to add a few words, cutecutetown, will the docs give up the patients if they think the quality of the 蛋蛋 is poor and there is no room to improve? If that is the case, even if I still want to try and go for other clinics, the queue would be too long for me, or they even don't accept new case due to the mile-long queue.
I will do the FET as soon as I can as suggested by you. After that, I might consider 1 or 2 more fresh cycles depending on my emotional readiness. If still all failed, then I will just go ahead with donor cycle. My friend is a few years young than me and she is married with a son. She and her husband are aware of all the procedures and potential legal imlications and am glad that they still willing to help me out.
While I still hope I can get bingo by using my own eggs, my biggest fear now is what if I still fail with the donors eggs. This is my last resort and I just can't imagine how can I face the failure of even donor cycles. While both my embryos and lining look good in appearance, the doctor said there is no way I can tell whether it's the embryos or my uterus simply not receptive until I tried with donor eggs. Is that really the case?
I always feel my doc is not 貪 $$ as she sometimes waived the consultation fee for one or two sessions during the ivf process. And after the 1st time failure, having known that the egg quality was not good, she did not proactively suggest me to try again until I insisted to do so. All these gave me an impression that she does look at the chance of success of the patient rather than to叫機會底既patients不斷咁去試. Just my guess anyway
Cheers,
siushuk
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cutecutetown
Hm... I think I know at least one or two private doctors who will do that (not greedy for $$). If siushuk's doc is yet another one, I am overjoyed for all jm's!
發表於 11-5-4 23:38
mother2be
you've found a good doctor. i hope mine is as good as yours.
發表於 11-5-4 15:29
You're not only an expert in your area, but also a great comforter to our emotional state. This is what most doctors lack of. The emotional side is equally important, if not more, to the technical side. We can of course take as many IVF/IUI/or other treatments as we could if money is not concern. But can we stand this emotionally is a very critical point.
Thanks for taking care of our emotional / psychological side while answering our question. It is a relieve to know that we all have different situations and cannot project ourselves to the other person's case. I am not a poor responder given my good hormones level.
Correct mindset is important. Thanks for giving us a guideline of when we call it stop. Your assumption is reasonable. The benchmark set is what I set for myself too.
Thanks for your kindness in walking this journey with us as well as providing us much emotional support and correction.
Totally agreed with mother2be. Thanks cutecutetown for your professional advice and emotional support. We ladies facing fertility issues felt really helpless sometimes and having support from others is really important for us.
1. You are not wrong, the ovaries indeed have the puncture wounds. Some women will still feel the pain inside their abomen a few days after the retrieval. The bleeding, hopefully of a very small magnitude, will be more contained inside your peritoneum. We tend to forget that in order to obtain the eggs from the ovaries, the retrieval needle has to go up and through the cervix. The bleeding from this muscular structure will come out down your vagina. While small bleeding is unavoidable, if you have excessive bleeding (e.g. soaking through your underpants or pads), let your doctor know.
2. Why do you think your doc will give up on you?? There has to be a good reason. Age in itself is not a full reason; usually it may come along with a high day3 FSH, or no follicle, or follicle doesn't grow, or too many attempts without success, etc etc. In any case, if your doctor rejects you, he/she has the responsibility to explain to you why. Then you can "happily" go to another doc, or at least think about the reasons.
Poor egg quality is one thing, but we also need to see if these "poor" eggs get fertilized & what kind of embryos we can get. I agree and also disagree with the comments made by mother2be. I can't deny that there may be doctors out there who let you continue treatment as long as you pay. However, I am sure there are also doctors out there practicing responsible medicine. That's why in my last message, I told you to go with your instinct of whether you like a doctor or not.
This is my first time writing in this blog and it is indeed thankful to have you ...
hi siushuk,
you keep consulting the same doctor for all your iui and ivf? do u mind to tell your doctor's name? in fact, doctor is important too...do u think your doctor is good or advicable to u?
