Friday 23 November 2012

The Journey, So Far...



I typed out a nice neat little index page with page numbers for Dr. Schoolie when I submitted all 250 pages of our medical reports.

Going through the process of organizing my records was a tedious and emotionally exhausting task.  Each portion brought up memories of how we felt at each turn.  It also made me feel frustrated that there wasn't a more efficient way to navigate through the difficult waters of IF.



May 2008
Semen analysis:  1.6 million
Normal pelvic ultrasound
Hormone levels tested but not on cycle day 3.
June 2008
Semen analysis: 1.6 million
Aug. 2008
D has bilateral testicular biopsy under the direction of urologist.  Findings: bilateral hydrocele and meiotic arrest.
D has infection after this procedure, and is treated twice with antibiotics (for two weeks each time). Up until 1.5 years after this procedure, D has infrequent “stabbing” pains in his testes.
Oct. 2008
Dr. Nada, Enocrinology consult, no findings referred to another endocrinologist.
Nov. 2008
Scrotal ultrasound: focal hypoechoic regions within the superomedial aspect of both testes measuring 1.2 and 1.4 cm.  Likely related to previous biopsies.  Bilateral small varicoceles are demonstrated.  Small right hydrocele.  3mm cyst on left epididymal head.
Dec. 2008

D- Endocrinology consult with second endocrinologist found no abnormal results.
CBC normal.
Jan. 2009
New clinic #2
Semen analysis. 0.6x10 6/ml
Feb. 2009
Semen analysis (washed), total motile count 4 million.
Day 3 FSH: 23.8 IU/L
Day 21 Progesterone: 48nmol/L
Genetic screening and other blood work (day 21 and other).
2nd opinion with Urologist.  His opinion was that the testicular biopsy was unnecessary, and that the results showed only a focal diagnosis.   No further recommendations.
Mar. 2009
Hysterosalpingogram: Right fallopian tube patent, left tube irregular, curved, tortuous and dilated, left tube appears blocked.  Antiverted, anteflexed uterus. Right ovary 2.5cm x 1.3cm, left 2cm x 1cm. Small irregularities in uterine lining.

Diagnosis: Premature ovarian failure, advised to consider donor programs.
April 2009
New Clinic: #3 Dr. Snowflake
June 2009
IVF cycle suggested to be changed to IUI.  Cycle cancelled: My sister had a massive stroke at age 28 (from an undetermined cause).
Sept. 2009
Day 3 FSH: 6.5 IU/L

Operative Hysteroscopy to remove small amount of scar tissue near embryo transfer site. 
Pathology Report: Endometrial curettings (1.0ml of hemorrahigic tissue and mucoid material): proliferative endometrium.
May 2010
Sonohystogram, results normal. (Dr. Snowflake).
Nov. 2010
FET #1: Transferred 1 donor embryo (from couple #1), rated “cleaved 4-6 cell”.
HCG <1.0
Feb. 2011
Adopted 6 blasts via Snowflakes
Created in 2005
April 2011
New clinic: USA, Dr. M Frankenstein
Semen analysis: Grade A, low count, borderline morphology.  Semen frozen (unused as of Oct/12).
Monitored for one natural cycle:
Doctor says follicles didn’t mature as expected.
Decided to proceed with adopted embryos.
Day 2 FSH:  19.6 mlU/ml
Follicle count: 7?
July 2011
FET #2: Donor embryos, 2 unrated blasts.  Embryologist says they are unrated because they were still collapsed 2-3 hours after they were thawed.
HCG <1.0
Sept. 2011
FET #3:  Donor embryos, 2 blasts 6BA & 5BB
 HCG <1.0

Nov. 2011
FET #4: Donor embryos, 2 blasts 4AA & 4BA,
HCG = 75, (6 days after transfer), 1547 (13 days after transfer).
Dec. 2011
Miscarriage confirmed at 8 weeks
Jan. 2012
D&C after incomplete natural miscarriage
Started 75mg DHEA/day
Mar. 2012
AMH tested: 0.42ng/ml
Day 3 FSH 17.5 mlU/ml
April 2012
IVF with ICSI (own eggs)

Medication:
· 40 units of Leuprolide on cycle days 3 and 4. 300 units of Gonal-f for 16 days, the last 8 days of stimulation 150 units of Menopur.
· See cycle sheet for other meds.
· 500mg Flagyl & Doxycycline for both of us in case of subclinical infection (2 weeks).  Started one week approximately before transfer.

Retrieved 9 mature eggs + 2 immature eggs, 7 fertilized, 6 survived.

Ratings on day 5:
1.     EBL: C1
2.     BL: B1
3.     EBL: A
4.     Mor: B1
5.     Mor: A
6.     Mor: “?”
7.     Mor: A
Semen analysis for ICSI
2 transferred, 1 blast 4AA and 1 early blast (unrated)

HCG = 38.4 (10 days after transfer).

Bright red spotting 14 days after transfer (HCG =278), miscarriage 22 days after transfer. 
Tested natural killer (normal), DQ Alpha (normal) and MTHFR (positive for heterozygous copy of A1298C mutation).
May 2012
Day 3 FSH 11.1
June 2012
Semi-natural FET cycle attempted.

Ovulated on day 11, doctor not expecting this early, cycle canceled.
July 2012
FET #5: own embryos, 2 transferred, 2x day 5 morulas, A & B1.

Started new protocol of 81mg ASA, 10mg prednisone, 40mg Lovenox at time of transfer. 
500mg Flagyl & Doxycycline for both of us in case of subclinical infection (2 weeks).

HCG 1.8, then declined.
Sept. 2012
FET # 6: own embryos, 2 transferred, early blast with “?” rating and blast rated 3AB.

Changed protocol (81mg ASA, 10mg Prednisone, 40mg Lovenox) starting one week before transfer.

HCG <1.0
Nov. 2012

1 comment:

  1. I so get this -- I just got my records together for second opinions, and I created a timeline of events so the doctors could see it without flipping through. It was exhausting work. I realized how much of the past five years I've devoted to trying to make babies. Sigh.

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