# in a muddle about what to do - DS because now single but DE/OE?



## agate (Nov 14, 2008)

I had BB in 2010 after doing 3 x ICSI (severe male factor, but also PCO) with DH.

Since then we did one more cycle of OE which resulted in a pregnancy of unknown location - which had to be treated with methotrexate - and 3 months later I am only just getting the HCG almost down to negative.

DH and I had problems for several years (he never really wanted children for example, whereas it was all I could think about) and finally split up. It doesn't change my very strong wish for BB not to be an only child. 

I did the last OE in greece and got a good response to stims and the embryos apparently looked pretty good quality - (I froze 4 but now can't use them because they are DH's which I am upset about but don't want to fight)  but in the previous cycles, the embryos always looked a bit rubbish and there were none good enough to freeze.

I know I want to go back to greece for future cycles because I felt really comfortable with the clinic and wouldn't want to go anywhere else.  I know it will have to be donor sperm now - and that feels like a good thing because with DH I always knew that the sperm were pretty terrible and, having been in a failing relationship, having a child that I don't have to 'share' with someone I don't get on with seems like a good thing.  My brother, I think, will be a good male role model for BB2 so I don't think he/she will go without that... and I'm 100% sure that its better to have a happy single mum than be brought up in a house with frequent arguments with a dad who has a rotten temper etc

Its really hard to estimate success rates but my best guess is that my chances for OE are maybe about 25% but with DE maybe more like 40% - so I guess I ought to be grateful that trying again with OE is still worth a shot but I am agonising over whether I should switch to DE now or try one more OE.

The last failure seemed worse than all the others because it went on for so many months and I had to have the metho shot which made me feel horrible for almost a month.  Up until EC during the OE I felt on a real high because the stimms seemed to go so much better in greece than on my previous cycles in the UK - but then the arguments and friction with DH made me feel very confused about the whole cycle because we were getting on so badly that having his child felt all wrong.  I feel pretty relieved to get away from him now.

The reasons why I am thinking of DE are:

- I am 39 - and I still don't really know whether my eggs are as bad as the UK cycles suggested - or as 'good for my age' as they seemed to look on the greek cycle
- I worry about the down's syndrome risk - I don't think I could have an amnio or a termination
- I worry that my genes aren't really that fabulous - we have diabetes and mental health issues in our family
- the pregnancy loss and the metho felt horrible - worse than a straight BFN and I guess its more likely that I will be able to avoid this if I switch to good donor eggs
- as the odds are better with DE it OUGHT TO take me fewer cycles to have a sibling for BB if I do that - which means having more money in the bank for BB (and BB2)'s future, so it seems like a more responsible thing to do - I'm estimating that 3 cycles of OE would cost about £13k and would give a cumulative chance of success of maybe 50% whereas 3 cycles of DE would cost about £16k and would give me a cumulative chance of maybe 80% (1 cycle of OE then 2 cycles of DE would cost about £15k and give me a chance of maybe 70%) - every extra £1 I spend on trying to get OE to work will be £1 I haven't got to provide for my babies in the future, so it seems a bit irresponsible to keep pursuing OE?
- as I know its going to be donor sperm, I'm in donor territory anyway, and a baby made from good donor sperm and good donor eggs ought to theoretically have a better mix of genes than a baby made from my ropy old eggs
- I feel completely comfortable that I would love a baby wherever the genes came from - I don't feel any need to 'grieve' for my own eggs... I just want to make the best choice for my babies - to give them the best possible future
- having spent a whole 2 weeks in and out of the clinic in greece I feel really comfortable that the egg donors are treated well which feels really important to me
- I don't feel that UK egg donation would be right for me as I have never felt as comfortable/in safe hands in UK clinics as I did in greece
- I'm really ordinary looking (and so was DH)- brown hair, average build, average height - so I would imagine that a lot of donors would result in children that at least looked a little bit like me and BB - so I think I'd 'match' well with either a greek donor or one of the eastern european students that the clinic often use

but....

I don't think I'd be happy to keep either the sperm or the egg donation secret and egg donation is completely anonymous in greece so my baby would never be able to answer her questions about her genetic family history if he/she wanted to later on.  

