Dr vs Dr


Well, well, well, so much to update you on.

We went and caught up with our existing doctor. We didn’t want to get into a “Denver says / you say” debate, so, after significant discussion (we chatted for 15 seconds as we walked into the dr’s office) we decided to lay low and not talk about Denver and just see what our Dr was thinking. Dr opens with “so – tell me all about it? How was Denver?”. hmm scratch plan A.. plan B was over an hr of very candid and useful discussion. Here’s (some of) the crib notes:

* Dr Current has read Denver’s results and sees they are good but cautions that they sample body was lots of young women, (Mrs IVF still thinks that from what she has read that there are lots of “problem children” like us who are 35+ who appear to have good success in Denver)

* Denver has found some things as per my last post that Dr Current hasn’t even tested for. Maybe means little, but we are strong believers that lots of littles can make an impact on the big. We both just feel that this whole thing is like unlocking a safe. No point getting 9 out of 10 parts of the combination right, that doesn’t get you where you want to be. Maybe Denver has the whole combination? Maybe this whole thing is just a cruel nightmare.

* The cycle. Mrs IVF has done all 3 “stimulant styles”, in summary:

– long lupron. (Cycles 1 and 2) where the eggs are put on a slow cooker. 1st cycle was our best retrieval (15) and 7 up for trf (from memory) and ended in 7 week miscarriage after we lost about half the eggs along the way to quality etc. 2ndcycle our worst (around 12 retrieved none transferred as we PGD all 3 and none passed so no trf) – again lost a lot to quality it seems.

– agressive stim. Double the stim dose, short, bigburst of the egg stim juice. No more eggs that cycle 1 (around 11) and no better maturity, and our prize was a chemical pregnancy

– lupron flare. only 5 eggs (which we still think is a fuck up with an E2 at 4,000 and an average of 10-15 eggs for the last 3 cycles) but, all 5 mature and all 5 fertilized and 4 made it to trf. All 4 trf, none took… landed on ‘bankrupt’ on the wheel of fortune – (can I buy a vowel? oh, and a baby?”)

So – rule out the aggressive stim cycle, as that didn’t do much (apart from deliver a bit of hyperstimulation actually), but its down to approach 1 or 3 in my mind.

Dr current said she would probably go 1. I am thinking 3 delivered the best maturity, but anyway who knows whats best, Dr C said she wouldnt PGD anything ( oh geez  – here come octomum 2009 – yeah right) if we went with her again, So after pushing PGD a bit in the past, she has “gone organic” on us.

* PGDvs CGH – very interesting. She said that PGD (the 9 cromo testing we have done to date) vs the Denver freeze test all chromosomes approach (CGH) is  like trying to play the letter A on a musical instrument. Denver, where the process is computer driven, is like hitting A on a piano. PGD, requires significant skill in the lab, so its like hitting A on a Cello. Not everyone can do it, so the results may not be as great. She is so confident in her labs (which I think basically pioneered PGD) that they don’t see any benefit in switching to the Denver approach as they get the same results either way, (they play a great cello I believe). The trick is that PGD is day 3 and CDH is day 5 (although Dr C said they can do a day 3 CGH if we wanted – hello, where did that come from?)

* Day 5 vs Day 3?  Denver goes day 5 as they want full blasts, take more than one cell to test and take it from placenta cells so you aren’t ripping off any arm or something, but day 5’s are harder to grow (clearly). Dr C goes with Day 3 and at day 3 all cells are stem cells so you haven’t taken an arm vs a placenta cell as they are all the same, you get to test early and get the good puppies back in fast so they are in the environment that they should be in. There is a famous Danish test (I think it was Danish) that biopsied day 3 and did nothing with the results. They just wanted to see if stuffing around with day 3 stunted growth vs ones you didn’t play with. Guess what. Playing on day 3 did impact growth. So…

* Can we get to day 5? We really don’t know – out of our 4 cycles only cycle one had excess eggs we didn’t trf – cycle 1.  Cycle 2 didn’t give us any. and Cycle 3 and 4 we trf back everything. So on the 1st cycle Dr C says the eggs weren’t good enough for freezing but wasn’t clear on if there were good enough to trf. She did add though that by day 6 they were not good. I agree, nothing is good on day 6. I reckon if Denver sees we can’t pull of day 5’s then they’ll trf early. Mrs IVF has read Denveree’s who have never had day 5’s elsewhere but got there in Denver.

So with that, I will leave it with you. Enough for one night. While the Mr IVF blog pole results haven’t quite been up there with American Idol volumes, 80% of you think we should go with Denver. Mrs IVF and I are thinking the same. It’s the fork, we need to go and see what the fork says to us.  We feel they are finding new things we didn’t know (more for a later post) and, well, they test every chromosome so we will know if we can have a bio kid or not.

Meanwhile – in day to day life, more and more of our mates are getting pregnant (good on them) and sadly more of my “out of the know” friends are pinging me on the “hey – where are the kids” question. I have an answer i give them, but again… thats for another post.

 Tonight I am just too tired to be worried about all of this. Work has been brutal, but hey, keeps us busy and this weekendwe are off to the NJ fair (assuming we can work it around MRS’s IVF’s bloodwork), so that should be fun.

Oh, period late again.

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One Response

  1. phew. That is a lot of information. I knew the difference from the GCH and PGD, but really only the ‘gist’ of it. You have given an awesome description!

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