Day 1?

I'm waiting for my period to start so I can start birth control pills on day 3 in preparation for IVF. Just when it's important to get the Day 1 correct, my body plays a trick on me. Not only did my period started later yesterday afternoon but it was very little. Then it came full force late last night. I didn't know whether to consider July 26th as day 1 or July 27th as day 1.

I called the patient co-ordinator and she confirmed that July 27th is day 1 since the full flow was much later in the day.

To do pgd or not to do pgd?

I stressed myself out today by debating in my head whether to do pgd or not. I have searched the topic on google and bing – “how accurate is pgd”, “limitations of pgd” and “pros and cons of pgd”. From what I’ve read, studies show pregnancy and miscarriage rates are lower with pgd. The latter is beneficial to me but if it lowers my chances of getting pregnant, then what good will the reduction in miscarriage rate do for me? Considering that I was able to get pregnant through IUI (6% success rate), will I be lucky enough to also get pregnant through the reduced success rate of IVF with pgd? Or is my luck running out since it took me five tries last year to get pregnant (even though it ended in miscarriage)?

Another concern I have is false negatives and false positives from the pgd results. What if the embryos were normal but the test results come back saying they are abnormal and I can't get any transfers? What if the normal embryos were traumatized by the pgd biopsy that it can't develop normally? Am I willing to take the risks? Or is this all just luck? Anybody know where I can get a magic lamp that will grant me just one wish?

Our next step...

Well, I am finally writing about our meeting with our fertility specialist on July 22nd. Since both IUIs failed, our doctor recommended IVF. In addition, she said that since IVF is expensive, she suggests that I have a hysteroscopy first just to make sure my uterus is ok (my uterus has a little dip in the middle). There is a waiting list for the hysteroscopy because the hospital only provides certain time slots for this kind of procedure. She said that there is approximately five months wait. Holy crap! I can't do nothing for five months. I've already been idle for the first four months of this year. I'm going to be 36 by the end of this year and my eggs are aging along with me. My husband asked if we can try with IUI and femera while we wait for the hysteroscopy. We got a go ahead from the doctor. Phew, I guess? At least I'm not idle. The doctor prescribed two cycles worth of femera so I guess I have two more tries this year.

Two other things the doctor brought up was IvIg and pre-implantation genetics diagnosis (pgd). She prefers that I do the IvIg in the hospital to be administered by the person who usually does this kind of treatment. Good news for me that she is cautious with regards to this procedure. As for pgd, she said that the clinic I went to earlier this year for the recurrent miscarriage analysis does this procedure. If we opt for this then we would probably have to do the IVF at that clinic. The problem I have with this is the full bladder and having to travel quite a ways. If we do decide on this path then I'll just have to suck it up and take it for the team.

IUI #11 - Insemination Day

My husband came with me to have the IUI at 9:30am today. When we got there, we took care of the fees and picked up a package of Crinone. My husband read the instruction sheet for the progesterone and it said "Start Crinone on Monday, 1 am and 1 at bed." Suddenly I hear my husband say "You have to stay up until 1:00 am to take your medications." I looked at him and the co-ordinator and I started to laugh. I told him that the "1 am" meant take one in the morning not the time 1:00am.

My doctor is on vacation so her partner is taking care of her patients for the time being. While performing the IUI, the partner doctor mentioned that I might consider ivig and ivf if this cycle is not successful because this is my 11th IUI. Since my miscarriages are unexplained, the ivig might help reduce the risk of miscarriage. The ivig is basically human-derived antibodies (blood transfusion). The partner doctor said it's best done with ivf to increase the chances.

On our way home, my husband and I talked about it and are seriously considering it. However, we need to discuss this with our doctor after this cycle to see what her medical opinion is since she knows my history.

Anyways, I hope that the talk of ivig and ivf is moot and this insemination worked. Fingers and toes crossed.