The bedside manner of a mosquito...

Alex and I vetted a *new* (to us) IVF clinic about an hour and a half from where we live, yesterday, and I'm left with all kinds of feelings after the experience.  We drove all the way there for a "fertility evaluation" to the tune of $325 for me - which included yet another draw of my E2, FSH, and a transvaginal follicular ultrasound (which I've had what feels like 10,000x at our other RE throughout our cycles and has always been normal, but "you never know what can change" so we went ahead with it).

All this is with high hopes to try something called mini-IVF or low-dose IVF to see if it will yield us better results in terms of egg quality - a theoretical approach not yet backed by research, but you have to start somewhere, right?  Few clinics are specializing in this now - this is only one of 3 within 2 hours of us recommended by our holistic health doctor (he knows of a fourth but wouldn't even tell us their name because he does not feel good about their approach).  We have tried the "conventional" IVF route where I was hyper-stimulated with all these drugs, and that clearly didn't go well as it yielded only one chromosomally-normal embryo that ended up not even holding on when we put her in.  

AND we are now on to a new supplement protocol (Alex had previously not been taking anything, and I had been on the basics that Western medicine has caught on to: a prenatal vitamin, probiotic vitamin D supplement, and CoQ10 - now we are adding NMN, Inositol, and FH Pro to that).  And back to eating Paleo per our holistic practitioner's recommendation (with extreme limitation to: refined sugars or carbs, alcohol; decreased caffeine as well) - the plan is to try IVF again in 3-4 months after being on these lifestyle changes, in the hopes it will positively affect both egg and sperm quality.  Hence, the seeing new clinics (one of which we can't even get in with until June).

The appointment itself went well, the staff was all very welcoming and kind and the testing turned out all normal results (as expected).  My follicular count is actually still quite good, they told me: "7 on the right, 7-8 on the left," as well as no uterine or ovarian structural abnormalities noted.  They also said that it's a consideration I may be on the PCOS spectrum given my irregular cycle lengths, painful periods, and elevated AMH, but the PA giving us my results stated that this should still be a candidate for mini-IVF, just not natural IVF as those patients tend to need help ovulating and maturing the eggs.  So, all sounded good.

The issue came when the physician actually got on the phone with us.  The "consult" lasted all of about 4-5 minutes, during which we told him about our lifestyle changes and the plan for moving forward, and he said, "You cannot change your egg quality.  You were born with these eggs and they have aged with you for 39 years.  Any lifestyle impacts that will happen to the eggs have already happened and 3-4 months of improvement won't do anything for them.  What can change the quality more is additional time without action, during which they continue to age.  Don't waste any more time, don't bother with supplements or large lifestyle overhauls.  Do more egg retrievals now.  It's just my opinion...and I'm just being honest with you."  

Alex and I literally sat there silent with our mouths agape, trying to absorb this.  It's what you expect to hear from any number of "traditional" RE's...but what about all the new science behind egg development - that 3-4 month period where they mature and the impacts it can make (again, looking at Fett's It Starts With the Egg)?  We were trying to figure out if it was more *sales pitch,* or sound advice.

AND isn't that the point of something like natural or mini-IVF cycles?  We couldn't believe we just heard this from one of the few doctors that our fertility expert had recommended (so of course we have set an appointment to review this with him, as well).  

One thing we know can matter that we are curious to see makes an impact is the lab.  Maybe that factor is the single most important thing to affect successful fertilization, at least in a case like ours?  Because I don't have a problem making and maturing eggs - all but one of the 38 we got in our first two conventional cycles were mature.  But the majority "disintegrated" upon initiating ICSI.  So, does it come down to technique, maybe??  Not trying to bash where we've been, but still, always looking for answers and a future solution.  Maybe just doing this with a different lab will yield us a different result.

I finally asked, "Let me ask you then doctor, what CAN I do to make a difference for our next egg retrievals, even assuming we go forward 'now.'"

"Enjoy your life."

You know what that response felt like?  It felt like one more person telling us to, "Just relax."  What a novel idea!  Enjoy my life?  We've been dealing with the pain of infertility for 6+ years while working full time and managing lots of other life stressors dealing with deaths/dying in the family, family drama, friend drama, COVID, etc.  We do our absolute best to "enjoy life" by cooking, exercising, spending time with our dogs, friends and family.  In normal years we vacation if we can afford it, but we haven't been able to do that in over a year because, you know, infectious disease.  It just felt so flip and dismissive.  As if we haven't been trying to do that for the last decade we were together and dealing with all this pain and disappointment.

SIDE NOTE: things I enjoy in life also include wine, salt and sweets.  All that has gotten me is 40 pounds heavier with beginning slight hypertension, apparently - yes that's the one result that came out of yesterday's appointment that I have now been told to monitor at home.  I'm not fully convinced it wasn't just anxiety from this whole situation, but we'll see as time moves on.  Anyway, these are things I immensely ENJOY, and all of them I'm trying to give up in the name of health.

Of course, we don't want to drop at least $20k more on another dead end road.  But that's the thing in this process.  There are no guarantees.  Everyone has a different opinion.  And the one that appears to have consensus leaves us feeling hopeless because our ages and prior results are all stacked against us.  So, do we even keep trying?  Do we even move forward with this at all?  It feels like something that would be foolish to give up on, but how far do we take it?

This is the journey of infertility: there are no black and white answers.  It feels like one large field of gray grass that you wander through and never seems to end.  You bump into things (ahem, opinions) and try a different direction and bump into more things (opinions) that turn you around and make you question the new direction you had decided to head in.  Two steps forward, three steps back.  And it's just overwhelming and can make you feel utterly hopeless.

We will see what our holistic doctor says about this experience when we meet with him Monday.  I have one more clinic to call and set up an appointment with today so we will see when they can get us in.  Praying for guidance as we try and decide on our next steps. <3