Our story so far. I am consistently having to type these up for new doctors or consultations, so I decided to store it here so I have it for easy reference the next time. I'm not quite sure why those who know me would be interested, unless this is good for your own resources, or for telling how long I've been giving you the round around. (I do want to say a big thanks for all the comments though, it does brighten my day to hear from anyone of you). Nothing to update for now, as I work on getting my health and fitness back into shape, look up more pre-adoption resources, deal with the rising pile of work and reading and squash work trips into the same period to clear time later, if we want to try medical assistance.
1. We were married in Dec 2009 (both 28). We started trying to conceive in March 2012. I waited till June 2012, then saw a gynaecologist. Cycles are very regular, 28 days, ovulation 14-16th day, periods last 5-6 days, heavy on the first 2. Have been testing with BBT, OPK indicators, tried TCM in 2012 and acupuncture in 2013. Cycles are typically very screwed up right after IVF, but then regulate after one or two cycles. Initial series of tests, run at Dr E in private care hospital, in July 2012. My AMH was 6.8 and FSH was 10.3. Initial sperm test was botched, but later semen analysis showed count of 107mn/ml, motility of 57%, 4% rapid, 53% sluggish and morphology of 2%.
IUI #1: Sept 2012, Letrozole 5mg, Gonal-F 75iu, Cetrotide 0.25, Ovidriel trigger, 7 follicles, scattered with 1 lead follicle. IUI. Crionine inserts, HCG negative
IUI #2: Oct 2012, Gonal-F 150iu, Cetrotide 0.25, Ovidriel trigger, 3 follicles. IUI. Crionine inserts, HCG negative
IUI #3: Nov 2012, Letrozole 5mg, Gonal-F 112.5iu, Cetrotide 0.25, Ovidriel trigger, 3 follicles. Lining too thick, tried naturally, no IUI, HCG negative
IUI #4: January 2013, Letrozole 5mg, Menopur 75mg, Cetrotide 0.25, Ovidriel, 2 follicles. IUI. Crionine inserts, HCG negative
2. Family history, no known history. My mother was 30 when I was born , 4 years later (consciously tried to conceive all 4 years), she conceived my brother. Both normal pregnancies and deliveries. She recalls severe menstrual cramps, to fainting when she was young, issues with digestion and sensitive stomach, never tested for any gynaecological issues. The cramps became much less severe after first child. She had heavy haemorrhaging after my brother's birth and 2-3 years after he was born, she had a cone biopsy of the cervix because of a suspicious Class 3 Pap-smear test. She was menopausal about 2-3 years after cone biopsy (approx. 39 years old). My father, was a OBGYN, then GP, retired.
3. Consulted Dr PC W at public hospital, to receive government subsidy for IVF treatment at govt hospitals. (This was after attempting to consult two other doctors at separate govt hospitals and having even the initial consultations postponed and wrongly scheduled because, they are that busy) AMH and FSH re-tested in April 2013, AMH 4.9, FSH 15.6, scheduled for June 2013 IVF.
IVF #1: June 2013. 450iu Gonal-F for first 5 days. Day 5 scan shows 6 follicles, 4 on the right, 2 on the left. Pergoveris, Centrotide, 300iu Gonal-F. 10 follicles, all 15-21mm.
Oocyte Retrieval: Retrieval on 14th day. 10 follicles, 1 egg retrieved. Egg did not fertilize. Was told that during retrieval, all the follicles were present, ovulation had not occurred. Also told that that NUH does not allow for changing medical protocols, if we cycle with NUH, the protocol used would be identical, 450iu Gonal-F and that based on these results, prognosis is <10% success rate.
IVF #2: Sept 2013. Norethisterone to better time schedule. Schedule date is pushed back because of doctor's availability and is continued for approx. 20 days. 450iu Gonal-F for first 5 days, Day 3 scan shows 2 follicles, E2 levels are low. Pergoveris added after Day 3, Day 5 and Day 8 scan still 2 follicles, remaining new follicles are tiny. Seen by replacement doctor Dr A, IVF cancelled on Day 8/9, E2 levels are a third what they were the first time. Told to consider donor eggs. Public hospital never returned calls for files, data or schedules follow-up check-up, despite multiple calls and messages.
Sept 2013: Spotting on Day 23 and 30 of cycle. Ovulation has not happened even as of Day 33 of cycle, scan at Mt E shows lead follicle still intact, two smaller follicles and antral follicles.
4. Consulted Dr S. L at private hospital. Told our prognosis is poor, to consider donor eggs. Consulted Dr N. at private hospital. Was told that both earlier IVFs are not considered complete as they never made it to retrieval or transfer. Took 75mg daily DHEA from late August – November 2013. Re-test of bloodwork on 13th November 2013, FSH 7.1, AMH 12.9
IVF #3 Nov 2013: 5 Antral follicles, Elonva 150mg on cycle Day 4 at midnight. 15 follicles on Day 8 scan, 12 eggs retrieved, lining thick. Orgalutran 0.25mg, Puregon 300.
Oocyte Retrieval: 11 eggs mature, 8 eggs fertilized. Took Duphaston after retrieval to induce bleed and prepare for FET. On Day 3, embryologist tells us that the size of the embroyes/eggs are small and dense, compact, quality may not be good. Day 3, cell split and speed of split is poor, 5 are graded poor, 3 are below average. Day 5, only 2 are remaining, 1 is a blastocyte but has poor fetal matter, the other failed to form a blastocyte. All discarded, no transfer.
Dec 2013: Ovulation is on Day 20 of cycle.
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After two years, we've tried pretty much everything. We've gone on holiday, we've stayed at home ("try more times, doesn't work if you just do it twice"), I've put my legs in the air for 30 minutes, we've taken TCM, acupuncture, even, and I'm not particularly proud of this, herbs that had deer bits. I've eaten more protein, more fish, less red meat, less refined sugar and flour, more veg, no caffeine, no alcohol. It has made zero difference. It's a bit naive to think any of that makes a difference, given that I was healthy to begin with, have a very clean diet, and no food or weight issues. I've put on more weight ("when I was trying, I ate bowls of ice cream to put on weight"), exercised, not exercised (because you know, it might fall out), I've lost weight (because seriously, that idea of putting on weight was just rather daft, when I was never either fat nor thin to begin with and... just think of the number of chain-smoking, malnutritional, obese women out there with excellent egg quality).
At this point, honestly I don't know what to do. I don't know if it is worth continuing, given the poor prognosis and chances of success. I am tired of the medication and constant logistics and disappointments. I don't think I've completely lost faith, but with every passing month and volatile cycle, I am sick of being so aware of every pain, every emptiness, every little clench of my bloated stomach, which oftentimes perhaps could be just my reaction to another nauseating young new mummy who just accidentally got pregnant. I am so sick of my own thoughts, and of other peoples' hope and their desperately existential reasons-this-is-happening for me. Despite being patient and aggressive, I really also don't know if we are doing the right things, or what we should be doing next.
