Posts Tagged ‘embryo’
Consultation re IVF - STICKING POINTS (Part 2)
Written by Arpee on September 23, 2008 – 11:42 pm -These topics are really the ones that have a lot of sticking points for me…
EGG/EMBRYO FREEZING
DrH also said that egg quality cannot be predicted and since I have old eggs, there is no point in egg freezing. They are able to assess the quality of the embryo through morphology to determine which will be transferred.
I don’t know if I picked up correctly on the discussion on Day 3 vs Day 5 transfer…
If there are only a few good Day 3 embryos, transfer is usually done on Day 3. If there are more than a few good Day 3 embryos, those can tested for PGD (preimplantation genetic diagnosis) or embryo screening.
DrH clarified that PGD is taken on the Day 3 embryo and results will be in for a Day 5 transfer. (So I am just realizing it now that if PGD is desired, that would automatically mean that it would be a Day 5 transfer - unless there is only a few good Day 3 embryo which forces a Day 3 transfer???)
On what is done to embryo and blasts that are not transferred - they are either frozen or discarded. They will freeze only those that are judged to have a high chance to survive the freeze/thaw. They give the blast up to Day 7 (which I suppose would be enough time/chance for the rest of the “lesser” blasts to survive before arresting) and will discard them.
Not sure if I captured that last statement accurately but that sounded a bit harsh… If I may quote from their clinic’s literature - “Only embryos that have fertilized abnormally, stopped dividing or have completely fragmented are discarded.” “Each embryo in our IVF laboratory is treated with the utmost care and respect…” DrH also mentioned that they are actually lean more leniently in judging the embryos to be frozen.
PGD OR EMBRYO SCREENING
DrH said that through PGD, they are able to determine if there are chromosomal abnormality (for 9 chromosome pairs only, not the 23 pairs) in all the embryos. This will isolate which embryos that have normal chromosomes from embryos that have abnormal chromosomes which lead to miscarriage. DrH also said that although PGD reduces the probability of miscarriage, it does not increase the pregnancy/live birth success rates.
The PGD is able to determine the gender of the embryo even at that point. (I read somewhere that there are some who practice gender selection using this method.)
DrH also said that as PGD will not be able to screen all chromosomes and I am of advanced maternal age, she recommends that if I do get pregnant, to have an amniocentesis for all the chromosomes since they cannot screen for Trisomy 21 (causes Downs syndrome) or Trisomy 17 and the like. (I don’t think I will do that since however the baby will be, I will accept. I will not terminate.)
I need to dig more into these. Please pray for wisdom and discernment that we make a decision that is according to God’s will.
Posted in Conversation, IVF, In Between Cycles, Infertility Learnings | 4 Comments »
Consultation re IVF - STATS AND RECOMMENDATIONS (Part 3)
Written by Arpee on September 23, 2008 – 11:30 pm -STATISTICS
DrH said that normal (fertile) couples chances of getting pregnant are 20% in 1 month, 50% in 3 months, 75% in 6 months.
She said that an infertile couples chance of getting pregnant is still even less than that with IUI - which I have seen different numbers from various websites ranging for 6-17%.
DrH showed us national stats on live births, miscarriages, own vs donor egg - all by age ranges. She believes though that 40 year old stats are closer to the next age range of 41-42 (than with 38 where it is in the same age range).
She said that their clinic’s stats are generally much higher than the national stats, except for the advanced maternal age where they are still higher than national stats but not much higher.
(I’ve actually seen their stats from SART so I knew what she meant when she made relative comparisons of their stats to the national stats. Their clinic is by no means the highest in the US though…)
IT TAKES ONE GOOD EMBRYO
DrH mentioned 2 successful advanced maternal age cases.
- One was 45 years old with 20 retrieved eggs that resulted to 19 fertilized embryos. PGD on all embryos showed that only 1/19 was normal and that was transferred. Now that patient has a daughter.
- One was 40 years old who had 1 failed IVF (without PGD). She went for a second IVF and out of the retrieved eggs and fertilized embryos, there was one lone embryo that tested well in PGD and was transferred. The lady’s beta is now being monitored.
OTHERS
DrH echoed back that some studies showed acupuncture to help but she would stay away from herbs.
She said that the meds would have no effect on my breast cysts. (I still am not 100% on that.)
POSTMORTEM ON RECENT IUI
DrH said that our recent IUI (second Follistim stimulation) was perfect according to her - but it still did not succeed.
Regarding the first Follistim stimulation which got cancelled due to OHSS (did not push through for IUI)… DrH said that it could not be converted into an IVF anymore since that decision should have been made in Day 8 so that antagonists are prescribed in order to convert into IVF. We were already past Day 8 when the impending OHSS was suspected.
DrH also clarified that they make calls until 6pm (only their incoming phones are turned off at 4pm so that they can do their housekeeping and return calls within 4-6pm). So I would have received a call re my results by 6pm.
She also said that she typically has post-mortems after failed cycles.
RECOMMENDED NEXT STEPS
I am on Day 50, so DrH said that when we are ready…. She would give me
- Provera to induce a period
- Skip the usual birth control pills (since I have irregular periods)
- Start me with Lupron
- Then proceed stimulate.
If IVF failed despite high fertilization rate, DrH said that she would not not recommend another cycle of IVF.
If IVF failed and there was low fertilization rate, she would say 2 things - 1) go for PGD or 2) go for donor eggs.
DrH recommended that we go through the IVF Seminar which is scheduled on Oct 8.
LASTLY…
DrH hugged me! I did not expect that but it felt good that she had no qualms on hugging. 
DH thinks that mentioning the hug in this post is sooo trivial. Man, are men clueless…
Well … that’s a lot for now… more data, getting a clearer picture, still need to dig more on specific topics.
Then need to digest info, step back, reflect and weigh, pray and decide.
Posted in Conversation, IVF, In Between Cycles, Infertility Learnings | No Comments »
