Friday, May 30, 2008

Clay Aiken

I never, ever thought I'd blog about Clay Aiken. But when he and a 50 year old woman conceive a child, I, for one, know that woman used Donor Eggs. So did he want a child so badly that he is having this friend of his carry a DE child or did she want a child so badly that she used DE and asked him to contribute.

I honestly don't care about any of that except that she is OBVIOUSLY using Donor Eggs and everyone else thinks she just got really lucky with IVF.

Friday, May 23, 2008

Excited and Closure

Well, although we continue Mission: Kill The Rats at our house, we do have some more appropriate DE news.

First, we met with our old clinic for the post-mortem for the failed thawing of the frozen eggs. The one thing I did NOT want to happen is for them to say "Well, this sort of thing just happens and successfully thawing frozen eggs is not very likely anyway." Therefore, I went in with the stats from the donating clinic and a couple of articles from Fertility & Sterility and Science.

Although they did imply that "this sort of thing just happens", they did indirectly admit that they had had a learning curve on freezing and thawing embryos and that likely this was the same sort of thing. No one said that directly (God forbid!), but there was an undercurrent of that sentiment. Also, both the RE and the embryologist seemed surprised and upset that this happened. Actually, the embyrologist seemed upset. The RE seemed more "circumspect."

I really, really didn't want to go in and be all "YOU'RE INCOMPETENT!" but clearly mistakes were made. The RE tried hard to close ranks saying "this sort of thing happens" and "maybe there was a difference in the water purification", but the embryologist seemed more upset that this was a complete and abject failure. We tried to tell them that we could have handled not getting pg, but not even getting a try was not cool.

In any case, the bottom line is that we are being refunded the all the money for the embryologist and transfer part of the cycle. We won't get our money back for the services already provided (HSG, trial transfer, medications, etc), but that seems absolutely fine. That refund turns out to be a significant chunk of change and will really help for this next cycle.

Which we are doing elsewhere. I've already mentioned which clinic we're using, but I think I'm going to refrain from doing it again, just to give everyone a little bit more privacy. That said, I've already had a phone meeting with the RE and the DE coordinator. I have everyone's email addresses and private phone numbers. (WOW!) I also have assurances that they are going to make sure I have a baby to take home with me.

Let me reiterate the stats: 80-85% success rates on DE with an 80% chance of two blastocysts and frosties with each cycle. Their FET success rates are also about 70%! That's higher than even my current clinic's fresh cycle success rates.

So here is an example that makes me feel like this is the right place for us to be: every single person, from the original intake person to the RE to the DE coordinator knows about us and the frozen egg debacle. Everyone brought it up first and said something kind about it. Every. Single. Person. At the old clinic, I had to correct everyone I dealt with (except my RE and his main nurse) that I was NOT doing frozen embryo but frozen eggs. Even the doctors at my monitoring visits looked at me with a blank face when I tried to tell explain what I was doing.

I also feel like at this new clinic their main goal is to make sure I have a baby. And they really think they can do it. I told the DE coordinator today that I would love to have twins and she said "Well, let's just see if we can get you twins." That statement would never be allowed at my old clinic.

Onward and upward and closer to bringing our child(ren) home.

Wednesday, May 21, 2008

Excited!

Besides remembering that yesterday was the day I planned to use a HPT with this cycle, I am very excited. I had my meeting with my new doc at the new clinic and I'm actually ....YIKES!!!.... I just saw a rat run through my garden. I must go now.

Monday, May 19, 2008

Unsettling

Last week, I emailed the clinic where the eggs were frozen. I wanted to let them know about the dismal outcome of the eggs. They emailed back today that they usually have a 85% thaw rate, a 66% fertilization rate, they implant 3 eggs and there is a 25% pregnancy rate. They told me there is a learning curve for this procedure and they were sorry my clinic didn't have more experience.

Although this was exactly what I wanted to know , it has made me so sad. We should have had a chance with these frozen eggs.

