The Journey to Having a Family Continues

After the loss of our son, Holdon, my biggest concern moving forward with trying to become pregnant again was being at high risk for a reoccurrence of preeclampsia. This is still a huge risk that lurks in the back of my mind, but after my 3 miscarriages since then, this fear has been overshadowed by other fears… fear of having another miscarriage, fear of not being able to have another baby, fear of moving forward with expensive fertility treatments that don’t have a guarantee, and could result in further heartache and disappointment. However, after giving it a lot of thought, we have decided to proceed with IVF and PGD (Preimplantation Genetic Diagnosis).

After 3 ½ years, four pregnancies, one baby in heaven and 3 miscarriages later, our journey with trying to have a baby has taken this surprising turn. It’s surprising because I always thought of IVF as a solution for infertility, and it didn’t initially occur to me that this was a solution for us because we get pregnant quickly and easily. However, the word infertility comes with different definitions and for us it means recurrent pregnancy loss.

Why do IVF for recurrent pregnancy loss?

In last few years, it has become possible to test the embryos at 5 days blastocyst with little risk of damage to the embryo because they only take one cell from the portion of the embryo that will form the placenta. This is called Preimplantation Genetic Diagnosis or PGD. With this testing, we will be able to determine if our embryos have any chromosomal abnormalities and only transfer normal, healthy embryos.

After my last pregnancy, we had chromosomal testing done on the fetal tissues and the results were abnormal. It’s uncertain if the previous 2 miscarriages were also abnormal because we didn’t have the tissues from those pregnancies analyzed. However, since our first pregnancy, we’ve had miscarriage after miscarriage and all other tests for possible explanations were normal.  Our Reproductive Endocronologist has determined that I have low ovarian reserve and that this likely means I have poor egg quality. In order to give us the best chance of having a healthy pregnancy, it has been recommended that we proceed with IVF so they can retrieve as many eggs as they can in one cycle and after fertilization, they can test the embryos and we’ll only transfer a healthy embryo. Thus decreasing the chance for miscarriage due to chromosomal abnormalities.

We know that 3 ½ years ago some of my eggs were normal because of Holdon so there is hope we will have some healthy embryos now.  However, there is a possibility that there won’t be any healthy embryos after testing and we will have wasted $25,000 on this procedure. This is the hefty cost of doing IVF with PGD. I have broken down the cost below for anyone that is doing research and wants to know the bottom line. Some insurance policies cover some of these costs but ours does not. This cost is a huge risk, but we don’t want to regret at least not trying. The alternative is to keep trying on our own naturally. We could get lucky and catch a good egg but the odds are much higher that we’ll keep having miscarriage after miscarriage. I’m not sure how I will be if we do the IVF with PGD and don’t have any healthy embryos at the end of it, but I do know that I’m not strong enough to keep blindly trying on our own and having more losses. So we now move forward with this new plan and for better or worse, we are quite literally invested in it, and the possibility of a healthy baby at the end is priceless.

I am extremely hopeful and optimistic that this is it. On that happy note, we have been given the go ahead to proceed this cycle. After signing 50 + pages of consents and reading some worrisome possible risks and side effects, we took a deep breath and signed every page. It’s like jumping into a pool head first without knowing how close the bottom is. I feel excited, nervous, anxious and afraid all at once!

The IVF and PGD Process

On August 16^th, I went into the fertility clinic for cycle day 2 testing that consisted of an ultrasound and blood test to check my estradiol levels. All was good and my doctor, who I’m going to call Dr. J, gave me the go ahead to proceed. The first step in the process was to begin taking birth control pills for 17 days to calm my ovaries and prepare my follicles for stimulation and egg retrieval. The intent is to prevent the follicles from maturing and releasing only one egg. The pill keeps your follicles at rest in preparation for the treatments ahead. However, taking birth control pills when you’re actively planning a family is hilarious. This is a good reminder that I need to keep a good sense of humor during all of this!

