Saturday, February 26, 2011

It's a Boy and Girl

How perfect is that. We are beyond thrilled. We thought for sure we would be having boys, so it was nice to get one of each. It was just what I hoped for. The twinkies look great. Our little boy was measuring 5 days ahead of schedule and weighed 6 oz, and our little girl was measuring one day ahead of schedule and weighed 5 oz. The anatomy scan showed everything to appear normal at this point. Today marks the start of week 17 of my pregnancy. It's crazy to think that probably 20 weeks from now my little twins will be making their debut.

Saturday, February 12, 2011

Doggy Style, In the Shower,Missionary Position?

I have learned that when having twins inevitably the question of how this miraculous event came to be is one of the first questions that people have. Here's the scene:
I say, "I'm having twins."
The other person says, "Do twins run in your family?"
I say, "Not really."
They say, "Are they ivf twins?"
I say, "Yes, they are. (Here's the part I would like to add but don't) "By the way how were your children conceived? I've always wondered if you guys did it doggy style, in the shower, or perhaps the famous missionary position? Since we are talking about the intricate details of how our children were conceived and since you just asked me a personal question, I didn't think you would mind sharing about your conception story."

People are just so clueless, but I think if I followed up with the above statement it would put it into perspective of how they just asked a very personal question. Here is my actual response to do twins run in your family. "Not really, these are medically assisted twins." Usually there are no follow up questions after that. I am not ashamed or embarrassed that we did ivf, but it would be nice if people could just say congratulations and not worry about how the twins got there. If it was a singleton, there would be no questions asked.

I have been so blessed this pregnancy so far. I am now 15 weeks and in a little over a week we will find out the sex of the twinkies. I can't wait!

Sunday, February 6, 2011

SIRM vs. CCRM

I have received several questions lately about my experience at SIRM and CCRM on online fertility boards, so I thought that I would provide my rationale and decision making process for choosing clinics. These are of course my opinions and experiences and you could have a totally different experience going to either one of these clinics. One final note before I begin my rationale, I am extremely fortunate to have insurance that covers ivf procedures - so insurance coverage dictated many of my decisions.

Who Doesn't Like An Easy Button or Why I chose SIRM first?

As most of you know, ivf can be a stressful situation. I have to say SIRM provides an easy button. The phone consult with Dr. Sher seemed thorough, and he easily presented me a clear plan of what he could do for me. A few minutes after the phone consult the ball got rolling with his office manager Sharon and everything started to unfold. I thought wow this process is easy. In my phone consult with CCRM it seemed like things were going to take much longer and would require several trips to Colorado. At SIRM everything was going to be done in one shot. I would spend two weeks in fabulous Las Vegas and hopefully come home pregnant. Dr. Sher ordered a battery of tests for me and discovered that I had Natural Killer Cells and would need intralipids and also that I have a thyroid issue (my TSH was over 5) known as Hashimotos (antithyroid antibodies) which would require using Synthroid. I'm so glad he discovered my thyroid issue, but I'm still not 100% convinced about Natural Killer Cells.

Another huge determining factor for going there was the cost. In total it was going to cost me $1000 plus about $100 for meds to cycle at SIRM because they are in network. CCRM was going to cost anywhere from $7,000-10,000 plus about $100 for meds because they are out of network, and my insurance doesn't cover genetic testing.

So we hit the easy button, and I said lets try Dr. Sher's "different theories." I had been warned my various physicians to steer clear of people who emphasize natural killer cells. There was a girl from my hometown who had success with Dr. Sher after about 8 failed ivfs, so I thought that I would give it a go. Did I find their statistics to be super impressive? No, but the bottom line was it would cost a ton less and we would have fun in Vegas and hopefully end up with a baby.

We did have an absolute blast in Vegas. It was running guy and I's best vacation ever. While we were out there, we both agreed even if it didn't work, we were ok with it because we had so much fun. I also met some awesome girls who were cycling at SIRM, and I still keep in touch with some of them. Friends are such a blessing!

