Home > Thaw Cycle #4 > What Would You Ask?

What Would You Ask?

Here’s where I am: I’ve been doing IVF/ICSI since July 2006.  We started because my husband had a vasectomy many years ago, so it’s not like we’d been trying for years and didn’t know what was wrong and needed a diagnosis.  We knew we’d need IVF if we wanted any hope of having a child.

I live in Hobart, Tasmania.  There’s one clinic with only 2 REs: one who is part-time (he’s mainly an obsetrician) and one who is full-time.  We started off with the part-timer but have been with the full-timer for a few years now. I would say they pretty much don’t have individualised treatment.  They have a few standard protocols, but mainly seem to pride themselves on keeping treatment costs low so patients can have many cycles.  Quantity, not quality.  If you have repeated failures, they don’t do investigations; they just suggest you keep on going on.

To go to another clinic would cost us money, time, more stress, and be logistically difficult.  That’s not to say I’m not up for it if need be.  However my husband gave me the ‘I’m tired of treatment and would rather not pursue it, but I’m doing it for you’ bombshell the other night.  So I don’t know if I could drag him by the testicles to an interstate clinic to try to get different treatment.  I’m willing to go without him though.  Having a child has become muchmore important than my marriage.

The only  investigations I’ve had are a laproscopy, hysteroscopy, hydroscopy a couple years ago (I had endo, which was removed, and the hydroscopy as inconclusive as fluid didn’t move through my tubes but they looked OK).  My obstetrician ordered a bunch of blood tests after Blobby’s miscarriage:  protein C, protein S, AT 3, Anticardiolipin antibodies, LAC, Factor V Leiden, Prothrombin G20210A mutation MTHFR C677T mutation, MTHFR C677T mutation, and Karyotyping.

I find it unbelievable that after so long, they still don’t try to find out WHY we’re having the problems we’re having.  They never check hormone levels (not even during stim cycle – he just relies on ultrasounds to tell him what’s happening), they don’t check for implantation issues, there’s been no renothing.  Hearing about the testing that goes on in other clinics has really opened my eyes.  I would welcome finding out I had a problem because then we’d know whether it would be likely to be able to be fixed or if we had no hope.

So if you were me, what questions would you be asking?  You all have experiences of different clinics and protocols.  Questions I’ve already come up with are:

  • As one of our embryos is a 3 day and the other two are 4 day, can the 3 day be thawed used this time and thawed a day ahead?  That way if it doesn’t thaw we still have 2 more we can attempt thawing.
  • Is there a wait list for donor semen?  (There wasn’t a few years ago when I did 7 DI/IUI cycles, but I think there is now.  Want to know just in case.)
  • Might DHEA help my embryo quality?
  • Any news on the egg donor wait list?  Where are we?  (This is probably a stupid question; I know other women on the wait list and we all seem to get difference answers to our questions.  Someone who is #27 was told recently she should have a donor by January 2011 – sorry, but that’s a HUGE porky she’s been told!)
  • The best embryo we’ve had was from a down regulation cycle.  Is this just a coincidence, or should be try down regulation cycles again?
  • What sort of implantation failure testing can be done?  If TasIVF doesn’t do it, where do I go for it?
Categories: Thaw Cycle #4
  1. 21/09/2010 at 6:02 pm

    I think that it’s great that you’re being so honest with yourself about your priorities. I’m just another infertile walking the same road, but from what I’ve read, I think your age is the main factor. You said that you turned 40 in June, is that right?

    My assvice is that if I were you, I would be putting my time and resources into donor eggs or donor embryos, even if this means travelling to the mainland or even further.

    I am so sorry that it has come to this, and that it has caused so much heartbreak to both you and your husband. I wish that you didn’t have to make such difficult decisions.

  2. Meg
    21/09/2010 at 6:25 pm

    I find the lack of routine blood tests during cycles very odd too. I’d feel a whole lot more comfortable if we got the blood tests done that other clinics seems to do as standard practice. There are not many options at TasIVF. I’m interested in killer cell testing, and the implantation issues you talk about too. And testing of the embryos themselves. In the US this is commonly done, how come we don’t get the option here?

    I’ve heard of some clinics doing phone consultations. Maybe this is an option for you to check out other mainland clinics?

    BTW, I think the woman who was #27 was actually on the list for donor sperm (I could be wrong)

  3. bir
    21/09/2010 at 6:49 pm

    How frustrating that your clinic just keeps doing the same thing over and over, especially over the time span that you’re talking. I know you’re not alone though – I have a close friend on the other side of the country doing exactly the same thing (frustrating as she DOES have other clinic options but chooses to stick where she is!!).

