Consult #2: With Dr. Shapiro

Had consult #2 with Dr. Shapiro today, on the phone. Here’s what went down. As always, please note that I wrote this stuff down quickly, that I am a layman and might not have understood all correctly, and that there could be many errors below. Please also note that all information I am trying to transcribe here is from what Dr. Shapiro said to me on the phone; these are not my words/researches/opinions.

General:

  •  50 – 55% chance this is something we cannot account for, because 50 – 55% of reasons for pregnancy loss are never discovered. The loss of a normal male is surprising and confounding. It is entirely possible that my problem is not discoverable. And therefore not treatable.
  • He is very surprised that I miscarried a normal embryo, considering how healthy I am, how normal everything is, and how easily I get pregnant. I can tell that he is now concerned that I am part of that 50-55%.
  • However, the genetic test I had done on the embryo cannot test for imprinting errors and mitochondrial DNA errors. (I explain what these are below.)
  • There is a small chance it could be an imprinting disorder in DH. Cannot test for.
  • Could be imprinting disorder in donor. Cannot test for. (IF it is an imprinting disorder, could be DH, could be donor, no way to know, it’s 50/50.)
  • Inflammatory process/immune response could be happening in uterus. Could be other uterine problem. In any case, it is  more likely to be DH than a uterine problem, he says; DH is the common denominator in all 6 losses, not me.
  • If my hysterscopy shows no uterine abnormalities, we will treat for the possible immune/inflammatory response with a scratch biopsy + antibiotics, and anticoagulants (Lovenox, aspirin). No Prednisone (I’ll explain below).
  • He says this is probably not a blood-clotting issue.  
  • He sees no reason to not try to implant the embryos.
  • He gives us a chance of success of 65% for DET, 55-60% for SET.
  • 20% chance of twins and 10% chance of pregnancy loss with a DET.
  • 1350 people have participated in the egg donor program (850 babies born). 16% have miscarried. 35 – 40% of the miscarriers have attempted an FET using the same batch of fertilized eggs. Of these, 50% were successful.
  • It is still most likely that my previous 5 losses were genetic, especially since the three embryos tested at CCRM had trisomies. The five previous losses could also be due to a mitochondrial problem that happens with great frequency in the early development of embryos in mothers in their late 30s, early 40s. Or it could be DH.
  • As for this 6th loss, he believes there is a less than 20% chance that it has something to do with me; in other words, 20% is the uterine problem rate.

What is an imprinting disorder?

  • The “on-off switches” of the DNA are messed up. In an early embryo, the # of “on-off” events is huge. Even if the father’s semen analysis is normal, his DNA can contribute to an imprinting error at this stage. 100,000 imprinting events happen in early development—half are related to the father, half are related to the mother (the donor, in my case). That’s the 50/50 chance of probability I mentioned earlier.
  • If a person exists, we know that he or she imprinted correctly themselves as embryos, so one would think their offspring would imprint correctly, too, but errors do occur.

What is the problem with mitochondrial DNA that can occur? 

  • These errors come directly from the mother. New data collected during the past year shows that it is really common for a woman in her late 30s, early 40s, to contribute a mitochondrial problem in early development that cannot be detected through genetic testing. As with an imprinting disorder, we are not (yet) able to test for it. The embryos test “normal.”

The immune system plays an elegant role, and why he does not want me on Prednisone:

  • The immune system plays an elegant role in reproduction, he says. And my immune system is showing that it is functioning well when it comes to implantation–embryos implant.
  • There are two types of cells involved. T Helper Type 1 cells & T Helper Type 2 cells.
  • What we want to down-reguate are the T Helper Type 1 cells. These are down-regulated by scratch biopsy + antibiotics. The biopsy does this by calling in tissue repair–tissue repair essentially = T Helper Type 1 cells. (So we down-regulate them by calling them in? Then using antibiotics? Not sure I understand this, but I trust him.)
  • What we do NOT want to down-regulater are the T Helper Type 2 cells. These cells actually help in implantation.
  • Prednisone would down-regulate or wipe out all T Helper cells. It is a shotgun approach.
  • Scratch biopsy + antibiotics down-regulates the cells I don’t want while favoring the cells I do want.
  • Only one patient has been put on Prednisone (by him? by RBA?) and it was because she demanded it, and had a previous immune disorder.
  • He says that the literature does not favor Prednisone; 2 papers 10 years apart agree that it causes more harm than good.
  • In the long run, Prednisone can cause 2nd and 3rd trimester complications, says the literature.
  • Prednisone increases the risk of abnormal placentation, hypertension, preeclampsia, increta (sp?), obstetric hemorrhage.
  • Prednisone increases implantation errors–not high rates, but not equivocal.
  • Not proven yet–Prednisone causes low birth weight, cardiac problems, and subtle birth anomalies.

