IVF is on my mind…

While I have been reading and keeping up with everyone’s blogs, I have been un-interested in writing about myself. There was nothing interesting to report. That has changed in that we have some progress after all of my second opinions. The writings below explore the opinions of the four doctors I have consulted with. Three of them are IVF doctors, and one is my RE. My RE is Dr. N, and the IVF doctors are Dr. H (#1), Dr. Z (#2), and Dr. ML (#3). I’m sure this post will get confusing, sorry!

Unicornuate Uterus

All four reproductive doctors concur that my uterus is not a likely cause of my miscarriages, although one of the four does think it could be a factor. I’m going to consider that good news, although I’m not fully convinced that it’s not part of the problem

IVF

My RE, Dr. N, is very pro-IVF for us due to my UU, as he felt doing a single embryo transfer was very important and I should not risk the chance of having twins naturally.

Our first IVF doctor, Dr. H (through Kai.ser), feels very strongly that doing IVF will be beneficial to us in that we can genetically test the embryos. His thought is that we would probably only get one genetically normal embryo based on my AFC and FSH (although we do run the risk of getting no normal embryos). His suggestion is the microdose Lupron flair protocol. I really liked his bedside manner, but I have huge problems with going on birth control for 2 months prior to cycling. I am very concerned about over-suppressing myself due to my borderline DOR. Kai.ser is an IVF machine that batches their patients and has great SART ratings, but I don’t think this approach is for me.

Dr. Z runs a private fertility clinic that only does IVF. He is a one man show. His big thing is that he also does immunology (something I am interested in because of my recurrent miscarriages). They are the most expensive option out of the three clinics, but I did have him run tests for my natural killer cells and my TH1:TH2 ratio (cytokines). After $800 for 4 vials of blood, my cytokine ratio was elevated but my NK cells were normal as far as I can tell. I do not understand what that means, even after consulting Google and reading some medical literature (I am able to wade pretty well through medical journals because my first undergraduate major was Chemistry…what was I thinking there, but that’s another story). If anyone has any insight into cytokines and recurrent miscarriage, please enlighten me. I am comfortable with his recommendations based on my results to have an intralipid infusion before my FET, and then do two more intralipid infusions upon confirmation of a positive pregnancy test. So what is my reservation with his clinic? I feel like they are just out there to make as much money as possible. The do a ton of unnecessary genetic testing that really adds to the cost (the overkill on the genetic testing is just my opinion). I realize that IVF is a business but I really didn’t like the feeling I got working with his clinic. I did like his protocol recommendation of a natural start IVF cycle (no BCP). I could see myself going back there someday if our plan doesn’t work out.

My final consult was with Dr. ML, who works in a large research hospital in SF (if you’re in the area, I’m sure you can figure out where this was, haha). I immediately loved her bedside manner and how well she knew my case. She does not quite agree with Kaiser’s diagnosis of DOR just yet, especially since I am still getting pregnant. Her suggestion was actually to keep trying naturally and if I miscarry again, have the embryo genetically tested so we can get an idea of why I’m miscarrying. However, she said if my husband and I wish to go forward with IVF, she would do an estrogen priming protocol, where I wear estrogen patches during my TWW prior to the IVF stims starting. And no BCP!

So what the heck are we doing with all this information? We’ve decided to keep trying naturally for the next couple of months and hope that we can just get pregnant on our own and it’ll work out for us. Lucky for me I have a lovely cyst on the left ovary (the side that is NOT connected to my uterus), so we are at least getting in good tries from the right side for the next couple of months. If we do get pregnant and I miscarry, we will try to get the embryo genetically tested.

We plan to start our IVF path with Dr. ML with my March cycle, with plans to actually do stims and retrieval with my April cycle. If we get a normal embryo, we will transfer it and see what happens. If there are no normal embryos, we will consider trying another cycle or possibly consider donor eggs. If I miscarry a normal embryo, then we will probably move onto surrogacy, or we may consider looking into doing some immune treatments with the Alan Beer Center, as we live close by.

I am not sure I want to keep miscarrying with no end in sight. Nor am I sure I want to do experimental treatments with no guarantees they will work (although if I’m saying that, IVF is a total experiment for us with no guarantees to give us a genetically normal embryo, so maybe I will be willing to try them). I’m not done yet, but I just don’t want to live my life from one miscarriage to the next, not knowing if it’ll ever work.

