Gene shopping

Thank you for rejoining me on my TTC journey. 2010 has been a long, trying year for us, the worst of our lives, but I truly believe our luck is about to change.

So where was I? Ah yes, I was talking about donor selection.

It was so painful picking a donor last time that I didn’t want to start looking too soon, so I waited until about a week before my second D&C. A history of frozen embryos was my number one criteria, followed closely by a history of recipient pregnancies. In other words, I was excluding all unproven donors and a lot of proven ones, too. My RE’s database doesn’t show these stats by default, so I picked out 5 donors who were available (which is more than I expected to find) and asked for their stats. I found out that a few had maybe 1 or 2 frozens per cycle, and one had a recent BFN. Not good enough. We need frosties not just for siblings, but for insurance in case of failure. Having to pay for a third fresh donor cycle is something we want to avoid at all costs. 

The donor coordinator sent me 2 additional donors who had stellar stats and would be available when I was cycling. She also said that another couple was deciding between these two, so we might not get our first choice if they picked first.

This was an interesting dilemma. We would’ve been thrilled with either donor, not just because of their stats but also because they had great profiles and each had some features that resembled mine. And at the time I thought if the other couple chose first, then we wouldn’t even have to decide—the decision would be made for us. Piece of cake, right?

Put yourself in my shoes: if you looked like me (blonde wavy hair, blue eyes, fair skin, O+ blood), which of these two donors would you choose?

Donor 1: Blonde straight hair, brown eyes, fair skin, A- blood, both parents and brother have brown eyes.
Here are her stats:

• 1st cycle-25 eggs retrieved; 3 transferred and a gestational carrier and none frozen; recipients delivered healthy twins
• 2nd cycle-43 eggs retrieved; 1 transferred and 10 frozen; recipients had a negative fresh cycle but did get pregnant from a frozen cycle and delivered healthy twins
• 3rd cycle-29 eggs retrieved; 1 transferred and 15 frozen; recipients delivered a healthy child
• 4th cycle-30 eggs retrieved; 1 transferred and 11 frozen; recipients have a viable pregnancy
• 5th cycle-49 eggs retrieved; 1 transferred and 16 frozen; recipients have a viable pregnancy

Donor 2: Brown wavy hair, blue eyes, olive skin, O+ blood, mom has hazel eyes and dad has blue eyes.

• 1st cycle: 16 eggs retrieved; 1 transferred and 4 frozen and it resulted in a miscarriage and 2 negative frozen cycles due to poor uterine lining from the recipients and they will most likely need a surrogate.
• 2nd cycle: 21 eggs retrieved; 1 transferred and 7 frozen and recipients delivered a healthy child
• 3rd cycle: 26 eggs retrieved; 1 transferred and 12 frozen and recipients delivered a healthy child
• 4th cycle: 33 eggs retrieved; 1 transferred and 11 frozen and recipients have a viable pregnancy.
• 5th cycle: 25 eggs retrieved; 1 transferred and 14 frozen and a positive pregnancy. 

At first I was leaning towards Donor 1 because she had blonde hair and fair skin. She’s a bit taller than I am, but I didn’t care. There were a couple things about her that bothered me though: someone in her family has gout (as does Mr. GB), and she has brown eyes. Gout was a gamble, sure, but when I started researching eye color more closely, I realized that with her as our donor, we had a 100% chance of having a brown-eyed baby, which would be a dead giveaway for a donor baby because Mr. GB and I both have blue eyes.

Here is how the genetics would work based on the eye-color calculator at TheTech.Org. All screenshots shown were generated from this tool.

