Thursday, February 4, 2010

A glimmer of hope and clarity

I walked into the RE's office with my stomach in knots. DH was unable to leave work today so I went solo, and the moment I sat down in the lobby I texted him: I'm here. Pray for me. I knew the appointment could influence us in our decision making, and I think I was so tense because it could make us decide to not do IVF....or leave us in the exact same place of indecision.... or maybe even help us to decide to do IVF. Either way, it felt big.

Dr. H gave me a lot of hope. He said that even with limited fertilization, he would still give us 50% odds of success! (I will explain this more...) I was not expecting this at all, and hearing that our odds could be this high made me want to cry and laugh at the same time. I think a big part of our hesitation about doing IVF is that, ethically, we are committed to doing a limited fert and we knew this would lower our odds. But how could we pay that kind of money for low odds? But here he was saying our odds weren't that low...

I called DH on the way home and explained this to him. I also told him about the discount the RE offered after I told him we were looking at other clinics that offered "Mini-IVF" at a special rate. Immediately, DH said he thinks this is the clarity we have been waiting for, and that he thinks we should seriously consider moving forward. And I couldn't agree more.

After all this time of angst and waiting, I can't believe we reached a turning point just like that. Thank you, Lord! We feel like the Lord has removed our hesitations, has made our paths straight, and opened the doors before us. Wow.

Some of you were curious about my RE's answers to my questions... here they are:

*What would you say our odds of success are with IUI's at this point? 10% per cycle. He has had couples continue with IUI's beyond 4 cycles and get pregnant, so we could still have this as an option.

*Odds of success with IVF and limited fertilization (important because we know it would lower our odds, but by how much)? 50%. This one took some explaining, since I definitely thought it would be less. I typically read that a regular IVF cycle has 50% odds of success for most couples, so I couldn't believe that a Mini-IVF cycle would have the same for us. But, in my RE's opinion, he would place our odds at 60-70% of success if we were doing traditional IVF since I am the same age as many of his egg donors, and he thinks the sperm will be fine once it can actually get into the egg. He said that my egg quantity is probably a little low (based on FSH & AFC), but he would guess that the quality is fine based on my age. Along with this, he said something I have never heard or read before: that the first few lead follicles that every woman has when they start a medicated cycle are typically the best quality eggs. He calls these eggs the "baby eggs" that most often produce the top graded embryos. The smaller follicles that catch up to the lead follicles can produce good embryos, too, but not always...and the best ones are usually those first few. So, in his opinion, our odds are not that much lower because we are using the best eggs.

I should add here that DH and I have considered that he may be "overly optimistic" in order to get our business. We know this is a possibility, but overall we trust our RE. He may be inflating the percentage somewhat, but we do not feel like he is lying....which is a big difference to us. These odds are guessing games anyway, but we trust his is an educated guess.

*I have found clinics that do "Mini-IVF" (with minimal stim drugs), and that seems like a good fit for us since we don't want many embryos anyway. What's his take on "Mini-IVF" for us? Does his clinic offer something like this (especially at a lower rate)? Our clinic doesn't advertise a "Mini-IVF" cycle, but this is essentially what we would be doing. He would do mild stimulation to produce 2-3 eggs to fertilize. He thinks this is the best option for us and did give us a discount. I don't think the discount is because doing things this way is actually cheaper, but just because I said I was also looking at other clinics and he was being competitive in a business sort of way.

*If we did traditional IVF, would he recommend freezing extra eggs? Does the clinic "flash freeze" the eggs? What have been the success rates with frozen eggs? Our clinic does freeze eggs, but he said it is such a new science that he can't recommend it. He said that have frozen a number of eggs, but only two customers have come back (so far) to use their frozen eggs and neither resulted in a pregnancy. He said if we felt like this was a good option for us he would freeze the eggs and not charge us. Based on what he said, I don't think this is something I want to hope for...but maybe if we got 4 eggs, fertilized 2, and froze 2 (for free) it could be an option.


*What's my antral follicle count? My FSH was 9. What do those diagnostics mean for me/ treatments? Are those a concern for him? My AFC is about 10. He did admit that that is lower and my FSH is higher than most women my age, but he emphasized the fact that these tests show quantity not quality...and he would still bet my quality is good. He also said there is no way to use these tests to predict if/ when my fertility will decline , I would go through menopause, etc. I'm ok with this answer, and I just can't worry about what the future of my fertility is. I just can't.

*Should I get my AMH tested (although, honestly, that test and its potential result freak me out...and I heard it's expensive, so I don't know if I even want it...)? No, he thinks that the test results would not change our treatment plans, so why go through the extra money and stress? If we were deciding whether or not to use donor eggs, for example, he would recommend it, but in our case he sees no need to test it.

So there's a detailed breakdown for you. :) I can't say we're at 100% confidence about moving forward, but it's approaching that level. I feel a lightness and hope that I couldn't even imagine during this past month. I feel the peace that I have so earnestly prayed for - thank you Lord! I know that many difficult days could lie ahead, and the thought of doing 3 IVF cycles and still remaining childless sounds more painful than I can even imagine. But, today, I am moving forward with hope.

Interestingly, I got another (!) pregnancy announcement via email today. I knew this friend was trying and actually had asked her to email me the news so I could process it. Well, I got that email this evening....but it didn't sting as much. A little hope is a great buffer for pregnancy announcements.

