I had my financial consult today and secured my spot in the December cycle by paying the co-insurance. I’ll begin birth control when I get my period. (Wouldn’t it be funny if I was pregnant right now and I had just tossed $1,000 down the drain? I mean, as problems go, I’d take it happily, but still.) A and I have to do blood tests to confirm we don’t have any infectious diseases, etc. I don’t have the details, but I believe meds start in early November, with retrieval in early December. (Can that be true? Does one do the drugs for a whole month?)
When I spoke with the doctor yesterday and asked about doing PGD or CGH, he didn’t feel it was necessary in my case, unless I really, really don’t want to have a miscarriage. He changed his mind a little when I reminded him that I only want to do single embryo transfers. Later I was re-playing the conversation and I thought, You know what? I really, really, really don’t want to have a miscarriage. There’s the emotional stuff, of course, and the physical. And then there’s the time. If IVF basically takes two months and then I am pregnant for, say, two to three months, and then my body holds on to the remainder of a pregnancy for longer than the pregnancy itself, which it likes to do, six to eight months could go by before I got the chance to try again.
Neither CGH nor PGD is included in my benefits, and would run $2,500-4,500, but can you really put a price on avoiding a miscarriage? I mean, since we’re already in Bizarro World and acknowledging that this is an option only a very privileged few would even have?
With PGD, assuming there is a normal embryo, the pregnancy rate is 50% and the miscarriage risk is 10-15%.
CGH, unlike PGD, tests all the chromosomes. There is a 70% chance of finding a normal embryo. If they do find one to transfer, the pregnancy rate is 70% and the miscarriage rate is 5%. The downside is that it takes three weeks to do CGH, so they would take the sample, then freeze the embryos and do an FET the next month. Their lab has a 98% survival rate in thawing embryos, so to me this is not a real downside.
All of this, of course, is predicated on the fact that my old-before-their-time ovaries can even make a decent number of eggs. The doctor recommends not doing CGH unless we retrieve at least five eggs. I understand where he’s coming from, because if there are only a couple of embies to choose from, it’s not really cost-effective and I might as well just let him pick one. But it doesn’t help with Mission Reduce Miscarriage Risk, so I have some thinking to do.
What would you do?
Gosh, what choices.
I am intrigued by, though very unfamiliar with, the idea of CGH. Given CGH’s numbers, though, I think I’d do that over PGD, even with the wait.
I wonder, would there be a way to start the cycle without having pre-determined it, then if you had enough embryos, go ahead and transfer one without any testing, and then do CGH on the other ones? That way, if the fresh cycle worked out, great, but if not, you’d have some good embryos frozen.
Good luck–exciting stuff!
Wow, that’s a lot to think about and quickly! I would pay $5,000 if I had it to avoid a miscarriage. Especially if I knew my chances of a repeat miscarriage would increase dramatically if I had one.
What does A think?
At this point I would use anything modern medicine had to offer. If you do CGH does that leave you on meds another month? Either way, I would do it.
Why leave it to chance at this point? I think I would do it, especially if >5 eggs are retrieved. Although, perhaps it is more critical if there are <5. I don’t know … just thinking, knowing what I know now, I would have done way more proactive testing prior to and during our cycle just to avoid where I’m sitting now.
If you’re doing any type of suppression med that can lengthen the cycle. For example, I was on BCPs, then Lupron for 3 weeks of suppression, then I started the stims (I think 10 days of those). Do you have your protocol or calendar yet?
“Can you really put a price on avoiding miscarriage?”
NO. NO YOU CAN NOT.
(And that is coming from someone who apparently has “easy, normal” miscarriages.)
I think that the one thing you did not report from Dr Travolta, so maybe he said it, but you didn’t write it, is that not all embryo’s go to the 5 day freezable stage, so that might affect your ability to do cgh.
If you can do CGH, I’d do it in a heartbeat, but I’d also transfer 3 day embryos because people also get pregnant from those little puppies.
I do a ‘natural’ cycle because bcp’s over supress my hormones. I do the lupron flare protocol which is: start lupron on day two of my cycle, add stims on day 5, stim for about 9 or 10 days, trigger, retrieve, wait for embryology lab to call, transfer, poke my boobs, cry, wait for beta–react appropriately.
Though I am not familiar with it, I think CGH sounds good. You will know going in that you have good embies. But even if you have fewer, PGD will be good.
I think for the most part, how long you suppress depends on the schedule. They take your LMP, figure the week for your retrieval and work backward. You could suppress for around 3 weeks+ stim for 7-10 then trigger.
One thing, and you probably already know this…you will have lots of blood draws and ultrasounds and sometimes you may not have choices for the time they need to be done. Hopefully your boss will be flexible with you. Most blood draws can be done early am, but u/s requires the doc. And as far as retrieval, you kind of don’t know the day too far in advance, though you can estimate it when you begin stims. You also might want to see if your doc requires any bedrest after transfer. Mine required 3 days strict, not even up for shower. some docs don’t require any at all. Most and between the two.
ooh, I am excited for you.