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Monday, November 2, 2009

Scratch That

Well, an interesting turn of events. Lots of info from today, and I'm still processing.

Met with Dr. RE#1 after US and BW. The first thing he wanted to talk about was my lining. Now, AF has been seeming lighter and lighter, and this was happening even before I did any assisted cycles, and so this was something I had mentioned to Dr. RE#1 before and he'd told me last cycle that everything looked good, that my lining was fine. But today he says he's concerned about it, so, okay, well, that's good I guess, because my light AFs have been concerning me. I ask how thick it is and he says 7.8, and that 7 is the minimum. He also says that he's concerned about the lining because I had a chemical pregnancy my first assisted cycle with them.

(Now, here's where it gets complicated and I'm going to fill you in on more messy details. It's never simple, is it? My first cycle with my RE, back in July, I took clomid, did a trigger, but did not do IUI. He asked me to come in for my beta 9dpo. Now, I thought this sounded a bit early, but this was my first cycle with the RE and I just thought that's how they did it. Anyway, the 9dpo beta came back positive, but I was told it was low and I'd have to come back Monday (1st beta was Friday). What a great weekend that was. Luckily, DH and I were out of town at a family wedding and I didn't have too much time to worry about it. On Monday, 12dpo, the beta was negative. He told me the numbers were, I think, 7 or 9 on Friday, and 2 on Monday. The next cycle I did with the RE the NP told me to come in for my beta at 14dpo. If that had been the protocol the first time I never even would have had a positive beta. I wonder if it wasn't just a false positive from the trigger. I mean, testing at 9dpo? WTF? But anyway, my RE now has it down that I've had a chemical pregnancy.)

So, because of this "chemical pregnancy," he is of the opinion that maybe I can get pregnant, but maybe my lining is the problem. And maybe he's right. So, what this means is he wants me to do injectables. So, that's fine. I don't mind injecting myself, actually (at least the trigger has been fine), but I know injectables will be a lot more expensive that what I've been doing so far, so there's that. So, fine, whatever, we'll do injectables.

Next, he says that my follicles look like they're already too big. He's says "they're not that big but they look big." Whatever that means (at least one was 10mm). He explains that he doesn't want to do an assisted cycle because whatever drugs I would take would feed those follicles that are already developing at the expense of other less mature follicles. I gather this to mean that I would end up with one or two mature follicles, very quickly, and nothing else, and he wants me to have more mature follicles than that, but not as quickly. I'm not exactly sure, but what it came out to was that we're not doing any drugs this cycle and then on cycle day 21 he wants me to start estrogen patches to "quiet things down" so we can start with "a clean slate" next month. This is called "estrogen priming" and it's usually done before IVF cycles. I'm not familiar with any of this. I will be googling later.

Finally, at one point in our conversation, as I was asking whether I really needed to move on to expensive injectables instead of staying with affordable non-injectables, and saying that I was thinking about the long term cost (i.e. if we have to eventually move on to IVF and we've already spent thousands of dollars on injectables, we may not have the funds to do more than one IVF), he outlined something for me on a piece of paper. He said that for most women the course of action would be to do 3 IUIs with clomid, then 3 IUIs with injectables, then 3 IVFs, until successful, and that would have a 97% chance of success. He also said that if one were to skip the IUIs and just do 3 IVFs, this would also have a 97% success rate (but he does not recommend this, of course). Really? 97%? Those odds sound... really good. That has actually eased my mind somewhat.

So, I was a bit disappointed overall. I'm itching to get back to it since we were forced to take last month off due to travel and scheduling conflicts. It's very upsetting to think we are going to have to wait another month. He did say that we can try on our own this month, and of course we will, and who knows, right?

So, no IUI#2 for me this cycle. But I will still chart and use the OPKs, and I will update through the month.

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