Supporting my sister

Some background - My sister is 24 and she and her DH have been trying for baby number one for over 12 months now. She had known endo and had originally thought this was making TTC difficult, she has had her first appointment with the FS and has found that she has low progesterone and a very low AMH. Her FS has said that at 24 yo she has the fertility of a woman between 38-40 and has poor egg quality. Her DH has normal fertility. She was very upset when the FS didnt have any appointments for five weeks but is coming inearly to see her next week to get things started, this has made her very anxious that she is running out of time

She has asked me to attend her next FS appointment as her DH may not be able to attend due to work commitments, though she says she would like me there either way as she understandably gets very emotional and has trouble retaining all the information she is given. Her Dh has also said he would like me there although Im not sure how normal it is for 3 people to turn up to a FS appointment ;)

Other support my sister has is my BF has been through fertility treatment and they are in touch via email and a colleague of hers has also been through IVF. My mum is trying to be very positive about it all which is upsetting my sister, her MIL said well at least its not her DH's fault :doh: and Im trying to be practical and to offer her someone to just listen. I am feeling some guilt (which I know is irrational) as my DH and I have been blessed with normal fertility. They are also going to speak with the counsellor at the clinic

So my sister has asked me to help them come up with a number of questions to ask her FS so far we have

- what are R's chances of getting pregnant through IVF and in what time frame
- is ICSI recommended in her situation
- would they initially transfer one embryo or 2
- what are the chances of multiple pregnancy
- is there an increased risk of chromosomal abnormalaties due to poor egg quality
- how many eggs would they hope to collect in a transfer
- is R likely to go into ealry menopause given her results
- what will the process be meds, egg pick up, transfers etc
- costs
- any reccommended supplementary therapies, lifestyle changes etc (R said the clinic was advertising a trial involving acupuncture so she is keen to find out more about this)

Any other questions/suggestions would be great. Im hoping to just sit quietly in the background and take notes for her.


I have offered down the track to be an egg donor if needed but I have my FX for hard for her and her DH to fall pregnant quickly with IVF

First of all, I just wanted to say your sister is very lucky to have you. This is a very difficult journey to go through. I can only imagine what it would be like being so young :(

I could answer some of the questions you have listed but I will leave it up to the clinic and FS. Let me know if you have anything you want answered straight away though :)

On to more practical things....
If I were you I would take a pen and paper to take notes. It just makes it easier to remember everything! That said, the clinic should have lots of handouts and info on their website. Your sister should also be able to ring them and ask questions when she needs to...After all, she will be paying enough! (it's about $8500 up front each cycle, plus day hospital fees and anaesthetic, etc).

Other things she might like to ask about -

Side effects of medications
Time needed to take off work for all the appointments (I found this particularly stressful)
Does the clinic do 2 or 5 day transfers
Additional cost of any medications (not all are included in cycle cost)
How long does the FS think she has in terms of egg supply?
Is the clinic open everyday?
The other thing to think about is emotional support. The hormones muck you around emotionally and physically, making the whole thing more difficult. Maybe you should suggest to your sister to join BB to chat with others who are going through the same thing??? Just a thought :)

I hope this helps! Wishing your sister all the best :)

Hi,

It sounds like you're doing a wonderful job of supporting your sister through a difficult time. Well done!

I think it would be fine to have you at the appointment, just get her to introduce you when she is called in and explain she thinks she'll benefit from having the extra set of ears paying attention in the appointment. I think she will appreciate having someone other than her DH, who knows all the ins and outs, to talk things over with. i would have likes that, anyway. My DP had a limited tolerance of discussing the fine details and the possibilities.

Be aware that the clinic may well have a standardised protocol whereby the FS gives the overall picture, and then more specific information comes from different individuals along the way. For example, regarding costs, we had an appoitment with the accounts person who went through the costs in detail with us, just after the first nurse appointment. The FS didn't really know what the out of pockets would be for us, as he said, he puts his effort into staying up to date with fertility techniques, not medicare rebate changes! But the accounts appointment was absolutely clear and specific about all aspects of payment. My clinic also offered a monthly group session with the embryologist, which was extremely informative. Ask anyway, just don't worry of he asks you to get more detail from another memnber of the team. Obviously for certain issues the FS is the one to ask - re ICSI vs IVF, other tests, egg supply, etc.

