We had our follow up appointment with our Fertility Specialist (FS) on Tuesday, after our latest cycle and second chemical pregnancy. Whilst it can be frustrating that it can take a month to get in for the follow up appointment, in a way it's a positive thing - it allows us to deal with our emotions from the cycle and think about how we want to move forward before speaking to our doctor.
I was worried that we'd go into the appointment and have our FS tell us to just keep trying. After being told we'd be perfect for IUI and two cycles not working, then trying IVF and then ICSI both with no embryos to freeze, I was feeling as though we were a bit of an experiment and our FS didn't understand how costly or emotional this 'experiment' was for us. I knew I was being unfair because honestly, fertility treatment IS an experiment. There are so many unknowns that can't be figured out until you start treatment. The doctors can't predict how well you'll respond to a certain dose of medication or if there are hidden problems that can't be tested for.
When we sat down, FS asked us if we had any questions for him. It was the perfect opening and I spoke about how difficult it was with us not getting any embryos to freeze after each cycle, how expensive it was and how we weren't sure if it was worthwhile continuing if we had to keep doing fully stimulated cycles. I mentioned that a friend had offered to donate eggs but we weren't sure if that was the issue - we'd never spoken about egg quality before. I was prepared for him to come back with 'it takes an average of four cycles' (I don't know if that's the case but someone did mention that once). I already had in the back of my mind that we could get a second opinion or see another FS who would be more proactive with alternative therapies rather than the 'well you can try if you want but science is what I'll stick with' approach that it seemed as though our FS took. But our FS's response - whilst hard to hear - was exactly what I needed.
He told us that whilst I was only 32, my ovaries were acting as though I was in my early 40s. I wasn't surprised, already knowing that I have a low AMH (egg reserve). The fact that I was falling pregnant but the embryos weren't continuing to develop indicated that there's likely something chromosomally abnormal with the embryos, and therefore probably meaning that my egg quality wasn't great. The FS told us we essentially have three options:
1. Give up on IVF and look at other options (e.g. fostering/adopting)
2. Explore egg donors
3. Try one more cycle after three months of DHEA medication and using Human Growth Hormones during the cycle to try and improve egg quality.
J and I had already talked about taking a break until August or September in order to have a break physically and get healthier, as well as getting back on top of thing financially. We were waiting to hear what the FS had to say, but as we'd already talked about possibly using an egg donor after one more try, I was already thinking that a cycle in August/September would be our last go with my eggs. I hadn't thought about new medication but essentially what our FS was saying aligned perfectly with what I was already thinking and it just felt right.
Here was one of the benefits of being an over-thinker, analyzing different options way ahead of time. For the last month I had already been thinking about potentially moving on to an egg donor. Even though it hurt to hear that we should keep it in mind and my eyes did well up with tears, it was ok. It didn't come as a surprise and I actually felt as though there was a light at the end of the tunnel. I think one of the hardest things to deal with fertility treatment is the unknown, and one of those huge unknowns is 'how long do we try for'. If the doctor is still telling us we have a chance, how many cycles do we go through before giving up on having a child? It's easy to say 'Never give up!' and there are some amazing couples who will go through treatment for 10 years. But the truth for us is that because we haven't got embryos to freeze from either of our IVF cycles, each cycle has been a full stimulated cycle which leaves us about $5,000 out of pocket after Medicare and Private Health rebates. I took a really significant pay cut to go to my new job to avoid the stress and anxiety that was a constant in my old job - so worth it, but making treatment so much more difficult. In the last 12 months we've had to put thousands of dollars into repairs/replacements in our house. If we never have our own biological child, not only is the money that we're spending on treatment completely wasted, but it's eating into the future that we can provide to E and any fostered/adopted children we may have. There are other factors as well - J turned 40 this year and best case scenario would be 41 before our child was born, E will be 13 or 14 - those ages will only increase after each failed cycle. And the hardest - the emotional burden of failed cycle after failed cycle. I am so scared of managing to keep a pregnancy and having a later term miscarriage. I know I would survive but I don't know how after everything we've been through.
On the other hand - if someone told me now that I'd never have my own biological child I could start my healing journey. There would be a whole heap of grief and pain, but I could start to move forward. I will be devastated if our last cycle doesn't work, but I am already mentally preparing myself and thinking about our next steps. One more cycle for us, one cycle with an egg donor and then moving on to fostering/adopting. Of course we might get multiple embryos out of either cycle and it might mean we do more transfers than I'm expecting but it could also mean that this time next year we'll be pregnant or heading on our way to fostering/adopting. I feel like by the end of next year we could have a little human sharing our lives and home - and all our love.
When we sat on the couch that night and spoke about our options, the reality of possibly never having a child that shares my genes did make me sob. But I feel ok now... I feel good about moving forward and I'm hopeful for where we'll end up.
