so where do we go from here?
So the other day was our follow-up consultation about my failed IVF, to discuss with my RE what went wrong, what went right, and what’s next. We are very fortunate to have some frozen embryos to try FET. But our first question is why that would work when all else has failed? (More on that below.)
Aside from her inability to impregnate me (yet), I adore my RE and have been pleased with my care. She makes me feel like I’m her only patient (from initial consult through every surgery and treatment). On top of her impressive history (as DE and ICSI pioneer), she is also clinic director, professor and mentor. She is kind, empathetic and very thorough. She inspires a deep sense of confidence that makes you want to put your faith in her gospel. Of course her gospel is treatment, and you want to believe. If we had unlimited funds, I might keep returning at whatever cost. But she is well aware that our future treatment options are limited, and FET is likely our last stop. I know she wants this for us too.
Yet when we walked out of our appointment, instead of feeling inspired, I felt like crying, like screaming. It’s not that she didn’t give me reason to hope, she always does. It’s that nothing else has worked so far, so why should I believe now? Have I lost my faith? Strangely, part of me feels that as long as we have those tiny frosty embryos on ice, there is still hope, a chance. But if we try and fail, well, then we have nothing. Maybe that’s the finality we’d need to somehow try to move on…
She recounted my history, from fibroids to tubal disease, pelvic adhesions and slightly irregular cycles. While my ute looked good and fibroid-free(!), she suggested I could have some scarring but that with a healthy lining that shouldn’t matter. Because I’d like to know if our natural attempts are as futile as they seem, I asked about my tubes (which she had cleared a year ago). She joked she didn’t care about my tubes anymore (IVF saves!). Hahaha, thanks very much, but I still care since they might be our only hope if FET fails. But there’s no way to be sure without more testing, which isn’t really useful at this point since I think four corrective surgeries may be my limit. Plus we just bypassed my crusty tubes and still no luck.
She walked through my IVF protocol and how she made each decision. She discussed my “aggressive” response (30 eggs) and said my ovaries are still young enough to produce some good eggs. We went through the fertilization results from IVF and ICSI. We had a lot of embryos (15), though not all of our bit parts resulted in the highest quality clusters. Our clinic grades embryos from 1-6 (instead of 1-4) and freezes those that have 6-10 cells with grades of 1-3 (instead of 1-2). This may explain why we had so many to freeze. Some of the frosties were good quality (grades 1-2); about half of them were the lowest quality for freezing due to some fragmentation (grade 3). They expect a 50-70% successful thaw rate, which if we’re lucky could leave us with 6-9 embryos. So thankfully, FET is still an option.
She walked through the FET protocol, which in my case would involve medication (bcp, lupron, estrogen patch, progesterone). Women with predictable cycles can do natural FETs, but not me. It would take 6 weeks from cd1, which means mid-to-late March at the earliest (and another cycle of nasty meds). Success rates are generally lower than fresh cycles, so they’d transfer an additional embryo (3 total) to bring my chance of bringing home a live baby back to about 35%. But these numbers don’t mean squat. I’ve been on the crap side of statistics enough to know that.
So the big question: why should we believe this would work? Why would we spend more money, subject my body to yet another experiment, and allow our hopes to be raised again? Why should we take yet another leap of faith? Do you know anyone who has had success with FET? Anyone have anything to share? Here’s what I’ve got so far…
Our future baby could be chilling right now. Maybe our golden embryo is still out there, just waiting to be thawed and transferred so it can implant its way into my completely healthy womb and grow grow grow. The high-tech world of baby-making is indeed a science, but it is by no means an exact science. The best experts use objective measures to ultimately make a subjective determination about which embryos might be more likely to thrive. But it’s still a crapshoot. Perfect looking embryos (like the glimmer twins) can fail to develop, and not-so-perfect looking ones can make absolutely perfect babies. They just don’t know enough yet. Maybe one day they will, but for now, grading and guessing is the best we’ve got.
Fewer drugs can mean a better response. The FET protocol more closely mimics the body’s natural cycle than an IVF cycle for fresh transfer. This is especially true in an unmedicated FET cycle. Even a medicated FET (to control timing and supplement estrogen and progesterone) is less intrusive than the high doses of follie stimulating drugs used in fresh cycles. Apparently, heavy ovarian stimming can adversely affect the uterus, which may inhibit implantation. (Of course this is not true for most, but I’ve always fallen on the crap side of odds when it comes to ttc.) My RE also explained that FET and DE cycles are often successful because fewer drugs are involved for the transfer recipient and the protocol is closer to her natural cycle. So some women may be more likely to respond to FET than a fresh transfer. Who knew?
More aggressive transfer. Because FETs generally have lower success rates than fresh transfers, they get a little more aggressive to compensate. In my case, they would transfer up to three embryos instead of two. The hope is still for a healthy singleton since I would be a high-risk pregnancy. Maybe 3=1?
Eyes on the prize, baby. If this is our last chance, of course I feel like we have no choice but to try it. Because we have to. Because I don’t know how to give up. I’d really like to believe that, in the words of the honorable Martin Luther King, Jr. (with deep respect), “we shall overcome.” I’d like to say we will fight until we have nothing left to fight with. That we have nothing to fear. That hope must prevail. That our day will come. The truth is I don’t know if we will ever make it to the “promised land.” But this may be the only way we’ll find out…
Edited: I should probably clarify that, in case you couldn’t tell already, I feel in my heart we need to do this. I wouldn’t know how to walk away from this chance. I suppose what I’m looking for is reason to believe it could work. We need to get our heads around it too… thanks again.