Crossroads

[arizonakiwi]

I hope someone here could perhaps give me some guidance as to the best path to follow.

My DH and I have been trying for a baby for over 4 years now, firstly an unsuccessful reversal then 3 IVF / ICSI cycles and 1 FET.
I guess the question is do we continue or decide this is the end of the road for us.

The 1st IVF they cancelled EC and wouldn’t let trigger because they were worried about OHOS and my estergon levels were 4 times higher than the acceptable level. The 2nd time they lowered my stimms by a 3rd but the same thing happened. After costing for a few days they let me trigger and we got 7 eggs but at the end of day 3 only one was surviving (4 cell), they put it back in and we got a BFN. For our 3rd time my stims were reduced by half and we had a good cycle, they got 5 eggs, 2 survived to day 3, they put one back (refused to both back because of policy....), We got a BFN despite it being a “perfect” 8 cell embryo. The last surviving one was frozen at day 5, we thawed it a couple of months ago – It struggled to get going and they gave it a 10% chance..... Sadly but not surprisingly it didn’t work.

Which brings me to my dilemma..... Should we try again and can how can I justify spending $10,000 on this when we have had such bad results to date. I returned to study last year and my DH has just set up a new business so it is money I really can justify spending when there is no reason to believe the result will be any different. DH has offered to sell his Harley (something special that took him years to be able to get and I know he loves) or some of his old gramophones his parents collected over the years and passed onto him to fund as many cycles as we need it but I feel these are special things that are his “treasures” and have special sentimental meaning. If it was a success I could totally justify it but I know if it is a negative I will feel like I had just put a match to these things and would always feel really guilty about it all (and worry he would eventually resent me for it).... Our Doctor can give us no reason for it not being successful and just says if you were a family member of mine I would suggest you keep trying. He has suggested we could try with donor sperm rather than my DH’s but in the next breath says because some of the eggs fertilised normally there is no reason to believe my DH’s sperm aren’t performing (so why suggest DS ?????) DS costs a lot less – we could have 7 tries for the cost of 1 IVF cycle but it would not be my DH’s child, and it is something neither of us feel 100% comfortable with.

DH has family with his x and while he would love to have a child that is ours I know the desire to have a child is not as strong for him as it is for me. I also feel time is not on our side so we can’t really put it on hold for a couple of years (I’m 35 and Dh is in his early 50’s). He says he will support whatever I choose (IVF, DS or giving up) But how do I get past the guilt of being selfish if we go ahead or put closure on it all if we decide this is the end of the road for us.

Any suggestion, ideas thoughts, solutions would be appreciated. I am feeling confused and don’t know what to do.

ArizonaKiwi

[Dexter]

Dear Arizona,

What a journey you have been on. My heart goes out to you. The decisions you face are gut wrenching and reading about your DH's willingness to sell the things most important to him, bought tears to my eyes. He is a very special man indeed.

I can't really offer any solutions here but wanted to show you some support. I got my BFP on my 4th IVF attempt and as hard and miserable as it was, still consider myself a lucky one. I am 36 and after 2 failed IVF cycles decided to throw caution to the wind and change clinics. The results in both my eggs and quality of embryos were remarkable. I did my research and found out that the clinic I was at was far less superior in culture medium and supported day 3 transfers as opposed to blastocyst transfers which was protocol with my new clinic. My embryos could never progress past day 3 with my old clinic and out of 15 eggs retrieved, only 4 were viable in the end. When I proceeded with a FET, they let me transfer a slow growing embryo, that only grew one cell (from a 4 to a 5) which was a complete waste of time. The rest of my frozen embryos failed to survive the thaw. I was at my wits end.

On the up side, a different clinic and new protocol provided remarkable results and although our first attempt with them resulted in a chemical pg, our 2nd FET gave us twins. They have no explanation as to why it never worked previously.

I guess what I am trying to hint at here is, before you make any final decisions, would looking into another clinic be something worth considering for you? I am just a big believer in doing the research and getting the best possible treatment. Maybe this is completely irrelevant for you but worth putting it out there.

Also, do you have the egg share program available to you? I don't have any experience with it but have seen it talked about on TV a lot. The IVF is free but under the terms that you donate half your eggs to an anonymous donor. Once again, I am talking hypothetically here.

Whatever your decision, I hope you find peace in knowing you have made the best possible choice.

