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  1. #1
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    Default A BIg decision...

    So my husband and I have just come out of our fourth failed IVF ICSI cycle and have been told that there is only one more chance to use our eggs or we could make the choice to move onto Donor eggs straight away.

    We have a friend who has offered to be a donor and I am completly comfortable with the donor path but I just want to make sure that we make a choice that we are happy with and will never look back and say 'what if'. Our FS would like to give another ICSI cycle a go and add Saizen as well as Luveris to the stimm part of the cycle, but there is no guarantee that it will help with my bad eggs (they are always immature - GV at EPU but mature 12-24hrs after. Our fertilization rate after is also bad and we cant get them past the 8 cells stage).

    I have so many thoughts running through my mind. Yesterday I was definitely not doing another IVF cycle (I just couldnt go through the emotional turmoil again with no guarantee) and kept thinking 'maybe there is a reason I cant use my eggs'. What if i did try another cycle and it worked but the baby had a disability because of my bad eggs, i could never forgive myself as I could have had a healthy baby with good eggs. Today I have been researching success stories where Saizen has been used and how it works and im confused as to which option we should now choose. It might be good to point out that DH is pro donor eggs as he doesnt want to see me go through all the crap again (mostly emotional) if the success rate is low/unknown with Saizen.

    There is also the financial side of it. A donor cycle would cost around $10000 and there are better odds of success with our donor (she has had three healthy pregnancies) or we could spend an extra $2500 on top of our normal cycle fees ($6000 total OOP) with a very low/unkown success rate. I just don't want to waste any more money.

    I guess im just asking for your thoughts to help me make a very tough decision...It would be very helpful to here from other ladies who have had to face this very tough decision and what their out comes were.

    Thanks

  2. #2
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    Abubby,
    We have gone down the egg donor path after 6 miscarriages with my eggs. Some of the karyotyping of fetal tissue post MC and via PGD has shown chromosomal issues which helped us make the decision as we were fairly confident it wasn't the uterine environment causing the MC's i.e I didn't test positive for any immune issues and was already on clexane for a thrombophilia.

    I don't think the decision is very often cut and dried to move onto DE, but to be honest in your situation I think persevering with your own eggs is definitely worth it. I know how heartbreaking it is to do cycle after cycle (we did 7 with our own eggs), but I think it could be worth putting your $$ towards a PGD cycle (array CGH) to test the quality of your embryos. With some clinics you are able to test at day 3, therefore not needing to get over the day 5 hurdle. I would also want to investigate why so many eggs are immature, are they stimming you long enough and at the correct dose? Has your FS been willing to tweak the protocol each time?

    I see your DH has MFI. Have you had extensive sperm testing, eg. a TUNEL assay or SCSA (DNA fragmentation test) to see what role this might be playing in your embryo development? As there are also techniques you can use to improve sperm selection, eg. Digital Hi Mag, HA-PICSI etc

    I know for us we felt we had to turn over every possible stone before we could move onto DE. We tried luveris a few times and the last cycle we did was aCGH and we used saizen. I had been on DHEA long term and the 2 embies which were tested and made it to blasto were both unsuitable for transfer (1 was abnormal, the other was inconclusive but likely abnormal).

    Also have you been tested for immune and clotting factors like NK cells, MTHFR, ANA, Factor V Leiden etc which are all things which could affect implantation?

    You will probably hate this but you do have age on your side and for some of us we have to do multiple cycles before we get that elusive BFP, let alone a sticky one. It is wonderful you have such a great friend in your back pocket as a back up but I would wonder if there are still several paths to be investigated?

    Last edited by Starf1sh; 30-06-2012 at 15:29. Reason: spelling

  3. #3
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    Thanks Starfish for your reply, you have definetly given me a bit to think about!

