Tuesday, April 11, 2006

So, how did it go?

The appointment yesterday went very well, except for one little hitch. Somehow, my file hadn't made it from dr. Sunshine's desk to dr. A' desk. I was not amused. Good thing I brought the few notes I had made when I first saw her.

So we spent 10 minutes going through our medical history, irregular cycles, 6 rounds of Clo.mid with good response but no results, satisfactory SA, ...

The plan is simple:
3 to 4 stimulation cycles (Menopur) with IUI.

After that there is the next phase of treatment, the name of which shall remain unspoken till the time is ripe. Cue ominous roll of thunder and flash of lightning.

I asked him about stim cycles without IUI, but he advised against it because we have been trying so long already (2 and 1/4 years). He thinks we're probably both subfertile, so working at it from both ends makes most sense. The sperm washing technique they use would select only the most motile sperm, which is a big improvement over simple sperm washing.

Subfertile means he thinks if we tried long enough on our own, we would eventually conceive, but he didn't suggest this as a route to go, thankfully.

Based on my irregular cycles and my weight (I consider myself slightly overweight) he suspects I may have some tendancies towards PCOS. He's going to check whether I have insulin resistance. If I do lean towards PCOS, I may not respond at all if the stim dose is too low, or I may overrespond to the stims if it is too high. The problem is those two limits may be rather close together. Probably, the good response to Clo.mid is a good sign, though nothing is guaranteed.

IUI poses a larger risk of multiples than IVF, so I asked about that. He was confident that he could manage that risk sufficiently. Zero risk is impossible of course. If I overrespond in a cycle he can puncture some follicles to reduce the number, or I could decide to cancel.

I didn't ask straight out about a referral to a psychologist, but as I was doing some last minute research the night before, I read that the Big Fertility Clinic has an on staff fertility counselor. Not only that, they organize relaxation classes*!
Dr. A' practice is a 'satellite' for the Big Fertility Clinic, which is located in another town. This means I can join their relaxation classes and get a consult with their counselor.

The detailed plan for the coming weeks is:
- wait for period (due next weekend)
- then make appointment to receive stim schedule (yeah right, I already booked an appointment)
- wait for period again
- start first IUI/inj cycle

The doc wants me to sit one out to make sure all the Clo.mid is out of my system, because it builds up over time. I'm a tiny bit suspicious of this argument, but making a fresh start sounds reasonable enough. I dislike waiting, but I know I've really seen nothing yet.

DH was his usual quiet self all through the appointment. ART is going to become more burdensome for him than before. I told him he might have to administer the shots, he doesn't like the sound of that (uh, well, at least he doesn't have to get them). I teased him that from now on all s.ex will be recreational, ergo we don't need to have any anymore. Not to his liking either. :-)

I know none of you will even hint that I might get PG on my own now, just in the nick of time. It can't happen. I have unopened bottles of never-before-tasted Abs0lut Vodka (raspberry and peach), a new bottle of excellent rum, and a wide selection of specialty beers waiting for me. You see, getting PG between treatments would just ruin my pity party on so many levels. :-)

* I guess this would be called a Mind/Body program in the U.S./Canada, but here people tend to call a spade a spade. ;-)



At 11 April, 2006 22:04, Blogger Beth said...

Sounds like a good plan. Now I just need you to fly across the pond, bring those bottles of Absolut and we will have our own little break cycle party with Absolut Asshats to go around. Very intrigued with the mind/body concept - keep us updated on how that goes.

At 11 April, 2006 22:50, Blogger fisher queen said...

Have a relaxing break. Drink up! Hopefully you won't be able to in a month or so.

At 12 April, 2006 00:15, Blogger Chee Chee said...

It sounds like the appt. went well and that you now have a good game plan.

Enjoy your ART break and have a few drinks for me!

At 12 April, 2006 02:17, Blogger Ladybug Ann said...

Sounds like a good plan! He does have a point about the Clomid leaving your body as it can hang around.

Those drinks sound good!

