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Posts Tagged ‘IVF Abroad’

I often get asked why people choose to go to the Czech Republic for IVF, donor egg IVF, and donor embryo treatments.  My friends Kathryn Kaycoff-Manos, MA and Lauri Berger de Brito over at Global IVF have recently been traveling in Europe speaking at a conference on cross border reproductive care. Their travels also included Prague and Brno and they kindly invited me to write a guest post for their blog on the subject of why people choose to go to the Czech Republic for their IVF Vacations.

Please stop by and let me know what you think, or tell me if I missed any key factors that made it appealing to you: http://www.globalivf.com/blog/?p=745

 

One last reminder…..this blog is has now been moved.  Please come over to our new home at www.ivftraveler.com/blog so you don’t miss out on new posts and hopefully many more lively discussions about traveling abroad for IVF treatments.

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Over the past month or maybe more, I’ve been in the process of moving this blog to new digs.  That’s why it has been so quiet here – moving and getting settled in my new online place was a lot more work than I had anticipated.  So thanks to those of you who stuck with me through the long pause.

I finally built a full IVF Traveler website, and now I have moved this blog into my new website home.   Now the move is done, and after lots of testing and tweaking, hopefully everything is working as it should.

So, please come join me over at my new place for a little open house – you can take a peek around and tell me what you think of my new website www.ivftraveler.com. I am offering some new services, and I’m very excited about how the business is growing.

I do plan to start more regularly blogging about IVF and egg donor IVF around the world on this blog.   The new blog URL is www.ivftraveler.com/blog I hope that you will stop by, and add my new RSS feed to your favorite blog reader.

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The path of infertility is so often filled with disappointments and sadness, that it is easy to misplace the hope you had when starting on this path.  And the more treatments that don’t result in a positive outcome, the harder it is to remain positive and optimistic about future success.   Trust me, I get it.  I’ve been there and wondered where I would get the motivation to try again.  

I recently read an interesting article about hope*.  The author, Judy Jones, said:

We define hope as goal-oriented thinking—in that sense it’s different from optimism, which is a sort of general expectation that good things will happen. In our definition, hope is more active than passive wishing.

I think that is an interesting way to frame it.  I know so many who go through their fertility battle guarding their hearts against “what could happen” or focus on waiting for the other shoe to drop and end up missing out on some of the joys along the way. Let’s face it, for many of us, the joys are all to few and far between to miss out on them.  Some women have talked about missing out on experienceing the joyful parts of their pregnancy because of the fear that something would go wrong and the loss of hope that they could really have a positive ending and bring home the baby that is their heart’s desire. 

I like this concept of re-framing hope into an action of goal-oriented thinking rather than just “being optimistic”.  The author of the article laid out a strategy that includes coming up with different pathways to your goal.  In their studies, the participants in hope therapy worked on various skills to help them develop pathways and increase their motivation and energy to get there.  The result was that the people in the therapy group had lower stress, better moods, and higher self esteem.

The road to parenthood often has a variety of potential pathways: IUI, IVF, donor eggs, donor sperm, surrogacy, adoption. I think sometimes it is important to focus on deciding what is the true goal – then let go of our vision of  perfection so we can explore the various options or pathways for reaching that goal.  It may include things that are out of our comfort zone – pursuing medical intervention, IVF treatments abroad, surrogacy, donor egg or sperm; and those choices force us to decide what it is that we are willing to do to reach our goal.  For most people, that list may change as time goes on – it is all part of the process of grieving the losses (fertility, genetics, miscarriages) and looking for hope for the future. 

Now, I’m not going to pretend that having hope or being positive is going to solve fertility challenges or get you to your goal of parenthood; but in my mind, if you’re on the road anyway, maybe the quality of life along the journey will be better if you’re feeling hopeful.  

And while the reality is that many of us will have our hopes dashed along the way – sometimes many times- at least during the journey we had moments of hope that helped make it easier, and hopefully in the end we reach our goal.

*Note: the full article can be found online at: http://www.more.com/2024/7577-a-plan-to-make-your

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The blogosphere is all abuzz about a recent NY Times article by Melanie Thernstrom, a woman who used egg donation and surrogacy to have her two children “twiblings”.  She very openly discusses their journey to parenthood and their choices for building their family.  Then in a follow up article, she beautifully addresses some of the criticism and questions that came in comments to the original article. 

