Wednesday, August 29, 2007

Stimulate, rinse, repeat

I had my post-IVF consultation yesterday. It did not leave me feeling happy and looking forward to my next cycle. Instead, it left me feeling frustrated, sad and lonely.

Dr. S. basically said that my embryo quality was excellent, so coculture definitely worked for me and we would do that again. OK, check, all in agreement so far. Then he said that I didn't have enough eggs, so in order to give me a better chance at a pregnancy that sticks, we need more eggs so that we have a greater chance of at least one of them being chromosomally normal. Check again, I would definitely be happy with more eggs. But then it started to go wrong. I asked about the random weird follicle growth of 6mm in one day, and he brushed it off as "it can happen" and "different people measure differently". I asked about doing a mixture of estrogen priming with microdose lupron, and he brushed that off, saying that estrogen priming hadn't worked well for me.

So, out of his ass it seems, he suggested long lupron. Que? Yes indeedy, I am the only poor responder ever in the history of the universe [OK, maybe a slight exaggeration] who has been put on poor responder protocols and then gone backwards to long lupron not once, but twice. My 4th IVF attempt was a long lupron protocol, and I was all excited to try it, thinking that it would fix my suppression problem. And it did, mostly. I had nice even follicle growth. But I had a crap fertilization rate, and although I had one good quality embryo I also had two very poor quality embryos. But he said I'd responded well to long lupron, and he liked the long lupron protocol, and that, seemingly, was that. Or I could try a cycle without suppression in the prior cycle, to which I responded that that didn't work for me. So he said, OK, long lupron. There was no budging the man.

Then I asked about stim dosages, because of the whole "my lead follicle grew 6mm in one day" fiasco, and he said, well, OK, we can reduce your dosage back down to 4 follistim + 2 menopur. Now, just wait a minute laddie, I was thinking. Don't just reduce the dosage because I effing ask a question about whether my dosage was a tad high. I asked him about this, he responded that I got fewer eggs at a higher dosage so it looked like I plateaued on the drugs and may as well go back down. I think he was beginning to get a bit annoyed with me because I started saying stuff like "are you sure you're not just saying that because I asked the question?"

So, not only does he want me to go back to long lupron, he wants me on exactly the same dosage as I was for cycle #4. I'm getting this strange sense of deja vu all over again. Where was the carefully individually tailored protocol? Where was the personal attention? It felt like he was just randomly throwing suggestions at me. You know, let's try this, let's try that.

I am supposed to call the scheduler, but I so don't want to. Not that it's really a question of whether I will cycle again at Big Clinic, I suppose. I promised myself one final try with my own eggs, and I am too lazy to try to find another clinic and go through all that rigmarole again. I am not ready to stop or move on to donor eggs or adoption. Not yet. I need a closure cycle. But I'm just not enthused about any of it right now. So I'm tempted to wait until November to cycle, instead of October. Just because. Although that could very well put me in NY for Thanksgiving, which will be highly annoying.

Some days, like now, I just wish I wasn't doing this alone. That I had a husband or partner to run all this by, to help me make decisions as to what's the best thing to do to move forward. Although I'm not kidding myself that a husband could very well have pulled the plug on IVF attempts several cycles ago, but at least I'd have a shoulder to cry on. It would also be nice if I could have a minuscule hope that this month's ovulation and next month's ovulation could maybe possibly get me knocked up naturally instead of being completely wasted. And I'd get to have sex every now and then. Sigh.


serenity said...

Sarah. I wish I had some assvice for you here. But I feel the same way you do - so much of IVF is throwing shit at the wall and seeing what sticks.

I am still convinced that it's the embryologists which make or break a cycle. Perhaps a long lupron protocol this time with Big Clinic's embryologists may give you better fertilization rate?

It's a thought, at least. Perhaps a grasp at a straw.

But you know what? If you're not comfortable with the protocol, it's YOUR cycle. And YOUR money. Who gives a flying farfle what your doctor thinks? If you're not comfortable with it, it's up to them to MAKE you comfortable. Push if you have to - make them make you feel comfortable. You're certainly paying them enough for the try.

*hug* I hope you find some peace soon.

bleu said...

I really wish you would forward your doc this post, truly. I think he needs to hear how you felt and how dismissive/wishy washy he sounded. This is the guy who really listened before yes? If so I think he may respond well to a letter. Just a thought.

Kim said...

Thinking of you, and sorry that the post-cycle meeting didn't go as well as you wished.

calliope said...

I'm just going to hope that this Big Clinic and this Fancy RE knows what they are doing.
& how much does it suck that all of this is done without a partner to rage with?!
There is a ton of magic in the air in NYC in November. I want some of that magic to be yours.

Orodemniades said...

Why bother using the same protocols when they haven't worked before? I confess I'm scratching my head on this one and wondering if maybe you should change doctors or clinics?

Orodemniades said...

I wish you could go to my clinic...I have no idea whether or not you'd be successful, I just felt that they listened to me when I had issues, and I wish you could find someone who did the same for you.

Cindy said...

Sarah, I am just so sorry. This is really disappointing. I can imagine how you feel. How frustrating to not move forward and try something different based on your individual situation. I am sitting here feeling really frustrated for you. :( I hope you can talk to him again or maybe get a second opinion from another doc there...or something. I know the coculture processes is key but for all the money you are shelling out for this stuff you should be able to feel satisfied with the plan. Do you think you will try to talk to him again?