Wednesday, June 11, 2008

Phone Consult with CCRM

I had my phone consult yesterday with CCRM. I think it went pretty well for the most part. I already really like Dr. Schoolcraft as he is all business, very direct, extremely knowledgeable and able to educate others well, no fluff, no personality (which is fine by me), and hopefully the man I will one day credit for my future spawn! He didn't give me false hope as Dr. Awadalla always did. I'm so glad we switched REs! Here is a brief run down of some of the things that Dr. Sch and I discussed.

First of all, he thinks we could be dealing with an egg problem. Interesting since Dr. A always lead us to believe it was slight MFI, if not his favorite, "unexplained diagnosis". But, according to Dr. Sch, even though I make lots of eggs, we don't have embies that are growing to 5 days in a lab. He thinks this is more than likely due to poor lab conditions that exist in many RE clinics that are not conducive to growing embies out to blast. He uses a vitrification technique that enables more embies to continue to thrive beyond 3 days. If an embie doesn't make it to blast, it's an egg problem (probably a genetic defect). Worst case scenario (and btw my greatest fear): none of our embies make it to 5 day. But, if they won't grow in his lab, they won't grow anywhere, so we'll have to think about other routes to a baby at that point. But I will have an answer, which is what I wanted and why we're going all the way to Denver.

He also wants to do the Beta-3 integrin endometrial biopsy. He feels that this should help us understand if I'm missing these "uterine sticky glue" receptors and maybe that's why the embies aren't implanting. He does not feel a laparoscopy is necessary for me (which is again a difference b/t him and Dr. A). He said a lap would show one of three things: 1) normal, 2) scar tissue, and 3) endometriosis. #1 and #2 he doesn't care about and #3 doesn't matter since we're doing IVF provided I have the above receptors from the biopsy. If I am missing those receptors, then I'll get treated with depot Lupron following our ER for a few months. If we were not doing IVF, then a lap could be considered, but we are no longer in that boat at this time.

Our one-day work-up appt. has been scheduled for July 3rd. This is great because both Steve and I are off work for the July 4th holiday for both 7-3 and 7-4 (yay for not having to burn vacation time!). We are doing tons of testing at this appt. I'll be getting a hysteroscopy as part of the standard work-up and Dr. Sch does suspect PCOS (since I had 33 eggs retrieved which is too many). If so, he'll add Metformin to my drug cocktail. Also, he orders tons of chromosomal testing to begin to rule out genetic issues from both of us. And, we will also be getting the anti-sperm antibody test (also part of the work-up). We'll know more about what protocol we'll be doing after the testing and bloodwork are complete. He did say that he doesn't use pure FSH alone and would use a FSH + LH combo with me and decrease the stims as we get further into the cycle to prevent OHSS and 33 eggs being retrieved...

Finally, we're doing CGH testing on all blasts (provided we have them at Day 5). This takes about 8 weeks to complete but is better than PGD because you are testing the placental cells in CGH (of at least 100 cell blast) vs. PGD which only tests from the embie, which has only a few cells at Day 2 or 3 and you do have the potential to harm the embryo. CGH tests all 23 chromosomes and PGD only tests 9/23 chromosomes. I think only a few centers in the country do CGH testing. We will do a FET after the results are back.

Denver here we come!!

21 comments:

Blue said...

Wow....that sounds like such a great consult and a really positive plan. One of the things I hate about all of this more than anything is the numerous blind attempts that don't yield any solid answers. While getting test results is definitely a scary prospect, hopefully you will finally get the answers you need to make your family. Knowledge is power I say! Hope you feel positive after this - it certainly sounds like things are moving forward in a good way.

TTCinDC said...

That is so exciting. What a great RE and GOOD LUCK with all the upcoming tests and the trip to Denver!

Christi said...

sounds like you are moving in the right direction, I wish you both nothing but the best! I hope the answers you receive are GOOD NEWS! :)

Suzanne said...

