Work in Progress…ARTApp

April 3, 2015April 3, 20154 Comments

I successfully completed another module in my Data Science course! Woohoo!! Eight modules down, one to go. Now I have one week off of study, then onto the home straight. I can’t wait to finish it.

Part of my final project was to develop an online web App; I decided to develop an App that uses the data provided by the CDC on Assisted Reproductive Technology and presents the data in more user friendly way. I bit off more than I could chew for this project because the data the CDC provides is a bit messy and required some cleaning up in order that I could manipulate it easily. Now I have ‘cleaned’ the data, I need to spend a bit more time making the visualisation useful. I got 100% for my project so I passed with flying colours, but I have a lot more to do before I share it with a wider online community. You can have a sneak preview!

You can see my ARTapp here. It was supposed to look a bit more like this…

Screen shot of my ARTApp so far

My idea is that someone can select a state they are interested in, it shows all the fertility clinics in that given state, then the user can select a fertility statistic they are interested in comparing their clinic against the state wide average. There is also a map of the states that shows the statistic average for each state. This is just a prototype for now, I will keep working at it and include all data available from CDC, not just data for fresh embryos. Also add in some more interactive charts for looking at ART data over time.

Now, wouldn’t it be good to know what the IUI stats are like too?

What is the probability of IUI success?

March 1, 20153 Comments

Our Doctor told us that we have a 20% chance of success with our IUI treatment (Letrozole Day 3-7, Ovidrel trigger 36 hours before IUI procedure and progesterone suppositories (50mg) for two weeks after IUI). After three rounds, that would be a cumulative chance of success of 60%. But this probability is a calculated estimate based on many factors that our doctor knows about us. For example, if you were diagnosed with unexplained infertility the probabilities of success are lower than if you have been diagnosed with an ovulation related dysfunction. Age, number of years trying to conceive and sperm quality are all examples of other factors that will influence your probability of success.

Success rates for IUI?

There are many predictive models out there to determine likelihood of success of IUI. Each model seems to be slightly different, but in general they tend to range between 9-23% success for unexplained infertility, and the important factors that determine this success also seem to vary from model to model. This is probably the real reason why that if you were to google ‘the probability of IUI success’, you won’t find much of a straight or clear answer.

Why do I care? The difference between 10% (a one in ten chance) compared to 20% (a one in five chance), is psychologically different and I’d like to prepare myself for these seemingly different odds! I trust my doctor, but I want to know more about why it’s 20%.

I spent several hours trying to find something useful that explained the most recent stats. But the website with the most useful statistics explaining the different probabilities is www.advancedfertility.com. However, the website is confusing, statistics are hidden away in text paragraphs that require reading several times, multiple hyperlinks to different pages that break up ease of understanding, how recent is this information and it is not always clear where their statistics have come from.

If you google ‘the probability of IVF success’ there is a plethora of useful information and supporting data (because the govt mandates the data is collected by clinics), also there is a really good resource, Society for Assisted Reproductive Technologies (http://www.sart.org/) who summaries the most recent data at the clinic level and the national level. They even have a patient level ‘Predict my success’ interactive tool.

So, I herby call for greater transparency and clarity on IUI success rates, similar to what can be found online for IVF success rates. I’m not looking for exactness, just more openness.

If you know of good resources to help understand success rates of IUI, please comment below and share!

On occasions I forget that there are two of us on this journey

February 26, 20151 Comment

I was really mean to Chris the other night. I mean really mean and I feel bad about it. We were in bed together and just about to switch out the lights when Chris asked

“Can I touch your tummy?”.

Now, I hate, hate hate my tummy being touched after eating dinner, I just hate the feeling, something probably related to my Irritable Bowel Syndrome (IBS). But even so, Chris wasn’t just being polite….so with a slight quizzical look said

“No!! Why???”

Chris rather coyly replied

“Because…..well….there might be a baby in there!”.

Oh. I can’t remember exactly what I said next because I had mixed thoughts at the time. But I know whatever it was, it wasn’t very thoughtful. I argued that that he shouldn’t get his hopes up because the chances of our success were low. Then we argued about the statistics of IUI vs natural conception. And so we rolled away from each other after our mini dispute agreeing to disagree and the lights went out. After about 30 seconds in the dark, I felt guilty, terribly guilty. I have been trying to not get my hopes high with this IUI because I’m afraid of them just being put back down, again… so there I was, trying to put Chris’s hopes down too. In the darkness, I quickly apologized for being mean. He said it was OK. I couldn’t get to sleep for an hour or so after this brief incident because I was lamenting on why I felt so guilty. Really it’s because I realised I had not considered him and his feelings, I was selfish and temporarily forgot that actually there are two of us on this journey together and I am not alone.

This is our journey together

My what big follicles you have – all the better for inseminating with!

February 14, 20153 Comments

Today is Cycle Day 11 and I attended the first ultrasound for my first ever Intrauterine Insemination (IUI). The clinic were very efficient today, I was in and out within 15 minutes. I sat waiting in the examination room for the doctor to arrive, and there on the wall was a poster explaining the differences between fraternal twins and identical twins – A handy guide or perhaps more of a handy reminder of the increased risk for multiples with IUI. Today, the doctor had a student shadowing her, I had no problem with this, but I think he looked a bit awkward throughout – bless his cotton socks.

The doctor showed the student my good uterine lining – apparently three lines is good. This is all new to me, so I appreciated her explaining everything. I had two follicles in the right ovary (as I had predicted) one 20mm and the other 28mm. I also had a teeny tiny one in the left ovary, only 6mm, but she said it might be nothing. So I am ready to go. They don’t open on a Sunday, so my appointment is on Monday 16th Feb. As a romantic Valentines day gift, I get an injection of Ovidrel at 1130pm. Not looking forward to this given my phobia of needles. I am undecided yet whether I will do it myself or get Chris to poke me in the abdomen.

This is all assuming my medication arrives tomorrow as freedom fertility pharmacy have promised me. Today I called them to check the status of my order with regard to my insurance approval. They had the approval for the Ovidrel, but not yet negotiated the progesterone. I don’t understand how this system works in the background, but from what I understand, it is crazy. So I said I would go ahead and pay full price for them rather than wait for the insurance company to do its thing. If it is covered, then I can just try to claim it back later….but I needed my meds ASAP!

The progesterone was $49 and the Ovidrel was $123 full price, with the insurance agreeing to pay up, my 10% copay made it only $12.30. Not too bad.

Cost of this IUI cycle, full price:

Meds inc. letrozole, ovidrel & progesterone: $311
Ultrasound: $225
Sperm Wash:$140
Insemination:$225

Total: $901

Expensive stuff!! Chances of success? Our doctor told us our chances were about 20%. Advanced Fertility.com breaks down the success rates even further depending on age, sperm mobility and treatment options. Apparently there is a 7.6% chance of success with one follicle, and an increase chance to 26% with two follicles. Wooohooo! But those numbers are still pretty small. there is almost a 4 in 5 chance that we won’t conceive. Putting it like brings you back down to earth.

Fingers crossed for a Valentines baby (Just like Chris is!). Happy Valentine’s day everyone!