Thursday, May 03, 2007

Tomorrow, tomorrow, I wuv ya tomorrow

OK, so exactly how long do your liver enzymes stay affected after drinking too much alcohol?

I decided last night that a glass of wine with dinner would be very nice. After all, if I'm about to get a diagnosis of a chronic liver disease, I may as well make hay while the sun shines. Of course, of course, I have a little self-restraint issue when it comes to red wine so one glass turned into three. And I am not stingy on the pour, so I am feeling a little worse for wear this morning.

And wouldn't you know it, the internist's office called to say they needed to reschedule Monday's appointment. My heart sank when they said that, because I was imagining another three weeks delay. But no, they are going to fit me in tomorrrow at 3pm. So there go all my plans of having a non-alcoholic weekend so that my liver is in tip-top condition for the tests just in case. And the secretary casually mentioned that I need to fast for 4 hours before coming in, so there also go my plans for a nice Friday lunch.

But, eek! I'm going to see the doctor tomorrow!

On a related note, I did a pubmed search for hep c and ivf, and found this:

Impaired ovarian stimulation during in vitro fertilization in women who are seropositive for hepatitis C virus and seronegative for human immunodeficiency virus.

OBJECTIVE: To analyze the impact of seropositivity with hepatitis C virus (HCV) on in vitro fertilization (IVF) outcomes. DESIGN: Retrospective, case-controlled study. SETTING: Fertility clinic of academic hospital. PATIENT(S): 42 IVF/intracytoplasmic sperm injection cycles in HCV-seropositive women and 84 matched control cycles. INTERVENTION(S): IVF/intracytoplasmic sperm injection treatment for infertility. MAIN OUTCOME MEASURE(S): Ovarian response to stimulation, laboratory findings, and implantation and pregnancy rates. RESULT(S): Absence of ovarian response was statistically significantly higher for HCV-seropositive women compared with controls (10/42 vs 5/84 cycles, respectively). For cycles with oocyte retrieval, HCV-seropositive women required more gonadotropin units compared with controls. The maximum estradiol levels and number of collected oocytes were similar, but HCV-seropositive women had statistically significantly fewer embryos available compared with controls. Embryo morphologic features, number of transferred embryos, and rates of implantation and pregnancy were similar for HCV-seropositive women and controls. CONCLUSION(S): When compared with matched uninfected controls, HCV-seropositive women display a decreased ovarian response.

Doesn't that just put the icing on the cake? I know, I should be grateful that they do IVF on hep C positive people. I know that. But as someone who is already diagnosed as a poor responder this kind of ratchets up the fear a bit - what if I go through all this, do the IVF and then have no response at all? And given that my last negative hep C test was the same month as my first IVF, I don't think that I could blame the previous poor responses on hep C.

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