Need Advice on first & last DE cycle

Need Advice on first & last DE cycle

Joined: July 31st, 2011, 5:44 pm

August 7th, 2011, 2:11 pm #1

To give you a little background . . . .After 3 poor IVF cycles last year my husband and I decided to move on to DE. I have pretty much every issue known to man and the biggest problem is my AMH of 0.2 at age 30. My husband is 46 has severe male infertility with low everything and a sperm DNA fragmentation of 27% when we checked last.

We decided to leave our previous doctor and move on to one that is well known in Dallas for doing donor cycles. He probably does 3 times as many as other doctors. He has a very nice large practice with 3 other RE's that is run really well. My only issue is that I've now learned that even though he is no longer affliated with the presbyterian hospital he still has very conservative views and will not let us use donor eggs and donor sperm.

My husband and I are only willing to do Donor one time, our insurance does not cover anything. So our thought is if we find a donor that gets about 20 eggs we want to do 5 of those eggs with quality donor sperm so that we have a backup no matter what. Of course I would rather have a child with a biological link to my husband but I also want to end up with a child at the end of this. My husband has no reservations at all with this and it is actually fine with him if we use all donor sperm, which I do not want to do.

Our doctor keeps saying how the egg is 90% of it and we don't need to do donor sperm back up but the problem is on our very first IVF cycle where I actually got 4 eggs none of them fertilized due to such a poor sperm sample. My husband's quality has improved since then but why risk it? I am comfortable with this doctor and I do respect his professional opinion but I just don't know if I wouldn't regret taking it.

We did interview another RE which I did not feel as comfortable with but he is well known with a good company and he will do donor egg & donor sperm if we ask for it. He also doesn't think we need to do it but I just don't know. Am I going overboard here? Is it unreasonable to want to do both just in case? What would you ladies do? Thanks in advance.
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Joined: January 19th, 2007, 7:18 pm

August 7th, 2011, 3:21 pm #2

Unfortunately, I know of many posters on this board who were dissuaded from dealing with sperm issues, only to ultimately have to use donor sperm. REs' refusal to deal with this issue is so common.

Do a board search using the term sperm dna fragmentation & you will find many threads.

TESE is an option that should come up, too, in your search. BBG has posted valuable info. on this issue.

This is a particularly sore subject for me b/c I ended up doing 6 DE cycles total to get 2 children. (3 fresh, 3 FETs.) With each cycle, I implored my REs for answers & to ensure we were doing everything we could. I told them we were only doing this once & it still didn't make a difference. Obviously, we did end up doing more than one cycle, but at the time of the 1st & 2nd fresh cycles, I truly thought it was our last chance. While sperm didn't end up being an issue for us, nothing I said had any effect on our REs in terms of them being more aggressive re. testing or treatment. I still had to do most of the work myself, including identifying tests I wanted. The sperm dna fragmentation test was one of the first & I had to suggest it & then sweet talk my 1st RE into ordering it. It just really makes me angry.

I think you are pursuing a very wise path. So many REs still act as if DE is the magic fix for infertility & it is for exclusively egg issues, but sperm & uterine environment are also issues & they get ignored until either many DE cycles fails or the patient starts making demands.

OK, rant over. You're on the right track here, IMHO. Definitely do the board search b/c there is a wealth of info. on sperm dna fragmentation here.
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Joined: August 17th, 2005, 11:44 pm

August 7th, 2011, 3:52 pm #3

To give you a little background . . . .After 3 poor IVF cycles last year my husband and I decided to move on to DE. I have pretty much every issue known to man and the biggest problem is my AMH of 0.2 at age 30. My husband is 46 has severe male infertility with low everything and a sperm DNA fragmentation of 27% when we checked last.

We decided to leave our previous doctor and move on to one that is well known in Dallas for doing donor cycles. He probably does 3 times as many as other doctors. He has a very nice large practice with 3 other RE's that is run really well. My only issue is that I've now learned that even though he is no longer affliated with the presbyterian hospital he still has very conservative views and will not let us use donor eggs and donor sperm.

My husband and I are only willing to do Donor one time, our insurance does not cover anything. So our thought is if we find a donor that gets about 20 eggs we want to do 5 of those eggs with quality donor sperm so that we have a backup no matter what. Of course I would rather have a child with a biological link to my husband but I also want to end up with a child at the end of this. My husband has no reservations at all with this and it is actually fine with him if we use all donor sperm, which I do not want to do.

Our doctor keeps saying how the egg is 90% of it and we don't need to do donor sperm back up but the problem is on our very first IVF cycle where I actually got 4 eggs none of them fertilized due to such a poor sperm sample. My husband's quality has improved since then but why risk it? I am comfortable with this doctor and I do respect his professional opinion but I just don't know if I wouldn't regret taking it.

