Trek back to the Denver clinic: third time at the rodeo

Last Sunday and Monday, we were in Denver once again for the required one-day work up to be able to move forward with our third and final frozen embryo transfer. This is our third one-day work up. And...I'm trying to count them...but I'm thinking we've had 7 trips out to the Denver clinic over the years. Yowza.

We left Magpie with her nanny at our place in New York (we were told no children allowed at the clinic, which seems sensitive to those struggling to conceive, and we didn't want to leave Magpie in an unknown day-care or sitter situation in a strange city). Will and I splurged a bit and booked a nice hotel and had our first night alone together since before Magpie's birth. It was a little bit hard to be without her, and I worried she would miss us, but she's super attached to her nanny, so it seemed optimal that that was who she stayed with. And Will and I really enjoyed having some time together. Flying without a toddler? What a relaxing experience! Nice dinner out? Wow! Actual prolonged daytime conversation with my spouse? Amazing! Will and I both remarked how great it was to just get to hang out and be adults together for a bit. Funny how parenting changes the landscape so much. Wouldn't trade it for the world, as you know, but this short break was really nice.

Being back at the Denver clinic was weird...strangely boring this time around but also nostalgic. We flew through much of the day without blinking an eye. The consents, the credit card payments, the procedural instructions on injections, etc.? We've got all that down pat.

Ultrasound was slightly interesting - at Will's request, they did an antral follicle count. I have 4 follicles on one side and 1 on the other. Drastically down from what it used to be, but I am not a spring chicken, and we've been infertile for just about forever, so it wasn't difficult news, honestly, and maybe even better than I would have expected. I actually passed the uterine doppler blood flow test they do, for the first time, so no required electro-acupuncture for me, which will be nice to be able to skip.

There was one awkward moment when the financial person was chirpy and kept saying, "So you've come back to get a sibling for Magpie! Maybe two!" I'm a bit embarrassed to admit, I failed to just nod and go along with her inanity, instead saying weird replies like, "We'll see. It probably won't work, but you never know." I knew  that without her knowing our history, I sounded like a negative freak, but I couldn't stifle myself in the moment.  She also said at one point, "So you'll transfer two blasts?" And I said, no that we'd transfer three. (I received a very odd look in reply. What can I say, lady? I guess we are freaks). This will be embryos 7, 8, and 9, and it took us six CCS normal blasts to get to Magpie. When I'd seen my OB a few weeks ago, she had suggested I just transfer one blast at a time, and I told her no way. Don't have the stamina for it. Have to go on depot lupron for two months ahead of each transfer. Am 43. And did I mentioned that it took 6 chromosomally normal blasts to get to Magpie? I have zero fears about triplets -it ain't gonna happen - and few concerns about twins.

I had the required hysteroscopy, which was fine, and we met with Schoolie, who seemed decidedly more at ease than I've ever seen him. He said that we had shown amazing and rare persistence with all of our cycles over the years, despite really bad outcomes, and that he was certain that this was why we had Magpie. That few couples go to such lengths; that cost aside it's just too emotionally difficult. We agreed wholeheartedly and marveled a bit with him that we'd both survived intact.

He went over the plan: that I'll do depot lupron again for two cycles ahead of whenever we will transfer because of my history of stage 3 endometriosis. We discussed that if I achieve a pregnancy, this will be pregnancy number 9, and that I will want to do everything I can to hang on to it (including PIO, which isn't their standard). And he didn't name a percent likelihood of success but said my chances of pregnancy are lower than they would be, given that we have one no result embryo (the testing didn't work, so don't even know if it's chromosomally normal), and, if I recall, two day 7s (normal would be day 5, or 6). He says their clinic has had had success with embryos that don't go to blast until day 7, but that these slow poke blasts have a markedly lower implantation rate.

