First Steps in IVF

So we took our first steps in IVF therapy, meaning, we actually did our first round. Sadly, it won’t be our only round as we were not successful, but I thought I would share about the experience since I wasn’t really sure what to expect, and I think knowing a few things ahead of time would have helped me.

I think IVF is wondrous, it’s amazing, and it’s clearly brought millions of babies to families that might not have been able to have them otherwise. But I have to say, it’s not easy.

We decided to change from doing the mini-IVF and that clinic for a few reasons. Mostly, I just felt that time was ticking away and we weren’t making any progress. Having done two rounds of IUI last year, had 2 cycles that were stopped before they even began due to cysts; we were ready to really have a good chance. I did my provocation medicine at the mini-IVF clinic, and all was looking really good in terms of the number of follicles, but then my estrogen levels were below what the doctor expected so he suggested we cancel the cycle. However, in giving me the choice to risk it and just wing it with funky estrogen levels, versus wait another month and try again, I felt that I was put in a situation with a choice that I didn’t want to feel responsible for. How could I decide the best thing to do? I was so emotionally invested in doing the retrieval, it was the day prior that this all happened, so I got overwhelmed and didn’t know the best choice to make. It was actually a good reflection for me as a doctor to experience how my patients might feel when I give them treatment choices and they feel incapable of making big decisions. I wanted that doctor to make it for me based on his expertise, knowledge and experience. Either choice I made, I felt like there could be regret and second guessing. Ultimately we decided not to go ahead until things seemed more favorable.

I also have a patient who works for another IVF doc, and my neighbor saw him to facilitate her now-six month old. So we decided to go and have a consult with him. We liked him so decided to go for it and do full IVF. Month one we couldn’t do anything since I had follicles that had been retrieved leading to more cysts, so I got on the OCP and waited another month (tick, tock, tick, tock).

Month 2 we started the stimulation meds. I do fine with the medications, needles don’t bother me, and my body seems to respond and do the right things. Things progressed well and we had quite a few follicles developing, so the retrieval was scheduled.

I think this part was the most surprising part in terms of physical impact. The retrieval is done under general anesthesia, which I knew. I was warned by the clinic that I would have some bloating and swelling, and probably cramping, afterwards. However, I was picturing I’d rest up that day and be good as new the next day. Ummmmm, no. I didn’t leave the couch for the first few days unless I absolutely had to, and wasn’t able to go running or do any exercise for at least a week. My whole abdomen was very full, and very tender. I couldn’t let my daughter cuddle up too close to me, and I couldn’t really walk fully upright for several days. I followed their directions and ate high protein, high salt, and took electrolytes, but it all just took time, much longer than I’d anticipated.

What really amazes me about IVF is what a miracle for all the steps to line up right. Nothing is taken for granted, success is not guaranteed; but when I saw the process first hand, and how many things have to go right just to make one baby, it was a real wake-up call. Of course, my age has much to do with that – at almost 44, the odds are not in my favor.

Here were our steps –

• we had 20 follicles by the day of my retrieval (seemed like a great number)
• of those follicles, only 10 contained eggs (still seemed like a good number)
• of those eggs, 5 fertilized (still ok)
• of those embryos, only 2 survived the five-day mark to become blastocysts (here’s where my heart started to sink)
• of those two blastocysts, neither were genetically viable, meaning neither could possibly survive based on their chromosomal abnormalities (here’s where my heart broke)

We had been told that at my age, 1 in 10 embryos were likely to be chromosomally viable. 1 in 10. And by then we only had 2. So in my head I knew the statistics, but in my heart and soul I was praying to have that 1. It only takes 1; we only need 1. But this time, it wasn’t meant to be. We were told they both would have been boys.

I was a hot mess for a couple of days, but then pulled myself out of it and got used to the idea. Many people have to do more than one cycle, I get that. What seems depressing is all the steps that would have to work out just right for us to get a healthy baby. What’s more – the doctor told me that once we get an embryo that is genetically normal, there is a 50/50 chance that when implanted, it will take and become a healthy pregnancy.

20 follicles, 10 eggs, 5 embryos, 2 blasts, and even with 1 normal, a 50/50 chance that that would end up in a pregnancy and live birth. I’m not betting girl, but even to me those are some horrible odds. And even though this isn’t primarily about money, I can’t deny there’s a part of me that wonders how many chunks of $20,000 we’re going to throw at this for such low odds of success.

One step at a time; we’ve decided we will try another cycle. Now I have to rest my body and let it heal, I’m back on the birth control pill to try to suppress all the crazy hormones. We’re hoping to do another cycle in July but we won’t know if we can until a couple of weeks from now.

So there it is. Not good news so far, but we are not giving up yet. And through all of this, we kiss and cuddle Valentina every day, appreciating fully how blessed we are to have her. I have such respect for couples who go through this time and time again – the stress physically, mentally and emotionally is profound, not to mention the investment of time and money. It’s nothing to sneeze at.

If anyone else is reading this who is going through this, please know that you are in my prayers, I’m giving you a huge virtual hug, and I have deep respect for your resilience and fortitude. I pray that the babies come and find all of us!