We did interview another RE which I did not feel as comfortable with but he is well known with a good company and he will do donor egg & donor sperm if we ask for it. He also doesn't think we need to do it but I just don't know. Am I going overboard here? Is it unreasonable to want to do both just in case? What would you ladies do? Thanks in advance.
that around with an antioxidant protocol. It took about three months and then we retested and his new number was 12%, which put him in the group of highest fertility potential. If you are interested, I can post the protocol. We also did ICSI. There was no way I was going to risk that, just too much invested financially and emotionally.
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Joined: July 31st, 2011, 5:44 pm

August 7th, 2011, 4:23 pm #4

Unfortunately, I know of many posters on this board who were dissuaded from dealing with sperm issues, only to ultimately have to use donor sperm. REs' refusal to deal with this issue is so common.

Do a board search using the term sperm dna fragmentation & you will find many threads.

TESE is an option that should come up, too, in your search. BBG has posted valuable info. on this issue.

This is a particularly sore subject for me b/c I ended up doing 6 DE cycles total to get 2 children. (3 fresh, 3 FETs.) With each cycle, I implored my REs for answers & to ensure we were doing everything we could. I told them we were only doing this once & it still didn't make a difference. Obviously, we did end up doing more than one cycle, but at the time of the 1st & 2nd fresh cycles, I truly thought it was our last chance. While sperm didn't end up being an issue for us, nothing I said had any effect on our REs in terms of them being more aggressive re. testing or treatment. I still had to do most of the work myself, including identifying tests I wanted. The sperm dna fragmentation test was one of the first & I had to suggest it & then sweet talk my 1st RE into ordering it. It just really makes me angry.

I think you are pursuing a very wise path. So many REs still act as if DE is the magic fix for infertility & it is for exclusively egg issues, but sperm & uterine environment are also issues & they get ignored until either many DE cycles fails or the patient starts making demands.

OK, rant over. You're on the right track here, IMHO. Definitely do the board search b/c there is a wealth of info. on sperm dna fragmentation here.
I really appreciate your honest response. I too have had to research on my own and press to get tests done. Luckily our local Dallas Resolve group has a private facebook board and we meet once a month or I wouldn't know anything! We found out abou the DNA fragmentation test and ordered it on our own over the internet. My first RE and the one we're seeing now didn't even suggest it. Although, the RE I am thinking about switching too did. All of them act like it's going overboard or over-reacting to do just a few eggs with donor sperm and I don't see what the issue is? Especially if we're using a donor that gets 20 eggs or more? Why not increase our chances of actually ending up with a baby! I appreciate your reassurance, the doctors make it seem like you are overstepping your bounds to request something even though you're the one paying for it and it's your life we're talking about!
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Joined: July 31st, 2011, 5:44 pm

August 7th, 2011, 4:27 pm #5

that around with an antioxidant protocol. It took about three months and then we retested and his new number was 12%, which put him in the group of highest fertility potential. If you are interested, I can post the protocol. We also did ICSI. There was no way I was going to risk that, just too much invested financially and emotionally.
Thanks Kacee, wow you had great results! After much discussion with our RE after ordering the DNA fragmentation test on our own he offered up the antioxident treatment. My husband has now been on it for a month? We were supposed to do our donor cycle at the end of this month but we lost our donor due to a bad cycle so it's probably better since we have more time now. We definitely have to do ICSI as well due to his low count, low motility, low morphology, etc. as well. Even if he has improvement in DNA fragmentation everything else is so poor that I think I still want to use some donor sperm. I have had so many friends with failed cycles recently. One of my closest friends that I met through the resolve board is now on her 5th donor cycle with no explanation as to why the others failed. We just cannot afford to do that financially or emotionally!
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Joined: August 17th, 2005, 11:44 pm

August 7th, 2011, 4:38 pm #6

one teachers salary. I had to figure out many things on my own, do research, get help from experts around the world, including the late, great Dr. Alan Beer. I was finally able to put all of the pieces together and convince the RE to try other things. In the end, I added long term Prednisone, Lovenox, Folgard 2.2 in addition to the traditional DE meds. I also used EmbryoGlue, assisted hatching and before and after transfer acupuncture, along with Lexapro to help increase blood flow to the uterus and increase my lining thickness.

We were successful after transferring to a clinic on the other side of the country (also one of the most reasonable), finding a tremendously successful donor. It took us until our 4th donor to have success. The results: a 6 year old dd, 5 year old dd, 2 year old ds and boy/girl twins on the way.

Here is the protocol my Dh was on:

500mg of Vitamin C 2x/day
400mg of Vitamin E 2x/day
100mg of Pycnogenol 2x/day
Proxeed 2x/day (purchased from freedomdrug.com, free overnight shipping, no script required)
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futurebeauty
futurebeauty

August 7th, 2011, 4:39 pm #7

I really appreciate your honest response. I too have had to research on my own and press to get tests done. Luckily our local Dallas Resolve group has a private facebook board and we meet once a month or I wouldn't know anything! We found out abou the DNA fragmentation test and ordered it on our own over the internet. My first RE and the one we're seeing now didn't even suggest it. Although, the RE I am thinking about switching too did. All of them act like it's going overboard or over-reacting to do just a few eggs with donor sperm and I don't see what the issue is? Especially if we're using a donor that gets 20 eggs or more? Why not increase our chances of actually ending up with a baby! I appreciate your reassurance, the doctors make it seem like you are overstepping your bounds to request something even though you're the one paying for it and it's your life we're talking about!
for sperm frag issues online. That would be very helpful to us.

