IVF consult update (long)

[changedname]

I know you guys wanted me to update on this!

So, I had the consult yesterday. She basically looked at all my #s (FSH, AMH, IUI response, S/A) etc to see what protocol I would be on.

I got about a million bits of paper to read also. My RE also told me to watch this video which she is says is the best she has ever seen: www.youtube.com/watch?v=GeigYib39Rs

I will be on suprefact starting on CD 21 of my next cycle then Gonal F until egg retrieval. I have done gonal before but need to look into suprefact as everyone on TB talks about Lupron instead. I am currently 4dpo.

She said she thinks I will have a good response and thinks I will have success with IVF (although she can't say it will happen the first IVF cycle of course).

We discussed whether to do ICSI or not. I'm undecided. Please weigh in on any thoughts. It basically injects a sperm into each egg so avoids concerns about eggs being fertilized. It's normally for MFI but as I'm unexplained - what if my problem is eggs not being fertilized? Should I pay $1000 for ICSI just in case?

We also discussed how many to transfer if there are a few. She said she recommends just 1 embryo because of my age and all #s being good. Again, please weigh in if you have thoughts or what you think you would do.

Also - it turns out it will be a bit cheaper than I thought:

$250 IVF registration
$5800 - IVF
$1000 - ICSI
(my meds are covered by my insurance)

My clinic also has a 3 cycle plan so:
IVF #2 = $5000
IVF #3 - $4600

I'm excited to get started! I'm going to start an ivf prep diet and do tons of acupuncture.

[sunflower22]

Thanks for sharing! Sounds like a good plan, I'm excited for you! And the cost is low compared to other things I've read, that's great! I am not sure about the extra $ for the icsi, I guess if you have the money and wouldn't miss it I'd do it. But if it would benefit you to save the $ then maybe try one time w/o the icsi.

I think 1 transfer is what I would do also, if all the #s looked good.

[ilovecandy]

What Sunflower said. Also yay for ivf and a good plan!

[Cheesecake]

Glad things are looking good!

I agree with the others. I'd try the first round without icsi, and transfer just 1.

Also, if the fertilization is the part where it goes wrong, they'd know that before trying to transfer right? Would that change anything in the cost of that round?

Sent from my phone, please disregard typos!

[changedname]

Jan 8, 2013 11:22:16 GMT -5 Cheesecake said:

Also, if the fertilization is the part where it goes wrong, they'd know that before trying to transfer right? Would that change anything in the cost of that round?

Sent from my phone, please disregard typos!

That is a good point and I should ask. I wonder if that would count as my cycle being cancelled. thanks for the input!

[KaraOrNot]

Exciting. I would do ICSI. I come from a MFI perspective, but overall, isn't a ton of money and because you aren't sure what the issue is, I wouldn't chance it. If it didn't work, I would always question it. Do you know the success rate using ICSI vs not?

Regarding number of embryos, my RE's shared success plan requires consent for 2 to be transfered, so I am assuming that is what we would do, if/when we qualify. I haven't done much research on this, but maybe you should page NQB on MMM. I know she struggled w/ the decision and had done some research on the number to transfer.

[jewel]

First, congrats! It's nice to make progress. I can't believe your IVF is so cheap (relatively speaking, of course...).

I'm trying to find my source online, but I've seen a couple of studies at work that relate IVF/ICSI to the embroy quality and risk of developmental abnormalities. According to the UCSF website (no source cited there), the risk of chromosomal abnormalities with ICSI is 4 times the rate of spontaneous pregnancy. If I remember correctly, the rate from IVF without ICSI was about half of that, but still double the rate of a spontaneous pregnancy.

Here's an article posted on a physicians' website, which talks about 2 studies conducted at Cedar-Sinai:

www.pslgroup.com/dg/254466.htm

Obviously, spontaneous pregnancy would be everyone's dream, especially around here. That said, I think I'd try one cycle without ICSI and see how it goes.

I would also probably do 2 embryos. We know we want at least 2 kids eventually, so if I have to do IVF to get there, I think I'd be OK with twins the first time around.

I think either choice, on both options, are good. It's really so personal, and plenty of people would probably do exactly the opposite of what I would. That's just what I would probably feel most comfortable with....

ETA - Sorry if that sounded too scientific and not so personal. I work in a field where I see a lot of this research, so for me, I think about all of those pieces. None of the increased risks will prevent me from trying to have a baby, but I also think about the best way to minimize risks and find a good balance of chance of success vs. risk.

[changedname]

thanks Jewel, appreciate the input.

The thing about ICSI - if I do it, then i will never know if fertilization is an issue. I kind of want to know if my eggs can be fertilized naturally.
Am also concerned about superseding the natural selection process etc - eggs that wouldnt have been fertilized naturally being transfered etc.

Although I guess IVF in itself is kind of superseding the natural process KWIM? Nature doesn't seem to want me to reproduce so far.

I will do a ton of research/reading on this before I make the decision. It's great to have sounding boards here as no one IRL knows anything about us tttc.

[jewel]

Jan 8, 2013 15:12:47 GMT -5 changedname said:

thanks Jewel, appreciate the input.

The thing about ICSI - if I do it, then i will never know if fertilization is an issue. I kind of want to know if my eggs can be fertilized naturally.

Am also concerned about superseding the natural selection process etc - eggs that wouldnt have been fertilized naturally being transfered etc.

Although I guess IVF in itself is kind of superseding the natural process KWIM? Nature doesn't seem to want me to reproduce so far.

I will do a ton of research/reading on this before I make the decision. It's great to have sounding boards here as no one IRL knows anything about us tttc.

That's a big part of the theory of increased risks for chromosomal abnormalities with IVF, both with and without ICSI. There are probably sperm and eggs being used that would have otherwise passed through without fertilization because they are not "ideal."

I'm aware of the small increased risks, but it's not going to stop me. I would try without ICSI first, but I'd probably still move foward with ICSI later, if I felt like it would help our chances of success.

My point is that ICSI is not just a matter of deciding whether or not to spend the extra $1000, is all (which you obviously know, just putting it out there for others).

Good luck with all of it. Keep us updated as you go along so that we can all keep everything crossed for you, as needed

[thoseareradishes]

Glad to hear you have a plan! What is the IVF diet? How diet affects fertility is so interesting.

[changedname]

I think I'm going to follow the diet from Inconceivable by Julia Indichova and The Infertility Cure. Mainly whole foods etc but no dairy.

[murdock]

Crossing fingers for you! thanks for posting the video!

I don't know, ICSI is a different decision for everyone. We're doing it, but it may not be right for you two.

[genet313]

I have no IVF experience but wanted to say good luck!!!