I hope you have enjoyed the information provided in our earlier egg bank donor egg blogs. It nicely sets the stage as to what the egg bank at RBA is about. For my first blog on this site (or anywhere on the web for that matter), I'd like to take a different angle and describe the dynamics of how one couple came to choose this form of reproductive treatment. Last year, a patient of mine referred her friend from another city to me. We contacted each other via e-mail several times and they decided to fly to Atlanta for a consultation. They were a lovely couple and it was a tough case. The woman was in her early 40’s and she and her husband had been trying to conceive for many years. In fact, it had been such a long time that neither of them could keep up with all of the details. However, she had undergone major pelvic surgery in the past, but this was unsuccessful. After the nature of the surgery was revealed, the forgotten details weren’t needed. Her tubes were open but irreparably damaged – IVF was the only reasonable hope. So, we started talking about what to do. We talked about FSH levels, protocols, success rates, cancellation rates, and miscarriage rates. We discussed the genetics of reproductive aging. We talked about cost. It was immediately evident that the couple would barely be able to afford IVF. It would be the dreaded "one shot" IVF cycle- always high-stress, for both doctor and patient. Based on the particulars of this individual case, all signs pointed to a poor outcome. But, there was still a chance- what to do?

Let's stop here and place ourselves in this couple’s shoes. They came to RBA to pursue IVF. Should they pursue the dream of having children through the use of IVF if there is less than a 10% chance of a live-born child? What is "plan-B" if they are unsuccessful? In our couple’s case, continuing to live childless or being foster parents are the only choices after the expenses of IVF are taken into account. Now, place yourself in the physician’s shoes. If we step back and look at this case from the perspective of economic efficiency, traditional egg donation makes a lot of sense. The pregnancy rate is exceptional, miscarriages are infrequent and we have little concern for genetic abnormalities. Thankfully, I practice in perhaps the only clinic in the world where I can provide a more affordable method of egg donation without sacrificing quality or outcome. Nonetheless, “clinical efficiency” doesn’t take into account the emotions of a couple sitting in front of me. Should I avoid the difficult, emotionally-laden conversation about abandoning the use of this woman’s own eggs, when there is still a chance of it working? Ultimately, it is the patient’s choice, and I did offer egg bank IVF to this couple. They wanted to be parents and didn’t want to fail. They had never considered egg donation before, but their sense of relief at finding the best chance of becoming parents, that also met their budget, led them to choose our egg bank without reservation.

The next steps included further analysis of this couple’s unique medical history to prepare them for the best chance egg banking can provide. Her screening tests revealed a fibroid (myoma) within the uterine cavity that I removed surgically. The couple underwent the required psychological and routine medical testing. A follow-up ultrasound revealed perfect uterine healing and we were on our way. The thawed eggs fertilized very well with ICSI (intracytoplasmic sperm injection) and we transferred two beautiful blastocysts. Unfortunately, one additional embryo did not meet our standards for freezing. But all ended well with a nicely positive pregnancy test (β-hCG) that continued spiraling upwards. In two more weeks, we were able to see a single embryo with a beautifully positive heart rate. Our patient is nearing the end of her pregnancy now.