Sunday, May 30, 2010

A thank you, some answers, and a big decision

I wanted to start by saying thank you so much to all of you for your support over these past few weeks, and particularly for all your kind comments following our disaster of an IVF cycle.  Given that almost no one in our personal lives is aware of what we've been doing, I honestly don't know what I'd have done these last weeks without all of you to lean on.  I mean that honestly and sincerely--so, thank you.

To answer the question that several of you raised after my last post, mini- or micro-IVF is basically just like regular IVF but with lower stims (for example, one approach might be to use Clomid in place of injectables).  The theory is that older women sometimes produce better quality eggs with less stimulation.  Mini-IVF is also used sometimes with young, high-responders who want a less expensive alternative to regular IVF.

Natural IVF is pretty much just what it sounds like.  Your body makes the same one egg that would be produced regardless, but the difference is that it's retrieved before you ovulate.  Again, the theory is that stimulation may adversely impact quality in some older women.  Women who do natural IVFs usually cycle every month, back-to-back, and bank embryos for a future transfer of more than one at a time. 

Both options are considerably cheaper than regular IVF but, obviously the success rates are also lower because you're retrieving significantly fewer eggs. 

Some of you were also wondering if we'd to go after my local clinic for reimbursement of our expenses, given that their serious f-up (i.e. measuring endometriomas and calling them follicles) was pretty much the only reason we traveled all the way to NY thinking we had 3 (possibly even 4!) follicles.  

I thought about this briefly but the answer is no.

First of all, it really only cost us about $25 per visit to my local doctor, because the insurance covered my ultrasounds and bloodwork (thank God!).  So in terms of what we actually paid for remote monitoring, there would be very little to recoup.  As far as our travel expenses are concerned, we were lucky to have enough hotel points from all my business trips that our 4 nights in New York were free.  We decided to drive rather than fly, so our only real expenses were gas, tolls, parking and food--still a decent chunk of change, but much better than it could have been. 

Second, I actually like the nurse who did the majority of our ultrasounds and I don't want to get her in trouble.  I think what she was doing was measuring anything that even remotely looked like a follicle and figuring my doctor would sort out the difference when he got the pictures.  I actually heard her say once, "I'm not sure if this one is a follicle but we'll go ahead and measure it and see what happens."  The problem, of course, is that the pictures they take are crap quality because they're so small and I assume they probably fax them, which only makes matters worse.

In any event, I'm chalking this up to a learning experience.  I was the one who wanted to do a long distance cycle, so I knew the risks that are inherent in that--miscommunication being a big one.  And I guess I should have paid closer attention myself.  I've seen the difference between a follicle and an endometrioma on the ultrasound screen too, but I just assumed if the nurse was measuring it, it must be a follicle.  And I didn't always get to see what she was measuring. So I guess the lesson here is to insist on seeing for yourself.  I should've known better.

I also don't want to alienate my local doctor, given that I actually still need her to process the bloodwork for my periodic immune testing.  As it stands right now, she is the only RE in my city who treats immune issues.  If I couldn't have my blood draws done there, I'm not sure what I'd do.

Someone also asked if this was actually SIRM's protocol, and the answer is yes, it was, and it was pretty much tailored for me.  We deliberately went with an antagonist protocol to avoid the risk of over-suppression, and the Femara I took was to help keep my endo from flaring.  The estrogen patch was added in at my specific request.  I wanted to try estrogen priming but, again, Dr. T was worried about the impact on my endo.  Normally SIRM uses injectable delestrogen, but we compromised on the patch.

So the bottom line is, I think I had a good protocol that was developed with my specific history in mind, and the lone egg that we retrieved measured 20.5 on trigger day, so I don't have any doubt that it was mature.  I don't blame SIRM in the slightest for this failure.  Unfortunately, the protocol is only as good as the ovaries you have to work with.

