Because the important moments in life just don’t fit in a status update! I started this blog when I was training for my first ½ Ironman, (70.3 miles) to record what I hoped would be growth and progress but ended up being a huge learning experience. Although fitness is one of the key ingredients to a happy life, it certainly isn't the only ingredient. My blog has evolved to document growth, progress and setbacks in other areas too. From my surprise proposal in Rome and wedding in the fall of 2013, to Mom's devastating stage IV cancer diagnosis and death 2 weeks after I found out I was pregnant. Who knows what shape it will take, but thanks for being along for the ride.

Sunday, July 3, 2016

IVF in Prague - Switching Clinics!

I was all set to have IVF at The Prague Fertility Centre (you can read my first posting here, and the second posting after I had my Skype consult here) when I received an automated response a few weeks ago from the woman I had been corresponding with for several months: 
Dear Madam/Sir,

thank you for your email. The 10th of June 2016 was my last day as a member of team at the PFC clinic.
I wish you all the best and good luck in the future treatment or actual pregnancy.
My colleague Lucie Zerbini: zerbini@pragueivf.cz will be a new contact for all my English speaking patients. So please contact her directly, I believe you will be in good hands. 
Take care and have a lovely day,

With best regards

Eva
This sudden change was very unsettling to me, but I told myself to calm down and that it would all be alright. At first, it was. My new English-speaking contact responded right away, and everything proceeded as normal...until I tried to get clarification on the dates of my treatment.

See, my husband and I (and Baby A, of course!) are flying to Vienna, then visiting Budapest and ending our 3-week trip in Prague. However, doing IVF in Prague will involve some back-and-forth from the other two countries. We need to take a 4 hour train ride (each way) to Prague from Vienna soon after we land to pick up my medication, for example, and I will need to return for ultrasounds and scans prior to the egg retrieval. Prague is only 4 hours from Vienna, but it is almost twice as far from Budapest, and we already have all of our hotels booked. 

I sent my new contact a tentative timeline of the dates and asked if these approximate dates seemed to be in line with what they were thinking. She responded by writing that exact dates could not be given, along with a lengthy explanation of how everyone responds differently to the medication, and that an IVF cycle doesn't work that way. I chalked it up to the language barrier and her not being familiar with my file and the fact that I've done IVF twice already, so of course I understand that dates cannot be exact. In response I mentioned that communication was a bit difficult, and asked if I could have another consult with the doctor. The first, and only, time I talked to the doctor, communication was literally difficult, as she could not hear me very well.

That's when I received this response: All your questions were always answered so I don't understand why you are saying that communication is difficult. 

Worried I had offended her, I tried to explain and reiterate that I would like to ask the doctor some questions. There has been no response, at all, and it's been almost two weeks.

So last week, I began seriously corresponding with Gennet, which I had originally considered. Right away, communication was much easier, as was their customer service. I like that they have a sister clinic in London, many more doctors on staff (similar to HRC), and that their website was much nicer. Okay, I'm probably not supposed to admit to that last one, but what can I say? Gennet was also on the original list of "approved" clinics our cousin who is a doctor said had as high of a standard of care as here in the US.

Their rates were slightly lower than Prague Fertility Centre (PFC), 2,200 Euro vs. 3,000.

IVF/ICSI package
The fee for an IVF/ ICSI package is EUR 2200 and includes:

-       Consultation and ultrasounds during treatment cycle
-       Tests for HIV, Hep B, C and Syphilis for both partners at the time of egg collection
-       Egg retrieval under general anaesthesia
-       Semen analysis of male partner
-       Fertilization ICSI, cultivation up to blastocyst, ev. assisted hatching
-       Embryo transfer
-       Cryopreservation of all remaining embryos ( classic slow freezing )
-       Storage of cryopreserved embryos/eggs for 1 year

They did charge 100 Euros for the consult, which I eagerly set up for a few days ago at 5am.

Since I already had my hormonal profiles, EKG and physical done, I forwarded my results to them. My consultation that morning with Dr. Martin Valachovic, senior IVF Physician, could not have gone better. He spent 45 minutes on the Skype call with me, versus the 10 minutes I had with the doctor at PFC. Instantly, I felt much more comfortable, and two days before we fly, I officially switched clinics!

While I am happy and comfortable with this new clinic, it is not to say that I am hopeful. Although their website advertises success rates higher than 40%, he said my chance of a positive pregnancy is about 10% given my low AMH level of .2. This is what the previous doctor from PFC had told me, and it is important to keep in mind, so that I don't get my hopes up.

Just like if I were doing IVF here in the states, he plans to put me on Menopur, a stimulation medication I am familiar with. He said that I will have the highest dose, and with that, we should expect to have about three mature eggs (previously, with an AMH of .4 back in 2014, I had 7 eggs). That's not a lot, especially given that of those three, not all of them will fertilize and develop normally. For my second round of IVF that worked, 6 of those 7 fertilized, but we only had 2 that were normal on day three. The others either had two polar bodies or were not dividing. This is not due to a fertility problem, but is instead age related. Starting at age 35, most women are going to start showing diminished egg quantity and quality. Yes, there are always out-liers and people who say "My grandma got pregnant at 53, with no problem!" but that is the general rule.

My last day of taking the pill will be July 4th, the day we fly. This will help time my cycle and starting the medication, which I pick up on July 7th. I will blog through this process while we're over there, of course. Wish us luck!

5 comments:

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