Decisions decisions:need advice on this last haul


#1

Ok ladies so we have been ttc for 3 years. 11 IUI’s 8 Ivf’s only made it to transfer twice. I am 41 and on my last leg before we move on to donor in August. I have great new insurance $35k so I am trying to decide what to do. Ladies in NYC over 40 or slow responders with low AMH please chime in and anyone else. Should I:

  1. Go to Cornell to see if I get lucky?
  2. Go to NYU. Heard they have a great lab
  3. RMA Ny?
  4. Stay with my RE and try to bank for transfer in a few months?
  5. Go to new hope and do the low Stim approach to bank blasts. I responded best to this protocol.
  6. Forget the insurance and go straight to DE?

I just can’t decide and dh is no help. Any advice you ladies can give will be greatly appreciated.

Thanks,

Alicia


#2

Given your age and DOR I think some sort of embryo banking with CCS testing might be the best bet. RMA does this… I actually just talked to them yesterday about it via phone briefly (just the finance person).


#3

Does your insurance allow any of that $35k to go towards DE? I would try again at least 1-2 more times with my OE.

I have not tried any of the RE’s on your list but I have an upcoming consultation with SIRM (Westchester office) If that doesn’t go well I will try Dr. Check. I have heard great things about Cornell. GL with whatever you decide.


#4

[QUOTE=sunrisec]
2. Go to NYU. Heard they have a great lab
3. RMA Ny?[/QUOTE]

These are great choices.


#5

Well I have low AMH and DOR - and when I was doing my research I heard Cornell is really good for that. Also I think banking is the best bet! Thats what I am doing (I am doing egg bankign though)


#6

Been there, done that

[quote=sunrisec]Ok ladies so we have been ttc for 3 years. 11 IUI’s 8 Ivf’s only made it to transfer twice. I am 41 and on my last leg before we move on to donor in August. I have great new insurance $35k so I am trying to decide what to do. Ladies in NYC over 40 or slow responders with low AMH please chime in and anyone else. Should I:

  1. Go to Cornell to see if I get lucky?
  2. Go to NYU. Heard they have a great lab
  3. RMA Ny?
  4. Stay with my RE and try to bank for transfer in a few months?
  5. Go to new hope and do the low Stim approach to bank blasts. I responded best to this protocol.
  6. Forget the insurance and go straight to DE?

I just can’t decide and dh is no help. Any advice you ladies can give will be greatly appreciated.

Thanks,

Alicia[/quote]

Alicia,
wow… we are in similar boat now… I had two healthy pregancies easy… Then wanted third at 40 and it is not happening. I had benefits so went straight to IVF to get the job done thinking I owuld be easy case. But after 40, things really change fast. I did 2 local IVFs before doing research like you and going straight to Cornell (very far from where i live).
So Cornell is top notch… very good. If you live there, go there. BUT>>>>>>> and this is big but… after what you have already done, I would be most apt to go straight to CCRM at this point. If you want to give it the best try you got, go there. THey test for absolutely everything and I feel like without a single bit of hesitation I can tell you that your body will be examined from top hair on your head to toenails and the full gamet (sp?) of issues will be examined. Then you can say you gave it your all. I am not a big fan of the testing on embryos. I feel like if you only have a few, put them back in and give it the best chance you have. So as a low responder, don’t waste your money on that. But don’t go to Cornell if you are really at the end of your journey. GO STRAIGHT TO CCRM.
Now, insurance … I’m in same boat as you… should I use my money toward donor or try again on my own. Hm… I haven’t found too many places that say you get insurance help with donor. So sounds like that is an out of pocket journey. So at 41, you should go straight to CCRM. Go today… go now and give it your best shot. If they can’t do it, no one can.
I think Cornell is good, but they leave many stones unturned and some of those hurt me I think (I think I had an infection in my uterus causeed the last IVFs not to work)… and they failed to do ICSI on my only good cycle of 14 eggs. I just don’t think they leave anytihng to chance at CCRM and that is what you need. Believe me, the one thing you don’t have is second chances and time. So go to the best.


#7

Just a quick comment on why I recommend embryo testing. At 41, even if you do get pregnant, there is a high chance of m/c… somewhere in the range of 40% of all clinically recognized pregnancies end in m/c (according to national SART statistics for 41-42 year olds.) So if you get pregant and m/c you will lose precious time while you wait to potentially cycle again. This happened to me on one of my IVFs. At almost 10 weeks, an u/s showed a m/c. I had a D&C and then had to wait 3 more months to cycle again. So I lost half a year.

So I’m really recommending this mostly to avoid m/c and the lost time that accompanies that.


