Monday, January 17, 2011

Aaaand here we go again

Thoughts on returning to the RE's office after a 14 month absence:

• This place reeks of desperation and despair.
• Why do I see more Hasidim at the fertility clinic than anywhere else in the city?
• (Well, where else would I run into them? It's not like they're hanging out at the clubs on Friday night.)
• (Not like I've hung out at any kind of club myself in the last 10 years or so.)
• Boy, all these comfy upholstered chairs would be a perfect breeding ground for bedbugs.
• Must be Bring Your Husband to the Clinic Day. Lots of sheepish-looking dudes getting called back solo.
• I can't believe I'm back here.

Dr. SF was really pushing for IVF this time. He said that while we can keep doing what we've been doing (low-dose gonadotropins plus IUI), it's pretty inefficient especially given our desire to avoid multiples. He said that with IUI I'm just as likely to get pregnant with twins as with a singleton, and reminded me (as if I needed reminding) that I could easily have ended up with twins when I got pregnant with BG. But he also said that really, we still haven't done all that much with project baby 2.0--those 3 (or 4?) back-to-back cycles in 2009 notwithstanding, the sum total of eggs I've produced so far is actually not that high. So he didn't have any objections when I said that we really wanted to try a couple of IUI cycles first and see how it goes. (My husband and I had discussed this beforehand and settled on trying 2 cycles IUI before we reconsider IVF.)

So we settled that we'll start a new cycle this month, pending today's bloodwork, and try to duplicate as closely as possible the 2006 cycle where I actually got pregnant. That is, rather than starting at 75 units and ratcheting up, we'll start with a few days of 100 units and dial down, since that cycle I did 3 days of 100 units, 2 days of 75 units, and a day of coasting before triggering on day 9. The Gonal-F pens in my fridge are still good, just barely, so I can use those.

Looking ahead, I asked if there was an option to do a low-dose IVF with the intention of ending up with as few leftover embryos as possible (since freezing is one of the aspects of IVF my husband is squeamish about). Dr. SF said yes, they do a letrozole plus follistim protocol for women who have had breast cancer or for whom high estrogen levels are otherwise inadvisable, with the aim of getting 4 or 5 eggs--with a day 5 transfer, that would mean probably few survivors. Since my insurance will cover 3 full cycles of IVF (meaning we don't have to try to pump out as many embryos as possible in one round that's our only shot), he thinks it would be fine to try that first, if it comes to that. And the other interventions my husband isn't comfortable with--assisted hatching, ICSI--would most likely not be needed in our case anyway.

Dr. SF ordered up bloodwork--progesterone, hCG (ha!), estrogen, TSH, the usual--and I'll get a call tomorrow letting me know whether I need Provera or can just wait for my period to come on its own. (I'm on CD 30-something and spotting, but that doesn't mean anything in PCOS world.) And--I can't even remember the last time this happened--I GOT TO LEAVE WITHOUT TAKING MY PANTS OFF. I know, right???

So there you have it. It seems this is an infertility blog once again. Yay?

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13 Comments:

Blogger May said...

Yay! Fingers crossed for quick and easy singleton conception!

I have recently (this week) returned to my own blog after a long absence. It's not IF, though; more random musings from a formerly sane mind. With pictures.

1:13 AM  
Blogger Thalia said...

I'm sorry you have to go through this again, but very pleased with your doc, I agree IVF is a much better use of your money, although I know there are challenges around that, particularly for your husband. Glad you got to a good place.

3:04 AM  
Blogger Jody said...

Sounds like a nice, solid plan. And huge cheers for the insurance coverage of IVF. It's a relief to know that the next step isn't being driven by money alone, right?

Let's hope you don't need the insurance money, though. Let the IUI work.

6:12 AM  
Anonymous Jacquie | After Words said...

Yay! Best of luck.

9:54 AM  
Blogger Yo-yo Mama said...

Boo?

I guess if one has to use an RE, it's good to have a plan, a backup plan, and a backup to the backup plan.

(bedbugs! *shudder*)

10:10 AM  
Blogger shanna said...

Best of luck! I'd love to see you with one (ONE!) more little baby just in time for Thanksgiving.

10:26 AM  
Blogger Rachel said...

Yay for cycling again! And wishing you all the best of luck with the IUIs.

My question is not why there are so many hasidim in the clinics (they obviously desperately want babies. There are few communities which are quite as unsympathetic to the childless couple while also supporting a 'whatever it takes' medical mentality) but more - why are they so unfriendly? Since the religion has no great hang ups on fertility treatments (supports things like IVF, you can get a medical exemption to do just about anything you want ... I know from personal experience), it just seems puzzling.

As for the husbands, I love their extremes: brash, this will work first time and is just a little medical procedure to utter shame and inability to make eye contact. At least they are more entertaining than the endless rows of Size 0, blackberry in hand, perfectly coiffed woman who seemed to show up on my last cycle while I wandered in in my pajamas, hair unbrushed having just rushed my daughter off to daycare with a bag of cereal in her hand ...

11:08 AM  
Blogger K77 said...

Good luck!

8:46 AM  
Anonymous Anonymous said...

I noticed that you mentioned that it is important that you not get pregnant with multiple babies. I am in the same boat due to my diagnosis of unicornuate uterus (1/2 the normal size + only 1 fallopian tube). What is the reason you can only get pregnant with one?

9:04 PM  
Anonymous electriclady said...

Hello Anon! The main risk in pregnancy in general for someone with unicornuate uterus (or most any uterine anomaly) is miscarriage or preterm labor. Intrauterine growth restriction is also a concern. (Size of the uterus is of course a factor, and I believe some think blood flow to the uterus may be impaired for some.) All of those things are of course multiply true if you're pregnant with multiples.

Since my first pregnancy was plagued by preterm contractions and preterm labor scares from very early on, I am even more concerned this time around--though my OB said that in many cases the first pregnancy "stretches out" the uterus so subsequent pregnancies aren't so bad.

I think of it this way: A twin pregnancy for me would be like a triplet pregnancy for someone with a normal uterus.

Hope that helps! Feel free to email me at citygirltales@yahoo.com if you have more questions, and definitely click on the links in my sidebar if you want to find others with UU.

6:55 PM  
Blogger OneTiredEma said...

Ooooh, good luck! At least it's a familiar world? (Cold comfort, I suppose.)

But SUPER YAY for pants on! I will never forget my first regular OB visit with Miss M, at 14 weeks, when I didn't have any kind of internal anything and I wandered out of the office in a state of shock. ("So this is what the real people are like!")

3:34 AM  
Blogger Ali said...

This. Is. So. Exciting. (At least for us readers.)

7:03 PM  
Blogger caramama said...

Good luck! You know we are rooting for you from the interwebs!

But I think you maybe missed something in your list, maybe you didn't notice it because people are so cautious about showing it: Hope. There is hope in that waiting room, as well. And I have it for you!

5:17 PM  

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