Tuesday, July 8, 2008

Protocol Starting

My DE coordinator sent me my schedule of meds for this cycle. It's pretty exciting to be moving ahead or at least doing something. Also, I'm not stressing out about this. It may be because I've changed my diet and no longer eat sugar (which can affect freaky out nerves), but also, I just feel intuitively that this is the right thing to do whether or not we actually get pregnant. I'm sure many veterans feel the same way at the beginning of a cycle when they don't know what will happen. But I do feel like we're on the right path.

I have to also admit that sometimes I get surprised when I read about other people's protocols at their clinics. I'm a research academic in the social sciences at a research intensive university. I don't make decisions to do things without thoroughly researching what I am doing. In fact, a friend and I were talking yesterday about how annoying it was to (think we) know more than our doctor does about our own particular fertility issues.

In any case, it worries me that clinics vary so much in their IVF or DE protocols. I'm less concerned about medical protocls (which already, I see differences between the two clinics in the number of estrogen patches they want me to use and when to change them as well as the amount of lupron they want me to use), but more on basic things like regularly scheduling 3 day instead of 5 day embryo transfer. The research solidly shows that 5 day transfers are more likely to be successful. Yet most of the folks I'm following in the blogosphere have clinics who routinely do a 3 day transfer. Both of the clinics I've worked with only do a 3 day transfer when things look really crappy, a sort of Hail Mary pass to your uterus. And they all grow the embryos out past 5 days before they freeze them to get the best ones possible.

This freaks me the freak out. Why are so many clinics not following the "best" practices for successful IVF and DE outcomes? 5 day transfers have double the success rates of 3 day transfers, no matter what the age of the mother. Why do some clinics continue to use 3 day transfers as their default? It also makes me a little angry, too, that other women who want a child just as much as I do are not getting the best chance they can. And I blame the doctors.


midlife mommy said...

I have one of those clinics. When I asked about blasts way back when, they told me that there has to be a change in the nutrient bath to get to that point, and the clinics that were working with blasts were not willing to share their formulas. Quite honestly, that could have been a load of horse manure and I wouldn't have known it.

DE Mommy said...

Hmmm. Interesting. I would have thought that the research clinics would share that information out of their ethical obligations to science.

stacyb said...

i was lucky to be at a university clinic that is ahead of the curve in their practices...that said i do agree with you that differences, especially the three and five day protocals, between IVF clinics is not something i understand. i mean, i don't understand why things aren't more uniform.

Anonymous said...

well, I had 5 day xfers there...why would yours be any different???

Kami said...

My RE (well embryologist) shares their knowledge - at least that is what I was lead to believe. My RE said clinics don't do the 5 day transfers because they either don't have a very good lab or don't want to increase their costs.

DE Mommy said...


So in other words, those clinics are more than happy to take a woman's money, but they do not give her the best chance to have a baby.

That makes me angry.