Chick Chat - The Infertility 101 You Don’t Get in your Doctor’s Office

December 11, 2007 - Tuesday
12:53 PM to (EST)
Guest Speakers: Lauri Berger DeBrito, B.S. and Kathryn Kaycoff-Manos, M.A.

Categories
Donor Egg • Gestational Carrier • Infertility • Insurance • IVF • Surrogacy

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Lauri_de_Brito	Hi Schwanke, guess we're first ones here
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Corey_Whelan	Hi to you two!
schwanke77	hi there - xmas shopping while we're waiting
Lauri_de_Brito	better than me, I haven't done my yet!!
Corey_Whelan	and to everyone else. I'm Corey Whelan, The AFA's Director of Development and your chat moderator tonight. We are going to have a very fun, but extremely informative hour. Tonight's guest speakers are the co-founders of Agency for FErtility and Surrogacy Solutions, Kathryn Kaycoff-Manos and Lauri Berger de Brito. Former patients themselves, they have dedicated their professional lives to helping the rest of us have our families.
Corey_Whelan	and btw, I can't find my glasses, so excuse the typos in advance!
schwanke77	I only just received the husband's list, so I'm knocking it out while I have 5 minutes without him around. LOL
Corey_Whelan	way to multi task schwanke!
Corey_Whelan	we'll be officially starting in about five minutes
Lauri_de_Brito	Yup, we've lived it, now we hlelp others through it
Lauri_de_Brito	Sounds good, Kathryn's computer is acting up... her keyboard isn't working!
Corey_Whelan	ok.
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Corey_Whelan	Lauri, do you want to write a few words about what you guys do?
Corey_Whelan	welcome skimv
slimv	Hi!
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Lauri_de_Brito	Absolutely. We started our company because of all that we both went through to have our children. Both Kathryn and I were former television producers, married later in life (late 30's) and then decided to start families... but it wasn't easy! Both of us went through many IVFs, IUIs, many many miscarriages, testings, procedures, et... you name it, we did it. Both ended up using donor egg & surrogates to have our children. Our agency was created out of a need we saw -- and wished we had available when we were going through the process. now we help with fertility consulting, surrogacy, egg donation, etc.... instead of producing tv , we produce babies!!
Corey_Whelan	hi everybody and welcome to tonight's chat!
Lauri_de_Brito	Hi everyone!
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Lauri_de_Brito	So where should we start?
Kathryn_Kaycoff-Manos	Hi. Thanks for inviting us to talk tonight.
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Corey_Whelan	our pleasure. welcome.
Corey_Whelan	guys, please feel free to ask Kathryn and Lauri your questions.
Kathryn_Kaycoff-Manos	Where are people at in their journey to have kids?
Lauri_de_Brito	We feel strongly that an important aspect of fertility is to go into it having a fertility plan in place...
teacher422	where are you ladies from?
Lauri_de_Brito	Doesn't matter where you are in the process... it's where you are going...
slimv	what do you think about IVF abroad?
Lauri_de_Brito	we're in CA, but both from East Coast
Kathryn_Kaycoff-Manos	Yes, many people look at one cycle at a time and end up 4 years later still trying without any direction.
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Kathryn_Kaycoff-Manos	I'm originally from NJ, then moved to NYC, then Boston, now LA
Lauri_de_Brito	I've known lots of women who've gone abroad for donor egg - there are some good clinics out there.. but personally, I 'd much prefer to see couples stay here in the US
hoping	we are adopting internationally and are waiting for next month for an embryo transfer.
teacher422	I amjust beginning...I am 43 high FSH and about to begin acupuncture...
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Lauri_de_Brito	Doing egg donation abroad is tricky - you don't get to know much about your donors... yes, it's cheaper but I don't think overall better
Corey_Whelan	hi sadgirl. hope we can help you tonight.
slimv	Yes that's true Lauri, but it's so expensive, clinics make it difficult to undergo tx here in the U.S. I want to undergo IVF, however, can't afford it.
Lauri_de_Brito	Okay, hate to tell you teacher 422 -- at 43, you're unfortuantley wasting your time if you're trying with your own eggs... you should be moving on to donor eggs
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Corey_Whelan	hi karen, please feel free to jump in and welcome
teacher422	Think so? nice positive feedback...
Lauri_de_Brito	That's why you need a fertility counselor -- there are ways of finding out how to do IVF here in US for less $ -- shared cycles, working with pharmacies, etc....
Kathryn_Kaycoff-Manos	teacher - while some women do get pg naturally or with IVF at your age, the numbers are not in your favor...in fact they are very small and not that encouraging. You can continue on in this path but you have to give yourself a time limit. Unfortunately, celebrities in the media are having babies with apparent ease at 43 and beyond, what they don't tell you is that they are using egg donor.
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sadgirl	i am just so happy that we have the insurance to do the ivf. i actually started my meds yesterday
Kathryn_Kaycoff-Manos	they have that right but it's giving an inaccurate impression as to how easy it is to get pg and how late you can wait to have a child.
