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Forum: Trying to Conceive with Medical Assistance

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  #1  
February 27th, 2007, 07:54 PM
TheyGrowLikeWeeds's Avatar Platinum Supermommy
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I talked further with my doctor and asked him about what I've been hearing about how IVF really is not for people with recurrent miscarriages. It's for people with problems conceiving. He said immediately, "Not true!" He explained that although that's the more common use for IVF, it also has helped people with recurrent miscarriages. I asked him about what was the percentage of successful pregnancies for people in my situation. He told me about 50% success with COH w/ IVF, about 25% success with COH without IVF. I then asked him about the progesterone shot. He said he'd do that if I really wanted to try it, but it hasn't really shown much of a difference for people with recurrent miscarriages. He had brought it up in the last meeting with him mainly to explain he'd be using it with the other two treatments (COH and COH w/IVF). He'd just hate for me to have a low chance at a successful pregnancy after all I've been through.

He suggested that if I want to know how the steps go, I should sign up for the required nurse class, which goes through each step of IVF with those that want to do the IVF treatments. That class is for questions based solely on the treatment itself and what my husband and I would have to go through during this treatment period.

He then said, he did not want me to go through this treatment until I feel confident with all my questions. He also said if I want a second opinion that he'd be absolutely supportive of that. He does not want any of his patients feeling unsure of any of the treatments they choose...especially IVF, since it is so involved and stressful.

I really do appreciate his understanding in all this. I'll be talking with him again at the end of March (if we can get a good meeting time since I have school and he is scheduled for a lot of medical conferences at that time) in order to clear any and all questions that I may have. He even told me some questions to bring up that I wanted to talk to him on the phone about. He wants to make sure everything is cleared up. Actually it's funny, my mother had wanted to come and be involved with the discussion with my doctor. I didn't think that was necessary. It's nice enough that she wants to help pay for it, but why make her come up from Florida just to hear my doctor talk. My RE called while I was on the phone with her so she wanted me to ask him a question. He said he'd highly recommend she come up to talk with him. He'd rather talk face to face. She jumped at the idea of see us all together. So it looks like I'll be spending some time with my mother too. On top of that, I talk to my father. My mother said she was going to ask him if he'd like to come too right after we got off the phone. Apparently she didn't get the chance. I called him later on to see if he's coming. He hadn't heard from her, but he'd like to be there if possible. So now I may see both my parents! My father said not to make the schedule to see my RE around his schedule. If he can make it, he will. Man, things get stressful when both my parents are around. Don't get me wrong, I love both my parents, and even though they are divorced, they get along very well. I just have so much cleaning up to do and preparations before they come. That's mainly on me, though. They aren't really picky.

Well, back to the topic. So, it looks like I may not be doing the progesterone shots. If that is correct that the shots won't help me, then I'm not going to bother. My RE mentioned that since I have tried the other two progesterone supplements (gel and suppositories), and they didn't really help, that he does not see the shot alone making any difference in my chances.
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  #2  
February 28th, 2007, 05:03 AM
~Sandy~'s Avatar Platinum Supermommy
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You also may want to look into something called PGD Pre-implantation genetic diagnosis and AH which is assisted hatching (forgive me if you know this stuff already). From what I have gathered in doing lots and lots of research (I have a habit of having to know everything when I find out I need something so I over research it) .... PGD can weed out any embies that have a X% chance of miscarrying. Most studies I have read say that with the PGD coupled with the AH the couple has a 80%-90% chance of a successful pregnancy. Which is awesome odds to me!! Maybe see if your doc does those things.
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  #3  
February 28th, 2007, 07:07 AM
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Sounds like you have a great doctor, which is so important when going through IVF. I'm glad you're getting the answers you were looking for.

Personally, I'm still curious on the IVF for recurring loss theory. I'm already fully into IVF so it's really just for my own curiosity at this point. I've also had 2 miscarriages with IVF which would indicate for me, that there is not a correlation between IVF and full term pregnancies. But, I'm not a doctor, so what do I know?

