Elizabeth’s Story

Hi, I’m Elizabeth, and this is my story.

I’m not a doctor or a specialist of any kind, just a former fertility patient who has been through some trials and tribulations and has learned a lot along the way. I set up this site to help ‘pay forward’ some of the fantastic advice and support I had from many strong and knowledgeable women I have met (most of them virtually, some in real life) over my years of trying to conceive our family.

Like many, I was told again and again that I had “plenty of time” to conceive. My husband and I started trying to conceive when I was 36, and I didn’t think this was at all unreasonable. Boy, was I wrong!

After two years ttc (trying to conceive*) – we didn’t go sooner because we’d been living apart due to work and hadn’t been able to “try” more than about 5 months a year – we finally checked in to see a specialist. A few basic tests were run, and several things were found to be wrong:

  • I had high FSH (19.6 – it’s supposed to be under 10) a.k.a. ‘diminished ovarian reserve’ (running out of eggs)
  • I had an endometrial polyp about the size of Africa (OK, it was “only” 5cm x 2cm, but this is huge in polyp terms) that had been basically acting as an IUD for probably years
  • During a hysteroscopy and laparoscopy (keyhole surgery) to remove the polyp, the dr also found that I had mild (stage 2) endometriosis

The high FSH was the worst. While a slightly elevated level might have just made things a little harder, the specialist shook his head and said that 19.6 was “not exactly a grey area”. I was devastated at the realisation that we’d left it all too late, I was out of eggs and would now never have children that were biologically ours. It felt like a black vortex of despair. I remember crying down the phone so  hard that DH* could hardly understand what the diagnosis was.

The specialist, thankfully, agreed to go ahead with the laparoscopy and hysteroscopy (to get rid of the polyp and check for endo)  and let us try an IUI with Clomid. Probably just to humour me, I figured. Oh well, I just wanted to be trying something.

Heaven knows how it happened, but somehow the one viable follicle in our first IUI cycle contained a golden egg. We were thrilled to be pregnant against all odds after 2+ years of trying, but of course consumed with fear that the pregnancy would end in tears. Amazingly, that one went all the way.

At 6 months I tearfully weaned our first little one, torn between the reality that she might be the only one I’d ever get to breastfeed and the desperate longing to find her a sibling somewhere in my shrinking clutch of ancient eggs. At this stage I was nearly 40 so, having already been told at 38 we were too late, I knew the odds were against us.

On our specialist’s advice, we tried a couple of Clomid IUIs since that had worked last time. We got follicles, but BFNs.* The original plan was to try three, but it just seemed like another spin on the hamster wheel, so we decided to move on to the Big Guns, IVF.

As a poor responder (high FSH, over 40) there are basically two protocol options – the microdose flare and the antagonist. Our specialist suggested starting with the flare, on so-called “max dose” of 300IU Gonal F, using birth control pills (BCPs) as precycle suppression. Result: Zero response. Next cycle: natural chemical pregnancy.

Plan B: “one last shot” (says my specialist) using an antagonist protocol, although he isn’t optimistic. We ditch the BCPs in favour of 4mg estradiol valerate (E2V) and go for an antagonist cycle. Yay, actually got follicles this time, but just 2 eggs from 4 follies, and a BFN.

The Saga goes on (more borrowing on the mortgage, some financial help from family, lots on the credit cards … I figure I can make money after menopause but not eggs).