Lauri_de_Brito	sorry teacher 422 -- I know I"m blunt, but i'm honest. if you've got the money to throw at it, by all means, go for it. But the stats are not in your favor.
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Lauri_de_Brito	sad girl - good for you!! most of us have insurance that will not cover IVF so we have to find other ways to pay for it... and we've gotten creative!!
Kathryn_Kaycoff-Manos	At some point you will have to decide how important it is to have a baby that is biologically yours or how important it is to be a mom. You need to give your self a time limit as to how long you are going try before looking at other roads.
hoping	we are trying to decide to do another fresh cycle after the FET of if this will be the end of trying with ART. I am 38,
sadgirl	yes we live in TN but my husband works for a company based out of MASS
teacher422	I see, but I believe in positive thoughtd, at this time I am unwilling to accept a donor. I want my "own" child! I may change my mind, but maybe not.
sadgirl	sorry that the print was so light
hoping	what are some creative ways to pay for IVF?
Lauri_de_Brito	Hoping -- what clinic are you with? Part of this whole process is you need to be with the right clinic and it doesn't mean that the clinic down the street or the one that got your best friend pg is the right one for you.
slimv	My ins. does not cover and you have to go through so much as far as shared cycles and be considered eligible to receive IVF assistance, it's alot of red tape. It's not easy at all.
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Kathryn_Kaycoff-Manos	teacher -- I can completely related to that, we tried with my own eggs for quite a while...but again, you have to give yourself a time frame for trying and then if you don't get pregnant determine what you want - a biological child or to be a mom. You are obviously still at the point where you want a biological child, but if it doesn't happen for you at some point you'll have to examine all the options. Sometimes it's good to start playing with the idea now just to get used to it...just in case.
sadgirl	i am so sorry for all of you that do not have the insurance to cover it. i know its hard. thats why it took us so long to find help and seek it out
teacher422	I do appreciate your honesty...
Lauri_de_Brito	teacher 422 -- I totally understand what you're saying. I've been there. I can't tell you how many couples we talk with where IMs are 40, 41, 42... it hurts but it's true, you've got to think carefully what you want in the end. I've got two children (age 1 & 2) same donor, same surrogate -- could care less about the genetics... I swear to you, it ends up meaning nothing. They are your own children no matter what... and people will tell you all the time... oh she/he looks exactly like you ... that's half the problem - nobody is talking openly about donor egg... boy I wish just one celeb would come out and talk about it honestly!! It would do a world of good!!!
slimv	Sad Girl, I am in S. FLa, you must be up North somewhere. Insurance companies down here don't pay. I notice in NJ and NY and other states, ins. covers up to a few cycles.
Kathryn_Kaycoff-Manos	For myself I got to the point where I just wanted to be a mom. I am now the mom to identical twin boys...we mixed my eggs and donor eggs in with an IVF cycle. I haven't done the DNA test yet (but will in the near future) but I can tell you it won't make a lick of difference if I am the biological donor...I AM THE MOM And a happy one at that. I'm glad I didn't continue to try with just my eggs. I moved onto the next step...I am no longer trying, I am a parent.
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shaymer01	Do you tell everyone you used a donor? Do you tell the child? Just curious....
sadgirl	I am in TN, but the company my husband works for is in MASS
Lauri_de_Brito	Creative ways to pay IVF -- yes, there's other options. Check with clinics across the country -- pharmaceutical companies. Unfortunately a lot will be based on IM's age... if you're 36 or younger you can probably get into shared risk /cheaper cycles....
bunky	Have either of you decided how and when to tell the child?
karen76	I am in the 2ww of my 2nd IVF. It seems like my embryos develop slowly and most did not become blastocysts until day 6. Has anyone else experienced this or found a good protocol that seemed to make a difference? It's hard to do a 5-day transfer wondering if the ones on day 6 might be better.
schwanke77	for the people that went the egg donor route, what were some of your fears before, during and after the process? What concerns do you have now about what you went through?
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slimv	The shared risk program where I am in S. FLa is $18,000 for 2 cycles. That's a discounted price not counting the $450 fee just for a consult. That is crazy!
Corey_Whelan	Lauri and Kathryn, can you guys tackle bunky's question?
Kathryn_Kaycoff-Manos	Most of us cannot continue to pay for IVF cycles....there are clinics that offer risk programs...many of us (and our clients) have taken a second mortgage on their homes. Capitol one offers a fertility loan, we also borrowed from both sets of parents. Also, if you've done a few failed cycles you SHOULD ask your RE for a discount. Most will give them to you. some clinics also will take unused donated meds and distribute them to clients who are having a hard time paying for cycles.
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teacher422	I hear you!! I have to try, but I can see why you say put a time limit on t...because it CAN get out of control. One must always consider options. Although i am a realist at heart I'm a romantic!
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Corey_Whelan	welcome guys.
