I’ve been AWOL this month, as ttc takes a back seat. However, I did have my phone consultation last Thursday with Dr O. When booking the consultation, you aren’t given a specified time, and I had two meetings that day, one at 10am and one at noon. Sure enough he rang during the second meeting, so after a morning spent taking my phone everywhere with me, including into the bathroom, I missed the first call. He caught up with me again in the afternoon and did all of the talking; I got the impression he’d gone through this spiel quite a few times and had it off pat, anticipating all of my questions.
Summary below for those pondering the IUI versus IVF question, although every woman’s case will be different.
Basically, he was very convincing about IVF. Rationale: although my egg reserve is very good for a 39 year old, my eggs are getting poorer in quality as I approach 40; a couple more goes at IUI would rob me of five to six months, factoring in the time it would take to get the sperm in (if sperm ordering is a known delaying factor, why doesn’t the clinic hurry this up?); my eggs would be of even poorer quality at the end of this period; IVF would have a 30% chance of success versus IUI at 10-12%.
I’ve responded well to the drugs, apparently, and he acknowledged that I hadn’t exactly had three failures, as my first go resulted in a chemical pregnancy. If I were a younger woman, a few more goes at IUI would be no big deal. But it’s all about the effects of time on egg quality at this stage, I guess.
He launched into a quick overview of how IVF would work for me. I would be on the long protocol, which he would generally use on a younger woman. I’d take a nasal spray initially, followed by Gonal F again, this time at 225 for two days and then 150 daily. After 14 days, I would trigger with Pregnyl. Eggs would be collected (would take 20 minutes and I would be knocked out, 2-3 hours’ recovery) and then put back in five days later in a quick and simple procedure similar to the IUI. They would probably implant two embryos, as the risk of twins is lower after 38 (usually 10-15% chance at my age; he gives me a 20% chance). I hadn’t realised that the clinic will also freeze extra IVF embryos (fee-free for the first year), which means I would have the chance of a better quality embryo if I wanted another child in a year or two.
It all makes sense rationally but my head is just not there yet. I know I’m not in the same position as a couple trying to conceive and I know my IUIs were monitored closely and medicated, so I had better odds than doing it the old-fashioned way, but I just can’t see going for IVF after three tries. Yes, I’m nearly 40 but it seems like a sledgehammer to crack a nut. As much as it might be wasting time, I think I need to have another few goes at IUI before giving up.
I briefly looked up long protocol and quickly stopped after reading about how the nasal spray puts you into temporary menopause. Dr O didn’t mention that. In the same article, I read about “mild IVF,” which uses gentle drug stimulation and involves the insertion of just one single healthy embryo, but this approach doesn’t seem to have gained widespread traction yet, unfortunately. It seems my version of IVF wouldn’t involve gigantic doses of hormones, so maybe I shouldn’t be worrying too much about this. And delaying IVF at this stage might mean those doses would have to be increased by the time I got to that point. With inferior egg quality. I just don’t know.
That’s the summary. Back to ignoring the issue while I concentrate on other matters.