DQ Alpha matching and NK cells:

  • Both of these were disproven years ago. Started with Susan Couchuk (have definitely spelled name wrong) in Philadelphia. She borrowed her thinking from kidney transplant studies.
  • Hypothesis: some women do not create proper blocking antibodies because of similarities to husband. Solution? Blood transfusion from husband.
  • She withdrew all publications she created, because this was proven to not be true; the FDA banned blood transfusions.
  • After ban, all flocked to immunoglobin therapy, and Dr. Alan Beer of Chicago. He died 10 years ago. He charged $3500 for an immune testing panel that he knew had a high possibility of false positives.
  • The research that Beer et al points to: 8 patients in a non-peer-reviewed study published in a vanity journal that Beer himself was the editor of. The research was faulty, the paper was a sham, and the successes were a sham.
  • Note: Intralipid therapy is a soy extract that has a very weak immune suppressive effect.

More on NK cells:

  • The name “natural killer” came about in the 70s and 80s. It is an unfortunate name.
  • In the normal (fertile) population, there are NK cells in the endometrium and they can help with implantation. They should not be down-regulated.
  • They suffer from a bad name, and a misconception of what they do.

Why he does not recommend Neupogen:

  • Cyclist “dope” with neupogen to increase blood flow.
  • The idea behind taking it is to increase blood flow to the uterus, but again, it is not a proven therapy. People are reaching, trying anything and everything. But trying anything and everything is not always such a good idea.

Why Lupron is okay:

  • He does not think Lupron is anything for me to worry about, because I had fine implantation. The only thing Lupron might possibly do is thin the lining, but my lining was fine.

Why Crinone is okay (and I don’t have to use PIO, thank GOD):

  • My progesterone was normal at first check, which means Crinone was doing its job.

Vitamin D and Folic Acid

  • We can put me on some extra Vitamin D and Folic Acid. It’s in the “can’t hurt, could help” camp. This was prompted by me. I don’t think he would have mentioned it otherwise.

Moderate wheat allergy

  • Celiac’s Disease has been associated with pregnancy loss but there isn’t any data on wheat allergy and miscarriage. It’s a good idea to be on a gluten/wheat-free diet.
  • But in any case, I will be on Lovenox this time around, and that is what they use to treat this.

Donor:

  • “Any new information on the donor? Any red flags in her profile? Is the one ongoing pregnancy still going well? Did the other couple, who got a negative preg test, eventually get a positive using this donor’s eggs?” –No new information. He said he’ll find out.

DET or SET?

  • SET is the better choice, because if this problem is random, it might not hit twice (would be two SET tries).
  • “But because you have already told me during our last consult, and now in writing in this last email, that you are at the end of your rope, and this might be the last try for you—then DET it should be,” he says.

Next cycle:

  • After hysteroscopy this month, should have normal period (I predict the last week of December).
  • 21 days later, I could start Lupron.
  • Same as last time: Lupron, Vivelle, Crinone, scratch biopsy, antibiotics, baby aspirin.
  • Not like last time: Lovenox, maybe some more Vit D and folic acid, and possibly a DET.
  • Basically the difference would be–Lovenox. And he doesn’t even think this is a clotting problem.

He’s a very smart and articulate man and I greatly appreciate the time he took to explain things in such detail. I feel lucky he is my doctor. I wish there were more he could suggest in terms of treatment, but I trust that he knows what the hell he is talking about. I don’t know how conservative he is being about the Prednisone…is he being conservative or is he just being super-smart? I mean, I know he is super-smart….it’s just that I wanted to take something extra, something more, something different. He recognizes that, and he is warning me that that is not a reason to take something. That by taking Prednisone I could be causing more harm than good. Thoughts? What do you think about the Prednisone?