Other questions might be:
Are there any other tests which are worth performing on your sister under the circumstances?
What days does the clinic perform the key procedures (I've heard of one clinic that only does EPU on a Wednesday - too bad if your follicles aren't quite ready yet!)
Given the low egg quality, are there any strategies they should consider for the future, eg, would they push to collect more eggs now to increase the chances of having viable frosties, in preparation for them expanding the family in a few years time? Or, for example, do a freeze all, and then another stim cycle, if not many good embryos developed first time, rather than transferring what they've got straight away?

I second N2L's suggestion of inviting her to join BB. :)

Good luck to her!

good on you for being there for your sister - being young and facing fertility issues is really scary, so definitely a good idea to have someone a little further removed that can take in the facts, and try and take the emotional filters out of it (as much as a sister can anyway)

i agree about taking notes

most of the questions i'd have suggested have been answered already - one that i waited til my tenth cycle to ask (cos i was scared he'd not think it relevant) was whether he could think of any alternative therapies to use alongside the IVF for increased chance of success. i had hit desperation point, and after much reading and research myself, i asked if accupuncture would help. he admitted the studies were inconclusive, but he wouldn't say no it wouldn't help, as he'd seen success with others. he couldn't recommend anyone as he wasn't local, but he asked the clinic nurse to research it for me. i ended up finding someone myself, and it was that cycle which resulted in our DD. it was the only thing we changed from previous cycles too. it may not be a first appointment question, but something to check out at some point. if she doesn't want to ask the FS, perhaps do some research on the help it can provide. i just had basic cycle support, but others have used accupuncture immediately before and after transfers to great effect

Thanks so much ladies, they are some great suggestions and extra questions,
pholi -Ill keep in mind the different questions for different people and make notes of what she needs to ask who. And stooring frozen embies for future pregnancies is another thing she wants to know about but I think at the moment she is even wondering if one pregnancy might be possible :cry:
BG- thanks for the suggestion, she is keen on accupuncture and now has private health cover which will pay part of the cost so she will be looking into it
N2L-thanks for the suggestions, Im a nurse and didnt even think to ask about side effects :redface:, I think we had put down how long did he expect her egg reserve to last, this is one of her biggest concerns for obvious reasons

Im planning on taking a notebook and sitting in the corner scribbling down the answers. Unless she forgets something she had wanted to ask Ill try and keep in the background and maybe have a coffee +/- chocolate and a debrief with her after the appointment as my MIL will look after my DD's for the morning

From what my sister has told me she will either be in the middle of a stim cycle or having a transfer (all things going well) when my 3rd baby is due so Im sure that will be a hugely emotional time for her with all the hormones and hopes and anxieties about her chance of a successful pregnancy then having our baby right in her face :( I know she will be happy for me but I can only imagine the feelings she will have at the time. She has been looking at different forums but hasn't found anything that suits yet, I might have to suggest BB to her now :)

BB is great when ttc. Although there are also lots of preg people here but if you can ignore that when you're feeling dodgey the support of the girls in the LTTTC & AC thread is fantastic. And is keeping me sane while trying for my first.

I think as long as you are sensitive she will be fine. There may be times she diesnt cope with your pregnancy but if you ate understanding and appreciative of the efforts she does make she will appreciate that. The worst thing is when people get angry or upset when you are just trying to protect yourself.

The others covered the questions to ask - so I have nothing to add in that regards. I just went with the flow and am trusting my FS to start - but I rely on DH to ask questions cause I usually can't think of any! Maybe next time I'll get the girls here to help me too :)

If she thinks too much she's in danger of stressing herself out a bit - so helping her to stay realistic but calm is important.

So nice to read a sister taking the effort. But it sounds like she really trusts and values your support and that is such an honor! I could never have my sister that involved! She looks at me with too much sympathy about the whole thing!

