Looking back, looking ahead
"Why is it taking you so long to get pregnant?" Dr. SF complained as he ushered me into his office. "I wish I knew!" I returned.
After taking two months off from reproductive medicine, I was back again. My husband and I had discussed it extensively, and not only were we ready to get back in the game, but he was ready to try IVF...with the stipulation that we freeze no embryos. Dr. SF was a little perplexed by this ("Usually Catholic patients want to freeze everything") but was game. Normally with a patient like me, he said, he would start with 200 IU Follistim, aiming to get about 25 eggs, maybe 10 of which would fertilize and 5 of which would make it to blastocyst--we'd transfer the best one and freeze the rest. But if we wanted to minimize the number of extra embryos produced, we could try a minimal stim cycle as we'd discussed previously, where we'd start with letrozole, then juice it with Follistim (150 IU, I wrote down in my notes). Ganirelix and Menopur would be involved somehow but I'm not quite clear on how.
Dr. SF warned that doing it this way would greatly reduce the odds of success, particularly since we're only doing single-embryo transfer--ironically, in the waiting room the day of my appointment they had on display stacks of copies of an article co-authored by the clinic director about how minimal stimulation cycles have success rates that are "disappointingly low" (8%!). But since I have insurance coverage for three fresh cycles, he's willing to give it a try with one cycle, and then we could reassess if it doesn't work. (Or if, for example, we discover that despite my generally good response to stim, my eggs are actually crap and don't fertilize or my embryos don't grow fast enough.) It's just a matter of getting the right egg, he thinks, since we have no reason to believe that anything else is malfunctioning.
But first, I wanted to try one more IUI...a Hail Mary cycle, I called it. Just one more, one last shot at the "easy" way, and one more to ease back in before leaping into IVF. This was all going on the last week of August. I didn't blog about any of it at the time because...I don't know, I was embarrassed about keeping on doing the same thing and expecting a different result? (I mean, come on, EIGHT IUIs? Who does that?) And, truthfully, I had a tiny bit of hope that I could just surprise you guys one day and say, hey, guess what news I have?
It was not to be. I got my period last Wednesday. The next day I got on a plane to fly cross-country to be in the wedding of my best friend from high school. Who is 12 weeks pregnant. By accident--she was actually on the pill when she conceived. The phone call when she told me the news was hard, I won't lie, even though I can hardly resent someone who has the good fortune of getting pregnant accidentally at 38. I just wish she hadn't said quite so many times how not-ready she was and how terrible the timing was.
I also wish I had remembered to call my clinic and let them know I had gotten my period before I left, so I wouldn't have gotten multiple phone messages over the weekend wondering if I'd gotten my period or if I'd like to come in for a pregnancy test.
Anyway, I'm going to call this week to set up our final consultation before we begin in earnest. I'm thinking we'll aim for a mid-November transfer, which will align well with my work schedule. I wish it could be easier, but since it seems like that's not meant to be, we'll tough out the hard way.
After taking two months off from reproductive medicine, I was back again. My husband and I had discussed it extensively, and not only were we ready to get back in the game, but he was ready to try IVF...with the stipulation that we freeze no embryos. Dr. SF was a little perplexed by this ("Usually Catholic patients want to freeze everything") but was game. Normally with a patient like me, he said, he would start with 200 IU Follistim, aiming to get about 25 eggs, maybe 10 of which would fertilize and 5 of which would make it to blastocyst--we'd transfer the best one and freeze the rest. But if we wanted to minimize the number of extra embryos produced, we could try a minimal stim cycle as we'd discussed previously, where we'd start with letrozole, then juice it with Follistim (150 IU, I wrote down in my notes). Ganirelix and Menopur would be involved somehow but I'm not quite clear on how.
Dr. SF warned that doing it this way would greatly reduce the odds of success, particularly since we're only doing single-embryo transfer--ironically, in the waiting room the day of my appointment they had on display stacks of copies of an article co-authored by the clinic director about how minimal stimulation cycles have success rates that are "disappointingly low" (8%!). But since I have insurance coverage for three fresh cycles, he's willing to give it a try with one cycle, and then we could reassess if it doesn't work. (Or if, for example, we discover that despite my generally good response to stim, my eggs are actually crap and don't fertilize or my embryos don't grow fast enough.) It's just a matter of getting the right egg, he thinks, since we have no reason to believe that anything else is malfunctioning.
But first, I wanted to try one more IUI...a Hail Mary cycle, I called it. Just one more, one last shot at the "easy" way, and one more to ease back in before leaping into IVF. This was all going on the last week of August. I didn't blog about any of it at the time because...I don't know, I was embarrassed about keeping on doing the same thing and expecting a different result? (I mean, come on, EIGHT IUIs? Who does that?) And, truthfully, I had a tiny bit of hope that I could just surprise you guys one day and say, hey, guess what news I have?
It was not to be. I got my period last Wednesday. The next day I got on a plane to fly cross-country to be in the wedding of my best friend from high school. Who is 12 weeks pregnant. By accident--she was actually on the pill when she conceived. The phone call when she told me the news was hard, I won't lie, even though I can hardly resent someone who has the good fortune of getting pregnant accidentally at 38. I just wish she hadn't said quite so many times how not-ready she was and how terrible the timing was.
I also wish I had remembered to call my clinic and let them know I had gotten my period before I left, so I wouldn't have gotten multiple phone messages over the weekend wondering if I'd gotten my period or if I'd like to come in for a pregnancy test.
Anyway, I'm going to call this week to set up our final consultation before we begin in earnest. I'm thinking we'll aim for a mid-November transfer, which will align well with my work schedule. I wish it could be easier, but since it seems like that's not meant to be, we'll tough out the hard way.
Labels: infertility, project 2.0
posted by electriclady at 12:24 AM
5 Comments:
The whole no freezing thing perplexes me too. But we all have our own limits. FET is what brought us the Mini. But I also think that the reason it worked was that I wasn't all consumed with whether or not it worked. I placed my mind on so many other things, and thankfully it worked out.
Good luck, sweets. I can't wait to hear more of your progress.
Oh, hey, and next year, we HAVE to make a point to spend more than five minutes together at blogher. That was just insane for me.
That feels like a big reversal that you guys will be doing IVF! Well, good to have a plan. Good luck.
I'm so sorry your at this place, but thank god you do have insurance coverge, Thats whats holding us back. You do whatever feels right for you, no matter what anyone else thinks about it. Best of luck with your cycle, praying and hoping this will finally bring you baby #2!!!
The dilemma of what to do with frozen embryos was what kept us away from IUI, although like you guys, I suspect if the IUIs had failed us, I would have found a way to convince the husband in the end. I'm bummed that the hail-mary pass didn't work but I'm excited to think that you have three new shots at the golden apple.
I'm always impressed when someone talks about getting 25 eggs through stims. I think the most I ever got was around 8 and that was on the max of follistim (350??).
And if you have 3 insured IVFs, then there's no reason to start high. See what those ovaries can really do and go from there. Don't wait December to let us know, OK?
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