XP: Our WTF - long

BzeetyD · November 2012

Hey ladydudes -

Thanks for all your quick thoughts yesterday before our WTF. It was helpful.

We had almost a 2 hour conversation with our doc, which was great and very useful to us moving forward.

She said that my DX would be something like "light PCOS" crossed with "DOR." I've wondered about the PCOS thing before as I have a high AFC (usually over 20) and I'm a very good responder to meds - I don't have any other marked external symptoms and my TSH is normal. The DOR thing makes sense for the quality issue... but the DX is a tricky one because in many ways treating those two conditions are the opposite.

I had my blood drawn for an AMH, a Fragile X test and a Counsyl genetic test. - Will be getting the results in the next weeks. Our doc thinks that my AMH will be normal just due to how I've responded to meds and that AMH has a lot to do with AFC. Which is fine, I just wanted it done.

DH will have a Semen DNA frag test - just to check - especially if we need to move to DE.

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We talked at length about cycling at our current clinic and using the best cycle we've had (our 2nd) as a guide.

I'm 36, I'll be 37 in January. Our doc said that biologically I'm likely older than I am chronologically in the egg department so.. she said that at 40 we could expect that, on average, 10% of a woman's eggs would be normal. Clinical thinking is that we'd need to see 10 "transferable" embryos in order to see a normal one. We've only seen 6. So trying for a 4th cycle or 5th cycle isn't unreasonable. She said, depending on DX and age, most clinics go with 5 as the right amount of tries with OE, giving this 10% stat. It's a numbers game. If there's 100 goldfish in a bowl and 10 of them are gold and 90 of them are white... it's going to be difficult to dip in an randomly catch a gold one. And we all know that.

We talked about HGH - but our doc doesn't think it will help with our issues and that it's usually used for poor responders.

We talked about Neupogen and she said that's mostly used for lining issues, which I don't have.

We talked about EPP and MDL and neither of those would be a good fit, given what the DX is and how well the antagonist protocol seems to work for us (I've gotten PG both times).

We talked about Braver.man and RI. Doc feels that I am not a good candidate for this as my RPL came back normal and I have no allergies or other indications. She also felt that there isn't good evidence for some of the treatments being used. Which I agree with to a point, obvs things like MTHFR and clotting disorders can be treated easily, but I already know I don't have those.

We talked about getting more mature eggs. This is the trickiest part at our clinic, so our doc recommended that we consult at CCRM and consider cycling there as they have IVM (in vitro maturation) combined with IVF and are one of the very best clinics for this.

IVF with IVM could allow some of the immature eggs that are retrieved to possibly mature in culture before being ICSId.

This is of interest to us as my follicle sizes are usually very good (so, I'm saying that we're not looking to mature 12mm eggs, if this next cycle goes anything like our others, we'd be looking to further mature a bunch of 14's or 15's - which seems possible to me.)

I'm also interested in trying CCRM to see what happens in another lab/clinic.

I realize that we have hundreds of choices at this point and our doc is just 1 opinion. But she did her homework for us and presented us with something we hadn't thought about (IVF/IVM).

So we think that we'll consult with CCRM and talk with School.craft to see what he thinks and if we'd be good candidates for IVF with IVM.

I know that generally CCRM pushes genetic testing on embryos and Mister D and I will need to weigh that out. Luckily they have one of the best freeze/thaw rate in the country and their FET results are very very close to their fresh transfer results. It is expensive, but it could help us avoid another loss.

I also know that CCRM tends to push DE, but we're not ready for that just yet, and for DE, we'd do it at our home clinic anyways. Our doc believes that we'll have success with DE - but I don't really doubt that either.

CCRM is also more expensive than our current clinic.

So that's where we're at!

I might do some research around CCRM in the next week(s) or so and see what happens with our tests before scheduling the consult - or not! I'm very interested in hearing any CCRM experiences, good or bad and from anyone who has used IVM with IVF. (please PM me)

I'm feeling MUCH better having some kind of "plan" in place and feeling MUCH better after talking with her. Mister D is feeling better too.

My favorite aunt & uncle live in Denver so that would be helpful and nice. Also flights from MN to CO aren't too expensive and driving is also a possibility.

First step is to see how the consult goes.

We feel hopeful but we're proceeding without setting expectations.

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For others: There is a whole separate procedure called IVM that is very interesting and I haven't seen much posted on these boards about it. Basically for those with PCOS or high AFCs but egg quality issues, they barely/lightly stimulate the ovaries and then extract all the eggs before they reach maturity and let them grow/mature in culture for a few days before ICSIing them and then putting them back in like a normal transfer. It's significantly less costly than IVF because there are less meds and less ultrasounds and blooddraws/labs. It's very very new so not many people are doing this, and there isn't a lot of studies on success rates, but for the right candidate - it might be an option. There are a few clinics nationally who are doing it. Just a thought for those who are looking for options.