Good luck,

Dexter

[shantala]

hi arizona

not sure if you remember me but i think we have cycled together at some point. even if we havent, i have seen you on the boards these last 18 months and am sure we have spoken before.

anyway, just thought i would give you my opinion. i think its amazing how people can go through one cycle after another and unfortunately (well fortunately) cant imagine how it must feel as we were lucky enough to get our miracle second time round. however, my opinion is that you should carry on. the reason i say this is BECAUSE you havent had any straight forward cycles. if you'd had 3 or 4 excellent cycles and there was absolutely no reason for it not working then i would maybe reconsider given your cicumstances. but since they've not been perfect cycles i think you havent had a fair chance at the whole thing. i would definitely consider looking into other clinics and just getting their views on your situation. thats the least i would do before you make your mind up.

i know what you mean about the guilt, getting your dh to sell the things he enjoys and has worked hard for. my dh has children with his x too and is 25 yrs my senior . he's worked hard for his motorbike and other assets but when we couldnt afford our first cycle his motorbike (his baby ) was up for sale. at the end of the day i know they love their bikes and other sentimental things but at the end of the day they ARE just assets. a motorbike can be replaced. it broke my heart when he put his motorbike on the market (i'm a great motorbike lover too) but hey, for the chance of a baby, i didnt think it compared. as for the gramophones, yes, they are something that cant be replaced, especially as they have sentimental values, but if his parents gave them to him FOR your infertility journey, then i think that would make my mind up for me.

anywya, thats just my thought and opinion. whatever you do we'll support you in and i wish you the best of luck. we ended up remortgaging the house to pay for our two cycles, which meant we didnt have to sell the motorbike (it was on the market, didnt sell for ages, a friend lent us the money until it sold but it never did....we paid him back from our remortgaging)...god only knows what we'd have done if it hadnt worked second time round. the bike would have been straight up on the market again!!!

usually i wont give my opinion on something like this as everyone's circumstances (financially, emotionally, physically, etc) are different and unfortunately there are no guarantees in this....ever. but i think given your cycles have been far from smooth, i dont feel like you've had a fair chance at IVF working. oh, and yes, you may say, you had a good chance with the one 8 cell embryo....let me tell you that our first and second cycles resulted in 2 perfect grade A 8 cell embryos each time....so thats 4 perfect embryos and only one made it. so that just shows how you havent had a fair deal.

hope what ive said makes sense....sorry for rambling.

xxxxxxxxx

[kbat]

It's a tough decision.... My dh had decided before we did this not to do adoption (he's a lawyer and was involved w/ a wrongful adoption case and saw a worse case scenario on how this works) and we too aren't comfortable about using donor anything (in our case, it would be donor eggs). For IVF cycles we wanted it to be 100% ours--if it was only "half" of one of us, we would just go for adoption that my dh doesn't want to do. That's a personal decision and everyone is comfortable w/ doing different things.

I've had 6 failed IVF--mainly I did 6 because my insurance covers 100% of it (minus $20 co-pay-- $15 for the first 4) plus co-pays for the meds (most expense I paid for meds was probably about $250 in a cycle). Since I didn't have really any out of pocket expenses, we figured we would max out the insurance. So we did all 6. Although I was pretty sure that I was comfortable at stopping at 6, I was surprised at how difficult it has been to "give up" on my dream to have kids.

Right now, I have decided to try traditional chinese medicine. I figure I would give it a try. I am not sure if it'll work or not, but it's much less expensive than trying to pay for a cycle out of pocket and in the end, I won't be any worse off than I am now. And who knows it may work for me. I did get pregnant once before doing any fertility treatments which ended in miscarriage.

I would say definately get another opinion before deciding. You should go on SART website and they will give you various clinics and a breakdown of the "numbers" for each age group for a particular clinic. Maybe you just need to go someplace that will give you the kind of treatments you need?

Good luck to you.

[Yellow]

Arizonakiwi, I thought I'd just offer my 2 cents. I think everyone has given good advice. I'm sorry you've been through so much and I hope things work out for you.

I'd just add that it might be worthwhile to look into a program with a money back guarantee if you haven't already. I know they sometimes have strict eligibility rules, but it may help make the decision easier. Good luck to you!

