The big phone call

OK, I am done with my consult with Dr. S. of Big New Clinic.

He was very nice, and very easy to talk to. Seems like a good guy, which is important. He said he thought they could help me, and that it wasn't necessary to give up on my eggs yet, so that was reassuring to hear.

We went through my sordid history, and it really sounded like he'd studied my medical records carefully. I like that in a doctor - don't like them flipping through as they're speaking to you!

He initially said that we had two options - do a microdose lupron protocol with BCP exactly like my best cycle, which I was very much against, or an estrogen priming protocol, which I liked the sound of much better. I'm not entirely up on what the EPP involves, but as he explained it essentially it involves monitoring for ovulation, then at 10DPO starting estrogen and at 11DPO starting antagon for a few days. Then antagon is stopped. I'm not sure if the estrogen is stopped, as I forgot to ask that question - I think not. Then you stim, and add the antagon back in when the follicles reach a certain size to prevent ovulation. No lupron, no BCPs. I've always been scared of antagon because of my early dominant follicle situation, but he explained that the initial dose of antagon in the previous cycle would take care of all that, and the estrogen would prime the ovaries to be more receptive to FSH. It all sounds very good in theory. I did ask what would happen if I did have a dominant follicle, and he said if I was worried and given my history I could have an u/s down here and if it showed a dominant follicle I could call him and we could cancel there and then if necessary without me flying up to Big City. So that sounds like a good plan.

He also recommended endometrial coculture. Yippee! Exactly what I wanted.

So, I pretty much got what I wanted, a different stim protocol and coculture. I actually wanted to do long lupron or EPP, so if he thinks EPP will help more (due to my low fertilization rate last cycle on long lupron), that is fine by me. I didn't actually even dare hope for him to suggest both EPP and coculture, so the fact that we are trying both is a bonus in my book.

He also said that they trigger with follicles at much smaller sizes than my old clinic - at 17-18mm. So that's another change we will make. He said they get better quality eggs at the smaller size. Hmmm, we'll see about that! Hopefully he is right.

I didn't really have any questions for him. He laughed when I said that Dr. Google was my friend and that I researched everything in advance anyway. I asked about any more tests we could possibly run, and he said I'd had pretty much every test going, so there wasn't any need to do anything extra. I asked about my thyroid level, and he said it looked fine and he'd be more worried if it was closer to 3, but it isn't. He said I'd have to rerun HIV, etc, tests and probably a pap before cycling, but otherwise we could get going whenever I wanted.

I am to call his scheduling coordinator tomorrow and talk to her about when to do the endometrial biopsy and other stuff, and get going from there. Yikes! It looks like I'm really going to do this!