    Our last cycle was with a new FS as our last one wasnt agressive enough for me and we changed just about everything from my previous three cycles. I have tried both long and short cycles, stimming for two extra days, 'coasting', double dose Trigger with a mixture of Pregnl and Ovidrel but always get the same result. My last cycle I was also on DHEA, Asprin, Metformin, predisone, feldene, CoQ10, fish oil, vitamin E, Zinc, folic acid and clexane. I also do weekly accupunture and before this cycle went on a 6 week detox, however, it seems that my eggs just arrest development at the GV stage regardless but they resume mesisos once the cumulus cells around the eggs have been stripped . FS seems to feel (after researching) that my issues are at a follicular level, which unfortunaetly have a very small chance of being rectified (although we are trying!!).

    At the end of May this year I also had a laparoscopy and hysrescopy with a D&C and Lipoidol flush and my test results came back negative for NK cells. So we have ruled that out as well.

    Im not sure if PGD would help us in our case as our embryos are too slow to beginning dividing up to the 8 cell mark then they just stop (at day 5 they only look like day 3 embies, and not very good ones at that ), mind you I am very interested in using HA-PICSI next time (with or without donor) just to make sure that it is not an added issue.

    I know we have time on our side Im just over failing. I just want to make the decision that will help us reach our goal faster and unfortunatley cheaper (as much as I hate to admit it money does play a factor in this) and at the end of the day i dont care if it is with my eggs our our donors because I know I will have a baby and how I get it doesnt matter, i just dont want to look back in a few years and think 'what if'?

    How long did it take you to reach a decision to use donor eggs? What questions did you ask yourself as you were going through the decision process in your mind? What helped you decide?

  4. #4
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    Abubby, you have certainly done your homework....I'm still wondering what part MFI is playing in your embryo development equation?? Would definitely recommend using a more sophisticated sperm selection technique for your next cycle and see if that makes any difference.

    We discovered during our donor cycle (by using Digital High Magnification) that my DH had very high levels of vacuoles present in his sperm sample, and all this time my eggs were getting the bad rap alone! By using this technique and donor eggs we ended up with 4 blastocycts, 3 of them graded A.

    As for making the decision, it really all came down to not feeling that I had faith anymore in my own eggs. My sister had actually offered to be a donor at the beginning of January 2011 after we'd just had a natural conception and then MC (which was pregnancy loss no. 5 for us).

    We decided to push forward with PGD as I needed more info about the quality of our embies before I could consider this. As I said we didn't have anything suitable to transfer and so we started to process of counselling with my sis and her DH for her to be our ED. While we were doing this I fell pregnant naturally but again lost this pregnancy so that kind of cemented our decision (although in hindsight this pregnancy loss probably had more to do with Asherman's syndrome but I guess we'll never know).

    Even though the path seemed clear that if we wanted to have a child we would need to use a donor, I still had to go through a process of grieving the loss of my own eggs and in some moments I still feel it. But like you, the opportunity to have a child at all was far more important that where the egg originated from.

    Going down this path does bring up some unexpected emotions and questions. Perhaps going to see your clinic counsellor to talk about the possibility of using your friend as an ED could be a good 1st step?

  5. #5
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    Thanks again Starfish,
    Im so sorry for your losses, they must have all been so heartbreaking. I have read about Asherman's syndrome (a friend of mine was recently diagnosed with it as well, after having two children via IVF). That totally sucks!

    I looked more into PICSI last night and will definitely be pushing for that!!

    I saw the clinic counsellor last week but he was no help whatsoever . He just wasnt on the same page as I was...

    Today I have been thinking that I would really love to give my eggs one last chance as if we were to do an ED cycle it probably wouldnt happen until next year with all the logistics to work out (she lives in Canberra and is in the Navy) and I dont want to sit around and not actively try to get pregnant. Some of my friends are beginning to think about trying and i just dont want to sit there and put on my brave face as they announce their pregnancies while I know that im not doing anything to actively try. But again on the flip side is the money. Ahhhhh i just feel so confused today!


 

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