Morphology | The Saga of Becoming Fruitful | Expressing and capturing our journey of infertility in a blog. This is the saga of becoming fruitful and hoping to become pregnant and parents. This is our story.

Posts Tagged ‘morphology’

Consultation re IVF - REFRAMING (Part 1)

Written by Arpee on September 23, 2008 – 11:51 pm -

We had our consult with DrH and she was very accomodating. She answered all our questions - I didn’t necessarily like all her responses, but it is good that she didn’t sugar coat it. She said that she would have discussed most of the topics anyway but appreciated the questions I sent in because it gave her an idea where we were coming from.

She said that she wished there were more couples who were more concerned on what would be done to their embryo. She just gave me some more additional things to dig more on too…

Anyway, I wrote all that I could remember from our consult … yes I forgot the recorder… and writing it down resulted into a very long post, so I am broke it into 3 parts.

OUR INFERTILITY FACTORS
The factors we are facing are Advanced maternal age, PCOS/Anovulation and Low sperm morphology:
- PCOS/Anovulation can be “tricked” by controlled ovarian hyperstimulation (COH).
- Low sperm morphology effect would be minimized with IVF.
- So, the only factor that we cannot do anything about is the advanced maternal age - that determines the egg quality. (I got the usual talk about “women are born with all the eggs for their whole lifetime. As the woman ages, the quality of the eggs “deteriorate”.” In essence, my eggs are old… my raw materials have deteriorated.

Re my 3.5 FSH - DrH said that what it means is that for a 40-year old woman, that was good. However, it still does not compare to a 25-year old woman’s eggs who tests as 3.5 FSH. My eggs are still 15 years older!

WHAT OUR IVF WOULD LOOK LIKE
Since I am a good responder to the gonadotropin, DrH expects to be able to harvest a lot of eggs if I undergo COH in preparation for IVF. However, she said that fertilization and viability of embryos from eggs of someone my age may not be very good, so just fertilizing a few eggs will not make sense and that the procedure will not be worth it. She also recommends to transfer back 3-4 embryos since the implantation of embryos for someone of my age may not be very good as well. (So that means the “fate” of embryos that are not transferred is a real key question.)

As for typical reasons for IVF cancellation, DrH mentioned 3:
- low stimulation
- overstimulation (typically for younger women)
- ovulated early (or early LH surge)

What to expect with Lupron?
- Before starting, ultrasound to make sure there are no cysts
- Start Lupron. Attend IVF Orientation
- Expect period
- Baseline ultrasound

DrH said that the Follistim dosage she would use for IVF would be at the same level as our 1st Follistim stimulation (that was cancelled) which showed I was a good responder. So instead of the $3K medicine cost estimate, she thinks I would only be using $1.5K worth of meds.

Progesterone is going to be intramuscular (IM) injection…on the butt? on the thigh???. (I was hoping it was just suppository even if it was a bit messier.) Uuuggghhh…

Tags: advanced maternal age, anovulation, consultation, follistim, infertility, IVF, lupron, morphology, progesterone
Posted in Conversation, IVF, In Between Cycles, Infertility Learnings | 6 Comments »

The 2-Week Wait

Written by Arpee on July 22, 2008 – 2:23 pm -

So I had my 2nd IUI for this cycle this morning…we started with the ultrasound to see if the follicles ovulated and if so, how many of them did that. Looks like I ovulated 1 on the right and 2 on the left.

But… I have no sonogram because I forgot to remind Dr H to print one. I was telling the medical assistant later as I was checking out and guess what she said “You don’t want those. You want the “real” ones in the next 2 weeks.” I told her “this is real as well”. Hmmmpph!!!

So “worst” case, triplets? For me, 1 is alright, 2 is better, 3 is a stretch but I think still good. Well, we will know in 2 weeks.

Sperm
Did anyone notice that I did not mention the SA results yesterday? Well, I intentionally did not mention that so as not to pressure DH (who reads this blog) on it. We however talked about it later, so now I can tell you about it.

My DH’s last SA was done late 2005 with good counts (71M) and motility (53%). What was below normal was the 4% morphology. When we asked Dr H last Sunday, she was not very concerned about the morphology and that she was after the motile concentration instead.

The post-wash SA yesterday for the first IUI was not very good with 4M motile concentration only. Perhaps it was because DH was nervous that he was only going to give a few millions. Perhaps because he was a bit sick. Perhaps because of the lack of lubrication. (I learned later that he did use s teeny weeny bit ) Anyway, Dr H said that maybe if we “stage” it better tomorrow.

So today, we used the recommended lubricant “Pre” from the lab that did the SA. The frontdesk person in the clinic actually said any non-spermicidal lubricant can be used. Here’s the front and backside of Pre containers:

… and we “staged” it. “Stage” - interesting word… let your imagination work. And we got way much better post-wash SA today at 19M motile concentration! (The desired level is 10M.)