For your situation, I am in the camp of being very assertive and doing the donor sperm for backup is very smart esp since you know your financial situation.

TIA,

futurebeauty
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Joined: July 31st, 2011, 5:44 pm

August 7th, 2011, 4:47 pm #8

Yes! We ordered it through SCSAhttp://www.scsadiagnostics.com/ Your doctor can order it through them or you can. I believe it was $350 including shipping and most doctors charge $800 for the exact same test. Just a word though, they send this big 5 gallon bucket sized liquid nitrogen canister for you put the sample in. We didn't know what it was and had it delivered to our work because that way someone was there to sign for it. Of course everyone wanted to know what it was!
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LizLA
LizLA

August 7th, 2011, 6:36 pm #9

one teachers salary. I had to figure out many things on my own, do research, get help from experts around the world, including the late, great Dr. Alan Beer. I was finally able to put all of the pieces together and convince the RE to try other things. In the end, I added long term Prednisone, Lovenox, Folgard 2.2 in addition to the traditional DE meds. I also used EmbryoGlue, assisted hatching and before and after transfer acupuncture, along with Lexapro to help increase blood flow to the uterus and increase my lining thickness.

We were successful after transferring to a clinic on the other side of the country (also one of the most reasonable), finding a tremendously successful donor. It took us until our 4th donor to have success. The results: a 6 year old dd, 5 year old dd, 2 year old ds and boy/girl twins on the way.

Here is the protocol my Dh was on:

500mg of Vitamin C 2x/day
400mg of Vitamin E 2x/day
100mg of Pycnogenol 2x/day
Proxeed 2x/day (purchased from freedomdrug.com, free overnight shipping, no script required)
50+ DNA fragmentation.

I do like the idea of splitting sperm...but it's so hard to predict # of embies. We end up with 8 blasts from 21 mature eggs.

Good Luck.
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Mrs. M
Mrs. M

August 7th, 2011, 8:02 pm #10

To give you a little background . . . .After 3 poor IVF cycles last year my husband and I decided to move on to DE. I have pretty much every issue known to man and the biggest problem is my AMH of 0.2 at age 30. My husband is 46 has severe male infertility with low everything and a sperm DNA fragmentation of 27% when we checked last.

We decided to leave our previous doctor and move on to one that is well known in Dallas for doing donor cycles. He probably does 3 times as many as other doctors. He has a very nice large practice with 3 other RE's that is run really well. My only issue is that I've now learned that even though he is no longer affliated with the presbyterian hospital he still has very conservative views and will not let us use donor eggs and donor sperm.

My husband and I are only willing to do Donor one time, our insurance does not cover anything. So our thought is if we find a donor that gets about 20 eggs we want to do 5 of those eggs with quality donor sperm so that we have a backup no matter what. Of course I would rather have a child with a biological link to my husband but I also want to end up with a child at the end of this. My husband has no reservations at all with this and it is actually fine with him if we use all donor sperm, which I do not want to do.

Our doctor keeps saying how the egg is 90% of it and we don't need to do donor sperm back up but the problem is on our very first IVF cycle where I actually got 4 eggs none of them fertilized due to such a poor sperm sample. My husband's quality has improved since then but why risk it? I am comfortable with this doctor and I do respect his professional opinion but I just don't know if I wouldn't regret taking it.

We did interview another RE which I did not feel as comfortable with but he is well known with a good company and he will do donor egg & donor sperm if we ask for it. He also doesn't think we need to do it but I just don't know. Am I going overboard here? Is it unreasonable to want to do both just in case? What would you ladies do? Thanks in advance.
I think the ladies in the previous posts have given you some good advice. Just wanted to give you a little more "food for thought." Do you have the option of some sort of a guarantee program? The reason I ask is b/c when I first started this DE journey about a year and a half ago I was convinced we would do only one cycle. FF a year and a half and we are down to one last embryo from a cycle that started with nineteen mature eggs (from a four time proven donor) and have not had success yet. We will thaw and hopefully transfer our last embie towards the end of this month and hope it will be our miracle but know there is about a 65% chance that it will not be (our clinic has a 35% success rate with SET with FET). However something has changed in me over these last months and I know I cannot be done until I have success. It seems the more obstacles and failures I face the more determined I become not give up until I succeed. By the way this is not my typical personality but something about this maternal instinct makes it impossible for me to give up. this is not something my dh, close friends or family (that know about our IF struggles can begin to grasp), however the ladies here "get it." So the long and short of it is we have spent just over $30,000 for the first go round and it is looking like we will come up empty handed and now we are trying to figure out how to scrap together another $29,000 for SG 3:1 shared risk program. If you have the option of shared risk, I would consider it. I think it makes the whole process less stressful when you do not feel like this is your last and only chance. GL!!
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