Jul 6, 2011

overwhelmed

Today I had an appointment so we can get started with a FET. I am feeling overwhelmed and disappointed, which is how I seem to feel after most of my appointments. I may really consider switching clinics sometime over the next few months because I just consistently feel like we're not being given the very best shot at success. It is difficult for me to tell whether this feeling is just a consequence of my general negativity or whether there is a deeper nugget of truth in it. In short, my 5 frozen embryos are much poorer quality than I thought. My RE would like to transfer an 8-cell B (our best remaining embryo) with a 5-cell BC (in the same straw) for this cycle.

I am not going to lie, the 5 BC sounds really crappy (no offense to you, little guy!) and I am just not feeling it. My RE would then like to do a 2nd FET following this one to exhaust all of our so-so frozen embryos before moving to another fresh cycle. This just sounds like a really low-yield plan to me and it seems unrealistic that all of them will thaw successfully anyway. Perhaps I am just impatient but I find this plan pretty disappointing. Instead, I proposed attempting to thaw all 5 and then culturing the ones that survive the thaw for a couple of days in an attempt to push them to the blastocyst stage and using this as a selection device to weed out the less competent embryos.

My RE was not a fan of this idea and my best guess why is $ - it would be more labor intensive and costly for the lab staff to attempt to grow my embies to the blast stage and it would also mean moving on to another fresh cycle sooner if the FET fails - more costly as well. Just some of the less nice realities of socialized medicine and full IVF coverage. The RE pointed out that by thawing everything and attempting to culture them to the blastocyst stage, we might lose everything and that that would be very disappointing for us. In truth, I would find it much more emotionally draining and disappointing to go through two FETs with not so great embryos and a very low chance of success than to lose all of our embryos and never make it to a frozen transfer.

I guess all of this is sort of a moot point - first we have to see how many even thaw successfully. If we are poised to transfer the 5BC and I am still feeling very negative about things, I could insist on adding in a third since one of our embryos is in a straw by itself. Since we are more or less unexplained at this point (I'd say the mild ovulatory dysfunction/lean PCOS is debatable and I would have gotten pregnant via ovulation induction and IUI if it was the main issue), I asked about the possibility of considering endometriosis or immune factors but the doctor felt that at this point, further testing is unnecessary and would only delay us further in proceeding with treatment.

Lastly, the RE implied (though did not directly say) that he agreed with me that my ER was probably a couple of days too late and that this could have potentially affected the outcome. Tomorrow I go in for bloodwork and ultrasound and if I get the green light, I will start estrogen for the FET tomorrow. So....that's where we're at and as usual I am praying to be pleasantly surprised.

10 comments:

  1. I am sorry your RE isn't seeing things your way and wanting to thaw all of them. I would want to do the same thing. Guess we don't have a choice sometimes but to go along with what they say unfortunately. I really hope you get a surprise BFP and don't have to worry about any more FETs!

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  2. I'm sorry that your RE doesn't seem to have your best interest at heart. With everything we have to deal with, it would be nice if the RE's could be a bit more proactive at times. I don't fault you at all for feeling disappointed with his intended protocol. I would feel the same. FX that your embies thaw perfectly and this FET is all you will need.

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  3. This is so tough, especially going from a failed IVF into an FET so soon. I know it's hard to keep your spirits up. If you progress and don't feel confident in your RE, I would definitely recommend getting a second opinion. I hope this FET works for you!!! I'm here to give you hope - my IVF didn't work, but the FET did. You never know!

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  4. I agree with you about the emotionally draining element of going through two FETs with not so great embryos. I think you are making the right choice in thawing and seeing how they look and implanting more or less depending on the results.
    I'll be thinking of you this cycle and wishing for the best.

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  5. I think you need to go with your instinct. The downside of socialized medicine is that these guys see so many more women than any private clinic would, and sometimes it makes them overlook your feelings. If you don't feel comfortable with this place, I think you should go elsewhere if the FET fails (which I sincerely hope it doesn't, of course!)

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  6. In my clinic they would have made me wait for the FET for a whole three months. That usually drives me mad. At least you get to go at it right away. You really never know, even with the less favourable embryos, I gave them all a chance although honestly only the ones that looked very good worked. I just wanted them all used up before I did another fresh, expensive as it is in Canada.

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  7. So sorry that there seem to be unanswered questions and that your gut is telling you something different than your RE.

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  8. I'm sorry the appointment is disappointing, but yay for moving on to the FET. I don't know if the clinic's decision about what to thaw/moving on to a fresh cycle has so much to do about money (they aren't the ones paying for it, health insurance is) as just clinic/hospital protocol. They tend to do what they are used to. Here's to hoping that they are right and you'll get something out of those frozen embryos.

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  9. I am so sorry about the BFN and the lower quality embryos. All I can say is that I have read several blogs that transferred lower quality or just single embryos and get pregnant from FETs. I, on the other hand transferred 4 top grade embryos and nothing took. It's a crap shoot. Hopefully one of these guys is just a late bloomer.

    xo

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  10. Thanks as usual, guys! I think I will at least ask about thawing 3 - the 8B and the 5BC and then whichever one is in a straw of it's own. Also, I had an interesting realization: I complain a lot that I don't think my clinic is proactive or aggressive enough in their approach but I have never actually said point-blank to any of the REs that I want to be as aggressive as they will allow. In the future, being more to the point about it might help me a lot! Just something I will keep in mind.

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