Options

As promised, here's a summary of what I learned from Dr E during our phone consultation last Friday.

Our current protocol (5 days Clomid, 2 injections of FSH, an HCG trigger and two IUIs) is pretty much as aggressive as we can go, short of IVF.

We could do all FSH injections, but as long as my uterine lining is good (Clomid can make it not-so-good, but it was great last cycle) the combination is as effective, and much less expensive.

She said that, with either IUI or IVF, once you get past 3 - 4 eggs (or embryos, in the case of IVF), the odds of pregnancy don't really get any higher, but the odds of higher-order multiples (triplets or more) do.

Speaking of, she confirmed that she's comfortable inseminating me with as many as 3-4 mature follicles. If I had more than that, we'd most likely cancel the cycle. We'll find out about that on Friday.

She's okay with doing up to six medicated cycles (this is #2). The statistics show (I've read this elsewhere, as well) that if you're not pregnant after six cycles of medications, you're not going to get pregnant with medications alone.

We talked a bit about our options, down the road, if we don't get pregnant after six medicated cycles.

IVF is God-awful expensive, of course, but they do have something called the "shared-risk" plan, which means that you pay a set (God-awful) amount, and for that, you get six cycles (plus transfer of any additional frozen embryos from those cycles). At the end of that, if you don't have a baby (actual, alive, coming-home-from-the-hospital baby, not just a positive pregnancy test) you get your money back.

The amount that you pay is equal to about two cycles, and includes medications and everything.

It's still incredibly expensive that way, but you have that guarantee that, if it doesn't work, you're not out the money. That's the only way we could even consider it, and that would still require taking a home equity loan.

But . . . (and there's alway a big but) . . . to qualify for the shared-risk plan using your own eggs, you must be able to complete the six cycles before you turn thirty-nine.

Yep, that pretty much rules out me and my ancient eggs.

I asked about the possibility of using Shrike's eggs, as she's about a year younger than me.

She said that we might get approved for that, but that there are a lot of hoops to jump through for approval of a known donor.

She totally got that we'd prefer to use Shrike's eggs if mine aren't going to work, but she also talked to me about the possibility of IVF with anonymous donor eggs.

The advantages there would be that the donor would be much younger than either of us, so the odds of success are higher, and the odds of chromosomal abnormalities are lower.

The odds she was quoting were a pretty big difference:
What we're doing now: 15% - 17% per cycle
IVF with my eggs or Shrike's: 35% - 40% per cycle
IVF with donor eggs: 65% - 70% per cycle

Those odds sound great, but my first gut reaction is that I don't want to use some stranger's eggs. (Especially given that we're already using some stranger's sperm.)

Of course, that's only logical if using mine or Shrike's is an option.

After all, if it's not an option, what would our next move be? Adoption?

We are open to that, if we can't get me pregnant, but if we're chosing between adoption and IVF with donor eggs, there are a lot of advantages to going for the IFV.

I'd still have the experience of pregnancy and breastfeeding, along with all the bonding that brings. We would also probably know more about the genetic background of the donor and would be able to pick and choose who we want and, of course, we would have control over the prenatal environment.

And, with the shared-risk program, if it didn't work, we'd get the money back and could use it to persue adoption.

I'm certainly not ready to give up on my eggs yet, so at this point we plan to stick to what we're doing for as many as six cycles.

After that, I'm not sure what's next. I'd really prefer to try IVF with Shrike's eggs before moving to an anonymous donor, but I need to ask Dr E a few follow-up questions about that.

She said it could take as long as four months from the time we decide to do it until we're ready for an attempt, so maybe we'd should go ahead and get started now with testing Shrike, just in case. I also want to find out what our timeline would be - when we'd have to start to get her in under the 39 deadline, if that's even possible.

Or, I could just get pregnant this cycle, and make the whole discussion moot.

Yeah, let's go with that option!