Introduction: RPL, IVF/ICSI/PGD/PGS/FET

hopeful16 · March 2015

Hello everyone.

I'm new to this Infertility Board, unfortunately, infertility is not new to me. My husband and I have suffered four miscarriages and are currently in the process IVF. Here is a quick summary of our IVF journey thus far:

3/4/15: Egg Retrieval

16 Eggs Retrieved -- 15 Fertilized via ICSI -- 10 Blastocysts Biopsied for PGD & PGS -- 2 Embryos Remain for Transfer

5/13/15: Scheduled FET

We are trying to stay as positive as we can, but also prepare ourselves for the possible negative outcomes, because of our past experiences. We were very hopeful when we learned we had 10 biopsies for PGD/PGS testing, but when we learned only 2 were healthy for transfer it was such a disappointment. Now I'm worried that the two we do have, will not survive the thaw. And if that happens, we will need to make the decision: Start the process/Pay the large amount of money all over again OR Start a new journey/plan without children.

I've lurked a bit at the conversations and I've noticed that many of you have done several cycles of IVF.... and my question is, how do you afford it? Are you taking out loans? Dipping into savings? We have paid for the medications, PGD probes, PGD/PGS testing, blood tests, ultrasounds etc out of pocket. For the lump IVF retrieval/transfer payment we took out a 24 month loan.

It has been a challenging five and half years. But I can say that my husband and I have only become closer and our relationship has grown stronger. I'm more anxious than anything at this point. I feel like I need to reach a finish line in this reproductive journey, one way or another. Anyone else feel that way?

Thank you for taking the time to read this.

dukegirlsc · March 2015

Welcome, I hope that this is your cycle and that your 2 embryos come out healthy and ready to grow! We are just starting the IVF process after 2 IUIs and 2 losses. For us insurance covers monitoring (ultrasounds and blood draws) and medications. We just have to pay for the IVF process and genetic testing, which is not a small amount. I'm praying we have a good cycle with lots of eggs since the attrition rate is so high. I understand your anxiety, I'm seeing the counselor our fertilty center uses and having acupuncture to try and counteract the stress. Just remember you still have other options no matter what the outcome of this cycle is. Fingers crossed and positive thoughts sent your way!

dolphin012 · March 2015

Welcome! Sorry for your losses. I hope this cycle and those two embryos bring you success. I am also just starting the ivf process -- started stim meds on thursday. Our insurance covers next to nothing (mostly diagnostic exams and tests) so we are mostly paying out of pocket, too. We dipped into our savings to do so for this first cycle. It is very stressful - i have many spreadsheets to compare financial options and track the transactions. We don't make a lot of money, but live quite simply and spend very little so are quite fortunate to have a savings to afford this. But since i am not use to spending money i was quite anxious earlier this week when everything was hitting our account!

We decided ahead of time we would do a max of two cycles. If the first one isn't successful, we will discuss with our RE and based on the results we may decided to stop there. They hope to retrieve more than 15 eggs so our though process is if none of those have good genetic material than its probably not worth pursuing another cycle. I guess where i am going with this is that i find it helpful to have a plan with an upper limit ahead of time. And yes, i understand your finish line feelings. It is a long journey and even if this doesn't work, i think i will just be relieved to know that it is unlikely for us to conceive our own and we can go from there.

Good-luck with this transfer!!

przemosbabe · March 2015

*PAIF*

I'm going to PM you but I want to say that protocol can have a lot to do with the quality of the embryos is what I have been told by my RE. I am really sorry you only got two normal embryos out of 10. That must be devastating. BUT you still have two. What if you have success with them? Do you really want 10 more babies in the freezer? I look at all embryos as babies so maybe thinking this way is not the same for you, it's just how I feel. I just want to point out that most human embryos are not normal, we are the least fertile out of all the animals. With that many losses, if it is not your embryo quality, I would suspect it's your immune system. I have what is called immune implantation dysfunction meaning my body attacks embryos as if they were a foreign object due to my endometriosis. I had to do IVF and then an aggressive frozen embryo transfer to get pregnant. I was an unusually patient that ovulated before retrieval twice, got immature eggs and had to do 4 IVF cycles before we got the right protocol for me. I made a lot of eggs we just couldn't get my protocol right. Then after getting the protocol right, we had to do the fet protocol to suppress my immune system and it worked. You should consider seeing a reproductive immunologist before transferring your two embabies. There is one in Chicago and her name is Dr. Joanne Kwak Kim. She is at Rosalind & Franklin university and she takes insurance. My insurance has zero fertility coverage, but they at Rosalind and Franklin are addressing your immune system and the problems within, so it's not billed as infertility. I have been her patient for two and a half years and I have never gotten a bill other than the one for the initial office visit. I think you should give them a call. If there is something wrong they will find it.

hopeful16 · March 2015

Thank you for your replies, I really appreciate it.

@dukegirlscI'm very sorry for your two losses. I wish you great things during your IVF process. Do you find talking to the counselor helpful? I have debated and have gone back and forth as to whether I should see the counselor at my RE office. Also, I've heard great things about acupuncture and I'm considering giving it a try. How has your experience been? Do you find it helpful?

@dolphin012 I absolutely relate to you regarding finances! I have spreadsheets to track the bills! That is great that you and your husband have a max number of cycles already decided. We have discuss it a little, and we usually conclude with a max of three, but like you said, we'll need to sit down with our RE before deciding to move forward with another cycle.

@przemosbabe I'm definitely trying to see the glass half full that we do have two embryos!

