Opinions welcomed

mtlaurel · August 2012

As I expected, our WTF today was not particularly helpful. Here's what we got:

- RE would not cycle our donor in a shared cycle again (to me, this confirms that the donor had a less-than-expected cycle)

- RE doesn't buy into IVIG or intralipids tx, so she doesn't see a reason to test NK cells, and my immune and clotting panels came back negative

- RE doesn't believe that sperm DNA frag. has anything to do with miscarriage or implantation failure rates - thinks it's more a factor in fertilization. And, since we got 100% fertilization with DE, she doesn't think it's a concern

- They would only split between donor sperm and DH's in a full DE cycle (which I don't want to do because of $)

- She suggested DH have karyotype test and that I have an endometrial biopsy

- She thinks last cycle was bad luck and that we have just as much of a chance for success with another cycle

Our history is in my siggy. I would prefer to move onto DEmbryo because of $, scheduling and possibility of returning to original clinic which is close to home. DH would prefer to do another split DE cycle because he wants to have a genetic connection.

Any opinions/suggestions on other tests, tx or things I should look into that could help us both make a reasonable decision here? Thanks!

Mrs.McIrish · August 2012

Did you ask why didn't they let you go to blast ? Was it just the number of embryos you had? Just because you had 100% fert doesn't mean much. Even I can get 100% fert and then they just stop growing! From what I've learned from you ladies, I am pushing for a 5dt if I make it that far with DE.

mtlaurel · August 2012

Yes, there were only two high-grade embryos on d3, so their policy is to do a 3dt if the pool has already been narrowed down by then.

I also know that in our OE cycles, remaining embryos degenerated by d5, with our DE cycle, this was what happened to the other 4 embryos:

1-MEB with disorganized inner cell mass and trophectoderm on Day 6

2-PEB with absent inner cell mass on Day 6

3-VEB with disorganized inner cell mass and trophectoderm on Day 6

4-degenerated after Day 3

reb259 · August 2012

I agree my understanding is fert can be 100% and if there is a sperm issue it will be evident by day 4.

Big hugs and hoping you find clear path forward

may2806 · August 2012

I think you are at the same clinic as me? I'm just curious which dr you met with.

My dr didn't believe in the immune stuff either but I was at the point where I had to look into it. I found a reproductive immunologist in NYC who will work with you while you are cycling somewhere else. Not that it worked for me though, but I had to try it.

I don't know anything about the sperm DNA frag test, but all this talk about it today has me wondering too.

If it's a sperm issue that DEmbryo would be better, but if it's a uterine issue than either one would have the same chance... or it could just be luck and a second DE cycle would work. That's really a tough one because it's so hard to pinpoint the problem (if there is one). ((HUGS))

mtlaurel · August 2012

Yeah, May2806, we're at the same clinic - I see Dr. T. Did you have any of the basic RPL panel run by i.vf.nj before you went on to the RI?

Mitzi Bishi · August 2012

It sounds like you are really between a rock and a hard place, which I know personally what a challenge it can be to have differing opinions from your DH. Your doctor also sounds like mine with the "keep trying" pep talk, but I'd take her up on the biopsy and karyotype tests, because knowledge is power.

I have a questionnaire from a book that helped to put things into perspective for us. It at least provided a way to get what was important to us personally onto paper without emotions and from there we could discuss it better. If you PM me your email I can send it your way.

Would he rather forgo having a child all together if he's not genetically connected? I know you've already had to mourn that genetic loss and I know he's entitled to wanting that, but taking time and resources from one area where things haven't worked when you've already had to make sacrifices kind of paints you into a corner.

may2806 · August 2012

mtlaurel:
Yeah, May2806, we're at the same clinic - I see Dr. T. Did you have any of the basic RPL panel run by i.vf.nj before you went on to the RI?

I see Dr T too. I actually had already done an RPL panel before I met with them, so I don't think they had run it again? But I'm not totally sure. I know I had many tubes of blood taken but I think that was just my yearly regular bloodwork panel. When I came to them I had already been dx'd with MTHFR and PAI-1.

annalisel · August 2012

mtlaurel:
I would prefer to move onto DEmbryo because of $, scheduling and possibility of returning to original clinic which is close to home.

Butting in from TTC>35. I'm sorry the WTF wasn't helpful.

Since our recent catastrophic IVF failure, my husband, especially, and I have started to look into DEmbryo too. In many ways it seems like the least sad option for us.

vanessagorc · August 2012

reb259:
I agree my understanding is fert can be 100% and if there is a sperm issue it will be evident by day 4. Big hugs and hoping you find clear path forward

yes, this is absolutely correct. Fert rate means very little, other than that the sperm were alive when forced it to the eggs. (it means a bit more when using natural fert technique...but really not much with icsi). This is also why there is some belief that icsi can lead to a higher rate of m/c and birth defects (and it's suggested to monitor icsi babies more during pregnancy).

We had fert rates in the 90%s and we know my dh has a huge sperm issue, but by day 4....we usually had nothing.

I would consult a MFI uro, bc from my experience RE's don't know much about MFI. They just tell u to do ivf w/ icsi. My RE will even tell u he knows nothing about it, which i appreciate...that enabled us to base decsions on advice from the true expert.

GL moving forward!!

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