Ghost: "cytoplasmic transfer"???

[qita71]

Dear Ghost

I am really confused about this, getting upset and wonder if you can advise at all..... Had my WTF appointment last night. Was not entirely impressed. The doctor didn't appear to volunteer any answers or solutions (and certainly no apology or regret). He didn't really seem on top of our case at all (I know he has many patients but...) and referred to the notes constantly and his nurse (the only times I saw the doctor were initial consultation, collection, transfer and the WTF- I do not know if this is normal?). I was glad I had done lots of research as in view of his reluctance to engage I had to kind of take charge of the consultation and suggest ideas! For example, I had an endometriosis operation in December and he has had the DVD of it since then and has clearly not looked at it.

Having told us all the way along that my eggs and the embryos were 'beautiful', and we know there is no problem with DH's sperm, he eventually advised us last night (after much cajoling from me as to if everything was so right, what happened) that the embryos did not grow as quickly as they ought. Hence being murolas at day 5 (when transferred) not blasts. He did, however, say that they had done plenty of successful murola transfers. So, he suggested starting on a higher dose of GonalF (300 mg) to try and get more eggs (we got 8 last round), with the embryos they are then going to do genetic testing (again- they did that last time and all passed) and use some embryos from the pool to inject into others to make them better and grow faster- he referred to this as 'cytoplasmic transfer'. However, when I look on the internet cytoplasmic transfer appears to relate to eggs not embryos and he said my eggs were perfect.

I am really dazed and confused. I am, however, concerned about time and so cannot face trying to get into another clinic here (Dubai) or back home (the UK) and the inevitable delay that will involve. So... I started on gonapeptyl again today at the same clinic.

If you or anyone out there has any thoughts on this proposal or generally on the above I would be most grateful....

Thanks in advance!

Qita

[Ghost]

Dear Ghost

I am really confused about this, getting upset and wonder if you can advise at all..... Had my WTF appointment last night. Was not entirely impressed. The doctor didn't appear to volunteer any answers or solutions (and certainly no apology or regret). He didn't really seem on top of our case at all (I know he has many patients but...) and referred to the notes constantly and his nurse (the only times I saw the doctor were initial consultation, collection, transfer and the WTF- I do not know if this is normal?). I was glad I had done lots of research as in view of his reluctance to engage I had to kind of take charge of the consultation and suggest ideas! For example, I had an endometriosis operation in December and he has had the DVD of it since then and has clearly not looked at it.

Having told us all the way along that my eggs and the embryos were 'beautiful', and we know there is no problem with DH's sperm, he eventually advised us last night (after much cajoling from me as to if everything was so right, what happened) that the embryos did not grow as quickly as they ought. Hence being murolas at day 5 (when transferred) not blasts. He did, however, say that they had done plenty of successful murola transfers. So, he suggested starting on a higher dose of GonalF (300 mg) to try and get more eggs (we got 8 last round), with the embryos they are then going to do genetic testing (again- they did that last time and all passed) and use some embryos from the pool to inject into others to make them better and grow faster- he referred to this as 'cytoplasmic transfer'. However, when I look on the internet cytoplasmic transfer appears to relate to eggs not embryos and he said my eggs were perfect.

I am really dazed and confused. I am, however, concerned about time and so cannot face trying to get into another clinic here (Dubai) or back home (the UK) and the inevitable delay that will involve. So... I started on gonapeptyl again today at the same clinic.

If you or anyone out there has any thoughts on this proposal or generally on the above I would be most grateful....

Thanks in advance!

Qita

Qita,

Cytoplasmic transfer is not allowed in humans in the United States because the risks are not yet known. I would absolutely avoid it myself, and I seriously question any clinic that would recommend it. It is only used in experiments in animals.

You are correct that cytoplasmic transfer is a procedure for eggs, not embryos. Once there are several cells formed, it is too late for cytoplasmic transfer. Also, I wonder if it would have any benefit at all when just transferring between cells from the same woman. Also, there is no evidence from what you have posted that indicates you have any issues with cytoplasm.

I would find another physician and another clinic.

[qita71]

Thank you both for your prompt and helpful replies. Much appreciated.

There are not many options in terms of clinics in the UAE and in my experience all of them lack the bedside manner and passing of information that I would expect from home. But I live here. I really want to have children and for personal reasons do not want to leave it much longer. I am at a loss.

[lou71]

Qita- Tell your doctor you are ok with increasing your Gonal dose, but don't want to do the cytoplasmic transfer. He should respect your wishes. What Ghost said was just plain scary and it sounds like you don't have many clinics to choose from. Why do an experimental procedure to try to fix something that probably isn't broken?

[qita71]

Dear Ghost SDtrying and Lou

Thank you all for your very valuable advice. I cannot tell you how much it is appreciated.