I think its possible to pay extra to have 'open donor' sperm shipped in from denmark so baby would be able to find out about his/her male donor later if he/she wanted to - but if its an anonymous egg donor I don't know whether that would make her/him feel better or worse if they could trace one donor but not the other?  I don't feel that being able to trace his/her sperm donor is worth the extra payment/hassle of getting sperm shipped in from denmark but is that because I am biased by having gone through a bad relationship with DH and feeling 'anti-men' in general?  Or would being able to trace his/her sperm donor make him/her feel better by having the possibility of being able to track down 1 donor even if they could never trace the egg donor?

I just don't know how my babies will feel in future - will they feel that I took the 'easy' way and 'bought' eggs, or will they be better off because they have better genes that I could provide on my own?

Obviously BB will always know her father, whereas BB2 (probably) will never know her/his sperm donor and I don't know how they will both feel.  Will it be any more complicated if BB2 doesn't know his/her egg donor either or will it not make any difference?

I'm tempted to try one more cycle of OE just to see whether using good donor sperm really makes any difference but if its got less than a 25% chance, is that really a responsible thing to be doing?  Some studies say that taking metho can compromise the chance of IVF success for at least 5 months as it damages the DNA of the eggs - so I really ought to wait until January if I wanted to do another OE, whereas I could cycle at the beginning of november if I switched to DE - switching to DE is what the greek clinic recommended to me because of having the metho shot and the unknown damage it might have done to my eggs because of my age.
........

I am trying to get my head straight so I that I know what I want to do when I can cycle again (when BB and are settled in a place of our own - probably november) - but I think the long wait in between the last cycle and this next one is giving me too much time to think.  I seem to change my mind several times a day between what is the most responsible decision.  1 more try of OE, then switch to DE or just get on with DE so I can hopefully get on with raising my family sooner rather than spending more years on the infertility rollercoaster - Infertility has been pretty much my full time 'headspace' for 5 years now - and, obviously, it'd be better for BB (and BB2?) if I can get on with 'living' rather than worrying about TTC for more years.

I tried asking my clinic and their advice was that I still had a reasonable chance with OE so I should pursue it if I wanted to but would have a better chance with DE (especially because of the metho).  I asked another doc who basically said the same thing - that it might not be necessary for me to give up on OE yet, but that if I did switch to DE it might double my chances.

I guess it will take more time to arrange for known donor sperm to be shipped so I'd have to get on with that either way if that's important, but how do I decide on whether to do that?

I can see for other ladies that switching to DE might be horrible but their only option but if you still have a reasonable shot with OE, it makes the decision much more confusing.  Has anyone been there and got any suggestions?

I haven't had my FSH or AMH run for ages and I guess I could go and pay to have those done, but I'm not sure it would add anything to my decision because I think the response to stimms earlier this year will be a better indicator (although the quality might be devastated by the metho).

The clinic also give the option of more economical DE - 'backup donor' where you are on standby to get the eggs from a backup donor who has been matched to someone else - so the physical match might not be as good and there will be more likelihood of having to arrange flights for BB and me at the last minute, but its Eu2000 cheaper per cycle.  BB has been to greece with me twice and has been fine with the travelling etc although I guess it might be a bit more difficult if we get really bad weather again this winter.

Can anyone help me find a way through this muddle?  

Sorry if I sound so selfish when its a TTC No2 question, and when I still, supposedly, have the option of trying OE, but it was always my 'dream' to have at least 2 children - and I am still just as obsessed/anguished by not having this as I was before I had BB.


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## suitcase of dreams (Oct 7, 2007)

hmm, not sure I can help too much as I'm not in quite the same situation - I moved to DE at 39 following 5 failed OE cycles, the last one with PGD which showed all embryos severely abnormal...I was given a less than 5% chance with OE so for me it was pretty clear cut

when I was ttc with OE, I was initially with a UK clinic, and then in Czech, but using ID release donor sperm from Denmark (incidentally ESB can ship very quickly from Copenhagen so don't worry too much re timing - if you do decide this is what you want it should be pretty easy to get it shipped to Greece in a week or so)
when I moved to DE, I also moved to anon donor sperm because I wanted things to be 'equal' - I knew the child wouldn't be able to find out anything about egg donor, so wanted to make it the same for sperm donor. others have gone the opposite route and ensured they have ID release sperm donor precisely because they don't have ID release egg donor but I personally felt it was somehow 'easier' for the child if neither were ID rather than one and not the other (had it been my eggs it was more important to have ID release sperm so they would know about both sides)

