Embryo culture by Beth Kohl

I was a little disorganised and only got this book at the last minute… now I come to draft my answers I can’t find the *** thing!

So bear with me for the very succinct and only two answers. I might manage to update tomorrow am, while the US is still asleep, anyhow!

Hop along to another stop on this blog tour by visiting the main list at http://stirrup-queens.blogspot.com/. You can also sign up for the next book on this online book club: The Mistress’s Daughter by A.M. Homes (with author participation!)

Questions:

      • The author  talks about how many embryos should be transferred at any given cycle. Should there be a limit?

        Here in the Uk there are very strict limits – 2 embryos if the woman/donor is under 35, 3 if above. And there is a lot of discussion about Single Embryo Transfer. Having a friend who had her (singleton) very early and suffered through NICU etc, I must admit I find it hard to understand how clinics can transfer 3, 4 or more embryos and risk complications and loss. I know that women are desperate to achieve pregnancy, but the risks are so high with multiples. Even with twins, I spent the first 2 trimesters worrying it would all go wrong.

          • Beth likens Dr. Frankfurth’s office to one that “should have belonged to a family doctor in Anchorage, circa 1950, and not to a late twentieth century endocrinologist.” How much do appearances matter? What were your first impressions of your RE’s office? Did/does that color your interactions with the RE himself or herself?

          I found it really hard choosing a clinic. There were two possibilities near enough to Hobbesy (my friend/donor) and one was obviously much larger than the other. I was very influenced by their level of friendliness (0r not) The larger clinic wasn’t very good at providing information, and said Hobbesy and I would need separate doctors 9so much harder to coordinate joint visits)

          The small friendly clinic had the embryologist mailing me direct with info… and had less of a hospital feel to it. It was good they remembered who we were. The clinic itself was a nice place to visit with free drinks and lots of magazines.

          One of the funny things was how at our first appointment, we were shown in to see the doctor and there were just two chairs, another had to be fetched to accommodate me, Mr DG and Hobbesy. You could see the cogs turning over in Mr R’s head wondering how we were all related 🙂

          This wasn’t a clinic with the very best stats, maybe, but it suited us. Small and personal.

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            ~ by drownedgirl on March 3, 2008.

            11 Responses to “Embryo culture by Beth Kohl”

            1. My clinic is really big, so I wasn’t really excited about just being a number. I chose it because one of the doctors is married to someone I know, so I was like, well, if he works there, it must be OK (not seeing him, seeing a different doc). After having dealt with this Super Giant clinic, I love them! Everyone is so nice and much like Cheers, they all know my name. (Maybe that’s more a comment on my fabulousness, then on them though).

            2. Thanks for your perspective. I agree with you on the limits issue!

            3. I wish I’d had your comfy Dr office!

            4. It’s hard to mesh what I know intellectually about embryo transfer with what I feel emotionally about embryo transfer. Like so many problems with IF when the two bump heads.

            5. Hi — Beth here. First of all, thank you for your thoughtful comments. This — this book club and your community — is incredible. Hey, so I thought it worth mentioning that like many of the issues I discuss in the book, I am uncertain about the rightness of imposing strict limits. Truly, I feel fortunate that there weren’t limits when I went through IVF since I fear I wouldn’t have ended up with my exact three children, if any. I also didn’t have to face any lifeboat situations, so who knows how I would feel if I’d been forced to reduce a pregnancy for whatever reason, or had decided to do so and then carried around that pain, or didn’t reduce and then suffered terrible medical consequences.

              As for appearances, I love hearing other people’s experiences and impressions. It is amazing to me how many people say they just sort of felt comfortable one place or another (or the opposite). I immediately got a feeling at each clinic I tried (three in total). If only I had trusted those feelings before heading down the path with the wrong doctors. Thankfully, I have become better at listening to that inner voice.

            6. I like your take on the embryo transfer limit. The thought of multiples and ending the journey in one pregnancy sounds very appealing. I have always wanted twin boys – they are so cute. But during the infertility lessons I have become much more aware of the risks and am very happy with the thought of a singleton. But as Mel said it is hard to bring this knowledge and the emotions together.

            7. Sounds like you have a pretty nice clinic. I agree on the limits issue and part of the reason was something I witnessed with a quad family.

              Thanks for sharing your thoughts!

            8. My RE (U.S.) is trying to move patients more in the UK/European direction as far as embryo transfer guidelines are concerned, and that’s one of the reasons I chose him. Of course, the uneven insurance coverage is a big issue here, but I don’t think it should hinder REs from setting more stringent guidelines.

            9. Thanks for your responses. I actually chose my clinic because it was considered the best in my state, and they were the only one that offered a shared risk program. They were a big clinic, and I did feel like somewhat of a number, but there was a personal nurse assigned to you that made me feel very good, and she knew me well and was the person who I dealt with most often. So although I knew I was just one of MANY, I felt like in some ways I did get personal service.

            10. DG, I remember reading about the early months of your pregnancy and the anxiety you felt upon hearing not one but two heartbeats. Thank you for your take on limits. My clinic never implants more than 2 at a time, and that is what I prefer, but like Beth, I think it should be a discussion between patient and doctor, not something imposed.

            11. I also think there should be some type of limit. However, I do think a lot of couples would agree to limit their transfer of embryos if more employers chose to cover infertility treatments in their insurance packages. Maybe someday that will happen. That being said, there was no way I would have transferred more than 2 (I was 33 at the time of the transfer) even if we had the opportunity to.

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