Second Opinion

Brugge
My fiance dropped me off at the general hospital of Brugge.  He has a meeting so I have to do the first meeting with our new fertility doctor alone.

He's a skinny, not-so-tall man who wears eyeglasses.  He called my name and I was really surprised it did not took me forever to wait in the waiting area.  He has read my files already and went straight to how he would handle our situation.

He would want to:

1. do a hysteroscopy to check if everything is still okay with my uterus and see how the salpingectomy was done.
2. do a series of blood tests to check if i have clotting problems, hormones that are not being produced sufficiently
3. start of with a whole new hormonal stimulation layout
4. in case of overstimulation, he will wait for a month before he will do the transfer.  That way my ovaries will have the time to go back to its regular size and my uterus will go to normal as well.

A few weeks later my fiance came along with me and met him for the first time.  He is a bit sceptical about starting up with a new hormonal scheme because we are never really sure how my body reacts to it.  He would as much as possible want to avoid hyperstimulation and avoid another losing cycle.  So our fertility doctor said, "I work part time in Jette at the university hospital of Brussels. I will take your medical files in there if you agree and discus it with my colleagues to be able to provide you the best treatment possible."  Which we agreed on.  The fertility clinic of the UZ Brussel is very well-known however it is 105 kilometers from our home.

Whilst waiting for further information from UZ Brussel, we started with the tests that Dr. Van De Vijver advised us to do.  My hysteroscopy was normal and my blood tests as well, except for my Thyroids that is having troubles producing enough hormones causing my TSH gland to work at its maximum to cope up.

On our third meeting with Dr. Van De Viyver, we both decided to have our third cycle done with him.  UZ Brussel suggested the same procedure as he would but with higher dosage.

Unanswered Questions

We have questions and we want to get the right answers from the right person.

What went wrong with our last ICSI cycle?

Doctor:  Your hormones are too unstable it is difficult to predict how your body reacts to the subcutaneous hormones. Hence resulting into OHSS.  You were lucky it did left any severe damage apart from having a swollen lower abdomen and weight gain.

Why did the embryo not implant in my uterus?

Doctor:  That is something we have no control over.  It is the nature of the embryo itself that decides whether or not to implant in the uterus.

Maybe it is because my uterine lining was not thick enough?  Why did you not do a test and check for the thickness of it?

Doctor: your uterine cavity is thick enough and ready for implantation, there is no need for a check up.


Why do our embryos stop developing at some point?

Doctor:  Again it is the embryo itself, there is nothing you can do about it.

Are there tests that we can do to  improve their quality so we will at least not waste a cycle and try again with a first cycle every after one transfer because we never got to the point where we have embryos in the cryo for preservation?

Doctor:  Not at the moment no.

Maybe you can do a hysteroscopy to check if everything is okay with my uteurs?

Doctor:  There is nothing wrong with your uteurs.  You have a child already so I don't think something is wrong with it.  It is not necessary.

A week later I told my fiance that I want to ask for a second opinon from a different hospital.  I informed our doctor and she was more than willing to hand our files to us.

ICSI: Our Second

A month after our first IVF/ICSI cycle, we tried for a fresh cycle.  Hopes were up again and we have nothing to lose.  Our gyne suggested we start with a higher dosage Puregon because I did not react right away with our previous cycle.  As patients, you trust your doctor's competence in his/her field.  She studied for it and know that she will take good care of you as a person and make sure nothing fatal will happen to you.  It is how it goes everywhere.

I reacted well with the medicine but way too well.  I was swollen, I gained >6kg in days time, I had difficulty urinating and my lower abdomen is swollen and painful.  Yes, I had an ovarian hyperstimulated syndrome (OHSS).  Too many follicles growing in varius sizes which the doctor advised to stop with the treatment for five days and guaranteed us that the follicles that were mature enough for aspiration will stay the same.  They aspirated 6 eggcells of which 5 were fertilized and out that 3 developed further.  They decided that they will do the transfer on the third day

We had a good looking embryo according to the Dutch doctor at the university hospital.  We were told that a 3 day embryo has the same equal chance of surviving and implanting in the uterus as a five day old embryo.  That was a relief for us.

So then again, I was clinically pregnant.  The doctor advised me to stay home dating from the pick-up of the eggcells until the first HCG blood test.  This time, in contrary with our last cycle, I did not have any lower abdominal cramps at all.  We supposed that was a good sign.  

I know I wasn't suppose to do any HPT before the first blood test but waiting is really not my best asset.  I bought five tests and I tested each day before the blood test.  All tests came negative, no slightly or blury second pink line.  Each day I was devastated and it was probably the five most exasperating moments in my fiance's life but he showed empathy towards me and told me we should not get our hopes down yet.

The blood test came negative and we felt lost for a while.  To worsen it all, the last two remaining embryos stopped developing and we don't know why.  I contacted the fertility consulent again and told her I would want to make an appointment with the doctor because it is our hearts' desire to talk to her about the whole cycle, where it went wrong and what their future plan is for us.  She replied telling us, send all your questions to us and we will relay it with the doctor and we will relay all her answers to you.  When she said that I just got furious!  How dare she to not give us the right to speak to our own doctor personally!  She eventually gave in and gave us an appointment.