Donor 1 has brown eyes, which by itself doesn’t rule out a blue-eyed baby, but the fact that both her parents have brown eyes means that Donor 1 does not have any blue-eyed genes, like so:

(Screenshot courtesy of TheTech.org)


So if you combine her genes with Mr. GB’s, you get brown-eyed babies:

(Screenshot courtesy of TheTech.org)


Donor 2, on the other hand, has blue eyes, which she inherited from her dad. Her mom has hazel eyes, like so:

(Screenshot courtesy of TheTech.org)


But no matter what color eyes her parents had, she only has blue-eyed genes to share, and thus our babies would at least by plausibly mine:

(Screenshot courtesy of TheTech.org)


So I started to fall in love with Donor 2. Luckily for me (finally, some luck!) all of my testing for our first donor cycle was still valid, and we were ready to place our deposit ahead of the other couple. Mr GB paid the deposit while I was having my uterus scraped (again). I was so incredibly happy that day. All of the horrible things that had happened to us were pushed from my mind, and I knew we had a great chance of getting pregnant again this year, with lots of frosties to spare!

Anyway, we get home from the surgery (on a Wednesday) and I have email from my donor coordinator saying she’s contacted the donor and will have a schedule put together as soon as she hears back. Then Thursday rolls by, then Friday, and then I start to worry. I hear back from the coordinator, who says she’s still trying to get in touch with the donor.

Talk about a long weekend.


Fortunately things worked out. She called back the next day in a much better frame of mind and said she would cycle. The coordinator had her meet with their psychologist a week later, just to make sure she was fully on board. So we had about a 2-week delay, which in the scheme of things wasn’t actually a delay because I had to be on the pill for that long anyway. I could have lived without the drama but eventually I did get the blessed donor calendar in my hands, and I have real dates and real drugs and we are READY!!!

I’ll go over the donor process next time.
Til then,
Golden Bud

And the journey continues...

Thank you readers and Buds for the warm welcome yesterday. It feels good to be here.

So back to my TTC journey. A quick review of the Golden Bud TTC timeline thus far

• 12/07: Start TTC
• 10/08: RE visit, fertility tests
• 12/08: IVF #1: cancelled on Day 8 due to no response
• 3/09: IVF #2: 2 follies, 2 eggs, 1 embryo, BFN
• 10/09: IVF #3: 2 follies, 2 eggs, 1 embryo, BFN
• 12/09: Start the donor egg process
• 3/10: Donor cycle

A lot of women talk about how hard it was for them to move on to donor eggs. For me the decision was a relief. I could finally stop throwing good money after my bad eggs, and the odds were so good that I couldn’t help but be giddy about the whole process, which goes a little something like this:

• Month 1: More testing. Most of my tests had expired after 1 year, so I needed an SHG (less painful than the HSG) and blood work, and Mr. GB needed a new SA and blood work. We were also required to meet with a psychologist and a geneticist. Not sure we go sure we got our money's worth in return, but the $350 for both was just a drop in the bucket so I didn't complain.

• Month 2: Mock cycle, which is basically a trial run of using the estrogen patches to test my lining. Mr. GB also had genetic tests done because we thought we were getting good pricing on the testing (we didn’t--long story). No genetic issues turned up, so we decided not to test the donor.

• Month 3: Donor selection & cycle—yippee!

Now it was time to select a donor. I admit I was a little naïve about the selection process. I thought I'd make it fun by booking a date for Mr. GB and me to bring our laptops to Panera and look at donor profiles over dinner. What I discovered was that most of the donors I liked were already booked. This process was actually the hardest thing about IF thus far and I was unusually cranky for a few days. At the time I really wanted to find a donor just like me—looked like me, built like me, personality like mine. It wasn't until this process that I think I finally mourned the loss of my genetics and any coincidental resemblance to me. Fortunately a donor I liked became available, and my whole outlook changed. It takes some women months to find the right donor. It took me about a week.

So why did I choose our donor? She had blue eyes (like ours), fair skin (like ours), brown hair (like Mr. GB), wavy hair (like me), and 0+ blood (like ours). I also really liked her personal statement—she sounded just like me. She looked more like Mr. GB than me, so I figured at least our children would strongly resemble Mr. GB and not some other woman. I admit I did not obsess over her family health history, her occupation or grades, or her ancestry.

