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!