MicroblogMondays: Great Beta Levels

It’s been interesting to support my cousin alongside her on her fertility journey.  Although she has been trying for more than a couple of years, she hardly ever reads any blogs or joins any online groups.  In those 5.5 year of trying to become parents, I was on many online forums, joined many FB groups, and was a regular reader of many many blogs.  Because of that, I feel that I have a lot more knowledge regarding things like the IVF process.  Many of the questions that she has asked me are ones to which she’d know the answers if she had been following infertility blogs.  I am happy to answer them.  It is just interesting to see the differences in our approaches dealing with our fertility issues.  And now that she is pregnant, it feels even more obvious that she doesn’t know much.  Every time she gets her beta results, she’d ask me if they numbers are good.  I have to reassure her that the numbers have been beyond good.  Here is the lowdown:

Initial beta on 7dp5dt: 80

Second beta on 10dp5dt: 577

Third beta on 16dp5dt: 5582

Those are crazy numbers, aren’t they?  When I saw that her second beta was over 500, I couldn’t help but wonder if the embryo had split.  This value was even higher than Annie’s second beta of 464 on 10dp5dt, and Annie was carrying twins for us.  Dr. E, my RE, said that there is a 1% chance that the embryo would split, so it could still be one very strong embryo.  One day my cousin was scaring me though.  She messaged me to ask if she should do an injection of progesterone in oil that evening.  It was already 11pm her time.  She was supposed to insert one progesterone suppository in the morning and two in the evening.  She only had one left in the evening.  A shipment was supposed to arrive that day but didn’t get delivered on time, so she ran out of the suppositories.  She still had PIO at home from previous cycles so she asked if she should inject some.  I asked Dr. E who answered me right away (you got to love her for her fast response).  Dr. E said that missing one dose of progesterone could cost her pregnancy, and urged her to inject the PIO right away.  My cousin did.  Then she told me that she wasn’t too worried about not receiving the shipment since she still had PIO at home.  It was just that the suppositories were not covered by insurance and would cost $1100, so she asked around and someone was willing to order some for her and ship them to her.  Of course the shipment was messed up.  And now knowing that skipping a dose could cost her pregnancy, saving that $1100 doesn’t sound like it’s worth it at all.  I just told her to always have progesterone around until her placenta takes over.

It does look like her pregnancy is going well.  I can’t wait to see how many babies they see on her first ultrasound!

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MicroblogMondays: My Cousin

My favorite aunt, my mom’s younger sister, died of cancer at 52.  Her older daughter is a couple of years younger than I am.  I’ll call her Jeannie.  I always think of her as very young, but of course it is no longer the case since I am already in my 40s.  She lives on the east coast so I don’t get to see her much, but I love her dearly as I loved and will always continue to love her mother dearly.  Jeannie disclosed to me a while ago (when we were expecting twins via gestational surrogacy) that she had not been successful in getting pregnant with her partner for quite some time.  Her fertility issues are similar to mine (minus the uterine problems): diminished ovarian reserve.  She had tried a few cycles of IVF using her savings.  Since she and her partner are both small business owners, it has been hard for her to come up with more money for more cycles after spending her savings.  It has been extra hard knowing that each cycle she may or may not make an embryo (you know, that’s the nature of diminished ovarian reserve).  She knows the details of our journey and knows that the twins were conceived via donor eggs, so she knows that it is within the realm of possibility.  With limited funds, she had to figure out with her partner how to proceed with treatment: continuing with her own eggs, donor eggs, or donated embryos? Or adoption?  Everything cost money and she wanted to be pregnant and have a baby like.. yesterday.  So how does one move forward when money is short?  Being disappointed over and over again with her own eggs (just like me), she was more and more open to third party reproduction.  Her friend’s friend offered her a frozen embryo for donation but she later found out that it wasn’t good enough for a transfer.  Dr. E (my RE)’s patient had a set of Caucasian/Asian mixed embryos available but for various reasons that didn’t work out either.  Watching her walk this path and walking alongside her every step of the way brings back so many memories of our journey.  There are so many similarities, and it does pain me to see her on the same path as well.  At the same time, because I have walked this path, I am so glad that I can be here for her whenever she needs me.  I know the emotions behind it and I have practical suggestions and recommendations for her.  I analyzed the pros and cons of fresh vs. frozen donor eggs for her.  She eventually decided to go with a set of 6 eggs from a local program because the cost is lower.  Bob and I offered to gift her a sum to cover a part of the cost but she graciously declined.  She chose a first time Chinese donor who hadn’t started the cycle yet so there was a chance for Jeannie to get those 6 eggs fresh.  To me, having fresh eggs to fertilize is better than thawing frozen eggs.  It’s amazing that with her young donor, 4 out of 6 eggs fertilized normally, and three became blastocysts.  Out of the three blastocysts, two were normal.  I can’t help but be very happy and relieved for my cousin.  We had 18 (out of 23) mature eggs, 17 fertilized, and we had 6 blastocyst at the end.  Four were normal.  So compared to our stats, my cousin’s donor eggs did fabulously.  Jeannie just had a transfer of a 512 (5AB) embryo a bit over a week ago.  Her beta was last Friday, which was 7 days past 5 day transfer.  I don’t know about you.  I find it a bit odd that beta was so early for her.  But no worries, as she got positive results for the first time in her life!  Her hCG was 80, which was a fantastic number for an early beta.  When I heard the news, I was so excited for her and at the same time emotional. I’m just so relieved that the first hurdle is over. Her second beta will be today some time.  I can’t wait to see how it progresses and I can’t wait to see my cousin become a mother finally.  I hope that this pregnancy will be smooth sailing from this point on.

We Have a Donor!!!