Further to what Sandy said, I would agree that asking about PGD may be the way to go. I don't recall now if you said you've had the genetic/chromosomal testing done or not (I'm assuming with 5 losses you have). Doing PGD is usually the standard course of action if you did show signs of issues with that testing.

Assisted hatching may also be an option, I have done that with my Day 3 frozen embies in the past and I did have 1 pg from that method, but it did end in m/c. The other option for you may be Day 5 blasts to transfer instead of Day 3. This is really only an option if you stim and fertilize well and have lots of embies because only a fraction will make it to Day 5, but the success rates at that point are usually higher (clinic conditions dependent). I went with Day 3 on my first batch and Day 5 on my second. There is no assisted hatching on the Day 5s required since they've already gone to blast stage.

Just throwing this info out there, you may have already discussed this with your RE. If not, just some more questions to add to your list.
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  #4  
February 28th, 2007, 07:42 AM
TheyGrowLikeWeeds's Avatar Platinum Supermommy
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Well, we've done the chromosomal blood test and found neither of us have a problem there. I don't know if that's the same as PGD. I do not know if we've done genetics testing, if that's a separate test, since those tests were done a long time ago (after the third miscarriage).
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  #5  
February 28th, 2007, 08:04 AM
~Sandy~'s Avatar Platinum Supermommy
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The PGD is actually done on the embryo itself not either of the parents. Basically on day 3 they extract 1 cell from the embie and test it, in the end they know pretty much everything about the genetic makeup of that embie and know whether it should be transfered or not. They even know the sex at this point. All embies that have PGD are not transfered until day 5 since it take a little over a day for the testing to be done,


Here is an excellent link to explain what they do with PGD
http://www.ivf-infertility.com/ivf/pgd.php



And this link here if you navigate it for a while, you can view real photos as well as explanations for each photo on PGD, Assisted Hatching, it explains and shows photos of ALL forms of embies. I <3 this site
http://www.advancedfertility.com/preimplan...20diagnosis.htm



HTH <3 Sandy
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  #6  
February 28th, 2007, 09:57 AM
TheyGrowLikeWeeds's Avatar Platinum Supermommy
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Thank you, Sandy! I'm going to read those and maybe ask my doctor about it.
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  #7  
February 28th, 2007, 02:45 PM
Astrid's Avatar Platinum Supermommy
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Wow! That was quite a bit of information to digest, LMAO! I would highly recommend a 2nd opinion just to get another opinion on your situation. In today's world, drs can say so many things yet have - intentions w/ that information. Don't get me wrong, I'm not saying your dr is one of these BUT it is always good to get a 2nd opinion on the situation, especially since IVF is so expensive in the USA. It is very difficult to say what I would do in the situation BUT thus far w/ my RE, he has been very preventative rather than pushing anything or any treatment which convinced my DH that he was legit. Before doing IVF, I would also go for a 2nd opinion. It may mean putting things off for another cycle or 2 but at this point, it is worth the wait to get it right.

Ok, sorry about being long winded!
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  #8  
February 28th, 2007, 08:49 PM
TheyGrowLikeWeeds's Avatar Platinum Supermommy
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No, you aren't being long winded. It's good advice. My doctor even suggested I do. Like I mentioned, even he said he doesn't want to do this unless I'm absolutely sure. Originally it was his last choice. He was pushing more the COH without IVF just to help save me money, but I am not willing, at this time, to risk multiples. I'm very fertile as it is. I'd bee too worried that I'd release 4+ eggs, the way that I work. LOL

My next appointment with him is just to go over everything and get all the confusion out of the way. If I go to another doctor to get a second opinion, I'll figure out then where and who, I'd like to see. My mother did a lot of research and found out my doctor is the head of the RE department. I feel pretty safe with him...not just because of his job position, but he really has such a great way of explaining things to me. I have a hard time understanding medical jargon and some doctors just have a difficult time dumbing down their language.
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