Unexpected answers, unwelcome delays

The results of my Yale Endometrial Function Test (EFT) are in.  I knew the second that my RE launched into the "so this is what we're testing for..." speech that something was up.  Otherwise she would have just said everything was fine.  So what's the verdict?

First, some background.  The EFT is an experimental test that is pretty much still research at this point.  It tests various secretions made by your lining which are essential for embryo implantation (if you're really science-y, read all about it here).  For the rest of us dummies, Yale's Dr. Kliman compares it to a surfer riding a wave.  Your lining is made up of two parts: the glands that produce the secretions necessary for implantation, and the stroma which is the connective tissue that holds the lining together.  The glands (the surfer) need to develop in sync with the stroma (the ocean) to catch the wave and create the proper conditions for implantation, or else your cycle is just a big fat wipeout (OK, I added that last part). 

Back to me.  While my progesterone levels were right on target for CD24 (test day), it turns out my glands were mildly out of phase with the stroma.  As in, according to my stroma it was CD24, but my glands were acting like it was CD18.  Lazy bastards.  The final diagnosis: moderate glandular/stromal asynchrony.  Translation:  fucked up lining to go along with my fucked up eggs.  Treatment: two months of Lupron-induced menopause to reset my system and hopefully have things sync up.

 

Me either, Liz.  Me either.

So here are the fun facts.  My RE is recommending proceeding with a new IVF cycle ASAP, given my ever-diminishing ovarian reserve.  We would tweak my protocol to use estrogen priming instead of birth control and Suprefact instead of Orgalutron as an ovulation suppressor, as apparently some women produce better eggs on Suprefact.  Which is important, as my RE helpfully informed me that I was wrong in thinking that I had only 30% normal eggs last time.  I apparently misheard.  I had 13% normal eggs.  Which, out of the 8 mature eggs I had, is exactly ONE.  I assume it's the one that made it to blast.  Wow, this appointment just keeps getting better!

Anyway, following the egg retrieval we would do another "freeze all" on Day 5.  This sucks, as I was planning on asking for a Day 3 transfer this time around based on the fact that the idea of having nothing to transfer is really, really horrible.  And as much as my clinic is convinced that they're perfectly mimicking the inside of a uterus and that if an embryo doesn't make it to Day 5 in the lab, it wouldn't make it inside me, I'm starting to think differently.  In my time blogging I've seen too many stories of women with dodgy-looking embryos on Day 3 that no one thought would make it to Day 5, who went ahead with a Day 3 transfer and got pregnant.  But it looks like I won't get the chance to try out that theory.

Following the IVF cycle I would do two months of Lupron depot shots to send me into joyous menopause and reset my uterus.  The problem here is that the Yale EFT is not conclusive, and in fact some REs online seem to consider it complete bunk and have said they would never do the Lupron treatment after an abnormal result.  Also, the EFT isn't able to pinpoint any specific reason behind the lining abnormalities.  It could be anything from an endometrial infection (my biopsies are always clear) to a hydrosalpinx (my tubes are fine) to endometriosis (no sign of this as I've never had any pain with periods) to a too high/too low BMI (I'm normal) to perimenopause (well, DOR, so duh...) to stress (boy howdy!).  Also, my Google-fu appears to be failing me right now as I've been completely unable to find any anecdotes out there where people had success after Lupron treatment for an abnormal EFT.  There are no failures, either.  There's just...nothing.

I know I should be happy that I've found a possible answer as to why our decent-looking blastocyst failed to implant last cycle.  But honestly, it just feels like yet another kick in the ass.  My fried eggs won't stick to my teflon uterus.  Really, is there ANY part of my reproductive system working properly?  No?  Then why are we even bothering with all of this?  And now we're looking at an IVF cycle (August/September) followed by Lupron (October/November) which means we're into Christmas and 2014 before another FET, if we even have any embryos at all.

FAAAAAAAAAAACK.