Monday, February 1, 2010

Revisions

I think the weight of our most recent diagnosis has finally hit both Hammer and I. It was a delayed response because it came right in the middle of loosing Hammer’s dad. It’s to be expected I suppose. Both of us have begun to feel down and defeated every time we think about that 48%. It seems insurmountable. And now we are still awaiting the results of my recent AMH test. This is the test that will really tell us how many eggs are left in my ‘baskets.’ My FSH is fine so my egg quality is fine but I’m such a hard stimmer and lefty has low antral follicle counts so they are wondering if I may have diminished ovarian reserves. I have to admit I’m really worried.

Our first IVF I was on the long lupron cycle and 225 units of Bravelle a day. We were almost cancelled but managed to get 6 mature eggs of which only 3 fertilized.

Our second IVF was long lupron again on 300 units of Bravelle + 75 units of Luveris. I had 11 follicles and 9 eggs were collected, 8 were mature eggs, and 7 fertilized.

We’re not getting vast improvements in the egg making department here. My only hope is that my AMH is fine and that the real issue is that I’m just not a good candidate for the long lupron protocol. We could really use some good news here. But I’m feeling a bit defeated and have found myself wondering if we should just drop everything and head to adoption, the sure thing, right? But it’s not a settled feeling, there is no peace in that decision, so we push forward.

Our third and final IVF will be a lupron flare protocol with 375 units of Bravelle + 75 units of Luveris. This is the max you can give a person AND it's a short cycle ~2-3 weeks which I like...a lot.

Hammer is starting to really struggle with the fact that, per his words, “it’s his fault” regardless of the fact that I’ve told him I’ve always known but that it didn’t matter, this is OUR trial and we are doing this TOGETHER and that if given the chance I would marry him all over again even knowing we would go through this. He is my soul mate, the one whom God intended for me,, there is not a doubt in my mind. I think that over the course of this journey he has really held it together while I have been a roller coaster since, as you all know, women are put through the majority of the procedures, drugs etc. I think this is his moment where he needs to grieve but it just kills me to see him struggle because I know full well what he is feeling. But it does not help that this comes on the tails of losing his dad and the fact that we both have always known for years he would never see his grandchildren and now it has come true.

And now we’ve come to the end of the line, last chance IVF. Go big or go home. So to pick us up and give us some hope I resumed my research on IVF/ICSI and DNA fragmentation. It was actually very encouraging. In one article showed that for men who did not meet ICSI criteria (Hammer) and were treated with antioxidants for 2 months, there was an increase in pregnancy rate that went from 6.9% to 48.2%. And that ICSI actually had a more negative outcome. Two other articles supported this outcome. So we are leaning towards not doing ICS because it is believed that the zona of the egg and good ole’ Mother Nature herself may be the best selector of healthy sperm in our case. We are, however, going to ask about assisted hatching which is used in couples who have had several failed IVF cycles, like us.

Hammer’s vitamin regime has been revised to the following (amount increase in parenthesis):

-Vitamin C 1000 mg (+800 mg)
-Vitamin E 800 IU (+400 IU)
-L Acetyl-Carnitine 1 gram
-L Carnitine 1 gram (morning and evening)
-Pycogenol 100 mg
-Co Q-10 75 mg

In addition to vitamins we will both begin drinking antioxidant smoothies:

1 oz acai juice
1oz pomegranate juice
1oz frozen wheat grass
½ cup organic blueberries
½ cup organic orange and/or pineapple juice
½ cup organic yogurt
2 tbsp raw honey

Hopefully this will be an even bigger antioxidant booster. We will also be ensuring that Hammer eats 2-3 dinner salads that contain organic mixed greens. Our chiropractor has an antioxidant screening test that Hammer will have done to get a baseline and then subsequent checks to see if his levels are improving. I’m posting all of this for those women out there who may have or may be interested in testing for sperm DNA fragmentation but then receive little to no guidance from their RE’s about how to treat it. Mainly because that is what we are experiencing but thankfully as a dietitian and background in research I know enough to find out how to treat it. My hope is that I can pass this on to anyone else out there who may need it. If those of you who are reading have any questions I will be more than happy to answer them as there is not a lot of information out there and it’s a controversial topic.

