Answers to Questions from Last Post

1. How much info do we get about the donor? Atlanta said 20-25 page PDF including genetic info, and baby photos, but what else? If there are future health concerns, can the donor be contacted by the clinic? Answer: I checked with RBA and they said yes, they keep the donors on file and as long as their contact info remains the same, they can contact them if anything were needed in the future. Their contract also points out that laws may change in the future regarding privacy, and recipients may be allowed to find out more info in the future if legal details were to be amended.
2. If we miscarry or have to terminate, does the refund apply? I read somewhere that success is considered a live baby so miscarriage/termination is included, but I can't remember where I read that, or for which clinic. Answer: Yes, both refer to "live birth" so you can try again until then or until you meet the maximum of 5 (RBA) or 6 (Shady Grove) cycles. 
3. I'd like to know the % of 5 day versus 3 day transfers, and twinning rates? Answer: SG has complex charts to show this, but basically, from 2% if you do a SET on day 5 to 46% if you do a double blast transfer on day 5. RBA has about a 45% twin rate but if I did the guarantee program, I would feel less pressured to do a 3 day or a double transfer so I would hopefully be able to avoid twins.
4. I want to compare chances of having frozens left over with a successful cycle? Answer: With the 1:3 program at SG, 52% of participants have frozen embryos left over, with an average number of two embryos. At RBA, about 50% have frozens left over, and I don't know the average number of embryos. 

Other random things learned:

I do not know how many donors are in the database at Shady Grove, but RBA currently has 56 donors (I think Shady Grove has more). But, they are adding a huge backload right now, and expect to have 100 by the end of April or beginning of May. It will likely take us that long to get our screening done and the consult with the physician, so the timing will work out well for us. 

Other facts of concern about Shady Grove: by going with Shady Grove, there is a chance of cancellation that isn't an issue with frozen eggs at RBA. According to their stats, in the 1:3 program, there is a 4% chance of cancellation if you are recipient one, 8% if you are recipient two, and 19% if you are recipient three. I'd likely be number 2 or 3 since I am a newbie, so that 19% is something to be seriously considered. 

And a concern about RBA: the refund program is not as great as I first thought. I was tipped off by this blog. I asked for RBA's contract and sure enough, the refund is not the whole amount, but the total minus $3K per cycle completed. Also, if you only do one cycle, you forfeit a fee of $16,500. It's strange, but it's in writing. So, worst case scenario, we would lose $15K if we did all five cycles, and $6K or $9K if we did two or three cycles. It's not as good as Shady Grove's but I am somewhat reassured by their high success rates that we wouldn't do more than three cycles anyway, for a max loss of $9K.

I hope that we have time to sit together tonight and make a decision, though I think it's pretty clear how I am leaning. The downsides to RBA remain: the need for both of us to travel to Atlanta is more of a pain than DC, the need for me to miss work for a week rather than just three days (not a huge issue- I have plenty of leave), and the refund program is not as good as Shady Grove's. However, the upside of not needing another HSG (which I think Shady Grove requires, and of which I am terrified, having been traumatized by my first one) and having a significantly higher success rate, as well as being able to start any time and not worry about timing and cancellations, all lead me to the important question: WHAT IS MY END GOAL? My end goal is to get pregnant as soon as I can, with a reasonable refund so we can pursue adoption if this doesn't work. To that end, I think RBA will make the most sense. But I will report back soon, once more things are decided and are set in motion.