Tag Archives: infertility treatment

Did you hear the one about the uterus transplant?

07 Friday Dec 2018

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rawpixel-585634-unsplashBut this is no joke. I’m so amazed and thankful to live in a day and age where reproductive technology exists, and continues to evolve, to help those diagnosed with infertility have a chance at building a family. I’ll say right up front that there are no guarantees that the treatments available will work for everyone, and in fact, they often don’t. Still, science gives us a chance at something that not too long ago, we wouldn’t even have a shot at.

Today I came across a headline that stunned me: “In a first, a woman with a uterus transplanted from a deceased donor gives birth.” I mean just wow – let that sink in. The article explains that there have been 11 babies born to women who have had uterus transplants from live donors (talk about a generous donation), but this is the first from a deceased donor. That opens some interesting doors. Personally, I’m all for organ donation. After all, I really don’t need my parts when I’m gone and if I could help the living, well, all the better. You can find the article here in Science News.

The uterus came from a 45-year-old woman who died of a stroke and had 3 children of her own. The recipient was 32-years-old and had a frozen embryo transferred into her newfound uterus, following IVF that was done a few months before the uterus transplant. She gave birth to a healthy baby girl. Congrats mama! IVF is hard enough, and IVF pregnancies can be marked with significant worry about all the things that “could” go wrong at any moment to take away all our happiness. But image the fortitude it takes to be the woman doing something like this? To be a scientific “first,” and all the fears that come along with those unknowns. She’s a rock star in my book.

I often wonder what reproductive technology will bring us in the decades to follow. What will be discovered to improve IVF rates? Hone PGS testing (because that’s one area with a lot of room for improvement and important potential if it can live up to the hype)? Improve donor egg and embryo success rates? Reduce repeat losses? Revive aging eggs? What will lift the veil on “unexplained infertility”? There are so many questions that still need answered. And so many treatments that can be improved upon. What will the future look like?

One thing is for sure, the future won’t be as bright until we have insurance coverage for everyone diagnosed with infertility. I know what an IVF cycle cost out of pocket, and I can only imagine what a uterus transplant would cost. Yikes!  I can’t speak to infertility treatment coverage in other countries, although I image all have their pros and cons, but here in the US, it’s abysmal. Shameful, really. When so many women and men cannot get the medical treatment they need for infertility, and money ends up being the limiting factor in the ability to address a medical condition and build a family, there is something seriously wrong with our values as a culture.

So as this amazing science evolves, I can only hope that we can get to a place where these reproductive treatments are available to those who are suffering and need them. We need this. kat-yukawa-754726-unsplash

Pregnant After Infertility: How to get a BFP (it’s not what you think)

11 Thursday Oct 2018

Posted by in Pregnancy After Infertility, Uncategorized

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If you’re in any online infertility support groups, someone will eventually ask the question, “What did you do differently when you got your BPF?” That’s a big fat positive (BFP) – AKA positive pregnancy test. Actually, you will come across this question repeatedly. Because everyone is desperately searching for that magic combo that will get them pregnant, or at least up the chances. For a long time I diligently read every response to these questions, scouring for the one thing that I could do differently – the key I had somehow been missing – that would finally make all my dreams come true.

And then I realized something.

It’s a slippery slope. Sure we all want to maximize our chances and try all the things, but at some point we start sliding into a very dangerous place. A place where we begin to second guess every single decision we make. A place where we beat ourselves up and ask, “if I only hadn’t eaten that cupcake…”, “if I only had started this sooner…”, “if I had only done x, y, and z…” then it might have worked.

And therein lies the problem.

We don’t know if it would have worked. But we sure do layer on the self-blame and guilt. Or we stress ourselves out searching for the elusive magical step that we’ve somehow missed in all our previous attempts, but if we could just find it, then the next time it will work. But then it doesn’t, and the mad search continues. And the guilt, frustration, hopelessness, and anger thickens.

