Posted by: Babyblues | March 6, 2018

Lessons Learned

July 30, 2018

In months, post IVF egg donor failure in Spain, reflection is a regular occurrence. Thoughts invade and often cripple my mind. I wonder if anything could have been done to improve our odds for implantation and pregnancy. Were we given the best chances to succeed? I know this is harmful, but I am a prisoner of my analytical mind.

In an effort to move on, free myself of the grief I experience daily, I am turning the page. I want to use my blog as I have in the past, to guide and educate. I believe that offering advice to other couples on how best to prepare for fertility treatment at an overseas clinic is a cathartic experience.

LANGUAGE

When visiting a clinic overseas, a majority of communications before you go for treatment will undoubtedly be by email. Written and spoken English fluency can vary greatly from country to country.  Be sure that you can understand instructions clearly. Demand from the onset that the clinic  you choose provide someone who is comfortable in both oral and the written English. This will save a lot of heartache and frustration once you arrive for treatment. Furthermore, save all email correspondence for reference.

When you arrive at the clinic be sure that that person you have been communicating with is available to meet you. In addition, if you have been communicating with a doctor that is fluent in English, insist that he or she is there to meet you when you arrive for visits.

Do not be afraid to assert yourself or be viewed as a pushy American. You are spending considerable money, and  most likely traveling quite a  distance to make your dreams a reality

DO NOT BE SWAYED BY FANCY MARKETING OR AWARDS

When we made the decision to proceed with IVF Egg Donation for a second time, we were determined to find the best clinic in Europe. This of course was no easy task as we  we live on the other side of the Atlantic Ocean. Once again, we relied on social media to help us hone in on top clinics. Social media is a blessing and a curse when researching overseas fertility clinics. Information overload and pretty pictures splash across the web. I caution one to never forget that all too often the website designed to facilitate choice for the patients, often sways in favor of the clinics that advertise heavily. Unfortunately, this can often lead to more focus on accolades for the clinic, while overlooking any potential negatives. Sadly, these reviews do not provide a complete picture of the clinic. I caution you to do plenty of research, do not rely on fancy awards or marketing written on any website. Dig deep to find the truth about the clinic beyond the pretty package presented on the world wide web.

Fancy awards and marketing do not mean automatic pregnancy!!! 

ASK THE TOUGH QUESTIONS

Before committing to a clinic get all your questions answered. Have a check list of what is important to you. There are many lists on the internet that can be tailored for your specific needs.  Do not be afraid to ask. You are not trying to make friends. You are investing a lot of money, and time to travel overseas for fertility treatment.

In the United States, we are accustomed to to a high level of medical care. The fertility clinics we visited in the United States were efficient, and methodical. Our expectations did not deviate when picking clinics in Europe.

The onus is on the patients to ensure that they are getting what the clinic purports to offer on it website or through social media. If in doubt, take time time to assess and reflect. Fertility treatments are emotional. It is not like buying a car. Committing to going overseas, is not an easy decision. Whatever you save in money, does alleviate the physical and emotional challenges of fertility treatment.

TALK TO OTHER PATIENTS

Before committing to a clinic, ask if there are patients who would be willing to share their experiences. Undoubtedly they will provide someone who has had a positive result. This does not mean that you cannot ask them questions that the clinic may be less than forthcoming about. The following are questions I wish we asked:

  1. How is the language fluency of the staff?
  2. Is there someone you recommend on staff that we should request for our coordinator and doctor?
  3. Is there any advice based on your experience that you would be willing to share?

In addition, do not be afraid to look for someone on social media who did not have a positive experience. If they were willing to voice their concerns on social media, they may be happy to share with someone who reaches out.

Since it may not be feasible for you to visit the clinic ahead of your treatment it is essential  hear both positive and negative experiences. Knowledge is power and by hearing both types of experiences one can better plan for future treatment.

TRYING A SECOND TIME? SEE IF THERE ARE OTHER TREATMENT OPTIONS 

If you are someone who has tried several times unsuccessfully to get pregnant with the use of assisted reproductive technology, it is important to do your research in regards to alternative treatment options. After our failures with regular IVF we met with our reproductive endocrinologists in the United States. Each  provided detailed explanation as to why they believed the process failed, and proposed different treatment suggestions for the future.