Kathryn_Kaycoff-Manos	bunky - I tell my clients - since it is relevant to my business, I told my family and close friends, but I feel it is my and my children's information (even though they are too young to know.) Once I find out if they are biologically related to me or not I will tell them.
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schwanke77	sorry for being slow here - what is "RE"?
Corey_Whelan	schwanke, reproductive endocrinologist
Corey_Whelan	IP is infertile people
Lauri_de_Brito	Shaymer01 and Bunky -- I had lots and lots of fears considering donor... and I already have one bio daughter (i got lucky and conceived on our first IUI then it was downhill from there) .. so it was a very tough decision to move on to donor. easier to do surrogacy. but I look back now, and %%%%!! I wish I had done it sooner... I never think about them being donor - they are MY babies!! 100% We absolutely will tell them at some point -- I think it's important to not have secrets and there is no shame involved in this. But right now, I only tell people close to us (family, friends) and I ALWAYS tell women when I start talking with them and find out that they're 39 and up and they think theyr'e going to have a baby the normal way easily. Some do, many don't
Corey_Whelan	IM is infertile mom
Lauri_de_Brito	No it's not, it's Intended Parent - but same thing:-)
Kathryn_Kaycoff-Manos	Again, it is not a secret, it is just not everyone's information...including their pediatrician. My donor was allergic to penicillin, I am not, but I tell their doctor that I am so he will be on the lookout for it. Honestly, I just want to control the information that is around them until they are old enough to understand.
frances1	I have had at least seven surgeries for endo, fibroids, adenemyosis, blood transfusions for anemia - resulting in a hysterectomy. I had no problem getting pregnant when I first married but miscarried and then had the problems listed above. So, I have been attempting IVF with my own eggs. with a gestational carrier. This third attempt resulted in three eggs on retrieval which fertilized and then divided beatifully. Unfortunately they had to be frozen because the cost of keeping the gestational carrier ready for each attempt was to high. so here I am with positive thoughts (like you teacher422) and faith and enjoying every minute of it. If this does not work, I will be ready to move on. It takes each individual what it takes, and I finally met a doctor who agreed with me and didn't just throw the statistics at me.
Lauri_de_Brito	There are wonderful online support groups for those who choose to go the egg donor route
Kathryn_Kaycoff-Manos	teacher -- for many of us it becomes a psychological, finanicial and physical drain...our relationships suffer and our life focuses only on having a baby. When it gets to that point you just want to have a baby...but only you will know when you reach that point.
schwanke77	Did you consider the pros/cons of egg donor versus adoption? If so, what went through you mind in that process?
Kathryn_Kaycoff-Manos	frances - that is the right attitude...enjoy what you have. But as Lauri said, we encourage looking ahead and having a Fertility Plan...some people end up stopping and that is fine, but it's a well thought out decision rather than one of exhaustion and giving up.
bunky	That was the line of thought I was having as well. Share with those closest - but use discretion as to when to tell the child (if they were conceived using an egg donor). This is all theoretical at this point but having done one IUI and 2 IVFs all of which failed; plus three spontaneous pregnancies all of which ultimately failed -- donor is starting to look more and more attractive to us. Trying to get the best chnace of success and finally become parents!
Lauri_de_Brito	frances1 - again, I understand the need to try with your own eggs. I did too! I was trying with my own eggs at 42. with a top clinic. and after having several consults with other top REs. I had already carried one child(bio), then miscarried many times, then miscarried with donor egg (so that ruled out it being an egg issue in my mind), then moved on to surrogacy and tried my eggs (age 42 but still looked good) into a proven surrogate, when that didn't work , I had my answer... I had been through enough. We moved on to donor egg/surrogate and got pg and had my daughter the first try.
Kathryn_Kaycoff-Manos	did we miss any questions? We're trying to keep up.
Corey_Whelan	I think you're ok. Guys, if your question was overlooked, please paste it in again to get it answered
Kathryn_Kaycoff-Manos	Bunky - I was still a great egg producer when we moved to ED but I was 43 and I had reached my limit. We also used a GS (Gestational surrogate aka gestational carrier). I was relieved to really up my odds and introduce an egg donor into the equation.
Kathryn_Kaycoff-Manos	I am in the tell camp for ED...I feel that it comes out as a dirty secret at some point if you don't tell...but a natural fact of their conception if you do tell. I will let them know just how wanted they were and that some wonderful woman donated some cells to help them find their way to us. I also feel this will become an increasingly popular way to have children and they will have other friends conceived this way (they already do, they just don't know it.)
