February 28, 2011

Consult Tomorrow

So, my consultation is tomorrow. Thanks so much for your questions and suggestions. I made a list and I will be speaking to my RE about each of them.  I also wanted to provide some information for those of you asking questions about PGD and my clinic.

PGD has been found to be useful for translocation carriers. It is one of the recommended course of treatments. It has been very successful for some and extremely unsuccessful for others. As a course of treatment for my BT, I’ve been told donor eggs, continue trying naturally (and withstand the miscarriages) or ivf/pgd. I’ve been trying superovulation in the hopes that a good egg would fertilize and implant. However, I’ve had no success.

My insurance will only cover ivf/pgd if I use specific doctors and stay in network. My geographic location and insurance coverage really preclude us from going anywhere else right now. I’ve looked up the SART rates for clinics in network and IVF success rates hover around 40%. At my particular clinic I am the only patient with a BT (honestly wouldn’t doubt if I’m the only one in the area). The clinic I am at has used pgd only 1-2x before. The SART rates seem to reflect even less usage at other clinics in network.
So, that being said, I feel like I’m forging this path all by myself. I’ve went back and forth between using PGD or instead pursuing an aggressive transfer (meaning 5+ embryos). I’ve seen both methods work for BT carriers. One woman implanted 9 untested embryos and ended up with twins. Most other aggressive transfers either failed or ended up with singleton pregnancies.

I have a lot of questions that I don’t think will be answered at my consultation. I know from reading others experiences that a probe will need to be built. My understanding is this can take up to 12 weeks. In the meantime, I’m not sure what my RE will want to do. However, I’m leaning toward drug free (including bcps) for the 2-3 months it takes to build the probe. I’d like to give my body time to be hormone free, continuing losing the weight that’s crept on, and just generally take care of myself. We will continue ttc those 2 months with the assumption it’s probably not going to work but worth a shot.
I’m also interested to see how this will affect cycling. I imagine most people who go in for a consult and ready to start the process. I feel like I’m a long way off still. So, not sure how helpful this consultation is really going to be. I often feel like all I do is sit and wait; for tests, a new cycle, impending miscarriage, etc. Unfortunately I am not a patient person.

Of course, I’ll let you all know how it goes tomorrow. Hopefully I come away with fewer questions instead of more. 

4 comments:

  1. Yes...such a big decision. I am not sure where you live but if at all possible, try and focus on going to a clinic that has alot of experience doing PGD. Likely the screening is done out of clinic but its the embryo biopsy technique and lab efficiency that is critical to PGD. That's my only advice. Because if your insurance is paying...go to the best there is that they will allow is my advice. PGD is expensive emotionally so go with a clinic that you have the most confidence with. That's my assvice for the day. Good luck.

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  2. OH and if you missed my comment on your last post...get your RE to line up a geneticist consult.

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  3. It's a tough decision: PGD vs. superovulation/transferring a larger number. Good luck with your consultation today. Also, I agree with Lisain - it's very important to know who is going to be doing the actual biopsying of the embryo. If they only do a few, I'd want to know. There's a huge range of skill with this. (It's even possible that someone else comes in to do the actual biopsying - I've heard of this in other labs).

    GOOD LUCK! Early or not, it's helpful to get all the information.

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