Wednesday, November 14, 2012

A lone contender

Its been an incredibly tough few days. I'm still not over how my cat died- the violence and the wrongness of it. And I miss her so much-- I've had multiple pets in the past few years- I had a cat when I was a student, and when I moved, I found her a good home and kept tabs on her for a couple of years, but letting go of her, while not easy, was possible.I've lost an another dog and cat which were family pets and while those losses tore me up, it was nothing like this. I never bonded with any other creature the way I bonded with H. I could not imagine parting from her, so I never even considered trying to find her a good home when I left New York, even though bringing her across oceans was not easy, neither for her nor me. In the world of a gzillion cats and dogs, she was special. This is really, really hard.

 Now, to the part I'm sure some of you were wondering about--my IVF cycle. In the end, I only had 4 mature eggs. 3 of these fertilized to form 2PN embryos. One embryo arrested immediately, started up again, arrested at the 4 cell stage and stayed there. The second looked perfect (Grade 'A') on day 3, but started stalling on day 4. The 3rd, met all of its developmental benchmarks perfectly, compacted on day 3, morulated(??) on day 4 and was a 'gorgeous' 3AA blastocyst on Day 5, at which point it was frozen.

So---all that, and I end up with what I would have ended up with in an IUI anyway- one great looking embryo, my sole contender.  Since we had only one, we could not even think about comprehensive genetic screening- we have to transfer this one, and pray. We are currently on the surrogate recruiting portion of this program.

A detailed postmortem of my IVF cycle is badly needed, with all the following questions:
1) Am I a poor responder to superovulation or was it the combination and timing of drugs which was not optimal for my system? On CD9, I had 6 synched up follicles, which, I suspect, gave rise to my 4 M2 and 2 MI eggs.  At that point, we switched to from Foliraf (recombinant FSH) to menagon(Urine extracted FSH + LH), upped the dose of stims, and on paper, based on E2 and follicle size, I responded, but most of what came then were immature eggs. So all of that later stimulation, and waiting for the last follicles to respond, *may* have been futile. .As my doctor said, this is gambling to a extent- we did, and we lost. If we had aimed for just 6, and triggered me sooner, would these 6 eggs have been better?
2)My follicles were probably not synched up, whatever that means. Here is a question for you all- does a long lupron or BCP protocol help? I have to go back and look at my baseline ultrasound, but I remember thinking that the follicles in one of my ovaries (the right one) looked larger, and those just turned out to be cysts. 

Anyhow, all of these are things for the future. I pray I will not have to do another IVF and  my one blastocyst turns into a take home baby, But I have to say, my odds are much, much poorer than I thought they would be at this point. I'm so down, for so many reasons. The unimaginable result of this cycle. The massive fight I've had with somebody close to me that near shattered me yet again, just when I thought I'd started to recover from my poor cat's loss. Issues with living in India-that is what triggered that fight. And still, by far the most painful, the loss of my cat.  This is the roughest time I've had in a while, almost on par with the darkest period in my life, the weeks after my first loss. I have not been able to stop crying for the past 2 days and this morning, just in passing, I thought about anti-depressants. I NEVER think about anti-depressants, not even during the worst times of my life so far, so that was a shocker. But- if nothing more comes along, I will mend and get over this. I'm really praying for some kindness from the universe right now.


  1. *hugs* Lots of reasons for you to be down - I'm sorry everything piled up all at once. Each one individually would be tough.

    A thought on your IVF cycle - I'm a poor responder, and only got 3 eggs, and 2 embryos from my first cycle doing a microdose lupron flare protocol (lupron, gonal-f (equivalent of your Foliraf) and menopur (equivalent of menagon)).  Second cycle on that protocol got 2 eggs and 0 embryos. (These are written up in my blog in April 2010 and August 2010).

    Then I switched to an estrogen priming/antagonist protocol, based on the idea that the lupron flare protocol oversupressed me (between the birth control pills and the lupron and the LH in the menopur). We got 6 eggs and 3 embryos from that cycle. (Written up in November 2010.)

    So even as a poor responder, it's possible to find a protocol that works better for you. May be worth a conversation about estrogen priming/antagonist protocols with your doctor.


  2. Yes...the purpose of pre-cycle suppression (whether that happens via long lupron, estrogen priming and ganirelix, or bcp) is to synchronize follicular development so they grow at the same rate.  You may or may not respond better to a different stim approach, but THIS problem could have been avoided.

    I'm so sorry.  For everything.

    Best wishes on part 2 of the cycle.

