Diagnosis: Male factor infertility complicated by DH's Robertsonian Translocation 13;15.
IVF #1 July 2006 (Pensacola, FL) 23 eggs retrieved. 18 fertilized via ICSI. PGD. 8 "normal" embryos. Freeze all cycle due to severe OHSS. Hospitalized for 8 days.
FET #1 November 2006 (Pensacola, FL) Canceled at the last minute (after taking all the meds and shots for about 3 weeks) due to nonsuppression.
FET #2 September 2007 (Pensacola, FL) Transferred 1 female embryo. BFN.
FET #3 November 2007 (Pensacola, FL) Transferred 2 male embryos. BFN.
Decided to change fertlility clinics, so consulted with CCRM in Denver and SIRM in Las Vegas. Chose CCRM and transferred remaining 5 frozen embryos from Pensacola to Denver to have them genetically re-checked. 3 embryos died upon thaw, 1 embryo's genetic test came back inconclusive. 1 embryo normal for chromosomes 13 & 15. Re-froze the one normal embryo and the one inconclusive embryo.
One-day work up at CCRM in April 2008. FSH 7.18, E2 29, AMH 4.3, AFC 35+, genetic testing on me all came back normal. DH's genetic testing came back with 65% of sperm are affected with the unbalanced translocation.
IVF #2 July 2008 (Denver, CO) 30 eggs retrieved. 26 mature. 23 fertilized via ICSI. PGD. 7 embryos normal for chromosomes 13 & 15. 1 embryo made it to freeze. Transferred 2 grade AA blasts. BFN.
IVF #3 November 2008 (Denver, CO) 34 eggs retrieved. 25 mature. 22 fertilized via ICSI. 15 blasts for CGH testing. Results: 8 abnormal & 7 no results. The 7 no results will be thawed, re-biopsied, and re-vitrified; and the cells will be sent for FISH analysis for the translocation. Should get those results by Christmas. UPDATE: 1 blast is normal for 13 & 15 and 1 blast still no result.
FET #4 February 2009 (Denver, CO) Our first ever BFP!! Beta #1 (9dp5dt): 174 !!!!! Beta #2 (11dp5dt): 401 !!!!!
While we were there in Denver, knowing that the cycle was going to be a freeze-all (due to the CGH testing), I wanted to make sure that all the i's are dotted and t's are crossed. I want to go into the FET (Frozen Embryo Transfer) knowing that we have done everything possible. I asked my nurse if there were any more tests that could be done on me and she mentioned that the only other thing that she could think of is the APA and Hypercoagular Panel. She said that the tests are costly, and they only recommend testing if a woman has had several miscarriages. I didn't want to take any chances, as it would be more costly doing another whole IVF/ICSI/CGH cycle than to have these tests done; so I asked her if I could go ahead and have those tests done. She said that she would talk with Dr. Schoolcraft about it, and he said that it'd be up to us. The APA is about $500 and the Hyper-Coag Panel is about $3000. What's another $3500 in the whole scheme of things, right? So two days before my ER, I had 10 vials of blood drawn (9 of them were for the tests and 1 vial was for my stim check hormone levels).
APA - There may be a link between APA (Antiphospholipid antibodies) and implantation failures. APA have been postulated to bind to phospholipids on trophoblast tissue, impairing trophoblast development and preventing normal placentation. In other words, the presence of APA may prevent the embryo from implanting in the uterus. My APA test result came back as normal.
Hypercoagular Panel - Most of my hypercoag panel came back as normal except for the Protein-S (free) and Plasminogen. My Protein-S level is low - mine is 54 and normal is 56 - 124. This means that I form clots easily (increased risk of thromboembolism). However, I have elevated Plasminogen levels, meaning that my body breaks up clots easily. It seems like one makes up for the other.
I was also tested for the MTHFR gene (hyperhomocysteinemia). I am heterozygous for the gene, meaning that I have one single copy of the gene (a1298c). The problem lies if there are two copies of the gene - causing the fetus to not get enough folate, leading to neural tube defect. But just as a precaution, I will be put on prescription Folic Acid (Folgard 2.2 mg).
My nurse said that she will call me after she talks with Dr. Schoolcraft about these results and see what he recommends. She said that my Protein-S is just two points away from normal, so he might just put me on baby aspirin or some other blood thinner.
While I had her on the phone, I asked her about how many days I would have to stay in Denver for the FET. She said that I could fly in the night before the embryo transfer and then leave two days later. And that my beta would be 9 days after the transfer. I told her that I probably would just stay in Denver until after the beta, so that I would know before coming back home. I would feel more at ease if I was not on the road during my wait.