After a failed IVF it is typical to have a follow up meeting with your doctor, often nicknamed the "WTF meeting" in the infertility circuit. It's a chance for you and your partner to ask loads of questions, discuss what went right or wrong and what could be done differently next time. I mentioned that we have been considering getting a consultation at another clinic which is unfortunately a lot further away. We phoned them and the earliest appointment we can get there is end of August! I would also need to take time off work just to go to it which is quite awkward. In the meantime we had our follow up appointment at our local clinic and actually it went a lot better than we had been expecting. Better that is in the sense that the doctor took loads of time to discuss things with us at length and answer all our questions, not necessarily in terms of our future chances which are still hard to say.
We have a few things working against us. My one confirmed blocked fallopian tube and the other one which seems to not be working hence the need for IVF in the first place. And now it turns out I'm classed as a "poor responder" to IVF hormones. My body doesn't make as many follicles as it should. And even when they do grow, some of them are empty so that doesn't help! The doctor has a theory now that maybe some months I'm not producing an egg naturally and he thinks this is part of the reason for our not getting pregnant naturally. For all I've researched into "empty follicle syndrome" (which is what it's called when you have less eggs retrieved at the egg collection procedure than the number of available follicles) I have never come across this theory.
If it were correct I've been trying to work out what that would mean for our chances trying naturally. The first IVF round I had six follicles but only two eggs. The last round three follicles and one egg. So that would mean a one in three rate of eggs approx. So in a given year, twelve months, I would only have about four eggs, that is only four months with an actual chance. Given that one fallopian tube is definitely blocked that would half it to roughly two. So only two months out of a year when there's a chance of conceiving. Add that to missing the "fertile" window one month if our timing is off and that would leave only one month per year. So that could explain why I haven't gotten pregnant naturally before now IF his theory is true! Hubby was wondering afterwards whether we should have tried naturally for longer before pursuing fertility treatment when he heard that. But if both tubes aren't working at all then it would never happen naturally no matter how long we wait.
Anyway. The doctor says we could try the antagonist protocol next time which might work better for me. Hopefully. But he also said I don't have to rush as the few eggs I do produce are great quality and he's not worried about my age. He suggested we take about six months off. He also said it could be a good idea to do some further tests before going "blindly" into the next round. He suggested we get our chromosomes checked and to test me to see if I might have a blood clotting factor (although last round he prescribed me baby aspirin after transfer just in case).
There is also a lab where you can send your blood to for more thorough tests and they check for natural killer cells. This is a very controversial area. The idea is that some women have overly effective immune system response cells which attack the embryo thinking it's a foreign body. There are meds you can take to suppress this response. Our doctor said that some doctors don't believe in it at all and think it's just a waste of money whereas others thinks it's really great. There was a conference in Biel in Germany apparently where there was a presentation and any of the doctors who went there were convinced. He said he's also had some patients who were helped. But it's up to us whether we want to go down that avenue or not.
I figure it's worth getting the tests done their anyway. They also test your vitamin levels and any gene issues. The problem is it takes about three to four months for the testing and we also need to try to see if our health health insurance will contribute towards it first so that will take some time sorting that out. With health insurance help it might just cost a few hundred euro here but without help it would be closer to 3000€ in which case we wouldn't be able to afford it right now!
If we're going to be busy with our new house over the next few months anyway, why not get these tests done and give round three our very best shot. Especially since the third round is the last round our insurance will pay towards and what with the new house and bills, we probably wouldn't be able to afford any more rounds after this. Yes the third round will most likely be our last whether it works or not since that is what we had agreed beforehand and at some point we don't want to just keep throwing money at something if it looks like it's not going to work. If it did turn out that the next round were to fail hubby and I differ somewhat on how we would proceed. He thinks at that stage we should accept kids aren't for us and try to move on, whereas I would probably consider looking into other options like mini/natural IVF with less hormones and less costs before being ready to accept it. We've had some difficult conversations about it all. I try to think positively in general but after two failed IVF cycles I am starting to really worry more about why it isn't working and what the future holds.
Apart from all that life has been great lately. It's very exciting that we've found new house and we'll probably be moving in just a few months; job wise things are also going great, I recently even got a small promotion! Now that I'm not currently going through fertility treatment I've had more energy for my social life and it's been fun meeting up with people more often and drinking wine again! I have also become friends with a new Irish girl living here which has been great since over the past half year several close friends have moved away. And I'm very happily married; it'll be our three year anniversary this August. So a lot of things are going really well and I'm very happy with my life...I just hope there will be a baby in our future.
Good luck figuring it all out and moving forward. Its our 3 year anniversary this August also - we definitely know we can through anything together after the experience of the last 3 years! :)
We haven't had our WTF appointment yet but we have had some test results back and have discovered we are dealing with 33% dna sperm fragmentation which is not so good... Now wondering if we have finally found our "explanation" or is this just one piece of the puzzle.. Our clinic is not particularly helpful and the embryologists so far have just told us to try again with pgd this time. I was wondering if you could ask your friend with the same diagnosis for any feedback... e.g. what supplements her husband took and whether they were otherwise completely unexplained... I guess any positive information would be welcome now as I am feeling quite stumped...
Thanks for your message. 33% percent doesn't sound TOO bad. With my friend's partner is was initially really high like 60% or something but he was able to get it down to under 20% when it was tested several months later. I asked her what he took and she said several supplements; vit C, E, zinc, Q10, he also improved his diet (think he also had some food intolerances which were preventing him from absorbing vitamins well enough from food). Good luck!!Delete
hmmm... seems like I had some trouble posting on your blog! can you please delete the above comment if possible? Thanks!ReplyDelete
no problem, doneDelete
While I'm sorry you had to have the WTF appointment, I'm so glad that your doctors are looking into new approaches and encouraging you to do some more testing and searching for possible things to address in your next cycle. My best cycles were antagonist protocol, I am a believer there. I think looking into all the possibilities for culprits is not a bad idea, especially if you are looking at your next cycle being your last "big guns" cycle. It's so hard not knowing exactly what it is that's causing this not to work so far. I am wishing you all the luck in the world, and the peace to be able to take the break and enjoy your house while you test and research and get ready for your next try. I hope you find an answer!ReplyDelete
Thanks so much. Yes there can be so many unknowns and it would be great to find out more before we do another round. Right now having a break and just focusing on the house has been nice!Delete