Sunday, November 1, 2009

Shopping Doctor's Offices & Treatment Plans

Chris and I are in the process of researching doctors, methods, embryologists and a whole assortment of issues concerning how you do this. Some things we have learned so far:

1. This is a profit driven part of the medical community. These are elective medical procedures so some of these guys tend to be used car salesmen of sorts in how they manage their offices. That is a little bit tough to wrap your brain around. I know this is a business to them, but this is my family. My children. I am trying to get into the flow of it, and learn to play the game. Man, I wish I paid better attention in high school biology. It would certainly make this whole thing easier in terms of learning what is involved quicker which helps lead to knowing what questions to ask, and what I should be fighting for.

2. They are not necessarily the happiest of places. These miracle workers are making couple’s dreams come true, yes, but at the same time, no one really comes here joyfully. There is an air of desperation and defeat. The typical clientele has come here because either they have been trying to get pregnant for a very long time and can’t, and meanwhile has watched all of their friends and relatives get pregnant around them. Or there are others like us that have suffered devastating losses through either multiple miscarriages, or loss of actual children, again, while watching their friends and relatives do it so easily. I don’t envy these guys and the work they do. It is incredible what modern science can accomplish, but holy cow, the emotional side of this is pretty profound.

3. Everyone has a different philosophy on how it should be done. We are currently stuck in analysis paralysis. We have no idea what’s the best way to go. We have talked to two different doctors, and both have completely different viewpoints on what we should be doing:

Doctor #1 – He takes into consideration our long term goals as a family, and is aggressive about taking out enough eggs to create enough embryos so that we have enough to account for at least 25% of them being sick, others that would be immature and not be suitable for implantation, others that would die off when subjected to the genetic testing, etc, so that we end up with enough to get me pregnant this time, and another time in the future if we so choose. I would be subjected to about 3 rounds of egg retrieval, or 3 months of treatment. That means 3 months of the hormone injections, 3 outpatient surgical procedures to collect the eggs, lots of monitoring and being in and out of their office and such. The most expensive part of this is the collection of eggs, fertilizing them, turning them into embryos. If we go this route, then we would bear all of the worst of the cost up front, and be set up for the long haul, whatever we want for our family.

Doctor #2 – She says that she strongly suggests only doing one round of egg retrieval. She says that being on these hormone injections along with the outpatient procedure to collect the eggs is no small thing, and that it can have a severe impact on my overall mental health. Given the fact that I am grieving the loss of my son, this is something we should consider strongly. Another reason they do it this way with only one round of retrieval is that when you freeze and thaw out embryos, you lose some of the success rate. It is just hard on them to weather it. Some will not survive it, and some will not be as good when implanted. The best way is if you can avoid that whole process entirely and implant them when they are fresh. If there are any leftover, then they will freeze them, but with the understanding that they will not be as good after having been frozen. There are, to date, no tests showing that it causes any problems with the children later down the road. It is just during implantation that you see problems with survival.

There is a third doctor in town that we have yet to consult. He is by far the most expensive (from what we have heard). We need to make an appointment to go talk to him and see what his thing is. I am scared he will have a completely different viewpoint that the other two doctors, which would make this whole thing even more confusing.

4. No doctor is willing to say any disparaging comments towards another doctor. So, crap. Now what do we do? We have made connections with some really great doctors throughout the course of having Noah, but no one will say anything about who is good or, more importantly, who is bad in this whole thing.

The learning process is ongoing. I will feel a lot better about life in general when we have a plan. This not knowing stuff is really eating at me. I have been told by these doctors that we can’t implant an embryo until it has been a full six months since Noah was born to give my uterus enough time to recover, and to get my hormones back on track, which will be January, so we do have some time. Any thoughts on this? I’d love to hear it.

1 comment:

alaskaem said...

Wow. Go with your gut. Who do you like best? Who do you trust the most? Who appears to be willing to give you the type of care you want for you and your future family.

You are amazing and I cannot wait to read about how things progress.