now my boys are here I do worry whether in future they will be angry at the choices I made - especially as they will know other children (we singlies meet up pretty often) who have ID release donors because their mums stayed in the UK for tx - but I made the best choices I could at the time and under the circumstances and I hope they will grow to understand that. I also hope that if they know from day 1 that they will never be able to find out about their donors, then they will be more accepting of that
no guarantees for any of this of course, will just have to cross those bridges as we come to them

re having a DE child when you have an OE child already, there's a thread here which might be of interest:
http://www.fertilityfriends.co.uk/forum/index.php?topic=260952.0

can't really help much otherwise I'm afraid, it's always such a difficult decision and there are so few certainties when it comes to fertility tx as you know already, follow your gut is all I can say
best of luck, it's always difficult trying to work out what is the 'right' thing to do, but I'm sure you'll work out what is right for you and BB

Suitcase
x


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## Rose39 (Dec 9, 2007)

Agate - I think what's hard for everyone in this scenario is that there is no single perfect answer. When you move to DE and DS you're weighing up so many different considerations and issues, that what is right for you may be different from what is right for someone else. I don't think you're in a muddle, you're just working your way through everything you need to consider in a methodical and logical way! And many people don't always come to an answer quickly, sometimes it takes a little while to find a way forward that is the most comfortable one for you.

From what you've written, it looks like staying with your clinic in Greece is important to you, which means that you'd be looking at an anonymous egg donor if you went the DE route. Would it be useful to have a chat with the clinic to find out how much information you'd be allowed to have about the donor? Different clinics provide different levels of information, over and above the basic physical characteristics. 

I moved to donor eggs after my egg quality started to decline and I'd had a missed miscarriage - I was scared I'd have another miscarriage and wanted to give myself the best chance of having a healthy baby (and finances were also a consideration). It took 4 attempts with DE/DS before it worked for me (I had really bad luck!) and I probably moved to donor eggs earlier than I needed to, but when I had the nuchal scan it was very reassuring to know that the risks were much lower through using a younger donor. I wanted to use ID release sperm but this wasn't possible as I'm CMV negative and my clinic wanted me to have a CMV negative donor, and there were no CMV negative ID release donors available at the time. I tried to get as much information as possible about my donors to pass on to my baby, but I made the best decision that I could with the information available and in the circumstances I found myself. 

It's impossible to predict what a donor conceived baby will feel about their genetic origins as they grow up , as Suitcase already posted. 

In terms of the own egg vs donor egg dilemma (and I went through this too)... could you afford to do one final cycle with your own eggs? Would that give you closure if it didn't work (obviously hoping that it did work!) so you could move forward with donor eggs more easily? Sometimes this is the course of action that ladies decide to take so they know they tried everything possible and felt more comfortable that donor eggs was the right next step for them? Obviously finances are a big consideration here, and often this isn't an option, and like you said, you'd want to have as much money saved up for when it did work. 

Would it help to talk the key issues through with a counsellor? Some ladies find this useful... or maybe contacting the Donor Conception Network could provide additional advice and information that could be helpful for you? 

There's a thread on the single ladies pregnancy/ mums board about those considering a second child - it might be useful to post there as well and ask for advice/ suggestions? 

Wishing you so much luck hun as you think these things through. If someone had said to me 3 years ago, after my relationship broke down, that I'd become pregnant using donor eggs and sperm using a clinic in Cape Town, I wouldn't have believed them! But I feel so lucky to be pregnant, and this was the path that ended up being the right one for me. I so hope that you find the right path for you.     

Rose xx


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## indekiwi (Dec 23, 2008)

Agate,

First off, I'm sorry to see your relationship with DH is over and to read of your recent pregnancy experience.    

Gosh, I wish there were some "right", definitive answers for you, but I just don't think there are any.   So my responses are very much restricted to and reflective of my own experience and subsequent feelings, which may or may not tie in to how you are thinking / feeling.  