I'm not sure I properly grieved not getting a chance with this first cycle. I moved so quickly to the DE cycle 2, that I haven't fully let out how angry, disappointed and sad I really am about the crappy thawing. This dude should not have undertaken the procedure if he was not qualified to do so.

My jaw is really tight lately. I think this grief is going to get out of me one way or another.

Friday, May 16, 2008

One Week In

Exactly a week ago is when we found out that only 4 eggs made it through the thaw and it was my first clue that things were not going to go the way I thought.

I hate that I keep saying to myself "I'm supposed to be on bedrest right now. I'm supposed to be wondering if my sore boobs are due to a pg and not the prometrium to make my period appear. I'm supposed to be watching a lot of TV and not working this week."

Nonetheless, a friend commented that I clearly don't let the grass grow under my feet.

I hate feeling as awful as I did on Monday. Whether it's healthy or not, I cannot stay in that place and wallow in the pain. I'm really glad we have a plan for another try and I know in the deepest part of my heart that if *this* one doesn't work, we are completely done.

A *week* ago. A *week* ago we were completely in another place. It seems like a whole other place. Oh, BTW, any advice for choosing a donor is welcome.

We looked over our financial estimate for this last cycle. They charged us $5200 for ICSI on 11 or more eggs. In actuality, they only did ICSI on 4, but I imagine some of that money also went for the thaw. We are planning on asking for most of that money back (along with the $700 for the transfer we paid for and didn't do). We were their guinea pigs and they messed up. Does that happen? Do you get money back when it's a failed event and they haven't done the procedures we paid for?

It's a lot of money, but it seems like years ago that they paid it. I just want to go forward now and have another real try again. For the first time.

Wednesday, May 14, 2008

What A Difference a Plan Makes

I am still upset. In fact, things got a lot worse as they days have rolled by. There are few things in this world as dreadful for me as the absence of hope. There are some theologians who argue that "heaven" and "hell" are places on earth; they are not different dimensions that we go to after we die, but a state of being while we are alive here. (There are some people who believe the Gospel of Thomas makes exactly this claim.) In any case, I know for a fact that life without hope is hell for me.

So on Monday, I made a call to the San Diego Fertility Center. For those of you who don't know, at over 80%, SDFC has the highest DE success rate in the US, if not the world. I am going to be in Irvine, CA in August for business reasons and it seems like it would be the perfect opportunity for us to work with them. Our initial appointments start next week and we've already been looking through the donor database for potential matches. Considering that our main criterion is success as a donor (defined as having participated in a DE cycle with a pg), we have a lot of donors to choose from.

When I spoke to the intake counselor, I realized how much I miss California. I shared that I had had three clinical miscarriages and 5 chemical pregnancies. I asked if that would disqualify me from being one of their clients. She assured me that they take everyone. She also said that the soul of my next child must have been working so hard to get to me. She hoped that this would be the path for us to finally be together.

I, of course, sobbed. But it's exactly what I was thinking. I don't have the one-child gene. I know my other child is waiting for me to find him or her. And I want to give it my best shot to break down whatever barrier is there.

Which is why, even if the curent clinic does offer, I don't think we are likely to participate in their DE program. If they have a donor who is proven, I might consider it. But honestly, we have money for one shot. I want the odds to be as high as they can possibly be.

The thought of using SDFC gives me hope, at least for today. Everything may change after we have our meeting with our current RE and the idiot embryologist. But at least, right now, at the beginning of this day, I think it will still all work out and we'll finally find our next child.

Sunday, May 11, 2008

Stages of Ick

I didn't realize how numb I felt yesterday until this morning when I woke up very sad. Feeling sad highlights the differences from feeling numb.

I'm also starting to flirt with feeling "angry." It appears that my progress through Kubler-Ross's stages of grief are not going linearly. I am particularly angry at the embryologist at our clinic for doing such a crap ass job. Clearly he did not research the best method to defrost our eggs. I have yet to see any number in the scientific that doesn't say that 70-80% of the eggs should survive defrost. It makes me very, very angry to think that his thaw rate was about the opposite of that.

