Stitching up the IVF game

It seems no matter how prepared you are for the ‘worst’ with IVF there are always greater depths to be explored.

Our fourth IVF cycle has now ground its way to a complete end.

There were a few close calls. Just when we thought we had it worked out, we were side-blinded – again.

Leaving before dawn yesterday morning we got to the clinic without a hitch. Considering our recent travel incidents, this was an excellent start.

With a knowledge that we were looking at a minimum pick up of two eggs were we upbeat and hopeful. Despite our history of low numbers, our fertilization rate has been good. Sure, when speaking of one embryo from just two eggs, then it is accurate to quote a fertilisation rate of 50%.

The brief chat with our fertility specialist, Dr. Loverley beforehand saw him tell us some uncharacteristic bold statements. Our experience so far of fertility doctors has seen me searching for clues in their poker face expressions. A shrug of the shoulders was our first specialist’s, Professor Doofus’, response to my question as to when I would bleed again. A large ovarian cyst had put an end to my menstruation, and would do so for five months. His response was to take no action. That was our last appointment with him.

Dr Loverley spoke of how we could easily see our best ever results. There were eight follicles. Weren’t only two of them near maturity? Yes, but there was a chance of additional growth in the five days since the last ultrasound.
Wobbles and I sat with quizzical expressions. It was too good to contemplate. We would be satisfied with two good eggs. The late suggestion of more seemed too greedy to wish for. Our two previous pick ups had resulted in 3 eggs and 2 eggs respectively.

After pickup I woke to find that two eggs had been retrieved. I felt elated. Two was fine. After a twelve plus hour fast I enjoyed my first sips of water and eventually could hear the gentle tones of Dr. Loverley’s voice as he made his way along the line of patient beds in the recovery area. I heard his happy announcement of numerous eggs to my neighbour before he appeared before my bedside and pulled the curtain closed behind him. His flushed face and big puppy like eyes alerted me to the fact the news was not to be good.

Of the two eggs, one was “degenerate” a label that seems rather insulting to this over 40 fertility-challenged woman. The other was not quite mature. There was also a term for the ‘quasi’ maturity of the second egg. A term that the after affects of anaesthetic and the rush of information I was about to receive does not allow me to recall. There was quick discussion with ward staff, a call to collect Wobbles from the waiting area, and a request to get Nurse Loverley on site. Suddenly there were four people surrounding my bedside, all with forlorn looks on their faces. I was distracted by Wobbles who looked broken. Instinct told me I needed to focus on getting information.

This was new. Having our own specialist on site was proving to be a blessing of sorts. He was there in person to give advice and not unreachable in his consulting room elsewhere. After our first sudden cycle cancellation I spent nine obsessive days waiting by the phone. The clinic had promised the specialist would call. Any word back then from Professor Doofus would have saved much angst and uncertainty. So, here was Dr Loverley looking both concerned and being extremely reassuring. I could not be distracted by Wobbles, even if his pallor continued to grow even paler.

There was going to be a few hours to see if the second egg would mature. There was still hope. I went through the range of standard low ovarian reserve questions; did he see this as the end? Would he not want to do any further cycles? He was authoritative in his certainty. Yes there were other protocols to try. No, this was not our last cycle. Was this common for antagonist cycles to lead to a lower number of follicles and a lesser quality of eggs? Yes, this was unusual. I could hear the clogs clicking over in his brain, as he rattled off a number of as yet untried medications and treatments. I started talking donor eggs. There was no hope of us finding a donor. No, he felt we were still not at the donor stage. Plus, the cycle was not yet over. There was still that one other egg.

Given today to process all that has happened, I hope Dr. Loverely was not making post-operative promises said to save the heartache of a tired and bleeding woman.

Somewhere in the midst of all this I was informed that I was stitched up. Something had been bleeding, later both Wobbles and I recalled hearing the word “artery” used but suspect that was a joint illusion brought about by shock and fatigue. I was given instruction to get myself to Out Patients immediately should I have additional bleeding or pain. My bedside crowd dispersed and I was given a moment to gather my thoughts before dressing and moving on to the seated recovery area. I lay there and listened as Dr Loverley congratulated my other recovery neighbour over her 16 egg haul.

It was some hours later while we were still on our way home that we received Nurse Loverley’s call. The other egg had matured. If was about to be injected with sperm, via the process known as ICSI. We would know the next day if there was to be an embryo to transfer. With another in a succession of reprieves, our fourth IVF cycle would live to see another day. There was a quiet confidence in our one formerly premature egg.

We were home by 8pm. We made vague plans for a possible return trip for transfer and did our best to speak in positive terms. It was a case of “when” we had the transfer, not “if”.

For the first time in this ongoing series of anxious overnight waits to see if eggs fertilized I went to sleep without concern over fear of receiving that early morning phone call.

Tiredness meant I forgot to leave my mobile on. As usual, Wobbles had slept with his phone beside his glasses and his alarm clock. When the landline phone rang I had no inkling of what was about to hit us. Wobbles stumbled around but didn’t get to the phone in time. He kept walking through to the bathroom. Moments later Wobbles’ mobile rang. I recognized the number but was thrown to hear the voice of Dr Loverley. I had no doubt what was to follow; the lone egg had failed to fertilize. The lab had now decided that it had been unlikely to fertilize. Finally, our run of down-graded hopes and last minute reprieves for this cycle had come to an end. There would be no embryo to transfer.

Again, the doctor was extremely kind. He encouraged us to make an appointment to see him as soon as possible. He was “very sorry” to have to deliver bad news. Our conversation ended. I could hear knocking of plumbing pipes and laid in bed while Wobbles showered, oblivious to latest twist in this sorry saga.

Today I am sore. I have not shed a tear. I do not know if I am too tired to be distressed, or too distressed to react. Mostly it is a feeling of being too stunned to know what to do.

Our super-charged IVF protocol did not work for us. Where do we go from here? At this stage it really is too hard to say.

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