At 12 April, 2006 02:50, Blogger Sparkle said...

Good going, great plan.

Having the month break is good - chance to relax before the big guns!

At 12 April, 2006 03:48, Blogger DinosaurD said...

Is that enough alcohol to last a whole month???? (This probably says way too much about me).
BTW, what ever happened to Visiting Canada - PartII? (Yes, I'm demanding as well).

At 12 April, 2006 05:00, Blogger InDueTime said...

You better share that! Glad you have a plan. Hugs my friend, xoxo!

At 12 April, 2006 22:04, Blogger N said...

Skål to you and Beth. Please let me know when you meet so I can join in...I can even bring some more of the Absolute (being brome here).

Sounds like a good plan you set up there with your RE. Also good to read about your mind/body, relaxing whatever you want to call it program. I hope it will do you good. Have you tried Yoga and meditation? Personally I have mixed results with that....helping redugin anxiety, panic and sadness.

Have a nice break...you start cycling soon anyways....

Take care!


At 12 April, 2006 23:26, Anonymous thalia said...

That sounds like enough for quite a party. Where did you say you lived again?

At 13 April, 2006 00:28, Blogger Just another Jenny said...

I'll join you and Beth for a few Absolut Asshats.
Have a drink for me!

At 13 April, 2006 00:42, Blogger Mony said...

That a girl.
A BFP! (Big Fat Plan)
I'll be here all the way.

At 13 April, 2006 01:24, Blogger UtRus said...

good! now you can chill since you've got a plan and a decent-sounding professional on your side. while you're at it, have some sushi and unpasteurized cheese and stuff with the booze! ;)

At 13 April, 2006 06:20, Blogger Millie said...

Your plan sounds like a great one to me. Stim cycles are so much easier in some respects than clomid btw (I found the side effects to be far fewer).

Enjoy the break and the raspberry vodka. That sounds sooooo very nice to me.

At 14 April, 2006 01:35, Anonymous Lori said...

Sounds like a good plan going forward. Good luck - and in the meantime - Drink up!

At 14 April, 2006 03:50, Blogger Mary Ellen and Steve said...

It sounds like you have a plan now. For me that was really reassuring. I hope that it is for you too. Try to enjoy yourself as much as possible while you are waiting for everything to fall into place. Good luck with everything!!

At 14 April, 2006 10:26, Blogger Ornery said...

Sounds like a great plan!

Despite the fact that my stim cycles have required a lot of monitoring, I'm still much happier on injectibles than I was on Clomid. Less side effects (in my opinion) and much more straightforward results.

Drink up!

At 15 April, 2006 03:44, Blogger k #2 said...

As for PCOS, prior to my pregnancy, I had VERY low insulin levels...in fact, my insulin rates were almost too low. If your RE suspects PCOS...let's hope he runs another hormonal level check. That tells more about PCOS than insulin. But, if you are like me, it is better to double check everything before you get things rolling!

Your plan sounds good and at least you know you've got a break to party! If anyone here told you this will be "your month" --- where have they been? :) I sure hope that you enjoy your Absolut!! Drink a few for me!

At 15 April, 2006 03:50, Blogger k #2 said...

FYI: Here is an interesting article about diagnosing PCOS.

I hope this link works!

At 15 April, 2006 17:47, Blogger Liz said...

Sounds like a good plan. I know waiting isn't easy but it sometimes does help. Have a few drinks for me.

At 16 April, 2006 20:17, Blogger ankaisa said...

It's a plan. Have adrink with me!


At 17 April, 2006 18:27, Blogger Angie said...

Hey! I just spent 2 hours reading your blog! I hope you don't mind. DH and I are seeing a specialist on Thursday to discuss out options. I have been TTC for close to 3 years now. I have done only 2 rounds of clomid, but last month found out that DH has a chromosome thing that is causing the problems (other than that he's fine). We are also looking into injectibles with IUI. We are thinking that it will be our best option. I just wanted to wish you success and hope!


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