The lesson I'm learning from this is that I should have trusted my gut. I have done a good deal of research into frozen donor eggs. I know that USC has an infertility program that has done extensive research with frozen donor eggs and deems it to be a viable alternative. I should have gotten over my fear of offending them and sent all the information I had to them to make sure they knew what I know. But if *I* know that, why didn't they? Wouldn't I look like a neurotic patient/client?

Well, I am a neurotic patient/clinic. And I'm not taking the blame here, but I'm mad at myself for not doing that. And more angry for them not to have done a little bit of research themselves.

In any case, I'm also feeling empty and sad. These were good eggs and they fucked them up. And now we have nothing.

I'm assuming they are going to credit us with some of the money we've paid up front but didn't receive for services. In addition, I assume that they are going to put us up front immediately on their fresh DE list. My problem remains with trust. They have a 65% success rate, whereas other places have a much higher rate. Why is their rate so much worse and should we continue to trust them? At this point, I'm only going to trust them if we get a proven donor with multiple successful donations.

Ok. So, considering the conversation I just had in my head, I am definitely in State 2 of the Kubler-Ross model of grief: Anger.

Saturday, May 10, 2008

Zero

Nobody made it until this morning. I start prometrium tonight and reduce my estrogen so that I will get my period in about a week.

We'll be setting up a meeting with my RE and the embryologist to discuss what happened. I guess then I can share all the research I was hording trying to not offend their knowledge.

Part of going through this is saying that we "tried" even if we don't end up with a baby. However, this feels like it shouldn't count. We didn't get to "try". I want a do over.

And to my dear friend who has been so worried about me and as anxious as I have been about this cycle, the one who gave me her extra eggs, it's ok. You were such a generous person to have thought of sharing your bounty of joy with me. That is so kind. It's sad it didn't work out, but I'm left with the knowledge that there are truly kind people in this world.

Friday, May 9, 2008

Not Good

Only 4 eggs survived the thaw. The embryologist used the other clinic's protocol and only 1 out of 6 survived that. then he switched protocols and 3 of the remaining 9 survived. I should have sent the information I found and told him to contact USC which has a much better success rate.

He hasn't even checked to see if the eggs that survived have their spindles or whatever. So these four may be complete crap.

And we don't even know if they will fertilize.

Although I know I've been saying that everything will work out the way it's supposed to, I'm very upset right now.

Thursday, May 8, 2008

Waiting for Godot

Or good eggs, which ever comes first.

Everything starts tomorrow! DE Daddy goes in to "do his thing" at 11:30. My last lupron is tonight and then I start all the other meds (doxycillan, medrol, PIO and still continuing the estrogen patches).

I'm clearly excited as the wake-every-other-hour insomnia has hit, yet I'm not sleepy or upset.

There are two types of stress: distress and eustress. I'm voting that I having eustress right now. Why not be happy while I can? It's going to work out anyway, whatever happens.

I'm ready to get going!

I'll be back tomorrow with an update on how many thawed. For me, that's the biggie.

Tuesday, May 6, 2008

Freaking Out a Wee Bit

With the thaw coming up on Friday, I'm getting a bit more anxious. And doing exactly what I should not be doing by googling any new academic information (or otherwise) on the success rates of frozen donor eggs. I know we've already bought the lottery ticket. Nonetheless, I'm still calculating the odds of winning.

There was a recent article in Science on improvements the success rates from frozen eggs. As Science is not too shabby of a journal, I got the article. The main gist of this article is that eggs have been frozen since about 1986, but until the advent of ICSI , it was simply not viable. The egg's membrane gets a little tough after being frozen so it's harder for the sperm to enter. ICSI changed all that so the REs became more interested in using donor eggs.

