23 June 2009

CD13, LH+, BostonIVF

Dang I am tired. More than a few hours of low level emotional strungoutness, some cautious hopefulness mixed with considerable nervousness, well, it eats my energy.
It is cd13, LH+ this morning (thank you, you friggin fickle pee stick god).
Boston IVF? well, it was interesting.
The doctor was nice, polite, considerate, thoughtful. I had an exam I was not expecting. A full one, inside, outside. Up and down. And well, he said I appear to be terrifically healthy which is grand and apparently my uterus is smooth and I have nice cervical mucus. Um, thanks?

Bottom line?
He'd do an IVF with me and absolutely thinks it is worth trying again even though he knows and acknowledged it would be challenging due to my age. He would not do PGD. He affirmed a conclusion I already reached-- anything other than polar body testing can damage an otherwise perfectly normal embryo, and if one is not working with many embryos, the risk is too high. His philosophy for someone of my age is to set out to make as many embryos as possible and literally put them all back. And then, simply let them sort it out-- the ones that are healthiest will stay longer.

He said he believes that any pregnancy is better than no pregnancy since each one has a better than 50% chance of going to term so "the odds are in your favor". Hm. An interesting philosophy.

What are the benefits of switching clinics? A few additional bloodtests and maybe some more insight into my egg quality and quantity, the addition of DHEA (I will take it anyway-- for those of you following along: 25mg 3x/day, EXCEPT for the two days before each potentially expected period, this stuff is not to be used in pregnancy if you can avoid it-- then, if the period comes, start back up again. Benefits in 4 months (yup 4, consistent with what I've read)-- and issues? hairy chin, acne. Hell, I'm halfway there already... )
And perhaps the clearest psychological benefit (and psychological challenge): the expectation that we would do IVF. Not IUI with potential for conversion.

Downsides-- it is in Boston which is a pain in the ass to drive to, I would need two appointments down there for testing prior to cycle kickoff, I did not feel great about the vibe in his office (blaring daytime TV, and an almost half hour wait for my appointment) or his office staff (although they were not un-nice), the cost is considerably higher than where I am now and I need to make sure it is worth it, and he wants to do another saline hysteroscopy...
Oh and he would go back to the long lupron protocol which means two months for every cycle, and his highest doses of stims are slightly higher than the place I am currently cycling-- one more vial of follistim a day than I do now which can be good or bad depending on how you look at it.

He did say if I am ever interested, I'd make a great candidate for DE and he also mentioned it just once, just at the very end. Said he felt I'd have a 50% chance per cycle if not higher. I told him it was out of my price range at the moment and he understood, but he also understood that that is just not where I am yet.

So given all that I learned, at least at this moment, this one- I guess I am not feeling compelled to make a clinic change. I did not feel there was going to be enough difference I guess-- enough philosophical difference or scientific difference or a larger dose of lady luck.

I do not have to decide today.
And maybe I will just get pregnant this cycle of fireflies and the beginning of summer and rain and rain and rain.
And if not, well... good to know I have options even if none of them is presenting itself as the obvious "right one" to take.


Anonymous said...

I am so glad you had the appointment. I have really been researching recurrent pregnancy loss and I (we) do have a 55% or better of staying pregnant once we get pregnant. Odds are slightly in our favor. BUT why do I feel like I am filling up the 45% of failures and will continue to do so?? I am not an RE, although I play on on my blog!, but I hope that since you can get pregnant "on your own" that you will and it will be the "right one".

sprogblogger said...

So glad your appointment went well, and glad that despite/because it went well, you still feel comfortable with your clinic.

(Oh, and seriously, Kate, email me your mailing address & I'd be happy to send you my leftover DHEA. I've only got a couple weeks or so left of it, but it's the good pharmacy microdosed stuff, and I know my insurance never covered it. No sense it going to waste when you could use it.)

I'm holding out hope that you catch a natural this month. Because I'm impatient on your behalf, and because a firefly baby would be a wonderful thing.

Thinking of you.

Michele said...

been thinking of you and I really, really hope that this cycle full of fireflies and rain works for you... that the planets are all in alignment and that things happen as they should.

I was actually surprised you waited only 1/2 hour at the RE in Boston. Unless I was the first appt (which I tried to be), we usually would wait, typically an hour or so. Of course, this was good training for my OB, where, other than twice, we've always waited at least an hour and sometimes two. As with everything, it seems that getting pregnant and staying that way is a huge hurry up and wait game.

IVF 40+ said...

1/2 hour for a wait -sista you need to come to Cornell - 2 hours is not unheard of.

The protocol sounds very aggressive which is good and I agree that putting all the odds back in is a smart treatment - odds increase quite a bit.

I can read in your words that you're emotionally knackered and I wonder at your resilience. You are already an amazing mother - you are fighting for a kid you don't even know yet. That's why you rock.

Anonymous said...

sounds like you have a lot of new info to process.. and from here it sounds encouraging. thinking of you and hoping the rain clears away to show you some sunshine through the clouds.

Grade A said...

I see you are in the gathering information stage. In terms of what to look for in a clinic--I just don't know what to tell you, but I will say I really didn't like my doctor, loved the nurses and wait times varied. Now at the OBGYN practice I really like my regular doctor b/c she gives me the facts with no sugar coating. There is one doctor at the practice whom I saw several times and thought she was too optimistic. (Please don't think "everything will probably be fine" is what I want to hear when i have been bleeding for days, lady!). Anyway, you have to go with what you know is right, and I'm not trying to change your mind, just putting in my two cents. p.s.-although I am in Boston, I did not go with Boston IVF, but I know several women who were very happy there. Thinking of you.

K said...

Well you know me...always the opinion gatherer, regardless of who's lame opinion it is. So, I'm happy you went for the Boston consult. Happy you are considering it. And I'm a big fan of the "change is good" concept. After reading back through your blog periodically, you've been through a lot. But not IVF, right? Honestly, other than the retrieval process, it's not that much different from medicated IUI, but it has the potential for tremendously different outcomes, as well as informational gleaning. Of course, cost is the factor too. And without trying to be an ass, I'll just say tick-tock, as another factor where IVF helps. Oh shit Kate. I know how complicated it feels. I haven't been able to make up my own damn mind about switching clinics. And, yes, clearly the "right" choice hasn't presented itself. But it will and you'll just know it when it does. Thinking of you...

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