I really hope all goes well for her and she gets her BFP quickly. Send her our best wishes xx

My sister hd her appointment today, her DH managed to get the day off but they both wanted me there so I went. She had good news after a cycle where she had really low progesterone she had a good cycle last month and ovulated which was great news, the FS said he was quite concerned with the first results but was more optomisitc after her second cycle. Her FS said she could continue to try to concieve unassisted if they wanted to and said waiting is not likely to reduce thier chances of having a baby but could impact on them having a larger family if thats what they want.

She asked a lot of the questions she wanted, spoke to the finance officer and now has an appointment with the nurse and counsellor to begin IVF/ICSI they said they always do a split round the first time to see what is more effective. She is really happy as the clinic is one of the cheaper ones and or her first cycle it will cost her about $2000 out of pocket including drugs, bloods, scans EPU, FET etc plus $250 for day admission for EPU and $250 for storage if they have extra embies

They go back early feb and if there has been a cancellation they will start that month, if not it will be in March. The FS told her with IVF she has a 30% chane to concieve which she wasnt thrilled about after but then I siad look at as roughly a 1:3 chance, which she liked the sound of. Im very excited for my sister and have my FX she gets some more good news soon :). It was nice to see her smile and be feel positive about baby making again

Thanks ladies for helping me help her

How wonderful that the appointment went well for herShe is a lucky lady to have such a supportive sister.

You are so wonderful to be on this journey with your sister! Full credit to you! My experience after sharing very brief info regarding my need to undertake IVF with my family, or sharing infertility news with friends, is that because people aren't sure what to say, they avoid the subject.

I've mentioned our need for IVF to my mum and sister a few months ago, just once....they haven't mentioned it again, or even asked how I am, or any quesitons about what its all about...

It will definately make a difference to your sister's journey!

Well it's now six months on and my poor sister is still awaiting her BFP. She went for egg collection and ended up with OHSS and was really unwell for a number of weeks, then had to wait a number of cycles before they would do a transfer. Her FS was happy that they had 7 day five blastocysts to freeze. She has now had two failed frozen transfers and is really getting down. Her FS had told her to seem him again if she had two failed cycles so she is seeing him next month. Between the first and second cycle the had a short holiday in Thailand which helped distract her. She was unrstandably devastated when the second cycle failed, it's so hardto know what to say. I took her a bunch of flowers and we had a chat :(

She is also planning on seeing the GP and getting tested for MTHFR and I suggested she get a coagulopathy screening done if hadnt had done done while she was being tested, she was also wondering what other tests she could have done? She was going to ring the clinic and check as she doesn't want to wait to see the specialist then have to wait another cycle for test results, although I don't know if she can avoid it. At present even with the low AMH and Endo her specialist has classed her and her partner as having unexplained infertility.

Thanks for your help ladies

Update - My sister ending up testing positive for MTHFR, she then transferred to another fertility specialist as she wasn't happy with the protocol her old specialist was following. Her second cycle at the new place she commenced antibiotics, steroids and low dose aspirin at her request and with the support of her new Dr and had 2 FET and is now 8 weeks pregnant with one bubba. I am so over the moon for her, can't explain how happy I am so I can only imagine how she and her DH feel!

excellent news!

Oh wow! Congratulations to your sister & to you Aunty 'Novella' :-)

How wonderful for her! You must be thrilled for her too.
If she didn't join BB before she can join the belly thread, great support in there too.

Woo hoo, fantastic news hon! She must be over the moon.

PS Miloro - check out your sig - OMG!!!!!!

This is a lovely story. I hope everything goes well for her!

What a lovely support you are for your sister!! I wish her all the best and hoping she doesn't need IVF. I was 23 when we found out we needed Ivf and when we started, it was very hard but the positive is, time is on our side which sadly a lot of ladies don't have. IVF is luck of the draw unfortunately, some ppl fall pregnant first go and some ppl take a while. It took us 3 stim cycles, 6 transfers and 1 year of IVF to fall pregnant, but my daughter was worth every minute of it. I jhave everything crossed for her.

I missed this, so awesome to hear! How is she going Novella?