Tuesday, August 31, 2010

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.

22 comments:

  1. I like how far behind I am in keeping up. I am keeping up and taking notes. This looks good. 81%? Holy crow, do they have a deal with the devil or what?

    PS. You have been cracking my ass up with comments lately and wanted to let you know how much I've really needed to laugh this last week. THANK you!

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  2. PS. I was just stalking your last post when your new one popped up here and I thought I'd totally missed it. Hence the "far behind" comment. You must have published just as I popped over. Hot blog!

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  3. What an enormous amount of information for you guys to digest, but I guess you've been digesting most of it for a while now. I wish I could give you a money tree. (Except I know you'd just spend it on liquor--you don't fool me with your "I'm super committed to having a baby" pretense.) I think the section that stands out most to me is the "which part offers the best chance for a healthy baby". That's quite a contrast. Even so, I would have no idea what to do in that situation. This is some hard shit.

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  4. Roccie, I am not that much younger than you!!! And thanks for the forewarning. Wow you are moving forward. Not sure how much I gleaned from yout WTF meeting but glad to see you're moving ahead. I'm so sorry for all the pain and stuffing around. Good luck and enjoy looking at donors. Great re the strings. Xxxx look after yourself my cycle sister!

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  5. I am feeling a bit dense here, but whatevs. So the idiots version of Roccie's plan?
    CCRM w/ DE, right?

    81% hot damn, that is awesome. One step at a time my friend, one step at a time.

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  6. Roccie, You're like a year older than me. And I know I have crappy eggs! In fact, pretty much most (not all) women over 35 have fewer, poorer eggs. That's not my judgement, just science.

    Good luck! I hope you win the lottery! I just sent a good friend of mine to CCRM, she has an appointment for early Oct. If you see a cute girl with dark hair say hi!

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  7. We're all on our own path, true enough. I understand that's what you're reminding us of in the preface.

    I like to go to a consult well prepared too, with a list of questions. The one time I didn't make a list, I forgot things and was annoyed at myself afterwards. Luckily, it wasn't anything major.

    It sounds like the advise of the RE was rather unambiguous. Still not a pleasant message to get, I'm sure, but clarity has it's advantages.

    Now that you're coming to terms with the idea of DE, I'm glad that it is available to you.
    Hope it works out for you.

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  8. Uhg. The statistics of infertility are horrible enough. Adding the "but because of financial reasons" just kills me.

    Wishing us all money trees.

    And ponies.

    And calorie free hot buttered popcorn! WITH REAL BUTTER!

    Sorry. I got too much sleep last night. And by that I mean. More then 4 hours. I'm giddy.

    But seriously, good luck. Not just in getting pregers, but getting past all this.

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  9. Occasional core dumps are a strategic necessity. Lots of questions, not a lot of tremendously clear answers. I'm sorry, Roccie. I am going to think good thoughts for your CCRM consultation.

    Money trees. Some ingrate chopped them all down:(

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  10. Wow Roccie it sounds like you had a brain cruncher of a WTF appointment. I'm with you though, I like these appointments... its when we get to hold our Drs accountable and make them give us answers why their plan for us failed. We get to drill them and make them dance around and show us a nice new plan for next time. I think you will get your nice plan too, it just seems like you have a few versions of it floating around right now. You'll get to the final draft soon enough.

    PS - I only just read your previous post as well and I have to say that that prego workmate of yours is an imbecile. Even if she wasn't pregnant she'd be a fucking fruitloop. But the fact that she is pregnant on top of being stupid must make her so frustrating to work with. You deserve medals for having to put up with her. xx

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  11. wow... info overload, huh? stats of 81% sound pretty fucking fantastic!

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  12. Thank you so much for the prayers for my family. I am praying that DE is the solution and you will be on your way to your baby by the end of the year!

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  13. You are simply awesome.

    That is all.

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  14. I want to agree with the above comment as well. I love you, Roccie. I wish I had some good eggs to give you because I totally would. ♥ And some of your comments around town are cracking my shit up. The thong smelling one? Nicely done. ;)

    I hear CO is beautiful in the fall. ;)

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  15. Hi, Roccie. I'm sitting in a hotel bathroom in Cleveland, drinking my bitter-ass TCM herbal tea at nearly 2am, because I fell fast asleep around 11 without having taken any pills, sipped any dark-as-night witch brews, or stuffed anything into my coochie. In case you wanted a pretty picture in your head...Anyway, that's a lot of info to take in, but how nice to have some real stats and the makings of a no-fucking-around next step! I know you'll choose what feels best. That >80% situation, though? WOW! Goooo, babies!

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  16. I am mind-beaming perfect donor vibes through the air to you. So here's hoping you don't sleep in a tinfoil cap! :)

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  17. I too, wish you had a money tree. I hate that money becomes such a huge factor in the land of IF.

    You have facts. Sound decisions are made from facts. It will be interesting to see what the phone consult will add to the information you've received thus far. Holding out hope that they could find a way for you to get what you really want...

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  18. Okay, I completely understood every word of that post which confirms our Vulcan mind meld.

    I am so impressed with how thorough your follow ups are with your RE. And 81%? WOW. Amazing. I am really looking forward to hearing about the phone consult!

    Girl, you continue to be my inspiration in all of this...

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  19. Hey, I found your blog from Minimenow - and as another "slam-dunk" no problem 40yo (when we started DE IVF) - oh, and I had a 4 yo boy conceived naturally (no ART) at 35. I was assured that I'd be a "perfect candidate for DE". We were so excited - now we are on our fifth attempt after 3 different donors (all 26 and younger) and I'm now 45. How could this have happened? No one seems to know.

    I do really hope your DE story is the perfect one they are painting for you - best of luck on your upcoming cycle!

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  20. Good luck with your ccrm phone consult. If you have any questions about IVF or DE IVF there let me know.

    1eggplease@gmail.com

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  21. Roccie - Your posts always crack me up. I love them and the comments you leave on my blog. I always think about you and laugh when I read your posts. You sound a lot like me with the whole analyzing everything under the sun. I have considered CCRM as we have family out there, but have never contacted them. I am just lost most days on what to do anymore. One day I want something and then another day a next. Sigh. Thanks for always giving me something to look forward too. :)

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  22. First of all thanks for your kind words on my blog, they mean a lot to me. It's nice to have someone how gets where you are and sadly I know you do. Next, wow that is a lot to digest...WTF is right! Sounds like DE are definitely a good option for you. I hear you on a lot to learn...we've been researching the whole donor embryos thing like crazy too. Hopefully the donor route works for both of us!

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