After we were cleared by our RE last Thursday, Bob and I talked and prayed on and off about the agency donor the whole weekend.  I was still waiting for the clinic donor coordinator to confirm that the in-house donor was still nowhere to be found.  Monday morning, I completed a phone consultation with the patient navigator at my clinic to discuss about the cost of the cycle and the timeline for the fees.  I got a good understanding of what we are getting ourselves into.  On Monday afternoon the clinic donor coordinator confirmed with me that Yes, she still could not reach the in-house donor who said she was going to be available in July/August.  After learning that news, Bob and I decided that the outside agency donor would be the one with whom we would like to work.  I wrote the agency director and notified her of our decision.  She was on vacation at the time and had told me that she’d read her email once a day.  Within two hours, she returned my email telling me that she had emailed our chosen donor to confirm her availability.  Once the donor confirmed, then we would proceed with signing the agreements.

This is the process: when you choose a donor, you won’t know if the donor will work with you until the donor agency director confirms with the donor that yes, she will in fact work with you.  So of course, there is no guarantee.  For all we know, the donor may not feel like it is the right time to donate again, or work/family/school/other things may get in the way.  Basically, life happens.  So Bob and I knew that the email could come back saying that the donor is not available.  The interesting thing is, I had been very calm and at peace about this.  I wasn’t anxious, nervous, or impatient.  From Monday to Tuesday, I just waited patiently for that email, not thinking too much about it.  I told Bob that we could always find a different donor if this one doesn’t work out because obviously if she is not available, then she is not going to be our donor.

The email came right after work on Tuesday, just after 5pm.  My Dear Colleague and I were in our office wrapping things up before we left for the day.  When I saw the email and read the first line, [Donor’s Name] has confirmed her availability”, I exclaimed out loud, turned to my Dear Colleague, and told her what I just saw.  I was tearing up a little bit!  Honestly, I was surprised by my emotions again.  I didn’t think that I would be so excited and relieved about it, given how calm and at peace I had been about the whole thing.  I think it had to do with finally getting positive news repeatedly after receiving bad news for a while.  It’s so nice to know that we are finally moving forward after being stalled for a few months.  I forwarded the email to Bob, who was super excited as well!  He said, We could have a baby next year!  Yes, that IS a possibility!  We could not contain our excitement.

That night instead of cooking, we went out for a celebratory dinner in our neighborhood.  We love this one deep dish pizza restaurant in the city.  The sister restaurant was opened a while ago in our neighborhood and we hadn’t tried it.  We ordered Bob’s beer and our pizza, and was told that the wait would be about 30 minutes for the deep dish.  No problem, we said.  So we sat there and enjoyed our time while waiting for the food.  Way after 30 minutes later, we were wondering where the food was.  The manager came by and apologized to us for the wait, saying that somehow the print ticket was messed up and the pizza was finally in the oven.  To compensate for our wait, he would comp us the pizza and anything that we would like right now to tide us over.  We were in a general happy mood, albeit with a hungry stomach.  We told him that the delay was okay (of course, with a free pizza) and ordered a salad.  At the end, all we had to pay for was Bob’s beer and the tip for the waitress.    Here is our celebratory pizza on the house:

Celebratory Pizza on the house!

Currently we are in the process of getting the following ready: the fee for the donor agency, the agreement between the agency and the intended parents (us), and the agreement between the donor and us.  After carefully reading the agreements, we had a few questions that got answered by the donor agency person tonight.  Apparently, under California law, the donor has to consent to how intended parents handle their remaining frozen embryos after they have completed their family.  If the donor does not consent to 1) donation for research purposes and/or 2) donation to another couple, the intended parents cannot legally do so.  The donor agency person checked our donor’s prior consent with the previous couple and found that she did consent to both, so the prediction is that she will also consent to both for us.  We also were wondering about the pros and the cons of keeping ourselves anonymous vs. disclosing our identifying information.  The donor agency person told me that it’s actually usually the intended parents who would like to know the identity of the donor so that future contact is made possible for any sort of health related issues.  She checked for us and said that our donor is okay with disclosing her information as well as to a meeting.  One is usually scheduled in the evening on weekday at the donor agency that would last for 30 to 60 minutes.  The donor, agency person, and we will sit around casually and chat about anything.  We have opted for meeting with the donor so hopefully a meeting will be scheduled after the agency person returns from her next vacation that will start in a few days.  I asked about donor sibling registry.  Apparently I was the second person who asked her about this in the past week.  The donor agency person said that she has no experience or knowledge about it but she’ll look into it.  Finally, she forwarded us our donor’s psychologist evaluation and made it known to us that our donor took an anti-anxiety drug for a period of time in college for general anxiety.  It’s interesting though, that I too was anxious in my last year of college and in fact had insomnia for a few months.  I eventually went on anti-anxiety drug for a few days.  Anyhow, I spoke with Bob.  Both of us don’t have any problem with it.

Tonight, we are finalizing the letter that we are writing to the donor as part of the requirement of the donor agency to help the donor have a sense of who we are.  I think that this is a great idea and we have put a lot of thought into it.  We detailed how we came to this point of egg donation, the treatment that we had, our backgrounds, how we met, our dreams as parents, and our interests and hobbies.  Most importantly, we are expressing our appreciation for her willingness to give this gift of egg donation to couples who otherwise have a really difficult time to become parents.

Tomorrow I will drop off the signed agreements, the check, and the letter at the agency.  After that, the agency will send the donor’s records to our clinic.  Things will officially start.  Depending on how much testing needs to be done and how much we need to sync our cycles, the wait from now to transfer could be from two to four months.  I am very thankful that we have come to this point, and hope that our donor will have a successful cycle like the one completed in May.  My heart is full of hope.  Praise the Lord for this big step forward!

From now on, we will call our donor Iris, (suggested by my dear friend M) which means this in flower language: “The flower symbolism associated with the iris is faith, wisdom, cherished friendship, hope, valor, my compliments, promise in love, wisdom.”

“You Are Cleared To Proceed”

Those are the words that were written in an email from Dr. No Nonsense’s nurse to me.  I was so emotional I nearly teared up.

