Wednesday, February 20, 2013

All my worldly belongings for a crystal ball..

I honestly was not expecting a BFN, given that the embryo had gotten to day 5, and the embryos I make naturally show an excellent capacity to implant. Statistically, I thought implantation was likely, with a strong probability of pregnancy loss.

So now, I'm asking the questions-
  • Was it an embryo issue? How did the embryo I made during superovulation compared to the ones I make during a natural cycle? 
  • Is it that the surrogates womb is less receptive than mine?
To discuss the embryo quality in my natural vs superovulatory cycles, lets look at the following percentages:

20 %  : The probability of anybody's getting pregnant, say, while being in their late 20s, in any particular cycle (correct me if needed, I'm citing from dim memory)

50-60 % : The probability of a high quality Day 5 blastocyst implanting in any given cycle. I've asked my RE to provide the stats from his clinic as well.

75% : Probability of my getting pregnant, naturally. Calculated using an average of 4 cycles, where I've gotten to clinical pregnancy stage through a natural cycle, 3 out of the 4 times.

So going just by this, the odds were really in favor of the embryo implanting, unless it was different from those I make in a natural cycle.

It is always possible that mine is one of those high fertility wombs that just allows all embryos to survive and implant, not just the best quality ones, making me a candidate for recurrent pregnancy loss. This possibility is derived from this study.

But there is the other possibility- that the superovulation produced poorer quality embryos than what I make naturally. I clearly respond badly to higher doses of FSH- In the start, I was on 300 IU follistim and 6 eggs were on the route to responding, and in the end, possibly gave my 4 M2 and 2 M1 eggs. On increasing that dose (to 450) and using a mix of menagon and follistim, we got up to 11 eggs, but I believe those later growing  follicles yielded the immature eggs, even though my estradiol levels rose appropriately.

I beleive, no matter what I do next, that if I go for another round of IVF, stimulating me very gently would be a more sensible option. I'm also going to elaborate on the role on myo-inositol, that I've started taking, in a later post/ Please, anybody who is an armchair RE or a real one, fee free to weigh in here. I'm thinking about 2 things

-Agonist/Antagonist (with or without conversion) with a low dose of FSH.
-Natural cycle, or very close to it, with mimimum stimulation, with a transfer to the surrogate.

I've also started thinking about donor eggs. I went and looked at this website, and I was pretty aghast- although it says Indian egg donors, the majority are caucasian and well, though a lot of them are very pretty, they don't appear to have done too much with their lives.Ditto the few indians there- a few of them look and sound like those girls that pop up on the websites where you download torrents. Plus the website does not seem very well run- one girl listed her height as 5.2 cm. What is she, Thumbelina?

 A really good friend talked about offering her eggs yesterday, and she is like my dream donor, smart, good looking, accomplished, determined and I think I would really be able to identify with her genetic babies, because god, we think alike. But she is a really good friend I'd want to keep always, and I've always believed that if you do these things, its best to use people who will not be in your life afterwards. Sigh- I just wish the strangers I am finding were more like her, but that is a really tall order.

If I go the donor egg route, I'd probably have to place an ad in the papers and pray I get lucky. Then there is that million dollar question- do I carry the baby or use a surrogate?  Honestly, when people talk about the joy and intimacy of a pregnancy, I no longer feel it. To me, pregnancy is terror, stress and the possibility of losing my figure, my baby, and my even keel, which has managed to hold through through all this, at 24 weeks. I can get past this, and god knows, things may even go well, but I don't at all feel like I want to do it.

What do I do?!


5 comments:

  1. I don't necessarily have any sage advice to give.  I just wanted to say sorry again.  Also, have you looked into donor embryos?  My two miracles came from one excellent and two less than stellar donor embryos (I will always wonder which one didn't stick around).  Good luck on whatever you decide!!

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  2. So much for you to figure out. I'm so sorry again this try didn't work.

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  3. Sorry I can;t provide the crystal ball! But I did use donor egg and have a little insight on that process. If you 'google' egg donor, you are likely to get lots of agencys that have huge pools of donors, but few will have been screened medically or psychologically yet. There are a lot of phase and profiles to look at, but they probably won't provide you with the info you actualy need. My advice tis to determine which clinic you would use for DE/IVF, and then ask them which donor agencys they have worked with in teh past and recomend. These agencys will likely have smaller pools, but have local, proven donors who haened for health issus and their emotional readinesCheck out my blog for lots and lots of info on DE, if you decide to go that route!  

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  4. I think I asked this question before, but don't recall an answer - have you ever tried more than one donor?  I know you had chosen one that other women have used with success - but I do think that sometimes for unknown reasons there may be incompatibility between a given woman's egg and a given man's sperm.  I know you think there's something wrong with your eggs and/or your ability to maintain a pregnancy since the donor is proven, and I'm not saying that you're wrong, but I just wondered if you've ever considered it a possibility.  I know you are a true scientist searching out a scientific, logical reason for all of this, and I don't blame you.  But I think that science doesn't (yet) have all the answers for this kind of dilemma, and there are unknown factors at play.  Many women change donors after a few unsuccessful tries, and I just wondered if you had done that or considered that yourself.

    I'm sorry that you can't seem to find the answers... and more importantly are having such a tough time on this journey.

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  5. Hmmm.  You are very logical about all this.

    Here's my thoughts, based on my reading through your archives:  I'd say there's a high probability there's an embryo problem.  Good *looking* embryos are not necessarily good embryos (you didn't do PGD, right?).  I say this based on the genetic reasons for at least one of your losses as well as the not-great cycle.  Could you have better embryos on a different stim cycle?  Maybe.  Would these embryos have implanted better in you?  Possibly...but if it wasn't a good quality embryo, you're better off finding out this way, as opposed to another loss, right?

    In my case donor eggs was the clear answer because I didn't have the time and emotional resources to investigate doing IVF at CCRM.   But I never ever considered a surrogate, even with a APA and MTHFR...  For me, it was the right choice.  Not the right choice for everyone.

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