Conference moira::parenting

I have a very good friend who is close to doing her first try at GIFT 
after several years and many types of treatment.  She would like to do 
the procedure under "light" anesthesia, which would keep her awake for 
the surgery.  The reason is that she had general anesthesia for a
laparoscopy a while back, and wound up with a roaring headache that 
wiped her out for several days.  

The anthesthesiologist has said that it is possible to do the 
procedure without general anesthesia, but the surgeon is applying 
pressure for her to be put out....

I would like to know if any noters who have gone through GIFT did it 
while awake, and would you be willing to share your experience with 
her, or with me to share with her (she is not a Digital employee)?

Thanks in advance,
Norma Frye (297-2682, CARTUN::FRYE)

There's a good discussion of different kinds of anesthesia in VMSZOO::MEDICAL
note 721.

I almost refused to do GIFT entirely based upon my previous experience with
the anesthesia during another laparoscopy.  I did eventually agree to do 1
GIFT, and explained my previous experience to the anesthesiolgist who was 
able to adjust the anesthesia sufficiently such that I had no side effects.

To give you an idea, whenver I have had anesthesia, I have always gotten 
violently ill afterwards.  With the first lap, it was done at 9:00 a.m., but
I was not released from the hospital til 8:00 at night, and that was at my
insistence since they wanted to keep me.  At that point, I was still getting
sick.  

Although I did not have the option of light anesthesia such as you mention for
your friend, I still would have gone the general anesthesia route for the
lap.  But I did luck out and the anesthesiologist was very good, so I had
the lap done for GIFT at 10:00 in the morning, did not get sick at all, and
was on my way home at 1:00.  I did have lots of confidence in the place I
went to, though, as a friend of mine had already had GIFT done there twice,
and had good experiences with the anesthesia after having a much worse 
experience previously.  A lot depends on the anesthesiologist.  Maybe your
friend will get a better anesthesiologist this time.  What facility does
she use?  My friend and I used Boston IVF and were very pleased.

Best of luck.
Cathy

    Someone in the Parenting community has been corresponding with me, re:
    my friend who is pregnant via the GIFT program...... I accidently
    deleted her last message.... and seeing as all I ever did was a reply
    to her notes, I can't for the life of me remember her last name or what
    system she is on!!!!!
    
    Sooo, Diane.... if you are out there still.... send me mail!!!!
    
    Thanks!
    
    M-L

A friend has recently discovered that she no longer has any eggs (and she
is fairly young).  She is considering many options, and I was discussing
GIFT and IVF with her when I realized that there are many things I do not
know.  Some of the questions I have are:

If GIFT more expensive than IVF?  What are the approximate costs for each
attempt at pregnancy?  Is the second try typically cheaper than the first
because of frozen eggs/embryos?  Under what circumstances would the attempt
be cheaper (I think I saw it mentioned as 6,000 one time) and what would
make it more expensive?  Does it depend on the doctor, or on the woman trying
to get pregnant, or what?  

Thanks for your help!

    Carol

    Hmmmm. I am assuming that your friend, in considering GIFT and 
    IVF, is planning on eggs from a donor. If she has premature ovarian
    failure, she cannot stimuate her own follicles (unless by some chance
    she has some left, but probably not from what you said). 
    
    Therefore, the usual procedure is to get eggs from a donor, fertilize
    them and implant them via IVF into the uterus. This is billed to the
    insurance companies as a complete IVF cycle. Depending on her
    insurance, the out of pocket expense can be around $2000. 
    
    I guess she could do GIFT but it would tricky. 
    
    Yes, extra fertilized eggs are frozen and the thaw cycles are cheaper.
    
    Advise her to call Boston IVF to get literature on their donor egg
    program (tell them she is a recipient).
    
    Cyn

<    Hmmmm. I am assuming that your friend, in considering GIFT and 
<    IVF, is planning on eggs from a donor. 

That's right; she has no eggs at all.  She has a couple of women from whom
she could get eggs, including her sister.
    
<    Depending on her insurance, the out of pocket expense can be around $2000. 

I've just learned that in Mass everyone gets coverage for infertility.
However, my friend is here in Colorado, and I don't believe her insurance
is all that great, currently (she has recently gone back to school and that
is the insurance which she has).  How much would IVF and GIFT be out of 
pocket?  Do *most* insurance companies (outside of Mass) cover infertility
treatments?
    
<    I guess she could do GIFT but it would tricky. 

How so?
    
<    Advise her to call Boston IVF to get literature on their donor egg
<    program (tell them she is a recipient).

That's a good idea, just to learn more about this.  Does anyone know what
it costs to get someone else to produce eggs for you?  If Jane Doe down
the street were to do this then would her insurance company likely cover
*her* drugs and surgery?  Anyone know if John Hancock/Digital covers that?