It was just a kick in the stomach and we had hoped (and crossed our fingers and wished and were overly optimistic) for six embryos ready for transfer - So that we could do three FET. I know, I know... I was being very optimistic lol. You are absolutely right about my immune system. I will be on the 'antihistamine' protocol for my FET. I will also be on Lovenox after the transfer. My RE believes it is a combination of my immune system and also the fact that my husband and I are both carriers of the severe strain of the gene SLOS (Smith Lemli Optiz Syndrome). It is rare that both partners in a couple would carry this gene, let alone the severe strain. My body could be recognizing that I've been carrying an affected child and that could be the cause of my miscarriages. The PGD results for SLOS on our embryos, (the predicted that 25% of our embryos would be affected) showed that 50% of our embryos were affected. Thank you for your referral of the reproductive immunologist!

przemosbabe · March 2015

@hopeful16 I would make sure there aren't any other problems before I transferred any more embryos, give them the best chance possible! I am so happy for you that your RE is not ignoring the fact that this could be your immune system rejecting healthy babies too. Most are ignorant and unwilling when it comes to this. Keep us updated ok? Xxx

dukegirlsc · March 2015

@hopeful16, I feel like talking to the counselor helps if for no other reason than I have someone to vent to that is not my DH. Men experience this very differently than we do, its not their fault it just is and having someone to talk to that basically validates the way I am feeling really helps me. Acupuncture is wonderful, she works with the fertility clinic and so she has done acupuncture before both of my IUI's but she also treats my stress and any other little issues that arise. I highly recommend it! Can you share what the antihistamine protocol entails at your clinic?

hopeful16 · March 2015

Thanks, @przemosbabe ! I'm fortunate to have found my amazing RE. She has been ordering a wide variety of testing on me for the past year, before even allowing me to begin the IVF process. She actually encourages questions and explains herself in detail. I will definitely keep you updated.

@dukegirlsc, I completely agree that men deal with this journey in a different way. I found support with a great group of women from TB during my darkest times, and it was such a huge help for me.

Along with my FET protocol, I was given my Antihistamine Protocol & Lovenox Protocol.

This is what my ANTIHISTAMINE PROTOCOL Sheet looks like:

"

This can be used to decrease inflammation and slightly suppress the immune system. In some cases, it is thought that the body detects the pregnancy as a foreign object and triggers the histamine response to "fight" the foreign object. This protocol is to prevent that from happening. You would begin taking the following medications with the start of Progesterone support (if doing FET cycle).

1. PREDNISONE 10 mg. 1 tablet by mouth daily. This will decrease to 1/2 tablet daily at the 8th week of pregnancy and will be completely discontinued by the 10th week of pregnancy.

2. CLARITIN 10 mg. 1 tablet by mouth daily. This will be discontinued at the 10th week of pregnancy.

3. PEPCID 20 mg. 1 tablet by mouth twice daily. This will be discontinued at the 10th week of pregnancy.

"

dukegirlsc · March 2015

@hopeful16 thanks for sharing that. I spoke to my RE about lovenox and prednisone and she stated she would not put me on those meds "just because" but that she would recommend another RE 4.5 hours away if that's what I really wanted. I'm trying to figure out exactly what to ask her at our meeting on Wednesday to determine how she comes to the conclusion whether or not to utilize those protocols.

FatPony · April 2015

@hopeful16, I hope everything works out for you. I agree with the previous poster about thinking about how many cycles to do before stopping. I'm a very practical, methodical person, so I felt that putting a cap on how many IVF cycles I would do really helped me feel in control. Planning helped saved my sanity throughout the process.

One more thing, it only takes one embryo to make a baby!! Good luck, if you need any support or need to vent, give me a shout.

jnissa · April 2015

(bfp and child mentioned)

I am late to the convo! But I did want to give you two things to think about.

The first is that I was at the RE last week discussing our options for #2, and she did tell me that at least at my clinic the success rates are extremely high if PDG PDS testing is done. I know each prognosis is different,but as a general optimistic thought, there's that!

Secondly, regarding deciding how many cycles to do and then stop. We did that (and are in the process of thinking about it again). And honestly part of it did come down to finances - moreso the second time because everything we spend to get a sibling for DD is money out of her future security. For our first child, we had said 3 rounds if the numbers were good and then donor eggs - but if the numbers were bad we were cutting it after one round and going straight to donor eggs. We were very lucky, because my numbers were very bad first round (four retrieved, 3 fertilized, 3 transferred) but we were blessed with DD. Going back for number two, the line is much tighter. We *may* do one round of IVF and if no luck we're calling it and moving on.

I wish I had a more helpful answer to your question about funding, but we are just very fortunate to be in professions where we had the savings to do this. That said, I had an amazing obgyn in my 30s who warned me - and I quote - "You can put this off till your late thirties if you want to, even your early forties. Just make sure you have the money to buy your way out of your decision." So there's been a savings stash for this all along. (It's long gone after one round of IVF though!)

Best of luck! Stay positive - because it's the most important thing you can do.

hopeful16 · April 2015

Thank you, @FatPony, I appreciate your support!

@jnissa, I have heard that PGD and PGS testing does result in higher success rates. I'm very happy that we did both types of testing on our embryos. Thank you for the optimism! It is good to hear during this stressful time!

Trying to stay positive!

adamkerryweds · April 2015

hopeful16 myself and my husband also are carries of the sever strain of SLO syndrome

hopeful16 · April 2015

@adamkerryweds, wow...! Are you using/have you used PGD to test your embryos?

adamkerryweds · April 2015

@hopeful16 yes we are doing PGD testing. we had our intake interview last week.

Introduction: RPL, IVF/ICSI/PGD/PGS/FET

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