Friday, March 20, 2009

ER day: Option to convert to fresh? ... DENIED

I just had a consult with Schooly where I asked him what he thought of us converting to fresh if we only get a handful of mature eggs at retrieval ... he said he thinks he could do a fresh cycle and we would get pregnant ... but he thinks we'd likely miscarry.

I explained to him that I'm concerned that the technology might ruin the eggs (and thus cause the demise of our embies) like it did in our last failure of a cycle and he said that he didn't think it would. He said that if we had just 1 embryo, he'd suggest we move forward with the PBB/CGH genetic testing.

I suggested to him that it seemed that he had better results on fresh cycles than they do on the PBB/CGH cycles so why would anyone opt to do PBB/CGH when they could do fresh? ...

FRESH CYCLES : 2007 SART reports indicate that 40 year olds cycling at CCRM have a 50% chance at clinical pregnancy.

CGH/PBB CYCLES: this group is on average 40 years old and CCRM is reporting a 22% clinical pregnancy rate.


Edited to add: 22% success is for PBB/CGH not blastocyst CGH (which has an 84% success rate). These stats are of clinical pregnancy rate and not live birth rate b/c they do not have live birth numbers for this new PBB/CGH technology.

Schooly indicated that you can't compare these two groups. 40 year olds who do PBB/CGH are women who probably should be using donor eggs where as the women who do the fresh cycles aren't at the stage where they need donor eggs yet.

I asked him what his success rate was for pregnancies from frozen oocytes (as this is likely the MOST delicate procedure that could harm the eggs) and he said that their pregnancy rate is the same from vitrified oocytes as it is with fresh oocytes ... the same.

Lastly, he said he wasn't even sure why we were asking this question. He really doesn't anticipate that we will yield a low mature oocyte count. Dr. Schoolcraft said he was confident we would get a lot of eggs - I told him that I'd rather operate in the realities of my life ... get that? Me, I was the one being all stern with bad bedside manners and HE was the one all emotional and optimistic! (This is funny for anyone who's spoken with or met Dr. Schoolcraft ... he's not exactly warm and fuzzy.)

So Berilac and I have until trigger day to decide which technology we will use ... straight fresh IVF or PBB/CGH while vitrifying oocytes.


  1. Best of luck in your decision...It's nice that Dr. S. was optimistic..and emotional :-)!

  2. Ok, I LOVE this quote "I told him that I'd rather operate in the realities of my life"... ROTFL. The whole conversation seems totally opposite of how you'd think Sch would react, huh? It kills me to say go w/ Sch and don't worry about it, b/c we all worry about it and obsess to the Nth degree. But I'd say go w/ Sch, and see how it goes when the time comes for The Decision...

    And I have to ask where the CGH/PBB numbers are from? Either something big happened, or those are different numbers than what Surrey quoted us when we did the FET in Sept. (albeit a million IVF years ago). He quoted 85% success rate. Tho interestingly, I'm one of those who's definitely on the edge of the donor egg cusp...

    Regardless, YAY for starting your CCRM cycle!!!!!!!

  3. Hmm... I don't know what I'd do either. I like to rush things along so I'd try the fresh cycle but after all our m/c's, "reality" has bitten us, too. Will pray for you...

  4. Good luck with making such a tough decision! I'm rooting SO HARD for you!!

  5. Wish I had some words of wisdom, other than go with your heart. I'm cheering you on!

  6. But what are the live birth rates? Higher in the PBB/CGH group? You know, Polly, maybe my over-40 cycles can give insight. Bear with me. I didn't have buckets of eggs, but we did make good embies and did get clinically pregnant with both transfers. At my age, the grading criteria and other viewable/measurable characteristics that indicate what might turn into a baby carry next to no weight compared to the simple element that is my age. "Perfect" embies are still, by and large, "bad" embies in the end. But at your age, you likely have a MUCH better chance of benefiting from the testing than most/all in that testing group, no matter how many embryos you make in a given cycle, because odds are that better-quality eggs/eventual embies exist -- you just need extra help sussing them out. (Same with young IFers with high FSH or severe PCOS . . . they just need the right kind of help to win the race.) Your history shows that you easily get pg when any fertilized egg is present . . . which, in a way, mirrors my experience that when an embryo exists, then pregnancy occurs, regardless of said embryo's viability. I believe my body can't reliably weed out the nonviable (those unable to go the distance, I mean) embies. For you, maybe, I hope, and Dr. S thinks he knows, the testing will help circumvent that issue by giving you the best chance. All random unknowns aside, of course.

