We met with the RE today and continued to discuss what to make of the latest failure and where to go from here.
He said that our repeated failures are most likely due to chromosomally abnormal embryos. However, he also said that we make lots of good-looking embryos and that based on that (and my age), he thinks we will likely succeed if we stick with it.
He emphasized that we're not near the end of the line, even though emotionally we may feel like it. He said we should not even consider donor egg at this time because he still really thinks we have a good shot at having our own genetic child.
In terms of specifics, the RE said that my eggs tend to be almost all mature at retrieval and that it's possible they would be more likely to be euploid if we triggered a day earlier when they are a little smaller than is the typical optimal size. He also said we should definitely do co-culture again.
We also talked at length about PGD. He said we could consider doing it at this point, but he doesn't really recommend it because research demonstrates PGD results in a lower live birth rate when it is used (because of the trauma to the embryos and the possibility of false positives/negatives caused by mosaicism). He said, though, that he would understand if we desired to use it just to get a read on what's going on with the embryos (even though it would lower our chances of success) and will do it if we want to. We asked if we could transfer the best looking embryos and then do PGD on any of the embryos we don't transfer, and he said that yes, we could.
He said also that given the number of failures, it would make sense at this point to look into other potential issues impacting implantation. One possibility is undiagnosed endometriosis, another is lining issues. So, he's fitting me in for a laparoscopy and hysteroscopy next Thursday to look for endometriosis and uterine issues. He'll also do an endometrial biopsy at that time to send to a colleague at Yale who does some sort of experimental testing on the lining.
We told him that we'd consulted with the head of the famous IVF clinic in Colorado and that we were going to get a consult with the head of the other great NYC clinic just to get their thoughts. He was supportive of this and said that it made sense to get second opinions. He continued to say that microarray is just not proven at this point and that it wouldn't be ideal for us because of the paucity of blasts anyway.
So that's it. Surgery scheduled for Thursday. Another consult with the other clinic in NYC the Monday after that. Colorado on hold for now.
What a whirlwind. Reasonable plan? We're not sure. Will and I both feel that our heads are spinning. And our hearts? I couldn't even begin to tell you about our hearts.
I feel like we'd agree to almost anything at this point. General anesthesia with intubation? Sure! Stomach pumped up with gas? Sounds grand! Abdominal incisions? No problem! Need to chop off my right arm? Here, just take it now! Oh, wait...that's going a bit overboard. Unless it might help...