How do I feel about it all? Sigh. I don’t know.

I’ll try again. One more time. I am already thinking about how I will not ask for any #s—no beta #s, no fetal heart rate #s, no measurements. Local RE can communicate all of that to RBA and leave me out of it. I will just close my eyes and hope for the best. Knowing the numbers will not help me control anything any better; it will only cause anxiety. I might even close my eyes when my uterus is up on that screen, at least until week 8 or 12, if I get pregnant, and if I make it that far. Dr. McKenna described early pregnancy as a bungee jump. Yeah. That sounds about right.

Good night.

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38 Comments

  1. I can’t remember if I actually commented here or just thought it in my head. But I think he’s onto something with DH being the common factor. After three IVF losses and a failed FET (a total of 9 embryos transferred), we finally agreed to do a split cycle with a sperm donor for our last shot. It was cheaper than any other alternative, and allowed us to compare DH’s fertilization and development with the donor. We ended up doing a 2/3-1/3 split (more of DH) and ended up with equal numbers of each embryo type. We transferred the two best (one DH, one donor). I am now 24 weeks with a singleton. I firmly believe that even though there is no test to prove it, our losses were linked to DH’s wonky sperm.

    Reply
    • Yeah I have to wonder. There just is not enough known about paternal contribution to all of this. That’s the first thing I thought when he said that 50-55% reasons for pregnancy loss are unknown—male factors. It sounds like you found your reason. I’d try donor sperm at this point. Maybe if this doesn’t work he’ll recommend we try donor sperm with a new donor. But I don’t think I will make it that far.

      Reply
    • P.S. yes you did comment on here before about this, thank you (:

      Reply
  2. Interesting, thanks for sharing in such detail! Um, did I read that right that Lovenox is used to treat celiac-related infertility? I am celiac but have been gluten free for 4.5 years (and all the time we’ve been attempting pregnancy). My current clinic is very anti-lovenox but my second opinions have not been. I am definitely interested in more info on this!
    Anecdotally, I know an awful lot of people who were successful after going donor sperm. I don’t know why but it does seem to be a common variable. It definitely is for me, yet my current clinic would not consider it a possible culprit. (Hence I should be calling them my former clinic). That’s a toughie because there’s no epigenetics with sperm, but a baby is a baby… at this point I think for us at least it’s on the table for our “last hurrah” attempt at the medical piece. Very interesting stuff that you’ve shared–I have also wondered about neupogen but I’m relieved to find that it isn’t necessarily the best option.

    THanks for sharing… good luck with your DET! It sounds like a good idea to me. But what the hell do I know? :)

    Reply
    • Thanks darlin. He didn’t go into more detail about how Lovenox treats Celiac’s but he did indeed say that that was what they use to treat women with that disorder.

      Donor sperm. Yes, I need to find out what the fertilization rates, etc., were with the other couples using this donor, because that will help me with the puzzle. I really wish he’d had more information during this consult.

      We could do donor sperm and donor egg…I’d do anything to get out of this maze with a family.

      Reply
  3. That is a lot of info and I am very glad that you have a doctor who will take the time to sit down and discuss everything with you. Sounds like you learned a lot!! How will they time the scratch biopsy? Mine was in the cycle before my transfer. It hurt but it finally helped me have success!! Thinking of you as you make decisions about the next cycle

    Reply
    • Unfortunately I did a scratch biopsy + antibiotics this past cycle, and it didn’t help…): But it was timed I think about 2 weeks before transfer, or something like that. It really does hurt! I might ask to go on light sedation. I’m going to have them dope me up with tropophil for the hysteroscopy—I’ve had it with painful probes into my cervix. I’m glad it helped you have success!

      Reply
      • Yes it hurt!! Hmm have you talked to your doctor about having them in the cycle before the transfer? I have mostly read of people having the scratch, then a period, then the IVF cycle. Worth a question!

        Reply
    • Well, I will end up essentially having 2 done—because the hysteroscopy will involve a biopsy (next week). And then I’ll get another one the following month.