We also got to see our favorite genetic counselor and nurse, who came out into the waiting room to joyously greet us. This was super nice and the best part of our whole visit. The genetic counselor emailed herself a photo of Magpie from my phone and said she was going to send it to the head of the genetics dept there, ("She will be SO thrilled to see this!"). Apparently we and our story are remembered. It was so nice to see these two. Our former nurse, who has been promoted into a different position, said she would handle our cycle ("Of course!"), so that will make everything feel so much more comfortable and familiar.

So we're a go. Probably going to cycle in the next four or so months. So stay tuned.

Mo

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FET #2: 3dp5dt

Hi folks - nothing super impressive going on over here. We are currently in the Denver airport about to catch our flight back to NYC. Slight mechanical problem, so we're a bit delayed, giving me time to post.

My wonderful hubby Will took me shoe shopping yesterday (because there is nothing a good pair of new shoes can't cure or at least help with). After that, he drove us to Vail where we looked at the snow-covered mountains and beautiful skier and snowboarder people (and their dogs - so many gorgeous snow-loving dogs!). We had a lovely lunch and low-key walk around Vail Village. Made me want to go skiing. Not right now, mind you, but well, in different circumstances. Nice to see so much snow out in Denver since the Northeast has been so deficient this year.

In terms of two week wait symptoms...I wouldn't say I feel nothing. I definitely think I am maybe occasionally feeling very slight cramping. Got that? It's a definite maybe. It's awfully subtle. Trying to not drive myself crazy with this. There have been cycles in the past where I felt what I can almost term as uterine "construction" feelings going on that were very reassuring, and at least so far, that's not happening. But it's not a total dead zone down there either. The faintness of the sensations, though - and their transient nature - makes it hard to know if my perceptions are just what I would typically feel if I hyperattuned to my sensations or whether there is anything else afoot. Ah well.

At airport security, they wanted me to go through their fancy millimeter-wave body scan machine, which I didn't want to do. (No room in my already neurotic brain for any crazymaking thoughts that I somehow doomed the implantation process by exposing myself to millimeter waves!)

So I opted for the manual pat down and explosives wipe.

Which should have been no problem...

except for the small fact that I tested positive for explosives.

Yup.

So I ended up getting all my belongings checked and wiped for explosives and an errrmmmmm, more "thorough" pat down in a private room from two lovely female TSA agents.

Which thankfully I passed. Otherwise I had visions of them shutting down the entire terminal as they did...well, actually....don't know what they would have done in that case.

Not sure what set off the machine. Maybe something in my estrogen patches? Or in the ethyl oleate from the progesterone in oil? (I'm using that every other day to supplement my Endometrin suppositories.). Who knows.

I'm still hoping that maybe I will feel something more definitive in terms of implantation sensations soon. There have been times in past two week waits that I felt like a line of condos was being put up in my uterus...but then before my natural pregnancies, I never knew I was pregnant before testing at all...(or maybe had an idea a day before testing. Maybe.) So I know anything is possible. Trying to keep an open mind and not torture myself one way or another. All of your reports on what you did or didn't feel was very helpful, by the way. It doesn't completely make the crazy go away, but it reminds me that whatever I am or am not feeling, I am definitely not at game over yet. Nowhere even close.

Wait...was that something in my uterus? A slight cramp?

There it was again...possibly.

Oh wait, it's gone.

Maybe it was my imagination.

Or maybe it was just gas.

Sigh.

Mo

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Bedrest sanity strategies after a 7th transfer

It is 2dp5dt today and I am ending my bedrest this morning. We've been taking it easy around the hotel this morning, having a nice breakfast, and me taking a luxurious shower. Soon we will be off to do a little light shopping before heading back to NYC tomorrow morning. Nothing too strenuous. Will and I are not big shoppers, but we enjoy shopping in Denver because it is so quiet in the stores - not the mob scene that trying to buy anything in NYC always is.

So far, I haven't felt any sensations that I would find very reassuring. Yes, I realize it's early, but checking back to the last FET, I had definitely felt some uterine twinges by now. I thought I felt some faint ovulation-like pinching yesterday, but it was brief, and oh-so-faint, and not really in my uterus anyway. I lay in bed much of yesterday convinced that the cycle was a failure, then trying to tell myself not to give up yet, and that none of this is in my control anyway. With that repeated self-talk, I was able to move into a more neutral place, a who-knows-what-is-going-on-inside-me-right-now place.

