The NEDC Visit & Mock Transfer

It feel like I have so much to write I am not sure where to start, and that I will forget something really important.  At first I thought I would write about our day at the Smoky Mountain National Park first since we went there on Tuesday, but I've decided to write about our visit to NEDC on Wednesday first while I have this somewhat fresh in my mind.  Plus I know there are some of you waiting to hear about our trip.

We arrived at NEDC at 9 am for our appointment.  I had been drinking water before leaving the hotel in the morning, but was trying to be conservative about the amount, since Katie the nurse had mentioned in one of my earlier phone conversations with her not to go overboard because we would meet and talk with Dr. Keenan first.  I remember during my last IVF how uncomfortable I was when my bladder was overfull.

Dr. Keenan was super nice.  We talked a bit about how we really enjoyed Tennessee and the Rocky Mountains National Park.  Then we went over our infertility history and surgeries.  Dr. Keenan had a resident doctor working with him.  I can't remember her name, but it was a unique and LONG African last name.  Dr. Keenan said that the average success rate for NEDC as a whole was 46%, which was pretty good for FETs (frozen embryo transfers).  Based on our history, we have an average success rate, not above average, not below average.  I was at first concerned about just "average", but he said average is great!  So I am keeping that in mind.  We were discussing something about age and I said, I am 39 you know?  He responded 39 is PERFECT!  That totally brightened up my day.  I told him no one has ever told me 39 is perfect before when it comes to trying to have a baby!  But insists 39 is great, so I will take his word for it.  He was professional, personable and made us feel really comfortable.

Some things Dr. Keenan told us to keep in mind:

• We do not need to worry about the quality of the embryos, nor the age of the donors.  If embryos were not of high enough quality, it would not have been frozen in the first place.
• Even if the embryos were great quality when frozen, there is no guarantee that the quality will remain the same once it has been thawed.  The quality of the thawed embryos is what is important.
• Even the best quality embryos do not guarantee a pregnancy, whereas often lower grade embryos produce beautiful babies.
• Dr. Keenan reminded us that we should keep in mind NEDC's overall success rate of 46 percent instead, and focus on selecting the donor family that best fits us.  And don't worry about the quality of the embryos.
• We will need to have a minimum of 6 embryos for our transfer.  This means we may need to select more than one family.
• We have agreed to have mixing of embryos from more than one family if needed (if the family selected has less than 6 embryos).  If that happens, we agree to do genetic testing to determine which donor family the baby is from.
• We have agreed to do an Open Adoption with our donor families.  That means we will have some kind of contact or relationship with the donor family.
• We are allowed up to 3 tries per pregnancy.  That is NEDC's policy.  That means if we don't get pregnant after the third try, we can no longer adopt embryos from NEDC.  This is because NEDC wants to give the embryos the best chance at life.  I can totally understand that and think it is a good policy.

After that we moved on to an exam room for my mock transfer.  Unfortunately, I found out that my bladder was not full enough.  They require a very full bladder so it gives a better view of the cervix in the ultrasound machine.  So they had to insert a catheter into my bladder to fill it.  I was not too excited about it.  The resident doctor did the prep work and filled my bladder with saline solution.    Luckily the process was not too unpleasant though I could definitely feel it filling up, and could tell that my bladder was pretty full!  Dr. Keenan then took over and proceeded to do the actual mock transfer.  With the help of the ultrasound machine (over the belly), he inserted a catheter through my cervix and into my uterine cavity.  In the actual embryo transfer, this catheter would hold the embryos that would be placed in the uterus.  But here, there were no embryos in it (i.e. the term "mock transfer").  This procedure is to make sure that the doctor is actually able to insert the catheter into the uterus, take some measurements, and that there are no surprises on the actual transfer day.  Everything went as hoped, and Dr. Keenan said it went perfectly.  I was then allowed to use the bathroom to empty my bladder (thankfully!)

