Sorry it has taken me so long to write about our WTF appointment...we got back into town late last night, and I am just now able to sit down and write about it! There were a lot of details so I am going to do my best to remember everything that our doctor said. I will do my best to keep it organized and not ramble! We had an entire list of questions in my head to ask him and surprisingly enough he answered all of them without us even having to ask! Hmph, you would think he does this for a living;)
First things first, we never went back to our Augusta doctor to hear the pathology results from the D & C, so he was able to give us all of that information. The pathologist only found placental tissue and there was no evidence of embryonic development. He termed it a Blighted Ovum, which is the cause of about 50% of first trimester miscarriages and is usually the result of chromosomal problems. Click
here to read more about it. Basically, the embryo implanted and grew placental tissue and a yolk sac, but the embryo itself never developed. We do not know if it was a boy or a girl.
He went on to explain to us that we are obviously dealing with both male factor and female factor infertility. I can't remember Andy's actual sperm counts, but the motility was 6% for IVF #1 and 20% with IVF #2. In a normal sperm analysis, this number represents the percentage of sperm that swim forward and should be >50%. Obviously if they can't swim forward then they're not getting to an egg anytime soon. He describes Andy as having a variable sperm quality...it's great one day and not so great the next.
On the other hand, he spoke with the embryologist about my eggs before he met with us yesterday morning. They both feel that I'm not producing the quantity of eggs that I should for my age, and the ones that I do produce are not developing into the quality of embryo that they expect to see in the first few days of development. IVF #1 they retrieved 8 eggs and 1 fertilized with
ICSI. IVF #2 they retrieved 12 eggs and 7 fertilized with ICSI. A normal 31 year old should produce better quality eggs than I am spitting out. He doesn't blame these problems on us or any events in our lives...they are out of our control. It is just unexplained infertility.
He brought up the fact that we have only made it to a 3 day transfer. The only embryo that has ever made it to blastocyst stage for a Day 5 transfer was the one that stuck with IVF #2. Also, none of the others have ever made it far enough to freeze for a frozen cycle. They kind of get to day 4 and arrest.
He said that there is still a chance that we can be successful by using our own egg and sperm, but the chances of that happening are much lower than originally thought. I guess this is the beauty of practicing medicine...you live and you learn. There are other options that would give us a better chance. He asked us if we wanted his honest opinion and of course we said yes.
He feels that we would have a much better chance by using an egg donor and Andy's sperm. He said that the egg usually leads or dominates when it comes to fertilization, so he doesn't think that Andy's sperm would be an issue if we could just get a better quality egg. We told him that we had actually been discussing switching to donor. At this point we would like for our child to be biological, but it is not a deal breaker. Besides, if Andy's sperm worked then the baby would at least be half of us.
Here are the success rates he quoted to us:
- IVF #3 with our own egg/sperm: estimated 25-30% (Originally 60-65%)
- IVF #3 with donor egg: 65%
To put things into perspective, I'm going to have to bring up the financial aspect of this and I'm sorry...but it's a fact of fertility treatments. If you remember, we purchased the shared risk package which gave us 3 fresh and 3 frozen IVF cycles for a set fee excluding medications, monitoring, and anesthesia. Since we have had no frozen embryos, we have lost 2 frozen cycles already. This leaves us 1 fresh and 1 frozen cycle. We can choose to do the remaining cycle, but we would have to come up with an additional $5000 to cover meds/monitoring. If we don't want to do the remaining cycle, we can cancel our contract and get 70% of our initial fee refunded. The way we look at it, we only have 1 shot and we don't want to waste it on something that only gives us a 25% chance as opposed to a 65% chance. We would rather put that $5000 towards the 65%!
We were able to talk to the financial department and the egg donor coordinator to get additional information on how it all works. The company that we purchased the package through also offers a shared risk egg donor cycle. There were so many different options that it made our heads spin, but the most appealing was a package that offers 3 split donor cycles and unlimited frozen transfers for a set fee (which costs quite a bit more because we are using a donor). If you don't take home a baby from the hospital after all of these cycles, they offer a 100% refund. All medications and monitoring for the egg donor are covered in this fee.
Here is our reasoning, if this makes any sense. The egg donor fee costs basically the same amount as it does to adopt. If we were to do this and it didn't work, we would be able to get all of our money back and be financially able to adopt. We would be able to say that we tried everything that we possibly could and there would be no what-ifs. I know there are a lot of people that wonder why we don't "just adopt". First off, it's an extremely complicated process...a lot more complicated than "just adopt". Last time I checked, we weren't millionaires, this wasn't Hollywood, and our names weren't Brad and Angelina. Secondly, I don't think we should be deprived of experiencing the miracle of pregnancy and childbirth if there is a good chance that this could work. I don't believe that adoption is a "quick fix" for infertility...the pain of all of this will always be there. I can promise you that. Anyway, that's a whole different discussion...I'll save that one for later! You have to give your heart 100% to adoption and we are not quite there yet.
After speaking with the nurse egg donor coordinator, we got a better understanding on how the entire process works. They have single donor and split donor cycles. In a single donor cycle, the girl gives one couple all of the eggs she produces in an IVF cycle. In a split donor cycle, they choose girls that have a higher follicle count. She usually produces 20+ eggs in a single cycle and they are split between two couples. This choice is much cheaper because you split the cost with another couple.
The donors remain anonymous and never know the outcome of the cycle. They undergo extensive genetic and psychological testing as well as testing for infectious diseases, STD's, cystic fibrosis, etc. If we decide to go this route, we would have to fill out paperwork that lists what we are looking for in a donor. We can be as vague or as specific as we want. She said that it is typically a 5-6 month waiting period to be matched with a donor that fits your profile. Once matched the ball starts rolling pretty quickly, so we have to have all of our ducks in a row financially. We wouldn't be able to apply for the shared risk program until we've been matched with a donor, but she says they usually don't turn anyone down. They just want to make sure that my uterus is healthy, and my uterus has always been beautiful. It's just those damn ovaries and eggs that give me a fit.
Oh goodness, this turned into a ramble. I'm sorry, but there was so much information. I know I am probably forgetting some things, but I just wanted to go ahead and post so that I wouldn't leave you all hangin'! We aren't making any decisions now. We're going to take some time to think everything through. We do know that there will be some huge changes to our life if we decide to go through with it because the money has to come from somewhere! We're already throwing around a few ideas, but I'll elaborate on that when the time comes.
We're a little disappointed with the news, but excited at the same time. Deep down we knew what he was going to tell us, so that made it a little easier for us to prepare. Also, I'm relieved to know about what happened to our pregnancy which does give me some closure.
We have a lot to think about now, so please pray for us! Advice is welcome from anyone that has ever dealt with an anonymous egg donor/split cycle. We would like to thank everyone again for your love and support...it means more than you will ever know. We will keep you all updated!
Can I get a whoot whoot? 
