Monday, 18 March 2013

All over the map

I've been on a total roller coaster for the past couple of weeks while getting ready for this FET.  When we got back from Mexico, I was down.  I was convinced that the cycle would fail and I almost didn't even want to start it.  Then, miraculously, I began feeling more positive.  I started doing some visualization exercises.  Nothing structured, but just more like letting my imagination run away with me.  I would picture M and I in the hospital after delivering our baby, receiving visitors.  I'd imagine taking cute pictures of the baby napping on M's chest, or flash forward to our excitement as our child takes his or her first steps.  Just to make it realistic, I'd even put some of the crappy stuff in there too, like hauling ourselves out of bed for late night feedings or freaking out over the baby's first high fever. 

Then, somewhere in the last week or two, the roller coaster started rocketing back down again.  Today, it seems to have hit a new low.  Not only am I thinking negatively about this FET, but I'm starting to wonder if I should even be doing IVF in the first place. 

As someone with Diminshed Ovarian Reserve (DOR), I tend to gravitate towards blogs of women with a similar diagnosis.  Some of these have found success through IVF, and some of them are still slugging it out with me in the trenches.  As a general rule, we tend to realize that our chances of IVF success are lower than normal.  And yet we soldier on, hoping that we'll be the success story.

Except when we don't.  In the last little while, I've come across a couple of bloggers who have been newly diagnosed with DOR or low AMH.  For whatever reason, their doctors have sat them down and told them that there's nothing to be done.  They're out of the game.  Do not stop, do not pass go, do not collect $200.  Go directly to donor egg.

Obviously, I know there's no single answer here.  Every patient is different.  But in almost every case, my AMH is lower than theirs.  By way of reminder, my AMH is 1.2 pmol/L, or 0.17 ng/ml.  That's "very low/undetectable" for anyone who's counting.  It's about as shitty as it gets.  And yet, when I asked my RE whether she thought we should even bother with IVF and try donor eggs instead based on those numbers, she seemed surprised.  She estimated that our chances of IVF success wouldn't be much lower than anyone else in my general age group, and that there was absolutely no reason to be thinking about donor egg at this point.

Today, I'm questioning that decision big time.  Out of 8 mature eggs, only 4 were good enough to fertilize.  Only one made it to day 5.  At best, I feel like my RE was overly optimistic.  At worst, she's delusional and trying to bilk us out of a lot of money.  Today, I feel like we've probably just wasted a lot of time and money on something that is virtually certain to fail.  Everyone else's doctor seems to think so, given numbers similar to mine.  I kind of feel like we're idiots for thinking otherwise.

I know I need to try to turn this around before the transfer on Friday.  It would be great to go into this FET with a positive (or at the very least neutral) attitude.  But for now, here's me:

someecards.com - It's never too late to give up.

21 comments:

  1. Don't give up!

    But... I totally, totally know how you feel. Even though I have DOR, my doctor hasn't ever mentioned DE and is also surprised whenever I bring that option up. It's so hard- each patient and each doctor is so different.

    Will be thinking of you this week and especially on Friday!

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  2. I agree with Aubrey -- please don't give up! Numbers are just numbers, and I truly believe too much weight is put into them without taking the whole picture into consideration. I had an AMH almost identical to yours, retrieved 8 eggs, 3 fertilized, 1 made it to day 5 and I am now 26 weeks pregnant. We were given a 15% chance of success.

    I also believe that acupuncture and eating avocados during IVF (my chiro told me it increases success rate of IVF 3x according to an English study) helped in the journey.

    That's just my two cents worth. Obviously you have to do what is right for you, whether that is IVF with your own eggs, donor eggs or going a different route all together. Thinking of you!

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    1. This is so similar to our situation it's freaky. I am putting avocado on the grocery list for sure! Congrats on your little miracle and best of luck with the rest of your pregnancy!

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  3. At this point, you've come so far, there's not point to the woulda, shoulda, coulda now. Concurring with JJ, there is so much variability with numbers. AMH is only one measure, you have to consider it with an FSH/E2 and AFC. Despite your AMH level, you produced eggs and you're also facing the challenge of male factor issues as well. Different clinics have their own "cut off" points where they recommend donor eggs. Mine does use own eggs with anyone over the age of 43 regardless of their labs, and some times clinics have different motivating factors for their decision points. (Spoiler alert, my post for tomorrow addresses this issue if you want to skip reading it) I know how cliche and horrible it sounds, but sometimes you truly never know. My colleague had a patient who had an FSH of 35 and an AMH of 0.2, she was scheduled for an appointment where the doctor would recommend considering donor eggs and she conceived on her own, before that appointment!

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    1. continuing... bring back that positive energy, there's no turning back from the transfer at this point, so go full steam ahead!

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    2. I love me a good low AMH/high FSH success story. Thanks for sharing!

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  4. I can relate to this. It's so hard to keep the hope up when analysing it all. Every Dr. has said to me that I'm still young (35) to consider DE. Well, it doesn't always have to do with age, does it! You still have a real chance in this FET though. Best of luck!!

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  5. Thinking of you and praying that positivity, hope, and peace find you before Friday. You've come so far! Take this cycle as it comes and, if the worst happens, revisit donor eggs then. For now, focus on the amazing gift of being able to pursue ART and for the one beauty that will be transferred on Friday!

