Infertility

update (long)

my doppelganger ...
... is awesome. the kindest most understanding person, who retired her s/n without hesitation. I was so worried that she would be brusque or hostile and had no expectation that she would be so sympathetic.

my beta ...
... is 10. So I'm ending the progesterone and going in for another beta Thursday and hoping it goes to zilch, or at least close enough to zilch to make everyone happy.

my what was effed (again) ...
our Wednesday appt was moved up to today. Including ....

1. cycle was excellent, and we're committing to a blast cycle with ICSI for #4. No protocol or med changes. We talked a lot about d3 vs d5 transfers specifically at my clinic and I'm comfortable going to d5 even if it's a total bust.

2. Hysteroscopy, will make an appt on cd1.

3. Redo all checklist items since it has been a year. May postpone this or redo items on this based on Beta #3 results as they may skew the numbers.

4. RPL testing, SCSA. Can do both or either upon my request but my RE does not think that the results will be helpful. From a clinical perspective we are already doing IVF which is what these tests can indicate at best, and RPL testing targets issues related to later loss, not very early or cp losses. We already have done a pretty close genetic screen as a checklist item so the remaining RPL testing to do would be to determine clotting disorders. SCSA pretty much what Patchens RE said.

5. CGH... will probably be a standard procedure within a few years. I personally didn't bring this up and don't think it's an option for us, as my RE agrees.

6. Second opinions encouraged. SIRM, feels there is not enough proof to substantiate their claims, and there have never been any clinical trials on intralipid therapy. CCRM tend to be very selective in the patients they accept. I don't get the impression that he finds a lot of fault with CCRM, is very respectful of their labs. RMA-NJ affiliated with CCRM. (?)

7. Bacteria. I forgot to ask this item even though it was on my list and I was staring at it at one point.

8. DE. He doesn't think that it's time, but he understands our interest in this as an option. We are lucky that my RE is on the DE board and is heavily involved in the process. We talked about DE for a long time and if anyone is interested I'll post those answers.

I'm happy to be resolving the stray issues from this cycle, answering stray questions from our meeting, moving on to our next cycle, simultaneously getting a second or third opinion, and working on updating my diagnostic testing. And somewhere in there I have to go to work.

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Re: update (long)

  • Wow...lots going on there. Sorry about the stupid beta issues. Sucks.

    Glad your RE sounds so supportive and informative!

    Thinking of you sweetie...

     

    TTC #1 since June 2008 *SAIFW*

    TI, IUIs, IVF = c/ps and BFNs

  • It sounds like you had a GREAT WTF.  Good luck hun!
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  • I don't even know which part to react to.  I'm so sorry that this wasn't your cycle, but it sounds like you are full of strength and resolve and have a new plan to move forward with.  I hear both exhaustion and hope in your words and am sending you a huge huge hug.  And some scotch. 
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  • Looks like you got a lot of answers.

    From what your RE said and Patchen's said, I have a feeling I am not going to get my RE to want to try intralipids either. 

    I'll still ask though.

    I hope these answers you got today will help bring you your much deserved sticky baby.

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  • Wow, first of all, Yay for your doppeldanger being cool!

    Also, I'm so sorry about the beta issue.  That sucks so bad.  But I am glad you had what sounds like a very good and productive WTF!  I hope your next cycle is it lady!!

    Big ((hugs))

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  • imageEdwina.McDunnough:

    my doppelganger ...
    ... is awesome. the kindest most understanding person, who retired her s/n without hesitation. I was so worried that she would be brusque or hostile and had no expectation that she would be so sympathetic.

    WOW, i'm glad that she retired her s/n, there's only 1 edwina :)

    my beta ...
    ... is 10. So I'm ending the progesterone and going in for another beta Thursday and hoping it goes to zilch, or at least close enough to zilch to make everyone happy.

    praying it drops and you can move forward

    my what was effed (again) ...
    our Wednesday appt was moved up to today. Including ....

