DEIVF Next Steps

Can it really be possible, that I have more good news? Uh-huh!

Today I had my sonohysterogram (SHG) — where your uterus is filled with saline to check its lining, and to measure its length in advance of Embryo Transfer Day (which won’t happen for a while yet).

I’d heard a SHG was nowhere near as painful as an HSG but I was a bit nervous about getting more bad news, so my MIL very kindly came with me. The catheter stung as it was threaded through my cervix, and there was some mild cramping (very much like menstrual cramps) for a couple of minutes, but that was it.

The good news? I have a beautifully smooth uterine lining. Dr. D declared that I had “passed with flying colours” which made me very happy indeed! I may have *actual* walnuts for ovaries, but my fabulous tubes and a lush uterus make up for it.  Almost.

Now we’re just waiting for DH’s karyotyping results — a precaution on our part, given our year — and then all the official pre-DEIVF testing will be over!

When we started on the IVF path, Dr. A (who diagnosed my DOR) recommended only two places in San Diego: Dr. D’s clinic, and Dr. H’s. So far, all of our pre-IVF testing has been done through Dr. D’s clinic because between DH’s workload and my trip to London, we’ve had to reschedule our appointment with Dr. H a few times. Today’s appointment with Dr. D marks the last time I see him because our egg donor, Nellie, is registered with Dr. H’s in-house agency which means we have to see him. Effectively, we chose our RE based on our choosing Nellie.

Yesterday we met with Dr. H for the first time. In the car, I noticed I was a little anxious: what if I didn’t like him as much as Dr. D? What if I didn’t like him at all?

I needn’t have worried.  He introduced himself as Firstname Lastname (not as “Dr. H”) and immediately told me I have “fun hair” which made me grin. (I do have fun hair!) Then he told me his brother-in-law is also from London and threw the word “bugger” (complete with English accent — touché, doc!) around to describe him.  It was a small detail, but his humour really made me relax. I liked him immediately. I also liked all of the support staff.

We learned a few things. Most significantly is that people with issues on chromosomes 8 and 9 typically experience lower fertility. He is the first doctor to link my diminished ovarian reserve (DOR) with my chromosomal aberration — to explain briefly, our cells are constantly being renewed, so old cells must die — a process called apoptosis. When cells don’t die and continue to multiply, it’s cancer, so apoptosis is a good thing!  So our eggs, like our cells, are programmed to expire after a certain time; and my inverted chromosome means that my eggs have been programmed to expire early.

I also learned that a likely explanation for my shorter luteal phases the past three menstrual cycles is because the eggs released were poor quality. That ties in with my DOR, but I was reassured to learn that menopause isn’t literally around the corner as I had feared. (I will probably be 45, instead of the average age of 51.)

He also praised DH and me for our understanding of my genetic reality. He was impressed that we had processed the information so quickly (it was only 6 weeks ago last night that I learned about my chromosome issue) and had moved forward so quickly. He absolutely agreed with us that donor egg IVF is the best way to proceed.  If I had either DOR or a genetic issue, it might make sense to try with my own eggs first — but given the “double whammy” it seems like trying with my own eggs is a bad idea. The issue is not if I can get pregnant — I think I have three times since January — the issue is staying pregnant and having a healthy baby. A near impossible feat, given my lousy eighth chromosome.

We left his office feeling hopeful, buoyed, and, erm, floored by how much this is all going to cost (but that’s a post for another time).

On Monday, we meet with the egg donor nurse to go over logistics, but we know this much:

I will get my period around Thanksgiving.

Around that time, I will begin the mock cycle, where I take hormonal injections to build up the lining of my uterus to see how I respond to the medications.

I will go on birth control to sync my cycle to Nellie’s.

Have a stress- and alcohol-free holiday season.

In mid-January, Nellie will begin her stims.

Past experience means we know she needs around 10 days of stims.

We will probably do a transfer on the 6th day, because DH and I are strongly leaning towards doing PGS on the embryos to minimise risk of miscarriage and birth defects (given our year, we are highly anxious about this, and the peace of mind it will bring seems like money well spent).

We will transfer 2 embryos, because that has a much higher chance of a successful outcome than transferring one embryo (90%, compared to 30%).

We will therefore have a 50% chance of having twins (twins!) but my height means I would carry such a pregnancy well.

All of which means… with a little bit of luck, I will be pregnant in early February.

Please keep your fingers, legs, and eyes crossed for us xo