IVF - Take 2

My wife called in today to alert the doctor of her period, and we have our schedule set for this our second cycle of IVF.

This time around the meds have been tweaked a bit to hopefully tighten the time spread of the developing follicles. In the first cycle the development of the follicles were spread out a bit and several eggs fractured during the retrieval. On the theory that those were the older follicles which fractured because they were overripe, we're pushing for a tighter spread to hopefully come out with more eggs to fertilize. If that doesn't pan out, we'll likely still do as well as the first time which was well above average for our age. (The doctor says that's because my wife is PCI-ish and as a result responds a bit better to the stimulation.)

We're also in a better position in regards to implantation and after. It turns out my wife's blood sugar was not nearly as controlled as we had thought. After posting some pretty good A1C numbers in past testing she got a bit lax about testing herself. It was something like double what it should be. She's now on slow-acting overnight insulin to get her morning number down, and we are both exercising and eating better. The control is very good now, and we are confident it will remain so. High blood sugar can interfere with implantation or cause a higher incidence of miscarriage, so this is an important factor. As those of you who have read my precious entries know, our first cycle ended apparently with what is known as a chemical pregnancy. We got one hint of a positive urine test, then nothing. False positives are practically unheard of, so we're pretty sure at least one of the three embryos we put back in started to implant then failed. With the blood sugar in control we've removed at least that one big obstacle to a successful implantation this time around.

In our first cycle we had five embryos of varying quality, the two least of which were not put back and subsequently survived longer than expected. We have discussed it and even though there is a risk of multiples we have decided that if the number and quality of embryos were the same this time we would want to put them all back. If the quality is higher, though, we may limit the number accordingly.

We had been talking about having my younger sister in law carry for us, but my wife really wants to try this time on our own. Also my SIL is having some tight finances at the moment, and taking the necessary time off might be a bit of a stretch for her. We'll see how things go if we need to do a third cycle. I don't think we could afford any more tries beyond a third, though, so if we do a third I'm inclined to push for at least a tandem transfer to her and my wife if possible to maximize our chances for that final shot. But like I said, we're optimistic about this cycle.

So that's how things stand. The retrieval is estimated to be around Nov. 20th. Hopefully the cooler weather will help a bit with the sperm quality. If all goes well we should be having a baby next summer.