It has seemed like many months of waiting, although it has only been four months since we found out that our last effort of my own egg cycles was over.  It took me a month to finally reach the point where moving on to egg donation felt like the logical and acceptable next step in our path.  The processing of choosing a donor and realizing that it wasn’t going to be an easy task was a bit overwhelming.  Once we thought that we could work with a mixed Chinese/caucasian donor, my uterus was not cooperating.  I think I had probably lost perspective along the way.  I had wanted things to move forward at my timeline since I had never anticipated problems with my uterus.  I should have realized by now, after being at this infertility journey for a few years, that when God has a time and a plan for you that do not match your own, there is absolutely no rushing it.  Who would have known that my own RE could not do a simple procedure that even a regular OB/GYN (like the one that I had before) could easily perform?  This is me rushing the timeline, and God saying No.

So what do we do?  We wait.  Right?  Nothing you can do.  In the meantime, I had requested the in-house donor coordinator at my clinic to contact the donor that we liked.  Although originally she had told me that she wouldn’t contact the donor until the month before the donor’s available time, which would be July (meaning right now), she started trying to reach the donor in June some time.  The coordinator and I have since exchanged a few emails.  Each time she told me that she had left voice messages and emails, but still had not reached the donor.  She would try and let me know.

How did I feel about it?  I actually felt okay.  I feel that you don’t have much control over this process anyways.  So if this donor could not be reached, it’s not hard to imagine that maybe God has other plans for us.  I had been reading up quite a lot of posts on the site called “Parents Via Egg Donation”, and came across a post called “The Truth about Donor Po.rn”.  The title totally got my attention immediately. What the heck is donor po.rn?  I read on.  And then it was as if a light bulb went off in my head.  This is basically talking about intended recipients of donor eggs poring over many many donor profiles trying to find the most perfect donor, and once decided on a donor, became uncertain about the first choice and went on to look at more agencies, clinics, and other sites to find a more perfect donor.  The post also talked about it as “The Grass Is Always Greener” syndrome.  So, I see two sides of this phenomenon.  Once you choose a donor and decide on her, do not second guess yourself, because if it works out, the baby that you will have is meant to be the baby that you will have.  On the flip side of it, don’t fall in love with any donors.  If a donor does not work out, then you choose someone else that may work out.

I think I did mention this.  In addition to the in-house donor pool, we also looked at the donor pool of a local agency.  There was one particular donor that we were originally interested in when we first met with the donor agency person.  She is half Chinese, half Caucasian.  She had donated in another city last year, and had only eight eggs and one embryo that was transferred and became a pregnancy for the recipient.  However, there was no frozen embryos left.  She is young (currently 24) and was chosen again for a second cycle by another couple despite the less than stellar first cycle result.  She was going to complete a cycle in end of May and we were waiting to see the results.  I was very pleased when I found out that the second cycle, which was done at a different clinic than the first one, yielded a much better, or I would say, excellent results.  Twenty-five eggs were retrieved and 18 were fertilized.  The recipient transferred two day-five blastocysts and became pregnant.  Six blastocysts were frozen for future use.  I remember reading her profile and liking her answers.  I remember seeing her pictures and thinking that this was someone with whom we could work.  In June, the donor agency person asked us if we wanted to work with this donor.  At the time, we were still waiting for my hysteroscopy at Kai.ser to be done in mid-July, as well as choosing between this donor and the in-house donor who could not be reached.  I was honest about it with the agency person.  And I asked if we could be matched with this agency donor first before I get clearance from my RE so that the donor could start testing early.  The agency person came back saying that usually REs don’t do any testing with the donor until the recipient is cleared.  Oh well, then we just had to wait.

When we were on the architecture river boat tour in Chicago, my phone rang and it was UC.SF’s number.  I knew I had to pick it up.  It was the very nice donor coordinator calling me letting me know that she had been trying to reach the in-house donor but had not been able to reach her for six weeks now.  So she told me to start thinking about other donors.  I was feeling really at peace at the moment.  It is clear that a decision has been made for us.  After all, we don’t have to choose between two donors.  Good thing we did not fall in love with any donors, per advice.  I informed her of the other possibility with the donor agency.  She was pleased to hear that and told me to contact her once my hysteroscopy is completed.

You know how my life was really chaotic in the last couple of months.  With all the family issues going on, all the bad news that we got from doctors about my uterus, and just all the waiting, one could easily feel weighed down.  I know I was.  It felt really heavy that life could feel so grim.  However, I had always held onto the trust and belief that God would one day take me out of the bottom of that pit that I have been talking about.  And plus, it seems that God was giving me that time to physically, spiritually, and emotionally be ready to start the egg donation process.  I went from being nervous, skeptical, angry, and apprehensive about it, to fully embracing the idea of having my own baby regardless of where the genetic source comes from.  It has really taken me a few months to come to this point.  I just want a baby.  And when God blesses us with one, that will be the baby that we will have.  The timing is everything.  If we had started any earlier, then the baby would have been a different baby.

After the successful procedure on Wednesday, I notified the donor agency person that the hysteroscopy had been done, and I had emailed my nurse the results.  Once I get a clearance from Dr. No Nonsense to move on with a donor, I’d let her know.  That was Wednesday.  She said she would wait for my email.  I feel that this is no small miracle that this donor is still available.  Usually donors get picked quickly.  When I saw those words “You are cleared to proceed and identify your egg donor per Dr. No Nonsense” in my nurse’s email at the end of the work day on Thursday, I was so emotional.  Wow.  We have been not-so-patiently waiting for this moment, and here it is.  We can finally proceed with the process.  I notified a group of my very best real life, online, and blog friends, and enjoyed the little celebration that everyone was having with us individually.  

I haven’t emailed the donor agency person yet.  I want to really pray about it and have Bob look over the profile of this donor one more time before we say Yes.  Plus I want to make sure that the in-house donor is still not reachable.  The pros about the in-house donor is that she could probably start her cycle immediately without doing extra testing. Cycling with her would be a few thousand dollars cheaper than using an agency donor.  However, if she is so flaky now, how do I trust that she’d follow through with all the appointments and testing?  I really do like the agency donor, and every time I think about cycling with her, I feel at peace.  So although it costs a few more thousands, and the timeline may be pushed back a couple of months, I still know that it is a good move.  I just hope that my body will be cooperating.  I have been on those birth control pills which cause me to bleed more than any other time.  I thought that once you are on BCP, you don’t bleed.  I bled for days, stopped for a few days, and am now currently bleeding again.  I am not too thrilled about that.  But I know that God has a plan for us.  If that includes me bleeding so we can’t start the cycle until the bleeding is done, so be it.  We have been waiting for so long.  What is a couple more months, right?

