I have to cycle again. Perhaps twice. If you are familiar with this blog, you know that my body hates stims and we create very few, if any, blasts. The thought of cycling again fills me with such sadness and stress. But I will cycle again. The question is (was), where? We are currently at one of the best clinics in the country: RMA of NJ. However, we did consider doing our next cycle at CCRM, which is, in my opinion, only a marginally better clinic. The biggest pro for CCRM is that unlike RMA of NJ, they will take my husbands morphology issues seriously. RMA has continually brushed off his problem as something that could be fixed by ICSI. I think we can safely say that ICSI did not solve our main infertility issue. CCRM will perform IMSI, as well as run DNA fragmentation tests on his sperm. RMA refuses to/cannot do these things. Having said that, the biggest con with CCRM is a deal breaker for us: if you do not meet their quantity requirements with blasts, you have no say in the type of genetic testing they perform. We will not move forward without 24 chromosome PGD, so CCRM is out. There are other pros and cons for both clinics, but the deal breaker is really all that matters.
Edited to add: There is some confusion as to whether CCRM will allow you to push to blast and do CCS testing if you only have 1-3 embryos. Just today they seem to have reversed their position, but it appears to go on a case by case basis.
Edited again: Correct me if I am wrong, but CCRM will not allow you to gender select. They can also no longer use human growth hormone during stim cycles. These are very big cons against CCRM.
We have made an appointment with Dr. Braverman in New York. While I know some people do not believe in reproductive immunology, I have witnessed multiple friends find pregnancy success after dealing with immunology issues. Moreover, Dr. Braverman takes morphology issues seriously. He will test my husbands sperm DNA. He will offer him a treatment plan and put him on supplements, etc. And this will hopefully, finally, yield us just a few more blasts. I am not greedy, I will take 2-3. We aren’t reaching high here. Dr. Braverman will also manage my clotting factors (alongside my hematologist), as needed for pregnancy. And of course, there will be additional immune testing, on both of us. To be honest, I am hoping that Dr. Braverman takes enough of an interest in our case that he will also manage our IVF cycle remotely.
Unfortunately Dr. B is out of network and his services will be 100% out of pocket. After 17 months of infertility treatments, this is quite an expensive pill to swallow. In fact, over the next 4 months, the amount of money we will have to spend on infertility treatments (again), is overwhelming. Besides the out of pocket costs at Dr. Braverman, estimated at $3-5,000 with testing (pre pregnancy), there is the CCS testing costs at RMA, $4,500-7000, plus costs of meds and various cycle expenses, $10,000-30,000. Insane amounts of money. It makes me sick to my stomach.
To those of you that asked, I chose the D&C specifically because I wanted to send everything from the procedure to pathology. The results should be back within 2-4 weeks. We want to learn as much as we can. We could fall within the 5% margin of error with RMA’s CCS testing. It’s a long shot though. I am preparing for pathology to result in no answers.
Our 12 year wedding anniversary and my husbands birthday fall within the next 3 weeks, so we have decided to spend a long weekend in Puerto Rico. We used to do this trip often, pre-infertility treatments, and I think (hope) it can be a healing getaway for us.
It feels wrong to type these things above, because I don’t want to diminish the past 9 weeks (or 17 months really). I don’t want our little guy, and this pregnancy, to be brushed under the rug so easily. I will just ask that you do not comment that you are happy we have a plan, or that we are moving on. Please. Don’t. We are not happy. We do not have a plan. And moving on will take a good long while.