      Reply
  4. That is a lot of information to digest but you have a really great doctor that was able to explain everything to you in detail! I must add that you take very good notes :) I am saying lots of prayers for you that this next round work!

    Reply
    • Yeah, I really appreciate how thorough he is. I feel that he and I are kindred spirits of sorts, on that front! We both like detail. He has great respect for his patients, I think—he talks straight, and he does not shy away from explaining complicated information. I get the sense that he knows I’m smart and can make sense of it all along with him, doesn’t talk down to me, etc., like some doctors do. He’s awesome.

      Reply
      • my last doctor definitely talked down to me. He was a bit arrogant to say the least.So glad you found a good one :)

        Reply
        • Ugh, arrogant doctors are the worst—had a few myself. They can make a hard situation even more unbearable. Yeah, I feel comfortable with Dr. Shapiro, and that’s no small thing. I wrote him and a nurse a gratitude email for Thanksgiving.

          Reply
          • aww that is so sweet of you! I am sure that put a smile on both of their faces. It’s always nice to know when you are appreciated :)

            Reply
  5. All of this is interesting to read. I completely agree with Dr. Shapiro’s assessment of the literature on immunological issues linked with infertility (though I think the reason those articles were retracted is because no one could reproduce the data). The genetic end still makes me hem and haugh as usually it effects things early and isn’t as cut and dry as we originally thought.

    That said, I do think your plan for moving forward is a good one. For my last FET, I was also on low dose aspirin + Lovenox. This treatment course was chosen because of my suspected APS and because treating with Predisone was also not ideal (too many long term risk factors). The only difference, though, was the PIO. My RE believes that Crinone isn’t enough for FETs (and after 2 losses while on the stuff plus verified low progesterone levels, I agree with her). In addition, I actually felt better on the PIO then the Crinone. Granted the shots are painful, but compared to all the side effects from the Crinone it was a lot better (and cheaper). Something to think about.

    Wishing you luck for the next cycle.

    Reply
    • Yeah, the difference is my progesterone levels were not low, they were fine, so the Crinone was doing its job. Did you have success with aspirin + Lovenox? I hope so! Yeah, I don’t have any suspected conditions on that front; I’m fine with the intervention it’s just that there is nothing indicating that I need it, so it doesn’t make me feel too confident that the Lovenox is the only change to my protocol. I was really hoping for Prednisone—but I realize that is based more on emotion at this point (wanting to try something different) than anything. Am currently researching, trying to find any/all Prednisone-related peer-reviewed articles…

      Reply
  6. I have a hard time with the donor sperm issue when you get high quality blasts and you know the karotype was normal. It’s frustrating since I’ve known a lot of women whose DH suffered from severe MFI and they had healthy babies. I don’t see how this imprinting thing can be so bad as to cause a miscarriage in a chromosomally normal fetus. I think there’s more to immunology than most REs want to admit or address.. But I agree there are limits as to what each individual patient will do.. If you and DH are open to DS, it would be interesting to see if it makes a difference but I still think it is an incompatibility (for unknown reasons) between your body and DH’s sperm–not inherently something wrong with the sperm. I hate that this is a guessing game as it is so painful to endure. Even though my DH’s sperm is “normal”, we did not get a single blast from two different donors. We were at a sub-par clinic so I blame them right now but if it happens again at RBA, I will have to face the DS conversation. A sperm unknown that doesn’t show up in tests. A crappy place to be. I like direct evidence and not circumstantial evidence. We can’t get that with ART it seems. Hugs.

    Reply
  7. If it comes to it, have you thought about donor embryo? I’ve been thinking about it a lot lately, and it has some definite advantages. Its much cheaper than donor egg or adoption, and since you can almost never know for sure that it isn’t a problem with the man’s genetics, it saves you that risk. Of course the only thing it doesn’t protect from is something uterine. I think we’ll end up seriously considering it if this pregnancy doesn’t work out.

    Reply
  8. I am so glad to hear that you trust Dr. S. That is half of the battle when it comes to making health care decisions. And from what you said about the consult, I would trust him too. Even better, his opinion should give you a little hope–he has not given up on you or your remaining embryos. Again, so glad to hear it.

