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parenthood after dealing with male factor infertility and multiple IVF cycles

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Decisions, Decisions April 21, 2005

My husband and I discussed our big dilemma last night. We both came to the same conclusion. We’re going ahead with the FET.

There are a few reasons for this but they all boil down to the fact that there just isn’t enough evidence out there to prove that this beta 3 integrin test is the end all be all with regards to the functionality of the uterine lining. It’s an experimental and controversial test with a wide array of opinions as to its applicability.

The studies are all over the map on this subject. There are studies that show that the beta 3 integrin isn’t consistent among cycles even within the same person. So it could show up on a biopsy one cycle and not the next. There are also studies that show that just because the integrin isn’t present in the mid luteal phase doesn’t mean it won’t be present in the late luteal phase. Some studies show that it doesn’t even matter if it’s present at all. And then there are studies that show that the lack of the integrin reduces the chance of pregnancy. There are just so many different views about the ramifications of this test. Plus, it doesn’t seem like there’s been a proven cause-and-effect relationship between the presence or absence of this type of marker and its effect on fertility.

There’s also my personal situation to consider. This biopsy was done in an abnormal cycle. My body was so screwed up from cycling back to back for 7 months that it decided to bless me with a fucked up 44 day cycle. And there’s the fact that we’ve had implantation. Sure, it didn’t last very long but an embryo did implant.

I saw someone with a similar background post a question on one of the “ask the RE” type message boards about this test. Like me, she had experienced both failed cycles and a cycle that ended in a chemical. She had the beta 3 integrin test done and it came back with the same result as mine: out of phase with the integrin absent.

The doctor replied that the beta 3 integrin is only one of many molecules that are involved in the attachment of the embryo to the endometrium, and that in something as important as embryo implantation, there is significant redundancy built into the system. If one type of cell adhesion molecule is absent then other molecules can take over that function. He went on to say that he didn’t think that the absence of beta 3 integrin should prevent her from trying to conceive, particularly in view of her recent chemical pregnancy which clearly demonstrated the presence of cell adhesion molecules that allowed implantation to occur.

Given all of that, we didn’t feel like repeating the test at this juncture would be the best course of action. Last night we decided that unless my RE had some compelling reason for us to repeat the test that we would go ahead and do the FET.

My IVF coordinator was supposed to either have my RE call me today or at the very minimum speak to her and relay her opinion on the matter to me. I waited and waited for the phone to ring, but it never did. I finally called my RE’s office at 3:00 and apparently my IVF coordinator had discussed it with my RE but she had to leave early to pick up her sick kid from school so she must have forgotten to call me. Thanks a lot. So the receptionist played relay between my RE and myself over the phone. Lovely.

My RE recommended that I redo the test. When I asked why I was told that it was because the test was inconclusive. Um, yeah. I kinda got that part already. You got anything else, because in and of itself that’s not a very convincing answer. I was told that we had three choices and that it was ultimately up to us. We could:

1. Do another endometrial biopsy to have the test redone.
2. Go ahead with the FET knowing that we could lose embryos.
3. Do the 3 month course of Lupron treatment before cycling again.

Let me just go through those options for a sec. 1) Yes, this may give us more answers but we may waste another cycle and another $1,000 to find out the exact same thing: nothing. Even if it showed something different, how would we know what would happen the third time? And how do we even know if the findings really mean anything at all? 2) Um, we have a good chance of losing embryos anyway. Thank you very much. Don’t you always have a chance of losing embryos? I sure do. We’ve “lost” our fair share already. 3) So, you want to put me on a treatment that we don’t know I need, nor do we know the effectiveness of, nor do we know if the “condition” even warrants treatment? A treatment that knowing my body could very likely end up ruining the next cycle anyway? No thanks.

Another reason I’m ready to go ahead with this FET is that I’m ready to get the hell out of my RE’s office. That’s not a good enough reason in and of itself, but I’m so done there. I’m not getting what I need, and I need to move on. The RE that I want to get a second opinion from doesn’t accept frozen embryos from outside labs, so I need to transfer them where I am. After that we’ll be free to go elsewhere.

So, my ultrasound and bloodwork appointment is tomorrow morning. Holy crap. I might actually be cycling again.

• Posted in : IVF Part 4: FET #2, testing, testing, 1,2,3
• Author : amanda

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