So friends, looks like we are moving forward.  This gives me chills!  Our appointment to talk about treatment plans with Dr. NN is on July 27th.  We shall see what he will say about all this.

Will keep you all posted.  Thanks for all the good thoughts, prayers, and blessings you can send our way!

The Beginning of Everything Egg Donation

I know this update is long overdue.  So much has happened since I last wrote about this.  In order to keep the integrity of the whole experience, I will keep everything in one post instead of two.  Please bear with me as this post will be ultra long.

I am Chinese and 5’8″.  My criteria for a donor had been: 1) 5’6″ to 5’9″, 2) at least part Chinese.  I have since relaxed my requirement because of the limited availability of donors.  The height requirement has been lowered a few times.  It went to 5’5″ and then 5’4″.  I had been standing firm at 5’4″.  We would prefer an in-house donor with my clinic because 1) the donors have been screened and are all good to go and 2) the cost is lower without the agency fee and other fees.

The last time I wrote about egg donation was April 7th.  At that time, I was still not quite ready to contact the donor coordinator at my clinic.  However, I suddenly felt an urge to get things moving on Thursday April 9th.  I emailed the donor coordinator the next morning, letting her know that we were ready to move forward with a donor egg cycle.  I specifically asked about three donors in whom we were interested.

Donor 1 is half Chinese half other asian.  She is only 3 inches shorter than I am.  Here is her stellar cycle history:

Cycle 1: 18 eggs retrieved, 15 fertilized, 1 transferred, 7 frozen embryos, live birth.  

Cycle 2: 18 eggs retrieved, 10 fertilized, 1 transferred, 5 frozen embryos, positive pregnancy.

Cycle 3 (cryo cycle): 18 eggs were retrieved and split into 2 cycles of 9 eggs. The first recipient received 9 eggs, 7 fertilized, 2 transferred, and 4 frozen embryos. The recipient is currently pregnant.

Cycle 4: 17 eggs were retrieved, 12 fertilized, 2 transferred, and 3 frozen embryos . The recipient is currently pregnant.

I liked this donor.  I wasn’t in love with her as the answers to her questions on the profile were okay.  She is only 21.  Full asian.  However, she is not available for a fresh cycle.  There is a second batch of seven eggs left from the previous frozen egg cycle.  And she has committed to doing another frozen egg cycle in which her eggs will be frozen in batches for future use.  I asked Bob if he would consider using her 7 frozen eggs since her previous frozen egg cycle yielded excellent results (pregnancy and four frozen embryos).  However, Bob wants to give me the best chance of pregnancy and still believes that a fresh cycle will allow us to do that.  I tried asking the donor coordinator if we could sync the cycle when this donor donates again so we can get half of the fresh eggs instead of the frozen eggs.  She said that unfortunately the clinic won’t allow that to happen.

So donor 1 is no go.

Donor 2 is half Chinese half caucasian.  She’s got the height as she is slightly shorter than I am.  She just completed one cycle with 13 eggs, 11 fertilized, 1 transferred, and 9 frozen embryos.  The recipient had a miscarriage and has not done a frozen embryo transfer yet.  However, this donor is unavailable to donate again until 2016.

Donor 2 is not going to work out either.

Donor 3 is the same height as donor 1.  I was very impressed with her profile and felt her sincerity coming through the page.  However, she is a mixture of caucasian and another asian ethnicity and may have only a little bit of Chinese.  She was in cycle at that time and another couple was already in line to be matched with her.  The clinic’s policy is not to inquire about the donor’s intention to donate again until the cycle is done.  So as far as I am concerned, she is not available.

Donor 3 also doesn’t seem like a possibility.

Just like that, all three donors are not available.  I was disappointed because I thought I had a good chance of having one of those donors.

Bob and I were initially adamant about not going with a donor agency because of the extra cost.  I crunched some numbers and found that going with an agency is doable.  So I started embarking on the journey of looking at donor databases at different agencies.  Agencies come in different shapes and sizes.  Some are national and have donors all over the country.  Some are small and local.  Many of the local ones do NOT have any asian donors.  One well known one in the city actually has 15 to 20 asian donors at a given time, which is quite good.  However, we didn’t see anybody who stood out.  I was remotely interested in one girl who is 5’4″.  That was it.  And the agency director does not provide a password for full access of the profiles until potential recipient parents meet with her.  So we made an appointment for a meeting.  In the mean time, we continued looking.

One day, I received an email from one of the donor databases that a first-time fully Chinese donor was available from the other coast.  She was tall, pretty, and educated.  I quickly forwarded the email to Bob and started daydreaming about the possibility of working with someone like her.  I clicked on her profile and saw that she was already reserved by another couple.  Asian donors are like a hot commodity.  You have to snatch them quickly before they disappear.  Plus, I looked more closely at the cost associated with this agency and the extra cost of working with an out-of-town donor.  Did you know that you have to pay for the travel cost of the donor and a companion of hers for all their hotel, meals, transportation, etc etc.  It adds up in no time.  And someone like her who is a first timer, you don’t know how well she would respond to the stimulation.

Another day, we found another fully Chinese asian donor on another database.  She was within my height requirement and was highly educated.  She had already donated 6 times.  The donor agency coordinator informed me that our current clinic would not agree to working with her because the ASRM guideline is for donors to donate no more than 6 times.  In order to cycle with this donor, who is also out of town, we will have to cycle with a clinic down in the LA area that would accept the 7th donation as well as pay the extra cost of travel.  Uh. No.