#8

testing

[quote=familyhopes37]Just a quick comment on why I recommend embryo testing. At 41, even if you do get pregnant, there is a high chance of m/c… somewhere in the range of 40% of all clinically recognized pregnancies end in m/c (according to national SART statistics for 41-42 year olds.) So if you get pregant and m/c you will lose precious time while you wait to potentially cycle again. This happened to me on one of my IVFs. At almost 10 weeks, an u/s showed a m/c. I had a D&C and then had to wait 3 more months to cycle again. So I lost half a year.

So I’m really recommending this mostly to avoid m/c and the lost time that accompanies that.[/quote]

Cornell won’t do the testing… just FYI. They don’t believe in it… especially for low responders. When you only have 3 or 4 eggs to work with, they don’t want to manipulate them. I asked 5 clinics when I was doing research and most of them did not recommend the testing for low responders. I had a good friend do it at the houston clinic or dallas clinic that works with CCRM and she swears by it. But she got pregnant with one good egg… she’s 32 though and not a low responder. just bad egg quality. Testing also takes time, so I think in the end, you won’t waste more just putting them back. You avoid freezing them too. Mixed reviews on the testing. Ask the clinic you go to. I know CCRM does do testing… which also improves their success rates a great deal (kind of articially so). Still think they are top clinic for hard cases.


#9

thank you for all your suggestions. This is such a tough decision. Macy we can’t afford CCRM. Any cash we have will be saving for donor. We just want to get the best shot for our $35k in insurance coverage. Macy did CCRM get your pregnant? are you pregnant now?

I need to sleep on this… keep the suggestions coming…

Thanks,

Alicia


#10

Ccrm

[quote=sunrisec]thank you for all your suggestions. This is such a tough decision. Macy we can’t afford CCRM. Any cash we have will be saving for donor. We just want to get the best shot for our $35k in insurance coverage. Macy did CCRM get your pregnant? are you pregnant now?

I need to sleep on this… keep the suggestions coming…

Thanks,

Alicia[/quote]

If you have 35k in insurance, would that not work toward CCRM? I’m saying to use insurance at CCRM instead of Cornell. I know you may have to travel, but that is nothing in the overall cost. You can get cheap hotels in CO and few cheap flights. I woudn’t waste money at NYU or Cornell doing the same thing over again.
I have not found many donor programs that use insurance for much at all. Maybe for about 5k of your costs… So the 35k will just be for cycles mostly with your own eggs and 35k should cover couple of OE cycles and the 5k of donor stuff that is covered.
I didn’t go to CCRM… i did the Cornell route and was a bit of waste. Now I’m tired out. But if i do another cycle, would be at CCRM if anywhere.
no … not pregnant.
And I’m not saying you would have success at CCRM. But anyone who has done a few rounds elsewhere should go to CCRM or nothing. I think the rest are no different than what you have already had. And you have little time or resources left to just try and get lucky. My opinion. Good luck.


#11

CCRM won;t take aetna out of the state of colorado from my understanding…

[quote=marcycantrell]If you have 35k in insurance, would that not work toward CCRM? I’m saying to use insurance at CCRM instead of Cornell. I know you may have to travel, but that is nothing in the overall cost. You can get cheap hotels in CO and few cheap flights. I woudn’t waste money at NYU or Cornell doing the same thing over again.
I have not found many donor programs that use insurance for much at all. Maybe for about 5k of your costs… So the 35k will just be for cycles mostly with your own eggs and 35k should cover couple of OE cycles and the 5k of donor stuff that is covered.
I didn’t go to CCRM… i did the Cornell route and was a bit of waste. Now I’m tired out. But if i do another cycle, would be at CCRM if anywhere.
no … not pregnant.
And I’m not saying you would have success at CCRM. But anyone who has done a few rounds elsewhere should go to CCRM or nothing. I think the rest are no different than what you have already had. And you have little time or resources left to just try and get lucky. My opinion. Good luck.[/quote]


#12

Alicia- Have you looked at the success rates for RE clinics in the US in your age group? Here is a great link that might help you: http://fertilitysuccessrates.com/report/United-States/women-41-42/data.html.

I was told by my RE in FL that I would have to use donor egg and so I decided to use the site I linked above to research the best donor program, fortunately for me the RE in IL did not think I was ready for donor. His clinic had amazing success rates for my age group, so we traveled to him and had a very successful IVF cycle. I feel it is very important to research RE offices and their success rates. Best of luck to you!
[URL=“http://fertilitysuccessrates.com/report/United-States/women-41-42/data.html”][/URL]


#13

I use RMA- a few new things… they DO NOT DO 3DT anymore. So you would have to make it to blasts. They do have a great lab and offer every service you can think of. They automatically did ICSI on our eggs due to my age. With that said I am still pending pregnancy… I have gotten blasts everytime… I think if it doesn’t work this time I am going to to the genetic testing. Then Im done.

