Friday, July 25, 2008

New Options

I'm doing a bit better then I was the day I found out my RE couldn't help me any more. At this point I've accepted the fact that IVF may never work for us and if it does it will take multiple attemps. I actually took the initiative to consult with Dr. Totoriello with SIRM NY. My consultation was on 7/22. Like CCRM SIRM is VERY advanced when it comes to genetic testing. Their success rates aren't nearly as high as CCRM's but they are more local and they will do most of the same tests that CCRM would do. I talked to the doctor for a while. Their clinic has a unique protocol called estrogen priming that they would try. Like the microflare protocol that my last RE used (and most RE's use) it's used for woman who are older or who have diminished ovarian reserve. He said he would use the "leave no stone unturned technique" he basically wants to do a lot of testing including the immunolotical testing I've been wanting to get done for 2 years now. It will check for numerous things. It basically checks to make sure my body is a safe place for an embryo and that it isn't trying to kill off the embryo. He also would do a SDT (sperm DNA test) to see if my husband has abnormal sperm (thus making our embryo's genetically abnormal). I will also be doing genetic testing on my eggs to see if they are normal. To my surprise Dr Totoriello told me that the normal response for health fertile woman in their 20's is getting 3-4 normal eggs out of 10. Meaning out of 10 eggs only 3-4 will be normal....for a perfectly healthy, young woman. I was shocked. No wonder the average woman only has a 15-20% chance of pregnancy each month.

Anyhow, the results take 4-6 weeks so I wouldn't be doing
a transfer. We'd have to see if any made it to freeze and if those came back as one of the normal one's (most abnormal embryo's wont' make it to blast-the day 5 stage) then we go back and get the embryo transfered. I'm not really going into this expecting to have a transfer or to get pregnant. I'm just wanting answers.

The down side to all of this is between the genetic testing and all the tests we need to get done we will fork out about $6,500. It's a LOT less then most people pay (people with no IVF coverage) but it's more then we've ever paid. So long as my husband gets a good job offer soon we will do it.

Speaking of job offer we should hear back in a few days if Jon gets the job he recently interviewed for. Honestly I can't remember if I wrote about it. I suppose if he gets it then I'll be writing a diary entry about the job and how it came to be.

Anyhow, back to my cycle. SIRM batches their patients so I'd start injections on 10/27. Wether that's lupron injections or the gonal F I have no idea but I'd be starting them around 10/27. I have to tell them by mid September if we want to do it and if we do we have to pay a deposite. Money isn't really to much of an issue so long as Jon gets this job. Right now we save a very large sum of money every month (unless we put it into the house for some kind of repair) so if Jon gets this job we will be able to save money and still be able to afford to pay for this procedure. Oh we also have to save for adoption too and that's going to be $5 or 6k.

Speaking of adoption the agency FINALLY got the last document they needed from my references so we are all set to meet them on 8/18. They will talk to us about the adoption process, take our $1,000 deposite and give us a lot more paperwork to fill out.

Here is some info from the SIRM web site on sperm DNA testing (they are one of the few clinics that believe in this procedure)

Although it is possible for abnormal SDIa to sometimes spontaneously revert to normal, this occurs rather infrequently.

- Although abnormal SDIa are detected in men with apparently normal semen analysis, an abnormal result is more commonly seen in cases of oligozooasthenospermia (abnormal sperm count, motility and/or morphology)

- There is some suggestion that the use of antioxidant therapy (L-Carnitine 3-5 grams per day, acyl carnitine 500mg-1gm per day, Vitamin C 500mg X 2 per day and Vitamin E 400 U X 2 per day) taken for 3-6 months, can in some cases cause the SDIa to revert to normal.

- There is some suggestion that men who have varicoceles ( a collection of distended veins in the scrotum) associated with an abnormal SDIa may experience a reversion of the SDIa back to normal, 3-6 months following surgical or radiological ablation of the varicocele.

In summary, an abnormal SDIa augers poorly for, but does not totally preclude a successful IVF/ICSI pregnancy. However, the prognosis worsens progressively as the age of the egg provider advances beyond 33yrs. Although abnormal SDIa results rarely revert to normal spontaneously


Jennifer said...

Sounds like you're turning over every stone out there to find answers - and that's great!!! I've heard great things about SIRM and estrogen priming protocols...I hope it works for you. As for the adoption process - best of luck on that too. I know it's a lot of paperwork and tedious little steps to fulfill requirements here and there. Are you doing an international or US adoption?

M said...

I am glad to hear SIRM will do those tests!--and that you don't have to travel to the other side of the country for them. Nice you have a little bit of a break til the start date in October, too.

Good luck with your DH's job. Have you found out yet? Also, I hope you two have been having some relaxing weekends together.

Sandy said...

Hi. I'm 35 & DH is 37. I know the boat you're in. DH & I have been ttc for 2 years. Have done 4 IVF cycles, which resulted in BFN, and had 5th ER yesterday. 6 eggs retrieved, all ICSI, 2 mature
-1 fert & waiting on the other, 4 immature - ICSI today - will have more news tomorrow. Embyologist said eggs had good morphology, but when she used ICSI should could tell the eggs were not that great. I could barely understand here, after that i let it go. Will wait for more results and to talk to Doc tomorrow. I can't seem to get out of any of the doctors whether they think my eggs are bad. Cycles 1-3 Doc said eggs were good. Cycle #4, doc originally said egg quality is not my issue, it's timing, after BFN doc said, "maybe your eggs aren't good". Did cycle #5 with Dr. Lavy in Conn, he thinks maybe my issue is quality, which he said prior to starting cycle. I did cycle with him anyway, because he was 1 of few docs that would use entirely different meds. No one wanted to try different protocols or meds. I went to see Doc at Columbia Univ for another opinion when i started rest down of cycle, he said, egg quality is not my issue.
We've done all the genetic testing, semen analysis, and my FSH is 7.
I've gone out to CA to see an accupuncturist, drank herbs, have gotten 5th & 6th opinions.
-Anyway, i'm sorry to hear that you're on the same hunt as I. You're strong, & doing all that you can do. Hang in there and remember, there are others like you out there.