When hubby and I started our journey to grow our family, we knew that it would be a difficult one. Knowing that and actually accepting that, I’ve learned, are two very different things. After a failed IUI, a pregnancy loss following our first round of IVF and two failed Frozen Embryo Transfers, we entered IVF round 2 with caution.“There’s no telling how many miles you have to run while chasing a dream.” — Anonymous
We met with our Reproductive Endocrinologist to discuss our options going forward… always a scary, especially because I know my dreaded Advanced Maternal Age will inevitably come up. We had 17 eggs retrieved during our initial IVF cycle, with 6 making it to the blastocyst stage. Because of this, our RE was concerned about the actual quality of the eggs retrieved. Currently, the only proven way to improve egg quality is through the use of a growth hormone.
Growth Hormones in IVF
The concept of using growth hormones (GH) in fertility is not a new concept (it was actually initially reported 20 years ago). As women age, their eggs do as well. Aging can cause a weakness in the spindle in the egg where chromosomes line up to divide following fertilization. When the spindle fails, as the fertilized egg begins to divide, chromosome may not distribute evenly. Instead of a pair of chromosomes going to each cell, three chromosomes may go into one cell, while one chromosome goes to the other. This results in an abnormal genetic makeup (incompatibility with life, birth defects or genetic disorders).
This was very appealing for us, especially since our first pregnancy ended due to a chromosomal abnormality called Trisomy 22, which is not compatible with life. Although we were hopeful that this was a random mutation, and our remaining embryos would be healthy, none of our remaining four embryos resulted in pregnancy.
In addition to adding GH to our regimen, our RE recommended changing our protocol for IVF round 2. For our initial IVF cycle, we utilized the long protocol, as, although I am AMA, tests showed that I have a good ovarian reserve (the capacity of the ovary to provide egg cells that are capable of fertilization resulting in a healthy and successful pregnancy).
For IVF round 2, our RE recommended that we use to Antagonist Protocol. Often in cases of women who have polycystic ovarian syndrome (PCOS), this protocol is preferred because it utilizes fewer stimulation medications to stimulate egg maturation. Stimulation medications often worsen these conditions with more hormonal exposure.
For this cycle, in addition to the GH, I will be taking Ganirelix, Follistim, Menopur and Letrozole. Here is a brief overview of each shot’s purpose:
Ganirelix Acetate – Ganirelix rapidly suppresses the pituitary gland in a matter of hours. By “turning off” the body’s natural hormones, they are less likely to interfere with IVF medications. The IVF medications take over by directing egg maturation, egg release, and preparing the uterine lining for implantation.
Follistim- It is a recombinant follicle stimulating hormone that helps healthy ovaries to develop and release mature eggs.
Menopur- Menopur injection contains human menopausal gonadotrophin as the active ingredient. This is a combination of two naturally-occurring female hormones, follicle stimulating hormone (FSH) and luteinising hormone (LH), extracted and purified from the urine of post-menopausal women. Menopur stimulates multiple follicles and helps eggs to develop.
Letrozole – Letrozole works by suppressing estrogen production, which in turn results in the pituitary gland producing more of the hormones needed to stimulate the ovaries.
Now that we have our plan in place, we are so excited to get started! Fingers crossed for a successful cycle and summer baby 😉