Honestly, I think the surgery I had last year ruined my egg supply.  Prior to the laparoscopy, my FSH was  less than 6.  Yes, my E2 was slightly elevated, but I was regularly having cycles with intense early PG symptoms.  That's why I always knew I had an implantation problem.  It was just so clear to me that *something* was happening early on.  We just couldn't seem to make it to a positive beta.

After the surgery, not only did my FSH skyrocket to 17.4, but all those intense, early symptoms pretty much vanished.  This should have been my warning sign.

I think my gut knew but my head didn't want to listen.  I needed to see for myself what my eggs could do.

Now I've seen it.

I would never have thought that only one cycle could give me the closure I needed, but it has.

We are done.

We will not be doing the mini- or natural IVF's I talked about, because I now know in my heart, my mind and my gut that it would be a waste of time and money.

I will not have a biological child of my own.

I will never have a baby with my father's eyes, or my mother's smile, or her beautiful singing voice, or my short, stumpy legs and big ankles (probably a good thing). 

But we haven't given up.

More on that to come.


  1. Wow, you've had a lot to process. First of all, I'm glad you didn't actually spend as much as you might have on that out of town cycle and the local monitoring--I'm glad it's some small consolation anyway. I'm also glad you have some sense of closure. Believe me, I know it isn't easy. It took us five IVFs and a ton of money spent, two out of state cycles to finally feel the closure for the genetic child. Of course we chose to go with no genetic connection at all for either of just seemed easier to the both of us...but we won't give up on becoming parents either. I was just sick of trusting my body and having it let me down personally.

    At any rate, looking forward to seeing what is coming next :)

  2. This is a lot that you've gone through, and I am impressed with your strength and calm. Life has thrown some hard s*&t at you lately.

    I don't know if this is where you all are going, but for me I think a donor egg would be good -- for me it's the being pregnant that means so much. And many of our mannerisms and expressions and passions seem genetic but are just a matter of proximity, so these kids will be like us (for good and bad).

  3. You have been through a whole hell of a lot. But you are clearly thinking things through, considering them, weighing the options. I'm with you about not alienating docs you still need, for now. It's very smart. Taking a stand only makes sense when there won't be bounce back.

    And thank you, very much, for your comments on my blog. I'd never even heard of anti-ovarian antibodies but will be asking my doc about them. No treatment, though:( Grrrrr.

  4. Julize, I think you are an incredibly strong woman. You have been through so much. I am glad you were able to work through everything and reach a decision. I am very sorry for the loss of your own biological child. It is so hard to accept. But I am also excited for you that you aren't giving up and can't wait to hear what happens next! :)

    - I asked my doc for the AOA test and he said it wasn't worth the bother, given that there was no treatment. Still would be nice to know though. Grrrr.

  5. Agh, I have been trying to comment on this for days but I keep getting an error and my comment dissappears. So I hope this one sticks, I have been thinking of you.....

    I completely understand your decision not to make a scape goat out of the clinic that stuffed up your scans. There are some battles that just don't produce any winners and sometimes the fight just isn't in you. It's a much better idea to keep them on side and conserve your energy for more positive uses. THat being said I admire your ability to push aside the error and just get on with things, you are an amazing person and I'm so sorry things haven't worked out for you yet.
    I really can't wait to hear your plans for the future. xxx

  6. I'm sorry the IVF was a bust. However, I am so happy for you that you have closure on doing another IVF and you feel good about that. I think it is really hard to get there and many people ruin their relationships and go almost bankrupt trying..

  7. What hell this cycle was for you, yet you've come out of this and you still have a shred of hope in you.


  8. I hope you are still checking your blog comments - I just wanted to check in to see how you are doing. I am thinking about you and am here if you need anything.

  9. HI Julize,
    Often think of you and check to see if you have updated. Hope all is well with you.

  10. hey - thanks for stopping by our blog. thinking of you and hoping you've found a new way to pursue your dream of having children. would love to hear an update : )