Wednesday, August 29, 2012

All about CGH microarray---part 1

I had my visit with my RE yesterday, with my parents in tow. Coming back to India, with the difficult choices to be made, I had expected no step of this process to be easy, and that was proven right with a vengeance yesterday. And its not even a process that should be easy, these are extremely difficult decisions, with a great deal of grey area and a lot of room for arguing pros and cons for any particular fork in the road. Unexpectedly, the point I had expected to be the sticking one, surrogacy, was more easily settled, but another point provided a great deal of debate-- that of genetically testing the IVF-generated embryos.

First, lets segue to another point, that of treatment choice in itself. Both my RE and the MFM specialist I saw in the US gave me the impression that of all the treatment options they would offer as the first choice, an IUI conception (probably with ovulation-inducing drugs thrown in) would be a top choice, and possibly, many of you reading would also agree. This stems from the finding that even women who have had 5 losses have a good chance (is it 50%?) of carrying to term in the next round. This is where the patient and the doctor part ways I think. The patient looks at a 50% risk of going through the hell they went through previously, and may balk, for good reason, I should add. Nobody who has not experienced that reason, personally, (being a truly empathetic audience is not good enough), will  understand why.

I personally, am invested in making the risk of miscarrying/late loss lower. That is all I'm about. I'd love to eliminate that risk entirely, but I know all I can do is make the risk as low as practically and economically possible (and everybody's capabilities here are different), but I can never, ever, despite the best laid plans and all the plotting, planning, testing and novel approaches (IVF, PGS and surrogacy included), can I make that risk go away. Despite all you account for, things can go wrong in yet another way, I am so blindingly, painfully aware of that, far more so now, than 2 years ago.

My doctor proposed a novel  exercise, and its one that is pretty useful and logical- consider and write out the 'cons' of pre-genetic screening of embryos.  I'm doing that, but more for my parent's benefit (they need to understand why I'm proposing this, instead of following the doctor's advice), I'm also going to write a 'Pros' list. This list of pros and cons should be useful for anybody who is at the cusp of this difficult decision. This is coming up in the next post...stay tuned.

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