    Reply
    • Yeah, it really is a good thing to be able to trust, isn’t it. I’m glad he hasn’t given up—but I have to say that he did not sound enthusiastic, either. ):

      Reply
  9. Wow, this is a lot to consider. The positive thing I hear in this is that you have the ability to run some bloods, add some low-risk treatments just in case, and maybe see a different outcome. I am always hopeful for you and wishing, wishing for better luck next time Xo

    Reply
    • Thank you for seeing the positives for me—I have almost completely lost my ability to do that at this point. Keep hoping for me, and I will hold out hope for you. xo

      Reply
  10. So much to consider. I so long for you to succeed next time. My heart is with you on this long, challenging journey. Thank you for liking my blog and guiding me up yours.

    On the prednisone question: I wouldn’t do it. But you will know and do what’s best for you. Prednisone can save adult lives too but is known to cause much harm in long term use. And the risks, as Dr. S reviewed with you, are considerable. Again, however, just my own view.

    Reply
    • thank you so much for that—it’s weighing heavy on my mind, the prednisone question. i just want to trust and go with what he says, but it’s nagging at me, the what ifs…or really what i am imagining is lying on the table, in stirrups, and scream-crying: “I should have tried prednisone.” so emotions and a now very strong desire to protect myself take over rational thinking.

      i have inner child cards on their way to my home. made me think of you, actually—you might like them. by isha lerner. i have the book but not the cards yet. the book provides a little bit of spiritual guidance.

      Reply
  11. Tess

     /  November 29, 2013

    I’ve used prednisone for past cycles, and it hasn’t helped me get pregnant. I’m cycling for an FET, and prednisone was prescribed (not long term — it’s just for implantation) but I had been considering not taking it. After reading what Dr. Shapiro said, I’m more inclined to not take it.

    The prednisone does mess with mental health a bit. And my doctor is throwing it in, “just in case.” But Dr. Shapiro seems more up on the recent research. To date it hasn’t helped at all.

    It sounds like the Lovenox is going to be what helps, and not the prednisone, in any case. And prednisone can hurt the fetus. I’d advise not to take it just for emotional reasons — the just in case reasons.

    btw – embryo donation in Europe is quite cheap if this is something you might be interested in, in the future (Czech, Greece, Spain.)

    Good luck, and take care.

    Reply
    • Wow, thank you hugely for this comment. It helps me a lot. After reading it I did some research on mental health effects—could be not too safe for me, actually, when it comes to mood, depression. I’m so sorry it hasn’t helped you! How frustrating.

      Embryo adoption is definitely still on the table. I used to live in the Czech Republic (Prague) so I’ve actually thought of that some—I know treatments are much more reasonable there and I’m familiar enough with the country and Prague that I would feel comfortable. (Although my Czech is nearly gone.) If you can point me to any information or resources on embryo adoption in those countries, I would greatly appreciate it.

      Reply
  12. Your case sounds sort of similar, and slightly different from mine. I’m MTHFR (C677t) and PAI4g/5G heterozygous. I’m a *maybe* case of PCOS with a high AFC. Like you, I get pregnant (nearly) every time I try. I was younger when I started (30)

    My first loss was a chromosomally normal boy miscarried at 8-ish weeks (growth at 6w4d was only 2 days behind and started lagging, not enough to alarm the doctors; missed m/c was detected at 12 weeks). My second loss was Turners syndrome. My 3rd loss was Trisomy 4, with all losses happening between the 7-9 week range. I’m using a sperm donor and he has helped create atleast 13 healthy children, so it is probably all me.

    I’m a scientist (an immunologist actually) and I’ve tried to look at this issue from every which way possible. I think, both in my case and yours, a genetic defect during meiosis (resulting in either aneuploidy or microdeletions/insertions that cannot be picked up through karyotyping) in the eggs or sperm or both has a higher chance of being the culprit as opposed to the immune system. Imprinting could also play a role. Folate is required for methylation (imprinting) and I do happen to be MTHFR-heterozygous, which will affect the folic acid levels. However, this second bit is all speculation.

    Anyway, Vitamin D is anti-inflammatory like prednisone (it actually induces similar effects in certain cells) and suppresses Th1 development and NK cell function, so if you are replete instead of deficient, your immune problem is partially addressed right there.