And then, I discovered through a donor egg forum that you can actually cycle in Malaysia with Chinese donors.  I found a lady who owns a donor agency there and wrote her.  We exchanged a few emails.  I told her my criteria for a donor.  She sent me a bunch of donor profiles.  The thing is, the donor profiles don’t say much about the donor.  They include the donors’ names, a few pictures, the family’s history, and the reason for donation.  Some of the profiles have a lot of missing information.  And the family history for all the donors say “No” for all the health conditions.  I don’t know how much we should believe that.  I told the donor agency lady the top three choices.  From what she told me later, it doesn’t seem like any of them will work out.  Plus the cost of cycling there is not as inexpensive as going to the Czech Republic.  The cost of traveling plus the cycle would be about 60% of what it’d cost to cycle with an in-house donor at our current clinic.  We also have to factor in the cost of travel and frozen embryo transfer if the first transfer doesn’t work.  Traveling to Malaysia around summer time is pricey.  All these factors make me hesitate in actually thinking further about egg donation in another country.

Finally it came time to meet with the local donor agency lady who has many more asian donors than any other agencies in the local area.  It was a nice meeting. We learned a lot about the cost and the process of working with her.  The take home for me from meeting with her is:

  • If we see somebody that we like, we have to be proactive because the donors will be chosen by others in no time.
  • You pay the agency fees for a donor after you choose the donor.  With first-time donors, you pay the agency fees first, then pay for the donor to go through her screening.  If the donor doesn’t pass the screening, then you would lose the money that you have paid for her screening.
  • If a donor doesn’t work out and you decide not to go with the agency anymore, you will be refunded majority of the fees minus $500 administrative fees.   However, if the donor has started stims already and at some point the cycle is canceled due to no fault of the donor, she gets compensated at a fraction of the fees, ranging from $500 to $1500.
  • We were told to check on the donor database daily for new donors.
  • Working with this agency will be about $5000 more than going with an in-house donor with my clinic.

We were interested in one of the donors who had donated before.  She is half Chinese and is currently doing a cycle.  However, her first donation’s record was less than stellar.  There were only eight eggs and one embryo.  Although the recipient did get pregnant, there was nothing left to freeze.  We were told to call right after her egg retrieval, which is coming up on May 13th, to look at her performance this time.

After our meeting with this lady, I had been checking the website every single day.  I checked one weekend and saw a brand new donor who is half asian (not Chinese).  She was tall (almost my height), very pretty, highly educated at a great university, and young.  My reaction to seeing her profile was very interesting to me.  It was a visceral reaction.  I was shaking.  This was the first time that I actually saw someone that could be a possibility for us, because she was local, tall, educated, and pretty, although she is not Chinese.  However, I saw things that did not add up on her profile.  I won’t go into detail of it, but I wrote the agency lady about it.  The way she explained the discrepancies was less than ideal for Bob.  Plus, another couple with whom the agency had worked for longer got first priority in choosing a donor, and this tall donor was one of their top choices.  We had to wait.  The next day, I showed Maddie, Aramis, and Jane the profile and we were all daydreaming about having this donor for me.  However, I still hesitated because she was a first-time donor and who knows how she would respond to drugs.  I am thankful to have friends who would mull over these things with me.

The next two days, I prayed for God’s wisdom and His hand in making a decision for us.  If this is not the right donor for us, I asked God to move the other couple’s heart so that they would pick this donor.  And also prayer for me to not be disappointed.  The next day, the donor agency lady notified me that this couple had picked this tall donor.  There was another shorter, 5’3″ donor, that was also brand new and 100% asian.  Just not Chinese.  I liked her profile as well, and she seemed much more sincere.  However, do we risk our money on a first-time donor who has no Chinese blood in her?

This made me think of a donor on the in-house donor database at my current clinic.  I remember reading her donor profile initially.  She is 5’2″.  Definitely way shorter than the requirement I had set for myself.  When I saw her profile, I didn’t immediately click on it.  And then one day, I clicked on it and was attracted by her.  She is half Chinese and very pretty.  I was impressed by her answers to the questions in the profile and felt drawn to her. She seemed to have this drive and is very goal oriented.  I loved what she said about the reason why she looked into egg donation.  And I loved that she actually cared enough to fill out the three questions at the end of the questionnaire: what she wanted to let the program know, to let the recipient parents know, and to let the future child(ren) know.  Many donors did not complete that part in their profiles.  She also checked that she was open to communicating with the recipient parents and children in the future.  All in all, she came across as a very open person.  I loved that.  However, I never seriously considered the possibility of having her as our donor solely because of her height.

On her profile it says that her four previous donations resulted in pregnancies.  So I emailed the in-house donor coordinator at my clinic her cycle history.  Here it is:

Cycle 1: 30 eggs retrieved, 20 eggs fertilized, 2 embryos transferred, 4 frozen embryos. Positive pregnancy with the fresh transfer and a live birth. Negative pregnancy with FET.

Cycle 2: 23 eggs retrieved, 16 eggs fertilized, 2 embryos transferred, 6 frozen embryos. Positive twin pregnancy with the fresh transfer and a live births.

Cycle 3: 26 eggs retrieved, 21 eggs fertilized, 2 embryos transferred, 2 frozen embryos. Positive pregnancy with the fresh transfer and a live birth.

Cycle 4: 26 eggs retrieved, 13 eggs fertilized, 2 embryos transferred, 1 frozen embryo. Positive pregnancy with the fresh transfer—miscarriage. FET to be determined.

She is currently 27 years old.  And it seems like the last cycle the results weren’t as good.  However, I also have to keep in mind that the uterine environment and the sperm are also critical factors in how many embryos are made and the miscarriage.  So I wrote to ask for my RE’s opinion.  Given this proven donor who is slightly older and a younger donor who is not proven, which one he would prefer.  The nurse wrote back:

“Dr. No Nonsense thinks she is a good candidate even though she is 27 years of age.  He would go with this  proven donor, rather than the younger donor.  We want to see at least more than 14 eggs and she makes a lot more than this.”

