Thursday, November 3, 2011

Ovum Donation Process

This was an exciting time in my life!  Yes there were injections, meds, numerous, almost weekly blood tests.  But I knew there was a purpose and having found a donor was half the battle.  She was healthy, young (21) and without medical intervention was producing over 20 eggs, which meant that she was definitely shareable. 

One of the risks in a shared cycle is the donor doesn’t produce enough eggs, and if you’re the secondary recipient, which I was, then there’s a chance that you can get cancelled to allow the primary recipient all the eggs. 

While the donor was being readied for her procedure, I was being medically prepared for mine.

A shared cycle is a bit more difficult to coordinate.  The donor and the two donees’ cycles have to be synchronized so that everyone is ready to accept the embryos at the same time.

I haven’t mentioned yet that the institution I chose was RMA (Reproductive Medical Associates of NY) and I cannot say enough about them!  The personalized treatment I received was unmatched!  A wonderful very smart and informed nurse was assigned to me and her communication was impeccable.  My emails were answered within hours if not minutes.  She was always very clear on next steps, medicines, follow-up visits, and most importantly was always full of encouragement and motivation.  

Contrast to the other place I signed up at from where I haven’t heard a peep since I filled out my application for a donor over 10 months ago!

Once the eggs were removed and tested I was allotted 15 of my own!  Of those, 11 were successfully fertilized and of those 7 survived.

I was on my way!

Thursday, October 20, 2011

Choosing Ovum Donation

So what was it that finally made us consider ovum donation?

Well I suppose the desire for a child is so strong that when the more conventional options fail you really do start to look at everything in a different light. 

The reason I originally felt negatively toward ovum donation was the uncertainty about a donor, mostly health-wise but also from a genetics point of view.  For my husband his two issues were the cost of ovum donation and his fear that for one reason or another I wouldn’t be able to bond with the child because genetically it wasn’t connected to me. 

It’s so important to seek guidance from professionals, friends in the know,  and the Internet to make informed decisions and to understand this miraculous process and all its benefits.

Since I registered at two separate fertility hospitals I got a lot of info from doctors, nurses and psychiatrists, and through this process our fears and misunderstandings were alleviated.

Uncertainty about the donor:  all of the respectable fertility clinics or hospitals follow practically the same process of vetting out unqualified donors.  The potential donor is not only subjected to a variety of health exams and blood tests and tested for various genetic diseases, but is also put through an aggressive psychological testing process to ensure that the donor is being up front with the information she’s providing.  I learned that out of every 10 potential donors that come through, only 1 normally passes all the tests and is selected into the donor program.

Genetically, I wanted a donor to have at least some of my features and I’m not unique so that wasn’t difficult to find.  However, since both my husband and I are tall (I’m 5’9” and he’s 6’3”) it was important to find someone who was at least 5’ 7” and that’s not so easy unless you go the agency route – which was our next concern – the cost.

Cost: varies tremendously from a shared cycle to a non-shared to an agency donor.  My friend and I had two totally different experiences.  She was on a hospital’s list for a donor for over a year.  When nothing came through for her she decided to find a donor via an agency.  Her total cost for the entire process totaled approximately $50,000. 

My husband and I decided to try the shared donor option.  Sharing a donor with another mom-to-be is less expensive because the donor costs are shared, and the waiting period is reduced.  After waiting 3 months I got the call that a donor was available – and she was 5’9”!!  My total cost, after a partial insurance payout, was $18,000.  The major difference?  My friend is pregnant with a singleton and has 21 frozen embryos.  I’m pregnant with a singleton and have 6 frozen embryos.  6 works for me!

Bonding:  I’m so glad I spoke with the psychiatrists at the two facilities I registered at.  I was never concerned that I wouldn’t bond with my child.  After all, we very seriously considered adoption – from anywhere in the world – but sadly, we were told that we were too old for adoption (me 46 and he 53).
While a donor egg child is not the mother’s genetically, biologically it is all ours.  It feeds off of us, it lives inside of us.  The egg is the facilitator and yes it has the genetics.  But who cares?  This baby is mine, he’s been in my tummy for 22 weeks now and I am so in love with him I can barely wait for his arrival.

Tuesday, October 11, 2011

The IVF Attempt

My appointment with the IVF doctor wasn’t very positive.  He looked at my prior results from AI and pretty much told me not to bother with IVF.  Did I mention his bedside manner was less than cheerful?  I won’t mention the place I went to (not just yet) because it is one of the finest NYC and US institutions but to tell you the truth I never would have imagined that I would be made to feel so uncomfortable about the whole thing as I felt there.  I felt old and I felt like no one was cheering for me.  In the end, I thought, it’s not so much about bedside manner than about results.

He gave me all the grim stats, the very low probabilities of women 43 and over getting pregnant using their own eggs via IVF.  All of this made me even gloomier but I remained optimistic and decided I needed to give IVF a try.

And the cost was high at $11,000 plus about $3,000 for the drugs.  If I didn’t produce the minimum required number of follicles my transfer would be cancelled and part of the $11,000 refunded.

