Has anyone in the shared risk program had SG pressure them to NOT test embryos?

[Anonymous]

I'm in the donor shared risk program, and my donor led to three pregnancies, and three miscarriages, all within a short time of each other. I'd rather move on to another donor, but I have 5 frozen embryos, and I have to use them according to the agreement, my doctor won't waive it.

It's clear there's a problem with the donor, so my next best option is to test the embryos. I've asked to send them off while we wait for my period, but the doctor for some unfathomable reason 1) wants to wait for karyotyping from other patients, when that kind of karyotyping is not reliable, mine was 46XX and he said it was probably my tissue that they tested and 2) recommended that I go forward WITHOUT testing, UNLESS there is an abnormal karyotyping--umm, three m/cs is RPL and I'm not going to do that and 3) will "discuss" testing with me after that comes back. . .

WTF? I want to believe he's on my side but there is NO WAY those embryos are going in me without testing after ALL THREE recipients miscarried from the fresh cycle. I would rather have another donor but at least if he holds me to the agreement, WHAT could be their objection to testing the embryos. The risk to young embryos is very small, and no way am I going through this FIVE times. Her embryos clearly love to implant, but clearly, they don't survive. If there's a normal one in the bunch, only testing can reveal it.

What would SG have to gain by delaying testing or denying it? Can they kick me out of shared risk for it? That doesn't even make sense, my friend with the same doctor tested her frozens after several miscarriages, and only one out of 4 came back normal.

Someone please tell me that I'm overreacting, and please explain why I need to wait to test these embryos?

[Anonymous]

You are NOT overreacting. This is a time to be a strong advocate for yourself - and for your future baby. Also, you should have yourself checked too - for possible immune issues. It is possible to miscarry a healthy embryo if your natural killer cells (which we all have) are overly active. This was a contributing factor in my two miscarriages. I had to be put on an iimmune suppressant for my third pregnancy to keep my body from attacking the embryo (the body can mistakenly think that it needs to protect you from a "foreign invader" and attack the embryo.) Also, do they have you on baby aspirin to protect you from the possibility of blood clots - which can also cause miscarriage? If I were you, I would also be wanting them to test the embryos given the recent history of miscarriages from all three recipients. Trust your instincts and persevere. Since you are still under contract with SG, maybe you can ask to switch doctors within the practice if the one you are working with continues to be unreceptive to your reasonable requests. Good luck!

[Anonymous]

Two quick things, do you want them to do the testing at their cost? That could be the only downside I see from a business perspective.

Secondly, ask to speak to the practice manager and express your concerns. The doctors are not always the last word.

[Anonymous]

Anonymous wrote:Two quick things, do you want them to do the testing at their cost? That could be the only downside I see from a business perspective.

Secondly, ask to speak to the practice manager and express your concerns. The doctors are not always the last word.

No, I have to pay. The contract excludes testing. I am willing to do it, the miscarriages are not worth it.

[Anonymous]

Could you submit your case to your doctor in writing instead of in a conversation where he can interject and be dismissive? I think you have very valid concerns and could type them up in a thorough, rational, and persuasive way.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Two quick things, do you want them to do the testing at their cost? That could be the only downside I see from a business perspective.

Secondly, ask to speak to the practice manager and express your concerns. The doctors are not always the last word.

No, I have to pay. The contract excludes testing. I am willing to do it, the miscarriages are not worth it.

What exactly was his reasoning for saying no? This is strange. Maybe he's worried about the dethawing necessary for testing?

[Anonymous]

I'm guessing he is concerned about stress on the embryos. Biopsy for this kind of testing is normally done when they are fresh. I very much understand where you are coming from but the process of thawing, biopsy-ing and re-freezing could damage one or more of your embryos to the point that they would not survive a subsequent re-thaw or be less likely to implant. Under the terms of your shared risk program, I'm assuming this increases the odds that SG would have to give you another "free" cycle or refund your money.

