IVF Questions

I promised On Fecund Thought that I would share our list of questions with her, so here they are! It’s proving to be quite a long list already and our appointment isn’t until 10 September.

  • How many fresh and/or frozen cycles will be funded by the NHS? How much do you charge for private IVF and FET?
  • Why do you think IUI hasn’t worked for me? What percentage of apparently fertile women using donor sperm will end up needing IVF?
  • Should we be concerned about the miscarriages, or are they just ‘one of those things’? Does the fact that I have been pregnant still increase my chances?
  • Is there an increased risk of miscarriage with IVF? I’m aware that IVF pregnancies are more likely to miscarry than natural ones, but I believe this is thought to be because infertile women are more likely to have miscarriages rather than because of the IVF itself – is that correct? Is there any chance that selecting the healthiest embryos will actually reduce my risk of an early miscarriage?
  • What do you think our chances of success are, and what can we do to maximise these? What is the likelihood of no viable pregnancy after several IVF cycles?
  • I’m concerned about my cervix making embryo transfer difficult and reducing our chances. How do you plan to address this? Do you do a mock transfer? Should I be concerned about my tilted uterus for any other reason?
  • What’s my AMH and antral follicle count? (I remember being told my AMH was fine, but I’m starting to worry about my age…)
  • Do I need any further investigations? If not, how soon can we start?
  • Is it safe for me to take a prenatal vitamin, magnesium and omega 3s? Are there any supplements you would or wouldn’t recommend?
  • Do you use the long protocol or the short protocol? I’m concerned about down-regulation – since I have a history of depression, would the short protocol be better?
  • How often would I need to come in for scans?
  • Do you use sedation or GA for egg collection, and can OH be in theatre with me?
  • Do you intend to use standard IVF or ICSI, or does it depend on the quality of the sperm once defrosted?
  • At what stage of development do you transfer the embryos, and do we get a choice in how many are transferred?
  • Is it OK for me to use the progesterone pessaries PR?
  • If a cycle is unsuccessful, how long are we likely to have to wait for a review appointment, and how long before we can try again?
  • If a cycle is cancelled, does it still ‘count’ as an NHS cycle? If a privately funded cycle is cancelled, what are the charges?
  • What are the contact details for your counselling service?
  • How much would it cost to store any remaining embryos for a sibling? Would it be feasible to use these embryos in OH?
  • Is it possible to donate any spare embryos to another couple?

I feel rather sorry for whichever doctor will be on the receiving end of these!

Spain and Beyond

Here are a few photos from our holiday in Spain:

I’m glad we went. It was hard getting it together enough to buy holiday clothes and pack, and I sometimes found it difficult being around so many people (OH’s family) while I was grieving, but it was also healing, being in such a beautiful place and with children. It was on the day of the second photo, meandering along the shore with my niece and feeling the waves lapping at my ankles, that I realised I was going to be all right. This is a broken world where I have lost two babies but it is also a beautiful world of sunsets and oceans and other children to love.

I sat and meditated on a sun lounger one night and I acknowledged that I don’t know what lies ahead of me. Maybe I will have a successful treatment and give birth to a healthy baby – I hope so, and at this point the odds are still in my favour. On the other hand, maybe I am medically infertile. Maybe I will have recurrent miscarriages, and maybe the next few years will be filled with grieving and loss. I realised that if that is my path, I will accept it, and I will do my best with what I’m given. For me, nothing other than a child of my own (conceived by me or OH or adopted) can fill my need to be a parent, but I can still use my infertility and bereavement to support others in the same boat, and my mothering instincts to be a fantastic auntie and godmother.

It feels as though I’ve come to a new place of acceptance. In May, when I realised my spotting might be implantation bleeding, I promised God everything I had if this was a viable pregnancy. I vowed I would give all the remaining money we have saved for fertility treatment to charity, even though we might need it for other expenses. And it turned out I was pregnant – but that still wasn’t enough for the tiny life inside me to survive. It will never be enough because I’m not being punished, and if I have the child I so desperately want, it won’t be a reward. It will just be what happens, happening.

Over the past nine months, I’ve read several books aimed at Christians who are infertile or bereaved, and I’ve seen two explanations for why bad things happen. One is the idea that this is all part of God’s plan and although we might not be able to understand why, it’s for the greater good. At first, I found this comforting, but it’s a double-edged sword: it implies that God is choosing to do this to me. Why would God single me out for so much pain, and shut his ears to my increasingly desperate prayers, yet look at the woman next door and immediately give her everything she wants? I can’t help feeling that a God who does that is cruel, and a God who is cruel isn’t God. And yes, you could argue that good things can come from adversity – I don’t think I would be getting on so well with my sister now if I hadn’t had the first miscarriage – but I’ll be honest: I would never, never, never, never have sacrificed my child to repair another relationship. No mother would.

The other explanation is that this world has been broken by sin, and therefore is a cruel and unfair place where tragedies happen to people who don’t deserve them. Miscarriages, therefore, are not necessarily God’s plan, but he can work with them. I came across this idea in What Was Lost by Elise Erikson Barrett, and at first it puzzled me, but I find myself increasingly drawn to it. I don’t know which theory is correct, if either, but I know this is the one that will allow me to maintain a relationship with God. I need God and I need to believe that God can work with adversity and bring good things out of shit circumstances, but I also need not to believe that he wanted me to lose my babies.

This is turning into a very heavy post, so I’ll finish with some good news. We’re starting superovulation on Thursday! Despite what I’ve written above, I have a good feeling about the treatment and I’m hopeful that the extra follicles (if we manage 2-3) will boost my chances of conceiving a baby with the right number of chromosomes.