Anyway, back to cycling it wasn't the best experience ever. Dr. Sher was very rushed and it felt like an assembly line of ultrasounds. Buzzing back and forth giving limited information and dropping his famous one liners. Which I was ok with because I don't need petting, and I'm a veteran at ivf by now. The communication was also not the best. The office would call me after 4 for my appointment times for the next day. They never knew when it was going to be until late in the day. The retrieval was my worst experience ever. I have never had bleeding before and I had bleeding for days. Granted it wasn't heavy but still, it had never happened before. I did have the most eggs ever retrieved though and by day 5 I had one awesome blast and one great looking blast to transfer. The transfer process was uncomfortable because of my bladder being full of water. The next day I waited and waited to find out how many embryos were going to be frozen. No one called me. Finally, I received an email at about five PM stating that 6 embryos would be vitrified. Eight is the most that I have ever had made to blast. Out of the 8 two were Grade 1 (the best) and the other six were grade 2 (really good).

Needless, to say despite the intralipids, prednisone, and great retrieval and fertilization report I did not get pregnant from the cycle. It was disappointing, but I knew that I had a plan B lined up.

PLAN B CCRM

I went to CCRM about three weeks after I got home from Vegas. I had already done my phone consult so scheduling my One Day Work Up was easy. I went by myself because running guy had a triathlon that weekend, so we decided that he could go another time to give his sample. CCRM was beyond impressive. Everyone knew what they were doing and it was a well oiled machine. Dr. Surrey was awesome. He explained to me how he wanted to proceed and was so caring and compassionate. I'm so glad he was my doctor. When I left that day, I knew that I had come to the right place. I felt very informed and I was excited to begin the process.

Cycling in Lone Tree was a breeze. I knew when all my appointments would be ahead of time. There wasn't a bunch of waiting to do and I got in and out of my appointments quickly which left a good deal of time for exploring and fun. Communication was excellent. There was only one time when they forgot to call me and tell me the dose of my meds, but I was able to reach someone after hours and get the correct dose.

My retrieval was so smooth. Dr. G did it and I experienced no bleeding whatsoever. They retrieved the most eggs ever and I had a great fertilization report (20). On day six the embryologist called to tell me that I had 7 make it to blasts. I was a bit disappointed because it was one less than SIRM and I had 20 mature fertilized embryos so shouldn't I have 10 make it to blasts? Anyway, I had two AA grades and the rest graded about as ABs or BB. They also thawed my embryos that I transferred from SIRM but two did not make the thaw. So I had a total of 11 being genetically tested.

Two weeks later Dr. Surrey called me with good news. Out of the 11 only one was genetically abnormal. It happened to be on of my AA from CCRM. All of my SIRM embryos were normal (one was no result) and all of my CCRM embryos were normal except one (one was no result). Great news, but it made me wonder why didn't this work at SIRM because based on my results I can pretty much guess that more than likely one or both were genetically normal at SIRM.

My CCRM transfer was such a great process. I did acupuncture before and after and really felt relaxed. Dr. Surrey did an excellent job with the transfer and when I left I felt like we did everything we could to achieve the best results possible.

Six days after my transfer I took a home pregnancy test and saw that I was pregnant. CCRM continued to diligently monitor my estrodial and progesterone levels for about 10 weeks. I am currently 14 weeks pregnant with twins. I never felt like I was in an ivf assembly line at CCRM, but I rather I felt like a valued patient.

SUMMARY: From my experience CCRM made all the difference in the world. Based on my genetic testing results I probably had at least one genetically normal embryo in every ivf cycle I did, but I never got pregnant. What that tells me is CCRM did a better job monitoring me and the lab did an excellent job preparing my embryos from transfer. We will never know why all the other times didn't work and that's ok. I'm just so glad that it worked at CCRM because I feel so incredibly blessed to have these two little babies growing inside of me.