A second opinion on everything, really.

Doc Awesome: Artist's rendition.

My second opinion appointment went really well yesterday. The staff at the clinic were very professional and rather friendly. I tweeted from the office that the patients sitting in the waiting room, however, looked a bit somber, but I can't blame them. It just made the contrast between the friendliness of the staff that much more apparent.

Dr. "I have an incredibly awesome/sexy South African accent" who I suppose I should just shorten to Doc Awesome was equally as warm and friendly. (I would've called him Dr. Sexy, but that's reserved for our vet: a post for another day.) I came armed with my list of a dozen questions and a folder full of test results. What astounded me was that I didn't have to sit and give my schpiel (menarch at 9, PCOS Dx at 18, ovary out the same year, thyroid problems at 20, POF/Hashi's at 26 blah blah blah)... he had actually read my file prior to my appointment and was able to give me my own summary back to me.

I find this astounding because with Dr. G, I could count on at least 20 minutes of repeat dialogue at every appointment, including having to go through my medical history at nearly every other appointment. Egads, a doctor that does his homework?? What is the world coming to?

Doc Awesome let me ask my myriad questions and many of the answers were ones that I had expected. Based on my various hormonal tests throughout the last year, it's POF. And like any POF-er, it's entirely possible to experience spontaneous ovarian function and even become pregnant, but that occurs in about 1% or less of the POF population. Bummer.

That being said, Doc Awesome said I'm a fantastic candidate for donor egg, and that POF-er's in general usually are great candidates for DE/IVF. Doc Awesome also oversees all of the donor cycles at this clinic, so I'm in capable hands. They run pretty aggressive treatments for donors and say they get as many as 20 eggs in one shot. Their success rates are also well into the 50-60% range with DE. I asked if my Hashi's could play in a role in the success of DE/IVF and he said that so long as it's maintained, it's a non-issue.

As far at the actual cycle itself, once we pick a donor and she is screened (and the screening process at this clinic is intimidating bordering on absurd- his words, not mine), I'd stop taking my birth control pills and switch to estrogen only. Meanwhile, she'd go on a stim protocol and trigger. The day of retrieval, Larry obviously has to do his thing in a cup, I'll add progesterone gel (sounds goo-tastic!), and the eggs are retrieved from the donor. Depending on how Larry's army looks, we'll either let them do the rumba in the petri dish or directly inject his sperm into the egg via ICSI. About 4 days later, I would come in for a 10 minute procedure to insert either 1 or 2 embryos into my lady parts... and then, voila, the 2ww. Should I choose, I can also add an hour of acupuncture/pressure before and about 45 minutes of the same after the transfer. All told, apart from the actual transfer and using donor gametes, it's par-for-par hormonally and experientially as any other woman experiencing pregnancy.

I mean, I wouldn't even get the giganto box o' needles from the fertility pharmacy. I could avoid needles.

This is huge for me folks. Huge.

All told, we're looking at about $15-17K when you factor in donor agency fees, donor fees, legal feels, and donor screening. (It seems silly that insurance wouldn't cover donor screening, since they are medical procedures, but apparently it's the one medical part of the process they don't cover, which can run anywhere from $2-4K.)

I'm not going to lie: this is WAY cheaper and potentially faster than adoption. And given my age, my other relative health, there's a good chance of this working on the first shot. I know DE/IVF is no guarantee, but even Larry brought up the point: if it didn't work, we would potentially still have other embryos on ice to work with again, given the aggressive retrieval protocol they run on donors.

And you know what? I do want to experience pregnancy and birth. I have resolved that I'll still be just as much of a woman and mother if I don't, but the pregnancy experience is still important to me after all. There's also a good bit of halachic vaguery about the Jewish status of a child born via donor egg, so believe it or not, according to Jewish law, donor egg is easier to navigate that adoption. I wouldn't necessarily need a Jewish donor if pursuing DE/IVF, but absolutely would need a Jewish birthmother if pursuing adoption, domestic or international.

After talking the appointment through with Larry yesterday, I think we're changing our minds... again. Once we save up the money, we're going to go for DE/IVF. I don't think adoption is off the table for us completely, but just not as our first shot.


In sum: Doc Awesome is pretty awesome. (He even complimented me for coming in armed with all of my info noting that I was "a lot more researched than the average patient, which is a great thing.") And when we're ready to go for donor egg... we'll be going with him. I feel really confident in his ability and he has a wonderful candor and sense of professionalism.

So yeah, there you have it. Donor egg is back on the table... and I'm really excited about it. The timeline all depends on how quickly we can hide away the cash, but I think we could probably do this by the end of next year.

I suppose I should start working on a new blog header image this weekend!