It’s a relief to know that she is a good candidate.  Bob and I got into a very serious discussion about the height.  Is that really a deal breaker?  With Bob’s height (6’5″), does it really matter that the donor is not as tall as I am?  Given having no baby vs. a baby who is not as tall as he would be if he had my genes, what would I choose?  Would I have hesitated if the donor were an inch or two taller?  Given this proven shorter donor and a first-time tall donor, what would I choose?

So many questions.  No one could answer for us.

But the most important question is, is this donor available?  If she was not, then this discussion would have been moot.  About ten days ago, I asked the donor coordinator if this donor was available.  This is the answer I got:

“[Donor’s name] will be available to match and complete a cycle in mid-July/August. Have you checked with your care team in regards to your checklist?”

I immediately updated Bob and wrote the coordinator back.  Our trip is from July 4th to July 11th. She said, “That should not interfere with the cycle as it looks like you both would be out of town around the same time, and would most likely move forward with the cycle after that. The donor is coming in next week to update her labs, so I can let you know if everything checks out for her. I can match you as soon as you have completed your checklist.”

Dr. No Nonsense’s administrative assistant went over the checklist with me.  There are only three things we have to finish before we could be matched with the donor. One is my complete blood count plus platelets.  It is easily accomplished.  At publish time of this post, I had already completed it with normal results.  The second is a saline sonogram to check on the uterine cavity as well as a mock transfer.  I originally was opting to get it done with my OB/GYN using my own insurance to save a few bucks.  However, given the timeline, waiting for my OB would take too long.  This procedure has to be done between cycle day 6 and 12.  AF still had not come on cycle day 44 after my failed IVF transfer.  I was worried that delayed AF would delay the procedure.  AF must have heard the curses I had for her because she showed up that afternoon following my phone call with the admin assistant.  So a saline sonogram had been scheduled.  (At publish time of this post, the saline sonogram has been done.  I’ll write another update.)  Finally, a special semenalysis with strict morphology has to be done and paid for privately (because insurance won’t cover for this special analysis).  This is to determine if regular fertilization, half ICSI, or full ICSI is appropriate for fertilizing the eggs.  This is a matter of paying extra $1000, $2000, or nothing.  We originally scheduled it for end of the month.  However, after the donor coordinator told me that the donor’s updated labs all checked out, and we wouldn’t be able to be matched with her until all the items on the checklist have been completed, I moved up Bob’s appointment to this week. This is what the donor coordinator said: “I am unable to reserve any donor for you and can only match donors to recipients who have completed their checklist. I do, however, believe that there is a strong likelihood that you can match with [donor’s name], and will definitely let you know if someone else ahead of you on the waitlist becomes interested in her.”  So we are doing everything in our power to make sure that we move ahead faster so we can be matched sooner.

All of a sudden, things are becoming real.  We are moving from only talking about it to actually doing things and having the potential of being matched with a donor who is pretty, attractive, with a great personality, proven, and half Chinese.

However, I still battled the height of the donor for quite a few days.  I know that there is no perfect donor out there.  I myself would be perfect for myself.  And I am very far from being perfect. Height WAS the second most important criterion for me.  However, I set my criteria a long time ago not knowing the extreme difficulty of finding a donor that would match the height, ethnicity, and prior successful donation criteria.  Even when I saw the “perfect” donor with the height and ethnicity, they didn’t have some other things that I didn’t know I was looking for.  Cost and distance are a problem with some of these “perfect” donors.  Plus I didn’t know that I actually care a lot about how attracted I am to the donor’s personality.

So day by day, I have been feeling better and better about the donor’s height.  And day after day, I have been feeling like that this is becoming less of an issue.  Eventually it will become a non-issue.

One day Maddie asked me how I felt about this whole thing and if I was at peace with it.  This is my answer to her:

“I feel like some force is leading me to that direction.  Given all the people lining up in front of me, all the ones that we had come across and been given a choice to pick, I think I would still pick her.  It just works somehow, with her personality, her ethnicity, her looks, and her fertility history.  I was thinking, if the tall pretty donor was available to us, putting her with the current donor together, I would still choose the current donor.”

The force is God.  I have been praying daily for Him to lead us in the right direction.  Somehow things have been working out with her.  The more Bob and I talk about this donor, the more we are excited about the possibility of the future.  I am so grateful for having friends who have gone through this process ahead of me.  Other than excitement, I have also been feeling doubtful, terrified, ambivalent, and a whole other gamut of emotions.  I confirmed with Aramis that these are all very real, normal, and legitimate feelings.  Good to know that I am NOT going crazy, that it’s okay to feel positive and negative about the same thing.

Okay there you have it.  Over 3400 words for this post.  This is a first for me.  I guess I did have a lot to say.  😉  I will let you all know the results of all the tests and whether we will be matched with this donor.

Therapy – Round Two Session Two

Session two with  my therapist was very productive, as usual.  She started out asking me how I had been feeling.  Honestly, I thought that I would be more sad than how I have been feeling.  I am very surprised that I can carry on my life like usual.  I don’t think I am being avoidant by brushing aside my feelings.  My therapist wondered if my calm feelings have to do with my mental and emotional preparation for egg donation since last July.  I have had so many months to get myself ready for it.  Now that the time has come, maybe the shock is not as great?  That may be the case.  I just know that I have been feeling good in general.  I am still not ready to contact the donor coordinator at my clinic.  I still have not written an email to donor agencies.  I haven’t even asked for our money back from the clinic.  I am not ready for these steps yet, but I feel good in general.  My therapist did mention that some women may feel periodic sadness during the egg donation process because it would start to feel real.  I will wait to see if that is true in my case.

I still feel a need to be distant from Chloe, my friends who said some hurtful things to me.  When Bob and I talked about plans for the summer, driving up north to visit with her and her family was one of the options.  After our little incident, I am not ready to see her.  Hence we decided to go to Chicago instead.  I told my therapist that I really don’t want to risk being there with Chloe in the middle of a egg donation cycle.  I don’t want to hear anything negative about what I am going through, although I believe that she’ll be very careful from now on when she talks to me about my fertility journey.  I just don’t feel like taking a risk.  My therapist told me that it’s okay to guard my heart and protect myself.  I somehow feel a little guilty for not going to see my friend, but then I really feel the need to take care of myself.