Thanks.  I know these questions may be somewhat detailed or hard to answer,
but I appreciate any info I can get.  :-)

      Carol

Her best bet is to contact RESOLVE.  They're up to date on insurance issues.

    A full IVF cycle, which is what Boston IVF would call the complete
    donor egg/transfer cycle, would cost without insurance around 
    $8000, I believe. What Boston IVF does is bill the insurance company
    for a complete IVF cycle, including a anonymous donor. They do not
    specify the donor name, nor where in the procedure the treatments for
    the JH patient and the donor differ. I am amazed that they get away
    with this, but so far JH has paid as if it were all done for just the
    JH patient (the recipient of the eggs).
    
    Boston IVF pays a donor $1000 for donation, plus all medical expenses.
    This includes some counseling, any follow up checks and any
    complications from drugs. All drugs and treatments are charged to the
    recipient's insurance company.
    
    The reason I think GIFT would be tricky is that normally the recipient
    is prepared so that her cycle will be ready to receive fertilized eggs
    about 2 days after the eggs are harvested from the donor. Instead, the
    recipient would have to receive drugs that would make her suspended in
    her cycle to just the spot where eggs would normally be release from
    her ovaries. With GIFT, you are putting the unfertilized egg and 
    sperm separatly into the fallopian tubes. The uterus would have to
    be in the correct state to receive this. I guess that would work, now
    that I think about it. I know that GIFT is more complicated and much
    more painful for the recipient. Instead of a simple IUI-type of
    procedure, which is just transferring the fertilized eggs to the
    uterus, the recipient would have to be put under, a laproscopy would be
    done, long needles in the abdomen to place the eggs and sperm in the
    tube... I guess I would go to IVF instead!
    
    I don't believe insurance companies would separately cover a donor.
    If they call RESOLVE, they can get names possibly of clinics in their
    area that are doing this kind of work and then can get details on how
    their programs work. Another good place to call for them in the Boston
    area to get free info is IVF Australia (are they called that now, or is
    it IVF mercia? Seems to me they changed their name) in Waltham, I
    believe. They are very generous with their literature.
    
    I have some info from Boston IVF I can se to you, send me mail if
    you are interested.
    
    Cyn

    
    Hello Everyone,
          This is the first note Ive ever writen in this file, although
    ive been reading this for about 2 years.
    
    My husband and I have been trying for children for 3 years and have 
    had all the tests done etc.  Yesterday (wednesday 2nd Dec) I visited
    the hospital to see a full time infertility specialist.  He said 
    he's going to start me on GIFT. We next have to visit him on 
    January 27th 93 to start the treatment.
    
    I was expecting to be on a waiting list for at least a year, so I 
    was very excited when he said January.  Its only costing me and 
    my husband 250 pounds (aprox $500 ) for the first time and 1000
    pounds thereafter.  Due to being so excited, I didnt ask many
    questions.  
    
    What I would like to know is what exactly happens from day one to 
    day whatever. 
    
    If anyone could explain to me , id be most gratefull.
    
    If ive left anything out of importance, id be happy to answer.
    
    Thanks in advance
    Samantha
    

    
    Just a quick update, I start taking Norethisterone on Friday 19th Feb
    till 6th March. Then on 7th March I start taking clomid again for 5
    days and pergonal for 7 days. Have a scan on day 8,9 and maybe 10
    and gift on day 11 or 12.  So by the end of March, I should know
    whether im pregnant or not.  So keep your fingers crossed for me.
    
    Sam
    

If it's possible .....I'll attempt to cross every body part possible!!!!

It takes alot more than luck to get to this point...........please know
my thoughts and prayers are with you......positive thinking is healthy 
and calming!

Donna & John

    
    Thanks very much Donna. If I cross all my body parts, I'll never have a
    baby :^)    so thanks for doing it for me .
    
    Sam
    

    Well today was graduation day for me at my doctor's infertility office!
    
    I must say we have been blessed against the odds with our IVF cycles.
    We have goten pregnant two out of three cycles and truly are grateful
    for the gifts we have received.
    
    I am 13 weeks pregnant and everything is going great.  I know we have
    a long way to go, but we have passed some of the hardest hurdles and
    I will definately stay in the moment.
    
    So we are proud to announce while in utero:  "Eenie"
    
    We had six embryos transferred and my sister named them "Eenie, Meenie
    Minie, Mo, Catch & Tigger"..so since one took, it's got to be Eenie!"
    
    I always believe in following our dream, which was having a child...
    didn't matter how that baby came into our life...just knew we couldn't
    do without...I say stay close to your dreams and they to will come true
    when it's meant to be!
    
    ...Lori 

    
    Hugs and congratulations, Lori!
    
    

    outstanding news, Lori!  Many happy months of pregnancy and a happy,
    healthy baby.