When we switched to IVF with an egg donor, we hoped that our odds would increase. Post failure after our first attempt, we did not ask enough questions, nor do enough to research to see what other treatment options are available. Instead we looked for a different clinic and rolled the dice. It was only after our most recent failure that we became aware that there are additional treatment options for women with a history of failure with egg donor IVF.

REMIND, REMIND, REMIND

If you are like me, then you have endured many failures. In addition, you may have a medical condition that may impact your ability to maintain a healthy pregnancy. When using an overseas fertility clinic you will not have the benefit of multiple visits. Your consultations will be over Skype. Therefore, since you will not have the benefit of direct contact with the doctor or staff,  you need to be your own advocate. In every correspondence or treatment plan the clinic needs to be reminded of your medical history, and may require additional therapies to help ensure successful implantation. DO NOT BE AFRAID to remind your physician that you underwent treatment at a different clinic. These clinics have many patients, and it is not realistic to believe that they will remember or be on top of every case.

Always be your own advocate!!!

AVOID TREATMENT DURING PEAK AND HOLIDAY TIMES

When planning our treatment, we believed that going in early December meant less crowds, and less chaos, We were wrong. In addition to the Christmas season, Europe celebrates Bank Holidays. These holidays can wreak havoc on your schedule. It is not uncommon for many closings, and staff shortages at clinics during holiday periods. This can result in long waits for responses to important emails or delays.

MAKE MEMORIES

Going to Europe for fertility treatments can be magical. For any couple that has endured these treatments, it means weeks of torture and schedules. We were blessed to spend the in between days, exploring nearby cities. Do not feel like you have to spend the entire treatment window in the clinic’s city. Take advantage of your time. Our first trip to the Czech Republic, we committed to staying in the city the entire seven days. When we realized that there was not much to do there, we scrambled to find places to go. For our second  trip to Spain, we planned ahead of time to explore other cities, rather than wait for daily embryo reports.

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Posted by: Babyblues | December 22, 2017

The Broken Warrior

December 22, 2017

We awoke today hopeful that a visit to the gynecologist would mean news of a positive pregnancy test. Unfortunately, our dreams were shortly quashed and shattered. Despite our best efforts, there is no pregnancy.

I am numb, devastated, and broken. After six fertility treatment in six years, I remain childless. In the wake of another failed attempt, my body and mind are beaten up mentally and physically. I am a broken #ivfwarrior. 

When I started blogging our experience last year, the response was powerful. We gained an amazing support unit, and in the process shed light on a very personal battle. Through my posts, I was able to educate the uninformed about the realities of infertility and assisted reproductive technologies.

I do not regret my decision to share the ups and downs, but simply ask a favor. We know that there are other paths to parenthood, but right now we need time to process, grieve and regroup from our latest setback.

We hope you understand, and do not perceive our request as rude or the antithesis of our transparent infertility journey. At this moment we need love; not second guessing or unsolicited opinions on how to proceed.

Happy Holidays!!

Love,

Burke & Jeff

Posted by: Babyblues | December 12, 2017

Praying for our Chanukah Miracle

December 12, 2017

When we planned our trip to Spain for egg donor IVF, it did not occur to us that the last days coincide with Chanukah.

Chanukah the Festival of Lights is a celebration of miracles. It is fitting that our embryo transfer falls on the eve of a holiday that celebrates triumph, overcoming insurmountable odds, and resilance.

For the past six years, our quest to conceive a child has been full of dark days. Sadly, our journey has not brought the light of a new life into our family.

We have been knocked down, but continue to persevere. We have not let defeat and disappointment break our spirits or will. Instead, we remain hopeful for our miracle child.

The themes of Chanukah are applicable to all; no matter what challenge you face, be your own bright light.

I want to wish all my friends and family a year of blessings and miracles.

Posted by: Babyblues | December 10, 2017

Now We Wait

December 10, 2017

In my last blog post, I briefly describe the science used to extrapolate the oocytes or eggs from the donor, followed by insemination. The picture below describes the development we hope our embryos reach by five days post retrieval.