It is just so, so hard to imagine that this could work, if I let myself think about it. And on bedrest it is hard to NOT think about it. Yesterday, I found myself needing to know that we have other plans lined up, that we are moving forward, that a baby one way or another is going to be coming our way.

So I ended up calling the donor agencies we've been working with to get a few women preliminarily tested. We've got three in the works, as crazy as that might seem. All three are seemingly good candidates. We've been going through the process of testing two of them since December. One of them stopped the pill late in December and we are still waiting for her to get her first period afterward so we can get her Day 3 bloods done. Gah. Another one has good Day 3s, AFC, and AMH, but is half Jewish, necessitating a bunch o' extra genetic testing, which we've been trying to line up. There's a third we've been interested in from way back when (our runner up to that first donor we loved so much who turned out to have the inversion on chromosome 9) and so I called her agency and they are contacting her to see if we can move forward with testing her. I'm just hoping one of these folks turns out to look like she is able to pass the Denver screening process.

In the event that this transfer fails, I would really like to be able to move forward in a fairly timely manner. Really and truly.

It felt a bit crazy to be lying here in my hotel bed hoping that at least one of the blastocysts was sticking while also phoning around to try to get our other ducks in a row for an egg donor. Weird to both hold hope that maybe we will get (and stay) pregnant from this transfer, while also feeling like that seems so unlikely, such a fantastical possibility.

At first I tried to talk myself out of double-tasking. Told myself to just wait and see what happens. It's only 9 days between this transfer and the beta. But then I decided that no, it's ok. We've been through enough that I don't have to wait and pin all of my hopes on something that may not work. I can have a big enough heart and mind to do both - to hope for these embryos and to keep moving toward another plan if we need it, another pathway to begin our family.

So strange as it may sound, I think my bizarre split-brain approach helped. I hate this feeling of limbo that the two week wait produces, such a sense of vulnerability, such a set up to enormous disappointment and sadness. It is also a time of hope and possibility - something we haven't had in a while.

I'm going to try to hold both of these realities. And I'm going to keep one foot in the potential of new life forming inside me and the other foot in the hard reality that we may need to find another pathway. I think I can hold both without one hurting the other.

I will keep you posted on any symptoms as they develop. As rational as I'm trying to be, it would be great to feel something is going on inside my body.

Question for you folks: those who have gotten pregnant, did you feel something in your uterus during the two week wait? At what point was it? And what did you feel?

More to come.

Mo

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All in: Thoughts on a 7th embryo transfer

Just back from the transfer and resting comfortably on my hotel bed while Will whips up a nice lunch for us. Bed rest has commenced and will end on Saturday morning. Kind of nice to have an imposed rest.

I did acupuncture before and after transfer, which I think helped relax me (along with the 10mg of valium they give you). I was so relaxed, I actually fell asleep during the hour-long lie down following the transfer (Will says I even snored a little). This transfer was much more comfortable than the last one because they didn't make me overfill my bladder. I explained how uncomfortable I was last time and how I can't seem to use a bed pan (all those years of practicing not peeing on myself lying down as a kid, I guess). So the tech actually let me get up and partially empty my bladder twice before the transfer. This made all the difference.

We decided to transfer three blastocysts back. I had six total frozen (five chromosomally normal ones and one no result), so we figured we'd use half on me and save half in the case I need to move forward with the woman who has so generously offered to be a carrier.

For those into the details, the three embryos transferred were of the following qualities:

1. A Day 6 3AB
2. A Day 7 4AB
3. An invitro matured day 7 4AA (was immature at retrieval and so fertilized a day late. Technically this one then is a day 6)

These are all three confirmed chromosomally normal...So with my amateur embryologist hat on, I rate these as seemingly one that looks pretty good (the straight up day 6) and two that are more wild cards (the day 7 and invitro matured one)...

we shall see...