26 comments:

Alena said...

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Alena

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Betty Rubble said...

This is all GREAT NEWS!!!

I'm so glad that you got some news and that your road hasn't come to an end yet! WOO HOO!

Leah said...

It sounds like a great appointment! And I doubt your RE was trying to give you false hope. I know my RE was always very straight with me, and it was sometimes discouraging, but I appreciated that he wasn't giving me false hope.

Okay, not that you asked for advice, but I've been thinking about your situation a lot, and was thinking. . . What if you took the normal meds, instead of less, and hopefully produced 10+ eggs. Have the RE extract them, then look at what he thinks the best ones are, and then only fertilize those? So, I think it wouldn't be an ethical issue anymore, and it would give your RE a better choice in which ones to try to fertilize. Just a thought.

So glad the appointment went well. :-D

jeanna said...

I really appreciate you including Him in your blog, even though I am not making the same decisions as you I still fight to hear our Lords voice through all the other voices out there. In reading your posts it really helps me analyze my own life. That being said, I am SUPER excited that you and your DH are thinking about IVF, I hope it is the answers to your prayers and I will be praying for you along the way.

Hannah said...

I'm so glad the appointment went so well and that you have some hope and clarity. I've been praying for you!

Thanks for sharing what you've learned about IVF. We're still in the IUIs (have had 3), but would be very conflicted about IVF too, so I really appreciate reading your thoughts on a limited approach - something I'd be a lot more comfortable with too.

I'll keep praying!
Hugs!

iwillbeamom.blogspot.com

Al said...

Yay, Hilary! It sounds like a great appointment and you sound so happy and hopeful. I can't wait to hear what comes next as you and your hubby process things in light of this new information. Such great news - 50% success!!! Fantastic!!

Rach said...

Great news! I'm glad the path is getting clearer.

AplusB said...

I'm so glad the appointment went well. I think you have a great plan to move forward if that's what you choose. I don't think your RE would give you unrealistic expectations. Sounds like he is very optimistic that he can make IVF work for you within your ethical requirements. Yay!
On another note, I wholeheartedly agree with your RE about the AMH test. BOOO AMH. I wish I'd never had mine tested! It was really just an afterthought at my RE appointment since it was too late to do the FSH test. I was actually the one to request it and wish I hadn't!

andreajennine said...

So glad to hear you got the answers you needed and that you and you husband both feel good about moving forward. If you do have extra eggs, take your RE up on the offer of free freezing! Of course, I'm a bit biased, seeing as how one of our previously frozen eggs is now a baby due in May... ;)

Rebekah said...

Sounds like great news! I'm excited that you are going to move forward with IVF, and that your doctor was willing to cut you a break!!

Melissa G said...

Hillary, I am so thrilled that you have found the clarity you'd been praying for. And even happier that you're both ready to move forward.

I can't wait to hear more.

Hugs!

Andrea said...

Glad that you are able to process all of the many thoughts that have pondered and find yourself moving forward. HOPE is ever present.

Cheers to seeing you get your BFP very soon :)

jones said...

Clarity is a beautiful thing and I'm so glad to hear that you are finding your way through this. 50% sounds pretty darn hopeful! Keeping you in my thoughts!

Jennifer said...

So glad you got such great news!!

Mellow said...

Glad you have some clarity. Hope is a wonderful thing! :)

Shanny said...

I am so happy you and hubby got your answers and are opting for a decision you can live with. I'm sending you lots of good luck!

Waiting said...

God is good! This is all great news. I am thankful for the your restored hope and I pray that God will bless you very soon!

Melis.sa said...

Oh Hillary! You sound so calm and peaceful!! I'm so glad to hear that your RE offers what you guys are looking for and thinks you guys will be successful!!

ps my fsh is right around 9 too and my RE wasn't super concerned with it bc of my age

A said...

I am so glad you got some good and peaceful results!! I think it is wonderful that you got your questions answered - such a blessing to have had a great appointment!

I left you an award on my blog!!

Courtney said...

I gave you an award on my blog. :-) I'm so glad your appt with the RE went well!

Michelle said...

WoW! That's exciting!

So, a mini-IVF is an IVF with not as much medication? I've never heard of that, that's interesting. The medication is one of the things that scares me about IVF. WOW!! Thanks for the info.

You have an award on my blog too. Great minds think alike COurtney! :)

SO happy for you!!!!!
xoxoxoxoxo
~Michelle

Anonymous said...

i'm so happy your RE meeting went so great! i hope making your decision is ALOT easier now!

21reena

addingtothepack said...

I am so very excited for you! I hope that you reach 100% clarity and peace with a decision soon.

Extra bonus for your clinic being willing to give you a we-want-to-compete discount on mini-IVF.

julie said...

Im really happy for you!

Melissa said...

I've recently been reading your blog. I know how scary it is to move foward with IVF with the possibility of it not working. I felt the exact same way. My husband and I were going to adopt but things didn't work out so this was our other option. We went for it,planning on giving it 3 trys. We did IVF/ICSI (normal protocal). I really didn't have many eggs...I think 7. 5 were fertilized and 3 we were able to transfer (no frosties) One of those 3 implanted and my daughter is now 15 months old. Just wanted to give you my story of success and hope! Good luck!!

Missy said...

This is great news! I'm so glad you have the clarity you were seeking. Good luck!