IVF Success Rate. What Does The End Look Like?

September 23, 2018

 

It has been a year since my miscarriage and coming upon a year since the due date of that ill-fated pregnancy.  Instead of preparing for a wonderful birthday party for my child’s first year of life, I am preparing for IVF treatments.  Instead of getting messy wet kisses and hugs filled with worry free abandon, I’ll be getting sharp needles and cold ice packs administered to sensitive places.  Over the last several months, I am no stranger to needles.

 

I have gone through seven inseminations. One at home and six with a reproductive endocrinologist inserting washed sperm past my cervix and directly into my uterus.  My uterus has been cracked open more times than a Budweiser at a tailgate party, with all the pain and dread the next morning, but none of the funny memories to recall.

 

Instead the next morning brings apprehension, anxiety and a sliver of hope.  Hope that a little spark lit somewhere deep in my reproductive organs and that sperm somehow met egg and a new life was beginning.  A baby that was growing waiting to be loved and would make its presence known in the short, yet somehow longest two weeks ever, it would take to get that magical second line on a pregnancy test.

 

It would start out as my little egg and the little sperm of a stranger.  No, we’re not still at the tailgate party, this is sperm that I paid for from a sperm bank.  I’m using a sperm donor.  Well at least the five times.  I picked my child’s genetic contributor from a catalogue.  A friend of mine helped me narrow down the choices.  We read about his personality and ambitions.  His age made my slightly nervous.  Most of them were in their early to mid-twenties.  Finishing university, including multiple graduate degrees and likely looking to make some decent cash.  Whatever brought them to the equation; I am grateful they decided to become a donor.  How can you really put a price on that?  Worry not!  The sperm banks and preservation centers have figured it out to the penny.

 

Then the story gets complicated. (Because heretofore, it was all straightforward, right???).  Remember the miscarriage I had last year? It was with my partner-at-the-time.  Well he resurfaces mid-treatment and makes me an offer I can’t really refuse.  He’s offered to be a known donor. I get all the benefits of being a single mother by choice and all it will cost me is the cost of paying a lawyer to draw up a contract that outlines my desire to be the intended parent.  The remaining points of the contract we have agreed to take to our grave. 

 

Having fresh sperm is meant to increase my odds because fresh sperm lives longer in the body than previously frozen sperm.  Isn’t that the same for items purchased from the local butcher?  Add to the fact the anonymous donor I picked out from the online catalogue was very similar to my former partner and it wasn’t something I had to think too long or too hard about.

 

Two intrauterine inseminations later with the fresh sperm and I am still not pregnant.  As I take my blood work to prepare for the third insemination (eight total, but third with the fresh sperm) and am informed by the doctor that my body is not responding to the stimulation drugs and that we will not be able to move forward with the next cycle.  Specifically my hormones, the follicle stimulating hormone (FSH) and estrogen, are not at the right ratio.  My FSH has skyrocketed to 22 and anything over 20 usually is too high for the stimulation medication to have any impact.

 

When going through stimulation or “stims” for assisted reproductive technology (ART) the idea is to “outsmart” the body and get your body into hyper follicle producing mode.  This ensures not only ovulation but also possible the recruitment of more than one follicle that will mature and be released.  In a typical menstrual cycle a woman will have multiple falls called to action during the beginning of her cycle and then just before ovulation one of the follicles becomes dominant and the others fall by the wayside.  The dominant follicle will ovulate.  In a medicated cycle, there may be multiple follicles that mature and will ovulate.  (Although during an intrauterine insemination you don’t want more than 3 or 4 to mature, because they are each subject to split.  Clomid stimulation is more likely to result in multiples, with Femara having a less likely clinical occurrence of multiples.)

 

All that science is daunting and magical at the same time.  But what happens now that my body has stopped responding?  Does that mean my effort to employ assisted reproductive technology to complete my family is thwarted?  I can’t help be filled with panic and dread when the doctor informs me my cycle is cancelled.

 

First of all the whole “cancelled cycle” is confusing phrasing.  Is my body cancelling my cycle?  My menstrual cycle is cancelled… as in menopause is imminent?  Nope, the medical part of the cycle is cancelled.  Which of course makes sense to a rational, sane person.  But after being pumped with hormonal altering meds for five days, I am anything but rational or sane.

 

The silver lining in it all and yes, I believe there is ALWAYS a sliver lining, is that my reproductive endocrinologist still believes I CAN get pregnant.  She gently suggests we move on to in vitro fertilization (IVF) as our next step.  In vitro, in Latin, means “in glass”.  Merriam-Webster defines it as “(of a process) performed or taking place in a test tube, culture dish, or elsewhere outside a living organism.”

 

In order to get my baby, they doctor will remove my egg (several to increase the odds of success) and my donor will contribute his sperm (in a cup in the office) and an embryologist will take one sperm and inject it into one egg and then we wait to see if the egg fertilizes.  Of course this all assumes that I have at least one mature egg that can undergo this process.  Lot’s of “what if’s” along the way, but in an ideal state, I get a little baby growing in a dish and implanted back into my uterus for safe keeping and growing for 10 months.  Talk about taking baby making out of my hands!

I am excited, scared, nervous, you name it…for these next few steps. I’ve spent the last few weeks getting my head wrapped around it all. 

 

Throughout this process I have silently wondered, what does the other side look like?  I hope, pray and positively affirm that it will look like a little healthy happy baby in my arms.  I also know all too well that when the doctors says I have a 1% chance of a successful pregnancy outcome, the alternate phrasing is that I have a 99% chance of not getting my take home baby.  Yet, I persist.

 

Why?  Because I have a strong desire to procreate and to be a mother to a second child.  My chances of success greatly increase if I chose to use donor eggs.  In fact most clinics won’t offer a woman over the age 44 an opportunity to move forward with IVF with her own eggs.  The chance of success is so low and they have to report their success rates into a national US database (National Summary Report ) this is after all a billion dollar industry and great stats can impact the long-term business prospects of a fertility clinic. I’m a businesswoman, I get it.  But my heart wants what it wants and business and emotions are not a kind cocktail.

 

In support of this widespread practice to not perform IVF using their own eggs on women over 44, my insurance won’t pay for the treatment.  Let me clarify that, they will pay 100%, including all egg donor medical care (sans deductible and co-pay) if I use donor eggs.  They will only pay for meds if use my own eggs.  This brings my IVF price tag to a whopping $15-18K out-of-pocket.  This doesn’t include the money I have spent on IUIs (not covered for women over 35) and donor sperm that was about $1,200 a pop, including shipping.  Then you add on fertility yoga, acupuncture, Chinese medicine tinctures and supplements all offering a possible percentile increase in odd of success. 

 

Infertility resonates in the most primal places of our body and minds.  It can be all consuming and no task too small, no dollar amount too great to give birth to a healthy happy baby.  Someone told me it was like a gambler’s promise and I don’t disagree.  Just one more time and then I’ll walk away.  If I just double down and focus, the odds eventually have to land in my favor. Well, this will be my last hand.  I am going all in and pray that I don’t end up with nothing.

 

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October 6, 2019

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October 14, 2018

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