Although you have done a few egg retrievals, you only have had 1 time of embryo transfer experience. In the majority of implantation failure, the competence of the embryo(s) is the main cause, not the uterus.
Indeed, donor cycles give a better success chance. In centres overseas where they do a lot of egg donor cycles, bingo chance can be as good as 70%. This is an uplifting encouragement, but do notice that there is still a failing 30%. I have to point out that while I can't exclude the possibility of a non-receptive uterus, many of these egg donors are college/university students (range from age 18-25), who have no "proven" fertility. This leads back to your case. Your friend seems a good candidate as an egg donor. If everything works out with her donation, you have a good chance. So, perhaps if you eventually have to use donor eggs, get a serious assessment of your uterus. This will be suggested/adviced by your doctor at a later stage (usually after a few ET of good embryos without bingo). I only foretell it to you to prepare you way ahead of time. I still think you have a chance with your frozen embryos, and if not, the 1-2 more ivf.
Keep me in the loop so I can perhaps help if your doc hasn't given you enough explanations of things.
cutecutetown
Thanks for all your praises and I am really honored.
In reality, I am just doing the "talking" while you ladies are doing the "action". Don't forget to be thankful to yourselves and your important halves too!
Thank you again for all your kind advices. All those detailed explanation did relieve lots of my unnecessary anxieties!
Yes, my poor eggs got fertilized in both attempts. But my embryologist implied that the chance of bingo for this time is still there but not that high - one 3C G2A and one 5C G2AA on Day 2, no embryo can be frozen (i think she tended not to say it in the way that will hurt me much). My ivf doc was not on duty that day and another ivf doc do the transfer for me. She has given me some encouragements indeed.
Maybe I am just losing confidence and worry that I will become helpless one day. I believe my ivf doc is the latter type as mentioned by you.
Hope you have already gone to bed by now. We troublesome women exhausted you, didn't we?
Cheers,
siushuk
點評
cutecutetown
Just see whether the 2 embryos will behave and implant. Keep your positive energy high!
發表於 11-5-5 22:30
Thanks again for your professional advice. i felt so much more relieved after your explanation. Due to the very few number of embryos I got each time, they are very very precious to me. So i actually very concerned of my own receptiveness of those embryos and willing to take a number of tests even though they might be too early to do and wasting money (i just want to be prudent i guess). I found out that I got an endometrial polyp when i was doing my HSG to test whether my tubes are blocked last Nov. The polyp was surgically removed in the next cycle. Also, since I got a family history of immunology issue, i took the immunology blood test in Feb. All my results came back normal except for the PAI-I mutation which might cause potential blood clotting. I was told by my doctor that shouldn't be a big problem in terms of implanation and i was given Metformin, cardiprin and daily Clexane injections after transfer in order to treat this problem. so hopefully this could increase my chances a bit.
Given that my responses are getting better gradually in the last few cycles (from 1 to 2 to 5), my doctor thinks that i should do the stimulation continuously without taking a break as the drugs seems to be having an accumulated effect. I have had 4 consecutive months of stimulation already, i am not sure if i can do continous stimulation like that. Is what my doc said making sense to you?
I always got a question in mind. My doctor believes that egg quality is closely related to age instead of FSH/AMH which test only quantity. Assuming this is right, and also to the facts that my husband's sperm has always been good and i got no blocked tubes, i really don't understand why IVF will bring me a much better chance given that i only got 2-3 eggs each time. I also asked this question to my doctor but i didn't get anything concrete from him. I also read from some overseas fertility forum that IVF is quite invasive to the eggs and patients with high FSH/low AMH might get even better chance by just trying out natually as they won't get a large lot of eggs to play with anyway. This is making some sense to me. Since we only tried for 3 cycles at most (and we were not actively trying by looking at the ovaluation period) before we moved to IVF, i sometimes doubt what the chances are by trying out naturally. This whole route that i took seems to be a bit odd, most people started with trying naturally and only see the doc when they found a problem. but for us, we started with the problem and working backwards. since most ladies only test their FSH when they see a problem, i doubt if there are a lot of women who also have high FSH/low AMH conceived naturally without noticing their problem as they just got bingo before they actually move on to do the test.
