If, that is, by “Mary” we actually mean “my estrogen.” That’s the information I took away from our consultation with Dr. Werthers yesterday afternoon.
My estrogen was too low during the last IVF cycle. A follicle with a mature egg usually produces an estrogen level of about 200. Since I had 25 mature eggs retrieved, that would call for an estrogen level of 5000. My actual estrogen level right before retrieval? 1700. That’s in the target range for a typical IVF cycle but wildly low for the number of eggs I had. I suspected that having such a high number of eggs could have had an adverse effect on egg quality, and Dr. Werthers confirmed that. Some of the eggs may have gotten the right amount of estrogen, but some most likely did not. This may have been the cause of our less-than-stellar embryo quality.
However, my estrogen was also too high. I was clearly overstimulated. Dr. Werthers said that some women experience no problems from the elevated estrogen caused by IVF stimulation. In other women, the increased estrogen seems to upset the uterine lining and inhibit implantation. No one yet knows what causes the difference, but I seem to fall under the second category. Even though our embryos weren’t top quality, Dr. Werthers said he regularly sees women with lower-graded embryos go on to get pregnant. Therefore, the failure of this last IVF suggests an implantation problem related to high levels of estrogen.
What does all that mean, practically? (Besides the fact that we fail at conception.) Dr. Werthers thinks that doing a cycle with our frozen eggs might enable us to skirt around my contrary estrogen. Doing an embryo transfer on a cycle when I haven’t been on medications that cause my estrogen levels to sky-rocket just might do the trick. So that’s the tentative plan.
It’s tentative mainly because we don’t know if our insurance will cover a cycle that uses frozen eggs. Once we find out if it does or not and, if not, what our out-of-pocket costs will be, we’ll make the decision about whether or not to move forward with thawing and fertilizing a few eggs. Please pray that we will have adequate insurance coverage and that we will have wisdom about the financial aspects of this potential cycle. We’re grateful to God for how this consultation with Dr. Werthers went, and we’re looking forward to taking some new steps in building our family!