Have uterus; need eggs

We had our phone consult with CCRM and Dr. G. this week.  

No shit show to report.

IF YOU READ ANYTHING READ THIS:

Dr. G told me the miscarriage rate is not 40% but 25-30% with my own eggs.  I sure wish I had some clarification here.  Online searches tell me 40%.  Is this a reflection on the CCRM attitude?  Capabilities?  I don't know, but I like it.  I felt like such a jackass for sharing that stat a couple posts ago.  I am delighted to retract and correct it. 

The call went better than expected.  I was fully prepared to leave the call wanting more information.  We expected to have to decide if I would complete the one day $4000 (!) evaluation to determine our next steps.

He said my numbers look normal (are you coming on to me Dr. G??).  He confirmed our last cycle met his approval - aggressive stimulation.  The pre-cycle prognosticators (I just wanted to use that word) were normal (FSH 5.6,  AMH <0.5, Antral follicle count 10-11).

The call also went worse than expected in some manner of speaking.  CCRM said most women my age with my general stats can expect a 50% chance at pregnancy.  Awesomeness.  Based on my last 2 results, he was cutting my number to 25%.  

What.

This is a much better number than what Large Fertility Operation told us.   Dr. G doesn't doubt he can get us to retrieval.  My current RE only saw a 10% chance to make it to retrieval.  There were gentle disclaimers from Dr. G, but I sensed he was confident we would make it to surgery using a different plan of estrogen priming.

Here is the crusher: the 25% reflects a one time fresh transfer.  I was hoping it would be similar to my IVF that resulted in a live birth.  We had one leftover embryo to freeze.  Dr. G clarified we would transfer everything from the retrieval, no expectation to make it to freeze.

It is one thing to see a 25% chance of success and two tries, but a one shot deal at 25%?

I am out.  I already sent the note over to Mel asking to move me over to the Donor Gametes room.  I can't wait to meet the blogger named Rocky Road over in the DE room, but my girl hasn't posted since 2007.

Dr. G summed it all up nicely.  Don't think about the numbers.  It isn't about the statistics.  Think about where you will be 5-10 years down the road.  What will you feel when you look back?

To quote my Rick Rollin' friend:

We're now pursuing domestic adoption donor eggs and looking forward to focusing on "when" we become parents instead of "if."

No joke, Amber.  I thought about that line a lot over the last few weeks.  It has always stuck with me.

Elegant.  Simple.  Heartfelt.
 
The End.



Technical notes for the die hards:

• DE program comparison - transfer 2 embryos with an 85% chance of pregnancy.
  
• Embryo glue is real.  He had a laugh when I asked him about it.  This might be old news, as Dr. G did not expound upon it.  It is a product with some kind of acid that creates a viscous environment, used for both IVF and DE.  Online search tells me it comes from UCSF, the first reported in 2003.
  
• What about that progesterone on the rise that damned your IUI from the start?  It is not likely to be a recurring issue for all retrievals.  My number was 1.4, a sure killer in a fresh transfer.  Virtually guaranteed to kill your success.
  
• The CCRM estrogen priming is different than my last estrogen priming cycle.  Dr. G stated it is not better or more aggressive, but different.  Large Fertility Op used patch estrogen priming where CCRM would have me take estrogen for a month.

Important IVF facts from a fellow blogger

I have a re-tweet.

Pretty much anyone who reads my blog certainly reads Playgroup Material.

I have 2 IVFs, 2 canceled IVFs, and 2 IUIs under my belt, but I still learned something from Amber's post.

Check it out.  Click the feet waiting for her turn with the vagcam.


Thanks to Amber for getting the info out on the street.  Out of the hands of the RE and into the hands of the people.

CCRM rumors

I dont know how else to get this question out in an effective manner.  I just heard a rumor and I want to scope it out.

Anyone ever hear of CCRM "embryo glue"?

Did I really just ask that question.

Maybe I am being punked.

Hi, I am Roccie and I am a hope addict.

I hate the word addict.  It should be used with caution. I don't mean to use the word without respect to anyone who struggles with addiction.  To me it represents something that happens when you know there are deep costs associated with it.  You do something despite wanting to do the opposite.

I am addicted to hope.  I can't help it.  We have our remote phone consult with CCRM on Wednesday.  My RE came through and got us jumped up on the schedule by several weeks.  Who ARE these CCRM people: that patients will wait for months and pay tens of thousands of dollars (on top of the usual tens of thousands of dollars) extra to see them?

Part of me wants to hear this miraculous new plan - how I can have another baby with my own eggs.  A very small part of me.  The addict takes up a lot of room.

Selfish me?  I am ready for donor eggs.  To tell you the truth, I don't want to cycle again with my own eggs.  There I said it.

