On Monday I started my seventh round of IVF.
2019 was the year of IVF. I underwent six stimulation cycles throughout the year, three of which led to egg retrievals. I learned quite a lot about the science of IVF – meds, supplements, timing… but most of all, I learned to temper my expectations. I can control several inputs in this process but I can’t control the outcome.
I started the year having just survived the first holiday season since we lost our baby girl in the second trimester. The day after Christmas 2018 was my consultation at CNY Fertility with Dr. Kiltz. He came in, larger than life, and talked a mile a minute about keto, keto, keto… and oh yeah, IVF too. I do have a great deal of respect for Dr. Kiltz for so many reasons. He is clearly dedicated to his patients, and he has built a fertility business that is more accessible than most clinics in the United States. His relentless optimism is infectious, and I left with a plan, and the feeling that this could work for us.
Then my lab results started coming back. AMH 0.08. Fragile X pre-mutation carrier. Sperm issues. We made adjustments, but I was not dissuaded from proceeding with stimulation cycles. This is the benefit (and the drawback) of CNY. Nobody is turned away, regardless of hormone levels, AFC count, previous failed cycles, age… nobody. All patients are made to feel like they have a good chance at conceiving.
My first egg retrieval in March resulted in zero eggs. Not to be deterred, I jumped immediately into another stimulation round (DuoStim). And success! The egg retrieval that followed produced our first embryo.
And then another failed stimulation and cancelled cycle in May, followed by yet another stimulation and early ovulation (and cancelled cycle) in June, followed by a luteal phase stimulation which yielded two embryos in July.
We took a couple of months off, and tried again in September, attempting to mimic the protocol from July. Nothing. I think the nurses kept waiting for something, anything to grow… so I went back for ultrasounds and blood work three times. Cycle cancelled after 14 days of injections.
321 shots in 2019. At least that’s the estimate that I have after looking back at my calendar and the number of days that I stimmed or primed with HGH.
24 ultrasounds
26 blood draws
10 pounds gained
Many unpleasant side effects
Lots of trial and error
3 frozen embryos
I worked extremely hard for our three embryos. I ran around the city for ultrasounds and blood work. I tried (vegan) keto for a few months. I went gluten-free. I tried intermittent fasting. Acupuncture. I meditated, I did yoga for fertility, I tried yoni steaming. I spent hundreds of dollars on supplements, thousands of dollars on stimulation drugs, and tens of thousands of dollars for IVF and PGT (preimplantation genetic testing – which constitutes its own post).
Each new stimulation cycle was an opportunity to start fresh, to try a new and promising protocol, to find the silver bullet we were looking for. Each cancelled cycle was such an extreme letdown for me, because I invested all of my hopes and dreams, time and energy, into the cycle. I did as I was told – I adjusted my mindset. I expected a positive outcome. I prayed for the cycle to work. I visualized my ovaries full of eggs. I obsessed over my lab results. I questioned each scan that showed zero follicles.
I became embarrassed to keep going back to the same local OB-GYN where many CNY travel patients from Indianapolis have gone for ultrasounds. The office is so small that all of the medical assistants seemed to know my story. I started to wonder what they thought of me – was I the desperate older woman without a chance? Did they think that I must have unlimited funds to spend on this venture? Did they think I was selfish for wanting to have a biological child?
My last cycle began in September, 2019 and was cancelled in mid-October, after 2 weeks of injections. Seven days of Letrozole, arguably the worst drug I’ve ever taken. My joints hurt. I was exhausted. I was spotting – I was told it was possible for my ovaries to be overstimulated even if they weren’t producing anything, and this was a sign of overstimulation. This sent me into a 60 day menstrual cycle which didn’t end until late November. In the middle of the longest cycle ever, I got the results from our PGT-tested embryos. None of them have Fragile X Syndrome or are Fragile X carriers. But all of them are abnormal or aneuploid, per CooperGenomics’ guidelines. The news was crushing. We will not discard these embryos. I would like to transfer them. There are debates raging online and among fertility doctors regarding the validity of PGT. Still, I realize that the odds of a viable pregnancy from these embryos are still very low.
I knew something needed to change. I wasn’t ready to stop trying yet, so I started researching optimal protocols for women with DOR (diminished ovarian reserve) or POI (premature ovarian insufficiency). I came across Dr. Sher’s work, specifically the agonist/antagonist conversion protocol. I read his opinions about Letrozole and Menopur being contraindicated for women with DOR, because it promotes excessive LH production. He theorizes that this can also affect egg quality. I had been on Letrozole for 5 of the 6 cycles, and Menopur for all of them.
So, here we are… stimming again. Trying again. I feel empowered by the knowledge I now have about IVF, about my body, and the lessons learned from past cycles. I am trying my best to release any expectations about this cycle, and avoid getting attached to an outcome I realize now that I can’t control. But it’s still damn hard. I should know on Friday when I go in for my second scan whether or not the agonist/antagonist conversion protocol is effective for my body.
Regardless of the outcome, I acknowledge that I now know to trust my intuition, listen to my body, and not blindly follow the orders and guidance of health care professionals and wellness practitioners. I feel lucky to finally be in this place.
A Life Reclaimed 