Wednesday, October 12, 2011

A Little Miracle...Seven Years In The Making


I want to share a special story with you, my readers, about a couple who went through a recent IVF (in vitro fertilization) cycle with us. This couple had come to us back in 2004 for infertility treatment. After the normal trial of IUI's (intra uterine insemination) did not work, they opted to do IVF with us. The cycle went well, the retrieval went well and there were three embryos to transfer. While doing the transfer of all three embryos, one embryo "floated" (aspirated) back out of the catheter. This was an unusual event for me and my staff. The couple decided to freeze that one reluctant embryo. Unfortunately, the patient did not become pregnant with that cycle. As it so happens, she soon became pregnant naturally and in the ensuing years, as sometimes happens, they had no trouble conceiving again, having three children in all.

In the meantime, the frozen embryo remained in our cryobank storage facility. The couple elected to leave the embryo there for the last seven years until recently. Grappling with the options of either continuing to pay for storage, dispose of the embryo or put it up for adoption, the couple opted to go forward with a frozen embryo transfer. We transferred the one embryo successfully and crazy as it may seem, the patient is now pregnant! This child will be both the "oldest" and the "youngest" sibling by virtue of this unusual series of events.

I am a spiritual man, if you have not guessed already. For us, every child is special, but I have a feeling that this child will truly be a special one, for it is my belief that for some divine reason his or her birth was delayed. How often I feel defeated when a cycle does not succeed and yet when something like this happens, I know that we can only do what we can up until a certain point, at which time the final steps of creation are taken out of our hands. Which brings me to one of my favorite quotes from Deepak: "When you live your life with an appreciation of coincidences and their meanings, you connect with the underlying field of infinite possibilities."

16 comments:

  1. So I did 2 frozen embryo transfers on may 22 but just did my beta blood test and it was 1.00 could I still be pregnant

    ReplyDelete
    Replies
    1. I think that would be a negative at 14 days post transfer. Sorry.

      Delete
  2. Hi Dr, this is my 3Rd icsi/picsi, this last one my Dr transfered 3 embryos of 8cells on the 3rd say I did my bhgc on the 10pt it was 14 but then I started bleeding on the 13 post transfer, i repeated Hgc on day 15th it was 123 and did it again 3days later it's now 142, pls what is the meaning of th

    ReplyDelete
    Replies
    1. Hello,

      Well everything was sounding good until the day#18 bHCG. The numbers generally double every other day and so it should have been 307 (approximately). Considering that it only went up to 142 is an indication that the pregnancy is not normal. It could either end as a miscarriage or be an ectopic pregnancy. the bHCG's will need to be followed closely at least every other day until it declares itself.

      Sorry.

      Delete
  3. Dear sir, this is my frst ivf cycle and I'm very close to HCG test dat is on 2 oct bt yesterday night I see some spitting and lightly pain in my back and in ovaries side I started inj susten 200ml plz suggest me what can I do I'm realy worried??

    ReplyDelete
    Replies
    1. You need to discuss this with your doctor. I can't make a diagnosis via the internet or without doing an examination. Once possibilities for the back and ovarian pain is the increased size in ovaries due to follicular growth. Without knowing how many follicles you have, I can't conclude that this is what is going on. Also as the estrogen increases, the cervical discharge would increase. Is that what you mean by "spitting"?

      Delete
  4. Hi doctor, I had my first bhcg done on sat(12/13/2014) on 15dpt it was only 12.6 my doc asked me to stop all medicines and await period. But do u think should I repeat beta again? I am a pcos women

    ReplyDelete
    Replies
    1. Yes. You have a positive so I would continue to follow the bhCG's every other day until you have four levels. If the levels risk normally, then you don't need to follow and can schedule the first ultrasound for 2 weeks later to rule out an ectopic. If the bHCG's are not rising normally then you can continue to follow. They should be followed until then go down to zero or at least less than 5 anyways.

      Delete
  5. I am undergoing fertility treatment in Denmark.  I really need your opinion.

    Well my partner (57 y.o.) and  I (36 y.o.) started fertility treatment 6 months ago. My partner has male fertility issues ( low spermatozoa count, which can be  very variable between 2 and 20 millions). He has a daughter 16 y.o. ( by IVF). We were lucky to get a daughter ( 5 y.o.) naturally after trying for 5 years. My partner is healthy, I suffer from a mild form of Mb. Bechterev (hla-b27 positive spondiloarthropathy), at the moment in remission already for 8 years.

    I had 2 early abortions (5 weeks) 3 years ago. Undervent all kind of tests incl. hysteroscopy, everything was ok.