I have an OE son (with DS) and a DE daughter and one on the way (with the same DS).  I have had all my tx in the UK, but the DS was donated in 2002 and so the sperm donor is, and is likely to remain, anonymous.  The egg donor is ID release.  I am open about how my kids have been conceived, so they have known / will know from the get go.  Personally, if I could change the anonymity aspect of the sperm donor, I would - for the sole reason of allowing my kids the option, should they wish it, of knowing about their genetic makeup.  Who knows whether they would have any interest in researching their sperm donor?  They may, they may not - I would just like to give them the option.  With respect to my daughter and bump, I am happy that they at least have the chance of finding out the identity of the egg donor - to my mind, it sort of evens up the score with my son, who at least has knowledge of 50% of his genes.  

Re OE vs DE, well, 25% success rates sound pretty good to me, so I guess it would come down to how concerned you are about the possibility of having a child with Downs and your fears of passing on possible predispositions for diabetes and mental illness.  We have the latter on my Dad's side which has been quite prevalent (and is genetic) so I fear for my son in weak moments.  I have to say however that it was not this fear that led me to DE, but an almost non-existent ovarian reserve and no / low response to stimms - so different drivers at play.  I've spoken about my feelings towards my baby girl elsewhere so won't go on about it again - suffice to say that I have used one of the frosties from the cycle that created her and am now 12 weeks pregnant with my third child.  Clearly, I have no regrets   .  

Concerning how any offspring will feel from being donor conceived or being the offspring of anonymous donors - we can all guess, make assumptions, try to stand in their shoes - but who knows what little personalities we have created / will create and how they will think.  We simply can't know definitively.  However, I suspect - but it's only my best guess - that whether you choose DE because of your family genetics or because you have a better chance of conceiving, won't matter too much to any offspring - the reason above all will always be that they came about from a fierce desire to create another life in your family, and were loved and longed for.  

Anyway, hopefully others will comment on some of your other points, but hope this helps in your determinations.  

A-Mx


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## Bethany915 (Aug 1, 2010)

Hi Agate

What a difficult decision, especially after what you have just been through  .

As the others have said , the decision to go OEs or DEs is obviously very specific to a particular person, so what might be right for one person will not necessarily be right for another.  Having said that, a couple of things spring to my mind from what you have said.  Firstly, you say that there was severe male factor when you were with your DH - now you will be using donor sperm that will not be an issue, so I just wondered if you had considered IUI with your OEs instead of IVF?  I know you mention PCOS but I remember (when I was posting on the IUI threads last year) that there were several PCOS ladies on there who got pregnant with medicated IUI.  That would be a lot cheaper than IVF with OEs (it was £700 at my clinic in the UK, don't know what prices are like in Greece) - so you might then be able to afford a few goes at that before considering moving to DEs?  Just a thought but another possible option to add to your deliberations...  Of course, if you have problems with your tubes, IUI wouldn't be an option, but I don't think you mentioned any tubal probs (you could always have an HSG to check).

Secondly, it might be worth checking with your clinic re the chance of another pregnancy like the one you have just had - my understanding is that most ectopics are pure bad luck and unlikely to recur - but I'm sure they could advise.

Finally, I don't think the risk of Downs at 39 is *that* high (I don't remember the stats but you might want to look them up).  I had my LO at 40 (with OEs) and the odds were still massively in my favour.

Good luck whatever you decide!

B xx


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## agate (Nov 14, 2008)

Thanks ladies.

Suitey: I'm kind of leading towards thinking that if I go with DE, having open ID sperm might be better... at least I could offer the child something if they were desperate to know something about their genetic origins..... but I'm not sure.  thanks for the info about shipping sperm - it does sound as though it'd be quite easy to do that - although of course it means making decisions about how many straws to buy given that the shipping cost is about 300Eu and then its 285-375 per straw.... so it'd make sense to buy all the straws I'm likely to need but then of course I don't know how many 'goes' its going to take.  Yes, I wouldn't want to against my gut instinct but that seems to be changing several times a day.

Rose: yes, that's a factor too - I found the miscarriage/PUL really hard to deal with emotionally, and its a big draw to try and reduce the odds of going through that again by going DE... I THINK the lowest odds for another miscarriage/PUL would be to go with FET blast embryo 'adoption' (the pg rates are a bit lower than fresh, but the miscarriage rate tends to be slightly lower because those blasts that survive the defrost well enough to implant are supposed to have endured a bit of natural selection by going through that process) rather than fresh DE but that has its drawbacks of not having any chance to have open ID sperm and I don't know how much the clinic will tell you about the donors or how much they will attempt to 'match' if its embryo 'adoption'.  

