donor problem, finances, and re-freezing sperm
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teri-chan - June 30

Hi Dr. Smith,

I'm in the middle of an IVF cycle with donor gametes (egg and sperm both). This was a very hard decision to come to, but everyone assured me that my chances would be far better with donor eggs than with my own. (We used the donor sperm for three reasons: (1) my husband's SCSA results were borderline, (2) we found a sperm donor who matched my ethnicity and other characteristics, but could find no egg donors who did, and (3) I couldn't bear the thought of having a child that was not genetically related to me, but was to genetically related to my husband. We bought all the sperm that this donor had available, which was three "ART vials" ("ART vials" have far fewer--on the order of 5 million--sperm than other vials).)

The egg donor produced 14 eggs, 3 mature (though more must have matured in the lab), 4 injected, 1 fertilized. At 41.5 I had an IVF at the same clinic in which I produced 12 eggs, 9 mature, 8 injected (one of the mature eggs was abnormal), 4 fertilized, 2 blastocysts transferred on day 5, 1 chemical pregnancy. It seems to me that my chances with this donor are NOT far better than they were with my own eggs.

CAN YOU OFFER ANY INSIGHTS INTO THE RESULTS?

This donor cycle started out as a shared cycle, which would have cost $12K. But since my donor didn't produce ten eggs, and I was the "primary" recipient, it reverted to a one-on-one cycle, which will cost me about $20K. That's a little over a quarter of what my husband and I make together in a year. I was told that at my clinic, shared cycles become single-recipient cycles in only about 10% of cases, and in those cases, the average number of mature eggs is 9.

When I started this cycle, I felt like I could afford about $35K (on top of the $15K I had spent previously on my own IVF cycles etc.). Since my clinic's "take home" rates with donors 53% (2003 ART report) to 64% (2002 ART report), I figured that three cycles would give me about a 90% chance of taking home a baby. (I get the 90% figure from assuming independence of the three cycles, and applying the standard probability formula figuring about a 55% "take home" rate.) Now I find myself with only $15K left, and I'm at a bit of a loss about what to do.

Do you have any sense of what it might be reasonable for me to ask of the clinic financially in a case like this. (The donor coordinator said to me when she called with the fertilization report, that I should not worry about the money, that the clinic would treat me fairly. I have no idea what that might mean in dollars and cents. DO YOU HAVE ANY IDEA WHAT A CLINIC IS LIKELY TO DO IN SUCH AN EXTREME CASE? Would it be appropriate for me to ask, for example, that they charge me only as much for an ultrasound as they charge the insurance companies of those who have insurance for infertility treatments? I think it's about a quarter what they charge me. I know you're an embryologist and that this isn't exactly your area of expertise, but you do work in a clinic, so you probably have a much better idea of the norms--if one can speak of "norms" in a case so abnormal--than anyone else I can ask.

If by some miracle, my clinic decides not to charge me for this cycle, I'll still be able to afford three shared donor cycles. (I've got a 73% chance that none of the three will become one-on-one cycles.) The problem is that I have only two vials of semen. DO YOU KNOW WHAT SORT OF CHANCES THERE ARE OF SUCCESSFULLY RE-FREEZING A VIAL? (I think it will be nearly impossible for me to find another sperm donor who "matches" me. My ethnicity is reasonably rare, and the characteristic other than good health that I'm most interested in matching is my intelligence. I am at the top of the charts on every standardized measure that has ever been made of me.)

THANKS!

 

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