About Me

Name: Liz

Location: New York

I'm 37 and have been happily married since Sept. 2002. Ivan is truly my companion in life. Our TTC journey has felt like a never ending roller coaster ride. We had an ectopic PG in Dec. 04 and in April 05 found out my IF is due to tubal abnormality. We were told IVF was our only hope. July 05 we did IVF # 1 and it was a chemical PG. We did IVF # 2 in Oct. 05 and it was a BFN. In Jan. 06 we did a combined fresh and frozen embryo transfer and it was a BFN. We were determined not to give up our dream of having a baby. IVF # 4 was in April 06. The cycle worked like a charm and on December 20, 2006 we were blessed with Hannah and Matthew.

We met on Thursday with our RE for the BFN follow-up. We weren't expecting much but were hoping she would be able to shed some light or offer some reassurance. We got neither. She recommended we do another FET with our 2 remaining snow peas. When I asked what they thought the problem was she could not give a direct answer because they don't know what the problem is. She suggested a second opinion and then discussed other options - donor egg, donor sperm, adoption and then stated she didn't think we would need that...so why the heck bring it up. They are a reputable clinic and I was angry that they couldn't give us an answer. I know sometimes it's hard and it seems they are as baffled about it as we are. We left feeling hopeless and scared.

We met yesterday with Dr. S (one of the best in the field). He went over the questionaire (20 pages) and medical records, often stopping and explaining things to us. As I listened I smiled and began to breathe, in a very relaxing way and it was good.

We were shocked and of course very pleased to hear that ours is not a difficult case. Is he being cocky or does he know his stuff?

He believes the main problem and what caused the fertilization problem was the ovarian stimulation protocol. He gave us a lengthy explanation and drew pictures but the jist of it is that the protocol didn't give my body a chance to "recruit" follicles before I began stims. We all begin protocols with either BCP or Lupron and then a few days later begin stims. Many who are on Lupron only decrease the dose when starting stims. The problem with not waiting for AF to begin before starting stims is that our body hasn't recruited follicles and our body is then left with developing follicles solely from the meds. This makes sense...now I understand why I've gone for a baseline u/s on day 3 and they've seen 13-15 follicles but when I've gone for my u/s on day 5 of stims there are only 5-7. We recruit follicles before AF arrives but since they suppress us with Lupron or BCP this isn't the case. Another issue with Lupron is that it causes your pituitary gland to secrete too much LH and it depletes your body of LH which will then result in poor quality eggs. To counteract the depletion of LH we should also be on a GnRH antagonist. What happens most with these protocols is that the embryos are compromized and the end result is failure.

We were shocked to learn this. He explained how clinics use these protocols and overlook the overall impact it will have and he is SO correct. We've all compared protocols and have been on similar ones with only the meds being different. Before choosing my RE I went to 4 different clinics and the protocol was the same.

He recommended that we schedule a sperm DNA integrity assay to rule out problems and assess antibodies.

Besides the change in protocol the other change will be in how they grade the embryos. Their graduated embryo scoring (GES) assesses embryo quality throughout a period of 72 hours. Embryos with a score of 70-100 have a 35% likelihood of implanting.

They will also do an embryo marker expression test (EMET) which measures the genetic marker known as sHLA-G. EMET is performed 46 hours after ER to identify EMET-positive embryos. Their research has found that transfering 1 EMET positive embryo in women under 39 results in better than a 60% chance of a viable pregancy.

After hearing all of this we are confident that it can and will happen. The dr is also very sure of it.

He wanted us to take time to talk and get back to him with our decision but we, mainly Ivan, let him know that we wanted to cycle with him. FORTUNATELY he will be cycling again in NY in April. I spoke with his coordinator last night and I will begin BCP around March 13 and will begin stims April 9.

I haven't felt this hopeful in a very long time....honestly I've never felt so hopeful about IVF. I know that in the end it is all up to a higher power but I know Dr. S will get us there.

About Me

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