But what about a concern that lingers in the back of my mind... Could this new baby feel different about the issue than I do?  What if s/he feels disconnected with me because of donor eggs?  Different somehow.  God knows I won't feel a thing different, but what if s/he sees her/his relationship with me different than the daughter I have by my own (now crap) eggs?

But what if CCRM makes the case that my eggs are an option?  Wouldn't I be a selfish monster not to consider it?

(Side rant:  Remember when Dior came out with a line of perfume called Addict?  I let go on the poor brainless twit pushing it at Nordstrom.  Look at the tag line.  "Admit it", as in one of the 12 steps to recovery.  I won't even get started on the Gucci Rush perfume, where poppies were pictured in the back ground.  Grrr.)

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.

The Shit Show that came looking for me

We are not pregnant.

I had a positive pregnancy test yesterday.  What.  I don't know.  I got up to pee in the middle of the night.  I figured the trigger shot was gone (14 days) and it had been 12 days since the IUI.  Why not just take a test and get the monkey off my back?

Jesus, Mary and Joseph, there is a line.  I carry it around all day with me.  It was very, very faint.  In fact, if you looked at it from the side it showed up better.  It was there.  I know only you people will trust me when I say I know what a negative looks like and this was not one of them.

I took the test again this morning.  It was negative.  No hope of the line.  What.  I turn around and Aunt Flo, that miserable bitch, is staining my toilet.  She has done that to me twice now.

It is 4 am.  Rocco and I look at each other, there isn't much to say.  We eventually go back to sleep, but when I roll over God knows how much later, he is still awake with me.  We are alone in our bed with each other.

I go to work today.  They pay me if I show up and I have a $25k - $45k cycle to pay in the coming months.  I don't know how, but I don't cry.  I am late for work, so I hit the Starbuck's drive through to get a coffee.  Decaf, as I am stupidly ever hopeful.  This is my rebellion.  I haven't had decaf in a long time.  

Rocco takes me to lunch.  I want to talk about how to choose a donor but instead I obsess over the money we don't have to pay for the next cycle.  I feel worse after lunch.  Poor Rocco, I don't tell him this.

I get back to work.  Pandora, a spreadsheet, and I forget about things for a while.  I change into a new tampon.  Wow, that is a lot.  I get a real coffee even though it is 2pm.

I jump when someone says PSSST so loudly I hear it through Pandora.  I turn around and you won't believe who the fuck is in my face....

The pregnant fertile bitch from work.

She is actually holding her belly and says to me that she hasn't seen me around (you clueless fuck, I sit in the cube catty corner to yours - did you ever stop to wonder why).  She then says (with this voice), "Look at my bump.  I am getting so fat."

Welcome to Shit Show II.

Yeah, I cried.  I tried to listen to her.  I heard something about food makes her sick and goes right to her belly.  She asked what was wrong.  Was work getting to me?  A lot of deadlines?  Are you sure you don't want to talk about it?  You sure you're ok?

Get me the fuck out of here.  

I am home with my dogs.

My decision

I hope it makes sense to move the thoughts from my head to paper.  I fear much will get lost in translation.  I will do my best to capture it.  I want to be able to refer back to it and reset myself if needed.  I feel positive.  I get it now.  The Shit Show has concluded.

I have been thinking about donor eggs since our first IVF failure.  My RE repeatedly told me "we are not there yet", but then one day, she did.  I felt prepared to discuss donor eggs back then.  It was when the choice wasn't mine that I had the problem.

The last few weeks I have been chewing razors, fearing what the almighty practitioners at CCRM would tell us.  Would they increase our odds to make it to retrieval?  Would they let us go ahead and try again?  How can they change the preparation, the stim, the fertilization, the development, the transfer and the outcome with a BFP?

They really can't.  I have come to realize taking me from a 10% chance to make retrieval to a 50% chance isn't enough.  What if they promise a 75% chance to retrieval?  Is that enough?  What number is enough?  If we had to pull teeth from our long term RE to get a low number, what new RE is going to risk a guarantee of success?  No RE in his or her right mind would do this.

Short of a miracle written on butterfly parchment and wax-sealed shut for accuracy by the horn of a unicorn by faeries, we are done.  My battery is beyond low and I don't have the energy to recharge it for another round with my eggs.

This decision became clear and silence fell all around me.  I think all the chaos I was feeling was from trying to fight my deep seated knowledge of myself.  I believe when you follow your true path everything falls into place.  Once I decided donor eggs were for us and made it MY decision, not one handed down by an RE, I felt at peace.  It is the craziest thing I have ever experienced.  Total peace once I made the decision.

Will there be a Shit Show II at the end of this week after my pregnancy test?  Maybe, but I doubt it.  I know getting pregnant from IUI and with my slightly expired eggs is a long shot.  I am, however, ever hopeful.