Playing the Odds

As I start to tell more and more people about our upcoming IVF journey, the most common question I get is: ‘What are your chances?’*

And honestly, I am always stumped.

I mean DE IVF has great success rates, much higher than own egg IVF. Something like 60-80% success depending on what studies you read and which clinic you go to.

But I have thin lining issues, and with a lining under 7mm the reviews are mixed. Some say the odds go down, others say there is no impact. For example, this article that shows the implantation and clinical pregnancy rate was the same between two groups of women using DE IVF – lining between 5.9 to 7.9mm and  lining between 8.0mm to 23.0mm – around 60-75%.

But then I am also at a higher risk for miscarriage, I think one study I read said that those with radiation damage to the uterus saw an increased risk of miscarriage of about 30% (compared to the average of around 20%). And that risk goes for as long as 22 weeks. Leaving aside the increased risk of low birth weight and premature labour.

So what are my odds of success?

I know there is no easy answer. That is why I have never asked my RE that question. The answer will be some version of ‘I don’t know’. But the last time we spoke the RE said he was hopeful. I’m going to translate that into: over 50% chance of success. Seems reasonable right? I mean, its not like anyone can prove me wrong, or right for that matter.

So yeh. That’s what I am telling people. The odds are 50-50. It is also a fun way to weed out the optimists from the pessimists.


*By ‘more and more people’ I mean two more friends. The grand total of people that know can still be counted on my fingers.

Family resemblance or just good profile selection?

One thing I have started to notice more and more is the obsession with family resemblance that most people have. I don’t think most people realize how much it creeps into any discussion about babies. Literally every time a baby is in the room someone will ask, ‘so who does s/he look like? Mom or Dad?’ or ‘Oh wow s/he is a mini version of [mom/dad]!’ or some variation of the same. Every. Damn. Time. I have started to take bets with myself as to how long before someone mentions family resemblance in any group setting where babies are involved. Even when we all get together as a family, someone will say ‘so who does [my nephew] look like now?’ .

It doesn’t really bother me that much, it is more of a mild annoyance. I don’t ever ask the question myself, and I have always been very bad at guessing the answer. To me, a baby looks like itself. Always some mix of both parents’ genetic material. Can’t we just leave it at that? Obviously this is my DE-IVF persona coming through, I just don’t think that resemblance to parents matters anymore. But for the sake of keeping the peace I will play along: ‘Oh yes, totally has dads eyes’.

But what about when the baby is mine? Will it sting more? Will I tell literally every one that asks who the baby resembles: ‘Not me. It’s just good egg donor profile selection’ Or will I just roll my eyes smile and nod politely and say, ‘probably more like dad’? I think it will be the latter. I imagine in most cases I don’t think I will want to open the door to a DE-IVF educational seminar, unless I have the time and they really need to know.

Maybe I can get a DE IVF onsie for the baby. Literally walk around with a sign to advertise the fact that any physical resemblance to mom is purely coincidental, or at least just good donor selection on the part of the parents. Will that stop people from asking the question? Probably not. I know that if this all works, that is a question I will need to get comfortable answering. How exactly I will handle it? Well, I guess I have lots of time to think about it.

 

Telling my notary

So apparently the contract with DEB USA needs to be signed in front of a notary. Which of course means I have to actually tell them what they are signing. Not to mention the form itself has the DEB USA logo on it right at the top of the page.

Luckily as a lawyer, I am also a notary. Not so luckily I can’t notarize my own signature. A bit of a conflict of interest there. I could find a random stranger to notarize my egg donation forms. But then I have to tell a random stranger that I am going through DE IVF. Luckily as a lawyer I have many lawyers as good friends. One such friend works in the next building over.

So basically another good friend now knows about our DE IVF journey. And I didn’t have to tell a random stranger.

Tomorrow we send the forms and the money to DEB USA.

Going down that rabbit hole.

 

Prep Prep Prep Prep Prep

(Anyone else hear the Work song by Rihanna in their head when you read that title? (for the record I find that song very annoying).

Hysteroscopy is scheduled for Feb 22. Just to check out the uterus make sure she’s ready to go and the fibroids haven’t taken over in there. Hopefully there won’t be any issues with that.

