Wednesday, July 21, 2010

Have you considered ...

In brief: a post in which I scratch the surface of embryo donation.

DinoD asked whether I would consider trying with donated embryos
(thanks for that question by the way, I had almost forgotten about
that option). So would I? Yes and no.

The law here* dictates that embryo donation has to be absolutely
anonymous (I double checked). Personally, I'm strongly
in favor of a measure of openness. At least, I would want my child to
be able to find out something about it's biological parentage at 18
(or younger even).

Besides that, I doubt we would even be allowed on the waiting list. I
assume donated embryos are reserved for those couples who can't make
their own. Likewise, I presume that having a bio child rules us out.
Even if the law doesn't say so, the clinics' own rules might. I can't
find this info online, oddly.

What about abroad?
When I heard about the 'snowflake programs' in the U.S., I toyed with
the idea. A holiday with an extra special souvenir, wouldn't that be
great.
Thing is, I heard about it in the context of - how to put this - the
ideological tug-of-war about ART. Think the 'every-sperm-is-sacred'
sketch by Monty Python, only without the slightest humorous
intention.

I can't see us getting through the screening of any religiously
inspired program. What can I say, non-practicing is rather the norm
here. I suppose there are secular donation programs too, but I would
have to investigate.

Very briefly, I researched possibilities for embryo donation in
Europe. In a number of countries embryo donation is banned outright,
in others the law allows anonymous donation, and in one or two the law
allows open** embryo adoption.
Interesting to know, however, I noticed lots of talk of very long
waiting lists on the local forums there ... and of trips abroad. In
some countries, clinics advertise embryo donation - no waiting list -
from professional (anonymous) donors! Tempting, I admit. No prices
listed online though.

Didn't the Genius bank have a embryo bank spinoff? No, too bad.


* Not specified where, for the sake of anonymity.
**'Open' meaning that the child has a right of access to information
about his biological parents at 18.

Friday, July 16, 2010

Where were we?

In brief: next attempt in August, same protocol but with placebo sauce.

Oh yes, of course, chalking up PG colleagues (another, indeed) and not
thinking about quitting ART. Quite the opposite, I've gone so far as
to plan another attempt this August.

We had a consult with Bigger Clinic in June (and then promptly went on
vacation). We chatted a bit about the previous cycle. Odd, the doctor
remarked, only 5 of your 10 follicles were harvested. I remember
finding that odd as well at the time, but the doctor that had
performed the procedures said the other were too small, the eggs in
them wouldn't be mature.

Then we moved on to talking about next time. In terms of trying
something new, there's little on offer. The doctor suggested changing
the protocol to a short one with different medication (Folli.stim).
I recounted the tale of our second IVF attempt, the only time with
Gona1-F, where we had 6 follicles in stead of the 10 to 12 with
Meno.pur, and asked whether this was the same. Not exactly, but
almost.

So we decided to stick with what we know (and have stashed away in the
fridge). Once we left, I felt a niggling doubt though. Should we have
tried a different protocol? Sure, the doctor SAID he only suggested
the short protocol because it's easier on the patient. But, what if
...

Meanwhile, I saw my RE at the Local Clinic, who reassured me that one
protocol or the other wouldn't make that much of a difference. He
agreed with Bigger Clinic's assessment, the choice we have is to keep
trying the same or quit (that was the gist of it).
He could only come up with one other thing for me to try, being an
endometrial biopsy. Not quite scientifically validated (insufficient
data), but based on more than anecdote (a few papers in Pubmed, that I
found). Supposedly, the slight injury caused by the biopsy causes a
response that is beneficial to implantation in cycles soon after.

On the scale of placebo*, it rates moderate. It's intrusive, but not
more so than a pap smear, not painful, not very costly and too quick
for much theatrics. Extra points if the test results are positive for
infection, then pills are involved.
So, I'll just hope its for real, cause naturally I agreed to trying it.

*
Fun studies have shown that different methods of delivering placebo
have an impact on their perceived effectiveness, depending on these
criteria. Saline injections 'work' better then sugar pills, ...