Monday, January 17, 2011

Let's Do It, Again, Differently

I hadn't been to the RE office since December 22, my beta BFN.  It's been the longest time away from what often feels like my "home away from home"... the longest break in visits since I started back in April 2010.

As I was in the waiting room, a man came in and said his wife and triplets were downstairs.  They wanted to see if it was okay to bring the babies up to see the doctors & nurses (I'm sure because they made them).  All I could think is.... get me back in an exam room before those babies come through the door!  And my nurse called me back and just as I was walking by the door, in come the babies... I glanced for a microsecond and hauled it back to the safety zone behind the door.

My favorite nurse, S, greeted me and when she got me back into the room she hugged me.  Tears were hard to contain, on both of our parts.

As I waited for Dr. T I wrote down the most important question I knew I should ask:  "How much more aggressive can we get?"

Dr. T came and got me from the exam room to join her in my office.  She seemed affected when she was talking about how much she wishes the IVF worked for me.  They all know it's taking a toll on me and I can see that they truly want me to succeed!

My Fertility In General

  • My FSH is consistently very good, especially for a "woman my age"
  • While my AMH is on the low side plenty of women still get pregnant with lower AMH's than me (one of the doctors in the group studies AMH closely and my AMH shouldn't be a factor, especially given my good FSH)
  • I absolutely should try again (they will tell women when it's not advised to try again)
  • Regarding my 'aggressive approach' question, the most aggressive approach with the best odds for success is donor egg however she does not recommend this for me yet (and I'm not ready to go there at this time)

IVF#1 in Review (Ganirelix Antagonist Protocol)

  • I responded well to the meds, 6 mature eggs (the 7th was almost mature)
  • Everything went well except it took 13 days of Stimulation to get to retrieval, she'd like to reduce that (it's unknown that if it takes longer to get to retrieval if that compromises the eggs - or something like that)
  • The embryos just didn't mature at the desired rate between day 3 and day 5
  • My progesterone (using the suppositories instead of PIO) was excellent, at 45 on transfer day - see the BIG shot in the A$$ is NOT the only option for progesterone!  Note, I did take my suppositories 3x/daily religiously!
New Protocol (Luteal Estrace/Microflare Protocol)
  • When my cycle starts this week, I'll call to report in
  • I'll use OPK to test for ovulation at home
  • 7 days after surge I'll go in to verify ovulation 
  • Upon verified ovulation, start Estrace, in pill form 2x/day (to synch ovaries)
  • On my next CD1 come in for bloodwork/ultrasound
  • Start Stims (Gonal-F 400IU)
  • Somewhere in here I also take a microdose Lupron (prevent premature ovulation)
  • Dr. T recommends adding Saizen, a human growth hormone; this will not be covered by insurance (approx $600) but goes along with the more aggressive approach I requested
  • She wants to do a Day 3 rather than Day 5 transfer this time, citing that my uterus would be the best environment to give the embies a chance
  • She see's no problem with A, my acupuncturist, coming with me to Transfer to do treatment immediately following transfer
  • Retrieval/Transfer will be sometime around late February/early March
I'm looking forward to getting started again!  


  1. It's amazing how quickly hope rebuilds after disappointment. I will keep you in my thoughts and prayers. I'm glad that you feel like you have a good relationship with the staff at your clinic. I envy you that. I've never seen the same nurse twice and have only seen my doctor for the "consultations."

  2. I am so happy that you are going to try again. I have been wondering how you have been doing! My thoughts and prayers will be with you every day hoping for your sticky baby!!

  3. Really happy to hear that you can start the ball rolling again. Fingers crossed! By the way - I think I would have nearly died of jealousy if I had to be anywhere near people showing off triplets! - and one might just have gone missing!
    your friend S

  4. I like the change in plans! It seems that things work out best when the doctor learns from what didn't work well and makes changes to make things better.

    And, reading your post makes me realize how lucky we are in our town. The nurses at my RE are a lot like the nurses at yours, very compassionate and involved in with the patients they help care for. I got tons of hugs from my REs nurses. What are the chances of two RE offices with staff like that in one town?

  5. I'm loving your glad she is proactive & willing to be aggressive. My RE's office sounds similar to yours with the nurses genuinely sharing in your emotions of the journey.

    Very best wishes for this upcoming cycle!

  6. This sounds like a great protocol and aggressive. This is going to be the cycle for you. Please keep us posted.

  7. The new plan sounds great. I have been reading about growth hormone and if I can access a similar product in NZ I would want go that way too. Good luck with this cycle!!

  8. LOVE your RE!! And most importantly, I love how your positive/hopefulness shines through in this post. This is it, BB! This is IT!!!


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