Wednesday, November 17, 2010

The Miracles of Modern Medicine

It's official: We've given up on nature and we're going with science!

About a week ago we finished up the diagnostic testing necessary to enter the donor egg program.  I had had almost every possible fertility test, but Adam had to have some tests.  Since we never had a problem getting pregnant, male infertility was never at issue, but obviously we don't want to go forward with this radical and expensive step only to find out that there was a problem on his side.  We both also had to be tested for a bunch of common infectious diseases.  I'm actually not sure why, but whatever - we're clean.

Adam and I spent about 45 minutes together at my computer picking out our top three choices for donor, but the process is so dynamic that, by the time we sent our choices in to K. (our coordinator), none of them were immediately available.  So K. sent us fresh list of donors who were open and we picked another and we made a match!

We had to decide if we just wanted to pay for one embryo transfer or plan ahead for a possible second try.  Our clinic offers a package where you get two "fresh" cycles plus any "frozen" cycles made possible with frozen embryos.  A fresh cycle is when they take the eggs from the donor, fertilize them, and then transfer one or two of the resulting embryos to the recipient a few days later.  If there are extra embryos, they can be frozen and saved for possible future transfers.  The success rate is a bit lower, but still higher than our chances the old-fashioned way.  If you just pay for one fresh cycle, you have to pay a-la-carte for the freezing process, the storage, and the transfer of any extra embryos.  (You have to decide whether or not to freeze extra embryos before you know if you've achieved pregnancy.)  We decided to buy the "multicycle" plan, where all of that is included along with a second fresh/frozen attempt if necessary.  The only thing you don't pay for up front with the multicycle plan is the second donor's fee, if necessary.  Of course if you get pregnant immediately, you've spent more than you needed to but it's a good deal, and I figure that paying for two tries up front gives us a great exit strategy.  If we paid for each try separately, there might be more temptation to continue on indefinitely, or at least, to agonize about whether to try again. This way, I know right now that we aren't going to go on trying forever, but I also don't feel anxious that we only have one shot.  In fact, with the addition of frozen cycles, we might have more than two tries, and frozen cycles are fast and easy.

The other big decision was that we are going to do a "split" cycle.  This means that we share the eggs produced by our donor in this cycle with another recipient.  However, since our donor had nobody else waiting, we're sharing the eggs with the clinic (they provide a frozen donor egg service and so can use the eggs).  So, if the donor produces ten eggs, we get five and the clinic gets five.  We get the extra if there is an odd number, and if the donor produces less than eight, we get all of them.  This plan is much less expensive because we only pay for half the donor's fee, but we have only half the opportunities to create viable embryos. This is one reason that it was very important to me to pick a donor who had at least some history of producing a lot of eggs.  It's no guarantee, but our donor has produced an average of 22 eggs when she's cycled in the past.  The average at our clinic is 15.

Once we have viable embryos, we might have to make a scary decision: whether to transfer one or two.  Our clinic does not do more than two at a time because multiples (twins, triplets) are not considered a successful outcome.  We'll deal with that issue later, but I think since we've paid for the frozen cycles up front we'll feel less pressure to transfer more than one at a time, if that even comes up.  It's possible we'll only have one embryo, or even none.  Anything can go wrong at any time in this process.

K. is creating our "calendar" right now.  She has to sync up mine and the donor's cycles.  It's amazing - they can actively manage our cycles so that exactly when my body would have produced an egg, the donor is producing eggs.  The recipient's role is actually easier than the donor's.  I plan to document the whole thing here, but for now, all I have to do is take the birth control pills.  About a month from now, things get more intense, with ultrasounds, bloodwork, and more meds, including self-injections. Immaculate conception is scheduled for the first week of the new year.

'Tis the season for miracles.


  1. Just curious, but what incentive does the clinic have to give you the best quality eggs in a 50-50 split with them? And what assurances do you get on that front?

    I've long been curious about this. I have several friends that have gone through this process and it seems the clinic has incentives to keep you coming back. I know you paid for two cycles, but they understand the emotional vulnerability of "just one more try" if those two don't work out, and the fact that by the time couples come to them, it is typically as a last resort.

  2. DM, As far as I know, there is no such thing as quality when it comes to eggs. It's only when you get embryos where there are some that are higher quality than others. We will own any and all embryos produced. I'll have to check about the egg quality issue, though, so thanks.

    The argument that it is in the clinic's interest to keep me coming back doesn't fly with me. Success rates are a huge competitive factor amongst clinics. This is one of those faulty arguments for government regulation: that it is in the interest of businesses to harm their customers.

    That said, I am working with a clinic with a great reputation - people come from all over the world to work with them - and based on my experience with them (and in comparison to the last clinic I used) I have complete trust in them. We've been under zero pressure to do IVF, donor egg, or anything else. In fact, when we first came to them I was convinced that we needed to to IVF with PGD and the doctor talked me out of it - long story short, it was not going to help us. There are many other facts that I've based my trust upon, but basically, I would never stick with this clinic for something so huge if I didn’t have that level of trust.