Monday, April 28, 2008

Twenty Questions

Thanks to everyone for your wonderful thoughts and wishes for getting me out of my funk. I'm feeling much better now that I had a stress-less weekend and was able to have some good conversations with Sweetie (plus lots of snuggling).

We have our appointment with Dr. Uterus tomorrow to discuss what happened with this last miscarriage and we've been dutifully preparing our questions for him.

Here are some of the biggies (with my own commentary, of course):

- What really were the chances of this happening two times in a row?
I'm more and more convinced that this was probably more common than he would have led us to believe. I don' tremember exactly what he said, but I got the impression that it was very unlikely that it would happen twice in a row.

- Do we need to have additional testing on either us to see if we have 'sticky chromosomes' that predispose us to nondisjunction problems (which in turn cause those pesky monosomies)?
While this wouldn't be something we could fix except possibly through donor gametes, at least we'd know.

- What are the chances that PGS on our remaining six totscicles will destroy them?

- How successful is the PGS test in finding chromosomally abnormal embryos and can it be done on 5-day thawed blasts?
If it is only 30% effective, for example, it may not be worth it.

- Do we need to do any immunological testing, even though both miscarriages were chromosomal?

- What are our chances of conceiving naturally?
I want to this know because frankly, there hasn't been a time that we had a legitimate shot at pregnancy while we were trying naturally. The first year we tried, my tubes were blocked. It was like I had my tubes tied. Nothing was getting through. The two times I have gotten pregnant, it was through ART and the months that we were 'off' I was either benched with ovarian cysts or getting over a miscarriage (which does wonders for messing up your cycle). I want to know if we have a legitimate chance even though ART may be a faster process - if it works.

- What are the protocols for doing an FET (which we would likely do next)?

- What is the thaw rate that the IVF lab has for frozen embryos?
Just because we have six on ice, doesn't mean that all six would make it through the thaw which really kills me, but what can you do?

And, before I head back to the padded cell, I'd like to say a little word about statistics. Several of those questions up thar can only be answered with statistics. I have come to eye statistics warily and with much suspicion over these two years. Statistics really aren't that useful to me anymore because they really don't help predict anything with respect to me. I've had lots of things happen that statistically had a very low probability of happening and yet happen they did. So, while they're somewhat helpful, I tend to make decisions now based upon the worst case scenario, not the statistically predicted one.

They also set me up for even more disappointment when something that should have a low statistical chance of happening (like a second monsomy miscarriage in a row) happens. Not only are you grieving that you have lost another pregnancy, but you are angry because statistically, this wasn't supposed to happen (don't even get me started on the statistics of miscarriage after hearing the heartbeat. That to me is the greatest travesty of statistics of them all.)

So, while I've pretty much given up on statistics, they are a necessary evil. I'm also stuck with them since Sweetie, mathematically-minded guy that he is, lives for statistics. I may ask Dr. Uterus, though, not to give us any more specific predictions about the chances of us having another miscarriage. We tend to take what he says as gospel so when it doesn't come to pass, there's another disappointment to handle.

Are there any other questions that we should be asking? Any thoughts would be greatly appreciated!
image: Dom Dada


Rachel said...

Since you seem to be soliciting advice, I think it's always a good idea to ask directly what the doctor recommends you do. I can't tell you how many times I have walked into an appointment with a prepared set of questions and then 2 or 3 appointments later the doctor will try to say "But you had an agenda. I didn't tell you what I recommended because of your agenda" (I hope you can read the tone here - it's a bit skeptical). So consider asking them directly what they would recommend.

JJ said...

Totally agree with Rachel--Ive had to be very direct with questions Ive asked (esp about chromosome testing/PGD) It's like they dont want to give you TOO much info. Best of luck with the appt!

Denise said...

Our clinic quotes thaw rates of 75%. Both thaws we've done were almost spot on 75%.

Can't think of any additional questions for you to ask, but just wanted to say good luck with your appointment tomorrow.

Mrs.X said...

Thanks everyone! Rachel & JJ - your suggestion is an excellent one and I will definitely ask them.

Denise- thanks for your best wishes. And, what a great thaw rate! I hope my lab's is as good.

luna said...

excellent questions. I'd definitely press on the PGD Qs too. you're right, statistics don't mean crap until you're on one side or the other. but we use them to make "informed" guesses about our next steps so they are a necessary evil. best of luck to you. ~luna