Original article link: http://www.nytimes.com/2011/01/02/magazine/02babymaking-t.html?_r=1

Follow Up Response link: http://parenting.blogs.nytimes.com/2011/01/03/more-on-the-twiblings/?scp=1&sq=thernstrom&st=cse 

Even though this has nothing to do with IVF abroad, it struck me as a wonderful article talking openly about the various aspects of third party reproduction.  As a patient, I often found myself at a loss feeling that I had to defend or explain my choices, and I love how she has communicated this in such a balanced and fair manner.

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Over many years and many cycles, I started compiling a list of things to help maintain sanity while enduring the excruciatingly long 2ww (2 week wait – the wait from when you have an IVF transfer until when you can test).  

The good news is that often if you are doing IVF abroad as part of an IVF vacation, you are still relaxing and then traveling home for at least the first part of your wait.  But then you get home, get unpacked, and bam!, it hits you.  The embryo obsession.  So, here are some ideas for the rest of your wait. 

I’ll share what I have – and feel free to add your own ideas.   The goal is to have enough non-stressful things going on that you don’t get obsessively focused on “am I?” or “am I not?” pregnant. 

Things to do to distract yourself during the 2 Week Wait:

  1. Drink 96 oz of water every day!
  2. Limit yourself to XX number of minutes a day to think about your embryos, then say STOP and distract yourself – visualize the embryos snuggling in for a long hibernation (around 9 months)
  3. Plan activities to distract yourself – such as:
  • Play games (board games, card games, video games, crosswords, sudoku, solitaire)
  • Do some crafts (knit, crochet, sew, beading, stamping…)
  • Art therapy: write a song or an essay or a book or draw a picture…
  • Organize your photos into albums
  • Organize your CDs
  • Listen to your favorite music or meditations on CD
  • Read something light and funny
  • Watch a video or go to the movies (take DH to a drive-in if you have one)
  • Listen to stand-up comedy
  • Chat on the phone, email all your friends
  • Go to acupuncture
  • Sit on a park bench and people-watch
  • Go for a long drive
  • Go for a walk in the botanical gardens
  • Make a list of things you’ve never seen in your town (stores or tourist sites you haven’t been to) and then go see them
  • Visit with nature (beach, lake, forest, mountains, waterfalls…)
  • Walk a dog (yours, a friends, or volunteer at a local rescue)
  • Get a pedicure
  • Retail therapy
  • Cooking therapy (there’s gotta be something you love to make or would like to try)
  • Invite a friend over for tea (decaf). You can include a fruit salad that just happens to have fresh pineapple, for the bromelain…
  • Spend an hour at your local bookstore or library
  • Visit a planetarium
  • Research a place you’d like to vacation
  • Go out to brunch
  • Go for a picnic
  • Go to a club and listen to live music
  • Pick berries
  • Plant some flowers
  • Sunbathe at a lake, beach or in your backyard
  • Go camping, build a campfire, roast some marshmallows
  • Watch a sunset
  • Go to church or wherever else your spirit can draw strength
  • Walk to an ice-cream shop
  • Go to a comedy club
  • Visit a museum or art gallery
  • See a play
  • Watch a live sporting event
  • Play mini-golf 

Surely, you all have some to add to this list?   I look forward to hearing your ideas!

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The recent volcano and resulting travel nightmares emphasizes the importance of having contingency plans – particularly when traveling for medical treatments.   Those safeguards and contingency plans will help make things easier if you are stranded by a volcano, hurricane or some other “made for TV” worthy travel horror story. 

Probably one of the most important things to realize when traveling for IVF is that our bodies don’t always work on schedule – so I suggest planning a few buffer days near your clinic on either side of your treatment.

For example, when my client/patients are planning their travel to Europe, I suggest they arrive 2 days prior to treatment, and leave 2 days after the latest likely transfer date (usually based on a 5 day transfer).  That provides a little buffer for recovering from travel hiccups.  I recently have had two clients on their way to treatment who were bumped from or missed connections that resulted in them arriving at the clinic a full day late –  which  could have been a disaster if they hadn’t planned the buffer days.   I think it is especially important if you are traveling from the US to Europe, since often there is only one flight per day. 