Lauri_de_Brito	shcwanke - yes I absolutely considered pros and cons of egg donation vs. adoption. and egg donation won hands down. It actually ends up costing somewhat the same - and there's not guarantee either way. I know too many failed adoption stories. As I'm sure all of you do. But with egg donation - at least you will get to experience pg (unless you need a surrogate as well) and there is much more control in the situation -- you get to use your partners DNA, plus you get to pick the DNA of your child ... in a sense -- by choosing your donor. With adoption you can get anything and you never know if drugs were involved, what the medical history is of the birth mom or dad.... you'll never know if there are diseases that run in the family, etc... things like that. For me, I'd rather know more than less... and I'm a bit of a control freak anyway
bunky	Yeah - we are definitely approaching that point of needing success (or at least our best chance of it). We are fortunate in that my insurance fully covers IVF and partially covers ED -- however, I have exactly 2 proceedures left to use. After that, it's all out of pocket and becomes a different scenario.
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Kathryn_Kaycoff-Manos	RE Adoption - We have had clients get pregnant while pursuing adoption and they are doubly blessed.
Kathryn_Kaycoff-Manos	Again you are fortunate. You definitely want to make a decision before you use up your cycles. If it covers ED could you possibly do one cycle and if you aren't successful then do an ED cycle and co-stimulate. You could still transfer yours and freeze the ED's. Then if it doesn't work you can have those embryos on ice. FETs are much cheaper as I'm sure you know. Just a thought.
Kathryn_Kaycoff-Manos	that last answer was to bunky
Lauri_de_Brito	for those of you on the brink of trying again with your own eggs or moving on to donor.. that's where talking with a good fertility counselor (not necessarily and therapist) can help. It will bring up whether or not you're even in the right clinic... are you at the best possible clinic for chances of success.....
bunky	LOL -- thanks Kathryn!
kateknox68	Lauri - not to sound stupid - but I"m assuming donor egg only really helps if you have issues with your eggs - if you're doing IVF and your eggs appear fine and your getting decent embryos - donor egg won't make a huge difference??
teacher422	Thanks for your feedbacak ladies! I must go but I definitely appreciated your take on all of this and i will everyone many baby blessings!! ::biggrin
schwanke77	good question kate
Corey_Whelan	good luck teach
Lauri_de_Brito	especially for you over 40s' -- it's easy to stay with your clinic, especially if htey're reputable... but there are a few clinics in the country that have the very best statistics for over 40.. they cost more, but if that matters, it's worth it.
Kathryn_Kaycoff-Manos	Adoption has some pros but also cons. It is not easy and many fall through...which is why people like to pursue ED...once those eggs are yours they are yours, no one can take them back. Not true with domestic adoptions. Also you can oversee all the prenatal care with ED.
Corey_Whelan	You can always utilize the cdc report to get stats for age groups.
tallgoldi	I really don't know much about any of this, and I don't think we have many options in Nebraska. How do I even go about finding a clinic and figuring out costs and everything? If this isn't the right forum to ask these questions, please let me know and I'll be happy to come back when this is the topic:) thanks
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Lauri_de_Brito	kateknox - yes it does matter about egg quality... but often times embryos look beautiful but there's no pg. that's when you've got to look at all factors... uterus, sperm, age of intended mother. we've got women in their late 20's, early 30's who have used egg donor because they were having too many failed cycles. some go on to be successful using a surrogate, some just stick with it, but others move to egg donor. it's different for each situation.
Kathryn_Kaycoff-Manos	kate - how old are you? That is part of the ED equation. Good looking embryos when you are older are not always good embryos. There are issues of mitocondria (which is the umph or energy left in the embryo) and old eggs don't have that much of it left. Even doing PGD isn't the answer. Modern science still really hasn't found a feasible solution to old eggs beyond egg donation. Of course there is always just good old fashioned luck of the draw...some women get pg with old age, but not many.
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Corey_Whelan	tallgoldi, we can help you find a clinic. Call the AFA's 800 number and Lisa will give you a list of recommendations
shaymer01	Isn't there some pending legislation, or talks of legislation that would have severe repercussions on ED?
Kathryn_Kaycoff-Manos	tallgoldi, this is the right place. Hold on for an answer
tallgoldi	ok
frances1	I think that if this doesn't work, I will be ready to move on. I have to open myself up to other things and listening to both of you who have children from egg donors confirm what my doctor has said - once the baby is in your arms it just won't matter and I have to focus on building a family. It has taken me longer than some but due to be being so ill from reproductive issues rather than having problems getting pregnant, I needed to go this route but I don't want to get stuck. That would be the worst. I thank you both for your honesty - your bluntness and your expression of happiness with your choice.
kateknox68	I'm 39 - male factor with one failed IV
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Lauri_de_Brito	CDC stats are not alwasy the best thing to use. Often times they are skewed. plus they are 2 years old. so you have to do research, call clinics, ask around, ask for current stats.. join other online support groups,
schwanke77	you mentioned about domestic adoptions where mother's can come back for the child (i'm seriously paraphrasing here, but you get the point). Is this not the case with international adoptions? Would a surrogate mother also have any rights?
Corey_Whelan	all of you, always, if you ever don't get the information that you need, you can and should contact me later on. Call 718 853 1411 or email corey@theafa.org. Just please put chat participant in the subject line
Kathryn_Kaycoff-Manos	frances, you are welcome. Things are always scarier when you are on the other side...once women make the leap they often feel relief and renewed hope.