  3. Hoping & praying for you & your blastocyst. Sending positive thoughts your way.

  4. Dear Jay,

    I am wondering about you and I could understand that you are feeling not so good. You are definitely not a poor responder - especially considering your e2 levels. Why do follicles have an asynchronous growth ? There are no clear answers but long lupron might help. I took BCPs for 15 days, started lupron 3 days before stopping BCP  (overlapped BCP with lupron) and then got my periods after stopping BCP. On day 3 of my menstrual cycle I started menogon and the lupron I continued until trigger. This worked perfect for me I should say. The residual FSH present during the luteal phase of previous cycle (the cycle before your IVF cycle)  can act on antral follicles and cause them to grow unevenly and when the stimulation is started this size discrepancy is aggravated - this is one line of thought. That is why using estrogen (BCP) and lupron during the luteal phase of previous cycle seem to help. Estrogen and lupron suppresses the FSH secretion. But what if the antral follicles really respond differently to the FSH ? Are the sensitivity of all the antral follicles to FSH is the same ? If there are less AFC is this discrepancy more ? Do women with poor ovarian reserve respond in an asynchronous way to FSH? There are lots of questions  to be answered ! I am sure the dominant follicles in your case did not allow the others to mature. One blasty out of 3 embryos great, really great ! Good Luck !

    Jay, I am really sorry that you feel so depressed. I am sure parting with loved ones (even if it is a cat) is very painful. The other thing which might have affected you is the horrible uncertainity inherent in an IVF cycle and the failure of your expectations. But if you stop looking at your life alone and start looking at other people you will realise how gifted you are in many ways. There are so many people who long for a baby and could not do anything because they do not have money. There are women who do not have good emotional support from their family and partner. I am saying all this just to make you feel better. Jay things will get better - just like happiness, your sorrow will not last longer too. Be happy : ) Take Care ! How about writing a post on asynchronous follicle growth ? : )

  5. I'm sorry Jay. Life is so unfair... I wish I knew what else to say.  I will send positive energy to your lone contender!!

  6. You've been on my mind a lot, Jay. I'm so sorry. Words really aren't enough. I am gaga for my animals. I can't imagine what you are going through. 

    I think trying some form of down-regulation (ie. birth control or estrogen patch) makes a lot of sense. It prevents runaways, starts everything growing at the same time. It's not foolproof but I think that it does help. 

    I am hoping for your One. 

  7. I'm sorry things are so hard.  I understand being so upset over the tragic loss of your cat.  :(

    I read one comment telling you to be happy for what you have.  Ignore that.  Sure, you should be happy for the good in your life, but this is hard stuff and there is nothing wrong with feeling the pain of it.  We all have our own reality and yours does not need to be compared to others who someone else thinks has it worse than you.  I am passionate about this topic and it took everything in me not address that commenter directly.

    That said - I have followed two gals now who had just one embryo to transfer - and they both have babies now!  There is hope, and I will hold hope for you. 

  8. First, I am SO sorry about your cat.  I've been that bonded to a cat before, I definitely understand how hard it is to lose a special animal like that, but the way it happened...I just can't imagine.  I'm so sorry.

    Sending up good thoughts and prayers for your lone contender!

  9. My thoughts are with you.  I pray the universe sends kindness to you now, as well.  Anti-depressants can help to get through particularly painful times....

  10. I'm sorry everything is so hard right now, and especially about your beloved cat.  I'm sending all the strength and good cheer that I can to you.  Take good care of yourself right now - try to get good sleep, eat and drink well, and spend some time with friends or family who fully support you.  

  11. I'm sorry you're having to deal with this disappointment on top of the grief about your cat. I really hope the universe gives you a break. And that this embryo develops into the baby you're longing for.

  12. I know only too well the pain of losing a pet with whom you share an incredibly deep bond. I am sorry it happened in such a horrible way and that you didn't get the many years of happiness you deserved to have with your kitty. Grieve as long as you need.
    I'm sorry you can't do the genetic screening that you wanted to but I am keeping my fingers crossed that your gorgeous frozen blast is genetically sound and will give you your take-home baby. Best of luck recruiting a good surrogate.

  13. I'm pulling for brighter days. Losing your kitty that way was cruel beyond measure. You are uprooted (or rerooted?) and embarking on a journey of great importance. I am pulling for your lone contender. I believe in a fighter and am wishing hard for the right surrogate to fall into your life and turn the light on, quickly.

  14. Sounds like the skies are dark slate over you right now. I'm really sorry Jay. I know there will be brighter days, but right now you need to focus on getting through this very difficult time.
    My thoughts are with you, dear woman.