"If you can't fly, then run. If you can't run, then walk. If you can't walk, then crawl. But whatever you do, you have to keep moving forward." Martin Luther King
I was worried that we'd go into the appointment and have our FS tell us to just keep trying. After being told we'd be perfect for IUI and two cycles not working, then trying IVF and then ICSI both with no embryos to freeze, I was feeling as though we were a bit of an experiment and our FS didn't understand how costly or emotional this 'experiment' was for us. I knew I was being unfair because honestly, fertility treatment IS an experiment. There are so many unknowns that can't be figured out until you start treatment. The doctors can't predict how well you'll respond to a certain dose of medication or if there are hidden problems that can't be tested for.
When we sat down, FS asked us if we had any questions for him. It was the perfect opening and I spoke about how difficult it was with us not getting any embryos to freeze after each cycle, how expensive it was and how we weren't sure if it was worthwhile continuing if we had to keep doing fully stimulated cycles. I mentioned that a friend had offered to donate eggs but we weren't sure if that was the issue - we'd never spoken about egg quality before. I was prepared for him to come back with 'it takes an average of four cycles' (I don't know if that's the case but someone did mention that once). I already had in the back of my mind that we could get a second opinion or see another FS who would be more proactive with alternative therapies rather than the 'well you can try if you want but science is what I'll stick with' approach that it seemed as though our FS took. But our FS's response - whilst hard to hear - was exactly what I needed.
He told us that whilst I was only 32, my ovaries were acting as though I was in my early 40s. I wasn't surprised, already knowing that I have a low AMH (egg reserve). The fact that I was falling pregnant but the embryos weren't continuing to develop indicated that there's likely something chromosomally abnormal with the embryos, and therefore probably meaning that my egg quality wasn't great. The FS told us we essentially have three options:
1. Give up on IVF and look at other options (e.g. fostering/adopting)
2. Explore egg donors
3. Try one more cycle after three months of DHEA medication and using Human Growth Hormones during the cycle to try and improve egg quality.
J and I had already talked about taking a break until August or September in order to have a break physically and get healthier, as well as getting back on top of thing financially. We were waiting to hear what the FS had to say, but as we'd already talked about possibly using an egg donor after one more try, I was already thinking that a cycle in August/September would be our last go with my eggs. I hadn't thought about new medication but essentially what our FS was saying aligned perfectly with what I was already thinking and it just felt right.
Here was one of the benefits of being an over-thinker, analyzing different options way ahead of time. For the last month I had already been thinking about potentially moving on to an egg donor. Even though it hurt to hear that we should keep it in mind and my eyes did well up with tears, it was ok. It didn't come as a surprise and I actually felt as though there was a light at the end of the tunnel. I think one of the hardest things to deal with fertility treatment is the unknown, and one of those huge unknowns is 'how long do we try for'. If the doctor is still telling us we have a chance, how many cycles do we go through before giving up on having a child? It's easy to say 'Never give up!' and there are some amazing couples who will go through treatment for 10 years. But the truth for us is that because we haven't got embryos to freeze from either of our IVF cycles, each cycle has been a full stimulated cycle which leaves us about $5,000 out of pocket after Medicare and Private Health rebates. I took a really significant pay cut to go to my new job to avoid the stress and anxiety that was a constant in my old job - so worth it, but making treatment so much more difficult. In the last 12 months we've had to put thousands of dollars into repairs/replacements in our house. If we never have our own biological child, not only is the money that we're spending on treatment completely wasted, but it's eating into the future that we can provide to E and any fostered/adopted children we may have. There are other factors as well - J turned 40 this year and best case scenario would be 41 before our child was born, E will be 13 or 14 - those ages will only increase after each failed cycle. And the hardest - the emotional burden of failed cycle after failed cycle. I am so scared of managing to keep a pregnancy and having a later term miscarriage. I know I would survive but I don't know how after everything we've been through.
On the other hand - if someone told me now that I'd never have my own biological child I could start my healing journey. There would be a whole heap of grief and pain, but I could start to move forward. I will be devastated if our last cycle doesn't work, but I am already mentally preparing myself and thinking about our next steps. One more cycle for us, one cycle with an egg donor and then moving on to fostering/adopting. Of course we might get multiple embryos out of either cycle and it might mean we do more transfers than I'm expecting but it could also mean that this time next year we'll be pregnant or heading on our way to fostering/adopting. I feel like by the end of next year we could have a little human sharing our lives and home - and all our love.
When we sat on the couch that night and spoke about our options, the reality of possibly never having a child that shares my genes did make me sob. But I feel ok now... I feel good about moving forward and I'm hopeful for where we'll end up.
"If you can't fly, then run. If you can't run, then walk. If you can't walk, then crawl. But whatever you do, you have to keep moving forward." Martin Luther King