We Don't Know

Today was the appointment that every seasoned fertility patient dreads.  The "Free Follow-up" you hope you get to skip because you have an OB appointment instead.  Instead, you sling your head really low in the waiting room ashamed of being on the wrong side of the statistics again and wish you could disappear.  Two new patients came in today.  They were both much older than BJ and I, and the females were both extremely overweight which means they probably have poly-cystic ovarian syndrome.  They have a tangible problem and even with their age probably have better odds than BJ and I do of having our own children.  It's more salt in the wounds.

My mom has been with me all weekend and went with us as a support to this appointment as well.  Dr. Donesky immediately pulled up our files and talked about how much improvement we did have.  We had a genuine grade-able blast.  He gave it a grade of 3AB (not the 3AA- which does not surprise me at all...I've been pretty confident Susan made that up for my behalf all-along) which is still considered excellent in quality and some clinics would have only recommended transferring it, alone.  We will never know if it was the 3AB blast or the early blast that implanted, but we do know it survived for a while and continued progressing to the point that HCG was circulating at detectable levels through my system.  We won't ever know if something was wrong with the baby, or if it was me, or if it was simply misfortune that caused the miscarriage.

Dr. Donesky did say that if he had to guess which couples would find success with IVF and which wouldn't, he would choose the couples who had a biochemical pregnancy over the ones who have never had a positive anything.  It's strange to not be classified in that group anymore, yet having nothing to show for it.  I wish I felt more confident about it.

He allowed BJ and I to ask questions.  I asked about doing a reproductive immunology panel, and he said he'd be happy to do it, but the research and results just did not seem to be promising. Studies are not showing increased success with the treatments for the immunological problems affecting fertility.  Reproductive immunology is a very progressive field, and there are lots of medical professionals that do not buy into it.  I don't know enough nor can I find enough research to make an educated opinion about it, but I'm certainly keeping my eyes peeled and am rooting for the people who I've met online that are doing it.  If I'd had multiple losses with perfect blasts everytime, I think Dr. Donesky and I, both, would be more interested.

Dr. Donesky had high hopes for the embryos we transferred this time.  BJ and I certainly did.  He told us we could take the easy way out if we wanted and try a donor egg cycle.  Knowing that BJ and I are not on the same financial level as Bill and Guilliana Rancic, it would probably be the closest thing to guaranteed success Dr. D can offer us.  For the life of me, though, I cannot accept being in my 20's, producing a strong number of  nice-looking eggs, and there still being something wrong with them.  You can't google "poor oocyte quality" without getting information about advanced maternal age and poor ovarian response, neither of which applies to me.  Dr. Donesky is not ready to throw in the towel either, and I promise you he knows a lot more about this stuff than I do.  He told us we have 10 years or more to try donor eggs, but if we want to try with mine, now is the time.

My mother chimed in at this point with a "What would you tell your daughter to do?"  Dr. Donesky said he'd tell her to try again.  He'd tweak things a little bit.  We talked about timing, endometriosis and the pain I've been having, again.  Endometriosis is an auto-immune disease, which kills me to say because it makes me feel like I'm really sick.  I don't feel like a sick person for at least two-thirds of most months.  It is possible that the endometriosis is creating an inflamed environment in my pelvis that may be harming my eggs.  He told us that eggs are on a 72 day cycle.  Dr. D has seen some endometriosis patients get better results after being suppressed for longer.  

After discussing with BJ and me for a few minutes about when we'd like to try again. He wrote a prescription for 3 months worth of depo Lupron.  Yes, more needles, but only 1 a month.  I will officially be in a medically-induced menopause.  This means no more pain, but no more trying to conceive either.  It means I have to learn how to live again.  In March, if BJ and I are feeling plucky and have found hope again, I'll switch to sub-Q Lupron and we can go for it again.  If we've found a happy place in this 3 bedroom + bonus house living child-free, then so-be-it.  We obviously still have that option...

Peace, Love and ?,

MK