fertility clinics

Hello, Goodbye- Part 1

It has been a busy, hectic, and emotional week. In fact we almost haven’t had time to process what happened last Friday.

Almost.

While I felt guilty in the moment, looking back I do not regret caving in the 11th hour and taking the home pregnancy test. Testing before the official test allowed us to leave early for our weekend of water sliding and cleared Friday night for much needed time to discuss the sad news and what would come next.

Our discussion that night was one of the most challenging in our marriage. Bill and I process bad news in different ways which often leads to disagreements during times when we should be most supportive of each other, like the night of a failed pregnancy test. Especially this failed pregnancy test.

After eight procedures, twenty embryos, one miscarriage, and putting all our hopes and money into the Celebrity Miracle Clinic for one full cycle, we were both reeling and not at all in a position to give to the other what was needed that night. The weight of a disappointment of that magnitude could crush even the most perfect of couples.

Because so much of the IVF process centers on me, it is easy for me to forget that we are both invested in this. We are both elated when we are at a peak and devastated when we are in a valley. I have often made the mistake of expecting Bill to be there to take care of me, to put me back together when I am falling apart, only to realize that he may not be whole himself. This was the case Friday night.

Adding fuel to the fire, we were not at all aligned with what we wanted to do next. I decided long ago we would go back to Celebrity Miracle Clinic for one more attempt at creating a baby with my own eggs. Who cares that we didn’t like our experience there? I reviewed statistics for the best clinics in the country and determined that Celebrity Miracle Clinic was the place to be for an old lady with egg quality issues who was serious about getting knocked up.

Bill, on the other hand, has a deep seeded dislike of Celebrity Miracle Clinic and suggested in a less than subtle way that we consider alternatives.

Cue massive, explosive argument.

Throwing a wrench into the recovery plans of a hormonal Type A infertile woman is bound to cause a wee bit of a problem. It was a long night. Hurtful things were said. The evening culminated in our holding each other at 2 AM seriously discussing whether or not we could go through IVF again at all.

In the physical world, some explosions are devastatingly destructive. Others are critical steps toward building something new and breathtaking, like an expansive tunnel to the other side of an enormous mountain. I feel that Friday night was creative destruction, the clearing of one set of ideas and mental debris that allowed us to find a new path through this huge obstacle in front of us.

The truth is I don’t care for Celebrity Miracle Clinic either. Take for example what happened Saturday. I went for my blood work at 6AM mountain time. At 12:41 PM a nurse from the clinic called me to see if I had done my blood work. I told her that I had. She was then supposed to call the lab and call me right back to give us the results. Five hours later, there was still no call and no results. I eventually called the after hours answering service and had to demand to speak to the on call nurse because I was told “lab results are only discussed during normal business hours.” After five phone calls I finally received a call back with the results of my long awaited pregnancy test.

This type of thing happens all the time at Celebrity Miracle Clinic, but I explain it away and suppress my feelings about it because they supposedly have the best lab and results in the country.

Bill’s suggestion that we consider going back to our old clinic, the one that gave us Spork, made me angry at first. But the more I thought about it, the more it made sense to me.

We initially went to Celebrity Miracle Clinic because we didn’t know if we were still making chromosomally normal embryos. While our old clinic can do genetic testing, they do it at an early embryonic stage that can damage the embryo to the degree that makes it less likely to survive and implant.

Celebrity Miracle Clinic uses technology that allows the embryo to be biopsied at a later stage and therefore does less damage to the embryo, using only a small number of cells from the part of the embryo that will become the placenta.

I debriefed with my Celebrity Miracle Doctor on Monday. He said that we had three genetically normal embryos that were of good quality and we were just “unlucky” this time.

Hmmm… maybe. Maybe it’s a little more than just bad luck.

In our cycle at Celebrity Miracle Clinic we had 5 embryos make it to the blastocyst stage. Of those five, the initial genetic test results came back with two embryos as genetically normal (euploid), one abnormal (aneuploid). The remaining two embryos had to be retested because the tests were inconclusive.

What? Retested? What does that mean?

That means Celebrity Miracle Clinic achieved a 40% failure rate on their amazing state-of-the-art testing and we had to do it again. After retesting, one embryo came back abnormal and the other embryo was Blob. In order to be retested he had to be warmed and biopsied a second time, removing even more cells from his 100 or so to support the test. 

When Blob was frozen the first time he was a 5BA blastocyst which meant he was still in his shell. During the second biopsy he completely reanimated, expanded, and even shed his outer shell. Then he was flash frozen again.

After that he was never the same. 

Embryos are supposed to fully expand after being warmed. In fact, re-expansion is the most important indicator for a successful implantation. Blob barely had a chance once he was warmed again and only slightly expanded.

What Blob looked like at transfer

What Blob looked like at transfer

What Blob should have looked like at transfer

What Blob should have looked like at transfer

Had the test worked the first time, or had Blob not been tested at all, he could be happily growing inside me. There is no way to know, but the testing could have been too much for him. It could have been too much for the other two normal embryos that didn’t implant in January as well.

My new/old clinic transfers embryos at an earlier stage, generally untested but also undamaged. Now that we know more than 25% of our embryos are likely to be chomosomally normal, we can go back to the new/old clinic and continue with some confidence that it will likely just be a matter of time and patience before one of those embryos sticks and becomes Spork’s sibling.

While we do run an increased risk of miscarrying an abnormal embryo that wouldn’t have been transferred at Celebrity Miracle Clinic, as well as an increased risk for Down’s Syndrome or other chromosomal issues, these risks aren’t higher than any other 38 year old who gets pregnant and are still relatively low. The trade off is that we put the embryos back to their natural environment without damage sooner, which bodes well for delicate embryos.