I put down our deposit before I even asked about her donation history. Another terribly naïve thing to do. Turns out she had 4 successful recipient pregnancies and I was thrilled! But I misunderstood the stats and thought that “0 embryos frozen” meant that none of the recipients had done a frozen cycle. What that really meant was that despite her successful recipient pregnancies, she’d never had embryos survive to freeze. But I let the 100% success rate go to my head and thought we’d have twins and be done with babymaking. Did I mention I was naive?

From the get-go I had a bad feeling about the cycle. I tend to be very intuitive and a little superstitious. My feeling of dread was caused by these events:

• Day 5 of stims: Donor coordinator calls and says the donor is responding great and her meds have been reduced. My intuition says OVERSTIM! Immature eggs! Failure!

• Day of ER is the day of the “spring forward” time change. I was paranoid that they would get her retrieval time off by an hour, and either the eggs would be gone or immature.

• Day after ER: Embryologist calls. Bad news. Of 20 eggs retrieved, only 8 were mature. Her worst cycle ever. So I was right about my fears of overstimming. The embryologist was happy with the fert rate though—6 fertilized—but all I could think was that we only got 4 more eggs than I can produce myself.

• Day of ET: Day 3 transfer of 2 embies. Saw a different RE than the one who’d done my previous 2 transfers. My bladder was overfilled and the RE had difficulty doing the transfer. So much so that the embryologist started to get worried. The RE put the embies back in the dish and kept trying. The second time was successful, but I couldn’t help but think that the embryos may have been damaged in the shuffle.

• Freeze report: Nothing made it to freeze. I wasn’t surprised, but I was still devastated. This was the most upset I’d been to date.

Call me a Debbie Downer, but by this point I was really worried. I spent a few days on the couch pouting and I was convinced we’d failed.

I think I'll wrap this up for today.

Til then,

Golden Bud

Be careful what you wish for.

Disclaimer: There are no pictures in this blog entry. I didn't write this to entertain. I cried almost every second I was typing. This isn't about being bitter, this isn't about being sad, and it most certainly isn't about trying to make people feel better about what we're going through. This is about life. Real hard honest painful unfair life. If you're looking for funny pictures and entertainment, you're going to have to look elsewhere.

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Be Careful What You Wish For

When we got our male factor diagnosis, I cried. I told my husband that I would rather have something be wrong with me, so this didn’t have to be on his shoulders.

What an idiot I was.

Since I was a young teenager, all I have ever wanted in the world is to be a mom. All I have wanted to do is to take care of my babies. Raise them and have the best family I can have.

Now I’m 34 years old… and I’m being faced with the possibility that we might never have that family.

3 weeks ago, I found out that our first IVF cycle failed. I knew that I didn’t respond the way they thought I might. I knew that our embryos were pretty sub-par. But I also KNEW that I was over-suppressed from the lupron. I KNEW that with a different protocol, I would respond better, and my eggs and subsequent embryos would kick ass.

Dr Z had other ideas. Half way through my stims, he became convinced that I had diminished ovarian reserve (DOR), AKA really old sucky eggs. He said that if this cycle didn’t work, he was going to do some additional testing.

But I KNEW it wouldn’t be necessary.

I was so wrong. About everything. And as usual, Dr Z proves why we picked him as our doctor.

The tests came back. My AMH is 0.5. That sucks. It worse than sucks. It’s sucktastic.

He says that he's not ready to throw in the towel YET. He likened my ovaries to a baseball team. He said that I have the players, but it was difficult to tell what condition they might be in, and how many might be on the bench. I said, "Great, I'm the New York Mets" (and honestly, after being a Mets fan for my whole life, I should be used to the disappointment).

Dr Z said now that he knows what the problem is, he can treat me more appropriately. He said my ovaries are a lot older than I am... probably about 42 or so… and now he has to treat me like that. He wants to see how I respond to a new protocol (my nurse should be calling me later today with details). But he also said that if this next cycle doesn't work, his recommendation would be donor eggs (DE).

My husband and I had already had a LONG talk the morning before we spoke with Dr Z about where we were going to draw the line. I finally know where he stands with all of the options, and I'm relieved about that. He's okay with DE, but not donor sperm. Okay with domestic adoption, but not embryo adoption.