There is plenty of information to explain the process clinically, but there is nothing to prepare a couple for the highs and lows of waiting for the embryos to develop. Feelings of fear, sadness, and doubt are daily occurrences. In addition, my emotions are heightened by the estrogen and added progesterone to assist with embryo implantation.

Logically we know that we have no control as to the outcome, but instead need to trust in the process . Emotionally, this is often not realistic or a source of comfort. We have invested a lot of time, energy, and money to get to this point. I have put my body through months of medications to prepare, but despite this there is no guarantee. At this moment we are in a free fall waiting for the clinic to use their best efforts to ensure our embryos develop into good quality blastocysts ready for transfer into my uterus.

On the day of the retrieval , we were informed by the clinic that for three days post retrieval an email will be sent to update as as to embryo development.

Post retrieval we were hopeful that a younger donor would yield a sufficient number of eggs to increase our odds. The first email, one day post transfer was a crushing blow, as there were only nine eggs. Several articles I have read on the internet indicate that fifteen mature eggs provides better odds for successful embryo implantation.

Upon receiving the above email, our moods instantly changed for the worst. A dark cloud loomed over us both. The support of our friends and family helped immensely. Personally, the messages and words of encouragement that we received through social media helped to lift my spirits. It did not matter whether it came from someone experienced with assisted reproductive technologies or just a kind heart. Our support network fueled hope and positivity.

When I woke up Saturday, I feared that we lost more embryos. I was in a store buying some gifts, when Jeff, who admittedly hates the daily updates, screamed to drop everything and come read the latest daily report:

Immediately, the sunshine peaked through the dark cloud looming from the day prior. From that moment we were able to enjoy what turned out to be a beautiful December day in Madrid. With renewed spirit, we spent the day exploring the beautiful sights the city has to offer.

Sunday, provided us with the last update of embryo development before transfer day:

Our embryos scientifically are on track for day three post retrieval, but now new fear creeps into our minds. What if we get to day five and there are not the three quality blastocysts as we were guaranteed by the clinic’s package? According to the above email, statistically only half of the remaining embryos will make it to blastocyst. What happens at this point? We know that going through another round of egg donor IVF is not a viable option for us as we travelled close to 4,000 miles for one last chance at conceiving a child.

Our only option at this point is to wait patiently until Tuesday to see how many embryos develop into blastocysts. We are hopeful, but cautiously optimistic. Anxiety levels are growing because of the uncertainty. No matter how busy you keep yourself, moments of fear and doubt creep into your thoughts. For now all we can do is have faith in the process and G-d.

Please stay posted for the next blog in which I describe transfer day.

Posted by: Babyblues | December 7, 2017

Gracias a Nuestra Eggceptional Donor

December 7, 2017

Today is the day our cycle moves from the body to the labs of IVF Spain 🇪🇸. The hope is that after the egg retrieval process and insemination, there with be three viable embryos.

Over the course of several blogs, I have written about the discomfort I experienced during the process, but failed to acknowledge the egg donor’s plight. Some may argue that it is a job because she is receiving monetary compensation. We do share this opinion.

As someone who endured three prior IVF cycles, I can attest to the emotional roller coaster, and havoc it plays on your life. The schedules and restrictions can be overwhelming. There is not enough money on the planet to compensate an egg donor for her sacrifice. For weeks,the nameless donor endured her own hormone induced torture. Her protocol required daily injections to increase her egg count. It is not uncommon for women during the IVF process to gain weight, and experience bloating and cramping. In addition, hormone injections puts the donor at risk for Ovarian Hyperstimulation Syndrome. The donor’s sacrifice is truly “egg”ceptional. The diagram below provides an excellent description for the day’s events for Jeff and the donor. My morning entails an additional ultrasound and blood work.

Stay posted for updates on the embryos growth.

Posted by: Babyblues | December 1, 2017

Journey for a Miracle

December 1, 2017

As we get closer to our treatment date, our anxiety levels are growing. The daily estrogen protocol is torture. I am fatigued, nauseous, and experience terrible headaches. I try to exercise in the hopes of alleviating the side effects, but find the benefits to be short lived. Tears are often shed, as my body is a battle ground. I know it is hard for Jeff to watch, because there is nothing he can do to make it more bearable.

