Tuesday, July 3, 2012

Failed IVF Follow-up

Hey, all.

So as you may have gathered, my first attempt at IVF was last month.  (I officially started injections on June 1st, and I would qualify it as 'over' June 27th when my chemical wasn't just suspected but verified).

The injections were actually exciting (gasp).  The egg retrieval was a really awesome nap followed by some awesome pain medications. (They retrieved 12 eggs - 10 mature).  I rocked the first half of IVF.

Then they called to tell us that only one egg fertilized.

Of the 10 eggs they retrieved, they did ICSI on 4, and let the other 6 do their thing.  Oddly enough, the one that fertilized was from a sperm that was just able to do it's thing.  3 days after my retrieval, they transferred my one fighter - an 8 cell grade B embryo (lovely number of cells, and sure not an A grade but it would've at least been on the honor roll).

Roughly a week and a half later, I took a positive pregnancy test, and 36 hours after that I was told it wasn't going to be viable.  You can read about that whole pitiful tale here.

So today was our follow-up appointment.

A little background on my RE - I'm confident in him.  He's the head of the reproductive endocrinology department at a kick ass hard-to-get-into university.  He travels and does lectures, he spends eons going over things with us, he knows the first name and number of people all over the world who can give him the best second opinion just so he has information to give to us.

Clearly, our problem was that we had only one fertilize.  And it's a bit of a stumper, because my eggs looked awesome, as did Bub's sperm sample.  Apparently when things look good like that, it's more likely that there is something 'invisible' wrong with the sperm aspect of things (but still it could be either of us, or both).

In the last week, my Doctor physically went down to the lab where they made the embryos.  He checked to make sure that the best embryologist there did it, and he did.  He checked to see how other couples did that day, they were fine.  He checked to make sure there wasn't a possibility of contamination, there wasn't.  He shared our story with all the other RE's in the office, he called a couple of people on the east coast to get second opinions.

So here were the options as they were laid out to me:

  1. We just do another IVF cycle in a couple of months.  They tweak my medicine a little bit, maybe have me make some more eggs to have more to play around with, but it would be a crap shoot.  Sure, they could mess with things for me, and sure it's possible (but not probable) that our fertilization was a fluke, but the exact same thing could happen again.  The one thing they'd definitely do differently is sift through the sperm super carefully to make sure they were using ICSI on the ones whose heads were able to 'burst' when they enter the egg.  (A lot of info this morning, forgive me for not being super clear I'm still going through it).  I'm hopeful that maybe that's the entire problem, and doing this would solve it.
  2. We do another IVF cycle, and with half of my eggs they use Bub's sperm, and with the other half they use donor sperm.  This would tell us whether the problem was with the eggs or the sperm (if donor sperm fertilizes well, it's a problem with the sperm.  If not, the eggs).  I fully support that women do this and I think it's awesome to have options, but for me it's not an option.  
  3. There's a scientific study going on, I believe in Massachusetts.  He described it as 'not clinical, it's scientific' which basically means research.  One of the phone calls he made is to the man that's conducting it and he's string pulling to see if we can get Bub's sample tested.  Basically it suggests that some men lack a protein that's needed in order to fertilize an egg, and that men with type 1 diabetes (which Bub has - not the type you get from a bad diet, he's quite skinny, but the one where your pancreas essentially just dies) are more likely to lack this protein.  Basically when a sperm gets in the egg, it doesn't tell the egg that it's there, so it doesn't know what to do.  If this is the case, when we do IVF again, they would use something called calcium ionophore.  My so-far understanding of it is that it's a special dish that has the protein in it, so everyone knows what to do.

So we're going with option 3.  In a week or so, we'll find out if we can be squeezed into the study, and DH will give yet another sample.  They'll check it here just to see his numbers, freeze it, send it off to the east coast.

If that's the situation and we do calcium ionophore, or if it's not the situation and we just tweak and pray, I'm doing it again in September or fall.  I'll just be more nervous, this time.  When you get to the IVF stage (the last stop on the crazy train) you don't want to additionally be the challenge within IVF, but there you have it.

I asked the Doctor if he ever tells anyone "you're just screwed", and he said that sometimes he basically has to.. But that if he was us, he wouldn't throw in the towel.  So there's that.

When we left, we were upset.  We always assumed I was the problem and Bub's basic response was "I don't understand why this is happening".  I don't give a shit whose fault it is, really.  The only reason to even know is so that they can hopefully do something about it.  And if he can't have kids, then I can't have kids, because the one thing I'm confident of in all this uncertainty is that we're supposed to be a pair.  Whether it's G-d or just random biological events that made us, we were supposed to end up together.

So far (it's only been a few hours) I go back and forth between feeling devastated and hopeless, and from feeling like 'okay well there's still shit they can look at'.  When you get to the point where your best (and only, really) shot is with IVF, your hope is pretty diminished to begin with, even though you have some.  To get here, and basically have to hear "oh, we're going to have to take a little more hope out of that tiny reserve you have left" makes me a little pissy.

So if you, out there in the interwebs, could make it a point to really, really want me to be pregnant - you know, make me one of those women you would genuinely be happy for - it would be greatly appreciated.

And now I'm off to write about things that I am thankful for...  But since I'd like to leave you with a goofy visual...

This is a house in Beverly Hills that I love, that I took a picture of the other day when I was in the neighborhood.

As part of my ridiculous ideas of what being childless would be like (which you can read about here) I'm thinking I should add this on the list of possible gimmicks.  Buy this house (which is millions of dollars), start wearing a witch's costume every day of the year, have many cats.


  1. I don't think I have ever said this in a comment on an IF blog before but.... It' sounds like you have a great doctor that is doing everything within his power to make this happen for you and keep you as informed as he can. That is great, and super rare I think. Option 3 sounds really good, altough... For option 2, I hear that Tom Cruise is newly available and I know how you feel about him!!

    1. Thanks - I hope he's on his game. He seemed like he was genuinely flustered, like "I'm going to get this to WORK" when we went in.

      And oh lawdy, Tom Cruise. Even if he & whatever girl has sold her soul are completely fertile, I'm confident he would never electively knock someone up outside of a lab.

  2. I agree with Sunshine, it sounds like you have a very good RE. I would also recommend you ask his thoughts on doing DNA fragmentation test on Bub's sperm. It checks for micro-deletion in the sperm's DNA, making it difficult to create viable embryos. Having said that, even if the results came back positive, you would not opt for donor sperm. But at least you'd know not to completely deplete your hope jar on further IVF cycles. Feel free to reach out to me if you want to discuss further. Love your blog btw, and thank you for your nice comment on mine. ;)

    1. Hey there lady! Thanks for the advice... So much to think about it's mind numbing.

    2. Anytime you're ready, just shoot me an email. Meanwhile, continue blogging! I have much catching up to do on here.

  3. You are totally one of the ladies I'd be 1000000000000% happy for!

    1. Yay! Gracias chica. I need all the luck & good vibes that can be mustered!