Friday, June 18, 2010

TWO Phone Consults

Yesterday, I mentioned that I was supposed to have a nurse's consult on Tuesday for our next round of IVF but I cancelled.  I wanted to talk to Dr. Hopeful first about trying to access the eggs in my right ovary.

So yesterday, I was finally able to talk to Dr. Hopeful over the phone.  I again told her about my concern that we can only access my left ovary.  Was there any other way to access the right ovary that was located high and behind the uterus?  It feels like such a waste to not be able to access the eggs on my right ovary, cutting down the number of eggs to 50% for my next cycle.  This is what I found out:
  • She will not try to retrieve eggs from my right ovary by going through the uterus unless it looks like the position of the ovary has changed.  This is unlikely, but it is possible.  She does not want to risk going through my uterus with a needle, jeopardizing the condition of uterus which may impact implantation of the embryos.
  • Many people have successful IVFs even though they only have one ovary.  This of course, is no comfort to me, knowing the crappy quality of my eggs.  Also it's not the same thing having only one ovary, versus having 2 good ovaries and knowing that your eggs from the right ovary is just being wasted!
  • She will not be able to do a laparoscopic surgery to remove the eggs during the IVF retrieval process.  In the past, egg retrieval was done via laparoscopic surgery, but that procedure is no longer used for IVF.  They have found that it is inefficient and have low pregnancy rates.  
  • Dr. Hopeful's clinic is not set up to do laparoscopic surgery.  It totally makes sense.  She is not trained for laparoscopy, and I wouldn't want her perform it on me!
  • Most IVF clinics do not do laparoscopic egg retrieval for IVF anymore.  According to her, there are no clinics in MN that do that anymore.  I would have to go out of state to have it done.  Today I called another IVF clinic here in the Twin Cities asking about laparoscopic egg retrieval.  They don't offer that in their clinic either.  I will try to call another clinic next week to see if they do it.  Just out of curiosity.
  • If I wanted, I can consider doing a laparoscopy surgery to try to move my ovary to better position, making it more accessible for egg retrieval.  But there are no guarantees.  It would mean postponing my IVF cycle for a few months.
  • For our next cycle, we will be doing 100% ICSI.  From my first IVF cycle overseas, I didn't seem to have any issues with fertilization, and therefore, ICSI was not considered.  But we will do it this next time around.
During my conversation with Dr. Hopeful, I mentioned that I had not been able to get a hold of the andrology lab director.  She had suggested I go over my lab results with him.  However, I had left multiple messages for his admin, but she never got back to me.  So I gave up on trying to reach him.  Well she said she would email him (he is based in Utah) asking him to call me.  

Less than an hour after I hung up the phone with Dr. Hopeful, he called!  So I had my second phone consult of the day, with Dr. Lab Director.  I was very surprised that he called me back so quickly.  He's what he told me:
  • Based on my first IVF cycle overseas, he didn't expect the outcome of my last cycle at the clinic.
  • My last cycle here, 8 eggs were retrieved, and 6 were mature.  3 of the 6 were mature but had vacuoles (similar to bubbles) in them, indicating that there were some issues with the egg.  According to him, this is very unusual.
  • According to Dr. Lab Director, in IVF cycles that have bad outcomes (like mine), in the next cycles, if nothing is done differently, 40% - 50% of the time they get a different outcome.  Possibly just a fluke.  The other 50% of the time, they get the same result.  So I guess, it sounds like we have a 50-50 chance of it working the next cycle?
  • So the question is, is the issue the egg or the sperm?  According to Dr. Lab Director, Babe's sperm seems to be fine, based on previous IUIs and IVFs.  Generally sperm tends to be more consistent.  It seems like the issue is with my eggs (no surprise here!).  Unfortunately, there is no good test for eggs.
  • His guess is, my body may have responded differently to the drugs or protocol of my last cycle versus the one overseas.  It's a possibility, but we will never know.
  • Doing ICSI is a good idea for the next cycle since we had such a low fertilization rate (only 2 out of 6). This will increase the odds of our eggs fertilizing. 
Based on the 2 phone consults I had, I have decided to continue with our original plan of doing our next IVF cycle in July.  We now have a nurse's consult next Wednesday, June 23rd.  I am praying that acupuncture and herbs will help improve the quality of my eggs.  I can sure use all the help I can get.

8 comments:

  1. I live in Utah. How come the lab dir is based in Utah?

    I only have one working ovary, so we are kind of in the same boat. I'm working my way up to IVF if this next IUI doesn't work.

    Good luck with your eggs.

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  2. So glad you got some information! I hate to hear that there's not really anything they can do to retrieve those eggs from that right ovary. I agree it does seem like such a waste. But the good news is that you're making a good number of eggs on the other ovary. We've always done ICSI (we are MFI) and I'm glad to hear you're doing it next time. Best of luck!

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  3. How frustrating to have eggs you can't access! Glad you have the other ovary in a good position though - what if they were BOTH in a bad location?

    I've switched back to Dr. Hopeful and have my nurses consult the day after you. Maybe I'll see you sometime at the clinic!

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  4. I'm glad your doctor addressed your concerns honestly. I hope the next cycle yields much better results.

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  5. I am so glad you got the info you needed. We always do icsi for ivf and I hope you get better outcomes. I have had egg quality issues in the past. I have done acu, not sure if it helps but it feels great and my embryos have looked better. They also have changed my meds and do endometrial co-culture (something controversial that my RE happens to love). I can get you more info if you want.
    wishing you good luck with this next round, it always feels better to have a plan of some sort.

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  6. So much information! It must be nice to be so informed. I think that doing all the alternative meds in addition to the IVF meds can only help. I'm upping your odds from 50-50. :)

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  7. I think it's great that your doctors have explained everything clearly to you. I also think that it's great that you're trying TCM to help your eggs, though you have to keep in mind that it would take 3-4 months before you'll see results. It's a wonderful start though in the right direction! The book I recommend on my blog has a chapter on ART and TCM. I think it might a great reference for you. Good luck!

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  8. Can sense your frustration. We love and miss you and your Babe and will keep you both in our prayers as you go thru the next cycle. KC

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