Kathryn_Kaycoff-Manos	Schwanke - no, it's not the case in most international adoptions, but there are issues of prenatal care and most children cannot be adopted for 6 mo to a year.
Lauri_de_Brito	kate are you doing ICSI - I would assume so with male factor? how many eggs are you getting? 39 is borderline to start considering egg donation. tell me more about your situation - what clinci are you at?
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bunky	I also agree with the comment that ED is going to be more and more common. I work for a small company and was pleasantly surprised when a male co-worker shared with me his experience of deciding and having success with ED.
Kathryn_Kaycoff-Manos	With surrogacy there are laws that protect you. The laws are best if you are using your eggs or donor eggs and not the surrogate's (the later is called traditional surrogacy.) It also depends upon which state the surrogate lives in.
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kateknox68	Maine Center for Reproductive Health - yes, we are doing ICSC - 8 eggs, 7 mature enough - 7 fertilized - 2 advanced enough to implant, both looked good but didn't stick...
Lauri_de_Brito	bunky -- yes, we will all find in the years to come that lots of our children were conceived in unconventional ways... but they will become more common
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Kathryn_Kaycoff-Manos	...some states do not uphold the contract other states are great for surrogacy. They will support the contract if the GS wants to keep the baby...but that is rare. I used to tell people (in all honesty) when my GS was pg with my twins "She's more afraid I'm going to leave her with the babies than I am afraid she's going to keep them." If she wanted a baby there's an easier way to go about it. She entered the agreement wanting to help us. The horror stories are usually traditional surrogacies. Believe it or not many IPs leave the babies with the surrogates and not visa versa.
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Lauri_de_Brito	kate - you're not gonna want to hear what I'm gonna say. at 39, you're producing well... but it's all about the lab. And at your age you should be going with a stronger clinic. did you only have 2 embryos at day 3 or day 5? I would recommend going with a different clinic :-(
Kathryn_Kaycoff-Manos	bunky -- in large metropolitan areas it is practically epidemic. In my preschool over 30% of the moms are over 40! I know a few used egg donor.
Lauri_de_Brito	Kate - at 39 you don't have time on your side. so if you are serious, you should probably explore other clinics that have better success rates and do more cycles.
Kathryn_Kaycoff-Manos	did we miss any questions?
kateknox68	2 embryos at Day 3 - the hard part and I'm sure this is true for other folks - they're just aren't a lot of options - unless I go to Boston and that's a huge undertaking (in terms of commute time, etc)...
schwanke77	I'm not sure you'd have an answer to this, but I'm tossing it out there. As a self defined "walking medical disaster", I've had my fair share of non-pregnancy issues in recent years. Because of that, I'm having a hard time considering anything like IVF, etc (just cannot take ANY more doctor appointments, ANY more tests, ANY more needles, ANY more pain, etc.). I also have personal issues with adoption that I'm not sure I can get over. Any suggestions for someone in my mental state in terms of a fertility plan to mull over while we continue to try naturally?
Kathryn_Kaycoff-Manos	Boston has some great clinics...you may want to set up a consult there.
Lauri_de_Brito	Another guideline Kathryn and I adhere to.. is if you've done 3 cycles with no success and nothing has changed in your protocol, it's time to move on. Your doctor is not helping you. You need to be proactive....
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hoping	thanks for your help.
tallgoldi	I know it depends on area, clinic, etc. But can you give me a ballpark for IVF so I can decide if we should even call the clinic?
Lauri_de_Brito	kate -- Boston IVF is a top clinic and would be worth spending the $$ and trouble... you should have gotten a better response than 2 embryos at day 3 with nothing to freeze....
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bunky	Kate - I can relate. After 2 failed IVF cycles, my husband and I made the decision to switch from our current clinic (10 minutes down the road) to a bigger clinic, with a world class lab over 50 miles away. It equates to 4:45 am wake-ups for me on blood draw days and over 2 hours in the car BEFORE getting to my job but I just keep chanting "keep the eye on the prize"!
Lauri_de_Brito	tallgoldi - are you asking costs? cause they're all different - -anywhere from 15k to 30k per cycle...
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frances1	My biggest fear of using an egg donor is how my child will react to knowing he/she was conceived with only one parent. How does one get over this...maybe just not think about something so much?
tallgoldi	ok. Well, that's what I needed to know. $15K is just not feasible for a "maybe" for us. We'll just have to keep trying IUI
Lauri_de_Brito	bunky -- I 100% agree with keeping your eye on the prize.. in fact, that's our catch phrase for our company!!!
