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.

Are You Pregnant?

You have no idea how many times in the past three weeks I have been asked that. I am just shy of being 12 weeks pregnant, but I am suddenly one big girl. I have gained 8 pounds. Why am I so large? Here are a few theories:

1. The two months plus of prednisone that I was on.
2. The fact that I was super skinny before, so any fat is noticeable.
3. I have experienced no barfing and am only nauseated when I get hungry

I'm not really sure the reason, but I have not been able to squeeze into my size 0 and 2 pants for quite sometime now. I am in maternity pants.

Needless to say, I have had to tell far more people than I would have liked to that I am pregnant. I work in pharmaceutical sales and I can feel the various doctor's offices that I go into looking at my stomach. Some of them will ask others try to pull it out of me by asking questions. Everyone is always in shock when I tell them how early in my pregnancy I am. Thank goodness I can say, but I am having twins.

All and all I think it is good that I am putting on weight for the babies. Hopefully, that will help them in the long run. It's kind of funny to gain all this weight when I have always been so tiny. Running guy and I get many a laughs at how drastically my body is changing.

Update on the Twinkies

I've been a little mia, but nothing bad has happened. I have just been busy with life. My little Twinkies are doing great. I saw them on Tuesday, and they were measuring 10 weeks and 3 days which is exactly where they needed to be. Baby A had a heart rate of 176 and Baby B was 164. I have to say that we are already putting little personalities on these precious babies before they have even come out. For instance, Baby A is always so good; always cooperative with the ultrasound. It's always easy to see the heartbeat and at our 8 week ultrasound the yolk sac appeared to be a halo over Baby A's head. Baby B on the other hand is WILD! The first ultrasound Baby B hid in a corner and we couldn't see it's heart rate at first. The second ultrasound it looked like it was playing with a balloon (yolk sac). This third ultrasound Baby B was jumping and moving like crazy. So in summary Baby A is our calm angel and Baby B is our wild free spirit.

I have been completely off progesterone and patches for over a week and so far so good. My next doctor's appointment is at Maternal Fetal Medicine in a week and a half. They are going to work with my ob to help ensure that this is a smooth sailing pregnancy. I am not out of the woods yet, but each week that goes by I feel more confident that my little Twinkies are going to be ok.

My Gummi Bears

So we had ultrasound #2 today, and it went great. My little guys look like little gummi bears. It was so cool to see how much they had changed from two weeks ago. They were measuring the exact same at 8.2 weeks (I am 8.3 weeks pregnant), and they had the had the exact same heart rate at 176 bpm. I go back in two more weeks for another ultrasound. It was so exciting for running guy and me to see them in there doing great. I try not to worry because of CCRMs super low miscarriage rate, but it is always in the back of my mind. The ultrasound tech was awesome. She took tons of pictures and was so excited for us. She said she has a special spot in her heart for twins because she has so many in her family. Baby A's yolk sack looked like a halo above it's head, and Baby B's yolk sack looked like a balloon floating around. It was too cute.

In other good news, today was the first day of only two endometriums and 2 vivelle patches. Yippee! Also, I lost an earring that I really loved last week, and I knew that I could never replace it because I got it at Target in April or May of this year. Much to my surprise there was one pair left in Target. I was so happy. They are such cheap earrings, but everyone raves about them and I absolutely adore them.

I would post pictures of my little gummies, but I don't have a digital copy and I tried to take a picture of them and it didn't turn out. I am utterly in awe that all of this is working out. I am so glad that I went to CCRM and wish that I would have traveled there a long time ago!

21

I can't believe that 21 is my new progesterone level. I am down to three endometrium inserts a day, and tomorrow I go down to two. Despite my initial progesterone drama, I am finally taking off. For those of you that are reading this and are stressed about progesterone levels, this just show that things can be ok even with low initial levels and spotting caused by those stupid inserts. The day before my initial beta my level was 5.3. I hovered in the single digits forever, and just last week I got into the double digits. I also only have to put on two patches tomorrow because my estradiol has been staying strong in the one thousands.

So tomorrow I need a little more good news. I go for ultrasound number two. I am still hoping and praying we see two little heartbeats and have appropriate growth for both babies.

Thanks all for the support on my lack of nausea. I still don't feel sick, but I am trying to enjoy it. It is a blessing because my poor friend who is a week further along than I am is struggling with bouts of nausea and I feel very bad for her.

I Should Be Happy But I Wish I Were Barfing

This is something I would never in a million years dream I would be saying: I wish I was barfing or feeling like barfing. Or even just nauseated, gagging at things, sligthly green, but alas I am none of those things. Don't get me wrong, I am extremely happy to be pregnant and to be pregnant with twins, but something is causing me concern - lack of nausea. Sure I have waves here and there, but nothing that is too severe. I would think that with twins I would be sick as a dog. Maybe it's coming. Today I am 7.2 weeks pregnant. I do have other symptoms such as fatigue, peeing in the middle night, and some pretty great looking breast (I have dreamed about breasts like these). So I'm just hoping everything is ok. I am totally fine not being deatlhy ill as long as everything is ok.

We go for our next ultrasound on the 28th. I'm hoping my little raspberries (that's how big they are now) are growing and doing fine. Has anyone else been pregnant with twins and felt pretty good? I just find this odd.

A Lifetime Movie

*loss and pregnancy mentioned

Two Mays ago running guy and I experienced what I like to call a bad Lifetime Movie. Picture it, the nice couple is anxiously awaiting their first ultrasound. The wife got pregnant on the very first iui try. Her betas doubled and now it's the day of the ultrasound. She is in the stirrups and the nurse practitioner begins the ultrasound. But wait she can't find anything. No sack, no heartbeat nothing. She seems puzzled. The couple exchanges worried looks. What's happening! Then the nurse practitioner finds the heartbeat beating away at the very bottom of the fallopian tube. Had it been a millimeter further along it would have been in the uterus. The heartbeat continues to beat. The nurse practitioner can't turn the machine off and their the couples sits, dumfounded. There is a nice strong heartbeat, but they know that emergency surgery is soon to follow and what the end result will be.

Fortunately, today's ultrasound was also like a Lifetime movie, but a happy one. This time the nice couple sat there and immediately the ob saw the sacs. She zoomed in on the first one and it had a heartbeat of 111 and was measuring 6.1. She zoomed in on the second one and at first didn't see a heartbeat but then zoomed out and saw a nice heartbeat of 118 and it was measuring at 6.1. Such a happier Lifetime movie.

So anyway now I wait for CCRMs take on my results. I wonder if they will be concerned because I should be measuring at 6.3. I think maybe the prednisone could have something to do with it. Also, I am hoping my progesterone, tsh, and estradiol are doing ok. Running guy and I are very happy with the results and my ob seemed to be as well. My ob said I could come back anytime for an ultrasound. She is awesome. I'm hoping that CCRM is as happy with my results as she was.