Today has been wonderful so far! Feeling so happy and hopeful for this IVF cycle.
I had my baseline ultrasound this morning to determine if my ovaries were sufficiently suppressed by the last two weeks of birth control pills.
I’m still having some bleeding from the hysteroscopy and apparently my ovaries weren’t feeling very cooperative, so it was kind of an uncomfortable ultrasound today (transvaginal, of course). But the doctor said my ovaries look perfect! No cysts, and the largest follicles on each side were 5 mm and 4.5 mm, respectively. He instructed me to stop birth control pills today as planned, then start my injectables in 5 days. I let him know they haven’t arrived yet, but hopefully will in a few days. I didn’t go into the whole saga with him… I’m just trying not to stress about it.
He told me he’s starting me on a pretty low dose of injectables because he expects that my ovaries will respond very well to stimulation. He said we can adjust the doses as necessary, but he wants to be cautious about overstimulating (OHSS). Because I’m younger (27) and based on what he’s seen from me, he says I should have plenty of good quality eggs and probably a 50/50 chance of a successful cycle, though he will have a much better idea of the odds once he sees the embryos in a few weeks. We’ll also be doing ICSI to increase the odds of fertilization.
We talked with him a bit today about PGS (preimplantation genetic screening) and EEVA, a noninvasive screening method offered by the clinic. Neither is covered by our insurance so doing them both would cost nearly $6,000 out of pocket.
Because my husband isn’t a carrier of CF we aren’t concerned about testing embryos for CF, but the idea of being sure we’re putting in a healthy, high-quality embryo is obviously very appealing. Our doctor said about 30% of embryos will have some chromosomal abnormality, but the chances of an abnormal one implanting is about 1 in 500. The risk is greater with age, but that’s not an issue for us right now. Given the fact that I’m young, the doctor didn’t think either PGS or EEVA was really necessary – though, he said, if money is no object we can obviously do as we like. Since we don’t have thousands of extra dollars lying around we’re probably not going to do it, since the risk is low.
The main benefit of PGS for us would be improving our odds of a successful implantation. That’s also the purpose of EEVA, which shows which embryos are the highest quality based on a number of visual markers. In an ideal world, we would do both – but in the world we live in, we’re comfortable enough with the risks of not doing them, given the price. It was also reassuring to hear that about 3/4 of all patients at our clinic don’t do these tests, and about 99% of patients my age don’t.
I would feel a little better about it if my doctor were willing to let us transfer two embryos (assuming we have two good ones), but he’s adamant that we only transfer one. He really doesn’t want multiples for me, especially given my CF. He told me that in some countries it’s actually illegal to transfer more than one embryo to patients under 37, which I had never heard! While the idea of upping our odds is appealing, I trust him when he says the risks are too great – both to me and the babies.
The last thing to do was sign our consent forms, which we did at the office – so this cycle is officially underway! Here’s hoping all my meds arrive in time and it’s smooth sailing from here. My next ultrasound is on the 11th (after 4 days of stims).
The rest of today I’m going to be curled up on the couch studying, since I have another midterm this week. Luckily it’s a perfect day for reading! We’re having a lovely soaking rainfall which we sorely need here, and it feels so nice and cozy inside. My husband’s at work, but the dogs are definitely DTC (down to cuddle) and I have a hot mug of herbal tea to keep me warm. 🙂
Update: Just got a call from the insurance coordinator at the clinic. The phone rang while I was vesting so I probably sounded like a crazy person picking up the phone with all that noise in the background! Nonetheless, great news: apparently my insurance has approved all of my injectables, so the pharmacy shouldn’t have any problems shipping them this week. Yay!!