Two survived the thaw 100% and were re-expanded. One survived 98% and hadn't fully expanded, but they said it was on its way. Here's what they looked like up on the screen just prior to transfer (I have highest hopes for the one on the bottom right).

Now to just rest as much as possible and hope that at least one of these guys decides to burrow in to the nice lining I've been working on developing over here...

I can't believe this is my 7th embryo transfer! Please please please let this one be the one.

Mo

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(Yet another) talk with Dr. Schl.

I spoke yesterday by phone with Dr. Schl. in Denver. Originally this call was set up to discuss whether it made sense to go forward with my sister as an egg donor, but once we received her AMH results, we knew that we wouldn't be cycling with her. Then the question became: How serious is this for her? What do I tell her?

At first, Dr. Schl. said my sister's situation wasn't so serious. Although she wouldn't be a good ART candidate, she would only need a single egg a month to have a baby, and at age 31 the quality would likely be fairly high. He said he estimated that she has a 50% chance of being able to have a child naturally and just needs to get started immediately. But then I told him that she is single, that she is not ready to have a family any time soon. His tone changed. In that case, he said, she has a big problem. In his opinion, she only has a couple of years left to have a child if she wants one. Ugh. Ugh, ugh, ugh. He said if she is not ready to have a child now, she should definitely consider freezing her eggs if she wants a child in the future. He recommended two clinics for this - his and a clinic in Atlanta - as the only two places to go.

I asked what I should say to her, how to phrase it, and shared how terrible I feel that we've uncovered this concerning news for her. He offered to speak to her by phone if I/she would like and explain to her the results of the tests, that he would like to take some of the burden off of Will and me by doing that. Which was a really kind offer, and which would be a huge relief. So I will be talking to my sister over the holiday and trying to arrange this. I wish all of this were not the case, not the reality. But I am grateful to have some expert help in framing the news for my sister so she can make whatever decisions she would like to about her future.

I also informed Dr. Schl. about what had happened with the first donor we chose. Told him that she looked great, had 33 resting follicles, everything panned out and we were good to go....and that then she turned out to have an inversion on chromosome 9. Those of you who know Dr. Schl. know that he is on the dry and non-emotional side, so I was quite taken aback when he said, "You're kidding me!!! An inversion on chromosome 9?!" I assured him that yes, that is what had happened, and remarked that Will and I have had a knack for hitting on rare and unlikely events during the course of our attempts at procreation. That's when Dr. Schl. said, "Wow! I wouldn't want to buy a lottery ticket with you two!" Um, ahem, no. You probably wouldn't want to. Typing this, I realize that it might sound like he was being insensitive, and maybe he was, but I actually found his response - his rather emotional response - validating in a strange way.

We talked about some other technical details on testing donors and the possibility of me getting an endometrial biopsy done soon that I won't bore you with.

But the other main topic we covered was the question of what I should do next. I am nearing the end of a grueling two month course of Depot Lupron. I will not have a donor ready to cycle with any time soon, it doesn't look like. So I asked him the unanswerable questions: What does he recommend I do at this point? Should I transfer back some of our genetically normal embryos? Or should I wait...does he think I need a surrogate?

His answer was interesting. "I think you will do fine with donor eggs."

Ooookkkkaaaayy.... I took this to mean at the time that he was voting we probably don't need a surrogate, despite what he has said at other points in time. But that my eggs are pretty cruddy, genetically normal or not.

He said that we can tell the embryologist what to transfer if we decide to transfer back some of our normals into me - maybe not transferring all of my very best ones all at once so that we have a bit of a backup plan in the (very likely seeming) case of failure.

After I got off the call with Dr. Schl., I remembered that at the beginning of the call he had said that the Denver clinic's computers were down. So then I wondered if he'd had my chart with him when we spoke, and whether he'd remembered exactly who we are and what our history is when advising me.

Hoping so. These are pretty big decisions facing us.

