The fact that I haven't posted in a while, coupled with my last post about spotting, probably clued you all in to my negative results. It was no surprise to me; by the time we had the test, I had already been bleeding for 4 days. Micah was very disappointed - he is ever the faithful optimist and he was holding out hope that somehow God was performing a miracle in the midst of the bleeding. I love his faith - but it means we process things differently. By wednesday, I had already realized that this cycle failed, cried, mourned, thrown things, etc. When the news hit him, he had to deal with it while I had already moved on.
We do have 2 embryos left, but I needed some answers before we just blindly allowed history to repeat itself. This is the 3rd loss we've had and the 2nd time I'd started bleeding before beta. So we scheduled a consult to talk to the doctor, which we did today. I do like the RE that we met with, but I'm not sure I left with any answers. He talked about research and how the word 'implantation' is a misnomer. (Really, the lining grows up around the embryo, it doesn't burrow itself into the lining.) The general gist of the conversation is that I'm normal. The reason that I'm bleeding early is just because the embryo has failed to implant. It's about the embryo, not me. It has nothing to do with my hormones or my uterus or anything like that. He thinks the the reason we've not been successful all boils down to the viability of the embryos.
The RE made an interesting point in terms of embryo donation (or adoption.) We talk about how we are giving 'leftover' embryos a chance at life. Point being - they are leftovers. While embryo grading is just guess about quality based on it's appearance, they use the embryos with the highest grade first. So, chances are, when we receive a donation of embryos, we're not getting the best. I guess I knew that - but I hadn't really looked at it that way. (He also talked about the percent of embryos that are actually viable and mentioned that even in natural conception, embryos are likely fertilized month after month, but most don't end up as children.) The bottom line is that persistence is key; it just might take several tries to find the embryo that will become our next child.
The one other things that he said we *could* try is to do an endometrial scratch (or endometrial biopsy.) Basically, there are some studies in women with recurrent implantation failure that show that "injuring" the lining in the cycle prior increases the chance of implantation. The RE didn't think that I fall into the "recurrent implantation failure" category since I've carried a child to term and my miscarriage last spring indicated that implantation is very possible. His words were "we can try that if it would make you feel better for the next cycle."
So, now I don't know what to think. First of all, the procedure does NOT sound like fun; most women call it painful. Secondly, he doesn't sound like it would be that helpful - we would be doing it just to try something different. On the other hand, if there is a chance it could help implantation, then shouldn't I try it? Or would I just be wasting my time, since success is mostly determined by the embryo quality?
So - there's my update. I don't know what our next step is. Do we just jump right in with another cycle? Do we try this scratch thing first? Since these that we have left are likely even lower in quality, do we donate the embryos back and look through FIRMs profiles again? (It would be much cheaper to use the ones we have, since they are already ours.) I don't know. I would love any advice or thoughts that any of you have.
First of all, you're in my prayers as always and I hope you find strength and peace somehow. Second, the RE that we went to in VA did the endometrial biopsy before all FETs because she had had success with it. I'm not proof of that success, but apparently she had some data to back it up. It's, by far, the most painful test/procedure that I had done, but like you said, if it gets you a baby, shouldn't you give it a shot? Doctors are always trying to scientifically rationalize these things when we know that, ultimately it's not up to any of us. Pray on this for a while and try to discern His plan in this journey and know that you have a friend in Maryland who's praying too!
ReplyDeleteI'm so sorry for the loss of these little ones.
ReplyDeleteMy only recommendation at this point would be to perhaps get a second opinion about why you started bleeding so early. The PIO and estrogen you were on should have kept your period away indefinitely (at least for a while--after weeks and weeks, you would likely have "breakthrough bleeding"). To dismiss full on bleeding that starts before you even reach 7 days past transfer is odd and disconcerting to me. Did you have your progesterone levels tested this time?
If you normally ovulate on your own and have a normal length luteal phase when NOT on a medicated cycle, I'd be tempted to ask to do a natural FET next time, but that's just me.
Praying for you as your grieve. (((hugs)))
First of all, I'm so sorry that you lost your babies. It hurts deeply. I know because I've been there too-twice.
ReplyDeleteSecondly, I have two other thoughts that I wanted to share with you regarding your post...
One being, that I agree with Diane. You should not begin bleeding before you stop your progesterone and estrogen. Those meds are supposed to keep your lining in tact. I never bled before I stopped taking them and you are the only person that I've heard of that happening to. In fact, it usually takes a few days after you stop those meds before your body breaks down the lining and bleeding starts. That is not normal and is quite concerning because perhaps an embryo is trying to implant but your lining is too thin (to grow up around the embryo). I would definitely look into this and bring this up with your doctor.
Secondly, I don't think the procedure sounds necessary. I know that when you receive a negative beta, your mind tries to rationalize what might have prevented it. The only thing that sounds strange to me is your early bleeding. The rest of the reality is that some embryos just won't continue to grow. I tend to disagree with your RE about the remaining frozen embryos not being great quality. Sure, that is the case sometimes but even in a fresh cycle, seemingly strong embryos don't make it. Some just aren't survivors. In my twins' case, there were 12 blastocysts in their set of donated frozen embryos and only 3 survivors today (my twins and another EA mommy is pregnant with one of their genetic siblings right now) - the other 9 just didn't make it for only reasons that God knows. Sadly, the majority of embryos won't make it, but couples still need to move in faith and try to adopt them as they all deserve a chance at birth and only God knows what His will is for each of them.
Again, ((Hugs))!!
Hugs and prayers!
ReplyDeleteI agree with Jen... these embie babes are in God's hands.
Only He knows their intended outcome. At least you thawed those babies and let them pass on to Heaven. You'll meet them again one day.
Praying that God gives you discernment. Sorry for your loss!
ReplyDeleteThank you all for your thoughts and prayers. And for your advice. I find your perspectives super helpful. Right now we're waiting this cycle out before deciding anything. I'm temping and opk-ing to determine what kind of luteal phase I'm dealing with naturally. It was fine before out DD but maybe something changed. I will definitely keep you posted. I appreciate you so much.
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