Then I was back on the exam table for my SHG (sonohysterogram) or SIS (saline infused sonogram).  This is a transvaginal ultrasound with the addition of saline into the uterus.  The resident doctor started off the procedure by inserting a catheter through my cervix into the uterus.  Then the transvaginal ultrasound wand is inserted and the saline solution is slowly injected through the catheter into the uterus.  Dr. Keenan was there coaching and advising the resident doctor through this.  I didn't mind as long as I was not in pain ( I wasn't), and she didn't break any part of my body (she didn't).  The saline in the uterus would highlight any irregularities in the uterus including polyps, fibroids, scar tissue or any other abnormalities.  Fortunately, he found nothing.  Everything looked good and I given my medical clearance.   I got my green light for a transfer in September!

Next, I met up with Carol the embryologist and Angie the (new) patient coordinator.  We went over the types of embryos available.

• PN2 (pronucular) - Frozen as Day 1 embryos, has a 90% of surviving a thaw
• Multicells - Frozen as Day 2 or Day 3 embryos,  has a 75% chance of thaw
• Blastocysts - Frozen as Day 5 or 6 embryos, has a 70% chance of surviving a thaw

According to the embryologist, the key point for us to remember here was that no matter what type of embryos we choose, the pregnancy rate was the same.  So, if that is the case, then the type of embryos we choose would determine that probability of them surviving the thaw only.  Of those that do survive the thaw, the pregnancy rate would be the same.  We will need to keep this in mind when we select our donor family.  

Because we are a bi-racial couple and want Asian-Caucasian embryos, our pool of donor families is fairly limited.  Plus, we also want to do an open adoption, that limits the pool even more.  Angie, the patient coordinator said she would look into the number of available donor families and give us an idea of how many families are available to would fit us.  She would email those profiles to us later.  

We then met with Juliana, the Program Manager and went over the financial information and some more forms.  After that, Katie the nurse came back and we went over my prescriptions and frozen embryo transfer information.  I am to reduce my Es.trace dosage down to twice a day, and add Pro.metrium (progesterone) twice a day, both for 5 days.  Then I should be getting my period a few days after that.  I will start my BCP (birth control pills) on the first day of my cycle and continue taking it until I get further instructions from the clinic.

After that we paid for our visit.  $1,200 for the program fee for NEDC's embryo adoption program and $520 for the office visit.  And then we were done!  Before we left, Angie surprised us by giving us the profiles of our donor families!  Because of our limitations (bi-racial and open adoption), we only had 8 family profiles that matched us.  We were pleasantly surprised and very excited to have them before we left the clinic!

After the appointment, we had a few hours to kill before heading to the airport.  We had lunch at the Smoky Mountain Brewery.  Then we walked around a couple of stores close by and went to Starbucks for coffee and went over the profiles.  I have to say, going over the family profiles is very exciting, but it is also harder than I thought it would be.  Babe actually felt a little uncomfortable with it.  If you think about it, it is a bit lot like a birth mom trying to select an adoptive family for the baby.  But it is the total OPPOSITE.  It feels like shopping for our baby.  But in the end, I have to keep in mind that we are adopting our child, and giving a frozen embryo a chance at life while fulfilling our desires to be parents.  We believe that God has already chosen a child/children for us to be transferred into my body. We are only a vessel in part of His plan.  And we pray that His plan is that we will be able to carry and give birth to this child.

We headed back to the airport in our rental car, and hopped on our planes to come home.  Other than our flight to Minneapolis being delayed twice due to thunderstorms out in New York and us not getting home till midnight, our trip home was pretty uneventful.

I really like Dr. Keenan and his staff at NEDC.  Knoxville has been a pleasant trip for us and the people there are all truly very nice and friendly.  I am so looking forward to going back.  September transfers at NEDC are between the 14th and the 20th.  So our transfer date will be in there somewhere. Now, we have to take some time to go over the donor family profiles again and select our family (or families).  After that we will wait for the family to approve us to adopt their embryos and then we will work on the Open Donation Agreement with the family through the National Fertility Support Center.  Once that is all done, we will hopefully have a date for our transfer.

I will post next about our visit to the Smoky Mountain National Park.