I had a sleepless night worrying about it all but came up with a plan of attack for the morning... First, I did more research. This was the most helpful article if you're interested further: http://www.guardian.co.uk/science/2004/ ... ationships It looks as though self-cytoplasmic transfer is at best experimental. Certainly not something I am interested in. Secondly, I called another clinic (the only other clinic here to my knowledge). I must have sounded so desperate on the phone that the kind receptionist put me straight through to a lovely and very helpful doctor. He was surprised at the proposed strategy and we spoke for some 10- 15 minutes. He has kindly agreed to see me before his regular clinic tomorrow morning to talk it through and see if he can assist. Finally, and with the agreement of the doctor I am seeing tomorrow, I went to my normal clinic and got the second Gonapeptyl shot- that doesn't mean we have to do anything this cycle but means we're still in the game should we choose to/ be advised to. I got a copy of my file- I have kept a copy and I will take a copy with me tomorrow morning. I also spoke at length with the nurse who has been dealing with me (doing all the ultrasounds etc) and who had sat in on our WTF appointment- needless to say my doctor was not around. She was extremely kind and understood why I was so dissatisfied and alarmed by our WTF appointment. I expressed my opinions about the doctor being unprofessional, not engaged and not advising us at all as to the experimental nature of cytoplasmic transfer or the associated risks. She did not disagree at all. She wants us to have a further appointment with him on Wednesday night (the first time the doctor is available) and to hit him hard with our views and that no way are we doing cytoplasmic. So we will do that although I cannot promise that my husband will not get angry as he is really livid- as am I the more I think of it.

So, that's me. Thanks you all once again and Lou and SDtrying, I hope all is still going well with you guys.

[lou71]

Yay Qita ---- Way to step up and take control! I love it. I think you totally did the right thing here. Good luck hun.

[riogirl71]

Good job taking charge and good luck!

[qita71]

Ladies

An update.... we had a truly unpleasant appointment with the doctor. For reasons I won't bore you with we have decided to stick with him minus the scary cytoplasmic transfer element. So I started stims on Thursday.

Thank you all very much for your help and support and I hope all's well with you.

Qita

[lou71]

Did you ever meet with the doctor from the other clinic? How did that go?

[qita71]

Did you ever meet with the doctor from the other clinic? How did that go?

Hey Lou. Yes, we did. Seemed nice and helpful but we just didn't know.

[Warren Dew]

First, I did more research. This was the most helpful article if you're interested further: http://www.guardian.co.uk/science/2004/ ... ationships

Thanks for the information.

I think I understand the reasoning behind it. Cell division requires a lot of energy, and until implantation, all that energy has to come from what's available in the original egg. If the egg doesn't have enough stored energy to start with - or enough mitochondria to make that energy available, especially as the mitochondria get divvied up between the daughter cells as cell division occurs - eventually cell division will stop.

During our original, failed, IVF cycles, we had fine fertilization rates, but the eggs all divided slowly or stopped early. In our case, the solution was to completely change our regimen, in particular dropping the lupron and switching to an antagonist cycle. However, I can see how giving the eggs that are to be fertilized more mitochondria also might make them survive longer and divide more - it would be interesting to see the actual statistics.

It does certainly sound like an experimental approach. Best wishes that your changes to your drug regimen will work, as ours did for us!

[Dinosaure]

Qita,
We live in Dubai too.
What happened after your cytoplasmic tranfer?
Is it Dr F. by any chance?

[Claredel]

I see why he offered you the cytoplasmic transfer but I don’t understand why cytoplasmic transfer and not simply mitochondrial donation? cytoplasm carries donor’s genes while mitochondria don’t.

[Abbie3]

What do you mean mitochondria don’t carry any genes? Of course it carries donor’s DNA, come on. It seems that after mitochondrial donation baby will have 3 parents)

I see why he offered you the cytoplasmic transfer but I don’t understand why cytoplasmic transfer and not simply mitochondrial donation? cytoplasm carries donor’s genes while mitochondria don’t.

[Claredel]

What do you mean mitochondria don’t carry any genes? Of course it carries donor’s DNA, come on. It seems that after mitochondrial donation baby will have 3 parents)

I see why he offered you the cytoplasmic transfer but I don’t understand why cytoplasmic transfer and not simply mitochondrial donation? cytoplasm carries donor’s genes while mitochondria don’t.

No, it doesn’t. If both donor’s egg and yours are fertilized and then your nucleus is transferred into healthy mitochondria while donor’s nucleus is removed, then yes. By the way that is what was offered to Ghost. But there are clinics that firstly transfer mitochondria and only then fertilize the egg with donor’s healthy mitochondria in it so that it won’t carry any DNA. Google the difference.