In some of my online groups of babies born in May of this year there are girls already pregnant again. There is still that stab of jealousy that people actually get pregnant when they want to (or don’t!), but then I feel a flash of something I don’t recognize. Wait, I know… relief. Thank goodness it’s not me! I think about how sick I get in the first trimester, how tired I am, how careful I try to be… and then I think of the little girl I have in my arms. I’m not ready to take away from her even a bit of my time or attention yet. We finally have what we have strived so long for and I really just want to sit with it in peace and joy for a while, to not complicate it. Plus I think it’s kind of nice having my body to myself for a little bit – no injections, no tests, no bladder pressure, no nausea or heartburn. Okay, yes, I am breastfeeding, but that’s not the same.

In fact, breastfeeding is one of the big reasons that I don’t want to start trying again anytime soon. The breastfeeding relationship I have with Kate is so very special to me, it is upsetting to think about weaning her before we’re both ready. I did some research and it definitely sounds like weaning is required – or at least highly recommended – before doing IVF. Nursing *may* reduce pregnancy rates, and obviously you don’t want to do anything to compromise a cycle. So I know I will have to wean her before cycling, and that makes me very sad. My therapist very wisely pointed out that it’s a hard decision to make, but that I’ll be hopefully giving Kate a sibling. I’ll have to decide what timing is right, which is more important.

The spacing we’re aiming at is 2 1/2 years between children. We are tentatively planning on returning to the RE to cycle again at the end of next year, when Kate is a year and a half old. That just feels so soon. Next year! Den waffles between, “It’s up to you, don’t rush into anything if you don’t want to,” and, “I’ll be 45 years old, I don’t have years to waste!” At this point I figure by the time another year has gone by I’ll hopefully be ready. So, tentative plans.

Which is why I’m so interested in IVF topics, why I went to the conference this past weekend. I kept my mouth shut about already having had a baby, I know how hard that can be for people to hear, even if Kate and Devin are both products of many IVF cycles. I avoided any kind of “intro to IVF” type sessions, for obvious reasons. The best thing about these conferences is not just information – you can get information ad infinitum online and from peer groups – it’s the direct contact with the doctors. I got to learn about the newest theories behind embryo grading from an Embryologist. I heard all about In-Vitro Maturation from the doctor who has been at the forefront of IVM and runs one of the only labs in this part of the country that offers it. And then everyone in the room got to ask questions of the doctors and talk directly with them. “What would you do in this situation?” “Do you agree with my doctor’s reasoning for this protocol?” “Would this new technique you mentioned be of use to this type of patient?” I really feel like there is no substitute for this kind of interaction. Nowhere else can you sit down with a group of REs and PhDs and pick their brains. Nowhere else can I get the same kind of feel for the newest technologies, protocols and theories.

The first session I went to was about treating low responders and low ovarian reserve. I am obviously not a low responder, but I get very few embryos, like low responders do, so I had hoped that they would have information that could be of use to me. Unfortunately mostly what I learned was that the poor quality embryos that result from a person with low ovarian reserve is not at all comparable to the embryos that I get after my crappy fertilization results. The session was very good for the women who deal with that problem, however.

The next session I went to was a “journey through the IVF lab” – exactly what they do, what they’re looking for in the follicles, the eggs, the embryos, and how they do what they do in the lab. This one was truly excellent and while we ran over time everyone in the room had so many more questions. I really think they could have stretched that one into a full day session and we would still have wanted more!

After lunch I attended the session all about In-Vitro Maturation, which was very informative. IVM, for those of you who don’t know what I’m talking about, involves retrieving all your eggs in an immature state, without going through stims, then maturing them all in the lab. This is great for PCOS patients who severely hyper-stim, or other patients who have some other reason for wanting or needing to avoid putting their body through the stress of stims. They also use it for cancer patients who want to preserve their fertility and need to do it quickly before their treatment. Unfortunately for me, there are two main take-away thoughts from this session. First, that the technology still doesn’t produce the success rates that normal IVF cycles do, the body does tend to do a better job of things though they are getting better and better at achieving egg maturation in the lab. Second, he was very clear that in order for IVM to work the eggs need to be retrieved early enough in the cycle. Which means that for people like me who end up with a shit-ton of immature eggs after stims and retrieval, their IVM techniques will likely not help those eggs. Bugger. (His reasoning, which is based on data he showed us in some charts, is that at a certain point in a cycle, roughly halfway through stims, there seems to be a point where eggs get “programmed” to either be mature and healthy or be immature and die. In a normal cycle only one egg of the antral group will end up being mature and released, while the rest all die off; the studies seem to indicate that this is a factor even in IVF cycles where a much larger portion of the eggs end up mature.)

The last session of the day I went to was a split session between an Acupuncturist and a Dietitian, both who specialize in working with IVF patients. The acupuncturist was interesting. I saw an acupuncturist during my last stims cycle (the one that ended up getting me pregnant with Kate). It’s a tough subject for me, because in some ways it does make sense and it seemed to help… but on the other hand some things they talk about, like judging your body condition by your pulse, just seems a little bit weird and far-fetched. I am on the fence about spending the money to do acupuncture the next time around. I had hoped that this session would tip me in one direction or the other, but it didn’t. I’m still squarely on the fence. I’d like to say the dietitian gave good info, but honestly I started blurring out most of it – there were a lot of graphs about proteins and genetics and probabilities in sample groups and not a whole lot of summarizing of these unintelligible details. I think the only thing I really took away from that is that there’s a reason I’m not a dietitian.

I have a few questions jotted down to ask my RE whenever I go back. Whatever we end up doing, I remain fascinated by it all and I have a drive to understand what exactly my body is doing. Especially since I saw two other women at the conference who mentioned having the same results as I do: highly sensitive to stims, lots of follicles, lots of eggs, very few embryos. It does not appear to me to be as rare as I initially thought it was. I wish there was more information out there, more resources. I may have to start putting together something.