Saturday, September 18, 2010

Why Donor Eggs, Part I

I've been trying to finish this post for two months, and not doing a great job of it. Turns out that being pregnant at 41 with health issues and working full time is not conducive to, well, anything else. So I'm going to put out what I've got so far and probably finish it off once I stop work, which should be in about 4 weeks according to the docs - just past 28 weeks.

We have been very honest about the fact that this pregnancy is thanks to donor eggs and that, of course, has raised the question of "why?". I don't have a simple answer to that question, but I want to talk about it here and I want a record of it to remind myself of the process.

Needless to say, there are two strands to the answer - the physical one and the emotional one. I may well repeat things that I have said in previous posts, but I don't remember clearly what I have and haven't said and I certainly don't think anyone reading it will, so I'm just going to stick in what's relevant.

We started trying to conceive more than seven years ago and our journey includes:
• 6 natural conceptions, all of which ended in an early loss
• 6 cycles of Clomid, all producing at least 2 follicles and all ending in BFN
• 1 IUI - BFN
• 1 straight IVF (16 eggs; 13 embryos; a grade 2, 3 cell and a grade 3, 4 cell embryo transferred on day 2; none for freezing) - BFN
• 1 ICSI with immune treatment and CGH array (5 eggs; 1 normal, resulting in a 4 cell embryo on day 3 (not sure of grade, but not great)) - BFN
• 1 IVF with donor eggs (5 eggs; 4 grade 1/2 embryos at 8-12 cells on day 3; 1 grade 1, 12 cell "perfect" embryo "on a mission" transferred on day 3; 3 frozen embryos) - BFP

And that would tell you the physical story right there! We could get pregnant on our own, at intervals of about 1 year, but it always ended around 5-7 weeks. We could NOT get pregnant on any kind of fertility treatment with my eggs - and the embryos we produced were rubbish! On the donor cycle, the embryos were great.

After loss number 6, a kind nurse in the pregnancy support unit asked if we'd considered donor eggs (not at that stage), so we spoke to our IVF consultant who agreed it might be worth a try, as did our recurrent miscarriage consultant. Everyone seemed to agree that it seemed likely that my eggs were an issue - physically, I knew that was a possibility but emotionally, I wasn't ready to consider that.

Right from the first pregnancy (the first month we tried - ha!) and loss, I had a feeling that something was not right. I had desperately wanted to get pregnant, but was not nearly as happy as I felt I should be when I found out that I was. I knew that something had gone wrong with the pregnancy, even thought the doctor assured me that losing symptoms for a while was very common. He took a blood test, I went on holiday, checked my messages at the end of day one to find an urgent message to call my GP. I phoned them and was told I should expect to miscarry at any time - it started the following morning, while we were on holiday abroad.

After another 6 months of trying (and assurances that one loss was very common and that it was a very good sign that we had got pregnant so easily) there was no 2nd pregnancy and our GP started to investigate - my hormones were OK (slight signs of PCOS) and CM's sperm analysis was also OK (not stellar on the formation front, but not bad enough to cause problems). Try some more . . . referral to infertility specialist. Two months before that appointment, I got pregnant again and lost it again. Infertility specialist refused to do any testing/treatment as I have been pregnant in the last 6 months. Marvellous!

Thankfully, I found a great GP within my practice who was prepared to refer me to the local recurrent miscarriage clinic for testing, which showed up my Factor V Leiden, which I briefly thought might be the issue - a haematologist soon cleared that up for me: 2nd and 3rd trimester losses, but nothing as early as mine. This was when we approached a private consultant and started on the Clomid.

My sister had conceived on Clomid and, although she'd had a missed miscarriage (a blighted ovum), she had, very quickly afterwards, conceived my nephew on it. I thought it was a slam dunk and so did the consultant. It wasn't! Neither was the IVF we went on to. In the meantime, I was diagnosed with PCOS, insulin resistance, low thyroid and another, non-specific clotting issue in addition to the FVL, all of which were treated. Three more natural pregnancies, three more losses. More Clomid, in combination with Metformin, more BFNs.

So, that’s the physical. As you can tell, we'd never had an issue with using medical advances in our pursuit of parenthood. By this time though, we were starting to lose faith - I had also tried homeopathy, reflexology, chinese herbs, acupuncture, nutritional testing and supplements, hypnosis and anything else I thought might give me an edge.

In terms of the emotional side, during all this treatment and time my attitude to our attempts to become parents started to gel. It's best described as follows: if you wanted a doughnut (for example), the first place you would look would be in your kitchen; if you couldn't find one there, you would go to the corner shop; if they were out, you would go to your nearest supermarket; if they didn't have what you wanted, and you still really wanted it, you'd go further, try harder and consider possibilities you thought you'd never entertain when the need for a doughnut first came upon you.