My follow-up consultation with my RE yesterday was packed full of good information and even a surprise. So first the surprise: we have one frozen blast left over from my last cycle! Sure I’m ignoring the fact that it’s been a month since my egg retrieval and fresh transfer and no one mentioned to me until yesterday that I have a frostie. Seriously, why did the nurse not call me with that update?! Anyway, I’m going to ignore that slip up and focus on the fact that I have a surprise bonus embryo that I wasn’t counting on. Of course it’s not tested and it’s an early blast graded “BC,” which isn’t the prettiest embryo but still has a 90% chance of surviving the thaw. I asked if BC embryos still make babies and my RE said, “yes”. In fact, just for fun, he looked back to my cycle 4 years ago – the one that resulted in the birth of my daughter – and we discovered that she was also an early blast graded BC. Maybe my crappy looking embryos fair better than my high quality ones. Okay, I’m grasping at straws here. I was 36 back then and I’m 40 now, so the chance that this little BC is healthy is lower. But still – it’s a chance.
My RE recommended using what we have and doing a frozen embryo transfer (FET). Using what we have includes a little frozen PGS “abnormal” girl too. Yes, you heard that right. My RE is recommending that I transfer a PGS abnormal embryo. But first a few points to clarify. We did not do Next Generation Sequencing (NGS) so the results are either normal or abnormal – all mosaics are labeled as abnormal. Knowing what I know now, I would have tested using NGS so that the results would have specified whether the embryo was mosaic and the percentage of mosaicism. But I digress. In any event, I have a lot of respect for my RE (and his knowledge base) because he isn’t quick to dismiss all abnormal embryos. He took a close look at the details of the results and saw that this particular “abnormal” embryo only has a tiny segment of duplication on the short arm of chromosome 17. He said that a small percentage of the population may be walking around with similar minor abnormalities and no one knows it because we never tested for that sort of thing before. This particular partial duplication will not lead to the birth of a child with an abnormality. Maybe my embryo will even have a superpower. Okay, that’s probably not true but I’d like to think so. The embryo may not implant or might be an early miscarriage (no different than what happens with so many pregnancies both IVF and unassisted) or the embryo could develop into a healthy baby. Both of these embryos are long shots simply due to my age-related quality issues, but it’s a chance. So the plan is to transfer both for my upcoming FET.
Going into this consultation I was prepared for the FET recommendation. I was also prepared to call it quits afterward if the FET fails. Over these last several weeks I’ve come to a place where I’m at peace with not having another child. I never thought I’d say that. And I’ll write specifically about how I shifted to that mindset in a later post. For now though, my RE convinced me to try one more egg retrieval and fresh transfer if this FET ends in another negative beta. My husband and daughter are both strongly rooting for another child, and my husband was also hoping to do one more fresh transfer.
My RE told me about some studies that followed women over the course of up to 12 (gasp) complete IVF egg retrieval and transfer cycles. The studies found that the chance for success increased over the course of 3 cycles, but plateaued after that. Meaning that after 3 complete cycles, the results don’t often change much. It should be noted that multiple FETs with eggs collected during the same retrieval only count once – that is, you can do several FETs and that doesn’t count against the 3 cycle benchmark. Of course there are exceptions to this rule, but when weighing the pros and cons of when I want to stop, I’m not going to keep doing this forever in the hopes of breaking the odds. Taking all of my cycles together and the particulars of my results, my RE said that if it were he and his wife, he would do one more IVF and fresh transfer after the FET. He said if we do that and still it fails, then I can feel confident that I didn’t leave anything on the table. No looking back and wondering. No regrets.
I like the sound of that. It makes sense. I think with the “break” of doing a FET first – since there’s so much less prep work for a FET – I can muster up the strength for one more IVF cycle. I don’t want to look back one day and wonder, “what if”. This plan seems like it will satisfactorily exhaust our options with my eggs. And if the journey ends there, I’m okay with that.
On a side note, I want to mention that I mustered up the courage to ask the scary question I had been avoiding. The “does repeated rounds of IVF cause cancer” question. My RE gave me a confident “no” and explained that the hormones used for this are naturally occurring in the body so the body knows how to process them. It doesn’t cause cancer. When I asked specifically about estrogen-sensitive cancers, he explained that again the answer is that IVF will not cause them. Prolonged estrogen can cause estrogen-sensitive cancers to grow (get bigger) but will not cause them. But he specified that it really does have to be prolonged exposure – the short bursts we use for IVF isn’t considered prolonged even when we do it multiple times. So I’m putting that fear to bed and thankfully moving on.