Thanks for reading. Here's a treat!

nawlinsgrl · November 2012

Hey B,

I was just getting ready to come on and ask how your appt. went. Sounds like it was very positive overall. It's great that your RE took that much time to discuss everything and provide you with all that information. I like to have as much info as possible and then take the time to decide what's best after hearing all my options.

Sounds like you still have some research to do before making a decision, but the info sounds very interesting and promising, and it's nice to have options to choose from.

hootie123 · November 2012

Wow that is a lot to take in. I just want to add that I did consult with C.CRM and it can take awhile to get a phone consult. I took the first available which was with Dr. G (who I loved!) but if you specifically want Dr. Sch then you should call now and set it up. There are online forms you need to fill out and get them copies of your records, etc.

I loved everything C.CRM said to me - and I would go there in a heartbeat if it wasn't so expensive. GL with your decision!

BzeetyD · November 2012

hootie123:
Wow that is a lot to take in. I just want to add that I did consult with C.CRM and it can take awhile to get a phone consult. I took the first available which was with Dr. G (who I loved!) but if you specifically want Dr. Sch then you should call now and set it up. There are online forms you need to fill out and get them copies of your records, etc.

I loved everything C.CRM said to me - and I would go there in a heartbeat if it wasn't so expensive. GL with your decision!

Thanks! I am open to any doc at CCRM! Evidently I misunderstood that School.craft was the consulting doc.

I think I'll call next week and get something set up for a consult.

Jlynn3 · November 2012

That is a lot of info! Wishing you lots of luck!

hootie123 · November 2012

BzeetyD:
hootie123:

Wow that is a lot to take in. I just want to add that I did consult with C.CRM and it can take awhile to get a phone consult. I took the first available which was with Dr. G (who I loved!) but if you specifically want Dr. Sch then you should call now and set it up. There are online forms you need to fill out and get them copies of your records, etc.

I loved everything C.CRM said to me - and I would go there in a heartbeat if it wasn't so expensive. GL with your decision!

Thanks! I am open to any doc at CCRM! Evidently I misunderstood that School.craft was the consulting doc.

I think I'll call next week and get something set up for a consult.

I think Dr. Sch is just the one that gets all the attention, but I'm pretty sure they all do phone consults.

Sophistikitty · November 2012

I also did a phone consult with Dr. Sch. As Hootie said there is quite a bit to fill out prior (most of it online). I was lucky there was a cancellation when I contacted them (last March) and the wait was about 7 weeks. I think there are other ladies on the boards that have been much luckier though and gotten appointment even sooner.

BzeetyD · November 2012

Sophistikitty:
I also did a phone consult with Dr. Sch. As Hootie said there is quite a bit to fill out prior (most of it online). I was lucky there was a cancellation when I contacted them (last March) and the wait was about 7 weeks. I think there are other ladies on the boards that have been much luckier though and gotten appointment even sooner.

Thank you Sophistikitty! I will get our request in this week. Hopefully by time the phone consult happens we could have our newest test results.

luvboston · November 2012

Sounds like your appt was positive, I signed up to consult with CCRM if I had not gotten my immune testing back before the appt I would have I was super impressed after talking to people and reading about them. They seem to be DOR experts. I did CGH and I think it was a waste of money for us but I think possibly no offense with your age it might be a something to think about. However if the eggs are iffy looking I would not risk it in fact I forced them to hold two back because I was so worried about them damaging them. I think CCRM is def worth the extra cash.

Edwina.McDunnough · November 2012

That's a fantastic WTF meeting and I'm glad you have a plan to move forward that addresses all the issues and concerns you have. I really hope your experience with C.CRM is positive and working with them is just what you need to bring home your baby. Thanks for sharing!

Gregermis · November 2012

That sounds like one of the most informative WTF appts ever. I'm super curious about the IVM procedure. Good luck moving forward!!

katt3233 · November 2012

I LOVE that your RE spent so much time with you! And it sounds like you really got all your questions answered and have a good plan. Wishing you all the best!

joules12 · November 2012

Sounds like a great WTF appt -- wonderful that you got so much information and feedback from your RE (and thanks for sharing details here). I'm glad that you've got a plan and that you're feeling more confident moving forward. Good luck with your CCRM consult and please do keep us all posted.

Julie21613 · November 2012

That was one hellova WTF appointment! Thanks for sharing that with us.... Gives me even more questions to bring to my WTF next week! I always feel so much better with a definitive plan in place after a failed cycle! I had a phone consult with Dr. Schoolcraft. I think I had my appointment on a off day with him. He really didn't seem to be prepared for my consult. He did speak of CGH testing but I never get enough eggs for that. Overall I was disappointed in my consult with him. I know I'm in the minority there so that is why I think it was an off day for him. I'll be very interested in hearing what he recommends to you.

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XP: Our WTF - long

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