Thursday, February 24, 2005

Lies and damned lies

Yeah, I admit it. In my restless and all-consuming quest for pregnancy, I've become a Google slut, constantly on the stroll for links that will do me. Tonight I found me a stud: Assisted Reproductive Technology Success Rates > 2002 National Report > Section 4: ART cycles using donor eggs.

Some of the information therein amounts to stating the obvious: "Are older women undergoing ART more likely to use donor eggs or embryos?" Why yes, genius -- because we're old, and our eggs are poached. By the way, thanks for the reminder about that old thing. Love you too.

Of more interest to me was this byte: "Thus, the live birth per transfer rate for cycles using embryos from donor eggs varies only slightly across all age groups. The average birth per transfer rate is 50%."

Fifty percent? As in, heads-you-win-tails-I-lose? As in, I hope my uterus gets half full, but it might stay half empty, even after I give you $15K that I can't really afford?

Suddenly, reality bites.

See, here's the thing. Many of us who choose donor egg think of it as the safe harbor for our sinking infertility ships. When we get the Dread DE Speech from our reproductive endocrinologists, they hold it up like the Holy Grail: "With your own eggs, your chances of becoming pregnant are about three percent. And if you do get pregnant, the chance of miscarriage in your age group is fifty percent. But if you use donor eggs, your chance of pregnancy is...fifty percent! And your risk of miscarriage goes down to that of your young, nubile, robustly healthy, did I say young? donor! And you can drive it off the lot today!"

Okay, I added those parts at the end. But you get the idea. When they're throwing all these stats at you, "fifty percent" sounds so much better than "three percent." And they push the idea so hard and are so upbeat about it, versus the wrinkled brows and long faces they pull when you venture that you might want to try to conceive a child with your own crappy 39-year-old eggs.... You start to get the idea that if you can only bring yourself to accept it, donor egg is the Way and the Life.

But. Fifty percent. That's a flunking grade. That's an effing coin toss, and I am not known for my luck. Suddenly I am so freaking depressed.

And it gets worse: "For all ages, singleton live birth rates (average 29%) were lower than the total live birth rates (average 50%). Singleton live births are an important measure of success because they have a much lower risk than multiple-infant births for adverse infant health outcomes, including prematurity, low birth weight, disability, and death."

Waitaminit. What's this 29%? I am a very dim bulb when it comes to mathematics of any kind, and I hope someone, someday reads this blog and enlightens me. But it seems like they're cooking the books to get their holy fifty percent number. If twins count as two live births for one ART procedure, what's the real success rate per procedure? The report goes on to note, "In 2002, 4,195 pregnancies from ART cycles that used fresh embryos from donor eggs resulted in live births...slightly more than 42% of these live births produced more than one infant (about 40% twins and about 3% triplets or more)."

I am so screwed. But it's too late to choke on the digits now. I'm facing down Dirty Harry's .44 Magnum: "You've got to ask yourself a question: 'Do I feel lucky'? Well, do ya, punk?"

No, I don't, Mr. Eastwood. In fact, my uterus is notoriously unlucky. But then there's this one, by Benjamin Disraeli (a British statesman) and quoted by Mark Twain in his autobiography: "There are three kinds of lies: lies, damned lies, and statistics."

13 comments:

wessel said...

Bee, your blog is just beautiful. I'm so impressed with all the helpful links on donor egg. I would have liked to have done that also, and would have, if I weren't such a computer imbecile. As it is, it will take me an hour to link your blog, and I've done that, oh, about a dozen times. See, when I was a kid, which was in the last century, we didn't have computers in the schools . . . but wait, I guess I'm giving away my age.

I am no help on the numbers thing (sorry). But I did figure out some time ago, after hanging out on the network54 donor egg board, that the RE's LIED through their teeth about my chances of success with donor egg. Oh it'll fix everything, they said. Yeah, right. That's why so many women there have had to do 2, 3 and 4 cycles in order to have a baby.

But look, not to be negative or anything--many many women do succeed on that very first try and I want you to look right into that barrel and snarl, "Yeah, I'm feelin' lucky."