First acupuncture treatment booked for Mar 9. Hopefully this will give me a head start in the lining department.

About 8 weeks away from my CD1 of  IVF. (Thank you POI for allowing me to predict my CD1 with such pinpoint accuracy). If anyone is taking bets, I would put my money on a start date of April 15.

This is where the control freak in me starts to take over. I need to be doing something to prepare my body for the upcoming cycle.

Here’s the pre-IVF prep game plan so far:

  • Workout regularly – 2 times a week HIIT workouts with weight training, 2-3 times a week yoga (this might be ambitious, but maybe if I write it down it will happen right?), maybe start training for a 10k run in May (starting in March both DH and I will train for the race-I may or may not run depending on where we are in the IVF cycle by race day, but I figure the training cannot only help things so training proceeds till further notice).
  • Watch diet – try to limit processed foods and salt intake, lots of home cooking, focus on good carbs, lots of fruit and veg, once a week red meat. Limit caffeine and alcohol of course.
  • Supplements – Platinum Naturals Prenatal vitamins with DHA, Vitamin D drops (1 drop daily), Folic Acid (1mg daily), Nutra Sea Omega 3 liquid (1 tsp daily).
  • Acupuncture – once a week till start of IVF cycle, then twice a week till transfer day.

I am debating whether to start Vitamin E pills and replacing my daily tea with raspberry leaf tea. It can’t hurt I guess.

That’s one benefit of IVF I guess, since I know exactly when I plan to be ‘pregnant’ I have time to prepare my body for it. Silver lining right?

The Therapist.

We had our mandatory therapy appointment yesterday. 

 It was not too bad. I tried to go in with an open mind. But I’ve never been to a therapist before so it’s hard not to be open minded about something I’ve never experienced. It’s all new to me. 

AG has needed therapy to deal with his exam anxiety so I guess he might have had a bit more to go on. But still this was an entirely new experience for us. 

That being said, and even though this was ‘forced’ upon us since we are using donor eggs, I can see the value in it. 

She was nice enough. She asked some tough questions and brought up some good points that we will likely discuss more going forward. Most had crossed my mind before. But AG was surprised by a few thing he had not considered. A few even stumped me. But overall it was a good session. And we have some further areas to explore as a couple. 

Some things that we need to discuss further:

How and when we will tell others about our DE IVF journey. 

I am already thinking about this on a daily basis. AG doesn’t have as much of an issue with it and is ready to tell everyone now. I am not so sure. I just need to decide when will feel right for me. 

One thing we haven’t really discussed is what we will do if we are so lucky as to have embryos left over from our lot that we will not use. Honestly I don’t think this will ever happen. I think we are more likely to use all of them and wish we had more to keep trying. But that being said there are some serious considerations if we are in that position. And especially if we do decide to donate to another couple. DH seems ok with donating. But I’m not convinced yet. Especially if we have any children from this lot. How will a future child feel about having other siblings out there?

This is already complicated by the fact that our egg donor has two children of her own and potentially two that have come from her egg donations. So a total of four half genetic siblings may already exist. That is going to be stressful enough for any future children. Let alone allowing a few more to exist through embryo donation. 

Another issue we both need to discuss is what we will do in case there is a risk that the child may be born with a disability or developmental issues. Or what if there is a risk to my life.  What if we have multiples? Triplets for example. Would we choose to selectively reduce to reduce the risk to all? These are things we have discussed. The chances of multiples are reduced since we will only be transferring one embryo at a time (mandated by the government on a funded cycle). But it is not impossible. 

I am already freaked out by the thought of carrying multiples. I don’t think my already weak uterus will be able to handle it. So I am positive I will be more than upset if we end up with multiples. But these are decisions we need to discuss now.  

Apparently, the risk of post partum depression is higher in mothers that use a donor egg. So both of us will need to be on the look out for that. That is news to me and I will be sure to tell all my family to watch out for that if and when the time comes. 

