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hi everyone,
my husband and I have been trying for a little over a year to conceive without success. i'm 33 and he's 31 and he has less than perfect count/motility/morphology. (he's at 10-20M on the count)
we recently decided to go with IVF in our area (northern VA) and have negotiated a pretty good price on it. 5000 for the cycle. 1000 for the ICSI. 500 for anesthesiologist. and she's said she'll help us with free samples/coupons on the medication and estimated around 2500 for that. (typically would cost 4k)
total: 9k.
We are 'rushing' to IVF because of my age and the fact that we want 2 or 3 kids so time is not on our side. we could probably get pregnant on our own given enough time, but we're really in a tough spot, and we feel like we have to 'choose'.
Are there any pointers/hints/thoughts you can provide us with? anything we may need to know to make this easier? anything to think about that we haven't thought of?
I work in a fertility clinic, but am not a nurse or doctor so I am no authority but here are a few things that come to mind...
Ask your doctor about their policies regarding how many embryos to transfer and what input you'll have in the decision (our doctors suggest a number based on quality of embryos, age of patient, risk factors etc and then let them add or subtract one from that number).
Ask about embryo storage costs and methods. Do they store on site?
Ask about genetic testing on embryos, especially if you have a history of miscarriages or if you or your husband carry any known recessive genes for common disorders (hopefully your doctor will offer you screening options based on your ethnic background. CF is common amongst caucasions). It's slightly risky, but if you know you're at a higher risk for having a child with a genetic disorder, you might consider having the embryos tested before transfer (but that's probably extra $$$).
Be aware of state laws regarding embryo care. Some states do not allow for the disposal of embryos. And know your doctor's policies on embryo/egg adoption. It may be a ways down the line, but some practices allow patients to donate embryos to infertile couples, who would be happy to accept your tiny frozen miracles.
Other than that, be patient. I've seen patients go through multiple rounds of IVF before getting pregnant, and others go through several and never conceive. It's a rough path but keep in mind that the results are worth it.
And your husband's SA isn't that bad! It's only slightly below normal, I'm actually a bit surprised they're doing ICSI unless there is a major motility issues.
Be sure you are both psychologically ready for that. It's tough... not only the treatment (exhausting) but the fact you can never be sure if it's going to work or not.
There also is the availability issue: lots of sonograms during the treatment to see how things go... They'll harvest your eggs when the eggs are ready... the transfer will take place when the embryos are ready... etc. It can be any day of the week, it can be at the weekend... Only nature decides, not you or your doctor. So even if you work, you'll have to be able to go to the clinic any time!
FYI, I've been through IVF for the same reasons as you (I was older, though).
My advice would be to remember that there is no such thing as "untelling"
I'm a long time poster on another board (for IF issues).... can't tell you how many times "newbies" to IF treatment excited about the amazing medical journey that they are about to embark on and confident of their success - tell everyone and anyone about their upcoming IVF.
Later they regret it - do you really want to give everyone a blow by blow account when/if things aren't going well. During the "2 week wait" (the time between transfer of embryos and the official pregnancy test) - you aren't going to want to be asked multiple times a day "if it worked"
Get ready to get a little crazy and feel a little chitty; all those meds are a lot to handle and do a real number on your pysche and your body.
Once you have the retrieval things get easier for a few days and them comes the two week wait which is just brutal because the entire time you wonder if it worked and over analyze every twinge your body makes.
It's one he11 of a journey and I hope it works for you the first time. You are still young, even in reproductive terms.
Best Wishes!
Have you done IUI with Clomid or related fertility drugs yet? I think that is usually the first step.
It might sound a little odd, but have your husband try these if he hasn't already: http://www.amazon.com/Daily-Wellness.../dp/B0000X6GDM
Is there a study saying they work? Not that I could find. Just anecdotes. We tried for over a year after our miscarriage, I had taken these for maybe 45 days and my wife became pregnant. Did they do it? I cannot say that. What I can say is they cost $20 something dollars for a months supply and IVF costs a bit more than that.
There's a newer method of freezing embryos called vitrification that you might want to look into. It doesn't seem like its particularly common yet, but if you're in NY, Boston or a large city area it might be an option to look into. Most clinics will do a cycle where they harvest a number of eggs, fertilize them and then a few days later implant 2-3 of them. The rest are generally frozen through more traditional means. Unfortunately, embryos frozen with the traditional method generally have a poor survival rate and if your first shot doesn't work there isn't a great chance of the frozen embryos working in later cycles. Because the fresh embryos are your best chance they put in a lot of embryos at once and you have to do it pretty soon after the harvest. I guess studies show the drugs are suppose to be out of your system by then and it shouldn't effect things but it does seem like a lot of extra stress to put on a body to me.
Vitrification frozen embryos are fast frozen which doesn't allow ice crystals to form which is the damage to frozen embryos. The results sound pretty promising, with reported survival rates almost as good as a fresh embryo.
More importantly this frozen survival rate opens up some other options that just aren't feasible with fresh embryo transfer. Single embryo transfer is now a more reasonable strategy since individual embryos aren't "wasted" by being frozen, which reduces the likelihood of multiple births. And genetic testing of the embryos can be performed that cannot be with fresh transfer. The testing can be performed on fresh embryos but the results do not become available until after the transfer has to take place making them pointless. The results allow you to screen for genetic conditions and identify embryos that are unlikely to be viable allowing you to select the embryos with the best chance of implanting first.
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