Wednesday, April 1, 2009

Questions for RE

I'm always so humbled by your kind words and compliments, but want to reiterate that I'm not really all that extraordinary. We all face fear in our own battles and we all seem to find a way to face it and move forward despite it. I have to tip my hat to all of you too because I think infertiles (and their partners) and babyloss parents are among the most courageous people walking this planet. We are all so full of fear, worry, and anxiety, yet we still manage to brave each day. Also, I can not forget the amazing women who set their fears aside to help other's have a family ... surrogates are some of the strongest, most amazing, courageous women as well!

Thank you to everyone who answered my questions regarding the D&C. K is still spotting, which I've read has happened to some women up until their period arrives. Of course most women, including me, don't have that, which worries me, but I'm tyring not to stress about it. I would feel better if K had a beta drawn to get a better picture of what's going on, but she is comfortable waiting until her follow-up with the ob next week.

Also, I'd like to thank everyone who replied to my question about acupuncture. I want to clarifiy that I did acupuncture weekly for several months leading up to IVF #1, which I continued through all of my FETs. Additionally, I did pre- and post-transfer acupuncture sessions with all of my ETs (and K did it with the FET to her). I wasn't asking if I should do it before and after the transfer, but rather if I should do it during stimminng and/or leading up to my cycle. When I did IVF #1 with acupuncture we had a good response and 8 blasts, so I'm trying to decide if I should do acupuncture again with IVF #2 (preceding the ER). I'm still trying to decide what I should do. I'm thinking that I'll do it at the very least during my cycle. I do find it to be relaxing for the most part, but get a little stressed about the added costs associated with it. I'll keep you posted on what I decide to do.

Tomorrow afternoon we are meeting with our RE, Dr. S, to discuss the recent FET with K and make plans for a future IVF cycle. I am disappointed that we won't have the pathology results back from the testing that was done on the fetal tissue until next week. I was really hoping to have it back before our meeting tomorrow. Although we won't have a definitive answer to what caused the miscarriage, we'll discuss all of the possible scenarios and focus on the one likely culprit--a chromosomal abnormailty in the embryo (i.e., an aneuploidy). I have many things on my list to discuss with Dr. S, but here are just a few of them:

  • Low E2 during IVF #1 - what impact did that have on eggs and embryos? what causes this to happen? will it likely occur in IVF #2?
  • Egg quality - how did they look? does he suspect that they have problems? can we do anything with the protocol to try to improve it? at what point would we need to consider donor eggs?
  • Embryo quality - how likely is it that most of my high-quality (A's) blasts have chromosomal abnormalities? what does the research say? at what point would we need to consider donor embryos?
  • PGD - risks? benefits? does he think it's necessary? etc...
  • CGH - (I know my clinic doesn't do it, but I want to chat about it.)
  • Metformin - i was on this with IVF #1 should I go back on it for IVF #2?
  • DHEA - can we test this? if it's low will he suggest putting me on it?
  • Acupuncture - could it have contributed to my good response in IVF #1? does he think that not doing it will affect the results of IVF #2?
  • Protocol - will we use the antagonist protocol again? will we add/change anything? will he shoot for low and slow stimming again or will he start me on a higher dose initially?
  • Timeline - when can we do IVF #2? how does he feel about doing ER and freezing all of my embryos if we don't have a surrogate ready to go do ET right after ER? (I'm guessing he'll be fine with this because we did this with IVF #1 and had 100% freeze/thaw survival of our blasts.)
  • Surrogacy Stuff - if K is able to move forward when would she be able to do an ET? what if K is unable to move forward with us? what if we have to find a new surrogate? logistics of finding a new surro? time frame of testing if we have to find a new surro? what about a dual transfer to me and a surro? (FYI--J is not down with this and made it clear he thinks it's a bad idea.) what if we don't have a surrogate? would he transfer to me? etc...

If there's anything that you think I should ask him, please feel free to provide some suggestions.

12 comments:

Kris said...

Niki- That is a great list of questions! I can't wait to hear what Dr S has to say. I did hear somewhere (can't remember where) that the clinic in Chicago just started going CGH testing. I am not sure if this is something you are thinking about, but just thought I would throw it out there for you:) GL tomorrow!!

Polly Gamwich said...

I think you've developed a great list of questions. And you know it's thorough when you want to discuss CGH.

It is too bad you don't have the genetic material results from your and K's recent m/c. In general CCRM says that 50% of blasts are abnormal (for a small sample of 37.5 year old women) - curious what your doctor says.

Looking forward to the update.

Just Me said...

Great list of questions, hoping all goes well with your appointment and you leave there with all your questions answered.

looking forward to seeing how it all goes.

meinsideout said...

They sound like great questions to me too. I look forward to hearing what he has to say.

A Mom in Jacksonville, FL said...

Hang in there! Hope all goes well with your appt.

Lost in Space said...

It really looks like you have it all covered. I always tried to break my down to past, present, and future for testing, procedures, and cycles, etc and it looks like you have done just that.

All my best for you tomorrow. I hope you are able to walk away with some hope and a plan.

Kelly said...

Very thorough questions there. I think you will come out of the this with a firm plan in place.

SMK said...

I am thinking of you today. Looking forward to hearing that you got the answers you were looking for. :) ((hugs))

S said...

Really good to get to the appt with so many solid questions to be better informed! I too always have a list.

I'd like to respond to a couple of your questions about egg quality, embryo quality and PGD, but it would be too-specific to what our situation is like (we create perfect looking embryos that have chromosomal abnormalities, PCOS/ICSI and male age/vasectomy). I'd recommend learning as much as you can about PGD beforehand from dr google, we have done that twice. that way, you can clarify your questions about the PGD and ask about the experience of the scientists doing it etc...

Good luck with the appt... and sending hugs to K for the follow up...

momsoon said...

Thinking of you today- hope to hear that the apt. yeilded some answers, a plan and some renewed hope...Keep us posted! xox

travelaunt7 said...

Good luck at your appt. I hope you get the answers to your questions. You've created a thorough list. I'm anxious to hear how it went.
Linda

MyLifeMyWorld-SharingADream said...

I'm late on this, but I think your list of questions was really thought out. How did your appt go?