We have fought through six years of fertility treatments. Each cycle we remained hopeful, but despite the use of assisted reproductive technology (ART) we remain childless.

Tonight we embark on the final chapter of our egg donor IVF journey. We will travel 3,794 miles to Alicante, Spain, in the hopes of conceiving a child.

The last six years have tested us both individually and as a couple. With each failed attempt there have been many trying moments. Our faith and will has been put to the test on countless occasions. Sadness and despair have crept into our lives at the most inopportune moments.

Thankfully, each failure served to strengthen our bond and marriage. We have encouraged and pushed each other. We have supported and loved each other. I truly believe there is no obstacle or test we cannot tackle.

As we embark on our egg donor IVF journey, I ask you to keep us in your thoughts and prayers for a successful pregnancy.

Please stay posted for updates in Spain. 🇪🇸

Love,

Burke & Jeff

Bryna Caren Bat Naomi

Zev Ben Chuvele Krindle

Posted by: Babyblues | November 26, 2017

The Point of No Return

November 27, 2017

Although I did not start taking medication for the real cycle until November 18th, November 15th was the “Point of No Return,” as we were required to pay eighty-percent towards the price of the Egg Donor IVF package. Once payment was processed, there was no turning back.

Three days later, reality kicked in when I started taking 8 milligrams of estrogen to prepare for the the “real” embryo transfer cycle in December. At the same time in Spain, our donor started the ovarian hyper stimulation phase, where she uses hormones to produce multiple mature eggs during her menstrual cycle.

On, November 28th, I will once again undergo a trans-vaginal ultrasound to check the thickness of my uterine lining. If the lining is not thick enough, my doctor will increase my daily estrogen intake to increase my chances for successful embryo implantation.

Since the start of the mock cycle, Jeff’s protocol has consisted of ingesting vitamins C and E on a daily basis.  On November 29th, Jeff will start taking Voltaren for a week. Voltaren is a prescription anti-inflammatory drug used off label to help liquefy and increase sperm count on collection day in the hopes of producing the best possible embryos.

Unlike our cycle last year, we do not have definite dates for the procedure. Instead we have a treatment window of December 5th to the 14th. Thirty-six hours before the beginning of our window, we will be told the egg retrieval and transfer dates.

On the day of the egg collection two processes occur:  Jeff’s sperm is collected, and the donor is put under anesthesia to extract her eggs. From that point science takes over to grow embryos in a lab for the next five days.

The hope is to have two viable embryos for transfer at the end of the five day waiting period. In addition, I will add progesterone to my protocol to further assist with embryo implantation.

Stay posted for more details about the science that occurs post egg retrieval.

Posted by: Babyblues | November 22, 2017

Let’s Get in Sync

November 22, 2017

With the synchronization cycle (a.k.a. the pill cycle) in the rearview mirror, it is time to describe what it entails. This phase, in it’s simplest terms, is the time when the donor and recipients menustral cycles are aligned through the use of birth control. In addition, there is an injection and endometrial biopsy that occur toward the end of the cycle.

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On the surface the cycle appears straightforward and relativity harmless, but for someone with a gastrointestinal disease, the birth control pill is harsh and uncomfortable. From the day I ingested the first dose, I immediately began to feel symptoms. My stomach screamed at me on a daily basis, but I persevered. I admit that there were days I was I ready to pack it in.

Twenty one days later the next and most painful part of the cycle occurred on one tortuous day. The day started off with an injection called Decapeptyl, which is used to suppress ovulation. This was immediately followed by a biopsy of the endometrial lining. The purpose of this procedure is to disrupt the lining and release growth factors to improved the chances of embryo implantation. It is believed to benefit those women who have failed to get pregnant through IVF.

biopsy

I have endured many painful procedures in my life with both my Crohn’s and fertility treatments, but this by far was the worst. For ten minutes my gynecologist continually inserted a tiny plastic tube into my uterus in order to extract cells. With each pass the cramps and pain made me gasp, nearly bringing me to tears. Nothing alleviated my discomfort, and since I cannot take over the counter pain relievers because of my Crohn’s disease, I had to fight back the tears and breathe through the pain. I can only hope that this procedure helps with embryo implantation.