    If you happen to go interstate, I will certainly recommend my clinic – it’s small and personal! Like yours they didn’t test me for anything ‘extra’ like killer cells, however… after a mc, then four failed FETs they were obviously also feeling the frustration. As they said to me… I have ‘great’ embryos (means shit when they don’t stick around!), my hormone levels are perfect, my cycles perfect, you name it… not so bloody perfect from where I’m sitting! So, they threw the book at me… for the last two months of cycling I was put on selenium, zinc, vitmin D, E and C all on top of my elevit and daily B group supplement. All of these can help with so much to do with fertility including implantation and mc – apparently (according to Dr Google). The big changes they made though was that the put me on clexane and prednisone 10mg. The clexane ‘in case’ I had a clotting issue that was not allowing an embryo to survive. The prednisone ‘in case’ I had killer cells attacking the embryo and not allowing it to survive. I have ‘some’ issues that I have never been tested for anything, but rather just whacked onto meds. Having said that… as you know I’m now 11 weeks UTD (touch wood). So, the thing I love most about my clinic is their eagerness to have it work, to try different things, rather than doing the same thing and expect a different outcome. My FS is great. My clinic doesn’t do PGD testing though – I’m almost 40, but I’m not too sure how I feel about PGD anyway, so I’ve just not thought too much about it.

    Perhaps none of this helps you, but I’m wondering how receptive would your FS be to a bit of ‘self’ medicating? I don’t mean in the extreme, and always run it past them first, but I wonder what they would say if you walked in and said ‘right, this is what we’re ‘adding in’ this cycle? Throw some of the protocols that you read about at him, and tell him you want to try it, and if he says no, then ask why not? If it’s not because of risks, then he needs to have a concrete explanation rather than it won’t work, or doesn’t suit you.

    Thinking of you!!

  4. 22/09/2010 at 4:44 am

    Stopping by from ICLW…

    Unfortunately, I don’t have too much insight into what questions you should be asking. I have a family history of a chromosome mutation, so as soon as I went to the RE, he tested me for it and turns out that I inherited the mutation. I hope that you can get the answers that you are looking for and find some peace. GL!

  5. Jen
    22/09/2010 at 8:12 am

    I clicked over to your blog kind of randomly from the ICLW list and am a little heartbroken for you even though we just met. I can’t even imagine how exhausting doing so many cycles has been for you. Thank goodness for the coverage you have in Australia. However, that doesn’t change what you have gone through. I’m 33 and have crappy eggs. After two cycles with my own eggs, we made the decision to use donor eggs. Being in America, we had options for donors and I was lucky enough to have a friend volunteer to help. As we were limiting ourselves to three cycles (financially), it was our last chance. It worked. We’re a couple of weeks away from delivering after some drama at 27 weeks. I tell you this as hope for you when you do come up on the list for donors. I hope you get a straight answer as to where you are on the list. Hugs.

  6. 22/09/2010 at 12:39 pm

    Wow…I never realized you’d done that many cycles!!! Holy cow! Have you tried seeking help through another RE who might be willing to work with you on a consult basis from a distance? There is a blog that I read, http://womenshealthandfertility.blogspot.com/, and I know people ask questions there all the time. Maybe that would be somewhere to start. It seems to me that this clinic just doesn’t have it together at all.

    I really hope that this FET works and that this is your last cycle. I’ll be thinking about you and reading…Best of luck.

  7. Tarah
    23/09/2010 at 12:01 am

    I don’t have any advice – I never had to deal with IVF but I want to send you my hope that things change and you’re able to get the testing and treatment you are craving.

    ICLW #115

  8. 23/09/2010 at 1:59 pm

    I didn’t have to advance to the level of IVF so I don’t have any clear advice. I just wanted to say I’m sorry you are going through so much and that you are in such a tough situation. Wishing you much luck in the future.

    ~ICLW #18

  9. 23/09/2010 at 6:19 pm

    Hi darling,
    I am so frustrated for you. I definitely think a different approach is absolutely necessary. Why keep costs down if you are not getting down anywhere? It is so unfair to you. I am going to email you an article I found when I was in my Googling phase that has a description of a pioneering treatment used for women with numerous failed cycles. Love you heaps!!

  10. 24/09/2010 at 2:37 am

    Oh Honey, you have been through so much and are still left with so many questions, I cannot begint o imagine how frustrated and angry you must be getting. I wish I could offer you some advice, but all I can give is my support. I realy hope that someone can help you out here.

    Personally I think a second opinion has got to be worth it. That’s not to say you have to do any future cycles with them, but just get their input into your case. Sometimes a fresh pair of eyes can see something that other can’t. Really hoping you get some answers soon and in the mean time, sending you a big (((hug)))

  11. 24/09/2010 at 9:33 am

    I am sorry but I completely disagree with your clinic’s approach. 14 cycles is a lot. They should not just be encouraging people to keep going without doing investigations. That is just wrong as far as I am concerned.

    If I were you I wouls be asking for a full RPL/Implantation failure workup. Here are a few docs I know of that do such things:
    – Dr Gavin Sacks (IVFA, Sydney) (tests for NK cells)
    – Dr Lynn Burmeister (Monash or MIVF in Melbourne) (NK killer cells)
    – Dr Devora Lieberman or other docs at SIVF in Sydney (RPL program – did not offer NK testing when I went)
    – some of the major city women’s hospitals have an RPL unit as part of the ob/gyn practice – RWH in Sydney do, but not sure whether they do NK testing.

  12. 24/09/2010 at 10:19 am

    Goodness – I had more monitoring done for a Clomid cycle! I hope you see results soon or are able to get better service elsewhere. Good luck and happy ICLW!

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