Thanks for sharing...very informative. I wish you the best of luck. How did you find this doc? I have read that other people are heading to Colorado also...

The Wright's said...

Wow! What a stark improvement over your old RE. It sounds like things are on the right track and all of this testing and the travel will be well worth it! I'm so happy for you to have a good, hopeful direction.

Jill said...

Sounds like you have a plan! GOOD LUCK in Denver!!

Jen said...

Wow. The whole consult sounds awesome. I think the plan sounds spot-on.
You know... being told you have an "egg issue" does not necessarily mean you naturally produce crappy eggs. My new RE explained that to me during our WTF and second opinion consult. He said often the RE doesn't know the right drug protocol and uses (in my case) too much of very powerful drugs, thereby producing loads of follies and eggs but getting poor quality. He went on to say that these overcooked eggs usually produce poor embies that don't survive... which sounds like what both of us are facing.
I'm glad you got a second, and such a great, opinion. I'm sure you will find success with him very soon!

Who Needs Patience? said...

Wow, sounds like a great consult! I really hope this doctor gets you some answers and ultimately the family you have been dreaming of!

M. said...

OMG! This sounds like an awesome plan!! How exciting!

I know this is the way to answers for you guys-- can't ask for more :)

Jen said...

Holy hell, Jill! I think you accomplished more in a phone consult than I have in a year of RE visits!
Good for you - I hope this superstar gets to the root of the problem. Sounds like he's working for the money, thats for sure!

Lost in Space said...

Wow! That was an awesome consult and I feel more informed just reading your post. Thank you so much for sharing it all. My RE thinks I have an egg quality issue too, but I do have elevated FSH so I don't think that is any surprise.

I wish you all the best with your appointment and testing. I am looking forward to following your journey.

seriously? said...

Glad to hear you were happy with the consult, it sounds like he will leave no stone unturned.

Enjoy the trip!

Suzanne said...

I'm so glad your consultation went well - he sounds like a great doctor!

Chelle said...

Congrat's! You are moving forward and the RE sounds amazing! My RE is in The Springs. Hopefully he isn't your old one or something... Are you traveling far to get to Denver?

Kristen said...

SO happy to hear you have a plan in place. I'm sorry Dr. S didn't work out for you...but I'm sure the new Dr. S will be your key to mommyhood!

sarah23 said...

That sounds great! I can't wait to hear how all of that testing goes. It sounds like you will be getting some answers.... hopefully the answer you'll get is that "everything is normal" and you'll be on you're way to a BFP at CCRM.

BTW, I was on Met too for possible PCOS. It really wasn't that bad.

Beth & Brian said...

I am so glad to see you are moving forward with a new RE! It sounds very hopeful. Good luck with everything!

DAVs said...

Wow it sounds like we are on similar paths at CCRM. I'm doing pre-treatment with depot Lupron (decided not to do the beta integrin test and just treat anyway b/c of my stage IV endo)...we just had our one day workup but our doc was out of town so we're waiting on a follow up phone consult. We're going to consider the genetic testing too...so I guess my pre-treatment could turn into post treatment. We'll see.
Thanks for commenting--we'll have to stay in touch.

MamaSoon said...

hi there! we just had our one day workup 10 days ago. I posted about the experience with Dr. S. Good luck to you. Stay in touch if you want. Who knows, maybe there will be a group of us there Aug/Sept. Good luck!

Penny said...

Wow that was really interesting to read. I am also a patient there, though with another doctor. Already I like it. I've also heard great things about their lab, which was one of the reasons I chose to go there too (well that and I live in the City, so it's easier...).

Good luck this upcoming cycle!

mymadori said...

Wow talk about a small world!!!! I came across your blog a month or two ago, when I switched REs and started going to CCRM. I read it every now and then, but today- I find out that you and I are both having our one day workup on the same day???? Wow. As for me, we get to skip some of it so we'll be there from 8am to noon. I live in Colorado though so not much of a trek for me! In case you want to shoot me an email, I'm mymadori@yahoo.com.