Having a Back Up Plan

Yesterday my son Seth (see photo of him with his Grandparents before my Mom's recent turn for the worse health-wise) experienced the Mac equivalent of the "blue screen of death." His MacBook Pro started behaving unpredictably and then refused to boot up at all. Earlier I had made an appointment at the Genius Bar but Seth had reassured me that all was well and I didn't need to bring his laptop over to the Clarendon Apple Store (25 min from our home). Then the meconium hit the fan and at 7:40 pm he declared an emergency and I grabbed the defunct machine and hopped in the car to make the voyage back into Virginia. I called ahead and the gang at the Apple Store told me that my genius would wait for me….is that great customer service or what?

The laptop was apparently experiencing a "kernel panic" or is it "Colonel Panic" ?? Beats me. in any case the system folder was corrupted and the only solution was a clean reinstall of the OS following erasure of the hard drive. BUT he uses Time Machine and should be able to nearly completely resurrect his machine once he returns to college this PM to start exams. Crisis averted….I hope.

It always helps to have a back-up plan. In fertility treatment this back-up plan could be the use of donor sperm, donor egg, donor embryo, gestational carrier or adoption. Although we can never know who will achieve success, we can often give good advice to those patients who need to consider alternative paths to parenting.

The use of donor sperm is the most common issue that we face in these discussions. In certain cases of severe male factor I think that considering the use of anonymous donor sperm is appropriate. In stimulated IVF we often consider splitting the eggs between husband and donor in cases of severe male factor BUT this makes no sense to me unless the couple is accepting of the concept of parenting a child born from fertilization with donor sperm. Don't waste the eggs if you are uninterested in using those embryos.

I currently have a patient who is successfully pregnant after IVF using this concept of a back-up plan that fortunately was not needed. Previously her attempt at stimulated IVF had resulted in very poor quality embryos. We were uncertain if this was an egg issue, a stimulation protocol issue or a sperm issue. We adjusted the protocol, used donor sperm to fertilize some of the eggs and the cycle was much more successful with fertilization from both husband and donor . Ultimately we had a bunch of embryos from the sperm donor and even two nice blastocysts from the husband. We cryo'd the donor sperm embryos and used the two from the husband. We were all ecstatic to see cardiac activity on sonogram recently and they are off for obstetrical care...

Having a back-up plan can make all the difference.