My biggest question right now is how to go about choosing a donor.  Given the few choices at our current clinic, do I have to venture out and check out donors at agencies?  One night Bob and I were lying in bed looking at all the choices at my clinic.  Now that he has to pay for the cycle for real, he is vetoing all the choices.  I don’t know if he’s joking or not.  But he has his criteria.  At the same time, he also brought up doing what Aramis did, which is to cycle at the Czech Republic, purely for the more affordable cost.  The only problem is that, it’s going to be even harder to find an Asian donor all the way in  Europe.  That would leave us with non-Asian donors as an option.  I actually thought really long and hard about it.  We not only have to think for ourselves and our lives, but also our future child’s life.  We are accountable for creating his/her story.  One day, we are responsible for telling our future child how and why we chose our donor.  I do not want to tell the child that the only reason why we chose to find a donor in an European country is because of its low cost, especially when we have the financial means to cycle here in the US.  It’s another story if we don’t have enough funds for that.  I am really mindful of the impact our choice has on our future child.  So I am going to try in all my power to decide on someone who has some connection to my ethnic background.

My therapist gave me some good points to think about.  She asked me to whom I feel the most connected out of the three potential donors.  Setting aside how “Chinese” these donors are, I feel the most connected with a first-time donor who is currently cycling.  I like her looks, her age, and her educational background.  The most important thing is that I love how she answered her questions in her profile.  Her responses are so thoughtful.  I want to be able to tell my child in the future the specific reasons I chose a particular donor.  I want to be able to say what I loved about her.  Of course I know that not every single donor would work out but I want to let the child know that we take this selection process very seriously and it has been done with love.  My therapist said that this is exactly how she wants me to start thinking about it: the reasons why we want to choose a particular donor.  She wants me to be able to tell my future child the story of choosing a donor with confidence and the particular quality that we find appealing about the donor.

My therapist asked me to think about how I usually make my decisions in life: with many choices, or a few choices.  Thinking back, we usually had three to five choices when we tried to decide on a fertility clinic both the first four rounds and the last four rounds.  Any more than that, it just felt too complicated and dizzying for me to process all the information.  If that’s my pattern, then my therapist thinks that having three potential donors to think about is a very good first step.  She said that some people bring in a whole spreadsheet of donor choices to show her.  To her, that will make it even harder to make a choice because the information of different people may get mixed together.  I am not someone who would create Excel spreadsheets for choosing a clinic or a donor, although there is nothing wrong with that if it’s your style.  So I will stick with the three potential donors that I have right now.  My therapist told me to continue to use my own intuition as I am quite in tune with my feelings.  She said I would know if I want to venture out to find more choices.

We also talked about transferring one vs. two embryos in the future.  I feel strongly about avoiding carrying twins because of the higher chance of premature birth and complications for both mom and babies.  I would rather do eSET repeatedly until we get pregnant.  Although Bob really wants twins and supports transferring two embryos, my therapist told me that it’s perfectly fine for me to be firm on my stance because I will be the one carrying the child.  I am afraid of the chance of an embryo splitting into two.  A single embryo transfer is the safest way to go.

Finally, we discussed about my fight with Bob the previous weekend.  I forgot what exactly we were fighting about.  But it seems like every fight comes back to the struggles of infertility.  Bob is still trying to resolve his feelings regarding the failed cycle and all the time and money that we have spent cycling with my own eggs.  During the fight, he asked why we did not consider adoption or egg donation sooner.  It sounded to me that in that moment, he regretted spending time and effort on these own egg cycles rather than focusing our energy on the other means to get us a baby.  I don’t think he truly regrets it.  But he has been angry with not being able to have a baby and it’s natural to think back and wonder about all the what-ifs and what-could-have-beens.  I do not regret a single thing that we did.  I reminded him that we made the best decision given the information that we had in the moment.  I would not change a thing about the past.  It was the past that brought us to this moment.  We prayed and we had peace about every single step.  I believe that we’re led down a path that will eventually guide us to our baby.  However, it was tough to emphasize on this point when he was angry.  My therapist said that it seems like Bob just wants a sense of control, because this process does not provide him (or anyone) with any control of the situation.  This is why he finds comfort in striving to reach our financial goals, because they give him back the control that he can’t have with the reproductive process.  However, it’s not good to have regrets.  So it’s important for him to work on getting over these feelings.  In terms of what means we use to have a baby, my therapist said that she usually asks if carrying a baby is important to the couple.  If it is, she would suggest egg donation or embryo adoption.  If it’s not, the adoption would be a logical choice.  I have been feeling strongly from day one about two things: being able to be pregnant and carry to term and having at least the genetic links to my husband.  Since these things are so important to me, egg donation is the logical choice for me.  Then we should focus our energy on grieving the loss of my genetic links and our effort on pursuing egg donation.  I know that Bob has the fear of failed cycles after spending all the money on egg donation.  We have to have faith in God for carrying out His plans, whatever they may be.  A couple of days after the fight, I asked him how he felt about egg donation, he said that of course we would proceed with it when we are ready.  So we are still on the same page about the next step.

At the end of the session, I felt a lot better about my ability to navigate the world of egg donation in the very near future when I am ready.  I also felt that it might be beneficial for Bob to come to a session once with me so that we could both talk about our feelings.  Unfortunately, my therapist is about to go on maternity leave and doesn’t have any early evening time for us.  She gave me the names of a few therapists in town that also specialize in infertility.  I am sure I will seek help if I need it.  But I’d rather not go with Bob to see these new people as they don’t really know me.  I do feel equipped to move forward when the time comes.  I just have to wait for the right moment.  I hope that moment comes soon.

“Keep Doing What You Have Been Doing”

Although I hadn’t been feeling too sad, I was looking forward to seeing my therapist.  My three sessions with her last year were so beneficial to me for sorting out my thoughts and feelings.  I was hoping that I could get a few sessions in before her maternity leave.