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18 thoughts on “IVF is on my mind…

  1. Sondra

    That very last sentence breaks my heart. I know how badly that hurts. I’m so sorry you’re going through this.. You certainly have so much to consider. Xoxo

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  2. Eventual Momma

    I am so sorry that you have to even go through all of this. I am so happy for you in seeking multiple opinions and then making the choice that best fits your family. Ultimately I am rooting for a natural pregnancy that does not end in miscarriage, but if that doesn’t happen, I hope the next few months go by quickly so you can get started. Even though one ovary doesn’t connect to your uterus, can they collect eggs from it too?

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    1. RJ Post author

      Even though I only ovulate about every other month on the side I can get pregnant on, they can still collect eggs from both sides. Modern medicine is amazing, right? Thank you for your support, I’m rooting for you too 🙂

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      1. EmilyMaine

        I was of the understanding that the body doesn’t ovulate left, right, left, right, left, right anyway and that you can actually ovulate from the same side multiple months in the row. I was looking into it when we were trying as some months I was sure I ovulated from the same side twice in a row. From what I read it depends which ovary delivers the best egg. And my specialist also said that where there is the case of one side not working that the other will take over and ovulate a lot more (we were asking as I had a kinky tube). So if that is the case (and I’m sure you know more about it than me) then you should get more than every second month as a chance???? Maybe?? Just trying to feel the hope for you 🙂

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      2. RJ Post author

        I think you are correct in the alternating ovulation statement. Since I’ve had the cyst on my ovary since last June (at least…I can’t believe it’s been there that long) I am most likely ovulating from the right (my connected side). I like to think I know a lot but who knows how correct I am, lol! I certainly hope that I am ovulating from the right more often. Thank you so much for the hope 🙂

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  3. EmilyMaine

    You have done so much research! It is good to be armed with information and see what people say they will do. I was so naive going into IVF. I just assumed that you did it one way so it didn’t really matter where you went. How wrong was I?!?!?! I know the idea of genetic testing embryos to then end up with none is full on but I am so glad that we went down this path as that was such a big clue for us that there was something pretty funky going on. Hoping that this year, 2016, is your magical year. xx

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    1. RJ Post author

      I really hope it works or gives us some answers! We shall see, I just have to know I’ve tried everything in my comfort zone before moving on.

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  4. Nara

    Wow. That’s lots of info! It’s great that you have so many sources and have explored all avenues. And lucky you living near Dr Beer’s clinic! I am seeing a doctor who does stuff like that but in the uk. Appointment next week. It sounds like you have lots of options. X

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  5. Isabelle

    Hi there. I clicked over here from another blog, and saw that you are at a crossroad for your options. I am from the same area so I know half of the doctors you are talking about here. haha. I also consulted with Dr. Z two times. Once before my first IVF and once after we failed our first 4 IVF cycles. Both times I decided not to go with him. I got the same vibe about his clinic. A lot of unnecessary tests and very expensive. I don’t know your history but I myself have DOR. If it’s truly DOR, being on BCP might really over-suppress you. I have been going to the same clinic where Dr. ML works. My RE is another doctor. Estrogen priming sounds like a good choice. My experience has been very positive with the clinic. There are many nurses and doctors, and your doctor doesn’t necessarily do the procedures for you. But she’ll be the main person that decides on everything with you. All the other doctors that I have encountered are very competent. I am currently waiting for my results after my frozen embryo transfer with my blastocyst made with donor eggs. This is our last one before we have to look for a donor again. Let me know if you would like to know anything about it, coz I can share tons of experience with you. Anyhow, good luck to you!

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    1. RJ Post author

      Hello there, Bay Area friend! I am DOR according to some docs, but not all. I have high FSH and border line AMH. I took BCP for 6 weeks for a polyp removal and my following cycle was so screwed up, so I am very against it. Thanks for the comment and offer for questions. I’m glad you like the clinic…it’s great to hear that. Making these decisions is so stressful but I know there is no way to know if I truly made the right choice. I wish you the best of luck with your FET, and I’m following your blog now so I can hopefully celebrate with you and support you.

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  6. the longest journey

    I completely understand your last sentence. It is very scary to keep moving forward with no idea of what is going to unfold. If someone could tell me 100% that I will miscarry again then I would pursue other options. Unfortunately, they can’t and I have to keep moving forward with hope, just like you. I hope that 2016 brings us both some answers and some good news for once. xo

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    1. RJ Post author

      I know! I wish I had a crystal ball to tell me the ending so I could feel better about trying again and potentially failing. Fingers crossed for both of us (and everyone else out there struggling).

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