Kathryn_Kaycoff-Manos	Of course money is a factor, but surrogacy might be a great option for you. We've had younger clients who also got tired of the needles and physical and emotional drain and used GS and ED. Again, finances play a huge decision in this. There is also TS (Traditional surrogacy) where the surrogate uses her own egg and does sperm inseminations (cheaper than GS with IVF) but TS is legally murkier. Our agency does not handle TS cases because of that.
kateknox68	Bunky - do you feel better about making the switch??
schwanke77	good question frances
Lauri_de_Brito	tallgoldi - are you doing medicated IUIs? if not, that's what you should be doing... and doing back to back IUIs (2 inseminations each cycle)
schwanke77	Lauri and Kathryn, you've been a great help with your answer. Thanks.
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Lauri_de_Brito	frances - we all agonized (and still do) over those issues... but the truth is these children are loved enough (and that's what I will tell them) that we went to such extreme lengths to have them....
Kathryn_Kaycoff-Manos	frances -- years ago people worried what they'd tell their child if they were conceived with IVF. I truly believe by the time our children get older this will not be such a big issue. If you present it matter of factly and tell them they were so desperately wanted and this was the only way to help them get to you they will feel loved and wanted. Not to disparage adoption, since I support it, but many adopted children feel unwanted and abandoned. With ED they are wanted and created with love and desire. I dont' think there will be the same issues in this area. Also adoption used to be shameful and look at it now...
tallgoldi	No, we're not doing 2 per cycle. We're doing it with my regular OB right now. I'm taking clomid and getting several eggs each cycle according to the ultrasounds. My son is almost 4, and we have been trying for 2 years for number 2. My husband now has diabetes (which he didn't when we conceived the first time) and his count is really low
bunky	Kate - I do in terms of knowing that we are doing everything in our power to give us the best chance of success. I am the type of person (a tiny bit controlling and type A) that won't be able to sleep if I'm not comfortable in my decision. And both my husband and I are sleeping very soundly right now. Of course, ask me again after I complete my next cycle -- the answer might change a bit if we have another failure.
Lauri_de_Brito	of course they'll still go through teenage stuff.. and hate us but it won't be for loving them enough ... and that's where I think honesty plays into it... I think if you keep it as a shameful secret from your child, they will feel that way. but if you don't treat it that way, they won't feel it.
kateknox68	Yea - I need to think about this. I don't want to go to Boston - but I haven't been happy with where I am.
Kathryn_Kaycoff-Manos	Frances, we have started to set up a support group for parents who have concieved with an egg donor so they can discuss these issues and how to deal with them. I foresee in the future having a similar support group for children concieved this way so they can talk about their feelings. I think this will be popping up more and more as ED children mature.
shaymer01	Isn
Kathryn_Kaycoff-Manos	LOL! Bunky, I think many of us here are type A! We are the type of people who take things into our own hands if they are not happening on their own
shaymer01	Sorry. Isn't there some pending legislation or talk of it regarding DE that could be limiting?
tallgoldi	I have another thought (that's definitely outside the box), but I would be interested to know your opinion- psychologically. If we try the IUI a few more rounds and want to consider a sperm donor, I though about maybe my husband's brother. Is it better to have anonymous donors- again I'm mostl talking mentally for us and the child.
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schwanke77	good question tallgold
Lauri_de_Brito	tallgoldi - that's your big problem. you need to be doing it with an RE... even if your OB is doing ultrasounds (thank goodness for that)... is that OB available on weekends? In any case, you can try upping the ante by doing back to back insems... one right when it's looking like you're going to ovulate, another the next day after the egg has dropped. worked for me.
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Kathryn_Kaycoff-Manos	Tallgoldi - great question. If you do opt to use your BIL's sperm you should have a contract and make sure that you, your husband, your BIL and his wife have a counselor talk to you. It depends upon the personalities on how this works but a psychologist will help explore the different feelings that may come up. There are psychologists that specialize in reproductive issues, make sure it is someone like that and not just a general practitioner.
Lauri_de_Brito	shaymer -- occassionally it rears it's ugly head... but we truly don't believe legislation will ever pass... there are too many of us out here and won't let it happen. FDA has tried to make it difficult - lots of testing involved and treating it like organ donation.. but I think it is here to stay - and I would not be afraid to do it because of the fear of pending legislation....
schwanke77	do you know of any on-line support groups for people trying and not quite ready to do the advanced medical options or adoption?
Kathryn_Kaycoff-Manos	There are now some donor banks that have donors that are open to being contacted in the future if that makes you feel better.
shaymer01	ty
tallgoldi	ok. We're definitely a few cycles away from taking that step, but it was a thought I had (and that way the child would still have the same bio grandparents, etc). Also thought about asking the OB to use sperm from both and then just never find out whose baby it was biologically.
Lauri_de_Brito	There are lots of yahoo groups for all different aspects of where you are in the journey. also google about it.. you'll find them. I"m sure AFA has lists too..
Kathryn_Kaycoff-Manos	MVED (Mothers Via Egg Donation) has many women that are still grappling with these decisions, plus women that have moved forward. There are some very lively discussions and you'll get lots of opinions. The good news is everyone on the board has gone through exacctly the same thing you are...and there are many women in your same position, still trying to decide.