There's also a new technique for freezing eggs called vitrification versus the old way of doing it, called slow freeze (or the roll-off-your-tongue formal name gamete cryopresevation). From what I can gather, virtification is a quick-freeze, dip in some liquid or another whereas slow-freeze takes up to 1.5 hours of slowly freezing the eggs. And the gist of the debate is that vitrification yeilds more usable eggs at thaw than slow freeze. Like, a lot better in both quantity and quality. In fact, some REs say that vitrification yeilds about the same result as fresh eggs. However, there have only been 100 births ever from vitritifed eggs and about 300-500 births per year world-wide for slow-freeze eggs. With those sorts of numbers it's hard to argue that one is really better than the other. (100 total is a really small sample size) Nonetheless, the 95% survival rate for vitrified eggs is impressive as the Science article above says.

Guess which one our clinic used?

How about "Not Virtification." In fact the clinic got all cranky when I asked which one they used saying that the research was not yet conclusive. Considering that yes, doctor's are likely to exaggerate their success rates and also that this clinic has a Really High donor egg success rate, I'm not going to get completely freaked out, just a little.

However, the Science article says that one needs about 50 slow-freeze eggs for a viable pregnancy whereas one only needs 21-25 eggs for a successful vitrified pregnancy.

That's when I start freaking out. We have 15 slow freeze eggs. ((gulp)) I start twittering and I don't mean updating my friends.

But then I go back to this peer reviewed article in Fertility and Sterility reporting a pretty signficant success rate (about 30%) for frozen DONOR eggs. That's a whole different ballgame than regular frozen eggs. Most women freeze their eggs in their 30s not their 20s. Their success rate is already lower. And I know that our donor was a true fertile Myrtle (as opposed to me, being somewhat of a fertile turtle). So then I reassure myself because I honestly believe that if 75% of these eggs can make it through the thaw stage, we'll have a decent chance.

And last night as I was getting all dramatic on myself thinking "If we don't get pregnant, this will be the worst thing ever" I had to stop and say "Ummmm, no it won't. It won't even be close." I've had a lot worse things happen than not getting pregnant on an IVF cycle. I will undoubtedly be sad. But it will not be the Worst Thing Ever.

I still don't know if I would be ready to give up if it doesn't work. (DE Daddy and I are in the midst of debating about this.) I'm still getting anxious. But this certainly will not be the Worst Thing to Ever happen to me.

Sunday, May 4, 2008

Thawing Set

The nurse called late Friday afternoon with the update. First, she says my lining looks perfect. (yay!) However, they are going to wait to thaw out the eggs until Friday not Monday as we originally thought. The embryologist doesn't want to thaw them Saturday-Weds (vacation, I'm imagining) and my RE will not be in the office next Monday so they are working all around their schedules. Apparently, the embryologist and my RE are very keen on being very involved in this process; I think that is good news.

They are aiming for a 5 day transfer which would be May 14. From what I've seen in the literature, frozen eggies often go at a 3 day transfer, although some do make it to 5 days. I don't know if for those who do 3 days it's because the embryos looks so crappy or if that's the clinic's policy. I am still surprised to hear of places that still routinely do 3 day transfers because I was under the impression that 5 days are much, much better.

So we're on the way. And I'm excited to be going forward but trying very hard not to become to invested in one outcome or the other. I want to go ahead and have the answer. But then I also want the best shot we can have for this.

Friday, May 2, 2008

Trip to the Doctor's

I went in today for my bloodwork and an ultrasound. I'm waiting to hear the results, but my uterine lining looked good. He said my stripe was "9". I thought I was looking for a triple stripe, sort of in my mind like Neopolitan ice cream. Does any one have any info or should I go play Dr. Google.

I'm thinking we'll start defrosting the eggies on Monday.

I'm really anxious to hear when everything is going to start up, and to make sure they don't forget about my heparin and prednisone for the (potential) auto-immune problems.

More later if I hear anything.