Sunday, January 25, 2009

Unhealthy Living

I haven’t had time to blog. I’ve been too busy making up for a year of consumptive abstinence by gorging on treat after delicious and unhealthy treat. On Sunday, the eve of our first anniversary, J the Elder impressed me to no end by disappearing into the kitchen after dinner and emerging twenty minutes later with Nutella crepes he’d just made. I showed immense restraint by having just three of them. On our anniversary the next day we went to our favourite sushi restaurant for dinner. It just so happens that there’s a Krispy Kreme right next door to it and it seemed like a splendid idea to get in line at the drive-through (why do they make it so easy?) and pick up one or two small doughnuts on the way home (well, four actually). On Tuesday I was back at work in my office at home when there was a knock on the door and a nice man from UPS handed over a box containing nine cupcakes, sent from California to our door by a friend of J the Elder’s who lives in Oklahoma and had lost a bet with J over the outcome of the Florida/Oklahoma championship game. Since there was a three-day freshness guarantee, we were obliged to consume these cupcakes by Friday and did so very stoically and without grumbling, ending our dinner with them every evening from Tuesday to Friday. Does putting on running clothes count? If it does, I did get a great workout yesterday without ever going outside or breaking into a sweat. I did intend to run, but it just didn’t seem to happen. Then last night we went out to meet an old colleague and friend of mine from Australia who was in town on business. It would’ve been extremely rude of me not to have those four vodka and cranberry juice drinks. I’ve often heard that the early pregnancy feeling is very similar to a hangover. If that really is so, I feel pregnant this morning. Very pregnant.

We had a telephone regroup with the doctor at CCRM earlier this week. Unfortunately it didn’t have the desired effect of making us feel any better. We were given a 35-40% chance of a successful pregnancy if we only have the one existing normal embryo from last cycle to transfer. Those don’t seem like very good odds, after all we’ve done to get to this point. Obviously we’re still trying to be hopeful about the three embryos that are being tested from this cycle, but it remains difficult to be too hopeful. The dilemma now is whether, if we don’t get another normal embryo to transfer, we should go ahead and transfer the one we have or whether we should somehow try to do another cycle, locally or at CCRM. It’s not only about increasing our chances of getting pregnant with one healthy baby with the transfer of two embryos. At this point we’ve got nothing and we don’t want to be greedy, but strategically, if we think we’d want to do another cycle for a sibling after one baby was born, then it would be much better to retrieve eggs now than next year.

It’s not immediately clear how we would afford a fourth out-of-pocket cycle, but if we could and went back to Denver, CCRM wouldn’t put me on birth control pills again, because of my Protein S deficiency and the resulting risk of blood clotting. They would also try Gonal-F only, rather than a combination of Gonal-F and Menopur. I did far better locally without birth control pills and without Menopur. In terms of protocol, they would either use Long Lupron again, or Antagonist. I need to read up on the Antagonist protocol before I can form a preference. The doctor didn’t seem to push one over the other and I’d always rather see a clear choice, since it would just make me feel as though the solution is obvious, rather than this being the Russian Roulette it really is.

If we decided to do another local cycle, it would cost us somewhat less, mostly in travel and hotel costs, but we wouldn’t be able to do CGH or microarray testing of all 23 chromosomes, because the local clinic doesn’t offer it. Instead we’d ask for a five-day biopsy and traditional PGS (pre-implantation genetic screening) on the blasts, to at least test for nine chromosomes. Usually this test is done on three-day embryos and then the normal ones are transferred two days later, but we wouldn’t want to put our three-day embryos through that, since they only have six to ten cells at that point and by taking out one or two of those cells for testing, you’re removing a high percentage of their genetic material. Also, it’s recently been reported that there are many false positives with this technique, meaning that some embryos might test positive for chromosomal abnormalities, but are, in fact, normal. Doing a five-day biopsy would mean vitrifying the embryos and transferring them in a subsequent cycle, which, while adding more time, does have the advantage of the body getting rid of all the stimulation drugs. If we did the local cycle, we’d probably arrange for any normal embryo/s to be shipped to CCRM so that we’d be able to transfer two together.

Of course this discussion is entirely academic until we get our results, because if we do have one more normal embryo, we’ll transfer the two at the earliest opportunity. However, as anyone who is going through fertility treatments knows, it helps to have a plan in place so that you’re not floundering and too upset to make a well thought-out decision should bad news come in.


  1. Actually, it was five. Krispy Kremes, that is.

    -J the Elder

  2. And why does it have to be "J the Elder"? Why not "J the Handsome" or "J the Studly"?

  3. Yayaya - I have been doing some unhealthy living in between cycles myself - pizza, fried mushrooms, fried cheese sticks, fried zucchini, fried cauliflower, ice cream with pecans, chocolate syrup, bananas, strawberries, cherries...

    That is pretty sickening although there are some fruits and vegetables up there...

    I have a backup plan, a backup plan for the backup plan and then I have plans B, C and D. Sigh.

  4. Gosh our tentative plans are soooo similar. I have 1 frozen 4AA (not genetically tested) and am afraid that if I got pg from that, that there would be no options for a sibling as my eggs would be too crappy to do another ER after the first child. So we are considering a cgh cycle just to have the option of a baby now and a sibling later. But then who knows if I'll even get any normals. Why does every decision have to be so hard?? Good luck to you!

  5. Loved J the Elder's comment! :-)

    Enjoy the time off from the fertility diet - I think you deserve a few drinks and a few Krispy Kremes and a few cupcakes!

    Good luck with the results - I hope things turn out such that you don't have to worry about next steps right now. I know how hard the waiting is, and I wish it wasn't so hard!

  6. IF throws so many major decisions at us. It is difficult to know what to do. I hope that the road becomes clear for you. I'll be reading your blog.

  7. I think your food consumption is just perfect! I get so sick of the "living like your pregnant" part of IF! I mean, 2 years of being pregnant and no baby! Then again, with some of those BFN's came some glasses of wine, some chocolate, some late night concerts and state fair beer....but those were bittersweet too. So, enjoy what you can b/c with what we've been going through, it is few and far between!

    I think the plan to have some frozen embryos for possible siblings is smart. I struggle with this too...and then I laugh at myself that we haven't even seen that we can have one baby and I'm worried about future siblings? but, I know that I would regret it if I didn't think ahead. So, in fear that you will let time go by and THEN decide you want to try again, I say go for the CGH cycle and have some good frozen embryos out there for when you want to go and pick them up! No regrets.

  8. I am still smiling over the J the Handsome and J the Studly. Rock on, you guys. Enjoy life and its little treats, this has been one challenging rollercoaster ride for you. I admire you both!

    Love, your pseudo-sister, JW

  9. Hi, Annisca:

    I read through most of your blog and just want to say that I'm pulling for you. I think what struck me the most are the images of you and J the Elder in the IHOP on just illuminated the sacrifices you're making to have a child, which I know all too well myself.

    I spoke to the counselor at Reprogenetics today, and I feel discouraged all over again. She said just based on my age, which is same as yours (I turn 42 in May), I can expect the majority of my embryos to be abnormal. It sounds like I'll be lucky to have one normal, even.

    I see that you did two cycles to get your two embryos. And from your description of your fertility levels, we are about the same (I have lots of follicles, FSH 9, E2 40-something, homo MTHFR mutation, taking supplements). Did CCRM encourage your Plan B, or did they say it would be a long shot to find another normal? My Plan B is to use CCRM for another IVF with CGH if I don't have any normals or even just one this time around.