Reality Check

We visited the new RE at the Fertility Institute at Posh Hospital today. We decided to go there because the new OB-GYN recommended them, because we thought they might do more thorough testing, because they are most conveniently located, because they have really high lab ratings, and because they were spoken highly of on the IVF Connections boards. For today's initial consult with Dr. Yet-to-be-nicknamed, I brought a sizable stack of medical charts from all our previous fertility tests and treatments. After he read through them all, Dr. YTBN sat down with Aaron and I in the office and said, "I don't really understand why you're not pregnant yet." Like us, he felt that with such easily treatable problems (low progesterone, mainly), it is strange that none of our IUIs or IVFs would have resulted in pregnancy. He suggested two possible courses of action to us. One, we take a step back to reevaluate and we try a few IUIs with FSH injections. If we do that, he would want to first do an X-ray to confirm that my tubes really are clear (I guess the saline sonogram I had done is not completely accurate for examining the fallopian tubes, even if the fluid is seen to spill out the ends). The other option would be to continue with IVF - but he says that option only makes sense for us if we are willing to freeze embryos.

He was completely sympathetic to our concerns about respecting human life, but he thought that we did not have all the information we needed to make our decision about that issue. He then went on to explain that even in a young, healthy woman, only one out of five eggs has a full set of correct chromosomes. The other four may fertilize and have the necessary chromosomes to grow to blastocysts, but they will not grow and survive beyond that. With those odds, he said, our previous practice of fertilizing just four eggs had almost no chance of resulting in a pregnancy. He asked how many children we want to have, and we said as many as the Lord gives us and that, before infertility struck, we imagined having four or more. In light of that, he suggested that we fertilize as many eggs as we can, transfer two embryos, freeze the rest, and then transfer them all back a couple at a time.

We like Dr. YTBN; he seems incredibly intelligent, but very mild-mannered and compassionate. We appreciate that he was very up-front with us and gave us the facts. That said, I left the appointment feeling very discouraged. I approached this consultation with cautious optimism, hoping that we would get a new perspective and direction that might turn our infertility treatments toward success. In the end, it seemed like we had moved farther away from the possibility of having children, not closer. It feels like the past two years of treatment have been a waste, like we never really had a chance of conceiving at all. We had been told that our odds for IVF, even with fertilizing only four eggs, were around 50%; Dr. YTBN said that with those limitations the chances of success are really more like 15% - no better than an IUI, and less than the average couple trying to conceive on their own. We have had such strong convictions against freezing embryos, and now we're being told that unless we're willing to do that we should forgo IVF altogether. We want to see if Dr. YTBN's facts check out (especially about only one in five eggs being chromosomally normal), and we will re-examine our practice of IVF in light of the new information, but we of course will not go against our conscience. Nothing has to be decided right away, thankfully. Deep down, I know that God is sovereign over all that has happened in our efforts to conceive up to this point, but right now I'm worrying that we've missed our chance. I thought we were heading in the right direction, medically, and now I've been told that we had the wrong map.