    I always found it striking that my first pregnancy (a chromosmally normal boy) actually ran into trouble before my second pregnancy (Turners syndrome), which looked almost picture perfect till 9 weeks, except for a slightly lowish heart rate. I noted that the heart rate was low in your first ultrasound in this pregnancy, which also is more indicative of a genetic issue than an autoimmune attack. Overall, I think we may share 2 issues: a tendency to genetic abnormalities during egg (and maybe sperm formation too) and maybe later, and a too friendly uterus that implants any and all comers. Studies showed that the uteri of women with RPL tended to be less discriminatory than those of women with normal fertility: http://www.nhs.uk/news/2012/08august/Pages/fertility-clue-for-recurring-miscarriage.aspx

    I eventually did IVF and went to surrogacy. I tried 2 surrogates, and interestingly, their wombs rejected 4 out of 5 of my AA-graded day 5 blastocysts. However, one of the 5 implanted and is growing normally, and is in the 18th week of pregnancy now.

    I think trying a genetically tested donor embryo while being vitamin D replete and taking lots of folic acid may give you a decent chance, and may be the most low tech and easy approach.

    It is really hard figuring out the right way forward when we know so little. I hope you can figure out a good way forward soon.

    Reply
    • Hey SciChick, I am very pleased to meet you out here. This is an extremely helpful comment.

      First off, I am sorry for all you have gone through!

      It’s helpful to hear your comment on Vitamin D. I did not know that. How much Vitamin D, do you think? I’ve already started taking it. Do you think I should get my Vit D levels checked first? Can too much Vit D be a bad thing?

      I’m so happy to hear that one is growing normally for you. What a long ride you have been on. Do you know why 4 of the 5 AA’s were rejected by the surrogates—do you think in those cases, too, it was genetic?

      I think I, like you, have a too-friendly uterus that accepts any and all–yes, yes. This theory has always struck me as right at a gut level, but also when I read about the experiment. But it has not yet been proven by randomized control studies, has it? I mean, the research so far on super-fertility is quite thin, yes? Still, I feel strongly pulled toward it. It resonates with my personal experience.

      You wrote: “I always found it striking that my first pregnancy (a chromosmally normal boy) actually ran into trouble before my second pregnancy (Turners syndrome), which looked almost picture perfect till 9 weeks, except for a slightly lowish heart rate.” I wonder if this is because the chromosomally normal boy had an undetectable imprinting error—and imprinting errors happen very early on and cannot be picked up by karyotype test. Would that explain why that pregnancy ran into trouble earlier?

      Would you mind sharing with me why you moved onto surrogacy—or point me to the best posts to read on your blog?

      You wrote: “Folate is required for methylation (imprinting) and I do happen to be MTHFR-heterozygous, which will affect the folic acid levels. However, this second bit is all speculation.” I’m MTHFR heterozygous, too. But I’d heard (from two doctors now) that they are moving toward not even testing for things like Factor V Leiden and MTHFR any longer because they’re finding that there is no relationship to RPL—have you heard this, too? In any case, I guess it can’t hurt to go on more folic acid—did you take supplements? If so, can you describe?

      Again, thanks for all this. I appreciate the time you took to write at length!

      Reply
  13. Kali

     /  December 2, 2013

    This is GREAT information, I’ve been following up on it with Dr. Google. Thank you for doing so much to help those of us who are in the same struggle.

    Reply
  14. Tess

     /  December 3, 2013

    Sci Chick – Thank you! That information was also very helpful for me. It sounds like Vitamin D and folate are even more important then I’ve been realizing.

    RE: Vitamin D — I’ve been on supplements for fertility and because I live in a northern, cloudy city. Apparently we can take up to 5,000 mg/ per day, but obviously check with your doc. There’s also a treatment for depression in which people are given a mega-amount to try to get people’s levels normalized. There’s a large connection between depression and Vitamin D depletion. (So everybody make sure you get enough sun or Vitamin D supplements.) I think it takes about 12 weeks for increased levels to regularize, so it’s best not to let them get depleted.

    “Embryo adoption is definitely still on the table. I used to live in the Czech Republic (Prague) so I’ve actually thought of that some—I know treatments are much more reasonable there and I’m familiar enough with the country and Prague that I would feel comfortable. (Although my Czech is nearly gone.) If you can point me to any information or resources on embryo adoption in those countries, I would greatly appreciate it.”

