Thursday, March 18, 2010

New Insight

I had an appointment today with Dr. Glatstein, my reproductive endocrinologist. I wanted to have a checkup with him to see what our plan would be for future kids and to go over what happened in the cycle with the twins. And now I know what happened...

First of all, of my eight eggs, here is what happened to them. One of them did not fertilize, two of them divided before being fertilized (it's a meiosis thing), three of them fertilized and then became multinucleated (this means that there is more than one nucleus in a cell, and the doctor will not transfer or freeze these type of embryos because of the high rate of miscarriage and abnormality), the last two are the ones that continued to divide and are now The Twinners. The doctor suspects that I have an egg quality issue which has been causing our problems. Why a perfectly healthy 26 year old should have egg quality issues, I don't know. But it is what it is and the doctor would not change our protocol at all (except for a minor change in medication because of what my insurance covers). He does not recommend doing any other kinds of treatments first (like IUI or clomid), since IVF is what worked and we think that there may be this minor egg quality problem. Also, he doesn't recommend ICSI or PGD because the eggs didn't seem to have problems fertilizing...only one of the available eggs didn't fertilize (the two that divided early weren't available so they don't count). Also, we don't have any known genetic issues, so there's no reason to do PGD. Also, we both agreed that we're only transferring one embryo at a time since I'm not allowed to have twins again. In order to make me feel better, though, we're going to freeze anything that's still cleaving (growing) on day 3 and I'll get to help choose which embryo to transfer based on how all of them are growing. Of course then I asked him if it would be possible for us to get pregnant on our own, and the doctor reiterated that it would be possible. It's a statistical thing...if I have decreased egg quality, there's just less of a chance of me getting pregnant in any given month (say 5% instead of 20%), and there's a higher chance of miscarriage if I develop one of these multinucleated embryos. That may explain my miscarriage on my first IUI! Anyways, I like now having some type of diagnosis and knowing what my next steps are. I need to have all of my testing done again (blood tests, semen analysis, SHG), and then I can start a cycle whenever I want. It most likely won't be for a while since we want to put about 3 years in between the twins and another baby and I'll want to try to plan for a delivery when it won't interfere too badly with school, and we'll get a chance to try on our own for a while. Then, if the statistics just don't go in our favor, we can start in on an IVF cycle when we're ready.

In other news, in case you hadn't noticed, TODAY IS THE TWINS' BIRTHDAY!!!! HAPPY 1st BIRTHDAY!!!!!!!!!!!!!!!!!!!
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