Armed with this knowledge, today we said goodbye to Celebrity Miracle Clinic. I sent the official form from new/old clinic requesting all my medical records. I called my nurse to tell her voice to voice. It felt a little like an overdue break-up, like severing a slightly dysfunctional but at one time mutually beneficial relationship that is no longer beneficial.

We said goodbye to more than just a clinic with that call today. At our first consultation with them back in July we were so filled with the hope we would wind up on the right side of their jaw-dropping statistics. We were mesmerized by their program and amazing facility. Today we are no longer awe-struck.  We said goodbye to that child like wonder and the certainty that Celebrity Miracle Clinic would swoop in and fix what was wrong.

We also said goodbye to Blob today. Even though I knew at transfer he had a slim chance, I fully believed he would make it. The start of my period today underscored the fact that he did not, something I have known since Friday but becomes so real when this time comes, the time when a cycle officially comes to an end and a new one begins.

While a little saddened, we are also turning a page. I received a call with the plan from the new/old clinic today thus taking our first steps through the tunnel we blasted into our own personal mountain. While the pain of goodbye is still fresh if I dwell on it like the pain of a fresh break up, there is nothing like the promise of a new relationship to help the memory fade.

It’s already time to look forward.

And so it is with infertility as it is with so many things in life.

Stolen Pens

I have been thinking a lot lately about whether or not to share the names of my clinics and have decided against it. However where we are currently going will become increasingly obvious to some of you as we tell our stories. It will be very apparent to you if are at all experienced with IVF and have done any research on the best clinics. It will also be clear to you if you watch a certain reality show on E!

If you do watch that show you have met my doctor, a couple of the nurses, and have seen the building that we affectionately call “The Mecca of Fertility.”

Hint. Hint.

Google it if you want. If you look hard enough you will find it. But I didn’t tell you. Not officially. Being new to this blogging stuff I am not sure that refraining from spilling the beans protects me from legal action but I feel better being a little discrete. If I become pregnant and famous I am sure the clinic would love for me to plaster its name everywhere, not that it needs more publicity. But until that time and not knowing the outcome I think its best if I take the safe route. Especially given the story I am about to tell you.

So yes, our clinic is world famous. The founder is our doctor and he literally wrote the book on assisted reproduction (another reason to fall madly in love with him as discussed in a previous blog). Couples from all over the world come to our clinic in the hopes that their dreams will be realized.  It is the clinic of choice for those that can afford to travel and pay for the best. It is where celebrities go to get help with baby making when they hit the conception wall.

Yes, our clinic is the clinic of the stars and it has the price tag to match. And it is that price tag that turned the Winslow’s into thieves one day in August of 2013.

Most of the clinic’s clients are like us. They have been through multiple cycles at clinics closer to home and have switched hoping to break a losing streak. As result, the clinic is dealing with patients that have already had extensive fertility testing. But that doesn’t matter, every patient has to go back through all the testing again. The clinic feels they are the best, have the best labs, the best doctors, and their reputation is not going on the line based on shoddy work done by a previous clinic.

So no matter what your history the clinic does all the diagnostic testing from scratch in a session they call a “One Day Work Up.” In our case it meant a flight out to see them to do a myriad of tests and an orientation session. This day was spent waiting to meet with billing, waiting to meet with our assigned nurse, waiting to see the doctor for a variety of tests, waiting to give blood and other samples. It was a day of waiting, waiting, waiting. For each appointment we had to check in at one of three reception areas.

Each of these reception areas had an ever so tempting cup of brand new pens with the clinic’s name and logo on it. Nice pens. The good stuff. The kind you would expect from a celebrity’s clinic.

Bored from all the waiting, we decided to make a game of stealing the pens. Our goal was to take as many of those pens home as humanly possible thinking that it would help justify the expensive price tag of the trip. Each time we would check in for an appointment we would find a reason to have to write something down, use a new pen, and take it back to the waiting area with us to stash in my purse. We laughed so hard each time we would successfully “steal” a pen that was clearly there for us to take anyway.

We passed time dividing the number of pens into our estimate of what one full cycle at the clinic would cost us.  This gave us an estimated value of each pen. The more we would take, the more the value of each pen would decline. When it was all said and done, over the course of the day we took 6 beautiful pens. Since that time we have added two more pens from subsequent visits.

Based on our number of pens and what we have spent so far each pen has a value that is still more than some people’s used cars.  As a result, I use these pens all the time. I feel like I have to get my money’s worth.

I also have a sense of pride and a flittering of hope every time I touch one. As much as I like to joke about stealing the pens and the price of the clinic, whatever we end up spending is worth every hard earned dollar . We know that before we give up on the dream of having a sibling for Spork we will have gone to the best and given it our all.

We are uniquely blessed to have the ability to be able to do this. We would never have been able to afford it even two years ago. But we have had a lucky couple of years that have made it possible to shell out the big bucks for the big guns. It means postponing a new addition to the house and really tightening the belt, but I can’t think of another thing I would rather have more than this.

The results of our One Day Work Up didn’t tell us anything new. We looked good on paper. My hormone levels, resting follicle count, and other key factors all were perfect. Bill’s little swimmers were in Michael Phelps like condition. The doctor said he didn’t usually see patients like us. His cases are usually more difficult.

Since then we learned our embryonic cells divide a little more slowly than they should and the optimism has faded ever so slightly. Its a sign that my advanced maternal age could be the reason we are having so much trouble this time. But we are still making genetically viable embryos and that is why we chose this clinic. They were the best to help us answer whether there was still hope for us, and there is.

Whatever the outcome is for our family, Bill and I will be able to rest easy knowing that we have given it our best shot. But if the worst happens, if it doesn’t work, at least we’ll have the pens. All eight pens…and counting.