Lauri_de_Brito	tallgoldi - that's a thought... have you discussed it with the brother?
Kathryn_Kaycoff-Manos	I think MVED is through www.surrogacy.com (but not 100% sure.)
tallgoldi	No, we haven't at this point. He and his wife just found out they're pregnant, so didn't think we'd discuss this until she was further along and until we were sure it wasn't working with just us.
shaymer01	If the odds are that much higher of success with DE, how do you decide how many embryos to transfer?
Lauri_de_Brito	One thing I want to add about egg donation .. if you do end up going that route.. often times using a proven donor is a good thing. It doesn't guarantee success, but at least you will know that the donor responds to meds and what the prior protocol was...
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Kathryn_Kaycoff-Manos	Tallgoldi - I hesitate not to find out and tell the child. You know how cheap DNA kits have become, I feel that in 10 years from now your child's science teacher will tell them to go home and get a piece of their parent's hair to do a test in school .What a horrible way for your child to find out. I really believe disclosure is the best options. you could possibly tell them it doesn't matter to you and if when they are older they want to test they can -- although I'm not advocating this, just a thought.
bunky	Kathryn/Lauri -- when we went for a 2nd opinion, after 1 failed IUI and 2 failed IVF, the new place just kept emphasizing their lab made all the difference. Would you agree with this statment -- or should I say would that argument sway either of you?
tallgoldi	Well, I figured if we did it we would eventually tell the child that they biologically could be either, but that it didn't matter to us either way. If it really mattered to the child, then I'd let them find out.
Lauri_de_Brito	shaymer - with donor egg, you really should only transfer 2 fresh embryos.. whether they are day 3 or day 5. unless they look really like crap. (which shouldn't happen but can). If you do a frozen DE cycle, you really should only transfer 3. remember you're dealing with much younger eggs, therefore much better quality embryos... sometimes even if they don't look as good!
Kathryn_Kaycoff-Manos	Shaymer - this is something you and your RE will discuss. Most feel that transferring 2 fresh embryos is sufficient if the quality is good. if not, possibly 3. It's hard to make a true decision in the hypothetical. If you do transfer 3 fresh ED I think the stats are aobut 4% for triplet.
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Lauri_de_Brito	bunky - the lab is CRITICAL... so yes it would sway me. of course, I'd find out more -- get their current stat,for your age group, for donor. do not use a clinic for donor egg if their success rate is less than 70%
Kathryn_Kaycoff-Manos	Yes, the lab can make all of the difference. I do think the two MOST important factors (but not the only impt factors) are the lab and the skill of the RE at the actual transfer.
shaymer01	this is an odd question but I have been wondering...why day 3 or 5 and not 4?!
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kateknox68	Lauri - can you say more about how/why the lab is critical?
Lauri_de_Brito	shaymer - most clinics do either 3 day or 5 day transfers
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Lauri_de_Brito	kate - the lab/embryologist is the key player... it's all about what they're doing.. and labs differ. You're RE needs to be good too, but it's about the ICSI, the cultures, how the embryos are handled, etc...
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Kathryn_Kaycoff-Manos	Shaymer - LOL! I like the way your mind works. I think that on day 3 that some embryos that might not do well in the lab could do well in the uterus. Day 4 could be a transfer but at that point, the ones that make it to day 5 are the heartiest. Day 4 is sort of an in between day and more is known if they wait to see which survive to day 5. Make sense?
shaymer01	I guess that makes some sense...I have always wondered though!
tallgoldi	Thank you very much for your help. At least now we know that IVF is out ($), but there may be some other options for us with the IUI. If it doesnm
schwanke77	K/L - thank you so much for all your answers. And to everyone else for their great questions. Though we're definitely not ready for the steps you all are so bravely taking (or have taken), this discussion has truly helped to frame many of the issues and considerations when/if we go that route. It's also given me many ideas on potential pitfall areas to research thoroughly and watch out for. I must sign off, but thank you again everyone. Good luck to everyone trying and Happy Holidays.
shaymer01	70% is very high Lauri! wow.
Lauri_de_Brito	another note for those of you who do straight to freeze cycles -- the embryos should be frozen at 2pn... the thaw rate will be much better. many smaller clinics still just wait to day 3 to freeze (and I'm only talking about straight to frozen cycles)... and they shouldnt'
bunky	Thanks Lauri - I was starting to contemplate coming back to my previous clinic for ED (since it is so much closer) but I'll stick out the miles and early rise time!
tallgoldi	doesn't work this cycle, I'll definitely talk to my OB about doing 2 IUI back to back.
Kathryn_Kaycoff-Manos	Kate - the skill of the embryologist in ICSI, the medium they use, the way they handle the embryos when loading the catheter...all these things are critical. Small human errors can make all the difference, so a lab that handles more volume is one that has greater skill, the clinic with higher stats COULD have a better lab (but stats can be misleading since some clinics screen out patients with more problems to keep their stats up and make decisions regarding the cycles iwth thier stats in mind and not their patients.)