The process was not as smooth as I thought it would be given the caliber of this institution.  After receiving a calendar that more or less outlined my drug intake for the next 30 days I was assigned to a nurse who would become my “go to” nurse for all questions, concerns, etc.  While this nurse was very friendly, I spoke to her maybe three times during the entire process.  Most calls were fielded by other nurses, and this made the entire process very impersonal and often confusing.  I only mention this because I think that dealing with infertility is stressful enough and that places that specialize in infertility assistance should, at a minimum, try to put their patients as ease and not add more stress during this process.

Purchasing the drugs was also a nightmare.  Since at my age it wasn’t obvious that we would ever make it to the retrieval phase, because of the limited number of eggs that I’d produced during the AI trials, it was possible that I wouldn’t need to invest in all the drugs up front.  This became a logistical issue for me as my insurance company accepted only one mail order pharmacy for infertility drugs and this pharmacy did not deliver on weekends.  Also deliveries had to be planned a day or two in advance.  With the Follistim injectable costing anywhere from $800 to $1000 a pop I had to plan ahead and at times wager a little to make sure I had enough medicine without getting too much.

After about 3 weeks of Antagon, Gonadotropin, and Follistim and many blood tests later, finally the day of reckoning, the sonogram.  Bad news, I was producing even less follicles than I had during the AI trials.  My IVF would be cancelled, as the requirement was that at least 5 follicles needed to be present for retrieval.

I can’t even describe what a dark day that was for me.  My husband up to that point had been very adamantly against IVF or Ovum Donation but he caved on the IVF once he understood the process better.  However, Ovum Donation was in an entirely different category, and as far as he and I were concerned it wasn’t going to happen.  That was a bleak day and one where my dream of having a child was totally shattered………..

Monday, October 10, 2011

Long Road to Ovum Donation

When you find your true love at the age of 38, and you’ve always wanted to have a baby, you try to make things happen quickly. 

That’s assuming you don’t believe it when people tell you that you can have a child into your 40’s because some aunt in the family did, or because you’re in great health and you look young!

I believed it and continued to take my time.  Add to that a husband who already had 2 sons from a previous marriage – so no one was pushing anyone to make it happen quickly.

Well we took our time getting married (5 years to be exact) and started seriously thinking about next steps in having a child shortly after that. 

I met a woman in the park who was 43 who told me she’d just conceived her first child naturally.  Wow – I can do that too.  Science is too complicated (and pretty expensive!) – it needs to happen naturally.  Plus I too was a healthy 43, and I looked and felt younger, and I had an aunt in Eastern Europe who conceived at 44 – so what’s the big deal?

Wasted another year trying the natural method.  Sad to say nothing happened.  I suppose a woman, unless from disease or some illness, doesn’t really know if she’s infertile until she really starts trying to have a baby.  Normally you’re considered to be infertile if after 1 year of trying you’re still not pregnant.  At 43 that year is a very valuable year.

Reality hit when I spoke to my ob/gyn about having a child.  Because of my “advanced” age he referred me to his colleague, a specialist in AI.  We tested and found I had fibroids, large enough to prevent a pregnancy or if there were a pregnancy would pose risks to it. 

The fibroid surgery took 2 months to schedule and 3 months to recover from so 5 months after I decided to do the “unnatural” AI I was ready for it!!  But was my body ready?

At this point let me just point out that while AI is worth a shot I’m not sure that, at the age of 44 and knowing what I know now, I would have put as much time into it as I did.  The mystery, fear, and perceived “unnaturalness” of IVF and Ovum Donation prevented me from even considering those options.  Emotions got in the way and ultimately time-wasting decisions were made.  I believe the 40’s, particularly the later 40s, are for IVF and Ovum Donation, particularly if you’ve never had a child before.

I did 3 rounds of AI each amounting to increased levels of medication, injections, and tests.  You’re body needs some rest between these sessions so the entire three attempts took about a year.

Every time I brought my husbands sperm to the sperm “cleaners” to get it ready for insemination I felt elated.  This was it – it was going to happen this time.  Insemination was easy – like a doctors visit except they plunge something into you that contains your husband’s sperm.  They let you rest for 15 to 20 minutes afterwards, during which time my mind would drift to the moment my pregnancy test showed the positive sign.  One week later, inevitably, the bad news.  No pregnancy.

During these AI sessions I’d go in for very frequent sonograms to see how many follicles (eggs) were being created by all these shots and medicines.  I rarely got to 3.  Considering that a young donor will make between 20 and 40 this wasn’t the best news.  But 3 were better than none!  And all you need is 1.

After 3 rounds of AI my doctor referred me to the IVF specialists.   I begged him for more AI but as nice as he was he told me it was time to move on.  Best advice although I didn’t think so then.

Fast forward to calling the IVF doctor, whose secretary, after asking my age, would not entertain an appointment until I proved to her that my hcg was at a certain number.  Panic – I think it was – sometimes it was more, sometimes it was less – they needed me to test again to be sure.  It was like joining an elite club and having to prove that you were worthy.

As much as I didn’t favor IVF a few months prior, now that time really was working against me and there was a possibility I didn’t even qualify for IVF, I wanted it more than anything I could remember ever wanting.  Panic, stress, depression.  I’m not a spring chicken anymore and as a result having a baby was becoming less of an option – it started to sink in……..