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Second cycle of IVF with pre-implantation genetic diagnosis (PGD)

Posted Dec 12 2010 6:35pm
I am a mathematical person and I am sure that helped me cope with IVF cycle one failing.  On average after embryo transfer there was only supposed to be a 30% chance of it leading to a viable pregnancy (success rates are higher than 30% now but that is what they were at the time).  Therefore, the fact that it had failed didn’t mean there was anything wrong with me, it was just bad luck and you are ‘supposed to’ need a few goes before it works.  That was my logic anyway and it helped me cope.  I was sad about the failure but I buried it deep down and I didn’t even cry.  People who know me know that I cry at the drop of hat, so they will be surprised to hear that.

The next step, was to apply for funding for cycle two.  I wrote directly to Sheffield primary care trust on Karen Fordham’s suggestion.  Their reply was that it was unusual to receive applications direct from the patient and could I ask the hospital to write?  Karen wrote to them to say that everything in my letter was true, she supported our application and she answered the rest of their questions.  In time we received confirmation that we had got funding for one more cycle.

For cycle two, we got 10 eggs, which had Intracytoplasmic sperm injection (ICSI) performed on them, and 7 fertilised.  They seemed to grow a little better this time and six grew big enough to be biopsied.  Of those, four didn’t have the abnormality and so the embryologist chose the best two to be transferred.
It was during this cycle that Steve and I realised that actually our failed first IVF attempt wasn’t just bad luck, there was actually a problem with our embryos.  The best two that the embryologist selected for transfer on cycle two, were much smaller than you would have expected them to be for day 5 (we were having blastocyst transfer this time).  One of the staff was talking to us about our embryos and she said “we do get pregnancies from embryos that are this size on day 5”.  The way she put the emphasis on the “do” made us think what she was really meaning was “we do get pregnancies from embryos that are this size on day 5... but hardly ever”.  She also said that the embryos were similar to our last cycle of IVF.
When we heard her say those things the penny dropped for both myself and Steve.  Actually the IVF wasn’t going well.   It wasn’t just because of probabilities and statistics that out first cycle failed, it was the poor quality of our embryos.  And on top of that news, it seemed that the embryos we were having transferred for cycle two were also rubbish.
I started my 2 week window* feeling very negative.  I already thought that the IVF had failed.  Sure enough two weeks later the pregnancy test was negative and this time I cried buckets.  I think it was so much harder this time, for two reasons: 
1. I was now statistically worse than average so couldn’t as easily blame the roll of the dice.  2. We now knew that our embryos didn’t grow well.  It seemed likely this was due to the quality of my eggs and this therefore was going to impact any future IVF cycles.
We had a follow up consultation after this cycle.  It was awful.  We were basically told that any future cycles of IVF may work but the chances weren’t high because it seemed I had poor egg quality.  Karen Fordham explained that in all women the natural ageing process means that egg quality is reduced as they age.  Apparently, the hospital sometimes observe that this has happened at an accelerated pace in some of their patients with Myotonic dystrophy. 

I was only 30.  No spring chicken as far as fertility is concerned but I certainly didn’t consider myself old.  Having fertility issues therefore came as a complete shock to us. 
I can remember Karen saying that my ovaries were like those of an older woman.  I should say these are my memories, I doubt Karen explained it in that way.  Some things however stick in your mind, maybe because they are hard to hear.  My key take away points from that meeting, were that I had ovaries of an older woman, my eggs were rubbish and IVF might never work for us.
Now I don’t want to unnecessarily worry any ladies with Myotonic dystrophy who may be reading this.  There is no doubt that plenty of women with Myotonic dystrophy get pregnant easily and many men with Myotonic dystrophy become fathers easily too.  Before I started IVF I did a lot of looking into fertility issues on the internet and I didn’t find anything that specifically said a woman’s fertility was affected by having Myotonic dystrophy.  You do see mentions of reduced fertility in men with Myotonic dystrophy.  The Myotonic dystrophy support group website mentions that fertility can be reduced in men occasionally.
Therefore although it seemed that my fertility was poor, I can’t be sure that it is because of my Myotonic dystrophy.  I choose to blame my Myotonic dystrophy though.
One other outcome of this follow up consultation was that the doctor said he wouldn't advise us to continue with IVF and PGD unless we had NHS funding for the next cycle.  We had by this point saved up enough for one more cycle and our intention was to use savings for one last try.  After this follow up consultation however, we realised our best chance of starting a family may be to use an egg donor.
*2 week window - this is the two week wait after embryo transfer but before you can do the pregnancy test.

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