    I'm not giving advice, really. I totally get the worry that testing might damage your embies. And I wholeheartedly believe in following your own instincts based on what you know to be true for yourself. But I wanted to chime in with the equally strong belief that sometimes following the RE's thinking is the strategy that stands the best chance for success.

    These decisions are so trying. I know you will be able to make the call when you need to, and that you're the best one to make it.

  7. Polly, I'm super proud of you for being strong and voicing your needs and wants. Sometimes even the best doctors forget that it is we who are the paying clients and our thoughts/concerns need not be swatted away, but logically addressed or we'll have every right to do as we see fit.

    Best wishes!

  8. I gotta go with Lisa's opinion on this. Good luck with your decision...not one I would be happy about making.

    Hugs. You are in my prayers.

  9. Gah - you poor thing - very hard decisions and I have no experience with the testing but just wanted to say good luck.

  10. Yikes. Big decisions. Why does it never get to be easy???

  11. Hugs, Polly. The decisions are never easy with this stuff, huh? I love that Schoolcraft is the more optimistic one right now. It speaks volumes on what he really feels going into this.

    I'm really not sure what I would do because of your history with "empty" follicles. Was it a protocol or clinic issue or is this something that could happen again? You will only know follie counts at trigger and even a bunch of follies could mean not many eggs......Not trying to sound negative, but I know you live in reality and this has likely already crossed your detail-oriented head. (-;

    I'm not sure what specifically drew you to CCRM, but I would think back as to why you chose to go there in the first place. Is it to get more eggs or to find out if there is something wrong with them? Likely, both, huh?

    Crap, lots of rambling and probably not helping at all. I know you will make the right decision for you, sweetie. I'm sorry it's so hard.

  12. hahaha, Dr. Sch was emotional and optimistic, lol. Didn't know he did that:-) But, I do understand where he is coming from too. Having experienced 2 m/c's and a chemical pregnancy, I had to do testing this time b/c I just didn't want to do that again. I want the best chance available for this one to make it...and further, if there is a problem with my eggs, I darn well want to know it NOW. I am so tired of doing this over and over again and the heartache. So, personally, I'd lean towards the testing. However, I do understand being worried and being impatient, so I understand you going either way with it. In any event, I, too, am super-proud of you for being your own advocate!

  13. Girl,
    We're praying for clarity and wisdom, and continued patience. You ROCK! You have such an amazing gift in your ability to capture our hearts......crossing all our fingers and toes for ya! xoxoxox

  14. What a conundrum! Good to hear that Dr. S is optimistic. I know this decision won't be easy for you, but as always, you'll make the right one when the time comes.

  15. Wishing you the best. I hope that when you meditate and pray on this topic, the answer comes to you.

    OUt of curiousity... if you got over 10 mature eggs, would he allow the surplus mature eggs to be fertilized and transferred and the remained biopsied and frozen?

  16. I was trying to comment from my DH's new iphone when it rang, I answered and I lost what I've typed.

    Anyhow... yaix...big overlook from my part. I don't know why I did not "get it" then. I assumed that the high 2007 success rate for the 40's was due to CGH, when in fact it was not being used then. I now wonder if we made the right decision.

    Too late for us though. So we just rest that the Lord will take care of us.

    Praying for wisdom and discernment for you and Berilac for this very important decision!

  17. Hmmm... if this Dr Crafty feels optimistic about things for you guys, I'll be praying too that whatever decision you make, will be the one for you.


    ps. Sorry, I haven't been around but do know that I am thinking of you.

  18. Hi friend, I'm hoping you arrived safe and sound. Coco is a cutie isn't she?

    I hope all goes well this week. Call me -- often, if you can.


  19. Polly, hope all is going well with your cycle, not long till ER now. I think everyone else has given you some wonderful thoughts, so I'll just add my prayers to the list. xxx