While I am not always a big advocate for travel insurance, it does provide some relief if things go awry.  Just make sure to check the fine print and see what circumstances are covered and what is excluded.  Many travelers affected by this Iceland Volcano (whose name no one can pronounce) are just now reading the fine print to see if their travel insurance carrier will cover their hotels and expenses until they can get a flight home. Without the coverage, you could be faced with thousands of dollars of unexpected expenses.  Most travel insurance seems to be covering the current volcano situation, but not all of them, so make sure you check the fine print before you buy your coverage.  

Usually you want to buy the trip insurance close to the time you book your trip to get the most coverage.  Travel insurance companies won’t cover something that already happened – so that flight you just booked to Europe next week would likely not be covered for delays from the volcano if you bought the insurance after the volcano erupted. 

You may also want to check into a “cancel for any reason” rider.  You will definitely pay extra for it, but that will help you if it turns out your period shows up late or some other circumstances arise to delay or cancel your cycle that just wouldn’t otherwise be covered by the “medical emergency” coverage of a standard travel insurance policy.  There are special travel insurance plans for medical tourism, but to date they seem to be so expensive that they probably wouldn’t be cost justified for a regular IVF cycle.  Perhaps that will change as medical tourism increases.   

More thoughts on travel safeguards tomorrow.

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So many doctors have differing opinions about which type of progesterone is best for your IVF cycle.  Each doctor seems to have their favorites or the ones they use for their practice.  But have you ever asked your doctor why they prefer one over the other?  Some may give you a choice of options – so how do you choose?

Many US doctors are strong proponents of the PIO (progesterone in oils) shots.  These are the intramuscular shots that hurt like heck!  But, the benefit of them is that the progesterone can be measured in your blood stream.  And with a little preparation (ice/heat/massage), for many patients, it isn’t nearly as bad as the initial anticipation of the shots. 

An alternate source of progesterone that is gaining some popularity with US and European doctors is Crinone 8% gel.  Inserted vaginally once (or sometimes twice) daily, most studies have shown it to be as effective if not more effective than the PIO shots or other vaginal forms of progesterone (measured in studies based on numbers of patients getting pregnant- aka implantation rates, and staying pregnant- aka loss rates).  If you like reading all of the details, here’s a link to two of the more recent studies:

A third common type of progesterone prescribed is the oral or vaginal capsules such as Prometrium, Endometrin, Utrogestan, etc.  These are widely used in Europe, and are also used by many reproductive practices in the US.   They tend to require more daily applications (sometimes up to 4 or 6 doses per day) than the PIO or Crinone 8% gel, so for some patients – this may have more of a nuisance factor.   Some doctors recommend use of the oral capsules vaginally – to essentially get the progesterone directly where it needs to go without having to be processed by your liver, and to minimize some of the side effects that are more prevalent when the medications are administered orally (such as sleepiness).  On the other hand, if your IVF medications (and stress) are causing insomnia, perhaps an evening oral dose of progesterone making you sleepy would be a welcome side effect.  

In the case of both Crinone and the Prometrium/Endometrin types of progesterone, you can expect to see a lower level in blood tests than you would with PIO, and that level may vary at different times during the day. So if you have a local doctor doing your monitoring for your cycle abroad, make sure they are aware of the type of progesterone you are using so they can advise you accordingly.

Also, if you are doing IVF abroad (aka an IVF vacation) remember that taking your progesterone on a consistent time schedule is important – so keep that in mind while you are traveling.  You may need to plan ahead, or slowly adjust the timing of your progesterone dose as you travel through many time zones.  Discuss this with your doctor and have a plan for making sure you get the progesterone you need when you need it. 

Also, if you are traveling with your medications, you need to do a little advance planning.  Make sure you have them with you in your carry on,  so that lost luggage doesn’t interrupt your medication administration and create a panic of trying to replace the medication while traveling.  You may also want to carry a letter from your doctor or pharmacy in case TSA or airport screening questions the needles, vials, or gel applicators you will have in your carry on luggage. 

The bottom line is that there are several very good options for progesterone support – and it is best to discuss the options with your doctor to decide which is the best choice for your case.

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