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Thursday, December 3, 2009

CD10, Crazy Infertile Lady Allowed to Go Insane

Here's what happened yesterday.

First, the ultrasound. My lining is on the thin side: 6.5mm, but apparently it is "beautiful" and "homogeneous." On to the follicles: I have 9 follicles measuring over 14mm (two of those are over 16mm), I have 15 follicles total that are over 10mm. As I was still considering IVF at that point, I asked the doctor if I had started out as an IVF cycle, what number of follicles would they have liked to see. She told me that the standard is "5 to 13," so I was well within that. (BTW, the Dr. performing the ultrasound was the same one that I had spoken to at my last visit, the one who had told me that if we went forward with the IUI we would have a higher than normal risk of multiples, and had offered IVF to me as an alternative.)

After the ultrasound and bloodwork, DH and I met her in her office to discuss our plan. DH shocked me by completely taking control of the situation and asking her about a bazillion questions about IVF versus IUI to the point that she said, "You know, I'm not sure I have all the answers you're looking for, maybe it would be better for you to speak with one of the doctors. Hold on." (note: she is an NP, not one of the main 2 REs at the clinic).

We were sent back to the waiting room to wait for RE#1 (my assigned doctor).

It was nice to see him, finally, as he is the doctor that I started with, and the one who knows the most about my progress so far. But as soon as we sat down it was clear he was not on board with IVF. Although he didn't exclude the option, and he answered all of DH's questions, it was clear that he was leaning toward IUI for us. It was also quickly clear that DH was in doctor love.

Basically, the RE's opinion was this: we are not at the point in our infertility treatments where it makes sense to move forward to IVF. He felt that it would be too aggressive. And the only reason not to go forward with IUI would be the increased risk of multiples.

So, really, what it comes down to is our tolerance for the multiples risk. As I said in my earlier post, DH and I would very much prefer a singleton to twins. And anything above that is out of the question. What makes this so hard to wrap my head around is that even with 9-15 follicles, our chances of failure this cycle are still far greater than our chances of success. There is still only a 20% chance of pregnancy. The main difference between this cycle and a "normal" one is that our multiples risk has gone from 10% to 20%, with most of that risk being in the twin category. But another way to look at it is, if our chance at getting pregnant is 20%, and our chance of having twins or more if we get pregnant is 20%, than our overall chance for twins or more this cycle is 4%. So it seems pretty unlikely.

Of course, then I think about the fact that most likely I will have at least 9 mature follicles this cycle and it seems insane to do an IUI. Just insane. I have not heard of anyone else doing IUI with this kind of response. At one point in our meeting with RE#1 he said, "Would doing an IUI under these circumstances be irresponsible? Well, the answer to that is: I do it all the time." (!!!!!)

So, it ends up like this: I am relying on my RE and DH to be my voices of reason. Of course I want to do IUI: the more follicles the better! But I'm a crazy infertile lady hopped up on fertility drugs! I trust them to hold me back if I want to do something nuts, and yet here I am the one leaning toward the more conservative route.

So, I'm putting my trust in them that this is not crazy.

Is this crazy?


  1. That IS alot of follicles, but I would probably go for it if your doc was comfortable with it. Like you say, it's not like all 9 will for sure fertilize AND implant.. I always think it's silly to cancel an IUI cycle after you (I) have been trying for so long and haven't been pregnant once, and all of a sudden "they" are sure that all 9 follicles will implant? Uh huh...

    So your IUI is Saturday, too? Praying for success for both of us!

  2. Good luck with your IUI! Your lining and follicle count are beautiful! (something I never thought I'd say to another woman, lol!)