I see well meaning women responding to these posts, listing all the things they did differently to get their BFP, and I bite my tongue. I get it. Really I do. I myself have done a ridiculous amount of things over the course of the years I’ve struggled with infertility. Do you really want to see my list? Honestly, it makes me feel a wee bit insane.  But I’ll share. I do want to preface this by saying I did not do all of these things at once. Each cycle was some combination of various strategies. Some I did for years, while others I tried and moved on from. They range from the medically directed to significantly more unconventional. But hey, I was willing to try ANYTHING. So here you go…

List of things I’ve done in my pursuit of a BFP (brace yourself):

  • Acupuncture
  • Yoga
  • Fertility-specific yoga
  • Castor oil packs
  • Fertility self massage
  • Emotional freedom technique (AKA “Tapping”)
  • Reiki
  • Meditation, including fertility-specific meditation
  • Affirmations
  • Craniosacral therapy
  • Crystal healing bed
  • Psychics
  • Prayer
  • Fertility spells/rituals
  • Identifying, working through, releasing blockages related to fertility, parenting, family history, sexual abuse
  • Psychotherapy
  • All the standard fertility tests and procedures
  • ERA (4 times)
  • Laparoscopy – removal of endometriosis, removal of scar tissue on Fallopian tubes
  • Surgery to remove fibroid
  • All the supplements as directed by my RE – DHEA, DHA, melatonin, Vit D, E, C, folate, ubiquinol, prenatal, myo-inositol, l-arginine
  • Western herbal treatments
  • Chinese herbs
  • Visualization
  • Changed all personal care, make-up, home cleaning, and kitchen supplies to non-toxic version with special emphasis on removing endocrine disruptors and carcinogens (including giving up some of my personal favorites like hair dye, gel nails, and most nail polish, *sigh*)
  • ICSI and no ICSI
  • Special medium/culture for older eggs (my RE said this gives older eggs/embryos more of the antioxidants and other nutrients they need to support cell division)
  • Protocol changes (though the vast majority of my cycles utilized the same protocol because despite my low AMH and DOR, I responded relatively well to a high dose protocol
  • HGH
  • Neupogen wash
  • PGS and no PGS testing
  • 3-day transfer, 5-day transfers, frozen embryo transfers
  • Caffeine free, no sugar, no alcohol
  • Occasional glass of wine (oh and that one time I got tanked – I needed that night!)
  • Juicing
  • All organic
  • Gluten free
  • Resting after transfer (my RE assigned 3 “Princess days” reserved for resting and pampering)
  • Not resting after transfer (whatever, I’m still a princess everyday)
  • Positive thoughts that the transfer worked
  • Lowered expectations/Negative thoughts that the transfer didn’t work

I’m freaking exhausted just looking at this list. It was a full time job. And I already have a full time job.

green club flower

And after countless cycles, do you want to know what I think really worked the 2 times I got a BFP? Here it is ladies…luck. Yep, that’s right. Random luck.

 

Now this isn’t to say that nothing matters in this process. I’m a firm believer that the skill of the RE (both in selecting and managing protocols, and in performing the egg retrievals and transfers) as well as the quality of the lab do make a significant difference in overall outcomes. However, all of my IVF cycles were with one RE and one lab. I think I had good chances because of my RE and lab, but clearly they were not able to miraculously make it work every time. Many times it failed and twice it succeeded. So I’m back to saying that luck was the deciding factor. Luck that the “right egg” was recruited and harvested in a given cycle, luck that my body didn’t go rogue and ovulate before the trigger, luck that Miss Egg was combined with the right Mr. Sperm that she seemed fond of, luck that the embryo hit a receptor site after transfer and implanted, luck, luck, and more luck.

I’m also not saying that nothing from my list mattered at all. Anything that supports good health – including physical, emotional, and spiritual health – are going to help you though infertility hell. Depression, anxiety, low self-worth, divorce – these are all more common among people going through infertility. Anything that can help you avoid or come out of those dark places is invaluable.

