Another WTF appointment at Large Fertility Operation

Time to pick apart my cycle: WTF went wrong and WTF did we learn from it.

I have come to enjoy the WTF appointment.  It is like the big game.  I prep and get all my business in order.  My stomach is a little nervous going in to the match.  I want to perform my best because there is just so goddamn much at stake.

Please remember I am not an RE.  Hell, I can barely keep my job in IT.  I am not a reliable source of information.  I do my best to transcribe things here, but there are much better bloggers you should use as a learning source. 

I want to suggest the following reading is not for everyone.  I learned some scary shit today.  (Yes, Rosie, N, Lisa, Lut, Stacie... Bunny - you too young, but don't get any ideas... I am speaking to you.)  This info is from MY RE and about MY body, so don't get worried it will apply to you.  I am older than all you bitches put together.

Look at all you pregnant mother fuckers.  Awesome.

If your name is not in that list and after reading this you think, "I am doomed", then you have misread this post.  Remember, individuals are all or nothing.  It works or it doesn't.  There is no half way point.  Don't let stats scare you.  Understand?

Anyhow. 

** UPDATED  **
A note to the weary, attempting to make sense out of this post: don't try it.  This is a core dump so I can recall all the information and try to confirm a decision.
 

Short Version

If I had a money tree, we would have another IVF cycle at CCRM.  They cost about $20k more, but RE admits they have something.  Donor eggs would always wait for us.

Extended version:

Semen stories, too bad, so sad
Curve ball in our last round.  Rocco has had crap SA after crap SA.  The semen sample for IUI wants to see at least 20 million.  We had low everything for all our SA and IUI.  Guess who rubbed out 134.5 million and 90% motility on our most recent IUI?  Rocco was calling out to all the ladies on the way from our last IUI - we were giddy.

I asked RE if now we could be considered IUI candidates?  No go.  This semen achievement thing can come and go.  Plus my eggs.  I have learned they are of questionable quality and approaching few and far between.  We used AZH in our successful IVF.  If the sperm found an egg, not sure they could bust their way inside this time. 

What plan offers us the best chance for a healthy baby?

• Donor eggs - she used the words:
• "slam dunk", 
• "ideal DE candidate", and 
• "pregnant in 3-4 months"
  
• More IVF with DHEA, etc.
• Large Fertility Operation doesn't have the magic bullet CCRM offers and admits my chances of success are best there to address poor egg quality;
• the chance of miscarriage at my age is 40%;
• holy shit, 40%.

Is there an indication of poor quality eggs?
Ha.  Turns out the problem is both quality and quantity.  Okay, didn't expect that answer to come that easily to my RE.

My miscarriage was likely due to a chromosomal problem.  Our beta tests looked good, but something wasn't right.  No heartbeat ever developed.  Perhaps isolated, but likely a sign of the state of my eggs.  My first RE suggested DE way back when, at the end of cycle one.  We always knew something was a little off. 

How does this relate to AMH?
It doesn't.  AMH is an indicator how I would respond to stims.  RE expects my AMH would be low, less than 0.5. 

What advantages do DE offer us?
I worried about Down's.  I would love my Down's baby as any mother would.  I was relieved to hear the risk of Down's was less than 1%.  Not a worry I needed to have - this is nice to know. 

Where should we cycle based on success rates?

• Large Fertility Operation (LFO)  53.8%
• Awesome Fertility (AF)             78.7%
• CCRM                                     81.6%

Numbers games.  It sounds like only the elite are accepted into the DE program at AF.  Good news is, I would qualify.  LFO takes anyone, including my Sisters of the Fibroid.  The way LFO looks at it, you just might get pregnant with DE, so let's try it.  AF doesn't want you to fuck up their stats.  I love LFO for this. 

Why weren't we offered a retrieval like last canceled IVF?
I was confused that RE offered to get our 2 follicles in our last cancellation, but didn't advise it this round.  It turns out my progesterone levels were on the rise - premature luteinization - with a definite impact on egg quality.  Only my evil friend Lupron can prevent this.  Or being young.  Whatever.

I can twist this into good news.  I messed up my meds, but if anything it might have helped.  Go figure.  Estrogen is the uterine padding and progesterone is the glue.  I already had too much glue with the premature luteinization.

What about embryo classifications and grades?
I sadly confirm this cannot this serve as an indicator for chromosomal abnormalities or genetic abnormalities.  My FET blast was gorgeous, but it didnt make it to a heartbeat.

Only 25% of retrieved eggs make it to blast.  We hope to see our donor retrieve 15-20 eggs, worst case getting us 4 blasts?  Getting way ahead of myself here. 

How many do we transfer?
Depends on the blasts.  I like this answer. One or two, TBD.

Could I be any more boring.

We have our phone consult with CCRM at the end of September.  Our RE plans to pull some strings to get us jumped up in line.

I love looking at donors.