DE Question

LittleLady77 · February 2013

Hi ladies-

I have been lurking for a few weeks now. You all seem to be a wonderful group of strong women.

Quick intro- I recently got DXed with DOR. I have been ovulating normally for the last 2 years with no pregnancies to show for it so it looks like my eggs are lame. We don't have insurance coverage for infertility and we can't afford to do round after round of IVF or even injectable IUIs. Our plan right now is to do one injectable IUI cycle and see how that goes. If I respond well we might try one IVF before going the DE route or we might just jump to DE in 2-3 month.

My question- I would love to hear your thoughts on fresh vs. frozen DEs and shared DE cycles. If we had insurance we would go with our own donor and a fresh cycle but there is such a cost difference with shared cycles and frozen eggs. I would love to hear what some of you ladies did and why.

Thanks.

AmCheri · February 2013

Hi there. Sorry to hear about your DOR diagnosis. I know how devastating that news is and how terribly frustrating it is to treat.

I hope it's ok if I'm completely candid with you. I understand your financial situation. We were 100% OOP for all ART, including meds which can be extremely expensive if you're DOR. Our cost of meds actually exceeded the cost of the cycle itself. In this situation you should strive to make the most of the money you have. We did not go the IUI route because the chances of success were so very low. Ultimately we had two cycles converted to IUI, both were BFN. After years of trying on our own, and then with the new DOR diagnosis, we knew we had an egg issue as well as a sperm-meet-egg issue, so IUI didn't make much sense to us.

We did one fresh DE cycle and are extremely fortunate because it worked, though I won't deem it a success until after the birth. We opted to stay with our original clinic for DE because he's one of the top in the country for DE cycles. We used his in-house donor pool. Success rates (defined both as clinical pregnancy rates and live births) are quite a bit higher for fresh transfers at our clinic and across the board. Some clinics, however, are seeing their frozen rates start to catch up with the advent and refinement of vitrification as the chosen cryopreservation process. You need to look at your clinic's numbers to see how they're doing with frozen transfers.

I can't comment on shared cycles because our clinic doesn't do that. I have seen many women on the boards opt for shared cycles and it does seem to be an effective means of cost control.

Would it be an option for you to delay your cycle a bit as you save up money for a guarantee program?

LittleLady77 · February 2013

Thanks. Part of me feels very silly for jumping right to DE without trying with my OEs first at age 30 but in the long term I just want to experience pregnancy and being a mother. It's heartbreaking but I don't want to be broke and childless.

According to SART.org my clinic is the best in Northern California (my area) and there are a ton of them around here so I feel good about that. They don't do shared cycles so I would have to go to a different clinic to do that but it's literally half the cost with 1-3% lower success rates.

Aren't the guarantee programs close to 50k? With my age the success rates are so high we probably wouldn't do that, nor could we afford it for years. If they are less then I would love to hear about them. I'll look into it more.

Thanks for your answer.

LittleLady77 · February 2013

To answer the IUI issue. I think it's silly but that's what DH wants to start with. Our doctor said we have a 5% chance with it for a cost of $3-4k. We only have a 10% chance with IVF and my cycle would cost $16-20k.

We certainly won't do more than one IUI round.

AmCheri · February 2013

I can't speak to any clinics other than my own. We have two types of guarantee programs. One program is $26,000 with 80% being refundable. The other is $35,000 with 100% being refundable. Both include all clinic costs and the donor fee, but meds are extra. It's worth looking into so you know all of your options.

I can understand your feelings about going straight to donor. I was 36 when we made that decision (and had three failed cycles and a m/c under our belt) and it was still devastating. You might want to do some research on DOR and its impact on the incidence of m/c and trisomy rates, regardless of age. I did prior to moving onto DE and it was quite enlightening and was ultimately what tipped the scales in favor of DE. That said, it's totally reasonable wanting to try with your OE first. Women with DOR can and do get pregnant with their OE. It's just not as easy for us and our cycles can be wicked expensive because of high doses of stims.

I wish you the best. You'll make the right decision and hopefully those who have gone before you can help ease your mind.

AmCheri · February 2013

LittleLady77:
To answer the IUI issue. I think it's silly but that's what DH wants to start with. Our doctor said we have a 5% chance with it for a cost of $3-4k. We only have a 10% chance with IVF and my cycle would cost $16-20k.
We certainly won't do more than one IUI round.

There's a lot to be said for taking the steps you both need to take before you can fully embrace the possibility of DE. You definitely don't just wake up,one day and think DE sounds great.