8 comments:

JB said...

I can definitely recommend assisted hatching. In fact, my clinic routinely uses it and has pretty solid pregnancy rates.

I can relate to the "he thinks it's his fault and feels bad" stuff. KB's crappy sperm were the reason we had to elect IVF, and then we discovered I am a poor responder, which is just icing on the cake. Antagonist protocols are indicated for poor responders, because they focus improving egg quality with estrogen priming and less early hindrance of follicle growth, so maybe ask your doctor about that. Also, an antagonist cycle goes much faster (by 2-3 weeks) than a lupron downregulation cycle, so that's a plus for you.

Hope all your wise interventions do the trick! You have a great plan!

Jesse and Mandy Peterson said...

My heart goes out to you. I may be on the other side now, but I still feel the twinge of pain as I read about what you are going through. And I feel like my experience doesn't even compare to your's. I can understand how and why you guys feel the way you do, and I just want so badly to see God answer your prayers. I have "expected" your miracle. Now I want to see it come to fruition. I don't know what God's up to- I've said that before- but I do believe He is steadfast and orchestrating big plans behind the scenes when we see nothing. I'm still praying for you guys. That won't stop. I'm glad things look promising for this cycle and am still believing God can do something through it.

Rachel said...

Wow! It's sounds like you have a wonderful plan set forth.

Andrea said...

Statistics...gotta hate them! I've decided to take my Dr's advice and try to not focus on them, as she reminded me they are not always 100%.

I only wish we didn't have to encounter all this uncertainty, but at least we don't have to do it alone...as we're all here for you.

More than anything, you have done EVERYTHING right. You've been an advocate for youself and have researched things and have a plan. And, I applaud your efforts, as this road gets long and taxing.

Sending love and prayers your way for great success.

xoxo

Nicole said...

Good for you for doing all your research! I of course am pro-ICSI because it's all we've ever done (needed to overcome our very specific MFI acrosomal issue), but another option if you are conflicted that we entertained was fertilizing half with ICSI and trying half "natural". Whatever you choose, you are your best decision maker!
I'm so happy for you to be having a plan and taking action, that helps so much I think, emotionally, with the helplessness and waiting. What a fast cycle! I can't wait to hear more about it as you go. GOOD LUCK!!!!!!

kdactyl said...

Ahhhh....I recognize your dilemma. We had a sever MF as well and I was older so was only getting like 7-9 eggs retrieved per cycle and even with ICSI..we were then only getting about a 50% fertilization rate....so not real good...BUT...we did do assisted hatching. It is also pretty common in our clinic and always done on older moms (I was just 40 at the time of the egg retrieval).


As for the antioxidant therapy...I sure wish I knew all this 3 years ago when we started. I read some at the very beginning of our treatments and I put my husband on high doses of vitimin C and zinc and we got our best numbers ever that first try (it was IUI) and we actually got pregnant that cycle. Sadly, we lost idnetical twins at 10 weeks. But...after that he didn't take the extra vitimin C anymore (he thought it was all hocus pocus) and his numbers continued to decline every cycle. That is when we went to IVF with ICSI....we got our baby on IVF#2...but it was a nail biter...only 8 eggs retrieved, only 4 fertilized. We transferred all four on day 3 (but 2 of them were really slow and only a few cells so I think those were just Hail Mary attempts by my RE since we had never had any get to blast). Luckily...one took. I think you can get your baby....even with lower ovarian reserve. And I truley believe all the antioxidants will do great things for DH's boys. Just keep it up. I have great hopes for you in the next cycle.

kd

Hillary said...

I am so sorry you are in such a difficult place. Please know I am praying for you!

makingmemom.blogspot.com

Waiting said...

I have an award for you!