Wednesday, 30 June 2010
That warm fuzzy feeling...
Between me and the Swedish clinic that is.
It seems the more questions I ask, the less love I'm getting back.
I sent an email about a week ago to Dr. Boss Lady and haven't heard back so today I decided to call. My favorite Nurse Inga answered the phone and was happy to hear we're looking at joining the circus again this fall. She immediately gave me the tentative run-down of "wandings", "shoot-ups", "pick-ups" and transfers, but I stopped her in her happy ramblings by saying:
She asked me to go ahead, and I started down my list of questions for Dr. Boss Lady:
• Our first round of IVF gave us four blastocysts. The fresh transfer resulted in a miscarriage. Our first FET was negative (with a faint second line that disappeared the day after). Our two remaining blasts did not survive the thaw.
Do you have any theories about why we had a statistically bad outcome? Egg, sperm, and/or embryo quality? Immune problems or a combination? Any suggestions to improve the stats this time is greatly appreciated.
Nurse Inga: - You realize we have very high standards for the embryos we freeze here, and there's an 8% risk of embryos not surviving the thaw in spite of being top notch.
Me (thinking, not saying): - Um, yeah, but last time I checked 2/3 is more like 66%. If this happened in any other situation I'd assume the team responsible would at least have an internal discussion of what went wrong.
• Do you believe that we can increase our chances by going through additional testing? Karyotype and immunology testing.
Should I have a hysteroscopy to look for polyps since I'm experiencing similar symptoms as before my polypectomy in Feb 2009?
Nurse Inga: - I'm writing, immune testing, polyps...
• I've heard of positive effects of using baby aspirin in combination with IVF, I also understand that there's no studies to prove it. My question is: Can it hurt?
• Egg retrieval of my left ovary was complicated because of its location and required the pain management nurse to assist the doctor by pressing down on my abdomen, leaving her unable to administer more meds. Can I request an additional person in the OR?
Nurse Inga: - Oh my, I'm sorry to hear that, we'll make sure a third person is available for your retrieval this time. You shouldn't be in pain.
Me, (thinking): - You think! (saying): - That would be great.
• Diver Dude's planned PESA turned in to a TESA when they were unable to find a sufficient amount of sperm. Is there any reason for a back-up plan such as donor sperm?
Nurse Inga: - Well, we don't have a donor program at our clinic...
Me, saying this time: - What? so what happens if there's no sperm? We just pack up and go home?
• Can you send my prescriptions here, or can a family member pick them up at the pharmacy for me?
• If necessary can I have some of the evaluating ultrasounds done locally?
• Could you please send copies of our medical records, electronically or via snail mail?
When I finished my list of can-do?'s the other end of the line was quiet.
- Hello? Are you still there? Nurse Inga let out a small sigh and asked me if I would like to schedule a phone consult with Dr. Boss Lady. I told her it sounded like a good idea and we agreed that August 11 would be a good day. After Nurse Inga promised to send our record promptly we ended the conversation.
Now I've got a bad taste in my mouth. I shouldn't feel like I'm inconveniencing them by calling. I shouldn't feel pushy or rude for not wanting to be "just a patient" and demand personal attention. Should I? This clinic in Sweden has one of the best statistics in Europe and the their prices for treatment is about half of what it is here in England, and oceans away from american IVF costs... Should I just trust that they know what they're doing and go with it?
I could get a second opinion, but I'm not sure we could really afford going anywhere else. Possibly another clinic in Sweden... I don't know, I don't think that I have much of a choice.
Any success stories you have of pregnancy in spite of a less than perfect relationship with your clinic and/or RE would be greatly appreciated. Or, I guess, success stories of changing clinics/REs would be helpful too.