Wednesday, December 17, 2008

A simple plan?

I finally had my phone consult with my doctor yesterday and came up with probably more questions than answers, but, for now, we have a plan. He wants to talk again after we get the results back on the genetic testing of the embryo (which should be a few weeks). If it comes back abnormal, then we are going to go ahead with a CGH cycle (I'll explain in a minute). If it comes back normal, I have no idea at all what we will do. He said he doesn't even know what that will involve because obviously I don't have implantation issues, my TSH was under control, and everything was going smoothly. So, I'm a little scared. I voiced my concerns over the lack of viable embryos we've been producing and he said it is probably just an age thing...that I don't appear to have the dreaded "diminished ovarian reserve" because we still get a good number of embryos and they appear to be of good quality, but I may actually have already started diminished ovarian quality that comes with age. He said that if it is chromosomally abnormal, that this may have just been normal-everyday-bad luck. The kind of "it can happen to anyone" crap that is always so shocking when it happens to YOU. So, the plan is that we wait for the results and then likely start a fresh cycle of IVF, which should start in about 2 months...maybe sooner, maybe later.

Now, CGH. I'm not going to give all the technical terms and stuff like that. I'm going to put it in general layman's terms and if you want more info, google it. It is a type of genetic testing that only 2 fertility clinics are currently doing, as far as I know. We will start by doing a regular IVF cycle, up to egg retrieval. The eggs will be fertilized by ICSI (injecting the sperm directly into the egg) and then they will be allowed to mature for 5 days. On day 5, they will carefully remove a cell or two and then flash-freeze the embryos for preservation. Those cells will be carefully labelled and sent to a special lab that tests all 23 chromosomes for abnormalities. This takes about 2 months lately because of demand. We will get a report on how many have actually come back normal (if any did, and you never know). Then we will prepare for a frozen embryo transfer where we will de-frost those normal embryos and place them back "home". The success rate for my age group for this is approximately 89% (but that was quoted on a fellow blogger's site and I'm not sure where she got that number). I've heard others say it is about 80-85%. So, that will be our last big shot. Hopefully we will get enough embryos and they will be strong. I say this will be our "last shot" but I doubt it - especially if the insurance works out and decides to pay for 6 cycles entirely ($10 copays) which is what they claim.

In the meantime, I've started DHEA in order to try to improve egg quality/quantity. My doctor suggested it and said that some studies have shown success, but he isn't sure...but it probably can't hurt. So, I start 25 mg 3x a day today. Wish me luck. I get so nervous on the androgen type medicines. I'm afraid my hair will fall out (and I'm growing it to give to locks of love) and I will start growing facial hair, and get a big pot belly from all the male hormones. But, he assured me the dosage is really low. And, at this point, what haven't I done? And, even worse, what won't I do? Jeez, I used to be so normal.

In any event, I'm going to try to enjoy the rest of this month. Since I have a forced month off after this one, I am free to enjoy some wine during the holidays, so I am taking advantage of that. I still can't bring myself to have even a cup of coffee for fear of egg quality repurcussions, though, truthfully, I still miss coffee every single day. Isn't that sad? Oh well...I hope everyone is having a great holiday season.


DAVs said...

I'm glad you have a plan.
And while I hate that you have to use all these cycles, I am completely in awe that insurance will pay for them :O! That is fantastic. Can I come work for your company? :)

On the DHEA--my CCRM doc said it improved response to meds but didn't say it helped with egg quality. Clearly I have an egg quality issue. I'm so confused. Do you mind sharing more? And no, I don't think your hair will fall out ;)

Wishing you a peaceful holiday season and all the best for a GREAT 2009 :)

MamaSoon said...

Hi Sue, I got that number from the genetic counselor at ccrm. sounds like a good plan.

Polly Gamwich said...

That sounds like a good plan to me. And I can't believe that stat ... that's awesome. From CCRM genetic counselor I got an 85% chance with DE and I'm 31. Of course, I'm not willing to do CGH on embies, just oocytes ... so they've got no stat for that - nobody does it!

It's a hard wait - waiting to learn about your lost baby. I've been there twice and it's painful, but I will say it was good to hear that the babies were chromosomally abnormal - sadly, it made me feel better. Be prepared that they can and will tell you the sex of the baby - in case you don't want to know, now you're prepared.

I think that CGH is the right direction to go.

Jill said...

Yes, enjoy the wine and everything else you love. I hope you have a great cycle ahead of you! Good luck.