Appointment with my sister

The appointment yesterday afternoon with Dr.Dry and my sister went well. Unfortunately, Mr.Right wasn't there (he was at a work-related meeting out of town), but it was pretty straightforward so I don't feel like he missed all that much. As expected, the visit was mostly about my sister and Dr.Dry getting her history since he knows far, far too much about my history already.

And my sister's history is pretty straightforward too: 2 pregnancies, both resulting in live births (and two cute nephews if I say so myself!) I found out that they got pregnant the first month they really tried (I'm not sure if that was both times or just for the first one; I seem to recall she told me that she got a positive pregnancy test the weekend of my wedding, but then got her period 2 days later - however was pregnant the very next month with her second child). Her cycles have returned and returned normally. So, she seems to be a good candidate, albeit with the caveat that she is 36 1/2 and so probably has the normal rate of genetically abnormal eggs for that age. (Oh yeah, and no need to remove her copper IUD, yay!)

The next step for her is to get bloodwork (FSH, LH, estradiol) and ultrasound (antral follicle count) on CD3 which should probably be early the week after next. (Interestingly, we're actually sync'd up with our cycles right now). That will determine whether we move on with her eggs.

In the meantime, for me, Dr.Dry started out the visit saying he was a bit on the fence about having me get a thrombophilia workup done and a hysteroscopy. We had long talked about doing the thrombo panel but had never done it. Obviously, I've carried a pregnancy for 13 weeks (which was terminated by us, not by miscarriage) so there's at least some indication that I don't have a clotting problem. But it's kind of one of those 'well, if we're going to put my sister to all the trouble (and we're going to go to all the expense) let's just make sure every last thing is ok with me before transferring those embryos to me' kind of decisions.

The story on the hysteroscopy is pretty much the same, although with a shared-risk wrinkle. I had actually asked Dr.Dry about having a hysteroscopy after my last D&C and he said at that time as we were preparing to try IVF with my own eggs again, that a repeat HSG would be sufficient to look for any damage from the D&C (and plus, an HSG can sometimes be therapeutic, helping to clear out the tubes, as it were). So, I did a repeat HSG. The doc who did it did find a small area in my uterus that was a bit 'ragged.' But it was minor and the assumption was that it was probably a bit of scar tissue from the D&C, but nothing that would likely affect the ability of an embryo to implant.

So, again, doing the hysteroscopy now would be a kind of extra effort to make sure all of the effort my sister and we are putting into this cycle won't go to waste. But then we talked about qualifying for shared-risk with my sister as donor and while it's mostly my sister that they'll look at for qualification (basically her day 3 results) he then said that we would need to do the hysteroscopy to make sure I wouldn't be the disqualifier for shared risk.

I'm not entirely thrilled about the hysteroscopy after yesterday afternoon, however, since Dr.Dry, in the course of explaining why they don't do many hysteroscopies anymore, explained that he felt it was unnecessary to put patients through the pain of a hysteroscopy. And that they were sort of a 'pain' to do in the office since they don't use anesthesia apparently and if they do find something they need to fix apparently they have to stop and send you to the surgical center to complete the work. Ugh. But, I know I tolerate pain pretty well. He basically said I'd just need to take a bunch of advil and just kind of grit my teeth for 5 minutes. Lovely.

Any hysteroscopy experiences welcome - even painful ones. At least I'll be prepared and maybe even pleasantly surprised if it doesn't turn out to be painful. (I always read people's stories of painful IUIs or mock embryo transfers and think, what are they talking about? I felt absolutely zero pain in any of those procedures. Maybe some minor discomfort but no pain. And I haven't filled a Vicodin prescription after a retrieval yet. In fact, I'm not even sure I took a Tylenol after last retrieval.)

So, I'm off to the lab on Monday to get blood drawn for the thrombo workup and I'll get the hysteroscopy done between CD5 and 10 of next cycle. I might also just start on OCPs this next cycle which would allow me to get the hysteroscopy done at any time and perhaps preserve being 'in sync' with my sister. Not quite sure yet if I want to do that. It would mean that we would give up getting pregnant on our own next cycle. (Which, of course, has a less than 5% chance of happening anyhow probably.)

My sister won't start OCPs until the cycle after next, so that really puts us at mid-March for the start of her stim cycle. We were pretty much expecting that kind of timing. I guess there was a little bit of hope in me that she might start on OCPs week after this coming week, but there's still the psych testing, counseling session and a bunch of other stuff that has to be done.

Finally, either my sister or Mr.Right (we still have to confirm with the donor office people whether it has to be my sister) has to do genetic testing which, apparently, is now done via cheek swab!! I asked about this since when I started at the clinic in August 2009 I had blood drawn for all of the genetic testing they require for IVF. And now they can just do a cheek swab and get a lot of that apparently. Has anybody had this done? Apparently, it's pretty cheap as well and most insurances now cover it.

I've still got to sort out exactly what permutation of known donor/shared risk/all-inclusive payment plan we're going to go with. I filled my sister in after the appointment about shared risk. I told her that even though that would give us 6 fresh cycles, we didn't expect to ask her to do more than one cycle. If it's really true that we can pull out at any point and get all but $6k back, we would do that. Otherwise, we'll just pay for a single cycle. Which would be more expensive if it doesn't work because either way we'll be moving on to shared-donor/shared-risk anonymous donor eggs at $30k, but like I said in a previous post: screw it. It's worth it to try once with her eggs.

So, we wait for my sister's CD1 so we can call and get her in for bw and us on CD3 (or CD2 or CD4 - they don't really care). I'm planning to go over to my sister's house the night before her CD3 appointment and stay overnight so I can help either get the boys to daycare in the morning or go with my sister to the appointment if she wants me to, or both. We'll figure out what works best based on the time of her appointment. Fortunately, our clinic has an office pretty near my sister's office.

Phew. A lot of info. But no real surprises. So far, so good.