Saturday, August 27, 2005

How I got here (third and final prequel)

Did you know that, unlike the USA, there are no Canadian statistics comparing the outcomes of various IVF clinics in Canada?
Did you know that in Canada infertility treatment is placed in the same category as cosmetic surgery (i.e. optional/lifestyle treatment)?

But I digress..

Let's get back to me.

I had left off things in November 2003. Depressed, dejected, turned away by the first IVF clinic we visited. Our sympathetic OB/GYN doctor refers us to a second clinic. This one is 3000 km away, but (apparently) has the best outcomes in Canada. The lovely doctor at this clinic (Clinic_2) does not take 9 months to get in touch with me. He calls me within weeks and gives me cautious encouragement.
And so it begins.

Feb 2004: Cycle 1
There are more tests to be done, protocols to be explained and drugs to be ordered. And, oh yeah, we must pay the $5500 fee for the clinic, plus an additional $400 for something called ‘assisted hatching’. The pharmacist calls a few days later. I need vials of Gonal-F and lupron. And, oh yeah, that will be another $5000. Credit card number please.
Three times a day my husband carefully prepares injections for me.
First one in bed at 8:00 am. We meet at home everyday at 1:00 pm for the second, and the third one is done at 8:00 pm. They can be done in the abdomen or thigh. I choose the thigh. After a few days, we go for blood tests (to monitor estrogen levels) and ultrasounds (to monitor follicle growth) ever alternate day.
Flights have been booked. We've told we should expect to stay there for 10 to 14 days. Luckily, I have a generous brother in the same city at the clinic. He has offered us room & board for as long as needed. We will have the added bonus of spending time with his 2 year old son- my wonderful, beautiful nephew.

The IVF nurse calls. She sounds concerned. You’re not progressing as well as you should have she says. Even with the very high dosage of Gonal-F that I’m taking, the follicles are not growing. If they don't see progress soon the cycle will be cancelled.
Now is a good time to panic.
Why is this not working. What is wrong with my body? What should I be doing?? We continue with the injections- and start injecting in the abdomen instead of the thigh.
Flights are delayed. The pharmacist orders more drugs (we need to continue the injections for a few more days) and I hand over my credit card number again. We do 13 days of ‘stimulation' and are finally given the green light.

Onwards to retrieval.
Stare at the ceiling. Try not to think about the fact that you are lying with feet in stirrups, with needles poking your ovary trying to suck eggs out of them. If this wasn't so pathetic it would be funny.
Eggs retrieved: 6
Not so many. We will need to spent another $1100 to 'ICSI' them.
But the eggs are not all mature. Only 3 can be injected with sperm.
2 embryos are created.
For this I paid $15,000?

We return home with 13 extra cells in my uterus.
Wait for 2 weeks.
Purchase and pee on home pregnancy tests: negative
Have a blood test to detect HCG: negative

Go directly back to Square 1. Do not pass Go. Do not collect $200.

The doctor calls to discuss the cycle. You didn't too well he says. I would put your future chance of success at 5%, if you want to try again, but I wouldn't recommend it.
We are foolishly persistent, my husband and I. We disregard his advice entirely.
By June we are ready to do this process all over again.

June 2004: IVF Cycle 2
New protocol (using an Antagonist)
Another trip to Clinic_2
Another 2 weeks living with my brother et al.
The results?
11 eggs.

3 embryos (they are lovely, according to the embryologist)
Pack 'em all in and head home.
Wait for 2 weeks.
Purchase and pee on home pregnancy test: negative
Blood test: negative

Hey....haven't we been here before?

Nov 2004: Third time's the charm (or so they say)

By now we are pros. I can do the injections myself. Abdomen always. None of those wussy thigh injections. I don't even care how many people are in the room when the vaginal ultrasounds are being done. The technician asks if a couple of trainees can stay in the room and watch. Suureee. Come on in. Make yourselves comfortable. What's a vaginal ultrasound between strangers?

By now it's same old, same old. Purchase airplane tickets. Lie to people at work about where I'll be for the next 2 weeks. Pack syringes and drugs carefully. Arrive at my brother's doorstep. Daily trips to the clinic. Bloodwork, ultrasounds. Everything looks good. Until one day it doesn't. I start spotting. The bloodwork shows Estrogen levels have plateaued, then they start to fall. The cycle is cancelled. Oh, and that same day I find out my sister-in-law is pregnant.

We meet with the good doctor. Various options are discussed. They have an embryo donation program. We are candidates. Do you have any Indian/Caucasian embryos? I ask. Uhhh, No...but apparently I can still receive a caucasian embryo. I mull over the picture of me giving birth to a blond blue eyed baby. There's always egg donation (almost impossible in Canada...I'll leave that to a future rant), adoption. We've heard all this before. Deja vu all over again.

February 2005

It's time for a new approach. Flying to a clinic 3000 km away is starting to take a toll on us in so many ways. My research efforts into IVF techniques and advances continues and I start reading about a clinic (much closer to home: only 350 km away!) that offers IVM: In vitro maturation. Immature eggs are retrieved, matured and fertilized. Maybe this is what I need. In both my first and second cycles we had eggs that were 'useless' because they were immature. Maybe this clinic (#3) would actually be able to use these eggs. More useable eggs = more embryos = better chance of success.

How much fun is this? Visiting IVF clinics all across the country? Using all my time-off and vacation days to get poked and prodded? Using all our extra cash to pay clinics and buy drugs? Soooo much fun. I feel like the luckiest brown girl ever.

Turns out IVM is not a great option. We decide to try it anyways. 3 eggs are retrieved (very very pathetic). I spend a day in hospital hooked up to anti-biotics. 2 embryos are created and transplanted.

You know how the rest goes. Wait 2 weeks. Test and test again: negative and negative. This time we have the added bonus of nightly intra-muscular projesterone injections. Oh I know. We thought the abdominal injections were fun...

May 2004: Gluttons for punishment

The clinic does not want us to do more IVM, but they are willing to try IVF. Why not? This has gotten to be such a routine part of our lives that it seems silly really to have months where we're not doing injections or dealing with the devastation of a failed cycle. I wouldn't know what to do with myself if I wasn't injecting something. A month without a vaginal ultrasound? Unheard of.

Cycle 5 will be a long-protocol micro-dose lupron cycle. Injections, ultrasounds, bloodwork, retrieval, ICSI, AH yadda yadda yadda. 6 eggs. 4 embryos (that's odd, the embryologist says, they're football shaped). Okay. fine. WHATEVER. Put them back in. 14 projesterone injections later and ... you guessed it!!!

Negative. Again.


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