Locked Down, but not Out

Since I've had a few people ask, I thought I'd let anyone wondering know that the next step in our IVF treatment will be postponed until the COVID-19 emergency is under control, and normal routines and services can resume. For those reading this overseas, as of 11:59pm tonight (Wednesday 25th March 2020) New Zealand is going into complete lockdown, with the exception only of essential services. For most people, this means remaining in their homes with the exception of trips to the supermarket/doctor/pharmacy if necessary, and we are allowed out to walk in our neighbourhoods for 'fresh air', provided we maintain social distancing from others of at least 2 metres.

Following the Prime Minister's announcement on Monday that we would be progressing to COVID-19 alert level 4: Lockdown within 48hours, a generic email was sent out from Fertility Associates. It provided a case-by-case list of what the plan would be for people depending on what stage of treatment they were at. As I have not yet started medications for my embryo transfer cycle, or been given a date for transfer, it will happen at a later time. We had figured over the last week or so that our cycle would likely be postponed, particularly since our next step, embryo implantion, would involve return travel from Nelson to Christchurch. We are feeling pretty relaxed about it, and feel fortunate that our cycle is at a good natural stopping point. As things stand, we have two healthy, unaffected embryos safely frozen, where they can stay for weeks, months, or even years if necessary. When society is able to return to normal, however long that takes, I can start the hormone medications in preparation and be implanted then. In the meantime, we will hunker down and wait this out with everyone else (from a socially distant proximity). I also figure now probably isn't the best time to get pregnant given the strain already placed on healthcare, and presumably maternity facilities will be extra busy in nine months time given the extra alone time many couples now have!

Stay safe out there everyone.

The Odds are Even

I had a missed call on my phone while I was at work yesterday, which I frustratingly didn’t see until after the Fertility Associates clinic would have been closed for the day. The specialist left a message saying they had our results (already!), and after some back and forth I was finally able to speak to them this afternoon. Of the four embryos biopsied, two were affected by the SCA3 gene, and two were unaffected. A textbook 50% transmission rate! We are super happy that we have two healthy, unaffected embryos so that we can have one implanted and one in reserve. It’s also great that the results were clear and that none came back inconclusive, as that could have required further testing and more agonising waiting. Both of the unaffected embryos were ones that were graded AB, so are also two of the higher quality embryos.

Autosomal dominant conditions like SCA3 mean each embryo has a 50% chance of inheriting the gene.

So within the next couple of weeks, I am to arrange with my GP to have my IUCD taken out some time before my next cycle starts. We will be using a ‘manufactured cycle’ to prepare my body for implantation, which means I will be taking more hormone medications to simulate what my body would be doing naturally had we conceived the conventional way. I am to call the clinic on my day 1, and they will advise me to start taking Progynova (estradiol (E2)) tablets. E2 is the main estrogen hormone usually released by developing follicles, and one of its purposes is growing the endometrium (uterine lining), which is what I’ll be taking it for. Fertility Associates will also make me an appointment for approximately 10 days later for a scan and blood test in Nelson to check my body’s response to the Progynova. They will also dispense Utrogestan (progestone (P4)) vaginal pessaries. This is another hormone normally made by a follicle once it has secreted its egg, and maintains the endometrium so that the embryo can implant and cause a pregnancy. An appointment will be made for approximately six days after the scan and blood test at the Christchurch clinic for an embryo to be implanted. Two weeks later I will have a blood test to see if the implantation has successfully resulted in pregnancy. From there, if I’m pregnant the risk factors will be roughly the same as a naturally conceived pregnancy, and so hopefully everything will progress normally from there. 

This is all starting to feel very real!