IVF#3 - Post IVF Consult

What happened and what's next? These are the 2 most frequent questions I've received and I'll address the what happened.

My beta was due on a Sun when the labs are closed, so I scheduled it for a Mon. The plan was to not test before the beta. Due to the torture of not knowing and some timing issues, we decided to do a home test after church on Sun. We thought for sure I was pg. We even went to Walmart and bought the digital test.

We each had our own cup of pee (both were my pee) and we each had our own pg test. I had the one with 2 lines and Kerry had the digital. We had the camcorder rolling. We dipped at the same time and just waited for what seemed like an eternity. I knew I would know before Kerry because his had a 3 min hourglass before showing the results. I was watching mine intently, waiting for that elusive 2nd line to appear... waiting... waiting... waiting... sweating... heart racing... you've got to be kidding me, where's the 2nd line???? Kerry's still oblivious watching his hourglass. I dropped mine and leaned over to watch his... tick tock tick tock... "Not Pregnant". Evil pee stick! I think I even heard it laugh at me. We sat there stunned. For the first 10 mins I was really impressed with how well I was handling it. Then a few tears... Then complete hysteria. I don't think I've ever cried that hard in my entire life. I can't believe it, I failed at the #1 clinic, what a blow.

The next day I had to go do my beta. We all know how that turned out. I faxed the results to CCRM. My backup nurse called to give me the results and then asked if I had any questions. I said, is this it? Do I get to talk to the doctor? She said of course and she took my file over to Dr. Schoolcraft.

Schoolcraft called me back within 20 mins, I was very impressed. He said he was sure sorry and that he thought for sure that one of the 3 transferred would take as they were great quality. He said that although it was a funky cycle, he felt it went much better than my previous cycles. He thinks there's an egg/embryo quality issue. I asked him would he do anything differently looking back. He said he would want to do CGH genetic testing on the embryos. He said that when I first came to him he wasn't sure that I would make very many eggs and that's why he didn't recommend it at the time. He feels we need to get the final question answered, are any of the embryos genetically normal. If there are normals, then it's just a matter of getting the recipe right. If there aren't, then it's time for donor eggs/embryos. I asked him if he would lower my stims any to keep my e2 from going so high and he said not initially as I start out fine, but then towards the end it goes crazy, so he would cut the dose down earlier after 4 or 5 days. I asked him if he would keep me on long lupron and he said yes, the only reason to not use it is if you can't get any eggs on it. I addressed my concern of an implantation issue, is it that my uterine environment is unhappy when jacked up on stims, or do I have an implantation issue? He said we would get to test the theory as my snowbaby or a CGH cycle would both be a FET cycle. He said all the standard tests don't point to an implantation issue as my tubes aren't blocked, the hysteroscopy and uterine bloodflow were fine and then all the ultrasounds showed my lining get to the right thickness with a triple pattern. He said the bigger arrow is pointing at egg quality issues as the embyos have struggled on all 3 cycles. He said if I wanted to unturn all stones, I could do the endometrial biopsy checking for the beta 3 integrin protein that assists implantation. The majority of patients missing this protein have blocked tubes or endometriosis. I've never been tested for endo, but I don't think I have it. We discussed natural vs medicated FET cycles and he said with me being in TN, it would be much better to do medicated as we would know the transfer date a month in advance vs 4 days. I asked if you take the planning aspect out of it, is one better than the other? He said they are about the same, but still recommended medicated and said it would be better to not chance that the cycle you go to do the FET your cycle hiccups and your hormones are out of pattern. He then said the other thing I could consider would be to do the CGH cycle first and then combine the embryos and have a better chance as we would have more to transfer. I asked if he felt confident that I would be able to get some blasts for genetic testing and he said yes, that if they would have cultured my 4 best embyros instead of just 1 (we transferred 3), he feels we would have had 2 or 3 blasts. I asked if he would test the embryo I already have frozen and he said no because he wouldn't want to put it through another thaw and refreeze.

For you CGH gals that are getting no results back, I did ask him what's that all about and he said they only remove 1 or 2 cells from the embryo and they have to amplify/copy the DNA about a million times to have enough DNA to analyze and if the reaction doesn't produce enough, the signal isn't clear. So the lab states that the signal wasn't clear and there just wasn't enough DNA and they don't feel comfortable saying if the embryo is normal/abnormal. He said he gives the patient the option if they want to transfer the no-result embryo.

I'll address what's next in my next post.