Tuesday, June 24, 2014

To IVF or to Clomid



We met with the Dr today regarding the results of genetic testing after last miscarriage (also my third). 

Brief History: ttc for 4 years now, 3 miscarriages. The third one was while I was on Lovanox and Baby Aspirin for MTFHR, thyroid meds and clomid to conceive. I still have the hematoma from my myomectomy last July but hopefully its going away soon (shrinking every month).

The genetic Testing results - Inconclusive not enough tissue to test (only maternal tissue was found).

The assumption is that this m/c was a result of a genetic abnormality (DH & I were cleared). 25 % of all pregnancies have genetic abnormalities, said the Dr.

The Dr would definitely like another hysterosonogram between CD6 and CD12 and since he was on his way out of the country today (Today is CD9) I am wasting a whole month waiting. I also have to decide by then, how I would like to proceed.

Dr said there were 4 options ahead for us
1) Clomid
2) Gonadotropins
3) IVF
4) IVF with ICSI and PGD 

I really only have to decide between #1 and #4. He recommends #4. DH is all for #4, I am trying to think it through.

Financially, I have enough left on my lifetime infertility benefits to cover 1 round of ivf, but the PGD testing will be another 4 to 5k that isn't covered.

With Clomid I have a higher chance of miscarrying, with IVF (& PGD) they will take the good quality eggs, the good quality embryos (PGD) hence lower chance of miscarrying (at least due to genetic issues).

I guess at the end of the day, I am familiar with Clomid and I know it works (I got pregnant during my 2nd cycle, but we opted for iui to maximize our chances.

I am not familiar with ivf and (the unfamiliar scares me a little). 

However if I were to be honest with myself, If i miscarry on Clomid, I know there is ivf waiting for me. If I miscarry on ivf, I feel like I am out of options.

No one can make the decision for me

Background on why DH is being impatient with me: in Feb 2012 (with my previous infertility dr) I got pregnant in same cycle as a hysterosalpinogram. It was a chemical and I miscarried by week 5. Previous Dr suspected polyps and wanted to do a hysteroscopy/myomectomy in same go. I hesitated went back to my ob/gyn who did the hysteroscopy. He confirmed no polyps but said my fibroids had to go. I asked DH to give me the summer to think about it, and find a dr willing to do laprascopic myomectomy. By fall of 12 I had a mysterious illness that lasted 3 months (Daily fevers of 102-103, night sweats and no diagnosis of what caused it, despite going to 3 drs) Needless to say by the time I recovered from that and found a dr and had the surgery it was July 13. I had wasted well over a year.


2 comments:

  1. I am so sorry for your loss! But I am wondering why ICSI? If your hubby can get your pregnant and, presumably, has had a sperm assay and doesn't have a crazy morphology/motility problem then ICSI would be overkill (my opinion).

    I had one DR who was a big fan of ICSI and then a second RE who is not a big fan even though my eggs are probably hard. In fact, if we were to do IVF (which we probably are not) we would not do ICSI. I just worry that it's an additional cost for very little benefits. Just something to consider. Please take your time deciding! It's a big leap. There's also nothing that says you can't go back to Clomid if IVF shows that everything is working well and there aren't any real issues.

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  2. I think the ICSI is for the genetic testing option, he did say I could do IVF without. DH has no issues with his sperm, so I wondered too.

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