    6. Second opinions encouraged. SIRM, feels there is not enough proof to substantiate their claims, and there have never been any clinical trials on intralipid therapy.

    there have been trials including one that LaneCA posted the other that was done in UK.  intralipids is the cheaper alternative to IVIG therapy and that has been around for a long time.  anyway, it doesn't work for everyone but can be the missing piece for some, including m&m2006 and schoolsout

    CCRM tend to be very selective in the patients they accept. I don't get the impression that he finds a lot of fault with CCRM, is very respectful of their labs. RMA-NJ affiliated with CCRM. (?)

    the lab that does CGH testing is in NJ, that's where CCRM, RMA and SIRM send their blasts for testing

    7. Bacteria. I forgot to ask this item even though it was on my list and I was staring at it at one point.  i need to remember to ask about this

     

    image 

    sounds like a great appt.  i think you should do the clotting disorder testing

    GL & PPV

    image
    Worrying does not empty tomorrow of its troubles, It empties today of its strength. ~Corrie ten Boom
    Courage doesn't always roar. Sometimes courage is the little voice at the end of the day that says I'll try again tomorrow. ~Mary Anne Radmacher (thank you beadinglady)

    It's been a long journey. TTC since 9/06. multiple IUI's and IVF's and 4 m/c's. IVF#3 = BFP, twins, induced at 34w6d due to baby b passing away (no explanation). Delivered on 35w1d, Baby A - baby girl, and Baby B - baby boy, our little angel.
    MTHFR A1298C & C677T, Immune Issues and Factor II
  • Wow!  That is a lot of information.  You are an information seeker like I am.  I just always want answers!  Your RE sounds great and very thorough. 

    I would be interested to hear what CCRM had to say about your situation.  I will say that I do not think they are selective in who they take.  I know they do pretty strongly suggest DE for some women, but my experience with them is that they will be honest and upfront but typically not refuse to have someone cycle there.

    I truly wish you all the best!

    TTC with DOR, low morphology, fertilization issues
    IVF#1 Oct 2009 (CCRM) - BFN
    IVF#2 March 2010 - Poor response/cancelled
    DE IVF#1 Aug 2010 - BFN
    DE IVF#2 Dec 2010 - Transferred 1, 2 frozen - BFP!
    TTC#2 FET Jan 2013 - Transferred 1 - BFP!

    Baby Birthday Ticker Ticker Baby Birthday Ticker Ticker
  • #1 - i'm really happy that you can remain the #1 best edwina mcdunnough on thebump :)

    #2 - sorry you're in beta hell, that crap is so annoying and unfair.

    #3 - sounds like you had a very productive wtf and i'm glad you were able to go through so many scenarios and get all your questions answered. sounds like you have a very open-minded RE who listens to you, and that's so important.

    ((HUGS))

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  • I'm sorry about the beta yuck. I hope that it goes to zero soon so you can just move on.  Your RE sounds great, and like he really listened to your ideas and concerns.  I hope that everything you need to do before you cycle again goes quickly (and that work doesn't interfere too much =).  Thinking of you.

    image
    After 2+ years and multiple treatment cycles,
    including an IVF vacation in Costa Rica/Panama,
    IVF #2 brought us our miracle baby!
    Baby Birthday Ticker Ticker

    Surprise!  Baby Boy is on the way!

    image

     

  • Wow!  That's a lot of info. 

    I'm sorry about your beta issues.  ((HUGS))

    Sounds like a productive WTF. 

    With respect to #1, my clinic does day 5 transfers.  So, even with small numbers of eggs retrieved, I have made it to day 5 both times.  I hope that it works out for you!

    With respect to #2, good luck with your hysterocopy!

    With respect to #4, my DH was required to have the SCSA done before IVF.  It didn't change our approach and things haven't worked out for us yet, so I don't really now why it was required for us.  I had the RPL testing completed.  There are doctors that argue that some of the blood clotting disorders can cause early losses and there are a few that argue that they can cause implantation issues.  If there is a treatment that can't hurt and may help, I would want to know my options.  Besides, my insurance actually covers the Lovenox I was put on because of these issues. 

    With respect to #5, I agree with you, I don't get enough embryos to merit testing. 

    With respect to #6, I agree with theworms.  My two IVFs were with SIRM and we used intralipids because of immune issues.  These didn't work for me, but the extra $200 each cycle that I paid for infusions is, in my mind worth it because it gave me the piece of mind that I tried everything.  With intralipids, it is a low cost and safe method of treatment.  If I were required to do IVIG, I would definitely want to see more proof that it was necessary before getting treatment (because of cost and risks involved).  I don't know much about CCRM.

    With respect to #7, this is something I need to ask about, too.

     Good luck!  I hope your next cycle is the one that gives you your take home baby!

    imageimage


    ~SAIF/PAIF/Everyone Welcome~ 

    Me= 37 and DH = 41 

    Dx: DOR, Endo, APA+ (really high beta 2 glycoprotein antibody and high everything else tested), heterozygous MTHFR mutation, positive for lupus anticoagulant, high FSH, low AMH and both tubes blocked (per HSG on 3/8/11)

    IVF #1 - long lupron (with HGH, intralipids, lovenox and BA); 4 retrieved, 3 fertilized; ET 2 blasts and 1 frozen = BFN

    IVF #2 - a version of antagonist with EPP (with HGH, intralipids, lovenox and BA); 6 retrieved, 4 mature, 3 fertilized, 2 blasts and 1 frozen blast transferred on day 5 = BFN.