Emotionally, I am in a very bad place. It took everything I had not to burst out crying several times during my call with Dr. Schl. Things feel fragile and tenuous. I am so afraid of making the "wrong" decision but also feel that doing nothing is contributing to how down and out I've been feeling.

Hard to believe that Christmas is a couple of days away. I feel like we'll be going through the motions a bit this year with me in this dark place and Will grieving the loss of his father keenly.

Wishing you and yours a Happy Holiday. Hoping that 2012 brings all of us the things we have been wishing for most, which of course are most likely not things at all.

Mo

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What would you do in our position? The Denver staff weighs in

After E.'s karyotype came back and we learned we couldn't use her as our egg donor, I spent a long time on the phone with the genetic counselor in Denver.

We talked about the different paths in front of Will and me, potential frontrunner options being: transfer some of our normal embryos back into me since I'm on depot lupron and prepping for a transfer anyway, find a new egg donor - such as potentially my sister, or go straight to a gestational carrier.

The counselor and I mused about what a great story it would be to transfer our own embryos after this donor fell through and have at least one healthy child from the five embryos. That it would feel like it was "meant to be" that the donor fell through (a concept I don't so much believe in usually). It would be a really lovely ending to a harrowing four-and-a-half year story. Because those embryos are so precious and are basically irreplaceable, I thought of maybe putting in a couple of the more wonky ones, in particular, one or two of the day 7 blasts.

At some point in our conversation, I told the genetic counselor that she is one of the few people who truly understands the medical complications of our situation - my cancer history, the reality of having five frozen chromosomally normal embryos that may or may not be able to make a living child, and whether or not that would need to happen in someone else's body or not. I asked her, since she understands the nuances of our history, what she thought she might do next if she were in our shoes.

She said she didn't know. She also said she thought it was a really good question.

She said what she wanted to do was write up a one-page summary of our history, embryology reports from our blasts, and the options before us, and she was going to convene a meeting with the head of genetics (who also has a PhD in embryology) and Dr. Schoolie himself and let them talk about what they recommend, how they see the situation, etc.

I was so, so moved by this, nearly brought to tears. It's things like this that make me feel the Denver clinic truly has our backs. Our situation still stinks, but it is helpful to know this.

So they met, and then they got in touch. Everyone agreed that we face a tough situation with no obvious answer.

Forced to give an opinion, the head of genetics said she didn't know what to recommend, but felt strongly that if we wanted to transfer our normals, we should transfer the best two or three. Problem is, there are only really two good ones, the rest are not so hot. So it seems terrifying to risk them in my body when we don't know if I can carry a baby to term.

Dr. Schoolie said what I thought he would say (and what my rational side had already told me): nothing about our situation had changed. He thought Will and my idea of trying an egg donor was a very, very good one, one that could scientifically answer the question of whether I can carry a baby or not. Given this, we should just gather ourselves emotionally, pick a proven donor from their in-house pool, and run this experiment asap. (No problem!!)  Sounds good from a scientific perspective but misses entirely the fact that it is not so easy for us to find a donor we feel comfortable with. God help us, but we're skittish about this; it took months of searching through multiple agencies to find E. And...well, we know how that turned out. The sister donor idea, he said, was also not a bad one, assuming she is fertile enough and that it makes sense for us and our family psychologically.

Bottom line, there were no clear cut answers, but it was really great to hear their thoughts. Even more than this, though, it just meant so much to Will and me that they took the time to discuss our case and weigh in on it. This is one of those reasons why it would be very, very hard to leave the Denver clinic. They get that we are a tough case with potentially multiple reasons why conception and carrying has been such a struggle. Their medical care is excellent. And then on top of that, they really want us to succeed.

I'm not sure there is much more I could ask for from a clinic. (Unless maybe they could relocate to NYC. Now that would be pretty cool.)

Mo

p.s. My sister has passed the paper and phone screen...we are trying to get some of her bloodwork drawn locally as soon as possible and then get her in for a one-day-work-up. Fingers crossed.



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Motherhood as a shade of grey: could my sister be my egg donor?

