the two extra blasts (I'm not sure why). And amazingly, he actually said that the quality of my eggs aren't bad. He thinks that my follicles need to be bigger in order for the eggs to be mature. Unfortunately, I stim slowly and I'm already at the max days that he'd like to stim someone. Add to that, my follicles don't grow at the same rate and I tend to have a lot of smaller ones which aren't mature. So, bottom line is that there's not much more we can do.

Based on my records of this cycle and last cycle, it does seem like the mature follicles/eggs are the ones that are 20+ mm. Anything smaller is immature. So, while most people can have mature eggs with a follicle at 17 or 18mm, I would not be one of those.

So, what are our next steps? Well, with 4 blasts to choose from, Dr. Sur recommended transferring two, the 4AB and 3BB from this cycle. The remaining two (which are day 6 blasts -- 5BB, 4AB) will remain happily frozen and hopefully, not be needed until way down the road.

In the meantime, I've been enjoying life again. Going on runs, drinking coffee, having glasses of is good once more!