    IVF #3 April was postponed to May, May was canceled. June/July was canceled. Had a cyst aspiration and then began IVF #3 in August. ER on 8/22; ET on 8/24 with AH. +HPT on 9/5. Beta #1 (11dpo) = 3; Beta #2 (15dpo) = 29; Beta #3 (17dpo) = 60; Beta #4 (19 dpo) = 118. Heartbeat at 6 weeks 6 days =132.  Lil is here!

    TTC#2:  Trigger + TI = BFN; Clomid + Trigger + IUI = BFN.

    IVF #4:  BCP + MDLF + Lovenox = 7R, 1F = Transferred 1 6-cell embryo on day 3 = BFN

    IVF #5:  MDLF + Lovenox = 4R, 1F = Transferred 1 10-cell compacting embryo on day 3 = BFN

    IVF #6:  (New RE):  Long Antagonist November 2014 (transferred two 8 cell grade 1 embryos and froze one blast) = BFN

    FET#1:  BFN

  • First, that is awesome that your doppleganger is awesome like that.

    Second, tons of info! That is so great that you were able to have such a thorough wtf!

    Third, I really, really hope that your next cycle is it for you! (((hugs)))

    ETA: apparently my word of the day is awesome, lol

    DX PCOS w/IR 01/08.
    Currently pg with our 1st after 6.5 yrs of IF (thank you IVF)
     
    My IF/Everything Blog
    There's No Crying in Baseball
    ***My posts are always SAIFW**
  • That's great that your doppleganger was cool!

    So sorry about your beta issues, but I am glad you had a good/informative appt.

    ((hugs)) 

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  • Eddie McD!  I just know your time is coming soon.  LOTS of luck to you!
    TTK 9/06 / TTC 10/08 / Twins 12/11 / Life Blog
    5 REs + 3 surgical hysteroscopies for septum/lap + 3 failed IUIs
    IVF w/ICSI/AH & acu = BFP!, unexplained spontaneous m/c @ 8w2d (our little girl),
    FET w/acu = BFP!, B/G twins!, lost MP @19w, dx w/funneling cervix @20w,
    twins nearly lost to IC @21w, saved by rescue cerclage, 17P & 16w of bedrest
    Our twins born @36w4d via CS when A came foot first

    Thankful for every day

    Baby Birthday Ticker Ticker

  • Sounds like a very informative meeting and glad you got some of your questions answered. Best of luck on your next cycle.
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  • Happy your doppelganger was so nice!

    Thanks for posting all of the info from your WTF. I really find it helpful to hear what other REs have to say about some of the different tests and treatment plans.

    I would love to hear what your RE had to say about DE if you wouldn't mind posting those answers. Thanks!

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  • Oh yeah, I am also interested in his thoughts about DE!  Thanks for putting all of this information out there.
    TTC with DOR, low morphology, fertilization issues
    IVF#1 Oct 2009 (CCRM) - BFN
    IVF#2 March 2010 - Poor response/cancelled
    DE IVF#1 Aug 2010 - BFN
    DE IVF#2 Dec 2010 - Transferred 1, 2 frozen - BFP!
    TTC#2 FET Jan 2013 - Transferred 1 - BFP!

    Baby Birthday Ticker Ticker Baby Birthday Ticker Ticker
  • I am sorry about the beta (((hugs))) Sounds like a great appointment though. Love that he fully supports you getting a second opinion. And so awesome that your doppleganger was nice!
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  • Edwina, it sounds like you got a lot of information. I am so sorry you are going through this, but I hope this next cycle brings you your sticky baby!
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  • just wondering about # 1 - why are you so dead set on a 5dt?  what about a 3dt with assisted hatching?

    ((hugs)) and GL with your next cycle!

    Lilypie Premature Baby tickers
  • Seems like it was a very informative appointment. I hope you got all the answers you needed and your beta drops quickly so you can move on. Good luck sweetie!
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  • So glad that your doppleganger was so nice and understanding!

    I hope your beta returns to 0 soon.

    And, it sounds like your WTF was very informative!  It sounds like you have great plans moving forward (it also sounds like you discussed a lot of issues that I have too!)  Wishing you nothing but good luck going forward!

    *P/SAIFW* TTC since 1/08 Clomid, 2 IUIs, 4 IVFs, FET 7 losses Baby Birthday Ticker Ticker
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