Several of you guys are really good guessers! Much better than I was at this game! When I'd imagined the acceptance rate for egg donors at the Denver clinic, I'd guessed something like 20%, which I thought sounded really strict...but turns out is really lenient, or more lenient at least than the Denver clinic people are. So a shout out to those who guessed the true number: Only 5% of people pass the screening process to donate eggs at the Denver clinic. Kudos to Nikki, Strong Blonde, and Anonymous for their correct guesses.

Now, when I think about this 95% rejection rate, I wonder just who are these people who are applying? I fantasize that like maybe half of them really have no chance in the world of making it anywhere (sort of the medical/genetic analogue of someone with a C or D average applying to Harvard). Like maybe many of them are 37-year-old chain smokers, or were born with six fingers on each hand, or have parents or siblings with medical histories longer than mine... probably not, but maybe...

We've started looking at the Denver in-house donors, but seriously? Kind of slim pickings there. And then the photos of these women as two to seven year olds - 1987-1990ish vintage, usually small and dark and grainy - make it impossible to tell what each donor might have looked like as a kid, let alone get a sense of how their features ended up later. So we aren't ruling this avenue out and will keep checking back on Thursdays, but we weren't really drawn in so far, despite these women's obvious genetic, medical, and fertility superiority to me and the general population.

In the meantime, we are moving forward with my sister as a possible donor. She is 31 years old and single, and lives about four hours away. I'm going to call her Marina here, which is something I used to call her when she was about three years old, when her favorite story was Hans Christian Andersen's The Little Mermaid.

My sister looks remarkably, incredibly like me, including features, posture, mannerisms, voice. As in, when I went to see her while she was studying abroad in Europe, people in the neighborhood where she lived set eyes on me for the first time not knowing I was coming or even that she had a sister and said, "You must be Marina's sister." At her recent graduate school commencement, a professor came up to her and asked if her sister was there. She said she saw me from behind and heard me speak and just from that was absolutely certain that Marina and I must be closely related. We have even been asked if we are twins (although this seems like a stretch). Not in a while, mind you, but very heartening when you are 8 years older than your sibling. Probably tough for her to hear, though! We also share a similar sensibility, similar wry sense of humor, similar ways of speaking and moving through space and waving our hands in front of us when we talk. We aren't identical by any means, but definitely sisters through and through.

Perhaps having someone who is so similar to me physically and psychologically is part of what has made it hard to go the third-party reproduction or adoption route. I like this added connection, enjoying looking back through old family photos and seeing various family members' features reflected in ourselves and our relatives. You are guaranteed to share 50% of your sibling's genes, and our child (Will and mine with my sister's egg) would have the same grandparents, and same relations throughout the extended family, which seems good for the child from a "Who am I?" perspective. The child would in fact be at least 25% related to me and so if you think of relatedness and parenthood as a Venn diagram, both Marina and I would share relatedness to the child, which is a comfort to me, and seems like it wouldn't be so hard to adjust my mental image of what immediate family is and include her in the genetic parenting picture. Sort of a "motherhood as a shade of grey" rather than a black or white you're either the genetic mother or you're not.

Because she's my sister and will always be close in our lives, using her as a donor would also be more complicated than using an unknown donor. We would want our child to know from the beginning that Marina played an important role in bringing them into our lives and realize they might feel a stronger attachment to her for it than they otherwise might.

Which often feels wonderful, and occasionally feels a little scary. One of the scarier 3:00 am thoughts is: What if my child prefers Marina over me? She is after all, younger and definitely the cooler, more fun, more dramatic, more artistic, let-it-all-hang-out sister. I'm the overachieving, overresponsible, more subdued one (and who in the world would prefer that?!). Whether she donates her eggs or not, Aunt Marina is likely to be the favored Aunt. And I reassure myself that alas, my child would be stuck with me, and be rewarded with visits to Aunt Marina on a regular basis. I am joking about the "stuck with me" part. Mostly.