Sorry again for my long question list. While i think my doctor is very experienced, he seems to be very busy and overly confident sometimes that he didn't give me a lot of explanation. I got to spend a few minutes talking to him each time. Glad that you are offering your help here and it's greatly appeciated by us.
Yes, I have kept consulting the same doctor. Will PM you the doctor's name but i bet you knew her. I personally feel good with this doc as she is patient, willing to listen and answer your questions. She is also willing to explain to you every single step of the treatment being taken on to you. The doctor is very good and the problem is on me!
Cheers,
siushuk
點評
cutecutetown
1st step to keep your positive energy high: do not blame yourself!! I am assuring you that you have done all you could and at your best.
發表於 11-5-5 22:34
Your last question makes a lot of sense to me. Actually, I have thought about your question before you raised it. I think you can try naturally (you have no blocked tubes, PCOS, other problems and your hubba's sperms are fine). You just got possibly low reserve of eggs every month which makes you not a good responder to IVF. But all you need is just one mature egg if you try naturally. The IVF method and the number of egg reserves are no longer relevant to you. I think you should try natural method in between your IVF cycles. In this way, you have lots of hope of getting pregnant without hurting your pocket.
點評
Whicheng
Like what I said in my pm to you, glad that the new doctor agreed with this point and also encouraged me to take some time off first trying naturally before pushing myself into this Ivf route again.
發表於 11-5-5 13:41
Good, the polyp was taken care of already. I suggested a uterus assessment because some women have uterine fibroid(s) (usually benign, but bigger in size than a polyp), which may hinder implantation. As for your PAI-I mutation, I don't think it affects implantation at all; however, after you will be pregnant and enter 2nd/3rd trimester, the blood clotting issue may be a problem. I don't have much knowledge in this, but your obstetrician will know better.
The continous stimulation (said by your doc) makes only some sense but not total sense to me. While I definitely don't have his medical knowledge to question his judgment, I think you also have a right to decide whether you want to keep going with ivf month-after-month with no break in between. Unless you are happy to pursue it every month, I think you should rest a little before starting up again.
You are very logical and indeed, you should also try natural conception during your "rest months". Other than your hubby's good sperm and you have regular periods, do you know if your tubes are patent (not blocked)? Any other etiology identified, e.g. endometriosis, pelvic adhesion ? In any case, as long as your tubes are good, I am happy to suggest that you may afford to take up to 6 months to try on your own. You may get lucky having a good egg and no need for ivf. Having said that, I don't want to get your hope too high because the chance is there, but not very high. However, this is much less stressful, not as invasive, and almost costs you nothing. Worth to try!
From a later posting I saw you have consulted another doc already. I am glad you have done so. If you ask me whether you should try natural first or finish with the frozen embryos first, I'd say go for one FET first; then, perhaps try a month naturally; then the remaining FET. After that, a few months of natural conception. If you are still helpless, come back to ivf. Do not hesitate to consult your new doc in between.
One last note on high FSH/low AMH. AMH, as compared to day3 FSH, is more consistent between cycles. It can also be measured at different times in a cycle, unlike "day3" FSH. In general, when ovarian reserve is low, AMH will also be low, while day3 FSH will be high. So, when you have a low AMH, you can almost be quite sure that it will be low even if you test it again and again. Day3 FSH, as you see from your own cycles, it has variations which limits the power to draw conclusion. Measuring AMH is a relatively new trend, and the test itself is not widely available yet. That's why most are still measuring FSH only, which is such an old test that is fully commercialized and automated (therefore, easy to do and cheap in price).
While I am also staying up late here, I do wonder why you should be doing the same. You are all at a certain stage of ivf, i.e. preparing, in the process of injections, or awaiting bingo after ET; so, be mindful to your body and don't over-exhaust yourselves. One of my unproven theories is that when you get overly tired, your body turns on its survival mode. What is survival mode? It is when the body has to spend all its energy in trying to survive, while leaving nothing for other functions such as those related to reproduction.
