Thursday, April 23, 2015

Which Do You Want First - The Good News or The Bad News?

Today was our visit visit/appointment with the new clinic.  Granted we have been communicating like crazy over the past month via phone and email (sending medical records, contact information, tentatively setting procedure dates, etc.) but it isn't "real" until you see things for yourself in person.

As I have mentioned before, there are only a handful of infertility clinics in the Twin Cities (soon to be one less).  Of that handful, there are two standouts - our old clinic and our new clinic.  Both clinics are consistently mentioned as the top clinics year after year.  Both clinics have good stats, and top doctors, etc. etc.  Our reason for choosing our old clinic was really luck of the draw.  The names of the two clinics are very similar.  While looking for clinics we happened across our clinic's monthly information night.  We went to the information night and just went from there.  So, if we would have happened on the new clinic's information night we probably would have ended up there.

It's all water under the bridge at this point.

We thought that the two clinics were probably pretty much the same, so we were pretty shocked when we walked into the new clinic.  The old clinic was, for lack of a better word, very clinical.  The waiting room looked like every other depressing clinic waiting room - neutral colored barely comfortable chairs arranged in boring rows - one right on top of the other.  Everything seemed efficient.  Not warm.  Not welcoming.  Efficient.  Doctor consultations were held in similarly depressing, efficient conference rooms.  If the doctors had offices they were tucked somewhere in the back of the clinic.  I bet that they were similarly depressing and efficient.

When you get off the elevators at the new clinic you see paneled wood walls - not icky old paneling, some beautiful dark wood that was stained within the last few years.  The reception desk is similarly paneled and hosts several receptionists so that no one has to wait very long to check in.  The waiting area is very large and hosts large comfortable chairs and couches arranged in small groupings with tables and beautiful flower arrangements sprinkled throughout.  It felt more like the lobby of an elegant hotel than the waiting room of a clinic.  Spending tens of thousands of dollars was somewhat softened by this waiting room.

Our appointment was primarily a consultation.  Instead of being whisked away to a terrible conference room we were guided to our doctor's office.  His office featured a giant desk of the same dark wood featured throughout the clinic with bookshelves full of awards, books and other impressive items behind the desk on the back wall.  It felt more like the office of a top executive than a doctor's office.  Well played new clinic.

We started by expressing gratitude that we were able to get in with the clinic and especially that they were able to tentatively hold procedure dates for us.  When we received the news that our old clinic was closing we were panicked that this would move our plans back by several months.

Then they did the craziest thing ever....they thanked us for coming to them.

What?  A clinic thanking us.  That's crazy talk.

The clinic is supposed to make us feel lucky like they are even considering us a patients - not thank us.

The new clinic is definitely A LOT different than the old clinic.

We talked through the steps of the process and timing.  All things that we expected.

Then the doctor threw a curve ball at us.

The old clinic was going to thaw the day 3 embryos and transfer as soon as possible after thawing - similar to what the India clinic did.  The new clinic wants to thaw our day 3 embryos and attempt to grow them into day 5 blastocysts.

Both our old clinic and the India clinic froze embryos on day 3 for a reason.....they did not expect them to make it to day 5.  On day 3 we actually had 6 embryos on day 3, 4 were frozen and two were left to try to grow.  Those two made it to day 4 and then expired.

We understand the reasoning behind growing the embryos into blastocysts.  If a fertilized egg can make it into a blastocyst (day 5 or 6) it's chances of actually turning into a viable pregnancy are significantly better than that of an embryo (day 3).  The doctor would rather transfer 1-2 blastocysts than 4 embryos.  Why make our GC go through multiple transfers when we could only do one good one.

That is if we actually have a transfer.  If none of the embryos can make it to day 5, then we will have no embryos to transfer.

And these are our last 4 embryos.

Then came another curve ball.....have I thought about attempting to carry a pregnancy myself?

While the day 5 surprise was unsettling, it was nothing compared to the pregnancy surprise.

The doctor only asked this question because we were talking about next steps if the transfer did not take.  We know that we may not be able to use my eggs at this point, which means that we would need to look into donor eggs or donor embryos, which means that I would become completely separated from the biological process of creating our child.  This is a very difficult situation to be in.

Carrying the pregnancy would put me back into the process.

I understand that my carrying ability is technically untested.  My losses were very early.  My symptoms with the second pregnancy suggested a second trimester loss.  My uterus size suggests a second trimester loss.  There are many documented cases of second trimester losses with unicornuate uteri.  However, there are also those who are able to make it into the third trimester and deliver near term babies.  These wins often come after several losses, and these wins are the exception and not the rule.

Through tears I explained that I don't think that I would be able to recover from another loss of my own, especially a later loss, and that I was not willing to put my own life at risk.  My husband vehemently seconded that opinion.

Our doctor explained that he was simply making sure that we were exploring all of our options and quickly dropped that subject.  We tried to wrap up on a high note, but left the office feeling sad and much less hopeful than when we walked in.

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