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  6. Ugh, I'm sorry. I struggle with the same feelings. Well, not exactly; I'm pretty committed to trying with my own eggs. But...last cycle I just had three eggs and they're just sitting on ice. We're waiting for me to cycle again so I can build a cache of eggs. Our MFI is so severe we don't want to waste his TESE on just 3 eggs. However, my doctor was so excited to get three eggs. And was positively giddy about the possibility of three more next cycle. Then of course I read about the bloggers who get like 19 eggs and I'm so discouraged. But it's such a difficult place to be in. It's hard to think positively all the time when you really consider the odds. And I sometimes wonder, with so many hurdles to getting a baby, is it really worth all the time, energy, angst, money for a baby with your own genes. What I keep telling myself, though, is that while there a lot of blogs out there, the vast majority of women going through IVF don't blog and our REs see these people, so they have a fuller picture of what works and what doesn't work. And they wouldn't in good conscience have us move forward unless they thought it would work based on their experiences with similar cases. That may be naive, but it's how I keep plodding forward. Good luck and I'll be thinking of you Friday.

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    1. Sounds like your RE has a really solid plan for you guys given your medical backgrounds. I hope it works out for you! Good point about the majority of infertiles not blogging...I guess it's easy to get tunnel vision after a while. Thanks for the reminder!

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    2. Thanks Aramis. I'm neutral to optimistic most of the time, but remain hopeful. You know, one thing that I did was circle + bloom and honestly I think that it worked. And I really don't believe in this kind of stuff. With most of it (acupuncture, herbs, supplements) I kind of go through the motions, not entirely sure there's any effect, but this mind body connection exercise felt different. At very least, it was fun to spend 15 minutes thinking happy thoughts.

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  7. I never knew what my AMH number was - just that it was low. (I didn't ask, because I knew that it would probably just depress me and make me feel utterly hopeless.) But given my AMH and my AFC (a whopping 8 follicles), my RE said she'd be happy to get 4-6 eggs out of me. She never mentioned donor eggs and didn't seem to have a gloomy attitude about my chances. I knew, though, that my chances were pretty damn low and that I wouldn't be one of those women with lots of embryos on ice as a back up.

    I don't know if it's encouraging at all or not, but I did wind up getting pregnant - without IVF (but with the assistance of Femara). I know that not every DOR story ends up like mine, but I want you to know that it's not completely hopeless. That being said, don't stress yourself too much about not feeling more positive about this. I don't believe that you need to be full of optimism for it to work. My faith in my ability to get pregnant was about as low as it could get, and it still happened. Don't put more pressure on yourself because of the way you feel.

    Sending you lots of good thoughts and wishing you lots of luck. *hugs*

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    1. Your blog was actually one of the very first that I came across when doing my early research, and I still remember getting misty-eyed when I saw your post with the surprise BFP. Stories like yours give me hope that stuff like this can happen, it's not just all 4-year old anecdotes on web forums. So happy for you and J, and thanks for the pep talk!

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  8. I think all of us infertiles- with DOR or not- have ups and downs. For me, it's seems like it is a daily change!!

    All it takes is one embryo to get you pregnant. Try to stay positive for this FET.

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  9. Keep your chin up and don't blame yourself for not being more optimistic. I think it is a lot more science and luck that gets us pregnant than optimism. While positive thinking definitely won't hurt I don't believe that negative thoughts truly have the power to turn something that was meant to be positive around.
    My advise: Allow yourself to feel exactly the way you feel. No judgement. No blame.

    Good luck on Friday!

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    1. I know what you mean...but then I read all that stuff out there about the ability of positive thinking to actually affect medical outcomes and I'm not so sure. I feel like it would be so much better for our chances to be able to be optimistic!

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  10. I'll be thinking of you on Friday... remember, it only takes one! (sorry, had to).

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  11. sorry you are havign a down day! right now you need to focus on teh positive - you have an embryo to transfer!!! i hope that works and you never need to think abotu the next step or DE! but, if you do, we will be here for you and I will tell you everything you ever needed to think/know/feel when considering DE. Its a lot of info and right now YOU DONT NEED IT so focus some positive energy on your FET!

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  12. I'm sorry you're feeling discouraged. I have these ups and downs as well; in fact, a lot of my positive imagery is pretty much what you describe.

    I think it is encouraging that you have a blast to work with. I hope so much that your blast becomes a person.

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  13. My heart goes out to you right now. I am so sorry that your roller coaster is at a low point right now... I hope you are a DOR success story, but even if you aren't I know that you WILL be a Mama someday, and all those daydreams will come true. We are all here for you

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  14. I've come to the conclusion that I don't think very highly of roller coasters anymore. I used to love them. You've already planned for this FET, so I say go for it and see what happens! You really never know. The choice for us to go to donor eggs came down to money. We did one IVF resulting in a chemical pregnancy and no extra embryos to freeze. IVF #2 was cancelled because I only ended up with one follicle growing. We could have tried again, but we were spending $6000 in stim meds alone. Seemed like a real waste if I wasn't going to produce eggs anyway. Financially, we had a choice between going for it with my own eggs or using a donor, but that was it. We only had one more chance. I still don't have that success story, but thought I'd share my thoughts on why we chose the donor egg route. Everyone is different though. If we could afford it, we would continue trying and trying again.

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I'm needy and your comments validate me. Help a sister out!