I know anxiety and questions probably keep you rest-less, but do try to get some sleep and don't spoil all the efforts and hardwork you have done for your cycle.
Wish all jm's quality rest and quality embryos
點評
miffycat
cutecutetown, you are so a nice JM. You are not just giving us valuable advice but also support us!!! =)
發表於 11-5-8 21:24
I referred back to my HSG report and its says in summary "bilateral patent fallopian tubes, suggestion of endometrial polyp". so i assumed the polyp was my only problem which has been taken care of.
Actually i didn't see a new doc, she's also an embryologist like you. I showed her the photos of my embryos and glad that she also thinks they look good and i do have some chances with my FETs. Similar to what suggested by you, go with the FETs first. If still no luck, then some time off trying naturally. and she also suggested that we can do iui on/off as i indicated that my cervical mucus wasn't as obvious as i was younger and worried that might cause difficulty for the sperm to get into the uterus.
Given my age and my embryos quality so far, she's quite positive on my case despite of the low AMH/high FSH. And she suggested that i might consider doing ivf again if still not bingo. She said she handled a number of cases which are much worse than me and still got bingo and she really thinks i shouldn't be that anxious. my current doctor made me felt like IVF was my only chances and i will be running out of eggs very soon if i don't do ivf ASAP. This made me really stressed out as i really believed that i would remain childless if i don't keep trying with continuous ivf cycles.
i feel much more relaxed after talking to you and this embryologist. She also mentioned that if i am prepared to use my friend's eggs at the end, there's really no point in pushing myself so hard now as she thinks my friend's eggs can still be good in 1 to 2 years time. and she also reassured me that she really thinks it's unlikely that i will have to use donor eggs based on her experience.
I just saw your last posting about staying up late. you are such a caring person and really care about us in a lot of different perspectives. so i am taking your kind advice and going to sleep now.
I went for oocyte pickup this morning. I was so nervous prior to the operation as I was not using anaesthesia this time. I kept telling myself I must endure the pain in return of my "hung fook" for the rest of my life. This mental power enable me to pull through the process. The procedure was less painful that I thought.
6 follicles were picked up (4 mature, one 2 smaller ones). Last time, I had 7. I hope all 6 fertlised.
In case if I have 4 only, should I go for 2 or 3 transfer this time? 2 allows me to save up 2 for next time. 3 gives me bigger chance while I don't want to spend extra money to freeze just 1 embroyo. This is such a difficult decision. Do you have any suggestions?
Thanks for walking this journey with me. I hope this is my last one.
Good to hear that the other embryologist suggested the same (the logical steps you should take in trying to conceive). With your donor-friend in mind, you have room to give yourself 1-2 years first. If you will consider doing iui on/off, I don't know if your current doctor will ask you to go on stimulation, perhaps with lower dosage. Anyway, don't worry about it yet because you still have a FET and a few months off-ivf. Simply enjoy the months with no injections to do.
Time flies and you have already got your eggs retrieved! Did you follow what you planned --> use ICSI, day3 ET, and assisted hatching? (It's been many postings since then, so I reviewed them just in case I mixed up your case with other's.)
6 eggs were not bad at all, and based on follicle size, I think you will get ~4 embryos, anything more will be a bonus. If you only culture to day2, i.e. Sunday ET, there is a high chance that the same scenario as last time would occur. If you culture to day3, I am betting on 2-3 good embryos. How much do you accept a multiple pregnancy (a pregnancy in which you carry 2 or more fetuses)?
At least let me know which day your ET will be and also your view on multiples so that it will be easier for me to lay out the different suggestions to you. Hope to hear from you soon.
cutecutetown
Hopefully I can get success with my fets. Anyway, even if no success will definitely take some time off and relax myself. Will keep you posted on my fet status.
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