Saturday, March 29, 2008

Things that make you go hmmm.

I had a consult with my RE on Friday. I came prepared. Why did it fail? Was it egg quality? How would they change the protocol next time? Are there additional tests they would recommend? Dr. Google and I didn't get an opportunity to impress. Immediately, the RE recommended that we undergo immunological and chromosomal testing. He said that most clinics don't recommend either unless there have been recurrent pregnancy losses, but that he felt it would beneficial to rule out these issues for me. I love the way he said "rule out." Turns out if there are immunological issues, they can be dealt with; heparin for example. If there are chromosomal issues, well, cue the chubby opera singer. I snickered when he said we'll know the results of the immune tests early next week but it will take around 4 weeks to know about the chromosomal testing. Of course it will take 4 weeks. Hell, take 6 weeks.

As for the rest, it wouldn't be a trip to the RE's office if they didn't bring up my age. My eggs, you see, have been around 38 years, not to mention the 9 months I hung out in utero. (I knew all those vodka shots back in '69 would come back to haunt me. Bad Fetus.) The good news is that I responded "perfectly" to the stims and have good ovarian reserve. My lining could be fluffier, but it just could have been a bad batch of eggs. Assuming no chromosomal issues, the RE feels we should try again. No need to discuss donor eggs or sperm at this point. (I didn't share that we wouldn't go that route.)

All of us who go through this grapple with the issue of when is enough enough. For some people, I'm sure the answer is when they're successful, when the baby is born. For others, the uncertainty and invasiveness and emotional toll of IVF proves to be too much. Some choose adoption. Donor eggs/sperm or living without a child of your own for others. But at some point, you make a decision. A heartfelt, thoughtful, determined, resigned possibly, decision. I've never been so close to that point.

I know this because my first thought when the RE mentioned that nothing really could be done about chromosomal issues, well then we know we're done. The truth is that the physical process of in vitro has been no problem for me. The shots have been fine. I know, I know, I've complained bitterly, but really, they haven't been bad. Grab fleshy stomach flab, insert needle, depress plunger, go watch Gray's Anatomy. Sure, the butt shots got annoying but I've had worse mosquito bites. I've had two bruises total during this whole process. And the dildo cam, well, it's always been gentle.

The emotional toll of IVF is another story. The uncertainty, the soaring joy following by the bring you to your knees heartbreak, the careful optimism, the preparing for the worst yet hoping for the best, the exhaustive frustration, the please, please, please let me not lose who I am and who the hell am I anyway. No, there is a shelf life on this. When we started this process, I thought, I'll do this as long as it takes. I could not have known how much the process would take. And take.

So, I can definitely see an end to this. Not quite yet, not unless, of course, the chubby woman belts out her final notes in 4 weeks. And if that's the case, then we'll both go on a diet.


Denise said...

When to stop is the hardest question of all. For us, it is probably either when the money runs out, or when we're "ready." I know for sure we're not ready yet, but I guess that doesn't mean I'll KNOW when we are ready to quit.

If they do find some chromosomal issue, would it not make sense to do PGD/PGS? I don't know a lot about it, but a couple of ladies in our ColoBlogger group had a pretty robust discussion about it. Even if there was a chromosomal issue, I wouldn't think it would affect 100% of the embryos. Maybe I'm missing something?

luna said...

melanie, I can identify with this one. our eggs are the same age. it's always a scary thought that they could be bad, even though there's still a good number of them left.

unless it's an across the board chromosomal issue affecting one of you, I imagine you've still got a chance for a healthy one. even if you had a chromo issue, PGD is a good option to weed out any bad embryos...

of course when to say enough is the question. hope the testing goes well and helps with your decision, whatever it may be... ~luna

Mrs.X said...

We discuss this topic once about every six months or so. After the first predicted miscarriage of this most recent pregnancy, we did have the chromosomal tests run on us and we are "normal". We haven't had the immunological stuff - we're waiting on the karyotype results of this most recent pregnancy.

Terita has a post on when to call it quits:

Personally, I'm not ready to make that decision. I'm not in the right frame of mind to really consider it. But, I think it is very smart to know that the question is out there and know that you will someday need to answer the question.

Hope this helps.

luna said...

hey, thanks for your comment. I knew exactly what you meant! ~luna

Duck said...

it's hard to know when to stop, I have no idea/inkling where that line is for me, but, i have a feeling I'm far far away form it, maybe somewhere around 4 cycles. Maybe when the disease makes my life unbearable again.
Hoping that it's something nice, like immunological, then you just shoot heprin, and get knocked up.

Rebeccah said...

One thing I always wonder is what people mean by stop, because I get the feeling we don't all mean the same thing, and that may be one of the reasons folks have such a hard time. For me, the "when" wasn't the hard part, it was the "what." What does "stop" mean? Does it mean no kids at all, or adoption, or stop trying with your own gametes? I don't know the answers, but it sure does set one's head spinning when you're pondering the questions.

Io said...

Obviously, I am far from knowing where my stopping line is as I can't even get out of first gear, so I don't really feel qualified to give you any advice or commiserate effectively. I just hope that when it ends, it ends well.
(Also, I'll try not to sing.)

Carrie said...

It is so very difficult to cope with the lack of control and the uncertainty of all of this.
Even if it was to take time/be a struggle but we knew it would happen eventually, well that would be such a different journey.
I'm glad you're getting the testing, and very envious of your system. I am still fighting for testing despite 4 losses, 2 chemicals and 2 failed IVF's. I hate living here sometimes.
I hope it shows up nothing or something very simple. It must be scary to commit to but I'm a 'would want to know' girl.
Hope you're doing ok and feel a little progress is being made. The waiting is awful.
Thinking of you x

Ahuva Batya said...

In some ways during our IF struggle, I have hoped for some definitive end-point. Something that would FORCE us to stop, no questions asked, decision made for us. It would have been such a relief on some level. We stopped once, for a year. It was a nice year, honestly. It was relaxing, relieving to let it all go. Obviously, we renigged on our decision as here we are again. It's just so hard to know when enough is enough. Sometimes a break is what you need.

JJ said...

When to stop. So hard to answer that question...we are seriously having to consider doing the chromosome testing before saying yes to another ivf--that for me may be the answer. pgd is an option, BUT the heartbreak that we might have to go through if we had NO embryos...ugg.
Such a tugging post--I hope that you get some more answers soon...thinking of you while you wait it out.

Jen said...

I don't have any good answers. I am obviously no better than your RE... But I wish you lots of luck going forward.