As they said in “The Hitchhiker’s Guide to the Galaxy”. AKA “Keep Calm and Carry On”.
I had my phone call with Dr O yesterday and it went pretty much as I had anticipated. Although I did “exceptionally well” for my age group embryo-wise and indications were quite good, it’s not unusual to have a negative cycle with high-quality embryos. Even at the age of 30, there’s only a 40-45% chance of success, so the odds are generally stacked against you in a first cycle.
A successful transfer needs both quality embryos and a suitable implantation environment. As we have the first, he said we could continue as planned or look into the environment to rule out any issues that are impeding implantation. If we want to do the latter, he would start with the basics, an auto-immune test and a natural killer cell test, and conduct further tests if anything is abnormal. If necessary, we would add immune treatment to my programme.
If the results are clear, we go ahead with frozen embryo transfer number two as before.
He raised the possibility of an endometrial scratch and use of embryo glue (which is added to the embryo culture to increase the embryos’ “stickiness”), though he would usually recommend this only after two consecutive failed cycles. I think I’ll skip that this time around.
Dr O also asked if I had been on Metformin, which he said might be “worth considering” in light of the OHSS I experienced after the stims in this IVF cycle. Metformin is used in the treatment of type 2 diabetes but also for polycystic ovary syndrome; as I had OHSS, or PCO traits (meaning I have a response similar to polycystic ovaries), I may have an increased risk of implantation failure or miscarriage. He said he would arrange a prescription for me with the nurses.
I like Dr O a lot, but I get a bit irked at the slightly casual way the doctors sometimes throw out the name of a drug and add it to your programme because it “might be worth considering”. If I don’t really need Metformin, I’d rather not take it. It was never mentioned before and I don’t suffer from PCOS to the best of my knowledge. I’m no doctor, obvs, but surely it’s not surprising when a healthy and fertile (for her age) woman over-reacts to artificial stimulation drugs. I don’t see how this means I have a problem that needs to be medicated. I’ll ask him about this next time we talk, though if he sends a prescription to the nurses, I imagine they will just instruct me to take it.
Metformin aside, all as expected. I laid down a cool €500 for a Reproductive Immunophenotype (ZIP) Test (ZIP Test sounds kind of cool) and Auto-Antibody Profile this morning and will talk to him about the results in about two weeks. My instinct is that the tests will be negative (famous last words…) and we’ll continue as before with FET #2.
In summary, “we don’t have to press the panic button” just yet.