Blogo-therapy (Session 4)

So I really truly was pretty zen on Sunday. And even yesterday after the negative, which was, if disappointing, not surprising (despite the, shall we say, equivocal result I got Sunday night), I took it pretty much in stride. I had one of those crazy busy days at work--I met with students for about 4 hours straight--and that kept me on task mentally. Then LG went to bed and I cried myself into a migraine. Bye bye zen.

I think I'm done crying and moving on to planning. I'd like to drink myself silly tonight, but there's too much work to do. Help me, friends, figure out the plans?*


*

So it would appear that I'm doing Dr. Gorgeous's "hybrid" protocol. Ordinarily, that's Femara cd 3-7, injectables cd 7-9 (and possibly beyond). She says pregnancy rates are nearly equivalent to a straight injectable cycle, but it invovles less $$ and less monitoring. She's actually not saving me any money (my copay for Follistim is the same whether I start on cd 3 or 7), but the time/stress difference is substantial (and, to be fair, the blood work is less intensive so that is a cost saving as well). But...let's travel back in time to April 2009, when I almost did the hybrid cycle, but ended up having a single mature follicle on day 6. That was when she put pre-cycle Luteal Estrace into my protocol. And this time? Per her request, I'm only doing ~4 days of Estrace (I started last night; bad Gwinne) instead of the usual 9 or so. Let's just say I'm a bit concerned about how this is going to go. I think I'm going to ask if I can start Femara on cd 2, use OPKs beginning cd 7, and see if I can come in for monitoring on cd 9 (instead of 10). I'm hoping that this length of Estrace is just enough to slow things down without having them come to a grinding halt (which is what Estrace, at a twice-daily dose for 9 days, does to me). I think she'll agree; she's had me start on cd 2 before, and monitored as early as cd 8.

I think I'm playing this by ear, in terms of how many hybrid cycles I'm willing to do. I think if I get 3 follicles, I'll keep playing. If it's only 2, I'll ask to do a REAL injectable cycle, shooting for 3-4 follicles. A year ago, the statistical threat of twins seemed significant. Right now the reality of twins is significant, but I'm willing to take the statistical risk and deal with what happens later. And then...I don't know. Then I need to figure out if I (a) get a second opinion and go out of state for IVF, (b) keep going with IUIs for the forseeable future (she's told me that IVF really doesn't hold much/any advantage for me), or (c) move on to donor egg/donor embryo. My tentative plan is that I'm willing to do IUI until I turn 38 (that's 6-7 more cycles). As much as I'd like a baby now, I'm just not ready to move on to donor egg. And the more I think about donor embryo, the more wrong the whole thing just feels, at least for me and my family.

That leads me to a question you might be able to help me with. Maybe in February, Dr. G mentioned hysteroscopy as a possibility. What I don't know--I need to ask her--is what a diagnostic hysteroscopy might reveal that both sonohysterogram and HSG (both of which I've done) do not. This cycle or next--assuming I don't bleed until cd 10--would be a good time for me to do it. Anyone have comparative experiences?

So I guess that's where I'm at. Ordering drugs. Ordering gametes. Making plans. Not dwelling on the baby I won't have in December 2010. (This year is turning out to be just as shitty as the last one, anyway.) 2011, here we come.


* You'll note that I am not considering the possibility that my beta actually comes back positive because, honestly, another chemical pregnancy would put me over the edge. [Anyway, thankfully (?), the official word is negative.]