The phone call came. I detected in the nurses voice that the news was not good. I was right – negative. Still no sign of Aunt Flo. Not pregnant just like I expected. For one brief moment, I imagined myself finding out a positive result and then not saying a word to anyone (unlike me) until when I was home with my husband. I just wanted to see the look in his eyes. Sadly this is not to be. Tonight I am going out with some girlfriends for dinner. A couple of glasses of red wine is on the cards. I just hope that no-one asks me any questions. One of my friends is likely too – as well intentioned as wht she is, she is thoughtless sometimes! Grrh!
Whilst IVF can be very a wonderful thing when it works, it can also be a frustrating experience when it doesn’t – particularly if you are over 40 years of age. The trouble is that your body clock time bomb is clicking away and unfortunately the quality of your eggs declines rapidly at this time. In fact, while the quality of embryos declines from about the age of 32 (yes 32), the decline is much more rapid at age 40 and above.
How do I know this? I visited a new IVF fertility specialist today. As kindly as what he was in delivering the bad news it was devastating to hear the facts. I had gone to him in hope only to be delivered bad news. At least it was more realistic than what my current Doctor tells me. My current fertility specialist tells me don’t worry you will get pregnant. Even though I know the odds are stacked against me it keeps me in hope. Hearing the facts from the new specialist made me upset. My age and the fact that 99% of my husbands sperm is abnormally shaped is a key problem. I had gone to him looking for a solution. Although I don’t think this is what I got.
On the positive, he told me his clinic did things differently. For a start, he would be the doctor who treated me – not like the clinic I currently attendwhere I get treated by whoever is scheduled to treat me on the day (a major plus). He told me that this particular clinic only did Day 2 embryo transfers not blastocysts. He thought the fact that I had lost so many embryos at Day 5 was wasteful. Interesting – a debatable point amongst the world’s experts.
It seems there are two schools of though in IVF – Day 2/3 transfers versus Day 5. My current clinic does either day 3 or Day 5 but this clinic doesn’t. In any case, I was directed to the patient co-ordinator and we set up some appointments to begin my next cycle. The first thing that happened was that I was informed that as I was deemed medically infertile, I would not be eligible for the medicare rebate and as such my total costs would be $12,800 with no hope of rebate. I was shocked. I went back to the Doctor to check this and discovered he had made a mistake. Phew – was I relieved. One hurdle down. However my next hurdle made me question why I was changing clinics in the first place.
When I analyzed the treatment protocol what I discovered shocked me. What shocked me the most was that he was recommending an Antagonist cycle with the same medication as what I had previously been on. He was also not convinced on the Colorado Treatment protocol. As far as I could see, there really wasn’t any major difference between the treatment protocols which clearly was not working for me. The only difference was the day the embryo got transferred.
With this in mind, I had to question why go through the heartache of change. The steps I would need to take to change clinics would mean I would need to get all the paperwork on police record checks and child protection checks from my current clinic. My husband and I would also have to go through counselling all over again. The clinic locations were not as easy and accessible for us to get to. All these steps would mean another delay to my treatment.
On reflection, I don’t think this clinic is offering me anything different. I can choose to transfer an embryo on day 3 instead of day 5 at my current clinic. Personally, I am not convinced that there is a hell of a lot of difference between Day 2 and Day 3 embryo transfers. Ours all seem to survive to Day 3. So I think I should just save myself the heartache and continue with my current clinic but still explore another doctor in that clinic who I know will offer a different protocol to what I am currently doing. Heck I might as well even try a day 3 transfer. At 40, I might as well try and preserve what embryos I have.
Without doubt the strongest indicator of a women’s ability to fall pregnant is her age. From age 35, a women’s fertility starts to decline alarmingly rapidly. It is rare to find any research that contradicts this basic fact – it is harder to become pregnant as you age and harder to maintain a diagnosed pregnancy.
Between the ages of 25-29, your likelihood of getting pregnant visa IVF is between 45-50%. However, by age 40 your chances of conception are almost halved.
As depressing as this might be for those of use old enough to worry about our biological clock, many of us still live in hope that our dreams of becoming a mother are realised. Without doubt I have pushed my body to its limits in doing repeated IVF cycles. The toll it has taken on me both physically, emotionally and professionally has been significant.
Now, as I sit here contemplating my impending 40th birthday I wonder if all the pushing has been good for me. However, if I asked myself if I would do it again then the answer would be a resounding yes. If I was younger, perhaps I would not do each cycle as close together as what I have done (4 stimulated cycles per year is quite intense) but do it I would.
Judging by the results of my my ovulation test kit this evening, I have a feeling that I will be ovulating sometime on my 40th birthday. Which means I will be having the last of my frozen embryos transferred into my uterus. If all else fails, then it is back to the clinic to start yet another IVF cycle.
Call me ignorant but after months of worrying about not being about to get pregnant before the age of 40, I am not worried anymore.
A sure sign of this is that after months of procastinating with the Police Record Check forms so I can start IVF, I have finally sent my form in complete with cheque. Somehow I don’t think I will be getting it back in time for the 1st September deadline when the new laws take effect.
Apart from the fact that my husband’s form has not been sent in yet, I imagine there will be a backlog of applications from the late rush of couples who have also submitted their forms. Obviously, holding off like me in the hope that they won’t have to do another round of IVF. In any case, I guess it means we might start the next round a little later.
It’s strange but I am less perturbed by the later start this time. In the past, I have pushed my body so hard, doing IVF with only a month break in between cycles. Once, I did a cycle back to back with no break. Now that was hard. All of my attempts, of course, have been done in my futile attempt to racie against my biological clock.
But the truth is, I will be turning 40 at the end of September. I am already in the statistically significant, lower end of the IVF success bracket. A delay of one month is hardly going to make a big difference. I think my body also needs a break to get back to its natural rhythm. The scary thing is that I’ve been doing this so frequently that I don’t even know what my natural rhythm is.
Apart, from that IVF is hard – I am in no rush to start again only to get another negative result. I need emotional space to come to terms with the last seven failed attempts. Maybe my birthday this year will not be about trying to conceive – maybe it will be about relaxing and enjoying myself. Now that would be a nice change.
After seven failed attempts at IVF, there comes a time when you have to ask some pretty hard questions to your Doctor.
I’ve been too frightened too ask – maybe I am not going to like what I might hear. But my visit with the Counsellor today did help in exploring what our options and questions we might ask our Doctor.
The questions are:
– Given our history and 7 failed attempts, what is the likelihood of us conceiving?
– Why do you think we lose so many embryos between day 3 and day 5?
– Do you think it has something to do with my egg quality or my husbands sperm?
– Should we try giving Day 3 embryos a go instead? (or Day 5 if relevant)
– Is there any kind of genetic testing that you think we should do?
– Are there any other tests that you think we should explore?
– Should my husband see an Andrologist?
– Should we have his sperm tested again?
– Are there any other alternatives that we should explore?
I am sure there are some that I have missed but these are the questions that seemed most relevant after repeated IVF failures.
Feel free to post any other questions you might have. We can all learn from other peoples questions.