I arrived early as usual.  Knowing that she is eight months pregnant, I wasn’t worried about my reaction to seeing her bump.  I have to say that she did not look like she was about to give birth.  She seemed to be very mindful of her choice of clothes as her sweater was big and did not hug her body.  My pregnant coworker who wears tight fitting clothes probably shows her bump more than my therapist does.  I commented on how great my therapist looked at this late stage of her pregnancy and asked how she was doing.  She said she was getting a little bit tired but overall had no complaints.

Once we sat down, she said that it was great to see me but she was sorry that it was under these circumstances.  The first 30 minutes were devoted to telling her about all that had happened in the past eight months since I last saw her.  The last time we saw her, we had not even started with U.CSF yet.  And I bet she wasn’t even pregnant with IVF yet.  It really had been a long time.  I updated her on the following:

  • First cycle in August was canceled because of a cyst
  • First cycle take two in September went well with four eggs, three fertilized eggs, and three embryos to freeze on day two
  • Second cycle in October with our surprise eggs from two little follicles so three eggs turned into two fertilized eggs, and then turned into two four-cell grade one embryos
  • Third cycle in November was long drawn out due to lack of response to Clo.mid and a subsequent natural IVF cycle yielded two follicles, one egg, and none fertilized
  • Intended fourth cycle could not take off due to lab closure for the holidays
  • Intended fourth cycle still could not take off in January due to a cyst, decided to move on with the cycle anyways, ovulated before cycle day eight, tried to grow follicles in the luteal phase, eventually follicles shrank, bled three times and ovulated twice in 23 days.  My body was screaming “GIVE ME A BREAK”
  • Finally fourth cycle started in February, unfortunately with a cyst again.  Still decided to move forward with natural IVF without medications.  Grew two follicles on my own.  Despite Gani.relix to hold off ovulation, ovulated prior to egg retrieval.  Still tried to retrieve but there was no eggs. Converted to IUI with 20 million sperm post wash.  Transferred all five embryos due to lab error of thawing more than we wanted.  Negative beta.
  • Met with Dr. No Nonsense to discuss egg donation

As I recounted all the details to her, I was a little choked up.  I didn’t cry as I didn’t feel like it.  However, I was a little emotional.  We went through a lot as a couple.  Since the very first cycle with Dr. E until the last cycle with Dr. No Nonsense, we have always had to make many last minute decisions that could alter the outcome of each cycle, hence the pregnancy outcome.  Through all the ups and downs of this roller coaster ride, my heart is set on not spending more time and energy on my own eggs.  I feel very strongly about that.  I really cannot bring myself to go to a monitoring ultrasound to check my antral follicles, to take any oral meds or do injections to boost follicle growth, and to wait and hope that I haven’t ovulated prematurely/we get eggs/the eggs fertilize/the eggs continue dividing/we have embryos to transfer.  I really cannot go through with this process again.  However at the same time, I still feel sad that other people achieve what we can’t.  I see other ladies with diminished ovarian reserve who have better cycles than we do and they miraculously get pregnant.  I fall into that trap of wondering “why them and why not me?”  Despite these feelings of inadequacy, my quest to have a baby with my own eggs has ended.  This is a very personal decision.  I am sure that many women in my situation would choose to try a few more cycles.  However, to me, doing fertility treatment with my own eggs for eight cycles is enough to tell me that it is time to move on to the next chapter.

And I am very grateful that my therapist is there to help me sort through these thoughts and feelings.

I told her all the things that I have been feeling and all the things that I have been doing to help myself feel better.  I cry when I am sad.  I talk to people.  I take time off when I need to.  I told her the whole thing with my pregnant coworker as well as my out-of-town friend who said mean things to me.  My therapist gasped and agreed that my friend’s statements were hurtful and insensitive.  She told me that it’s important to set healthy boundaries with people, including pregnant coworker and this friend.  I told her that I am feeling okay.  This time it feels so different from last year.  We have a plan.  I have been mentally preparing myself for egg donation since last July. So it feels like I have had a lot of time to digest the possibility.  I also firmly believe that my emotional stability has to do with all the prayers that we have received since the beginning of our journey with U.CSF.  God really has watched over us and been with us every step of the way these many months.

I told her that I am still not ready to write to the U.CSF donor coordinator or to contact any donor agencies yet.  I haven’t even written the billing lady at the clinic regarding our refund for all the procedures that we didn’t do (no eggs, no culture, no ICSI).  I am simply not ready.  She told me that it’s totally okay to take time for myself to be ready for the next step.

We discussed a little bit about choosing a donor.  My husband and I finally looked at the in-house donors again.  We used to joke about having donor 1 or donor 2 as our donor.  And now that we really have to pay big money to find someone, Bob all of a sudden becomes picky.  My criteria come down to proven fertility and decent person with decent height.  Bob seems to have a longer list of his wants.  There is a full Asian donor (half Chinese) who is really young (21) and had four donations that resulted in four pregnancies.  I think she could be a good choice, but Bob has reservation because she did not go to college. She is so young though.  You just don’t know what she’ll do in the future.  Anyways, Bob vetoed almost everyone on the list and wanted me to consult with donor agencies.  My therapist told me that my choices and Bob’s choices will be very different because women usually value proven fertility more, and men just want to find someone who is like their wife.  So we will eventually have to come to a mid point.  Nobody is perfect, but we will really have to be comfortable with our choice.  The therapist thinks that I am very in tune with my feelings.  So she is confident that I will come to a choice with whom I am comfortable.  She also told me to consider my feelings around my future child(ren) having half siblings running around due to the donor’s successful history.  I haven’t really thought about that, so I’ll have to give it some thoughts.

At the end of the session, my therapist asked me about the timeline, i.e. when we’re looking into doing a DEIVF cycle.  I said three to five months.  She was relieved to hear that.  She said she was worried that I would say next month, because she thinks that I will still need some time to grieve and have closure for the loss of my genetic links to my future child(ren).  And then she told me this:

“Just keep doing what you have been doing.  I am here to help you.”

I come out of the session feeling empowered.  Life is full of possibilities again.  And I get to talk to her again next Wednesday.

I am grateful for that.