Galloping Cats said...

Wessel sent me over so thought I'd say welcome to blogland and good luck.

Bee said...

Thanks for stopping by! Blogland is such fun...a whole new community of folks to get to know.

Anonymous said...

Hi Bee, This is Malka. I got here through Wessel who I know from high FSH over 40 bb. You've made an excellent summary of some of the nasty little facts that can jump up and bite beleagered IF women just when they think they have found a foolproof solution. DE is like a coin toss in that the probability of success is the same, 50%. But the comparison stops there is that which side of a coin you land on is random but whether a particular DE cycle ends in success is probably not entirely random, just not knowable right now (not that that helps one iota right now either).

I've poured over the CDC ART report to see if I could find any info on your very smart question. The text says that there were 3629 pregnancies from fresh DE cycles that resulted in life births. Because it appears that the denominator is pregnancies and not live births, and because a pregnancy is counted once regardless of the number of babies growing in that pregnancy, I think the numbers are o.k. That is, that 47% of the transfers resulted in a pregnancy that resulted in the birth of one or more newborn. Whew! this stuff is complicated. I am going to send the CDC folks an email to make sure that this interpretation is correct. I will let you know when I get a response.

Take care,

Malka

Bee said...

Thanks Malka. It would make me feel a lot better to know that the 47% is a solid number. And even though I was taken aback when I wrote that entry...50% is STILL much better than 3%. And, if I can get pregant through DE, my chances of miscarriage are much less than with my own eggs. So there are undeniable positives. I just think that women who move from IVF with their own eggs to DE need a "reality check" at some point, because we tend to think of it as a guaranteed solution. Thanks for posting Malka! How are you doing?

Anonymous said...

Hi Bee,
I love your blogg. I'm new to all this blogging, so please forgive me for any goofs. I post as "K" on the network54 DE board.
My clinic told me that their "success rate" for their donor program is 70 - 80%. They are supposedly the best clinic in Canada and we really didn't think to question them. You can imagine how excited we were/are to receive those numbers.
When we had two Grade A embryos transfered on Thursday, they told us they only do about 1 DE cycle per month... hmmmm... Not sure what to think now, but we have already forked over the $15,000 and all we can do now is sit and wait.
What it came down to for us was that we had to give it our best "shot" (:))
I am feeling lucky (and naive maybe ?).

Kat

Bee said...

Hi Kat,

You are in the 2ww!!! I am so excited for you. At this point, the heck with the statististics, you have two embryos!! I remember that when I transfered my one little embryo after my IVF (with my own egg) I felt so special for that time...as if I were pregnant right then. It was a nice feeling though of course then I started worrying about when I could get my beta. :D How are you feeling?

Anonymous said...

Hi Bee :)

I'm feeling fine :) Of course I analyze every little twinge (could this be implantation? I constantly ask myself :)).

I too did a cycle w my own eggs. At first it took, but then we lost it very early on. So of course the clinic counts me as a "success" bc I did get pg for a few days...

Thanks for asking :)

Kat

Anonymous said...

Got to Spain (check out www.ivi.es) and pay a quarter of the US price for ALL the eggs of an anonymous donor and pay only if the cycle results in a transfer. Done it, with success and frozens.

LKW787 said...

Yes, stats can easily be "cooked." I wanted a clinic who's stats were based on "live birth" not just pg rates, a clinic comfortable with culturing embies to blast, And a clinic that would negotiate on fees. Also cuz I didn't want twins I chose one that agreed to eset (elective single embryi transfer.)

LKW787 said...

For this reason I chose dr. Buyalos at fsac in to, ca. Our first fresh cycle worked. They also have an in house donor pool tho I didn't use it.

Anonymous said...

My wife tried 2 tra transfers under donor eggs but no pregnancies.

Anonymous said...

My wife tried two IVFs using her own eggs and two transfers using donor eggs, but no pregnancies have resulted. Very frustrated.

We have two more forozen eggs to be transferred. Should she continue to use the forozen eggs? Would it be harmful for her health if she try too many times? Would apprecaite any coments. Thanks