For me there were certain things from my list that helped more with my good health – things like regular acupuncture, yoga, meditation, psychotherapy, as well as others. Then there were things that ended up stressing me out thereby probably doing more harm than good for my overall health. Sometimes it was simply doing too many things from my list at once that stressed me out. I felt overwhelmed and spread too thin. That led to feelings of guilt that I “should be” doing more. That wasn’t helpful at all.

So my advice to anyone that is interested is this: cut yourself some slack. Find what supports your peace of mind and overall good health. Do what feels good for your body, mind, and spirit. And if or when it stops feeling good, reevaluate. Maybe it’s just not working for you anymore. And that’s okay. Because these things we do probably aren’t going to make or break our cycle. They may make or break you though. The cycle, well, that’s mainly luck.

And may luck be on your side.

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Do you trust your RE?

15 Tuesday May 2018

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When you become involved in the online infertility community, you learn a lot about what happens with other women during treatment cycles. You quickly find that different doctors subscribe to different beliefs, strategies, and practices. Not all doctors or clinics are created equally. And sometimes the differences seem to teeter on negligence.

Just recently, in fact, I heard from one woman that her RE is recommending that she cancel or convert her IVF cycle to an IUI because her lead follicle grew too much and is “overripe”. She has several other eggs that are prime size for retrieval, but her RE subscribes to the idea that the healthiest eggs (that is, the ones most likely to become a baby) are the ones that respond first to stimulation meds, so if you miss your lead follicle(s) you may blow your whole cycle. Compare this to RE’s who purposely “sacrifice” lead follicles to allow smaller ones to catch up in hope of gaining a bigger harvest. Their belief is that with more eggs retrieved, you have a better chance of getting the baby. Two very different approaches, with potentially very different outcomes. This woman is stressed and torn about whether to forfeit this cycle or proceed.

Another women is fuming because for the second cycle in a row, her RE wasn’t able to retrieve all of her eggs due to issues with the dose and timing of the trigger. So her mature eggs are stuck in her ovaries. The RE should have known better and made adjustments after the first cycle.

Then there are the tests that should have been done, but never were. Protocols that weren’t individualized for women, who were treated like numbers instead. The examples can go on and on.

Some of this discrepancy is no doubt due to limitations in the research. Some things just aren’t fully known yet when it comes to assisted reproduction (or reproduction in general for that matter – the birds and the bees was clearly too simplistic). But a big part of that discrepancy also falls on the shoulders of the RE. They simply are not all built the same. And the most disturbing part for me, as someone in the health profession, is that not all RE’s stay up on the current research or are even qualified to understand the research (it takes training in research methodology and statistics to really understand the studies that are published. Just because it’s published doesn’t mean that the research design and/or statistical analyses fully support the conclusions drawn in the study). So some RE’s unfortunately aren’t up on the current findings, and some really don’t understand the findings that they read. I don’t mean to pick on RE’s – it’s like this in any discipline that attempts to bridge the gap between research and practice.  And then there’s the RE’s personal experiences, which can influence how they practice.

I often joke that I should be awarded an honorary degree in reproductive medicine after everything I’ve been through and all the studying I’ve done. Seriously, I know more about reproduction than my OBGYN. But all joking aside, I’m not an RE. I rely on my RE to advise me, make the best decisions for my individual case, be knowledgeable about current research, and care about making this work for me. And I do. I trust and respect my RE. I actually think he’s awesome for so many reasons.

And that gives me a sense of peace. I know that if this doesn’t end in a baby, it’s not because my RE wasn’t skilled enough or should have done something differently. That isn’t to say that I wish we wouldn’t have done some things differently, but I do believe that we did the best we could at each step with the information we had. And when we got new information, we changed things up accordingly.

Going through IVF is easier when you trust and believe in your RE.

It really is. In life we often have to advocate for ourselves, and I want to encourage women to speak up during infertility treatment. Ask questions – as many as you need to until you feel satisfied with the answers. Don’t be shy. And if you don’t feel comfortable with your RE – if you don’t believe in their skill and trust them – consider finding a new one. I know that’s not always an option. You may be restricted by insurance, geography, or other factors. But if you have the option, exercise it. If you don’t have the option,  it makes this difficult process that much harder.