Tuesday, October 30, 2007

Binary Outcome

First of all, I owe a big and delayed THANK YOU to both JJ and Babyblues for the awesome CD's, they are in my car and soon to be loaded on my iPod...you girls really outdid yourself...and JJ, your voice is amazing. Thank you both again!

Next, we have decided to move forward with IVF...seems strange to type this....but I have also figured out a lot about myself over the last few weeks, mainly that I was feeling shy about blogging because I am superstitious and kept thinking that by blogging I might somehow be jinxing myself...which leads me to the recent discussion, errr fight I had with my husband about IVF. He is a math guy, focuses on statistics...he is in the finance business...I on the other hand, am a feeler, a guesser, a what iffer. Needless to say we are constantly finding ourselves in arguments over me worrying about everything related to getting pregnant - if what I eat will effect the outcome, if going to acu will help or hurt, you get the idea. I think he finally had it with me and looked me straight in the eyes and said this: "Babe, we are faced with binary outcomes, you will get pregnant or you will not - it will happen on our first try or it will not...there is nothing else we can do and nothing else to worry about!" At first I was so mad at him, how could he look at all of this so simplistically...but then, over time it started to sink in that he is right. IVF will either work for us or it won't, I will either get pregnant or I won't - I have to take everything one step at a time and deal with each result when it happens. No amount of worrying or second guessing is going to change the outcome.

My realization could not have come at a better time because we had our regroup meeting with the RE last week and now we have more decisions to make. She believes that there is a genetic component to our multiple miscarriages and would like us to do either PGS or CGH prior to transfer. What might you ask is CGH? We had the same question. Our clinic is working with Yale on using Comparative Genomic Hybridization to test all 23 chromosomes (vs. the 9 tested with PGS. Here are the other stats the gave us to ponder...bear with me, this gets technical!

PGS:
9 chromosomes are tested with the FISH technique.
There is a 10% chance of misdiagnosis.
While it is true that PGS can damage the embryo, it is also true that for patients like me, same age range with recurrent miscarriage, IVF success rates were seen around 33%, with PGS and IVF, success rates jumped to 66%
Cost: 5k

CGH:
All 23 chromosomes are tested
The process takes 2-4 weeks, so all embryos are frozen
The freezing technique used is vitrification, which results in a 95% successful thaw rate vs. 70% for traditional freezing.
Pregnancy rates are unknown as this is a new study, but it is doubtful they would be less than a regular FET.
Cost: 2k, no charge for FET. My doc believes this will be the way genetic screening will be done in the future and it will cost up to 10k because of the microchips needed for the test.

AND, all of this could go completely down the toilet if we only have a few embryos on day three...if this is the case we will transfer those and hold our breath!

So, what to do, what to do? I really would welcome any thoughts on this...

6 comments:

Dreamer4agift said...

Wow, what decisions you have! I tend to think of the cheapest route as long as it has good possibilities.

I think that's what's great about the men in our lives...we, women, tend to worry ourselves to death and in the men walk, ignorant and all, and say things that make sense.

Good luck with whatever you decide.

Mands said...

I think that IVF is a miracle of modern medicine. There are so many options available to us today, and such good doctors out there trying to help us. I say start with IVF and then follow your doc's advice further. Good luck!

TeamWinks said...

Those are difficult decisions, and I wish I had some advice for you on that front. Good luck with the choice. I'm sure you will make the right one!

Caro said...

CGH is a good technique, I've used it and seen it used a lot in cancer research. I guess more information is always good and it will include all the info that the PGS would give.

I'm happy to look up more info for you if you tell me some more details.

JJ said...

Glad you are enjoying your CD's=)
I am sorry I am not going to be much help on this one...but Ill be here to support you 110% through the process!

JV said...

After multiple early miscarriages following IUIs with injectables, I did PGD on my first IVF, and every day I wake up so very grateful that I did. I was lucky and responded well, produced a good amount of eggs, which ended up being a bunch of normal-looking embryos. Without PGD, we would have never known which embryos to prioritize, and would have started transferring all the seemingly "best" ones first, which we now know were doomed and would have turned out to be miscarriages due to their chromosomal abnormalities. In the end, instead, we transferred only one embryo - it stuck, and I am now in my 28th week. I get hit with waves of panic just thinking of all the hopes and all the heartache and all the tears that could have been. I feel faint just thinking about it. PGD does have its costs - financial and emotional - but in my experience it was totally worth it. We had decided to set it all up and move forward with it only if our number of embryos would be above a certain cutoff, which we felt comfortable with. Of course we didn't know how it would go until the crucial day 3, but I am so glad we planned for the possibility of numerous embryos. I would do it again the same exact way, as scary as it was. I wish you best of luck, from my heart.