Phone Consult Update

We had our phone consult tonight with Dr. Schoolcraft from CCRM. He started out by asking us to summarize our infertility journey. After knowing that we had four failed cycles he immediately recommended that we do CGH on our next cycle to check for chromosomal abnormalities of our embryos. He said that it is possible that we have been transferring chromosomally abnormal embryos back in to my uterus. Even though they are great quality under the microscope this does not mean that they are chromosomally normal. He explained that it is possible to have a child naturally, our dear L, because in many cases only 30% of a woman's embryos are chromosomally normal. He explained that patients who have had the CGH testing done prior to an embryo transfer have a 70% success rate because they are only transferring back chromosomally normal embryos. He said that PGD is kind of out-dated (which my local RE said that they are developing more and that PGD should be in a better place a year from now) and that CGH is the new PGD. Which I wholeheartedly agree with. CCRM is one of the best, if not THE best clinic in the country. They are on the leading edge of technology. Their lab is top notch and the first in the world to grow an embryo to day 5 and they are also the first in the world to do CGH, which tests all 23 chromosomes, not just 5-9 like PGD.

He asked if we had any karotyping done to check for chromosomal abnormalities or a balanced translocation of chromosomes. Our local clinic has taken my dear husband's blood for this and he recommended that I call them to have it done on me also because we could both have a balanced translocation or I could just have one and not my dear husband, so it is important for both of us to be tested. I will be making that phone call tomorrow. This is important information for us to know if we decide to cycle there and do CGH because then they can make double sure that they are not transferring back abnormal embryos.

He also recommended some other tests that he would want us to have done when we go down to Colorado for our one day work-up. They include a sperm DNA fragmentation, ultrasound to check out "down there" and blood flow to my uterus, blood test to check hormone levels and communicable diseases, hysteroscopy, semen analysis and beta 3 integrin (like the endometrial biopsy I had done, but they would actually send the cells to a specialty lab to make sure that I have the beta 3 integrin in my uterine lining which is necessary for implantation to occur). I will also have to have my blood drawn on day 3 of my next cycle and have it freeze packed and sent to Colorado for testing or bring it on the plane with me so that it can be tested in their own lab. Sounds like fun, huh?

My dear husband and I have decided to go ahead with the one day work-up. Depending on the results of all of our testing we will then decide for sure if we want to cycle at CCRM. I have to say, though, that since Dr. Schoolcraft is arguably the best fertility doc in the country, if not the world, why would we waste any more time? I am getting to a point that I need to have an end in sight and I don't know that I am up for cycling locally again and then doing another frozen cycle and then still possibly needing to go to CCRM. I just don't think that emotionally I want to do that. We told Dr. Schoolcraft that we are in the warranty program locally and he said that if financially or logistically we needed to cycle here again, then to go for it. He also pointed out ever so eloquently that if it has not worked at our local clinic four times, then why would it work at all? Good point!

We asked him what our next steps would be to schedule the one day work-up and he transferred me over to Jackie to get more info and she is sending us out a packet. I am supposed to call them on day 1 of my next cycle to schedule the work-up. We will have to fly out between cycle days 5-13 to complete the work-up.

The ONLY hang up I have about cycling at CCRM is the logistics of my dear son, L. Over the last four years my dear husband and I have talked about going to Vegas for a couple of days or really anywhere for a couple of days to get away, but I just have this huge fear of getting on a plane without L. I love flying, but I always have that fear that my plane will crash. I just CAN NOT get on a plane without him. I told M that I would be an absolute wreck if I got on a plane without him. Unlike at our local clinic, children are allowed at CCRM. However, the one day work-up will be 6-7 hours long and I just don't forsee that going well with a child in tow. I asked Jackie if they had a drop-in day care that they contract with where I could bring him for the day and she was not aware of anywhere that I could take him. So, if anyone wants to fly to Colorado for a day with us, let me know:)

Before Dr. Schoolcraft transferred me over to Jackie he said "Good Luck". I told him thank you and that after four failed cycles it is hard to have hope that this will happen. He explained that we were great candidates and that I produce great eggs and plenty of them. He also said that he had talked to six potential out of town patients just like us today and that out of all of them that we had the best prognosis for success and to "keep the faith". It was so nice for him to acknowledge that we should NOT give up. I felt that my local doc had lost optimism and hope for our case and, to tell you the truth, it stung to hear him say some things that he did, but I appreciated his honesty. I just think that it is hard for any clinic to compete with arguably one the best clinics, which is CCRM. Having said this, to my local IVF friends who love our local doc just as much as I do, I still love my local doc and think that he is arguably one of the most compassionate docs out there. Really, I can't say many bad things about him and I would recommend him in a heartbeat to anyone else local that is considering IVF. I just think that my case may require more advanced technology that he does not have available to him.

So, the wait is on for AF to arrive! Since I have been on fertility medications for the last 18 months, not sure how regular I am anymore. Hopefully she will show her ugly side and come right on schedule the first week of January. If she doesn't show at all (Hope is creeping in...) then that will be a good thing too! Man, wouldn't a natural conception at this point just be a riot!

Here are a couple of CCRM articles for further reading:
http://www.reuters.com/article/pressRelease/idUS212174+30-Jul-2008+BW20080730

http://waywardstork.blogspot.com/2008/12/our-bfp-what-finally-made-difference.html

Kris