We won’t move on to DE until we get a second opinion. So, if IVF #2 fails, we plan on probably getting two second opinions: one at Colorado Center for Reproductive Medicine (CCRM), a leading center for ART, via phone consult and another at a leading medical center in Manhattan. Following those, we'll probably be moving onto DE.

However, DH is convinced that now that we know about these issues, IVF #2 is going to work.

I'm going to start acupuncture again, start seeing a chiropractor and we're going to try to go to an infertility counselor, because i'm really depressed. The IVF not working was bad enough - now I’m a devastated mess. There hasn’t been a day without crying since I found out. I don’t know how much more I can take.

There’s no question now that I’m in good hands. Dr Z clearly knows what he’s talking about. I can't imagine many people would have looked at me last cycle and said DOR. I thought I was just over-suppressed, but he saw my response and said, “Look, even with your normal FSH and normal antral follicle count (AFC), something is wrong here. This isn't because of medication. We need to run more tests.”

He was right. I hate it - but he was right.

He also said that my blood work came back positive for the genetic mutation MTHFR. I’m going to find out exactly which mutation tomorrow, when I get copies of my blood work. Dr Z says I don’t have to take any blood thinners, but he has me now on very high dose folic acid. I’m taking a total of 5mg daily. He says that he needs me on it for 4 weeks before we can try again, so we can still plan on cycling for March. I’ll have to continue taking the high dose folic acid as long as we’re TTC or pregnant… which right now feels like the rest of my life. Another complication of MTHFR is elevated homocysteine levels. However, my homocysteine levels are normal.

I’m sorry that this was so long. It’s all the information I have. I feel like all of my dreams are slipping away from me. It’s very easy for people to say “oh, it’s not bad news” and “oh there’s still hope” but this is the end of the world for me.

I’m 34 years old and my eggs are crap.

The worst thing about this is the not knowing. In the beginning, my evaluation was normal. Every single part of it. Dr Z says these tests are really expensive and the insurance companies won’t pay for them unless they can be shown cause, which the failed IVF cycle gave us. I wish we had known about this 2 months ago. Or 7 months ago when we went through our initial testing.

And I hate what this has done to me. EVERY girl I see whose only diagnosis is MFI, I think to myself “that’s what you think” or “for your sake I hope so”.

Because up until 2 days ago, MFI was my only diagnosis too… and I had all the hope in the world.

Now it will be a miracle if I can even use my own eggs.

From the top to the bottom in one phone call.

Be careful what you wish for.

A wake up call

"Hi, Mrs. Dandelion Bud. It's Nicki from Dr. RE's office. I just wanted to tell you we got all of Mr. Dandelion Bud's blood work back. The genetics are all normal."

On one hand, that wake up call this morning was good news. No hidden genetic issue to worry about as Mr. DB gets older... no genetic issue to pass on to unsuspecting children...

No explanation for our Male Factor Infertility... that's the other hand.

There's nothing we can try to fix. There's no concrete explanation. We're left with conjecture. "Has there been any trauma to the testicles?" Not directly. Mr. DB had a bilateral hernia repair as a child. "Oh, the hernia repair". Only one side was affected, but the surgeon recommended repairing both sides "just in case".

Our RE says science is finding that these hernia repairs are commonly the cause of male infertility, lacking any other diagnosable explanation. One little slip of the scalpel... one surgeon with less than 100% focus... one surgeon not considering his 4 year old patients' future fertility.

And then there is none.

So, now what? Now it's IVF with ICSI.

What will happen is after I go back on months of birth control pills to rest my ovaries and sync to the RE's schedule, I'll get shots. Every day. Painful shots that will stimulate my ovaries to produce bagillions of eggs. Or 12. Whichever. Mr. DB will "provide a sample". They'll pick the best of his and the best of mine, and they'll inject the best sperm into my eggs.

And then we'll wait. And

Short of one careless doctor 30 years ago, we have no explanation for what we're going through. All I know is, while our diagnosis is "MALE" factor infertility, the physical pain is mine. The emotional pain - that belongs squarely to both of us.

FUIF. Really.