Decision time: "4th IVF Stimulation" or "Using donor gametes" ?

May to July '16 was more of family joys and less of emotional turmoil. After getting back to Bangalore, I met Dr. Rashmi Yogish on my Day-2 of the next month, and the question remained the same: "Another IVF Stimulation" (4th to be precise) or "Using both donor gametes"?

My DH and I had different views this time, again. He insisted to go for donor gametes, however I wanted to go for the last stimulation. My logic was that if I have to go through all the physical pains of IVF procedure just to try if I could experience motherhood, then why not exhaust my egg reserve than using someone else's. No! I do not have a problem with donor concept but I still have hope; maybe it's not the egg/embryo quality in question but the environment where the embryos are expected to florish. However, ERA test conducted proves that my uterus is Receptive.

Also, it feels a little weird to me. Imagine, I go through the entire IVF process, successful pregnancy, labour and child-birth and then have a baby who neither resembles me nor my DH. WHAT!!! Wouldn't it be super-obvious that either we accidentally got our baby exchanged in the hospital crib or used donor gametes? Come on! If you are so OKAY about the no-resemblance part, then frankly speaking, adopting a child is the best solution! Unfortunately, in today's age also, infertility is treated as a taboo topic and an inauspicious thing. I am not sure how well it is treated outside India but we Indians are driven a lot by "what will people say/think?" and that is more disturbing and frustrating than not being able to conceive. Living in a metropolitan city like Bangalore, I have peer-pressure, I feel horrible for the women in rural areas where women are abused and treated as outcast.

Doctor was in agreement with my logic and wanted to give it a one last try before concluding that its the uterus which needs attention, and not the embryos.

So, we all agreed to go for the last IVF stimulation of my life! Yes, it was a declaration. I have no idea how much one stimulation could  impact one's body, and here I am daring for the 4th one. Frankly, even if this fails, would taking so much risk with my body be a complete waste? Huge amount of money spent on so many IVF cycles can still be earned, but health gone bad once cannot be undone.

Anyhow, we went ahead with the decision of doing OPU in Aug'16.

Bidding Goodbye to Nova Delhi after 2 more failed Day-5 Blastocyst Transfer

After the failed Fresh Embryo Transfer (ET), Dr. Nalini Mahajan planned a Day-5 Blastocyst Transfer in the next cycle, under the same conditions as that of ERA.

There was a delay between ERA and next transfer because of two reasons: 1) OHSS and 2) either skipping a single dose of Estrogen substitute tablet on my behalf or a malfunction of some medicine, which caused untimely bleeding.

Also, during the Stimulation Process for Oocyte Pick-Up (OPU), I felt I had OHSS symptoms. Although, nobody at Nova Delhi agreed to me, but the internet said it all. I agree that not all information on internet is 100% correct but feeling like a bloated lower abdominal area made me look pregnant and the fullness inside gave me the idea how carrying a baby inside would be like.

Ovarian HyperStimulation Syndrome (OHSS) occurs only after the eggs are released from the ovary (either after ovulation or by receiving a shot of Human Chorionic Gonadotropin (hCG)).

So, the body needed time to get back to normal before proceeding with the next transfer.

Two Day-5 Blastocysts were transferred in Mar'15, but even that didn't work in our favour. A Blastocyst transfer is supposed to have better Success Rates than Fresh or Frozen Embryo transfers. I was waiting to get lucky with my next cycle then, last cycle at Nova Delhi as I was left with just Two more Day-5 Blastocysts. Trust me, all of them were mostly Grade-A, and few were Grade-B. I guess, what matters is "The Right Time". At that point in time, mine seemed far away. We were losing hope with each failed cycle.

The next cycle (3rd transfer at Nova Delhi, under Dr. Nalini Mahajan) was also a Two Day-5 Blastocysts transfer. This was done in the consecutive month, Apr'15, sadly, my beans didn't stick this time also.

I didn't want to start afresh and try another IVF cycle at Nova Delhi, even though Dr. Mahajan was quite experienced and knowledgeable. Somehow, I felt something was missing. That pushed me to get back to Bangalore and try my luck with Nova Bangalore.

I had read a lot about Nova's Success Rates being exceptionally good, hence the decision to visit Nova Bangalore.

All this might seem pretty casual but trust me, when you are going through all this, your body takes a lot of foreign particles inside and your brain works overtime. All you need to do is keep your cool and stay happy... because if mind isn't healthy, body can never be healthy. My DH gave his best in keeping me away from worries, tensions, tears and fears.

A fresh ET & ERA at Nova Delhi

After we met Dr. Nalini Mahajan (Nova IVI Fertility, New Delhi), my DH also felt the positivity in her approach. We went ahead with our treatment with her.

In Oct’14, I had my OPU (Oocyte Pick-Up) and 17 oocytes were retrieved. I was on Injection Menopur 450UI from CD6 and OPU was done on CD13. But before the OPU, she had me change my hypertension medicines. 

Earlier I was taking a combination of Tablet Newtel 40 and Newtel-H 40. According to her, Telmisartian Hydroclorothazide was not pregnancy-friendly, so she changed my medicines to Methyldopa 500 thrice a day.

Three days after OPU, a fresh ET was done, which didn’t succeed. A failed fresh ET and 2 failed IUIs in the past were enough for her to conduct a test on me called Endometrial Receptivity Array (ERA). It is kind of a biopsy of the endometrium done under specific conditions, HRT (P+5) to be precise and the procedure is carried out just like IUI. HRT (P+5) means Hormone Replacement Therapy and P+5 means intake of Progesterone (Injections and/or Capsules) +5 days. 

The report took 10-15 days to be published and sent back to the clinic. Thankfully, mine was Receptive. The preparation, procedure and publishing of report happened during Dec’14 and Jan’15.

Seeing the ERA Report, Dr. Mahajan made some changes in her plan for the next cycle.