Friday, March 18, 2011

update - 2 weeks until Transfer

Two weeks!! eek!

I got my estrogen and progesterone levels back yesterday. E2 is 997 and p4 is .08. Everything looks good on ultrasound. My lining is 9.9. (That's awesome. 10 and above at transfer time is what most RE's shoot for. I should be well past that in two weeks.)

A few days back, when the fertility clinic's IVF coordinator contacted me to see how I was doing, I told her the estrogen was giving me severe headaches. She said to take Tylenol.  I was thinking to myself, "That would be about as effective as taking a tic-tac. Actually the tic-tac might be more beneficial because at least then I'd have fresh breath."

Today the RE's nurse from the clinic contacted me with my numbers and also asked how I was doing. I mentioned that the headaches continued but that it was okay. She said right away that I shouldn't have to suffer and told me that I could take the pills internally instead. That would have been nice to know a few days ago.  ;) Glad to have that info now though!!  So far, the headache has been much less today. Woohoo!

I also may have mentioned that I spoke with my own OB about carrying twins and my indecision over how many embryos to transfer, assuming they were all good quality. She really cautioned me about carrying twins as I've already had one preterm delivery with my first daughter. That's about all she was able to offer. However, just yesterday I was able to get more information that I found really helpful. This is what the OB said.
The American College of Obstetricians & Gynecologists did a review of "Single Embryo Transfer" vs. transfer of 2 embryos a few years ago, looking at more than 500 IVF cycles. The difference in pregnancy rates was small (around 30% for the SET cycles vs. around 33% for the cycles w/ 2 transferred). But the difference in multiple rates was impressive (SET gave all singleton pregnancies while the other group was about 2/3 singletons & 1/3 twins).

Your IM is 39y/o so her embryos are less likely to survive. That suggests a lower pregnancy rate but the proportion of twins should remain about the same.

SET is the standard of care in most European countries. But most European national health services allow every citizen a few IVF cycles while we pay for each cycle ourselves in the US, so the pressure is on to succeed the 1st time. Which brings us to the American Society of Reproductive Medicine guidelines for 39y/o w/ good-looking embryos: transfer 3 Day-3 embryos or 2 Day-5 blastocysts.

I understand your concern about setting yourself up for failure [transferring only one embryo] w/ AMA eggs, so perhaps you could offer to do more cycles if necessary?
I feel like this information is finally what I need to feel at peace with the decision I have made to transfer one good quality embryo.  I don't want to set us up for failure At the same time, the sacrifice my family would have to make if I were to carry twins has the potential to be very great. That 30% risk of carrying twins, outweighs the 3% better success rate of transferring two. That seems like a no-brainer. Finally some solid numbers. I take comfort in numbers. lol

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Everyone is absolutely entitled to their opinion and I love to hear alternative view points. That's the spice of life! However... please know that if your comment is in any way (1)derogatory toward the intended parents, (2)lacks common courtesy/tact, or (3)provides an uneducated stance it will be moderated. Difference of opinion is fine. Stupidity, not so much. Positivity - it does a body good! :)