One thing that I thought was actually quite funny was that neither of us agreed on the number of kids we wanted. It makes sense though. We both have been prepared for zero children. So we never really talked about how many children we wanted. It just didn’t make sense. But I feel like that is one of the most basic things most couples talk about. 

He said 2. I said as many as I can. My theory is that, if through some miracle I am able to carry a baby to term, I am not going to stop until we have exhausted our embryo lot. That being said, when I thought about it some more, I think after 4 kids I might not be as inclined to continue. Plus we would have to consider my health, our ages and financial ability to even support that many children. So I guess there is a limit to what I want too. But honestly I would be ok to stop at 2 if we are so lucky. For now though just one will be plenty. Thank you very much. 

I did get a bit emotional talking about our situation in general. I am starting to realize that I am more bothered by my infertility than I previously thought. It always takes me by surprise. And I will probably have many more bouts of crying before we are done. 

Overall it was a pretty productive conversation. And I think it really did help AG and I to start thinking about the future and how things could change for us. I am definitely looking forward to discussing this some more with him. 

#MicroblogMonday: Random shit I think about

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How may embryos will we get?

The ED (I feel like I should name her, is that weird?) has an egg lot of 7 mature eggs.

DH’s swimmers have literally never fertilized an egg before. Of course, all his stats are great and there is no reason to believe they are not  up to the task. But do they need like a practice egg or two to get it right?

Obviously not all eggs fertilize. And not all that fertilize grow to viable embryos for implantation. But I wish there was a statistic that could tell me how many we can expect to see. The clinic will use ICSI to encourage fertilization. I think the standard stat is that this results in a fertilized egg 75% of the time. DEB USA guarantees that we will have at least one viable embryo to transfer. The coordinator at the clinic said that she has never seen less than two embryos result from a DE lot that came from DEB USA.

I am hoping for at least four, but will be content with three. In my head the magic number of IVF cycles before I will give up trying is three. I figure after 3 tries with good embryos and (hopefully) a decent lining if it isn’t working then it wont work at all and we need to move on. So I would like to have at least three good embryos to give this our best shot.

Here’s hoping.


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Mandatory Therapy

Finally I heard back from the therapist who is supposed to meet with us to discuss the emotional implications of using a DE.

To recap, I emailed her last Tuesday (Jan 31). When I did not hear back I called and left a voicemail on Friday (Feb 3). And again on Tuesday (Feb 7). I even emailed the coordinator at the clinic and asked why she wasn’t responding.

Apparently she has been away for the past week and only just got back (on Tuesday according to the coordinator). And my email landed in her junk mail. Regardless, I am not sure why it took her two days after she got back to respond to my voice mails. But anyways. She apologized, and since this is mandatory, it is not like I have much choice.

She explained the process. DH and I will need to come in to discuss the emotional impact of using a DE. It will be a 2 hour session and there will be a $250 charge. She books up pretty quickly (she only works Mon Wed Thu) but since we are not starting till April we have a bit of time.

On kink though, DH leaves for New York next weekend and is not back till mid-April. And we are planning to get started on the IVF cycle the minute he gets back. Since I am on HRT, I can pretty much predict my day 1 in April will be a few days after he gets back. That way if the first cycle produces an insufficient lining we can just keep going without loosing too much time.

I told her we have already selected our donor. And her reaction implied to me that there really wasn’t much to talk about now that we have already selected a donor. (I guess most people have issues finding the ‘perfect’ match?) So if we were to schedule a meeting in April,  there would be a lot less to discuss. So it all sounded like this was a session that would be almost pointless by the time we are able to see her.

I don’t mind doing it. I mean it can only help make sure that I am being sane and rational about this whole process. I feel it will be very helpful for DH. I have been dealing with the reality of IF and loss of my own eggs for over 20 years now. I read up on it, participate in the forums online. I have this as outlet to discuss what I am going through. DH has really only had since he has met me, and even then we weren’t actively looking into IVF until last year. He is a med student, so gets the process well enough. But psychologically he might have a bit more to discuss and process than I do. And as a couple it can only help make sure we are both on the same page.

Turns out, the therapist had a cancellation for Monday at noon. So we got that appointment. So that’s it then. DH and I are all set to meet the therapist on Monday.