Lauri_de_Brito	shaymer - there are some clinics with a 90% donor success rate!
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tallgoldi	Merry Christmas everyone! Good luck to all of you
Lauri_de_Brito	any other questions?
tallgoldi	OH, one more question...
Lauri_de_Brito	bunky - what clinic are you with you?
Kathryn_Kaycoff-Manos	Also, please feel free to email us at: agency4solutions@aol.com
tallgoldi	So, even if my husband's count is really low (1-3million), would doing one the day after do any good or would his count still be too low?
Kathryn_Kaycoff-Manos	tallgoldi - go for it
bunky	K - good point on the manipulating the stats possibility. My clinic pointed out their stats and freely admitted they get many of the more difficult cases...like me! And still have solid #s -- I think ED for my age group was 75% or so..
Lauri_de_Brito	tallgoldi - yes, all it takes is one sperm!
bunky	St Barnabus IVF (NJ)
tallgoldi	thank you! Take care
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Lauri_de_Brito	bunky - then you're at a good clinic. and you are.. I see
Corey_Whelan	guys, we're winding it down, I'm sorry to say. I wanted to mention that The AFA will be holding a patient educational event in San Francisco on Feb 10th at the Presidio. Kathryn and Lauri will be there and for those of you who live in the area, we would love to see you as well.
Kathryn_Kaycoff-Manos	as you probably know, it's best to wait 3 days between "donations" but if why not do "one for the road" if the day before sample was after three days. You never know which swimmer might be the one to get through.
kateknox68	Many thanks for all the great advice
Lauri_de_Brito	Thanks to everyone and good luck to you all...
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shaymer01	thank you very much!
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bunky	Thanks!
Lauri_de_Brito	hopefully there will be lots of babies in 08
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Kathryn_Kaycoff-Manos	75% is very good. 90% is not a cdc reported stat
Corey_Whelan	I want to thank all of you for being here, you have no idea what it means to see your names every week! (shaymer)
shaymer01	Amen to that
Kathryn_Kaycoff-Manos	Good luck everyone!
Corey_Whelan	and thanks especially to Kathryn and Lauri for giving us their time this evening. Thank you both so much.
Lauri_de_Brito	Our pleasure
shaymer01	thanks Corey (and i even missed a couple weeks!)
Kathryn_Kaycoff-Manos	thank you all for the thoughtful and provocative questions and Happy Holidays!
shaymer01	Happy Holidays to you as well!
bunky	I'm still learngin the acronyms but this definitely helped!
Corey_Whelan	I know you're all out the door, but lastly, please consider making a donation to The AFA's chat series so that we can keep it free. Happy holidays everyone and good night.
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Kathryn_Kaycoff-Manos	we're still here if anyone wants to ask more questions
bunky	LOL -- I thought you were all done?!
Kathryn_Kaycoff-Manos	If not, we'll call it a night.
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bunky	Are either of you familiar with the newly published Fertility Diet?
Kathryn_Kaycoff-Manos	We're supposed to be but my fingers are all warmed up.
Lauri_de_Brito	I read some articles regarding it.. but there didn't seem to be anything new.. other than don't do a no-carbs diet
Kathryn_Kaycoff-Manos	Yes, I have heard about it. Diet is great but when you're younger. When you're "older" you don't have as much time for the subtle effeccts of the diet to work. The clock is ticking.
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bunky	I mentioned it to my RE -- she asked me to send her a link or the synopsis of it that ran in Newsweek. That surprised me a little that she wasn't familiar but then, that's not really her focus, is it?
Kathryn_Kaycoff-Manos	Bacially, you want to be at a good healthy weight if you are having problems conceiving. Sugar is bad (even if you aren't trying.)
Kathryn_Kaycoff-Manos	Diet is old news...and not medical...and not a moneymaker for the RE. Many REs don't support mind/body or acupuncture either. Go figure.
Lauri_de_Brito	bunky - it's an older study actually -- and it's for 'regular' people - -not those of us who are fertility challenged and that's probably why your RE wasn't that familiar with it.
Kathryn_Kaycoff-Manos	She's probably reading medical journals, not Newsweek
Lauri_de_Brito	At least you hope she is
bunky	Good point!
bunky	I have to say -- I'm LOVING the acupuncture.
bunky	PLus, within 2 months of starting acupuncture, I spontaneously conceived for the first time in almost 2 years!
Lauri_de_Brito	Alright, I'm gonna have to call it a night. Good luck to you Bunky!! Hope you get PG soons!
Kathryn_Kaycoff-Manos	All right. I think we're going to sign off now. Thanks again, we had a lot of fun and hope to do another chat sometime soon. If you want us to come back please let Corey know
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bunky	Thanks!
Kathryn_Kaycoff-Manos	PS - I loved acupuncture too!
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Chick Chat - The Infertility 101 You Don’t Get in your Doctor’s Office

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