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Comment by Rachel on July 29, 2011 at 10:16am

Hi Lori-read through that document as well... could not find anything specific to the embryo transfer issue that we are chatting about. Double checked with my husband, and he agrees that the nurse did make the statement (it caught his ear as well), and I thought that I had read something in that act about control over numbers (I didn't worry about it at the time, as we were already told we are having 3 implanted), but I must be wrong. I found another link this morning in my search for information about transfer numbers that is a little less legal, and it discusses the rationale for how and why things are done w/regard to transfer numbers and the recommendations for members of the SOGC (Society for Obstetricians and Gynaecologists of Canada). I found it to be an interesting (albeit clinical, and somewhat scary) read.

http://www.sogc.org/guidelines/documents/182E-CPG-Septembre2006.pdf

I will keep searching for that info, as it is bugging me now that I can't find it!!
Rachel

Comment by Lori on July 28, 2011 at 4:44pm

Hi ladies. I started a blog a few years ago and kind of let it fall apart because I found I was always struggling for something to say, but I decided today to start it up again to document my infertility journey while living with diabetes. I know that I wish there were more infertility/diabetes blogs out there (if you know of any other than Managing the Sweetness Within, please let me know!). Anyway, if you're interested, it's at http://bittersweet-surrender.blogspot.com.

Thanks for the link, Rachel. You're right, it's a bit of a dry read. lol I wish I had a law degree to understand it more. :)

Comment by Rachel on July 27, 2011 at 10:49am

Lori-it's rather a dry read, but I hope it helps... sorry it is a federal act, not a provincial one.

http://laws-lois.justice.gc.ca/eng/acts/A-13.4/FullText.html

Thanks for the CGM info!
Rachel

Comment by Lori on July 27, 2011 at 8:09am

Hi Rachel,

I'd be really interested to read about that legislation if you're able to find the link. Thanks!

I use the Medtronic Paradigm 522 which has a built-in CGM. I chose it specifically because of that feature... I can not imagine having to carry two devices all the time. However, if Animas had a built in CGM with their pump I think I would have gone with them. Medtronic customer service can sometimes be a headache to deal with (fortunately, I do not have to call them very often - in fact, I've probably only dealt with them 3 times in the 5 years I've been pumping - but 2 of those 3 times I had to call they had me pulling my hair out!). It's too bad that our options are so much more limited in Canada.

Comment by Rachel on July 27, 2011 at 6:32am

Hi Lori
to answer your question about numbers, when we saw the nurse last week to discuss the drug protocol, my long list of questions included what to do if all of the implanted embryos take (our Dr has previously told us he would be implanting 3). She said that it was not ultimately up to the team (ie them) how many we tried to 'keep' (sorry can't think of a more appropriate word), but up to us as the patient(s). Being the realistic creatures that we are, we ave already discussed the difficulty of increasing the 'high-risk' factor even more... and to directly answer, finally :), she also made a comment that it was not up to them how many embryos were transferred initially, either. There is some legislation that pertains directly to this whole issue, and I will try to find the link that they provided us with eons ago to assist you. I think it may answer your question more concretely than 3rd party hearsay ;)
My own question now is which CGM do you use? I am one of 3 people in our ADP clinic who use the Roche (Spirit) pump, so I am already a minority. We are strongly leaning toward the Dexcom, even though we would have to import it from the US. I just seems as though the user feedback is the best, and I am personally going to take the opinion of those who use them over those who sell them :) Roche does not have a CGM of their own (yet), so that's where we are at.

Rachel

Comment by Lori on July 26, 2011 at 2:44pm

Rachel - I just remembered a question I'd meant to ask...

Have you discussed with your doctor how many embryos will be transferred? My doctor has recommended that we only transfer one at a time (assuming that we have more than one viable) and freeze the remainder. She doesn't want to run the risk of a multiple pregnancy when it will already be considered high-risk due to being diabetic. I understand her reasoning, but at the same time I want the best chance of success so I would kind of like to push for 2 embryos.

Comment by Lori on July 26, 2011 at 2:03pm

Hi Rachel,

I am in Ontario too and will (hopefully) soon be starting IVF. The fertility clinic (Mt. Sinai in Toronto) hasn't gotten that deep into my diabetes yet - the dr was happy with my A1C and not much more was said about what has to happen before IVF.

Thank you for sharing your experience with hormone therapy thus far and how it has affected your blood sugar. That has certainly been something on my mind.

And rant away! We can all appreciate your frustration (one reason why I started this group)... Try not to let the doctor get to you; just remember that you are the one living in diabetes each day, not him. Our blood sugar will not be perfect at every moment of every day. All that I think can really be asked of us is that we test and make the necessary corrections.

Good luck with the CGM! I use it once every two or three months to see how my blood sugar is trending (simply due to expense), but once I start IVF I plan to use the CGM all the time (and throughout pregnancy if I'm lucky to be successful) as I'm sure it will be very helpful in keeping my numbers tight.

Comment by Lou on July 26, 2011 at 12:08pm

I don't know about you Rachel but I find it humiliating, (then frustrating) like we haven't already tried our proverbial 'nuts' off to get to the referral stage. It's like if you can't actually say something constructive about how to do it, don't say anything. I have shocking problems with progesterone... in fact any progestogen type drug :0s hates me... (((hugs))) from someone who understands chick x

Comment by Rachel on July 26, 2011 at 7:50am

Hi guys! Funny how I was just lamenting to my husband this morning that there was no one to talk to who would understand what it's like to have IVF AND diabetes... Someone smiled on me today!
I am 37 (closer to 38 now :( ) with diabetes for 28 years. New to pump therapy and looking into CGM for reasons explained below. (we are in Canada where the choices seem a wee bit more limited) I had a tubal ligation (as a result of a 'practice' marriage) at age 23, and rather than reverse and due to my age already, it was decided that the best and 'fastest' thing is to do IVF therapy.
We are about a week into our first IVF cycle, with lovely (or not!) response to progesterone that is making my b.g. trend up by about 25%. Our repro Dr. said that my numbers needed to be 'perfect' at transplant or it won't work. I get that, as a group diabetic women trying to get pregnant are probably the most realistic of all people, but I still wanted to cry in total frustration and overwhelming downheartedness. He has my numbers sitting in front of him, it is obvious the work we have put into getting this far (we are down 2 full point on A1c to 6.5 in 6 months). We have the permission of my endo, who is very practical about speaking of the elephant in the room when it comes to diabetes and pregnancy, let alone assisted fertility. I appreciate that he is just trying to be sure that we get what we want and he continues with good success rates. But it would have been nice to have a little more understanding. Obviously we are doing whatever we can to make this work, that is why we are in his office!
Sorry, I hope this makes sense, and apologies as I think I am on a rant... :0/
Rachel

Comment by mhynes on July 20, 2011 at 7:14pm

Lori thanks for the info. I will ask about other possibilities besides PCOS. I worked.my tail off for the 5.7 so I am pretty proud.

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