Thursday, January 10, 2008

My "Perfect" IVF Cycle

Thank you for the supportive comments regarding my niece. I really appreciate it and I am doing much better now. Life just throws curve balls at you and you have to hop along, however slowly, to catch them. I really love my niece and am going to try and help her as much as I can with her disability.

***

Today I am wondering where my husband and I go from here. We just had our first failed IVF. Let me tell you a little about that cycle. It was "picture perfect" according to my RE. In fact, my RE actually told me that I responded "like a 22 year-old egg donor." At retrieval, I had 25 eggs retrieved, 19 of which fertilized, and had two 5-day blasts transferred. They were early blasts, however, so there was not yet an inner cell mass. That was fine by the embryologist and RE.

After retrieval though, I became worried after learning that I had nothing to freeze despite being a reputed hyper stimulator and the number of good embryos still dividing three days after transfer. The embryologist assured me that each embryo/blast is its own unique genetic entity - and that you can't say "oh I had a bad batch of eggs" or "this is indicative of bad egg quality." He said most people at our clinic (60 percent) have nothing to freeze. Not that it made me feel any better. Because there was and is (especially since the IVF did not work) this little voice inside my head telling me that my eggs are incapable of going past the early blast stage.

Everything was perfect during our IVF cycle. Both my RE and therapist (who specializes in infertility counseling) said they were "shocked" it did not work. Great. But it did not. So where does that leave us?

I do not have any reason to think that I have "bad" eggs, whatever that means. My FSH is low, I had beautiful embryos three days after retrieval and, again, 19 fertilized. But I am 36, so my eggs are older than the 22 year-old egg donor I was being ridiculously compared to. But still, WTF? 25 eggs and nothing? This is a reminder that the doctors and embryologists, however fancy their facilities and whatever their success rates, do not have it completely under control. The unknown factor will always be the unknown factor. And, as an uber-controlling person who loves the formula "Do X and Y To Get Z," this is what most distresses me about IVF and ART in general. No, that formula is Do X and Y To Possibly Get Z or ZZ, or zero.

My RE went out on a limb and said that it will happen with IVF. He says that we just have to catch the right embryo. Sounds like going fishing to me. And fishing is pretty hard based on my own limited experiences. I remember sitting there for hours with my dad doing nothing and not figuring out how to even throw the damn line.

My RE also advised that he won't change anything for the next cycle because I did "so well," which simply astounds me. And just so you know, I'm going to one of the top clinics in the country. The doctors there have fabulous success rates. It is just so hard to wrap my head around; we have 19 eggs fertilize and it does not work, while my friend has a crappy IVF cycle (she is a poor responder) and has four eggs retrieved, one of which fertilizes and is now a beautiful baby boy. (I'm very, very, very happy for her of course, I'm just saying - nothing adds up to make any sense at all).

The painful lesson is this: it is definitely quality over quantity. And even with quality, it might not work.

Our next IVF is tentatively scheduled for April 2008.

13 comments:

Tracy said...

I'm convinced that it is a numbers game...with you producing that many eggs, you are bound to produce a good one, I would think. It is a bit like fishing. You might be interested to check out this link:

http://www.advancedfertility.com/eggquantityquality.htm

You probably don't want to hear this, but my FSH numbers were in the normal range, too. Unfortunately, all that really tells us is there are a lot of eggs. The whole quality thing is up in the air. I think you are right to question your doctor, but on the other hand, it's definitely worth trying again.

I'll be keeping an eye on you.

lifefromhere said...

isn't that crazy it can be "perfect" except for the result?! your "perfect" cycle sounds a lot like my recent failed IVF with the number of eggs retrieved and fertilized. probably the only reason we had embies to freeze is because we did a 3dt. I'll be lucky to end up with any for an FET.

I do think it's a big crapshoot. they're looking for the best embryos, but they don't really know for sure which can make it. "perfect" looking embies fail all the time and less than "perfect" looking embies make perfectly healthy babies.

I wondered if we had insisted on a 5 day blast if we would have had a better idea. my husband will not do IVF#2 but my RE said she wouldn't change a thing either because I responded so well.

it seems to be quality over quantity, but the odds are better when you have more eggs I guess. and the odds are better for 2-timers, so it's worth a shot.

unless you're talking about live births, I think clinics' "success" rates have more to do with their protocols than our likelihood of success. (for ex., success can be measured in cycles making it to transfer rather than pg or live births.)

~luna

Shelli said...

Oh boy, do I hear what you are saying.

I too have been the mystical "looks good on paper" 39 year old. Low FSH, E2 always in limits. I respond well to meds, and had textbook follie size and growth. No known issues. No clotting disorders, no thyroid issues, and DH has no issues either.

