Our WTF appointment

My husband and I had our WTF appointment today to discuss the failure of FET #1.  Our doctor reminded us that infertility treatments are just as much art as science and she doesn't ever really know why some embryos make it and some don't.  They just don't have that insight.  But she reassured us that it was still worth it to give our remaining two 6-celled frozen embryos a chance.   The embryos wouldn't have been frozen if they didn't meet a certain quality criteria.  And she said that they were from a good "cryo batch" because the 8-celler that we used for FET #1 thawed perfectly, without any cells dying.

We went back and forth on whether to do assisted hatching on the embryo.  Part of me really wanted to do it because we did that with Ian's embryo and it worked (and we didn't do it for FET #1 and we failed).  But part of me was really resistant to do it because it increases the chances of monozygotic twinning by 2% and the doctor said that there was no evidence that it increases success rates.  The only reason they did assisted hatching 2 years ago with our IVF was because "way back then" they always did assisted hatching when they did ICSI.  But they've changed the practice so that ICSI doesn't always mean assisted hatching.  In the end, we decided not to do assisted hatching.  The idea of having multiples scares us a lot more than having no children other than Ian and that's how we made our decision.  We are also sticking to our guns and only putting one embryo back for FET #2.  The doctor thinks this is the right call, especially given our strong feelings against having multiples.

The doctor told us many stories of how people just get emotionally worn down from constant failures and by the end decide to put back multiple embryos.  One poor couple, who had twins from a prior IVF, were strongly against more multiples.  But they were so worn out from failures that they decided to put back two embryos instead of one.  And they ended up pregnant with triplets because one of the embryos split.  So they made the extremely hard decision to selectively reduce and they eliminated the identical twins.  The doctor said that the decision almost ruined this couples marriage and it was an extremely difficult process.

The doctor also told us a story of a couple who had 10 embryos frozen at a very early stage (so that quality was unknown).  The couple decided to do a series of single frozen embryo transfers in order to avoid having multiples, but all of them failed.  By the end, the couple had 2 embryos left and they decided to put both back.  What did they get?  Twins.  Yep.

I also asked why some women are on lupron for a FET protocol.  She said that it is to ensure that a woman doesn't ovulate through the estrogen.  If a woman ovulates, then her naturally produced progesterone will cause the timing of the lining to be off and by the time the doctors are ready to do the transfer, the lining will have already started the sloughing process.  If a woman ovulates, then the FET cycle will have to be canceled.  But most women do not ovulate through the estrogen and our doctor thinks it's much better not to use lupron because it actually has the counterproductive effect of thinning the lining and then more drugs are needed to thicken it back up.  I also asked why some women are on bed rest after their transfers and she said that it just isn't necessary.  She said that if "activity were a contraceptive, then no teenagers would get pregnant."  She said that uterine cramping should be avoided for the first 3 days after transfer, so that I shouldn't do any activity that could increase uterine cramping.  But she didn't think that me mowing the lawn and chasing after Ian all weekend after the transfer caused FET #1 to fail.  Either way, I'm happy that my husband hasn't planned any weekend getaways that would happen immediately after the transfer for FET #2.  We had such poor timing for FET #1.

And so we continue...I'll be starting the protocol for FET #2 sometime in mid-August when I receive mother nature's monthly gift.