It's just tough to know that your chances with IUI are so low after spending so much money. We were given approximate odds and I later found out that my clinic has never seen a successful IUI cycle under circumstances like ours. Please don't mistake my comments for negativity. We wanted to try everything, too. My comments should be viewed solely through the financial perspective and choosing the route most likely to be successful when money is an issue.

LittleLady77 · February 2013

AmCheri:
LittleLady77:
To answer the IUI issue. I think it's silly but that's what DH wants to start with. Our doctor said we have a 5% chance with it for a cost of $3-4k. We only have a 10% chance with IVF and my cycle would cost $16-20k.
We certainly won't do more than one IUI round.
There's a lot to be said for taking the steps you both need to take before you can fully embrace the possibility of DE. You definitely don't just wake up,one day and think DE sounds great.
It's just tough to know that your chances with IUI are so low after spending so much money. We were given approximate odds and I later found out that my clinic has never seen a successful IUI cycle under circumstances like ours. Please don't mistake my comments for negativity. We wanted to try everything, too. My comments should be viewed solely through the financial perspective and choosing the route most likely to be successful when money is an issue.

Your comments aren't negative, they are realistic. Honestly, thank you.

MrsSwitzee · February 2013

Choosing DE is a huge decision and one made only when it's the right time for you. We made the decision to move to DE early because we tried one OE cycle and failed miserably (did not stim on high doses). I am a very realistic and practical person and did not want to invest more money on OE cycles with only a 1% chance of success. So for us moving onto DE just made the most sense emotionally and financially.

Our clinic does not offer a frozen egg option so that was not a consideration. They do have a shared donor program but with a primary and secondary recipient depending on how many eggs are retrieved. If not enough eggs are retrieved in a cycle then the primary recipient gets all the eggs and the cost is increased to almost that of an exclusive cycle. We chose an exclusive cycle upfront because we wanted the best chance at frosties and did not want to wait for another recipient couple to want to cycle.

I wish you luck in whatever decision you make.

LittleLady77 · February 2013

MrsSwitzee:
Choosing DE is a huge decision and one made only when it's the right time for you. We made the decision to move to DE early because we tried one OE cycle and failed miserably (did not stim on high doses). I am a very realistic and practical person and did not want to invest more money on OE cycles with only a 1% chance of success. So for us moving onto DE just made the most sense emotionally and financially.
Our clinic does not offer a frozen egg option so that was not a consideration. They do have a shared donor program but with a primary and secondary recipient depending on how many eggs are retrieved. If not enough eggs are retrieved in a cycle then the primary recipient gets all the eggs and the cost is increased to almost that of an exclusive cycle. We chose an exclusive cycle upfront because we wanted the best chance at frosties and did not want to wait for another recipient couple to want to cycle.
I wish you luck in whatever decision you make.

Thanks, do you want frosties for future siblings down the road or for better chances?

MrsSwitzee · February 2013

Short term we want frosties for better chances, long term chances for a sibling would be great.

LittleLady77 · February 2013

I think the part I struggle with is cost vs. chances. At half the cost I could do 2 DE shared cycles vs one with frosties. We could afford to do it this year vs. saving up, but am I just being cheep and what about siblings later? it would be sad if my future kids were only 1/2 related. Ugh, it's such a hard call

MrsSwitzee · February 2013

LittleLady77:
I think the part I struggle with is cost vs. chances. At half the cost I could do 2 DE shared cycles vs one with frosties. We could afford to do it this year vs. saving up, but am I just being cheep and what about siblings later? it would be sad if my future kids were only 1/2 related. Ugh, it's such a hard call

So true! Even with an exclusive cycle there are no guarantees there will be frosties. I do think whatever decision you make you have to make it whole heartedly since we can second guess ourselves crazy...

MrsT4 · February 2013

The prior posters already gave you good advice and I was also going to suggest that you and DH should really think about if you want more than one child. Assuming you do, how important is it for them to be 100% genetically related? I have at least one friend IRL who stopped at 1 child, primarily because she could not get the same donor again. She was dealing with DS, not DE but her concerns about having siblings not being 100% related were the same.

Shared cycles just scare me personally, because even with a young donor, all eggs are not necessarily going to be of prime quality and will produce children. But I also understand the need to think about costs for all of this.

I only briefly looked into frozen eggs and my clinic wasn't too comfortable with the idea. Therefore, if I really wanted to pursue it, I would have most likely had to travel or switch to another clinic that was more open to it. Honestly, I did not have it in me to switch clinics again, so we went with a fresh dedicated cycle.

Good luck to you...I know it's not an easy decision.

