The background

March 21, 2009 at 11:22 pm · Filed under My story

This is just to give you some background on where the experiences detailed here came from.  This is kinda long and is not required reading.

My DH and I got married in 2004, when I was 35, and we threw away the pill directly thereafter.  I didn’t expect any problems getting knocked up – my ma had 4 kids after the age of 35 and both my grandmothers had kids well into their 40s.  I was wrong.  About 8 months later I was at the RE.  All kinds of tests which we passed with flying colors, on to Clomid, IUI, etc, racing through the treatments with the feeling of time breathing down our necks since we wanted a baby now (esp. because we wanted more than one baby, and we knew things were tight for that…).  During the sequence of IUIs my RE discovered that Mr. Nishkanu’s swimmers were numerous but funny-looking and slow (i.e. morphology and motility was low).  It didn’t look like they’d be able to find their way, even if they got the helping hand of the IUI catheter.  We decided to fast-forward to IVF w/ ICSI.

The first cycle started about 10 months after starting with the RE, I was 36.  The cycle didn’t go great, though I didn’t really know that at the time.  I had 6 eggs and transferred 3 embryos on day 3, I think the most advanced had 4 cells and the least advanced looked like pizza (i.e. extremely fragmented).  And nevertheless: I got pregnant!  But it was one of those low-beta, low-doubling, drawn-out affairs, and ended up being a blighted ovum.  When we went for the follow-up appointment, my RE gave us the donor egg talk.  I was shocked.  This was the first time I had heard there might be a problem with my eggs.  I couldn’t believe it, I wasn’t that old,  I had a great family history, and… I had gotten pregnant!  Could it really be time to give up already?

We decided to give it one last college try and asked the RE if we could do one more cycle.  The clinic had a meeting about it and decided to let us go forward.   They pulled out the big guns, put me on microdose Lupron and blasted me with huge doses of Follistim.  The result… I was undersuppressed and got a dominant follicle.  In the end I had 6 eggs retrieved, but only 1 was mature.  I had 1 dying (probably already dead) embryo transferred 3 days later.

In the mean time Mr. Nishkanu and I decided to get a second opinion.  Even while we were on that 2nd cycle at our local RE, we went to the big city and took our records to Cornell.  The RE there thought there was a lot that he could do for us.  So, after the failed 2nd cycle we started cycling at Cornell.

That was difficult, because I had to move to New York for 2 weeks for every cycle (note: I work full-time).   Fortunately, Mr. Nishkanu voluntarily came with me for the two weeks every time to provide moral and logistical support – I could not have done it without him.  And the new RE was right.  I was astonished at my first cycle there that I got something like 19 eggs.  We had 7 (live) embryos on transfer day, that was double what we had gotten in two cycles at our local clinic.  They looked good too – 6-8 cells.  Unfortunately they didn’t work that well though.  The first cycle was a BFN.

The second cycle though… I actually really got pregnant.  For real this time.  I had a decent beta!  And I had good doubling!  Now things were looking good!  But there was no heartbeat at the 7 week ultrasound.  We were back to square one.

At this point I was ready to stop.  When our miscarriage was diagnosed, we decided to have a D&C so we could have the embryo’s genes tested (she turned out to have a chromosome deletion, a genetic problem which is not age-related – just random bad luck, my RE said).  The (local) surgeon who did the D&C was not as competent as I would have wished.  I had major pain after the surgery (to the point where I visited the emergency room begging for pain medication).  I also suddenly stopped being able to walk due to hip pain.  It took a month of not walking before a physical therapist figured out that the hip pain was radiating from my back, which had seized up due to stress.  That was enough for me.  My body was falling apart, and my career was suffering because of the regular “time-outs” for mysterious trips to New York and the pain, depression, and anxiety that were their regular accompaniment.

We took a time-out for a couple of months while Mr. Nishkanu and I discussed what to do next.  He really wanted to do one more cycle, I really did not.  Finally, we made a compromise: I would be willing to do one more cycle if we had the Plan B already in place for what we would do if the cycle didn’t work.  I researched adoption, he researched donor egg.  We decided we would do DE, and found a clinic on the West coast that had an in-house donor pool, good success rates, and would facilitate future contact between our eventual child and the donor (this last point was key for us and the reason we went all the way to the West coast).   Having put that all in place, we went to NYC for one last cycle, got a chemical, and that was it for my eggs.

We went into the DE process with a ton of optimism.  Our clinic had quite a few profiles for donors available and we found one fairly quickly that we both really, really liked.  We were matched with her, and moved ahead to our donor cycle.   We sent her a thank-you card and a gift and she actually wrote us back to wish us good luck – what a gem she was.  We had 14 eggs, and 10 embryos, and were approved for a 5-day transfer.

When we showed up for our transfer, we were surprised that the doctor suggested we transfer 2 embryos, since our clinic usually pushes single embryo transfer for donor cycles.  The embryologist explained that this was because our blastocysts were early, not yet developed well enough to be able to grade them.  Still, they were blastocysts, which is more than we had ever had before.  So we transferred two and allowed ourselves to hope.

Our clinic has an 80% positive pregnancy test rate on donor cycles.   I had gotten pregnant – at least a little – on more than half of my previous cycles.  So we were shocked when on this cycle, with 2 embryos from a young donor, we had a complete BFN.  For the first time I really realized that donor egg was not a panacea that would solve all our problems.  Maybe there is some problem with my DH’s sperm that they can’t diagnose.  Or maybe the problem is actually that I have a killer uterus.  I realized that instead of having escaped from the hamster wheel of doom (as I came to call the repeated IVF cycle hell), I was now just running on a new one – a slightly more comfortable one, but just as doomish and never-ending as before.

At our post-cycle meeting our RE said she thought the problem might actually be with the (unproven) donor’s eggs – the embryologist had mentioned that they were more fragile than usual.  Still, she said, we had two frozen embryos and one of them looked to be excellent quality.   We still had a good shot.  A few months later, we transferred those two.

And then the low point of bad luck of this entire story came… I actually got food poisoning on the day of transfer.  I think I have gotten food poisoning only one other time in my entire life.  Why did it have to be that day?  I spent all night barfing and the next day sleeping through a transcontinental flight.  It was clear that wasn’t really good for the cycle. Boy, that really bit.

But back to the story.  The cycle ended with another chemical (hey! at least something survived the barfing spree!) and then I was done.  Done done done done done.  But then… Mr. Nishkanu… his dreams… please just one more chance… he needed it for closure… OK.  I would do one last cycle, but it had to be with a proven donor.  And it was really only one cycle, not one fresh cycle and then more cycles to use up the frozens – if the fresh cycle didn’t work, we would take it as a sign that the problem is with me, and if there were any frozen at that point we would put them up for embryo adoption.

So, new donor, new cycle, 23 eggs (!), 19 mature, 13 embryos, and 2 blasts transferred… this time not because the embryos weren’t good but because it is the last shot and we were going for the gusto.  One blast graded AA, one BB.   None made it to freezing which saves us from the argument later about embryo adoption.   Now it is just wait and see.

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