Thursday, 16 July 2015

Our IVF history - a recap

As part of the preparation to meet with the fertility clinic and proceed with IVF, I have updated our fertility treatment history for the new specialist. I don't expect that the specialist is going to have read every item in our files, after all we have been trying to conceive for nine years now - that would be a lot of paperwork! Instead I have created a treatment cheat sheet with all the key bits of information, and if there is something interesting then the doctor can look in my file for the specifics.

1. September 2007 – IVF #1 (Dr Doreen Yeap)
Understimulated, cancelled before egg collection
Synarel from day 21, FSH 75iu x2, 112.5iu x2

2. January 2008 – IVM #1
13 eggs retrieved, 8 matured, 7 fertilised, 1 blastocyst transferred, Negative result
FSH 150iu x 3 days

3. March 2008 – IVM #2
Ten eggs retrieved, 8 matured, 7 fertilised, no embryos to transfer
FSH 150iu x 9 days

4. May 2008 – IVF #2
20 eggs retrieved (17 mature, 3 immature), 14 embryos fertilized, 4 blastocysts frozen
OHSS – 3 nights in hospital, Freeze all cycle
FSH 150iu x 5 days, 225iu x 11 days, Orgalutran x 7 days. CD 12 E2 1800, CD 14 3000, CD 16 5500

5. August 2008 – FET #1
1 blastocyst transferred, Negative result

6. October 2008 – FET #2
1 blastocyst transferred, Negative result

7. November 2008 – FET #3
1 blastocyst transferred, HCG level of 21, 44, 0

8. April 2009 – FET #4
1 blastocyst transferred, HCG level of 35, 110, 388, 1700, 4280.
D&C conducted after ultrasound – no heartbeat at 9 weeks. No reason for miscarriage found

9. August 2009 – IVF #3 (Dr Mike Aitken)
33 eggs retrieved (24 mature, 9 immature), 17 eggs fertilized, 13 embryos at day 3, no blastocysts
TESA – 5 samples frozen. FSH 225iu x 12 days, Orgalutran x 4 day. CD 11 E2 2959

10. October 2009 – IVF #4
20 eggs retrieved (12 mature, 8 immature), 5 eggs fertilized, 2 embryos transferred at day 3 (6 & 9 cell). Negative result
Used fresh semen sample. FSH 225iu x 9 days, Orgalutran x 3 days

11. May 2010 - IVF #5 (Dr Graeme Thompson)
Cancelled due to potential for OHSS
200iu Puregon. CD 9 E2 5000, CD 10 E2 10,000, largest follicle 14mm

12. September 2010 - IVF #6
Cancelled cycle, estrogen dropping, 1400, 1300, 1300, 1200, 950
112.5iu Puregon, Orgalutran

February 2011 - Ovarian Drilling, laparoscopy and dye-test completed

13. June 2011 - IVF #7
Cancelled due to potential OHSS
100iu Puregon, dropped down to 50iu.
CD 12 E2 5100, 22 follicles, LH 15

14. August 2011 - IVF #8
Known sperm donor used
10 eggs retrieved, 2 immature, 8 fertilised, no further cell division. No transfer
Lucrin, Gonal F 37.5 > 75
CD 8 E2 510, CD 12 E2 1200, CD 14 E2 3300, CD 15 E2 4400, CD 16 E2 4700,
CD 17 E2 3300, CD 18 E2 2200 ~20 follicles, CD 19 E2 3400, CD 20 E2 3700, 8 follicles >14mm

15. October 2011 - DIUI #1
Known donor used. Negative Result
Clomid, CD 12 E2 1600, trigger injection, 2 straws used, slight spasm when sample inserted

16. November 2011 - DIUI #2
Known donor used. Negative Result
Clomid, CD 11 E2 1400, trigger injection

17. May 2012 - Donor FET #1
Donor embryo, Day 2 3 cell embryo. Negative Result
Clomid, CD 13 E2 4000, Pregnyl trigger injection

18. June 2012 - Donor FET #2
Donor embryo, Blastocyst. HCG level of 7, then 4.
Clomid, CD 12 E2 2700, Pregnyl trigger injection

19. August 2014 - Donor FET #3
Donor Embryo, Day 2 4 cell embryo. Negative Result
Clomid, CD 14 E2 1836, Natural Ovulation

So that brings us up to date (I think). Please let me know if I have missed anything - sometimes it's hard to keep up with it all!

Tuesday, 14 July 2015

Getting started again - IVF

We got a letter back in May from the public health reproductive clinic stating that they were restarting the publicly funded IVF program. Of course the program has changed significantly from what it originally was when we were referred to the clinic. It wont cover anyone who requires sperm donation, which is a bit of an issue as that is what we were pursuing. Also, it now only covers one IVF cycle and the replacement of any embryos generated.

It does state that certain patients may proceed to a second IVF cycle at the discretion of the KEMH clinic if they meet relevant clinical criteria. I'm not sure what the criteria is but I'm hoping it's a fail-safe so that if the first cycle is a total bust (no embryos to transfer) that they will let us do a second cycle.

To be referred to the private fertility clinic for our funded cycle, we had to re-do all of the tests that we have done many times beforehand. At first I felt it was a waste but realise it is a necessary evil to at least check where we are up to.

Firstly I still have PCOS - my ovaries still have the usual 'string of pearls' appearance, and my AMH (Anti Mullerian Hormone) level is 48.6 pmol/L which indicates PCOS and the higher risk of OHSS in a stimulated cycle. I had hoped that my sustained weight loss would have helped but apparently not. Also apparently my B12 is quite low, and iron is borderline - both good things to know.

Murray had to do a new semen analysis of course, but we got a huge surprise when the results came back nowhere near as poorly as they have previously! The count and morphology came back normal when they are usually on the low side, but most importantly the motility came back at 30%, 20% of with progressive motility! Considering the cut off is 40% and 32% respectively, it is still low but so much better then the 0-6% he has had every other time! That result has meant that he feels much more comfortable with doing IVF again. It would be good to repeat the DNA fragmentation test as well to see if that has changed at all.

So we are off to our GP on Thursday afternoon to get an updated referral to the fertility clinic, and then we just wait and see when we can get started again. The fertility clinic actually called me today as we still have one embryo in storage that was donated to us - they ring to see if we still want it. I explained that we were keeping it as a back up in case our fresh cycle doesn't work, and she said that was a good idea, and that even if that one didn't survive the thaw, she could probably find one on the day if worst came to worst, which made me feel more confident also.

I don't really want to go down the IVF path again - in fact nothing would make me happier than for the adoption agency to call up and say we have a child, but 20 months in the approved applicant pool  has made me realise that nothing can be taken for granted.