[FionaA]

Hey Arizona

I'm so sorry that you have such a tough decision to make. It peeves me that IVF is bad enough without having to worry about the cost of it all. I can't really add too much, I think the other ladies have given some sterling advice. I agree with Shantala that it seems worth giving it another shot because your cycles have not been smooth sailing and as your doc says there doesn't seem to be anything stopping you getting preg. Have you thought about shifting clincs as Dex said? Also worth considering. I reckon that the clinics can be quite variable, and you would want to find a top notch embryologist as well as good fertility docs.

Have you made a decision yet?

Fee

[stressball]

hi,
I sm involved in a study...to save money....It is called Duramed study...see if you can enroll in this study...your out of pocket cost would range from 3000-8000...the cost of meds is the major cost in this amount....so see if you could in this or some other study..that way you will save money.....I have a thread in the IVF thread...if you want more info....

[IndieBlue]

She's in New Zealand...I don't think they have any study participants there?

I would look in to a different doctor, and a Shared Risk program (money back guarantee).

[arizonakiwi]

Firstly, sorry for taking so long to reply to all your kind and thoughtful suggestions, I have had reports due and midterms over the last few weeks so I have been trying to put this IVF “thing” to the back of my mind and concentrate on them.

While I haven’t replied until now your kind words and supportive suggestions have helped carry me through the last few weeks and feel a little less alone in all this. They gave me a good perspective on things and calmed me down a lot.

Unfortunately in New Zealand there is only one main clinic with branches in seven different cities and a couple of other clinics but one is a 7 hour drive away and the other is in the South Island which is even more travelling. None of the clinics appear to have shared risk programmes, egg share or the option to pay a premium for guaranteed success or a refund at the end. I did e-mail a request for information to one of the other clinics but haven’t heard back from them (makes me wonder how reliable they would be if they aren’t interest in following up an inquiry).
I think for me I need to have a plan and know where we are going with it all. For now I am going try and focus on my study, I have end of semester reports due in a few weeks and then exams coming up in June. Once that hurdle is over I’ll give myself some time to find a way to make this all happen. I know I personally need to give it a couple more goes before I can let it go and I agree with what some of you said – that I really haven’t had a straight forward cycle,

PS: Shantalla – yes of course I remember you!!! I’ve been following your progress, Congratulations on the birth of your little girl,

Fee: I hope you are eventually able to work from home (you deserve some home time with your little boy)

Thank you for all you support and encouragement – it really helped over the past few weeks and it meant a lot to me – even though it took me a while to reply

Love to you all, Angela

[shantala]

arizona - glad you remember me ( ) and dont worry about the delay in replying. i am glad our suggestions have helped in some way. even if it is just to let you know you are not alone. for now, focus on your midterms (and best of luck with them) and then make a plan on how to go next. sounds like a great plan in itself!! best of luck and i'll be keeping my eye on you!!

xxx

[kellym]

Hi Arizona,

I was so sorry to read about your struggles! I think it is a good idea to take some time off, focus on your studies and 're-energize'.

I wanted to let you know of a test that my DH had done that might help shed some light on your situation. My DH had a vasectomy reversal as well and when we couldn't get pregnant naturally we were told that it was because the reversal hadn't worked well but that IVF/ICSI would be the solution. Well, it wasn't that easy. Finally after 9 attempts we are pregnant with twins but we sure had a battle to get here!

Anyway, over the course of our repeated failures, we started doing more and more research ourselves. One study my DH found on line was fairly new at the time (June 2007 I believe, or maybe 2006). This study looked at chromosomal problems within the sperm as a result of vasectomies. The conclusion was that males who have had vasectomies and then a reversal (after several years - I believe it was 9 years) had a greater chance of having sperm fragmentation. These abnormalities are not visible through a microscope so are not included in the standard sperm testing. These sperm can fertilize an egg but then the embryo stops developing in the early stages of development and/or pregnancy because of chromosomal problems.

As a result of this study my DH and I asked our RE whether they could order a SCSA test for him, which they did. It turned out that my DH's sperm had 50% fragmentation - apparently anything greater than 30% fragmentation is considered poor fertility potential.

Anyway, before going through another round, it might be worth this test given that your DH has had a reversal and is over 45 (which apparently also impacts the fragmentation rate). At least then you would be able to know whether his sperm is fragmented and then can make decisions with that additional information. I am from Canada and we were able to get the test results within 2 weeks so it isn't a lengthy process.

Good luck to you. It is so hard when no one seems to be able to tell you why it isn't working!

Kelly