Yet somehow we have flunked over and over at Babymaking 201.

My RE seems to have a similar view. I have a lot of eggs, but it's possible that they are not quality eggs. If my next stop is IVF next month, it will be interesting to see if my experience is similar to yours.

That all being said, I still think we have a decent chance to succeed at this. Because even fishermen that have bad catches usually get a good one eventually. ;-)

Denise said...

There does seem to be no rhyme or reason to it which is so frustrating. We have yet to make it to a transfer, so we have no reason to doubt egg quality at this point, but I still worry about it. There are just too many variables and, in my opinion, too many undiscovered reasons for all of this.

Although science has come pretty far with ART in the last 20 years, it still isn't as developed as you would think based on how the media spins things.

Denise said...

Forgot to mention, I loved your choice of at-bat song for day of ER. I got a vision in my head of you dancing like a fool to the Pointer Sisters!

Grayson said...

It absolutely doesn't make sense. I wish for you and M. that it was more controllable or straightforward.

Melanie said...

When I was doing IVF, I felt like the Dr.'s were guessing half the time. When one thing didn't work, we'd try another, and another... It's so hard and so unpredictable and so unfair.
I have PCOS so I always produced a ton of eggs, but most of them were crap. Even at 29 and 30 y.o. when I was doing it.
Hang in there. Be an advocate for yourself if you think there is something you need or want to try. And above all else, take care of yourself. April is just around the corner...

Anonymous said...

I had a "Perfect" IVF Cycle too.
16 Follicles, 16 eggs retrieved, 16fertilized. Similar to you, none were good enough to freeze. But we did have two 3 day embryo's transferred (a "1" and a "2" -- all others were too fragmented). Anyway, I have no idea why it doesn't make sense. It's a rollercoaster. I'm trying to decide when to have my next IVF. It's hard not to get discouraged. Although misery loves company, what I'd love to hear are some success stories....to cheer me up. Any takers?

Alexandra said...

I just completed my fourth ivf attempt. My pg test is due for this coming Tuesday - I am 6 days post embryo transfer and I have 6 more days to go, I swear to you it's torture! But I am keeping my fingers crossed.

I am 32 years old and apart from PCOS neither myself nor my husband have any known fertility problems. We know because we have done all the testing needed to establish that, including DNA, antibodies, blah blah blah, the works. Nothing, everything works perfectly fine!

Of course, one could argue that PCOS is a potential problem but the truth is that it is more of a syndrome rather than a fertility issue, as every woman suffering from PCOS has totally different symptoms and most of them manage to conceive perfectly healthy babies on their own. I too got pregnant 3 years ago by myself but it didn't work out - but that's another long and sad story.

So, here I am, giving ivf a fourth chance.

During my first ivf cycle I produced 25 eggs, 19 were fertilised, 9 made it to day 3. Doc decided that we should transfer 4 and leave the rest as they were too fragmented.
Result = nothing

During the second attempt I didn't take any hormones, we did what my doc called a "natural cycle". I produced 1 egg, it fertilised fine so the dear doc transferred it at day 2 - he didn't want to risk leaving it on its own longer.
Again, result - zero!

During my third attempt I took all the hormones of the universe. We combined 3 different meds. I produced again 25 eggs, 19 fertilised, again most were fragmented, so I had 6 transferred on day 2.
Result, zero, once more!

This time, the fourth time mind you, again I took an enchanting cocktail of all the hormones available to mankind. I produced 19 eggs, 10 fertilised, we transferred 7, 5 perfect 2-day ones and 2 slightly fragmented ones.

And I now I am waiting, praying, hoping, keeping my fingers, my toes, my arms, my legs, my hair, my thoughts, my husband's, my mother's, my father's, my neighbours' fingers, toes, hair, ... crossed that this time it will actually work.

IVF is a complicated, painful, costly process that requires a lot of guts. I know people who did it the first time round and people who have been trying for years.

Egg quality is important, it so happens that people who produce a lot of eggs sometimes lack in quality. But that's not a problem. Every cycle is different and every cycle has a different chance.

So, all we can do is keep the faith and find the strength and the support to keep on trying. It will eventually work, it has to!!

Anonymous said...

do not go to blast stage, my firm belief is that eggs are better back in the body from day 3 and viable embryos are being destroyed because they cannot develop to day 5 outside of the body. The theory is great but in practice so complex that many clinics cannot control the variables adequately.

lisa said...

Thanks for sharing this informational blog post with us. Today infertility becomes a common problem of almost about 10% of such couples whose age is between 15 to 40 years. Sometimes the main reason behind this problem is that when one of the two partners may reaches at the age of thirties then the power or ability to produce young one decrease automatically.

lily said...

Nice blog, thank for sharing

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