I hear that Cornell has only 2 protocols and that they are very interpersonal. Alot of people have left Cornell and came to
RMA. My RE says that New Hope is a scam… That your paying for all this money and in reality it still a crap shoot. If I was to go somewhere after this… I would look into NYU or see is SIRM takes my insurance.

Hope that helps.


#14

Great point and as of yesterday, the 2011 success rates are posted on SART, the most accurate and reliable source for information stats.

[quote=gte1011]Alicia- Have you looked at the success rates for RE clinics in the US in your age group? Here is a great link that might help you: http://fertilitysuccessrates.com/report/United-States/women-41-42/data.html.

I was told by my RE in FL that I would have to use donor egg and so I decided to use the site I linked above to research the best donor program, fortunately for me the RE in IL did not think I was ready for donor. His clinic had amazing success rates for my age group, so we traveled to him and had a very successful IVF cycle. I feel it is very important to research RE offices and their success rates. Best of luck to you!
[/quote]


#15

what did you decide to do… I tried CCRM and they wont take my insurance either. I don’t think SIRM does either.


#16

Thanks Ladies,

mywish got me thinking about emotionally dealing with doing more cycles. I think what scares me or knots my stomach up is going to yet another clinic, doing some tests over again. Another consultation. etc… It is draining. When you switch you get more hopeful thinking it will be the one. I am leaning towards staying with my clinic (SIRM), then doing international donor cycle. We are also exploring adoption. May do both at the same time.

Will keep you posted.

Alicia


#17

[quote=sunrisec]thank you for all your suggestions. This is such a tough decision. Macy we can’t afford CCRM. Any cash we have will be saving for donor. We just want to get the best shot for our $35k in insurance coverage. Macy did CCRM get your pregnant? are you pregnant now?

I need to sleep on this… keep the suggestions coming…

Thanks,

Alicia[/quote]

If your $35k insurance coverage does not cover DE, then of course it makes lots of sense to use it for OE. And if you’re going to use it for OE, then $35k should cover you at CCRM. We cycled there. They did CCS testing even though we only had two embryos. Total cost–and we were out of pocket–was about $32k (including the precycle testing, including the CCS testing, including ICSI, but not including meds). I’m not including meds in the cost because my insurance covered those so I have no idea how much they would’ve cost.

But that said, RMA-NJ in Morristown, NJ is a lot closer to you, has a Manhattan office so you can do your monitoring conveniently, has excellent success rates AND, this is the most important part for women our age, DOES CCS TESTING. Oh, and it’s cheaper than CCRM. I would trust them before I’d trust Cornell or NYU, and I say that as someone who actually consulted with IVF docs at both Cornell and NYU. Those two clinics have a lot going for them, but for the amount of money we’re spending I have trouble justifying spending it at a place with lower success rates, and I just plain do not trust clinics that don’t offer CCS. I just think if they don’t offer it, their lab is simply not good enough to do it well (i.e. their lab would hurt the embies if they tried).

For comparison, here are success rates for women 38-40 and 41-42 (by success rates I mean LIVE BIRTH, not just pregnancy, per cycle):

Cornell: 38-40 25.1% 41-42 14.3%
NYU: 38-40 18.8% 41-42 10.3%
[B]RMA-NJ: 38-40 33.7% 41-42 19.4%
CCRM: 38-40 35.3% 41-42 32.4%[/B]

Notice how RMA-NJ and CCRM both have success rates in women 38-40 that are almost DOUBLE the rates of NYU?


#18

Huh… Now you have me thinking since I have had multiple cycles at RMA with good blasts and no births…

Where to go from here if not cornell or NYU?


#19

You are at SIRM… If they take my insurance I may go there for consultation, but like you I have no desire to continue with more tests and then have the same result. What is international egg donor… Never heard of it. Is it cheaper. I already am looking at adoption.


#20

Hi Alicia,

Could you consider cycling yourself and doing a shared donor egg cycle at the clinic that you choose at the same time? The shared DE cycle would cut down on the cost, and if you make it to transfer with your own embryos, then you can freeze donor embryos for later use. As you can see from my signature, you are stronger than I - I couldn’t handle more “failure” and moved on to adoption much earlier. This is such a personal decision, and certainly if you aren’t ready to throw in the towel with your own eggs, then you have to keep trying now.

I think that giving myself a break and having a wonderful adoption experience took the stress away, and led me to be successful (thus far) with my current pregnancy. I am sure that there are 40+ women who have easy pregnancies, but this pregnancy has been really, really hard for me. Adoption was sooooo much easier! So, I guess that I would take this into account too; and the older that you are, then the higher the risk.

I hope that your next cycle with your OE works out if you choose to move forward; but I just want to let you know that you will love your child no matter how he/she comes to you. You will be a mother soon, one way or another! Hold on to this and best wishes.
:grouphug: