The hardest part of IVF

The hardest part of going through in-vitro fertilization (IVF) isn’t the physical part. It isn’t the daily injections that you have to give yourself, or having blood drawn every couple of days. It isn’t the sometimes severe abdominal bloating from the multiple grape-size follicles growing in your ovaries (if you’re lucky enough to grow multiple follicles). And it isn’t even the surgery to retrieve the eggs from the follicles, which involves an IV (I hate IVs) and a fairly substantial needle puncturing your uterine wall from the inside (you’re welcome for that visual).

It’s the waiting. And waiting…and waiting.

In the special case of donor egg IVF, there’s additional waiting before you can even start the process. We’re still waiting to hear if our egg donor, Marie, passed her genetic tests. In the meantime, we got special permission from our favorite Belgian egg donation nurse, Bernadette (voilà!), to do my test-run with the new hormones (the so-called ‘try-cycle‘) before actually getting the results. Luckily, I passed that test on the first try — I think perhaps the first thing that’s gone ‘right’ in this whole process…? I may not have any eggs, but I can still grow an endometrium LIKE A BOSS.

We got even more good news this week: our case was presented at the bi-monthly staff meeting, and Marie was approved as our egg donor! I wasn’t too worried about this part — as her in-person screening appointments didn’t seem to raise any red flags — but it’s still nice that it’s official. However, her approval is contingent on her genetic tests, which are still not back from the lab…

Why is this a problem? Well, because we’re trying to get the actual donation cycle done over Marie’s summer break, our timeline is rather tight. We have tentatively planned Marie’s first ultrasound for 9 July, which would get her back home before she starts teaching. We even bought the flights(!), though with cancellation insurance of course. But to make this timeline, I need to have an injection on 26 June that they will only give me if Marie’s genetic tests are ok. And can you guess when those test results are due back? On 27 June…exactly one day too late.

Apparently this process can’t be rushed, at least at our clinic. However, Bernadette worked her magic on the lab technicians and convinced them to send the results by 25 June — two days earlier. That means we should find out if this cycle is a ‘go’ in time, but only at the last possible minute. Because obviously this whole process isn’t suspenseful enough already.

That brings us back to the waiting. In the best case scenario, the test results will come back on 25 June, and Marie will be fully cleared as our donor. Then I can have my injection on 26 June, and Marie will fly out in early July with both her kids (who I like to think of as ‘Model A’ and ‘Model B’). We will all drive to Belgium on 9 July for her first ultrasound. If everything looks good there, then we can move on to the next of at least eight more distinct stages of waiting. Because that, my friends, is IVF in a nutshell.

What genetic diseases will our donor be screened for?

In just a few short days, our egg donor Marie and her husband will be flying in from the US for her screening appointments in Belgium. In addition to meeting with our doctor, a psychologist, the coordinating midwives, and etc, a big part of the jam-packed day will be a meeting with a geneticist. This geneticist will be searching for any genetic diseases that may preclude her from donating her eggs to us. But what genetic diseases will they be screening for, specifically?

There are four tests she needs to have, and the only one she’s had so far is the chromosome analysis. As I described in a previous post, Marie found out that this test can be done much more quickly in the US than Belgium, and she even convinced her doctor there to write up a lab order. However, we still weren’t sure if the results would come in before the screening appointments next week. We even had a bet about what would come back first: the results of the chromosome analysis, or her new passport. (I was betting that the passport would be the last to arrive, leaving us biting our nails until the very last minute.)

Well I lost…the passport came back first. But we also got the results of the chromosome analysis! All normal, as expected for that particular test given that she has two healthy kids. That leaves three more tests that she will need to have done when we’re in Belgium next week.

What are the additional tests?

The are three other diseases that they specifically screen for:

  • Fragile-X: A genetic disorder characterized by intellectual disability, behavioral challenges and certain physical traits like a long face. The likelihood of carrying this gene is higher for women, where approximately 1 in 151 are carriers.

  • Spinal Muscular Atrophy: A genetic disorder that affects the control of muscle movement. Approximately 1 in 50 people are carriers.

  • Cystic Fibrosis: A genetic disorder that causes severe damage to the lungs, digestive system, and other organs. Approximately 1 in 23 people are carriers.

We were a little shocked to learn the statistics for these, especially for cystic fibrosis. Even if Marie is totally healthy otherwise, and even though my husband would also have to be a carrier to result in the baby having a 1-in-4 chance of getting CF, they won’t let her donate if she’s a carrier.

Then is that it?

So if Marie passes all of these tests, then does she get the all-clear to donate? No, because as I’ve mentioned before, we’re apparently trying to create a genetically-flawless, award-winning baby.*

The geneticist will therefore also check her family history for a number of other inheritable diseases. They won’t say exactly what they’re looking for — I think partly because they know people would just lie if they knew. But I understand that a few of the ones on the no-fly list are breast cancer and other inheritable cancers, autism, and epilepsy.

If they do find any of those, then Marie’s out of the running, and it’s back to the drawing board for us. That would be extremely frustrating — to say the least — since most people with any number of issues can pop out a baby any time the mood strikes them. It would also be quite a blow since we had such a difficult time finding a donor in the first place. So let’s hope that doesn’t happen, and that we can move on to Stage 2 of creating this genetically-superior wonder-baby.

*(Unless my husband has any diseases, which they don’t care about in the slightest. It’s perfectly legal to pass down your own genetic problems to your baby. You just can’t give them someone else’s!)