To top off an already uncomfortable week, I had an unexpected early tooth extraction and bone graft to prepare for a dental implant in the near future.

The pill cycle was anything but easy, and certainly tested my strength, will, and determination  After this difficult cycle, I know that I can handle whatever challenges may lie ahead.

strength

Stay tuned for the next blog in which I talk about preparations for the “real cycle.”

Posted by: Babyblues | October 24, 2017

The Mock Cycle Is No Joke

October 31, 2017

In order to be better prepare my body for the embryo transfer in December, I spent most of October putting my body through a hormone induced mock cycle. The cycle uses the hormones (estrogen and progesterone) in the hopes of thickening the uterine lining.

img_4453-1.jpg

For seventeen days, I took a dose of 6 mg per day of estrogen. After ten days a vaginal ultrasound was performed to see how well the hormone therapy worked. The last five days of the cycle were the estrogen with the addition of  800 mg of progesterone.

A thick uterine lining is an essential component as this is the area in which the developing embryo implants in the early days of pregnancy. The ideal thickness of the lining is from 7 to10mm. I fell on the lower end, with 7mm by the time of the first ultrasound.  With this information in hand, my doctor is Spain made adjustments in the dosage of Estrogen for the real cycle.

thin-endometrium-infertilitypart-i-dr-sharda-jain-life-care-centre-15-638

For anyone who has endured hormone therapy, you feel my pain and discomfort. For those who have never experienced these treatments, it is best described as an emotional and physical roller coaster. Every day was a challenge both emotionally and physically. I am pretty sure that there were days Jeff was ready to strangle me.

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Thankfully for Jeff, October is the baseball playoffs. There were many days that we barely saw each other. A blessing for our marriage :-).

In all seriousness, people rarely speak of the impact on the spouse not undergoing the fertility treatment. These amazing individuals have to endure the wrath of the hormones, and can never truly empathize with the patient’s plight.

My refuge was exercise. My friends and family can attest to the fact that I am a gym rat, and enjoy the endorphins of exercise.  I am never one to complain about heat and humidity, but I was experiencing a double summer with the side of effects of the hormones, compounded by the unseasonable warmth of October.

Once October 20th came I was happy to give my body a break.

Stay tuned for the next blog in which I explain the birth control pill cycle.

Posted by: Babyblues | October 24, 2017

Vamos a España

October 26, 2017

In my last blog, I announced the intent to try IVF with an egg donor one final time. We are determined that the final round of fertility treatment is to be performed at a top notch clinic in a geographically convenient location in Europe. This is no easy task, as there are many top rated fertility clinics in Europe.

This time three countries were in play: The Czech Republic, Greece, and Spain. All offer great clinics, making the decision a difficult one. The lure of Crete is hard to pass up, but ultimately we had to cross it off the list because of geography.  Next on the list is Prague in the Czech Republic. We have visited Prague twice and truly enjoy the city and its people. Unfortunately, the commute to and from Greece and the Czech Republic in the winter months requires multiple flights. One lesson learned from last year’s adventure to the Czech Republic is that my comfort after the procedure is of the utmost importance.  This left Spain, which is attractive for its many clinics, and the ability to fly directly to and from New York.

During the course of his research, Jeff uncovered many attractive clinics throughout Spain, complicating the decision making process. In addtion, Spain is more expensive than the other two countries, which was a source of stress because we grappled with whether we should exceed our predetermined budget. In the end, we realized that the cheaper clinics are more difficult to travel to, and therefore, will require us to spend the money saved on transportation costs.

We are happy to say that we are going to https://ivf-spain.com in Alicante, Spain. We truly believe that this clinic is thorough, and gives us the best shot at conception with donor eggs.

As we move forward with preparations for an early to mid December embryo transfer date, I will be chronicling the various steps in the process.

Stay tuned for the next blog in which I write about the mock cycle.

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