[Guest]

Dear Peter
I am about to start IVF here in BRazil after unsucessful IUI. My doctor here says that she needs to delay my period this month so that my cycle next month doesn't coincide with carnival ( atime when it is impossible to get any of the drugs I need, and to get an anaethetist). So I am starting on Provera tomorrow. Then about 2 days after my period starts I am on Gonalf-f for 8-10 days before harvesting and implantation 3 days later. I will be coming back to the UK practically as soon as I know the result. (no way I can stay any longer because of conditions of my research grant). My doctor says it's OK to fly although she'd rather I didn't .
Im choosing to do it here in Brazil because I have to be here anyway, because of the cost (about a third of the price) and because I am using a known donor - my best friend.
My doctor says that she wants to transfer 3 embryos because of my age (35), my endometriosis and my total lack of sucess over the last year. And says there is a 5% chance of triplets and I have about a 30-40% of pregnancy.
What do you think of all this? I'd be pleased to get some advice or just another take on it, so I can discuss things with my doctor from a position of more information.
thanks
Julie

 

[peter]

Please see my comments in your text:

Dear Peter
I am about to start IVF here in BRazil after unsucessful IUI. My doctor here says that she needs to delay my period this month so that my cycle next month doesn't coincide with carnival ( atime when it is impossible to get any of the drugs I need, and to get an anaethetist).

Rather unfortunate but I suppose when in 'Rome'!

So I am starting on Provera tomorrow. Then about 2 days after my period starts I am on Gonalf-f for 8-10 days before harvesting and implantation 3 days later. I will be coming back to the UK practically as soon as I know the result. (no way I can stay any longer because of conditions of my research grant).

Research grant?

My doctor says it's OK to fly although she'd rather I didn't .

This doesn't really make any difference, thousands of women fly in the early stages of conception.

Im choosing to do it here in Brazil because I have to be here anyway, because of the cost (about a third of the price) and because I am using a known donor - my best friend.

Sounds reasonable!

My doctor says that she wants to transfer 3 embryos because of my age (35), my endometriosis and my total lack of sucess over the last year.

Think very carefully about this. In the UK you would be advised to have 2 embryos only, 3 are only transferred in exceptional circumstances.

And says there is a 5% chance of triplets

Yes, that's about right, it's a relatively high risk and triplets have a significant efffect on you and the babies (apart from the practicalities!!)

and I have about a 30-40% of pregnancy.

This is very generous, 20% would be closer.

What do you think of all this?

See above. I personally would prefer to be treated in the UK under our strict guidelines and regulations.

Regards,

Peter

I'd be pleased to get some advice or just another take on it, so I can discuss things with my doctor from a position of more information.
thanks
Julie

 

[Guest]

Dear Peter thanks for your answer
I am in BRazil doing research for my PhD (hence research grant).
I was wondering still about the 2 or 3 embryos question. WHat are the special cases that you mention when 3 would be used? I know that 3 is the normal number here, but obviously I don't want to get pregnant with triplets.
thanks
regards
Julie

 

[peter]

Please see my comments inyour text:

Dear Peter thanks for your answer
I am in BRazil doing research for my PhD (hence research grant).

Very interesting! A medical subject perhaps?

I was wondering still about the 2 or 3 embryos question. WHat are the special cases that you mention when 3 would be used?

The standard in the UK is now 2 embryos. 3 would only be considered in those patients with many failed cycles and in the 39-40 age range. From what you have said about your case (bear in mind that I do not have all of your details) if I saw you in a clinic in the UK I would recommend 2 embryos.

I know that 3 is the normal number here, but obviously I don't want to get pregnant with triplets.

This is the point and needs very careful thought. Hard stretched neonatal intensive care units in the UK find it extremely difficult to cope with triplets, your health is at risk, the babies health is at risk, there is an increased risk of long term problems with the babies and so on.

Regards,

Peter

thanks
regards
Julie