Friday, June 28, 2013

Decision, and depressed as hell

Thank you all for your input on my last post- I agree with you in that 2 vitrifications should be off the table.  What I was hoping to do was collect the biopsy on day 5, and freeze the biopsied cells. But it looks like that won't be possible, even though I may have been able to get my hands on the materials needed in time.

Doing things in India has the advantage that it won't break the bank, and this is a tremendous advantage that should not be taken lightly. And then, there is the tremendous emotional support that is offered to me by my family.

But one can never have their cake and eat it too- this is a technologically retarded country. NICUs are primitive compared to the setup in the developed world. Fetal DNA analysis from maternal blood (like Sequenom's Tri21 test) during pregnancy is going to take years, if not decades to get here. There is probably one guy who can do a decent aminoicentesis, and I may have to fly my surrogate to another city to find him.  A trophectoderm biopsy is not here yet, or atleast, it is not there with my doctor, who expressed extreme reluctance in doing this procedure. My lack of preparation had an extremely large part to play in this, I just sprung this on him, so he did not have time to prepare, with dummy runs etc.


But there it is- no testing.  I have to just collect whatever grows till day 5, and transfer to the surrogate.

Atleast 40-50% of the day 5 blastocysts  (there was a study definitively showing this) are going to be abnormal. My RE countered that despite such odds, people get pregnant and deliver healthy babies. What was left unsaid was how this is achieved: you transfer multiples. Out of 2 or 3 embryos, 1 may be normal. I'm starting to believe the theory that most women's wombs can distinguish between a normal and abnormal embryo. This may very well be the reason for the high frequency of BFNs in IVF and in natural pregnancies as well. The transfer of 2-3 embryos can also sometimes result in a pregnancy with multiples, which may be slightly or tremendously detrimental to the lifelong health of the resulting children, even if the pregnancy is without complication.

So now, I may have to do what everybody else does: transfer 2 at a time, or I may be doing this for a while, at tremendous cost.  I just have to then pray that if my surrogate gets pregnant, it is with a singelton, not twins. A twin pregnancy is considered high risk in the developed world. Here, given the standards of management, you would have to rely on luck for everything to go ok, and I'm somebody who has had absolutely no luck in this process so far, and now, I have to pray that I find that luck. Scary as hell.

6 comments:

  1. Wishing you the best with the procedure. I hope that yours is one of the success stories heard about in Indian surrogacy.

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  2. I have no words of wisdom, just wanted to let you know that I'm saying a prayer for you, your embabies and your surrogate!

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  3. Rebecca (Which Way to Baby)June 29, 2013 at 12:02 PM

    I know it is scary, and I know it is really hard to believe, but it can be possible for your luck to change in this area even with a tough history. I miscarried a baby, we had 3 failed adoptions, and then I miscarried 6 more babies over the course of 5 more pregnancies. (I make beautiful-looking embryos, and I was in the beginning of my 30s at the time, but many of them turned out to be chromosomally abnormal.) And yet, in spite of all of that, one of the 2 embryos we transferred in our hail Mary attempt hung in there, I had a far more uneventful pregnancy than I ever could have hoped for, a quick C-section recovery, and an amazing 15 months since. We still comment that we can't believe how everything went from being a decade of heartbreak and struggle, which we thought was how our reproductive life would always be, to this. I am hoping so much that you find yourself having similar thoughts a year from now!

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  4. hello Jay....I am sorry you have to worry this way.
    Btw...are you talking abt getting CGH tests done? Is it part of PGD or are they the same? Are you still doing this at DrMalpani's clinic? Sorry for barging in with all these questions. With 4 miscarriages under my belt I too am trying to find out what my next options are :( Your blog is godsend. I really appreciate what you're doing for a naive infertile Indian community like ours.

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  5. Yes Sherin, I'm talking about CGH microarray, coupled to something called a trophectoderm biopsy. The good news is this technology will be in India before the end of the year, through a Delhi-based company called Iviomics.

    The problem is most doctors will have a learning curve or would be hesitant about the embryo biopsy. So there is the bottleneck.

    Choosing or not choosing a biopsy is a bloody difficult call to make...there are many pros and cons either way. Were your losses due to aneuploidy?

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  6. Oh Rebecca..Thank you for saying this. It helps, and your story remains an inspiration. I hope to god that all of us in the trenches are visited by Lady Luck at some point.

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