Friday, October 06, 2006

Back from dear ol' doctor

Well I am back from the doctor. There' s a lot to go over with you, so let me break this down as simply as possible. When I am worried about confusion, I, cling to my bullets. I hope you can follow!
  • Dr. C was there today. Gosh I love that man. The first thing he asked was whether or not we had any questions. I immediately got teary (I didn't think I would cry) and told him I just wanted to know if he thought we still had a chance. He reiterated to me that we have all the right stuff and that we just fell on the lousy side of the odds. Normal women who try to get pregnant have about a 1 in 5 chance each month. I have fallen in that negative chance both times. He said that he still believes we have every chance of this working but again, it's a matter of how long I think I have the emotional ability to try.
  • Next we discussed using ICSI (forcing one sperm and one egg together). He said that he was disappointed with our fertilization rate the first time (6 our of 14) and that he would definitely advise that we used ICSI this time. We didn't use ICSI the first time as we weren't aware of our additional sperm-binding issue. We agreed. Dr. C put the fertilization rate with ICSI at about 70%. My fertilization rate the first time was about 42%.
  • Keeping that 70% number in mind and the fact that we have had two negatives, Dr. C. said that he would advise us to fertilize every egg that they could get out. Last time they got out 21 eggs, 19 were mature, we used 14, 6 fertilized, and 5 lived. (Are you with me here?) After some discussion with Dr. C, we decided to compromise and hold our number to 19. We will fertilize 19 eggs. Following Dr. C's stats that 70% should fertilize, that will give us 13.3 sticky babies. Now that is just a stat and could be higher or lower.
  • We discussed transferring 3 this time. Dr. C. said that if we want to transfer 3, he will do it, however, given my age and the quality of our sticky babies (which he calls embryos of course), his gut still says 2. This is very difficult. Three sticky babies increases our odds and cuts down on the number of transfers and "result announcements". But 3 also increases the chance of one of the babies being sick. Mayo is, as I have said before, adamantly against triplets. I so want to do 3 but would feel horrible if all 3 made it and one was sick. So we will stay with transferring 2.
  • We also discussed a 3 day vs. 5 day transfer. Mayo usually does day 3 transfers, however, they will do a day 5. This means that the sticky baby is more mature when it is transferred back to the womb. Dr. C.'s philosophy is that getting those babies back to "nature" as quickly as possible is always his preference and there is a chance that if you wait until day 5, you may not get to do a transfer at all because they all passed away already. We agreed that this may be something to try in the future but not this time.
  • We also discussed a procedure called "assisted hatching". This is another procedure that he doesn't believe I am ready for, but we could choose to use in the future. This procedure helps the embryos break out of their shell before they are transferred. (Complicated stuff, huh?)
  • Dr. C. agreed that we need to stay as far away from birth control pills as possible and hopefully, ultimately, far away from migraines. We will proceed with a different method which should achieve the same results. People, if I avoid the migraines, this month will be a BREEZE!
  • We signed all the paperwork, and I start taking my first medication SUNDAY. Wow. This is coming fast. We are scheduled for a November 6-10 retrieval and transfer.

Okay, I think that's the answer to everything and as many details as we have right now. JB and I feel very good. I am doing well. I am learning to be content with my circumstances, however, that doesn't mean we don't want to try again. I compare it to someone with an illness, like cancer. They have to learn to be at peace with their sickness, but that doesn't mean that they don't try to get well. That's how we feel. Ultimately, we would like to have 4-5 more tries out of this next cycle.

Your prayers, as always, mean the world. If you have questions, please feel free to post a comment and ask. No question is too weird or stupid. Trust me. If you are asking me, I am sure I have asked it at some point. I'd be glad to share. And if it is really complicated, my dear little JB can answer.

Okay folks, round 2!

7 comments:

Anonymous said...

Wendi, thanks for explaining everything so well. For someone who does not know a whole lot about this process, it is interesting to learn about it. I have one question though...my supervisor in my office went through IVF and I think they finally succeeded on their 5th try when they did the hatching thing...are there disadvantages to doing this? Why wouldn't you try this right away?
Thanks,
Kristen

Wendi Kitsteiner said...
This comment has been removed by the author.
Wendi Kitsteiner said...

Kristen,

This is actually a GREAT question. There is an article in the Annals of the New York Academy of Sciences that really helps explain this:

Currently, most fertility centers around the world use assisted hatching (AH) techniques to help embryo release out of the zona pellucida (ZP) and thus increase the implantation rate. For the last 13 years, several studies, assessing AH in different clinical indications, have given disparate results, making the selection of patients or embryos in need of this treatment complex. The most relevant conclusion obtained so far is that AH has a beneficial effect in women with repeated failures of embryo implantation. Finally, the potential value of AH for indications other than repeated failure has to be weighed carefully to make sure that AH does not reduce the chances of implantation.

Okay, so basically, this process isn't something they want to do if your embryos CAN work on their own b/c they don't know if it helps or not or if it could actually HINDER or not. So as a result, they reserve it until it seems that your embryos are just not working on their own. Two tries doesn't qualify as officially knowing.

I hope that makes sense. This was a great question and really made me think as well.

Wendi Kitsteiner said...

Kristen, John said he had a better way to explain it.

John gave this analogy:

If I were to use a step stool in my house, it probably wouldn't help. It would actually hinder. Only after DISCOVERING through trial and error that I was too short to reach the top shelf, would we choose to use the step stool.

Not sure if that helps.

Anonymous said...

Josh says...

Wendi, one day you will look back at this time and be amazed at your strength!

Wendi Kitsteiner said...

Josh, thanks. As soon as I saw your name I wondered what in this blog could evoke a joke. Love you man!

Anonymous said...

Wow Josh!!