Wednesday, April 7, 2010

Back To The RE.... Finally!

After my IVF transfer was canceled, I tried to schedule a post-IVF conference with Dr. Hopeful, but she was on vacation until April 5th and the earliest available appointment to see her would be May 5th.  But the receptionist said she would leave a message with Dr. Hopeful to see if she could squeeze in an appointment sooner.

I finally called the clinic today.  I figured I'd wait a couple of days for Dr. Hopeful to catch up from being on vacation.  When I called the receptionist said Dr. Hopeful had been busy with procedures since she's been back and she's probably still haven't had a chance to catch up on her messages. Okay...... so I figured I'd give her another day or so and call back.  Less than half an hour later, the clinic calls back with a few options to squeeze in to see Dr. Hopeful.  It pays to call and get on their case!

So now we are set for a post-IVF conference with her next week on Tuesday, April 13th.

Now, my goal is to set out a list of questions to ask Dr. Hopeful when I see her next week.  Here's a high level summary of my last IVF cycle:
  • I was on BCPs for 24 days, then on Lu.pron for 12 days before starting stims.
  • I stimmed on Meno.pur and Follis.tim for 13 days
  • At day of trigger, I had 10 mature follicles, another 9 or 10 that would potentially be matured at retrieval.  Lining was excellent at 15 mm.
  • At egg retrieval, found out that the right ovary was at a "difficult location", and eventually we were not able to retrieve any eggs from that right ovary.
  • 8 eggs were retrieved from the left ovary, 6 were mature.
  • At 2 days post retrieval, only 1 egg fertilized.
  • At 3 days post retrieval, another egg fertilized.  But the first embryo was only at 3-cell.
  • At 4 days post retrieval, 1st embryo was only at 4-cell, and 2nd embryo had stayed at 2-cell.
  • Embryo transfer was canceled since all embryos had arrested.

Some questions that I will be asking Dr. Hopeful when I see her next:
  1. What could have caused the right ovary to be in a "difficult location"?  Why was it never mentioned to me before? (I was able to retrieve eggs from both ovaries from my previous IVF a year ago).
  2. What would have cause the the low fertilization rate, only 2 in a total of 6 have fertilized?  Would 1 year make that much of a difference in the quality of my eggs? (My previous IVF, I had 8 out of 12 fertilized)
  3. What could have caused the embryos to have arrested before day 5 transfer (only at 2 and 4 cell stage)?
  4. Why wasn't a day-3 or day-4 transfer considered since I only had 2 eggs that fertilized?
  5. Should ICSI have been considered? (I think this was not considered since we did not have any issues with my Babe's sperm)
  6. Would you recommend any additional testing?
  7. What would you recommend for the next cycle?  Would you be changing anything with the protocol?
I'm hoping to get some answers as to what happened to this cycle.  And what would be different in the next.

So, what else would you ask the RE if you were me?


  1. So glad you got an appointment so soon. I think you have all the important questions. GL!! I hope she gives you some answers.

  2. Glad you got your appointment set. I hope you get all your question answered and you will have some peace in knowing why the transfer was canceled. Fingers crossed that the next round is your round!

  3. Maybe you could also ask if they would consider the assisted hatching along with the ICSI to increase the odds of implantation. Not sure if this will help in your situation but maybe worth the question?

  4. I'm so glad you were able to get an earlier appointment. Good for you and persistence! Great job on the list of questions also, I can't think of any to add, but many of your questions I will be asking our Dr on our next visit too. I hope you get the answers you need to feel better and get ready for the next round. Thinking of you!

  5. Those all sound like great questions! Hoping you get some answers and a new game plan.

  6. That is such good news that your clinic was able to fit you in earlier, it would have been very difficult to have to wait till May to get some answers.
    I think you've got great questions there and can't think of anything additional to add but thought i'd say something on the subject of ICSI in case you are interested... My clinic recommended we do ICSI after our first ivf cycle had a really low fertilisation rate, there is nothing wrong with my DH's sperm so I initially couldnt see the value in doing ICSI as I thought it was only used in MFI cases. But I have been told (and this has been confirmed by a second clinic) that in any case where fertilisation rates are low it is recommended to use ICSI as it will almost always result in better fert rates. Sometimes eggs can have hard shells that make it harder for the sperm to penetrate naturally. Good luck for the appt!

  7. Have you done a Clomid challenge test to look at your ovarian reserve?? That might be something to look into before jumping into your next IVF cycle.

    As for ICSI, we did it on all of ours and had fabulous fert rates. I highly recommend it even if DH has stellar swimmers! If the issue has to do with the "shell" of your matter how good your DH's sperm is, they might not be able to penetrate it.

  8. So glad you could get in earlier rather than later. I'm glad you're going to ask about ICSI. I know some clinics always use it in every IVF and there has to be a good reason for that. Also, I would ask if another protocol might work better for you. I did micro-dose flare protocol our first two IVFs with crappy response. This last round with new RE we did the antagonist protocol and had 35 eggs retrieved with 25 mature. Still no pregnancy (fingers crossed for this pending FET), but a far cry better than our old protocol. Good luck!

  9. Those sound like great questions. Very well laid out.

  10. I'm glad you were able to get in much earlier than expected! I found it terribly annoying to have to wait SO LONG for a consult w/Dr. Hopeful - and the she didn't have any clear answers for me anyways. Sigh... infertility would be a whole lot easier if we could ever get any clear answers on anything!