    As mentioned we started then IUI for 6 months ago, 3 cycles using pergotime and the 4th using both pergotime and gonal. All negative. After 1 cycle pause we agreed to undergo IVF (icsi), long mode. Was treated first with nosespray Synarela (GNRH analog) for 2 weeks and later on added Gonal injections for 2 weeks. Finally retrieved 10 eggs. Done ICSI and on day 3 we had 8 embryos of which only two were of acceptable quality one of 4 cell and another of 6 cell. I wanted to go on to blastocyst stage but embryologists insisted that we underwent embryo transfer on day 3 with those 2 embryos. 

    Well my doctor did not listen to my and my partners wish and I said yes. Although I knew that quality of embryos are crucial for successful ivf (btw we are paying ourselves for ivf).

    It turned to be negative.

    Another thing is that we would like to try one more time ivf/icsi.

    So, Sir, this is all about second opinion:

    1. Do you think that blastocyst choice is  right in my case, if yes, should I insist for that even though there is a chance of embryo development arrest.

    2. Do you think we should continue with icsi or ordinary ivf?

    3. What would be the shortest acceptable interval between 2 ivf ( I do not want to wait too long)?
    Thank you in advance. 

    ReplyDelete
    Replies
    1. Hello. Thank you for sharing all your information. In answer to your questions, certainly if you can get an embryo to blastocyst, that helps because it gets you that much closer to the implantation stage, but not all embryos will make it. In your case, the embryo quality was NOT good enough and that is probably why the embryologists did not recommend culturing further. Also, whether or not the embryos make it to blastocyst stage is highly dependent on the quality of the lab and its ability or success in culturing embryos.

      Yes, I said that the embryos were not good enough, and they certainly were not the best embryos that you could have had. The ideal embryos will be 7 or 8 cells and grade 1 or 2. The fact that they were only a 4 and 6 cell shows that the embryos were somewhat compromised. This is the likely reason for the failure in this cycle.

      In terms of trying again, in general you should skip one month in between. That usually works out well because of the premedications that are used. In my clinic, I premed my patients with the birth control pill in preparation for a cycle. That requires one month. If you use the long protocol again (2 weeks of agonist), that will require the birth control pill as well.

      Good Luck

      Delete
  6. First, thank you very much for your prompt reply. should i also try birth control pills (also while I am using Synarela, gnrh analog)? Thank you in advance and very happy New Year. Sincerely, Kristina

    ReplyDelete
    Replies
    1. As mentioned, I use the birth control pill between cycles. What you do will depend on the protocol that your doctor uses. There are no universal standards or protocols. That is what makes IVF or any fertility treatment different between doctors and clinics, which leads to differences in results. The good part of using the birth control between cycles is that it allows the ovaries to me quiescent for a month, gives control of the planned cycle to the doctor and has been shown to increase response to stimulation.

      Delete
  7. My hcg is 2 after 11 day s of et .it is good sign or i m just hoping

    ReplyDelete
  8. Hello,

    I am 12p3dt and had my Beta yesterday 11dpt. It is negative with a level of <1.2, however I still have not started my period and have no signs that it may start soon. I'm continuing my meds until AF arrives. Is it possible that I could have late implantation and could still get a positive beta if I test again?

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  9. Hi, my husband and I did a two embryo transfer on May 4th and our first blood pregnancy test came back negative which was given to us exactly 7 days later we did a frozen transfer because everything was so perfect with my body as far as the doctor said they retrieved 23 of my eggs my husband fertilized 17 they ended up only freezing 11 but during the process they said my hcg level was too high so they lowered my meds because they said if I had done a fresh transfer I would have been sick for 2 weeks so they said our two embryos we're so perfect that they should be framed so I'm not understanding why test came back negative. Do you think it's a possibility that I could still be pregnant do you recommend I continue my meds and just take a home pregnancy test?

    ReplyDelete
  10. Hi dr
    I am 38 gothrough icsi on this april my egg retrivel date was 28th april and egg transfr was on 3rd may my embryos stop growng on day 3 but they trnsfer 3 embryos of 2 of 4 cells and 1 of 6 cells
    My hcg test date was 13th may and that was a negative with 1.20
    I was on cyclogest 400mg and folica
    my dr said that continue your medicn and repeat the test after 48 hours
    On 14th may i start brown spotting just 2 spots and after that no spoting, no bleeding no cramp
    what it means and now what can i do now
    My dr also suggest that if this cycle fails you start taking glastrone tablets for 3 months and then repeat icsi again
    what do you suggest

    ReplyDelete

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