Wednesday, December 19, 2007

An X-ray, an aspirin and a freezer

I had my consultation with Dr. M. at Local Clinic this morning. I set it all out before him - exactly what had happened since leaving him and going to Big Clinic as far as cycles, tests done, things that happened. All that shit. And all my thoughts on my difficulties with moving to donor eggs, the possibility of donor embryos, the possibility of doing one last cycle using my own eggs with Big Clinic. Basically, it all came down to the fact that I was stuck with my thinking but wanted to use the frozen embryo up before moving on with whatever I end up moving on with. If I do do another cycle at Big Clinic, I shall use a different sperm donor, so there's no point holding the frozen embryo in reserve as I'll never be able to get a full genetic "sibling" to match up with it to try to do a frozen transfer with two embryos.

To my surprise, he didn't laugh at the idea of another cycle with my own eggs. He said I'd worked very hard at this and the chemicals were a good sign that Big Clinic was almost there, although disappointing. So if I wanted to stop, that was up to me. But if I wanted to try again, and felt up to trying again, he didn't think it was a bad idea. Now that shocked me, as I always thought he'd be very gung-ho on donor eggs, but I guess when it's someone else's statistics that I'm fouling up, he is more open minded. Funny that, eh?

He brought up implantation issues, saying that implantation is really the last frontier as they have no clue how to fix implantation issues but he was glad we'd run all the immune and clotting tests (yes, I have done all those), and that they'd turned up negative. He still thinks on balance that I have an egg quality problem and not an implantation problem. However, given that I have had polyps in the past, he thought it was worth investigating whether they'd come back or not before doing anything else, and he thought I might as well start taking a baby aspirin once a day on the basis that it won't hurt and might help. We went over whether I should do another saline sonogram or another hysteroscopy or another HSG. Ha, funny (not) that I've already had all three. Anyhoo, that surprised me, because I thought HSG's were to check for open tubes, but no, he said he'd also use it to check the uterine cavity. On balance, he decided that he wanted to do an HSG. So I said fine, whatever, pump me full of X-rays. I don't care.

I asked about an FET/IUI combo. He said he could do it. He said technically he could do pretty much anything, but he didn't want to. He said that the IUI would make it less than ideal circumstances for the FET, and vice versa. And he said my frozen embryo could have a chance if it survives the thaw, as it is a B-grade embryo so it's not too bad (a grade 3BB blast for those who need to know such things) so we should do everything possible to give it the best chance we can. Which in his mind is a full medicated non-ovulating FET cycle. He said 95% of patients have something to transfer after thaw (although admitted that most have more than 1 to start with), and for women aged 35-37 (tee hee, I get to travel back in time because the embryo is from when I was 37) their success rate with FETs is 45% per transfer. So I said fine, whatever, pump me full of lupron and progesterone. I don't care.

So out he and his little med student went, and in came the nurse. She said to call when I get my next period and I'll go on birth control pills and we'll go from there. And I said, well, hey, I'm on cycle day 4. Can't we start now? [You know me, blogosphere, ever one to take the bull by the horns]. I don't see why not, she says. Let me go see if the ultrasound technician is still here, because we need to see if you've got any cysts. But sadly the ultrasound tecnician was not there so I did not get any wand action today. But, here's the plan:

Today: Blood draw for E2, FSH. Check. Get all the prescriptions for meds. Check. Start baby aspirin.
Tomorrow: Get an ultrasound to check for cysts. The nurse will call later in the day with the go ahead or not for BCP. Start BCP.
1/2/08: Have HSG.
1/5/08: Start 10 units of lupron.
1/9/08: Have WTF consultation with Dr. S. of Big Clinic. Surprise him with a little FET action going on in the meantime.
1/12/08: Stop BCP.
1/17/08: Blood draw for E2, u/s. If all OK, and have had period, start estrogen patches and doxycycline. If no period, hang on and wait.
1/31/08 or thereabouts (day 15 of patches): blood draw and u/s. If all OK, stop lupron and start progesterone, medrol and tetracycline
2/5/08 or thereabouts (day 5 of progesterone): embryo transfer if the little bugger survives the thaw.

If it doesn't work and I decide to cycle again with my own eggs, that means I would do the coculture in early March, and the IVF cycle in April. So that gives me a few months to really come up with a plan for donor eggs or embryos or what.

So, that's that. How I spent my morning. By Sarah Solitaire, aged 39 and a quarter. But hoping to pretend to be 37 and a half if all goes well.


Celeste said...

Woah, SS, that's a ton and half of information! It soudns like you're feeling god about the action & plan, and that's what counts. It's amazing how freaking resilient we are, isn't it?

I also really enjoyed your last post, but didn't have time for commenting. Very well put. :o)


Amy said...

I'm so glad he was willing to do what you want!!!!

bleu said...

I am always amazed and delighted how you can manage to be witty even in the midst of everything else.

Stephanie said...

Hey there, psychic Fert*l*ty Fr*end!! I was going to suggest an HSG or a saline sono as a possible option to discuss with small local clinic!! Heh, you read my mind!

Oh, and, incidently, I *did* write that letter of protest and, we now have free tickets to the comedy joint waiting for us! :-)

Anonymous said...

Oh, Sarah, that's terrific. You sound so much better and happy now that you have a plan of attack. I'm really glad you're moving forward, and I'm praying for your little embie to hang in there and do his(her) job.

June Bug Momma said...

Wonderful plan Sarah!!! I am hoping your embie will make you a momma! :o) Good Luck! Hoping everything goes your way in 2008!

Marcy "meg" said...

I am so glad you have a plan! Sounds like a great one!