Marina has no children yet and is unsure if she wants them. We've offered to pay for her to do a cycle, freezing her eggs if she would like, and at least for right now, she is not very interested. She thinks if she does decide to parent, she'd probably like to adopt. Which is funny, right? That a genetic connection is so important to me and here she is likely able to have such a connection and really doesn't care? The world is an ironic place.

We've thought of using her as a donor since she approached us and offered us her eggs a couple of years ago, but I always held off because of all of my "What Ifs." Being the older sister, I worried that her giving us this gift might somehow cause her suffering later, or maybe she'd regret it, or maybe it would complicate our relationship in some negative way. We will explore all these areas with her and with a mental health professional, but somehow it doesn't seem so difficult to imagine anymore or so fraught with danger. Maybe opening our hearts to E. as a donor has made us more open to alternative paths in general, I'm not sure. I am sure that this seems the right path to take at this moment in time.

Here's hoping my sister can be in the Denver's 5% - or at least be deemed suitable to donate to me. They've already approved her family medical history, despite the fact that we all have six fingers on each hand and her older sister Mo has a medical record a mile long.

Mo

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Should I stay or should I go?

Thank you guys for your thoughtful comments - it really helps to read your take on our situation, your encouragement, and your questions. We appreciate it.

One of the questions you so thoughtfully asked was about whether we might want to leave the Denver clinic, since they are so stringent in donor screening and gestational carrier screening and preparation.

That's a good question.

Part of me is glad that if there is a chromosomal problem with the donor we wanted to use that we found it, and part of me is frustrated, since the finding is of unknown significance. But knowing what we now know, we wouldn't want to go with her without screening the embryos. And apparently, the CCS testing cannot pick up this problem (one thing we considered was seeing if we could go forward and just discard the affected embryos). Denver won't let us so it's a moot point anyway, and no other clinic we know of can do the CCS testing - even if they did, starting over from scratch with a new clinic would take a lot of time and $$$.

But going forward, the question remains: Would we maybe want to go with a different clinic?...tempting.

The problem is, the Denver clinic's stats are so darn good.

Here is a link to the top 10 egg donor clinics in the U.S. Denver is number 9 (lower than I would have guessed). But they also have a much larger sample size, so I trust their numbers more than some of the other clinics listed (and besides, they are still the closest to us of those listed...)

But really, maybe many other clinic's numbers are so close that it doesn't really matter significantly, right? So we looked in to this...There are two clinics in NYC we would consider, our old clinic and one other very reputable clinic. Our old clinic's success rate is 12% lower than Denver's (plus they don't vitrify embryos, which is really a deal breaker). The other NYC clinic's success rate is 8% lower (not as bad, but truly significantly lower, plus, we'd have to basically start over, which is expensive and time consuming).  Also, have you noticed how unlucky we are? We sort of think we need the stats as much in our favor as possible.

I also looked into the best clinic near where my sister lives in case we go in that direction, since it would make her life so much easier if we kept things local for her. Sadly, the best clinic where she lives has a success rate that is 20% lower (shocking!! I'm a little embarrassed for them, actually). No way we could do that.

Based on all this, at least for now we're thinking of staying. Not totally happy with this, but don't see a great alternative  either. I want to move forward as quickly and successfully as possible. I am beyond frustrated. I can't believe how difficult this is, how mired our situation feels to me.

In terms of alternate paths, we are anxiously mulling transferring some of our normals to me...so more on that soon. This scares us though, as we really don't know if I can carry or not, and at almost 40 now, I may not be able to replace those embryos (not to mention that I don't have the psychological stamina left to do more IVFs). I would hate to throw such carefully acquired and irreplaceable embryos in my old death trap uterus if there is no chance at life there, you know?

So that's where we are today, although things change frequently around here. We have emails in to the Denver clinic to find out more about the process/screening requirements involved in a sister donation and to find out the password to the Denver in-house donor pool (it would be great if we found someone suitable, although I'm not so optimistic about that since there are less than 60 women in the pool). Call also in to a psychologist for Will and me to talk to about the emotional complexities of a sister egg donation versus using an unknown donor. We want to be thoughtful about this decision, or at least screw up our kids thoughtfully, you know?

