I’m fairly overwhelmed, and upset with some of the information I was given today at our consult. Maybe later I’ll post on my feelings and reactions, but for the time being, below is simply a recap of the answers. These questions probably weren’t in a very good order, so I apologize for the awkward flow. Those in quotes are very close to my doctor’s words, but I was writing fairly quickly!
Eric and I passed on all genetic testing for him and me, as well as our embryos… Is there anything you’d suggest at this point?
Genetic testing on Eric and I won’t have an impact on the success or failure of our IVF cycles, only on the health of children, God willing we ever get to take some home. I assume this is why Eric and I passed on this testing initially, as if we’d had children the ‘traditional’ way, for lack of a better term, we wouldn’t have been pre-tested. This testing isn’t all that expensive, well, relative to IVF treatment as a whole, so I decided to go ahead with this today. It’s an easy blood test, which is drawn at the University and sent away, so heck, why not. The testing service used is Counsyl and the diseases they test for can be found here. I should have these results in 2-3 weeks.
Testing of our embryos may be something we want to look into, but our physician wasn’t overly concerned yet. Perhaps this is dependent on the results of another blood test I had drawn today, the Anti-Mullerian Hormone Testing of Ovarian Reserve, more on this topic below.
After our positive pregnancy test, I was prescribed both progesterone and estrogen supplements, why?
“Both your levels were too low on the day of your first positive beta. This is not uncommon with an IVF cycle, as even though we are trying to mimic the natural process, it’s almost impossible and thus we often need to supplement hormones the body would normally make on its own during the cycle.”
Does this reveal any link to why we weren’t getting pregnant on our own or with the IUIs?
“Hard to say since we didn’t test your levels during your IUI cycles.”
Throughout our monitoring I was repeatedly told, and shown on ultrasound, I had 15+ follicles, why did we only retrieve 6 eggs? Were all 6 mature? Does this relate to egg quality, some defect with me?
“All 6 were mature, although only 4 fertilized, although we never expect a 100% fertilization rate.” Male factor infertility is not an issue for us. “As to why we only retrieved 6 eggs, hard to say, but this and other signs point to a low ovarian reserve, basically you’re running out of eggs and/or you have too few good quality eggs. Other signs include your cyst and high estradiol level which caused your first IVF cycle to be cancelled, and your miscarriage which can also be an indicator of poor quality eggs.” My FSH was 7.7 when tested last, which my doctor says is good, but not always the best test, hence the Anti-Mullerian Hormone Testing of Ovarian Reserve (AMH) blood draw was done today. I should have the results by the end of the week.
Was the timing of our retrieval too soon or too late after our trigger?
“Very hard to say. IVF is not an exact science.”
Do you believe our miscarriage is in any way related to our unknown infertility issues? Or do you view our past IVF cycle as a success which just unfortunately resulted in a miscarriage?
“At this point we only possibly suspect poor egg quality related to low ovarian reserve. If you experience two miscarriages in a row we’d need to look into the cause further.”
Do you suggest we change the medications we use in future IVF cycles?
“Yes, we need to use a stronger protocol in an effort to ‘wake up’ more follicles in the hopes of retrieving more eggs. Next time we will use the micro-flare IVF stimulation protocol.”
Will we be allowed to transfer two embryos in a future cycle, even if transferring at 5 days?
“Yes, since we transferred two embryos in your past cycle without success we would allow you to transfer two embryos in the future, either at 3 days or 5 days depending on embryo quality and grading.” My doctor stressed the risk of multiples, a 39% chance of twins when transferring two, and a 3% chance of triplets, as IVF embryos are somehow more likely to split. How and why, I have no idea!
Do we have any reason to suspect immune issues? Is it possible to test just to rule them out? Anything else we can test to rule out?
“You don’t have any risk factors, I see no reason at this point to test.”
Is there any possibly link between my infertility issues and those of my sister (no biological children), my aunt on my father’s side (no biological children), and my grandmother on my father’s side (difficulty conceiving)?
“Very difficult to say without digging into their medical histories, which we don’t have access to. Some fertility issues are hereditary, such as Polycystic ovary syndrome (PCOS), but you do not have this condition, nor any other which is considered hereditary.”
What are our next steps, how soon can we start our next IVF cycle? Anything I should be doing in the meantime?
“As soon as you get your next period, call and we can get you started on birth control pills and then right into the stimulation drugs 4 weeks later. No need to sit out several cycles, as at 7 weeks pregnant when you miscarried, you’re body wasn’t under stress and therefore doesn’t need to heal. You’re more than welcome to spend your money on supplements claiming to improve egg quality, or try acupuncture, but there are no medical studies which prove any link to improving IVF success.”