Infertility

In retrospect, I was an idiot.

I was brought up and educated to believe that I could do anything. What I failed to realize was that my body, my corporeal self, might not comply.

W. and I got married when we were 34 because we decided we wanted children, and he felt very strongly that the children needed married parents. So we stopped using birth control, and got married, and nothing happened. And nothing happened. And. Nothing. Happened.

I woke up on the verge of my 41st birthday and realized that I wasn’t pregnant and that maybe it was time to do something about it. So I made an appointment to see my ob/gyn, who I’d been seeing for about 15 years. She did a checkup (including a sonogram), sent me off for day 3 blood work and an HSG, and gave me a referral to a reproductive endocrinologist. Little did I know that that sonogram was the only the first of many viewings of my ovaries with the dildo-cam (a/k/a transvaginal ultrasound).

The HSG wasn’t that bad (take a painkiller an hour beforehand). However, while my tubes were clear, the HSG showed that one of them was in a fixed position. Because of this, the radiologist suspected endometriosis.

Once all that prep testing was in hand, we went to see the RE. He said, pretty much right off the bat, that he thought we were a candidate for IVF. This freaked us out! We’re just starting here and he wanted to jump straight into an IVF? After some discussion, he agreed to let us try a medicated IUI. In some ways, that IUI was like sticking your toes in the water – figure out how the system works, how the injections go, etc. Needless to say, the IUI was unsuccessful, and not inexpensive.

So we got on the IVF calendar. The arrived at protocol was a month of birth control pills – oh, the irony – followed by microdose Lupron and a combination of Repronex and Follistim. I started the BCP, and went to my college reunion, where I met a classmate with little hair as a result of ovarian cancer. She'd had multiple IUIs and multiple IVFs. Her doctors said that the cancer was unrelated to the many ovarian stimulations, but, but, but...it was a little freaky.

The IVF proceeded smoothly - six eggs were retrieved, three fertilized, all three embryos were transferred (4, 5, and 6 cells). And - bingo! First IVF worked! We won the lottery! Beta of 23 at 11dp3dt. Appropriate increases to the beta! Egg sac seen at 5w3d! Heartbeat seen at 6w3d! NOTHING seen at 7w3d - the whole sac had disappeared, and the beta had dropped. Early miscarriage. It was probably a chromosomal issue, but that's just a hypothesis as there was no tissue to test.

So we waited a couple of months. I had a saline sonogram to check the interior of the uterus. We went on vacation for a week. And we did another cycle, but with a different protocol - an Antagon suppression. I was on stims for 11 days, starting at 6 vials a day, increasing to 7. Eight eggs were retrieved, seven fertilized, but only two 6-cell embryos made it to transfer. Wait, wait, wait, the interminable two week wait. BFN.

Following that failed cycle, I went back to the RE for a follow-up and discussion as to next steps. His initial reaction was that we should try donor eggs. I asked if it was worth getting a second opinion. To his great credit, he said yes and offered the names of doctors at both NYU and Cornell, and when I expressed interest in Cornell, he called a doctor there on my behalf. If I had called that doctor directly, it would have taken months to get an appointment. Instead, I was in the office at Cornell 3 weeks after the BFN.

(to be continued)