Sunday, January 13, 2013

Memphis and Our Decision


     Our last attempt in December again did not end in a positive pregnancy test. We did start another round of medication. My results from the CBC came back normal so my doctor did not let me take Decadron this month due to the side effects I was having. We had some trouble getting an insemination appointment since there was lots of holiday time that the office was not open and my husband was working during the day that Monday so since our Memphis consultation was on Wednesday, I decided not to make an insemination appointment and see what we would find out in Memphis.
     We traveled to Memphis this past Wednesday. The doctor met with us and went sheet by sheet through our medical records and asked questions and took notes. He first looked at my husband’s records first. We learned something new while going through them. He explained how my husband’s morphology (their formation/shape) was not good as well. The doctor told us that he only had 3 in 100 (3%) sperm formed correctly. The doctor then took one of the semen analysis results and did some math to give us and idea of how many viable sperm he would have in a sample. For that analysis, my husband only had around 7,500 viable sperm. This sounds like a lot but most people have millions. From this information, he told us we would have to do a different form of In Vitro Fertilization(IVF). One with Intracytoplasmic Sperm Injection (ICSI). He said we would be unable to perform standard IVF due to this low number of sperm. In standard IVF, the eggs are retrieved and the semen specimen is placed in a dish together and the sperm must penetrate and fertilize the egg on its own. When they perform this procedure, they need at least 15,000 sperm per egg. So my husband would not have enough to be placed with just one egg and we might have as many as 30 eggs. So with ICSI, individual sperm are chosen and then they are injected into the eggs.
     There are some risk we would be taking and most are the same as for any couple, but my PCOS lends me to a higher probability of suffering from Ovarian Hyperstimulation Syndrome. Basically, the doctor explained that when you take injectable gonadotropins (which help you produce and grow multiple follicles containing eggs) there is a chance when your ovaries are growing that your ovaries keep enlarging and growing and cause some significant side effects. He told us that we might want to do a “freeze all” method. This method includes doing the same protocol as usual but when it came time to do the embryo transfer you would freeze all embryos created and wait a month to let my ovaries reduce in size and calm down. I would then return a month later to have the thawed embryos implanted.
     With this news, we looked at statistics and cost. As of 2009-2010, this center had around a 60% pregnancy rate in women my age. If we use frozen embryos then it would rise to around 67%. He did say that ICSI and frozen embryos would push us to 70% or slightly more. I asked him about the effectiveness the first time and he was hopeful and said we have those same odds and their goal is to get us pregnant the first time. As far as cost, it looks like we would need around $13,500 for one cycle including a freezing fee. If we have enough embryos to develop, the fee is only around $3,000 for a frozen embryo transfer in case we have to try again or want a second child.
     So we have decided to go with IFV at this time. We know this is not 100% but we have faith in Him! We have a few pre-screeners we must do before we can be approved for our first cycle. My husband had a current semen analysis so he only has to be tested this coming week for syphilis, HIV -1 and -2, Hepatitis B, and Hepatitis C. I will had a pap smear and CBC that was current. I will have to get test for my blood type and RH, syphilis, HIV -1 and -2, Hepatitis B, and Hepatitis C, and a rubella titer. I will also have some ovarian reserve tests. This includes tests for Follicle Stimulating Hormone (FSH) Luteinizing Hormone (LH). As well as a sonogram and blood test for Estradiol (E2) and Antimullerian Hormone (AMH) on day 3 of my next menses which will be around the 23rd of this month. I will also have to have a sonohistogram performed between day 6 and 12.
     After these results are in, a decision will be made if we can or cannot start our first cycle. So it could possibly start mid-February. That is exciting! We just now have to work hard to secure the finances by then. So, I will be having fundraisers to help me raise $8,000 in one month since we already have around $5,000! So, if you have any ideas or would like to help me please just contact me.
    Before I end this post, let me say that I know some people do not support IVF or the freezing of embryos. We are all entitled to our thoughts and beliefs. I do want you to know that we are not entering this process with only the hopes of having a child and thinking into it any further. We know that major moral and ethical decisions must be made and we do not take those decisions lightly. We will be asking God to guide us. We must make these decisions before we start meds. This office has provided us consent forms to read so that we might discuss all the implications of certain procedures. So please pray for us as we try to make such decisions.

No comments:

Post a Comment