Everything remains unclear, but damn I'm trying to move forward anyway.

Mo

P.S. Guess what percentage of donor applicants passes the screening process at Denver? ...if you leave your guess in the comments, I'll post the answer soon. I think you might be surprised - I was. Known donor screening is different apparently (thank god!!), so hopefully not as steep of a hill to climb. Major kudos and a shout out to the closest guesser!


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One-day work up - the second time's the charm?

As promised, here's some of the details from our one-day work up a week ago.

Objectively, the day was pretty uneventful. I had the expectation that the whole thing would be a breeze (after all, we've done this before), but I was wrong. The one-day work up was surprisingly draining. By the end of the day, we were wrung out.

I started the day with a hysteroscopy, which hurt more than I remembered, and which was normal. Met with the donor nurse, who seemed OK. I am not warming to her as much as I did my prior IVF nurse, but oh well. We don't have to be buddies. When going over the huge binder they give you (my new "donor" one is grey, versus the white "IVF" one I was given before), she instructed me to be in close touch with her and basically said she is not going to be the one to be on top of everything. "I have 79 patients, so it's up to you to keep me up to date on all the details." Hmmm...Ok. I don't love hearing this, but if this is the case, it is good to know.

Will and I both had lots of blood drawn for communicables and we're running some additional genetics on Will that hadn't been done before (CF, SMA, thalessemia, etc.) - didn't see the point since I'm not a carrier, but now we'd rather know.

We met with Dr. Schl. and discussed everything that might help with implantation. We went over all the somewhat scientific things he supports (e.g., depot lupron - ugh, and the Denver miscarriage medication protocol of Claritin, Pepcid, and prednisone) as well as the more fringe immunological things that have been recommended to me by others (e.g., IVIG, intralipids, lovenox) and he reiterated he won't prescribe any of that but is willing to collaborate with someone else if that's what we want to do. So we'll have to decide. I'm not much of a believer in fringe myself, but we're at the edges of medical science with our situation, unfortunately.

We all acknowledged that while this donor egg attempt is promising, it may not work for me. And so we spoke together about using a gestational carrier in the future if need be. The basic gist of it was a positive one: that between my uterus and a gestational carrier's, and my eggs and a 23-year-old donor's, that somewhere in that mix we would finally succeed. We told Dr. Schl. that we have had very preliminary communication with someone who, knowing our story, generously offered to be a carrier. He was very enthusiastic about this. She won't be available until later in 2012 and we would need to get to know her much better and see if she is even still interested (it's been a while since we chatted about it) as well as have her medically screened. She has PCOS, which we told him and he said that that is absolutely no problem, which was a relief to hear. Even though we're doing the donor egg cycle right now, it was so helpful to discuss this, because if we did need to go this route, I feel much more comfortable with this person than with any of the anonymous profiles we looked at. Hopefully we'll learn I can carry a pregnancy, but it was really nice to begin to talk to him about what might happen if I can't and hear his genuine enthusiasm about it. (And those of you who know him know that he is not a generally enthusiastic guy!)

We met with the psychologist for the psych eval, which was fine but not really helpful. She seemed to conclude about 20 minutes in that we are very well read on this topic and have thoroughly considered issues like integrating a donor child into the immediate and extended family and the what's, when's, and how's of disclosure. And we have thought a lot about this. But interesting at least to see what the eval entailed.

Will also gave his sample for new chromatin assay and semen analysis without incident.

And then last but not least were the off-the-books visits. These were my highlights of the day. We saw our nurse and exchanged hugs and news.  And we met up with Danielle from genetics. She admired pics we have of our donor and said visually the match is a very close one, one of the best matches she's ever seen. And in general, she just made it so clear that she is rooting for us. She said she's kept my file at her desk all year rather than refiling it with the not-in-cycle files, and that every time she saw it, she'd tell herself, "I know they'll be back." "I know they're going to have a successful outcome somehow."

Please let it be true.

Mo

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