I took the pill every day up to the evening on September 2^nd. Then I stopped and waited for my period (hopefully my last for a long time!). This brings us to today. Today is cycle day 1 and the start of my IVF cycle! I begin giving myself; or rather my husband will be giving me, Follistim injections for FSH (follicle stimulating hormone) tomorrow evening, September 7^th. I will continue the Follistim injections for 3 days and then begin going into the clinic every other day, starting on September 10^th, for ultrasounds and blood tests to monitor my follicle activity and check my hormone levels. After the September 10^th appointment, I will be given further instruction for taking other medications. I will likely continue the Follistim injections for FSH and begin Menopur injections for FSH and LH (luteinizing hormone) These will help my follicles mature and prepare for ovulation. Once I get close to ovulation, I will take another hormone, Ganirelix, this will block the release of LH and help delay ovulation and increase the chance of producing fertile eggs. It seems contradictory to take a hormone to ovulate and then take one to block it, but this is to make sure I don’t ovulate before egg retrieval. I will continue to go into the clinic every other day for ultrasounds and blood tests to see how I’m responding to the medications. Once my eggs are ready to be retrieved, Dr. J will give me the go ahead to take a trigger shot, called Ovidrel, in order to make me ovulate. Once I take the trigger shot, I will go in for the first big appointment: the egg retrieval. This is expected to happen around September 18^th. I will be put under for the procedure and Dr. J will retrieve all my eggs from my ovaries that mature for this cycle.

Once my eggs are retrieved, they will be fertilized with my husband’s sperm and they will grow the embryos in the lab for 5 days. On the fifth day, they will test all the embryos that survive to 5 day blastocyst for chromosomal abnormalities (PGD). Then if all goes well, we will have our second big appointment: the embryo transfer. Dr. J will transfer one healthy embryo into my uterus for implantation. I am praying and hoping for at least one healthy embryo, but if we are lucky and there is more than one, we will freeze the rest in order to be used if we do not have successful implantation. If there is successful implantation, then we’ll save the rest of the embryos for the possibility of future children. Please note, due to my history of preeclampsia, Dr. J does not recommend transferring more than one embryo because carrying multiples is more dangerous for a mother with a history of preeclampsia. However, according to Dr. J, the odds are very good that there will be a successful implantation with an embryo transfer that has been tested and found chromosomally normal. Dr. J will also prescribe progesterone and estradiol to help support the uterine lining and increase the chances of a successful implantation. This is the best-case scenario.

The worst-case scenario is that we do not have any healthy embryos after testing. Below is a list of all the associated costs and possible risks and side effects.

IVF and PGD Costs

• $15,000 for IVF
  (this includes all the ultrasounds and testing leading up to the egg retrieval, the anesthesiologist fee for the egg retrieval procedure, egg retrieval, fertilization, embryo development in the lab, and transfer of viable embryos to the uterus)
• $5,000 for PGD
  (includes chromosomal testing of all the viable embryos)
• $2,000 – $5,000 for Medication
  (this fee varies depending on the amount of hormones required on an individual basis)

Possible Risks:

• Failure to produce eggs
• Eggs may be damaged at the time of egg retrieval
• Eggs may not fertilize
• Embryos may not develop normally
• PGD may damage the embryo
• There may not be any chromosomally normal embryos to transfer
• The embryo may not implant in the uterus
• PGD does not guarantee the birth of a normal baby
• Multiple gestations (even with only one embryo transfer, there is a higher possibility of the embryo splitting prior to implantation and having identical twins)
• Miscarriage and ectopic pregnancy (even with the transfer of a chromosomally normal embryo, there is still the risk of miscarriage and ectopic pregnancy with any pregnancy though the reason for miscarriage due to an abnormality is greatly reduced)

The list of costs and risks above are huge and I can see how this is not for everyone. We did not come to this decision lightly and are getting financial help to pay for this and there is no guarantee that it will work, but we are going on blind faith that it will. We are not ready to give up on the family we so greatly desire and because of this, we have to at least try. I don’t want to regret not trying it in 10 years when it will likely be too late.  There are many things that can go wrong, but there is one great thing that can go right, and that is the possibility of a healthy baby.

There is a mantra I repeat during my fertility yoga series that gives me strength…

“I clear out all the negative thoughts that no longer suit me and maintain my hope to bare a healthy child.”

This will get me through the upcoming weeks.

In the meantime, I have so many things to be thankful for. My wonderful and amazing husband, who reminds me every day that I’m enough for him, is foremost on that list, as are our parents and siblings and our amazing friends. And if we can’t have any more children, we are blessed with 3 beautiful nieces and the coolest little a nephew in the world and another nephew on the way, and we have lots of friends and cousins children to love as well. We will never by lonely for children to spoil! And most importantly, we will never forget our beautiful, angel Holdon. No matter what happens and if we don’t have any more children, we are already parents.

DISCLAIMER
The information on this page and throughout this website is provided for informational purposes only and is not intended to treat, diagnose or prevent any disease. The entire contents of this website are based upon my personal experiences and opinions, and is not intended to replace the one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information.