Strunella · February 2013

We are going with frozen DE for a variety of reasons. The waiting list for fresh eggs at our clinic is over a year. We absolutely don't want to wait that long. Using an agency for eggs is crazy expensive. I also don't love the idea of having to rely on someone else for cycling...too many ducks have to line up for everything to run smoothly. Finally, it is a heck of a lot cheaper to use frozen eggs.

Having said that, the success rate at my clinic is great for fresh eggs and not so great for frozen. So, we'll be traveling out of state to another clinic where their expertise lies in frozen eggs. Their fresh/frozen success rates are equal and the majority of their cycles are now frozen.

Having siblings that are 100% biologically related is obviously a personal decision. It's just not something that DH and I are hung up on. We have a biological son, and our DE baby will only be a "half sibling" to him. It is more important for us to have another child in our family than it is for them to be 100% genetically related. Furthermore, DH and SIL are both adopted, and are not genetically connected to either their parents or each other. I guess I just think that there are a lot of ways for people to be considered part of your family, with genetics only being one factor.

LittleLady77 · February 2013

Strunella:
We are going with frozen DE for a variety of reasons. The waiting list for fresh eggs at our clinic is over a year. We absolutely don't want to wait that long. Using an agency for eggs is crazy expensive. I also don't love the idea of having to rely on someone else for cycling...too many ducks have to line up for everything to run smoothly. Finally, it is a heck of a lot cheaper to use frozen eggs.

Having said that, the success rate at my clinic is great for fresh eggs and not so great for frozen. So, we'll be traveling out of state to another clinic where their expertise lies in frozen eggs. Their fresh/frozen success rates are equal and the majority of their cycles are now frozen.

Having siblings that are 100% biologically related is obviously a personal decision. It's just not something that DH and I are hung up on. We have a biological son, and our DE baby will only be a "half sibling" to him. It is more important for us to have another child in our family than it is for them to be 100% genetically related. Furthermore, DH and SIL are both adopted, and are not genetically connected to either their parents or each other. I guess I just think that there are a lot of ways for people to be considered part of your family, with genetics only being one factor.

would you mind sharing how you are going about getting your frozen eggs? The only ones I've seen are $16k for 6 eggs. My doc says I would need another 5-6k on top of that for the procedure.

I would also love to know about the clinic that specializes in frozen DEs.

LittleLady77 · February 2013

Thank you all for the honest heart felt advice and support.

I guess having siblings that are not 100% related isn't that important to me. I just worry about them getting teased or one child being smarter or better looking and the other one feeling bad about it.

I'm an only child and I always wanted brothers and sisters. The plan was always for two or three kids and I felt very strongly about that. Currently I'd be happy with one but I know I won't feel that way forever.

JM1977 · February 2013

You are asking a lot of great questions, and I hope the feedback has been helpful!

RBA in Atlanta seems to be the most well-known frozen egg clinic (https://www.myeggbank.com/donor-eggs/index.php). They would definitely be worth looking into as an option.

We used Shady Grove in Maryland for DE. They are one of the largest DE clinics, and they have a 6-cycle guarantee program. There are a couple of different options with how it works (pay the largest amount upfront for 100% refundable and no extra charges per cycle or pay less upfront for mostly refundable but some fees due for each cycle). They also have a discount program for couples who make under a certain amount per year for the last two years (I think it's around $90,000 household income).

We were in the 1:2 split cycle program (more expensive than the 1:3), and we ended up with 1 embryo that we transferred for our daughter and 2 more frozen. We transferred one of those last month, and I am now pregnant with a second. So for us it worked out to have 100% genetically related siblings from a split cycle, but we were willing to take the risk of not having that in order to save the money on a split vs. exclusive cycle.

I wish you all the best moving forward!

Strunella · February 2013

We are going to RBA in Atlanta, as JM mentioned above. You get 6 eggs for $16,500 with a guarantee of 2 high-quality embryos. If you do not meet the guarantee and do not end up pregnant, you cycle again for free. They also offer a 5 cycle guarantee plan for $30k. We are testing and monitoring at my local clinic and my drugs are covered by insurance, so there are definitely additional costs there, but I don't think it's anywhere near $5-6k.

I am also an only child, so I definitely understand the desire to have more than one child. This is why we are moving on to DE. After 3 miscarriages, we are done with my OE.

Even biologically related children can be diametrically different! There can be a "smart one," a "pretty one" and an "athletic one." I know a set of 7 year old twins who don't even look like brothers, nevermind twins. And frankly, SO many people tell us that DS is my DH's mini-me. And I'm his bio mom. So, I'm already prepared for a DE baby! When I consider all of that, DE just doesn't seem that daunting to me.

LittleLady77 · February 2013

Thank you all so much.

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