[Anonymous]

Anonymous wrote:I'm guessing he is concerned about stress on the embryos. Biopsy for this kind of testing is normally done when they are fresh. I very much understand where you are coming from but the process of thawing, biopsy-ing and re-freezing could damage one or more of your embryos to the point that they would not survive a subsequent re-thaw or be less likely to implant. Under the terms of your shared risk program, I'm assuming this increases the odds that SG would have to give you another "free" cycle or refund your money.

This is what he's worried about but balancing the risk of damaging embryos, with the risk of another late first-trim m/c, I am more than ok with the extra risk. Also, I happen to know that another friend did thaw and test her embryos, without being kicked out of shared risk.

Since I do think my doctor is one of the more compassionate ones at SG, I do think he may be getting pressure from his board/actuaries/profit-at-any-cost hounds to recommend certain things.

I think they know equally well that since ALL THREE couples had miscarriages, they're going to have a fight on their hands if they try to prevent testing. I think all my doctor can do is recommend.

This would explain why he says he wants to wait for the karyotyping from the others, maybe that's how he makes a case to them.

I'm confident of winning this battle. They can't realistically think that my having another miscarriage is going to increase their profits, and I pay a donor fee each time, so they actually lose nothing, really, by my moving on, which is hwat was my first cnhoice--a new donor.

[Anonymous]

Btw, I've researched it and it seems that thawed and refrozen embryos have the same implantation rate. You may lose some at thaw but that could happen when you go to transfer.

[Anonymous]

I have one friend who after several m/cs (like me), had her embryos thawed, tested and refrozen within SG's shared risk program.

Any others?

I am not going forward without testing my embryos, and they lose ALL my money if they drive me away, whereas they get another donor fee if I stay. . . I do NOT see their financial incentive, but my doctor has not yet agreed to send my embryos, saying he's waiting on testing. . . which will make NO difference in my decision.

This is really stressing me out, I hate feeling adversarial toward my doctor.

Any suggestions on being patient--as in the end, they WILL let me test my embryos, they can't reasonably prevent me--would help.

I don't understand why they can't just be more gracious about it. I have an email saying he will respect my decision, then why won't he let me send them off? I've agreed to wait for another saline sonogram, but they could be making arrangements now.

Why, when I'm paying tens of thousands of dollars for this, do I have to feel like I can't talk to my doctor, like he's not on my side? I'm thinking of changing but not sure I'll get a better experience with another cdoctor, if this is a SG policy.

[Anonymous]

OP here, my nurse wrote and said the doctor is making arrangements for testing the embryos. I'm relieved but still furious that they fought me on it and left me tortured thinking they would make me choose between losing the financial comfort of shared risk and risking more miscarriages that would cost me 6 months and untold heartbreak each.

I HATE that they thought it was up to them, those embryos were mine, the risk was mine, and it was MY body and heart that they were asking to take a chance by trying to prevent my testing. My 6 months lost per miscarriage.

Obviously they found abnormalities in the karyotyping of the other couples--though that didn't affect my determination to test MY $20,000 embryos!

While I'm FINALLY relieved for myself, I hope with all my heeart that the doctor and anyone else involved in delaying this obvious decision one day soon feels the torture of someone else controlling a medical decision that is puts them or better yet, a loved one (my family was tortured thinking I may have to risk another miscarriage with embryos that had already caused three), at great risk for heartbreak, for arbitrary and unreasonable reasons. May they feel that, and know it's karma, and regret leaving me hanging for so long, asking me to wait, which by definition suggests that they were thinking of trying to prevent me from doing it.

I want my baby but damn the industry to hell for the unnecessary anxiety and heartbreak.

[Anonymous]

OP you need to chill, are you in therapy?

[Anonymous]

Infertility patients are crazy!!!!!

[Anonymous]

Anonymous wrote:Infertility patients are crazy!!!!!

You might feel a little crazy too if you went through what OP has been through. You lack compassion, empathy, and good judgement, which is clear by this post. Let's see how sane you stay when life throws you a major curveball. Hopefully people will be nicer to you than you have been to this woman.

Stay strong OP.

[Anonymous]

OP glad they are testing the embryos. Good for you for sticking to your guns. I don't think people, drs included, always think about the physical and emotional ramifications of miscarriage. Be strong.