So I'm not sleeping. Again. I think I'm so past the point of tired that I just can't sleep. And believe me I've contemplated the single, unused, pre-transfer valium that is currently with my IVF drug stash in the basement. In lieu of that, I'll give writing a try.
I had an unbelievably good conversation with Dr. Gorgeous today. We were really talking about all this stuff. One of her greatest assets as a doctor is that she really considers the whole patient. She entertains finances, emotional considerations, logistical work considerations, as they intersect with reproductive concerns. That is, she fully supports my decision to take this down about fifteen notches back to unstimulated cycles (saying natural seems weird, given how much stuff I'll still be doing), and if/when I decide to bring out the Follistim again, she's also willing to have me monitor locally.
While she clearly hasn't given up on me, she's also said that medically there's not a reason for me to do one kind of cycle or another at this point, as I've tried it all. I'm not sure that's exactly true, but it's also pretty clear that there's not a huge difference in my cycles no matter what I do. And she said of all her patients, I'm in the very very top in terms of my education about all this. You're smart, she said, you make good decisions. (If only she knew the stupidity I've been up to this week!)
Donor egg, we both agree, is my best shot and the logical next big step. But I'm not ready to do it, and I'm not sure I ever will be (she did suggest seeing a reproductive counselor, and I might do that at some point). At 37, with a decent FSH level and decent AFC [it's my AMH level that sucks beyond words] I have a hard time making the mental leap to my eggs are crap let's use someone else's. She said today she thinks I've got about a 40% chance of conceiving with my own eggs. Let's just say that's better odds than getting a tenure track job in my field. Which I've done. Twice. From where I sit, that sounds pretty good. Not fabulous. But worth trying. She suggested 6-8 months of this unstimulated-or-whatever plan. I'm giving it Sept-Nov and then back to Follistim or something. Maybe try IVF in December, with an EPP protocol? Maybe do that out of state?
So the plan: no stims [believe me, it's going to take some self-restraint NOT to use my leftover drugs], one ultrasound on cd 11, trigger with Ovidrel [she was pretty adamant about that, not for timing but for luteal support], then Prometrium, Lovenox and all the rest. That's how I got pregnant with LG, more or less, after a year of clomid and repronex. Maybe I'll be so lucky again...
Sorry to hear you were up and not able to sleep. I guess I wonder whether, if using you own eggs is important, why not try an ivf even though you win't likely have very many eggs to work with? That'd give you a chance to see if your eggs are still good, its just conception that's the hard part. Obviously though, that is an expensive gamble, but it would give you a very serious shot before moving to egg donor.
ReplyDeleteI still think that these iui's have got to work at some point. Maybe your LG recipe will be the lucky break and it won't come to having to make that hard decision of what to try differnt, and when.
hope you sleep well tonight!
Thanks for the input, InB. I know IVF worked for you, and it's worked for many. It was really important for me to try IVF and I have (2 cycles were converted back to IUI, 1 went to retrieval/transfer). And I'll certainly get a second opinion from another clinic before I skip to donor egg. But for now, low-tech is the easiest, cheapest, psychologically- and logistically- most manageable plan for me. Dr. Gorgeous is also very glad we tried IVF but has indicated MANY times she thinks it holds no major advantage for me at this point. It's just a matter of spitting out the right egg and getting the sp*rm in there...
ReplyDeleteIn February, I found out my AMH was .6 and my FSH was 10.5. My doctor didn't want to let us to IVF (covered by our insurance at 100%) but I begged and we tried: 3 eggs retrieved, 2 fertilized and 1 transferred, only to have a miscarriage at 5 weeks (very low initial beta). I was ready to move on to donor eggs, but continued with the weekly acupuncture, supplements (including royal jelly and bee pollen) and I added soy isoflavones on days 3-7 (claimed to be a "natural" clomid) and shockingly, found myself pregnant when I thought I was just late due to post-miscarriage wonky cycles. I know your situation is a bit different having to coordinate IUIs, but don't give up hope! As a sidenote, I did try DHEA while doing the IVF and it made me feel like crap and only three eggs were retrieved (out of 12 follicles!) so I don't think it did anything for me. Thinking of you ~
ReplyDeleteThanks, Stephanie. That's the kind of story that gives me hope! The soy thing is interesting.... I don't eat soy because I get headaches from it. But I wonder if that's a form I would tolerate.
ReplyDeleteI seem to be doing okay on DHEA, but I'm only on 25 mg/day.