Here’s the short version of those 7 cycles, BUT watch very carefully the difference in [visual] embryo quality in the cycles where I did high stim vs. how the embryos looked when I did low stim. Yes, looks aren’t everything in this game, but looks (expressed as embryo ‘grades’) are quite highly correlated with success rates. And the difference here made me sit up and pay attention long before I knew we were pregnant. See what you think. The grading system used at my clinic went from 1 (awful) to 5 (near-perfect).

ttc#2 2.4 years (starting at age 39.11); FSHs 19.6, 9.6, 9.7, 12.4, 8.5, 18.8, 16.4, 9.0, 12.1, 9.0 (w/E2V), 8.1 (w/E2V)

 Age Cycle Result Embie 1 Embie 2 Embie 3 Embie 4
 39.11, 40.1  Two failed IUIs (Clomid)  BFN x 2
 40.4  IVF#1 (MDL, 300 Gonal F)  cancelled, no response  none
 40.5  Break cycle  chemical pg
 40.8  IVF#2 (antagonist, 450 Gonal F, ICSI)  4 follies, 2 eggs, 2 embies, BFN  7-cell grade 3  4-cell grade 3  (no pics, but see grade 3 embie in IVF#3 for quality)
 40.10  Break cycle  chemical pg
 nearly 41  Break cycle  chemical pg
 41.2  IVF#3 (antagonist, 450 Gonal F + 75 Luveris, ICSI)  6 follies, 6 eggs, 4 embies, 3 t/f, low level chemical pg/BFN

IVF#3 5-cell (not graded)

IVF#3 7-cell grade 3

IVF#3 7-cell grade 4 compacting

IVF#3 8-cell grade 4

 41.5  IVF#4 (antagonist, 450 Gonal F + 75 Luveris, ICSI)  6 follies, 3 eggs, 3 embies, BFN

IVF#4 4-cell grade 4

IVF#4 6-cell grade 3

IVF#4 8-cell grade 4

 41.8  IVF#5 (antagonist, 450 Gonal F + 75 Luveris)  cancelled, one follie  none
 41.11  Break cycle  Natural BFP; m/c, D&C @ 7wks  ********* SWITCHED TO
LOW-STIM
  *********
 42.1  IVF#6 (low stim antagonist, 150 Gonal F + 75 Luveris, frozen sperm, no ICSI)  2 follies, 2 eggs, 1 embie, BFN IVF#6 no pic but it was a 9-cell, grade 4 or 5
 42.3  IVF#7 (low stim antagonist, 150 Gonal F + 75 Luveris, with Dex, ICSI)  4 follies, 4 eggs, 4 embies t/f, BFP!

IVF#7 4-cell grade 4

IVF#7 7-cell grade 4, compacting

IVF#7 8-cell grade 5 compacting

IVF#7 8-cell grade 5 compacting

IVF#7 fraternal twin girls born by C-section at 37w1d (age 42.11) – so two of the above took!

Acupuncture, Chinese herbs and supplements, baby aspirin, 5mg folic acid.
DH did acu, herbs, vitamins (under duress).
Protocol & supplements info: http://www.network54.com/Forum/264844/message/1184096897/

<– There’s a much better write-up of all this, including the full protocol and all these embryo pics, up on Amazon in the 2nd edition of my little booklet, Navigating the Fertility Treatment Maze: Where to start, what to ask, if you’d prefer to have this story (and revised versions of some “how to deal with REs” posts, plus some extra thoughts) on your e-reader, phone, or laptop. Even if you don’t get it, you know what’s in it, more or less, so can you do me a favor and click “Like” anyway? 😉

Everyone’s story is different, of course, and the sad reality is that some end up with no baby at all. I am not going to spend a lot of time on this blog/site telling “me” stories, but I know many who come to a blog like this want to know who is posting and where they are coming from so they can better judge what’s credible and what’s not.

I’m not a dr, and I don’t have any special qualifications for all this, although I do have an academic background that allows me to read and evaluate scientific papers and research. I don’t give out medical advice; I’m just trying to share what I’ve found out along the way (sometimes from drs, but the lion’s share has been via other women who’ve gone all out on researching particular things).

I’ve been down the infertility vortex (both the primary one and the secondary one); I was lucky enough to emerge on the lucky side of both, but of course at the time I had no way of knowing which way things would go. I just hope I can share a few useful snippets that will be helpful to someone, somewhere.

Kia kaha (stay strong), and may you all fulfil your dreams of a family.

Elizabeth

* If you need subtitles on the acronyms, head for the acronyms page

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