    If you go to fertility friends.co.uk and go to the international section & choose the country you are interested in — you can read the lists on the Czech Republic, Spain and Greece.
    http://www.fertilityfriends.co.uk/forum/index.php

    I believe the Czech and Greek clinics charge about 1-2,000 Euros per cycle for embryo donation. I want to say about 1,200 Euros, but I’m speaking from memory, so don’t quote me. Spanish clinics also do double donation or embryo donation cycles.

    In a double donation cycle the clinic will match the egg donor to your picture and chose a young sperm donor.

    In Greece some of the clinics run two donors at the same time for egg donor cycles, in case one donor doesn’t work out. The second donor they will match with a local sperm donor, and locally use those embryos for DD cycles. I think that’s why European clinics tend not to have waiting lists for double donor cycles. (Also – the young, healthy age of both donors means there is a high rate of implantation & birth.)

    For the Czech republic there are several clinics I’ve heard recommended in Prague and in other towns. There are a bunch of clinics — here’s one as an example in Brno. http://www.reprofit.cz/en/ivf-lecba-darovanymi-oocyty

    On fertility friends — some of the people in the Czech section started a facebook page where people are talking about donor cycles in the Czech republic and sharing pictures of egg donor and double donor children, ect.

    There’s no waiting lists at most of these European clinics for egg donor or double donor. Often times it’s cheaper to go to Europe, even including travel, for egg donor or DD. The donors in the Czech Republic are Czech citizens. In Greece they are often Greek, Ukranian, Georgian, Russian, Italian. In Greece you can say the nationality you would prefer. In the Ukraine you can see pictures, but in the Czech republic, Greece, and Spain it is anonymous (mandated anonymous by the government.) You send in your picture and they will match your donor to you. But you can ask for age, nationality, and education level in Greece.) I think you can bring over donor sperm, if you want for some of these clinics. I think these cycles are more expensive then the DD cycles that aren’t explicitly matched to us. But an egg donor cycle in the Czech republic or Greece is about 4,500-5,000 Euros — so overall it’s just much less money, even for ED.

    And this is the contact info of a UK nurse living in Greece. She works with two clinics in Greece & two in Spain. I haven’t contacted her myself, but I’ve heard she answers questions for free on skype. (The clinics pay her to arrange cycles for them and coordinate treatments with English speaking women. There’s a lot of British women that go to Europe for IVF, egg donation and double donation.)
    http://www.ivftreatmentabroad.com/theteam.html

    Apologies for the information dump. My DH and I are planning to first try egg donor and then do a mixed egg donor/ double donor cycle. (Increasing the chances of success if at first we don’t succeed.) We’ll probably go to Europe because of the cost. And, if this doesn’t work (again!), at least we’ll have been somewhere interesting (Barcelona, Athens, Prague). Anyways, that’s the plan.

    Good luck and take care xo

    Reply
    • Woah—incredible amount of information here! I can’t thank you enough for taking the time to do this. And again apologies for going MIA–I needed to take an internet vacation. I am going to look into all of this and am sure will be back in touch with questions as am not sure I understand it all. Anonymous donation sounds a bit tricky, but it’s good that in the Ukraine you see photos. It would be tricky for us mainly because DH is Asian…but then again if we adopted a child he or she wouldn’t necessarily have any Asian features….Thank you for all of this!

      Reply
      • Kali

         /  December 6, 2013

        You can get Asian sperm, and many if not most banks can ship it internationally to the clinic.

        I’m Indian (South Asian) and I’m using an Indian sperm donor and latina donor (s) so the baby will be half-Indian, not an obvious donor egg baby. I don’t plan to disclose to strangers, just the child and those who already know.

        Reply
  15. Tess

     /  December 3, 2013

    For some reason my comment didn’t post — I think it’s in moderation because I linked to web sites talking about the European clinics. (You can google fertility friends uk, go to the forum, and look up international cycles. There are different sections for Greece, the Czech Republic, and Spain.)

    Reply
  1. Babying my immune system / Soothing recipes for you | the unexpected trip

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