30 January 2009

pendulum

we should do this thing

no we shouldn't. it is crazy. irresponsible, it probably won't work anyway...

no really, we should. if not now, never, right? we should go for it!

no we shouldn't. oh, so much money. this time there is no donated follistim or menopur. we cannot really afford it. and the chances are so low anyway...

yes we should. this is our one last chance. I turn 42 in 2 weeks. the doc said yes. we should go for it....

what the hell am I thinking?

Apparently, this.
The doc said we can do another cycle. Suggests an "Antagon" cycle (anyone out there with experience to share?)-- it is shorter than the classic lupron cycle in terms of number of injections (yay)-- No BCP's..Stims start a few days after cycle day 2 or 3. Then when the lead follicle is about 14mm, stims plus an antagonist (why, why, why do I always think of Antigone? NOT a good association) to keep ovulation from occuring...then, when everyone is ready...hCG this time in the butt not the belly...

He has no idea what happened in my last cycle. Why the follicles were mostly fluid and only a few with granulosa cells. He is decreasing my dostinex (for a pituitary tumor that secretes prolactin in wee bitty amounts).

I asked about DHEA. About estrogen priming. About lupron flare protocols and whether we can test the hCG level the day after the injection and the day before egg retrieval to make sure it is "ok".... no to DHEA, no to estrogen priming. He likes using antagonists for second cycles...

So now, we want to do this, but there are no medications donated at the moment (anyone with extra menopur or follistim? I'll send you cookies), and we cannot afford to take on that additional debt load.
But, of course, we might anyway. Might, ha. you know we will.
This, my friends, is the evil slippery slope of IVF. You try once. You cancel early. You want to try again. Since you never know: Maybe this time. Maybe this time. Maybe this time...

4 comments:

Doug said...

hi

Joannah said...

That sounds like the protocol we will be doing next month. I'm 41. I hope you can find a way to do it. Are there any resources on the web for donated meds?

I totally understand the back-and-forth thinking. It's the tug-of-war between your head and your heart. But what the heart wants, the heart gets!

All the best to you! You're in my prayers.

Maredsous said...

I just had a long talk with my RE. He is also allowing me to go on another try. Here is the summary of our conversation.

I will be going on DHEA, supposedly it only takes affect after 4 months, but I think I have seen people commenting that they see affects earlier. My RE strongly recommended against the antagonist protocol because pregnancy rates are not as good even though egg retrieval goes better. Remember I did the lupron flare protocol this time and had better success than the agonist protocol (My guess is because of the lupron suppression)

My doctor also said at this stage he gives me a 1% chance and that with others he would have stopped IVF altogether, but he said he knows that I understand the consequences and is willing to try a little harder.

Here is the plan
Start DHEA during luteal phase
Monitor antral follicle counts at the beginning of each cycle (he said we won't do this indefinitely but we can do it for several months.

On a cycle that looks good 7-10antrals? we will start. This also means no BCP which I have read can also suppress (I firmly believe that my body doesn't like BCPs and have always wanted to bypass this step any way.
Do another lupron flare.
When decision time comes, either go IUI or IVF I think I will draw the line at 5. If there are 5 or more go IVF if less IUI. My RE really thinks IVF is more successful but after the last attempt I am doubtful.

My follicles were not fluid filled so there must have been eggs. The Dr. thinks they just fell by the wayside (died). I think I ovulated. (the night before the procedure I had an intense pain in my side something I had never felt before and my bbt jumped the next morning (I couldn't find any data that said that HCG can also do this, but by looking at others charts I think it might induce a temperature shift.

Well, I didn't mean to write that much, but I am glad I have everything clear in my head.

As my husband says, a kid will cost way more than the IVF so really why worry about it.

Oh, we are likely to also have a DE cycle ready to go during this process if possible.

Sarah said...

okay i still need to read your more recent post but wanted to offer before i forget: if my cycle works you can definitely have my 450iu vial of gonal-F. i know it's not what you're using but it's exactly the same thing as follistim and my RE let me use my old follistim in combination with the gonal-F that my insurance this time wanted me to buy (even though it wasn't covered, ARG!). it's unopened and good for a long while and exactly the same as follistim, just different manufacturer.

also my feeling about going again: if you don't try i feel like not knowing if it might have worked would just eat you alive. plus there is a lot to be learned from last cycle and making adjustments as you go is part of IVF. good luck!!