But, having thought about it today, it occurs to me that either the 'backup donor' fresh or the frozen embryo adoption seem a bit more ethically justifiable to me.  As its not as if they were created specially for me... if I (or someone else) didn't show up that day to use them, they'd just end up being/staying frozen.  I am really comfortable that the greek clinic treats its donors well, but I don't know whether my child would feel more comfortable if they knew that they weren't created just for my 'selfish' needs.... I am not explaining this very well... but I can sort of imagine feeling a bit more positive defending my decision if its embryo 'adoption'.  My understanding is that the clinic runs a backup donor for every fresh donor cycle.  If I was on standby for backup donor embryos and the backup donor isn't needed for the main recipient, then I'd be able to use the back up donor eggs (with open ID or anon sperm) for a fresh transfer... but if no-one wants those fresh eggs, the clinic fertilises them with anon sperm and then freezes them so those are the embryos available for adoption.  Fresh back up donor eggs are 3000Eu (compared to main fresh donor 5000Eu) with frozen back up donor embryos for 'adoption' for 2000Eu.

Its a really good point you've made that there is no way to predict what the child would think later... but I guess if I feel comfortable then I'd be able to convey that sense of ease to them when they are little so they are more likely to grow up ok with it?

Indekiwi: yes... the idea of having open ID of one of the gametes seems tempting... so that I could offer the child something if they wanted more info.

Bethany:  yes... I've been thinking of DIUI as well.  I think if I was going to try it, it would work out easier/cheaper to go to copenhagen because there are more flights there, and it'd be cheaper than important sperm from denmark to greece.  My guess would be that I'd have maybe a 12% chance for each DIUI and it ought to cost maybe 1000 Eu for each shot (given flights, accommodation, meds etc)

Its supposed to be medically safe to TTC 3 months after metho (anytime from now), but given studies suggest it will reduce the chances for at least 5 months (december), I don't think it would make financial sense to do an OE IVF before Jan... so I could....

1) try DIUI for 2 cycles in denmark starting next month before giving up and moving back to OE or DE in greece in Jan
2) try a backup donor or a FET embryo adoption in greece in november... then if it worked I ought to be over the moon... but if it didn't and I still thought my eggs were worth a try, I could do another OE in jan, or continue with DE/EA
3) wait until jan and try 1 more OE
4) start in november with a 'full DE' fresh cycle

I guess my first move is to clarify with the greek clinic whether you get any information if you do a backup donor or FET EA and whether there would be any attempt to match?


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## morrigan (Dec 8, 2009)

Not sure I can offer any useful input but just wanted to offer my support.

You've been through a lot - one thing I would say is that you've not mentioned your emotional take on it - whilst you are thinking of what's best for the children which is obviously your priority - you have to factor in whether your ready to move on with de without getting closure on oe. And also when you'll feel ready to put yourself through the vigours of a cycle.

Re diui in Copenhagen - just check out anonymous thing out there as last I knew you could only get open donors via 
a midwife led clinic as doctors not allowed to use it.

I'm sure the fog will clear very soon and the right path will show itself.


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## agate (Nov 14, 2008)

thanks morrigan.  I don't really 'feel' one way or the other about the closure thing about OE.  I'm really more concerned to make a decision that my child(ren) will be comfortable with.    Having had BB, I couldn't imagine carrying a baby and not totally loving it or caring about where its genes came from and I don't think I'd be sitting around thinking 'if only' I'd tried harder with OE - just that I don't want to do something that would make my kid(s) unhappy when they grew up... I can't force them to believe what I believe, but my hunch is that if I am comfortable with a decision then they will grow up with that message and be comfortable too?


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## morrigan (Dec 8, 2009)

I think your so right about the how it's dealt with being the key - I worry about the fact I didn't use open donor but I take heart in the fact there are so many combinations if scenarios with family's out there that my child won't feel alone. At the end of a day economics have to come into it as much as I don't like it - much the same as I'd love to not have to work but that's not possible either !

Given the trouble I had conceiving current bump I'm doubting if number 2 is s possibility it will be with oe - in my head embryo adoption seems easyier to get my head around in terms of balancing genetic info. Who knows what will 
be possible by the time our children are 18.

Good luck making your descion.


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