Thursday, September 28, 2006

The beginning of the end

At our appointment this week with the dr. we went through my IVF protocol.
The protocol is pretty standard, but for those of you curious to know, here it is:

BCP for 25 days, during last 5 days add nasal spray
Wait for period, continue nasal spray
Get baseline echo, continue nasal spray
Start stimming, continue nasal spray at lower dose
After 6 or 7 days of stimming first u/s and blood draw.
More stimming, spraying and checking.
Trigger shot.
Request DH's contribution & undergo egg retrieval
Anxiously await transfer
Anxiously await beta

This schedule puts ER in the second week of november.
Of course, I don't need to remind any of you that all of this is subject to last minute changes.

I should be thrilled, excited and hopeful about finally starting IVF, but to tell the truth, I have mixed emotions. Yes, I've been waiting to get here for what seems like ages. Yes, IVF is the treatment with the best prospects of success.

The thing is, this is the final phase of ART. After IVF, there is nothing.*

Before, I always found comfort in the thought that there was always IVF, if all else failed. I knew of course that IVF wasn't a sure thing, but it was still out there to try.
Now we're here, I have to look the harsh reality in the face that this could fail too.

My clinic claims that 85% of the women that do 4 IVF cycles with them get PG and deliver a baby. That still leaves 15% of women who do not. These odds are good, but I know they'll be of little comfort if I fall on the wrong side of them.

But it's not really the statistics that get under my skin. It's the stories I read on your blogs that get to me. I can put faces to those statistics now, or pseudonyms at least. The joy is real and so is the sorrow. I'm no longer the complete innocent I was last year. Some might think that's a loss, but let me put it this way:
Do you miss the days when women went into their wedding night knowing little to nothing about what was awaiting them?

Don't get me wrong. I'm fortunate to have the opportunity of doing IVF and I appreciate that. I know some of you have been waiting for a chance at IVF for a long time, and posts like this must be hard to read.


* Nothing in terms of getting PG and delivering a child.

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Tuesday, September 26, 2006

Scrap the vineyardian ...

... bring on the IVF!

Tomorrow is CD1, and that makes it day 1 of my protocol. Oh joy!
No worries it starts off easy enough, with a round of BCP's.

Then it gets complicated. Complicated enough for me to grab my cell phone - I'm going to need to set some reminders - only where's the organizer menu? NOOOOOOO! My newish cell phone doesn't have a reminder function!!!! Sure, I wanted the cheap model without all the bells and whistles, but come on, my old phone had an organizer. I thought newer was supposed to be better. AAAARRGGHHH!

I have 20 days to figure out a solution. I could always just go out and buy a new mobile phone, but I'm too stingy frugal
to do that. I'd swap with DH's phone, but it's one of those dreadful sim-locked things.

I'll write up the protocol later, after our next consult this Wednesday. It just arrived in the mail. TODAY. This is the information package my dr. ordered for me on our previous consult on the 6th of this month, I saw him put it in the computer then and there. I expected it to be waiting for us after our holidays. 10 days is plenty of time to prepare and send it, no? Apparantly not. 14 days post consult, I decided to call and check what was up. "Oh yes, you're right here in the computer, but your name hasn't made it to the secretary's todo list yet. How odd! We'll send it to you right away." Grrr. What a fabulous start. If you treat my file this way, how much better will our gametes fare? All I said was "Thank you", of course.
They did send it to me right away, between my call last Wednesday and today is perfectly reasonable.

Now I only have 1,5 days to fret over those agreements the clinic wants us to sign. Perhaps that's a good thing.

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Wednesday, September 20, 2006

The Campfire

I'm shamelessly going to steal an idea from Barren Mare. Imitation is the sincerest form of flattery, so I've heard.

In a post from a while back, she introduced the Campfire circle. The basic idea is to give new bloggers to IF blogland a warm welcome. To be precise, I've added a section to my blogroll called the Campfire for this purpose.

So if you've started your blog just recently and would like to hang out around the fire a while, let me know. Even if you've been blogging for a while, but can't seem to find your audience, come on over. Of course I'm just a small fish in blogland, so don't expect a lhttp://www.blogger.com/img/gl.link.gifot of traffic, but every bit helps.

Let me quote this from Barren Mare's Campfire post:
I should stress from the get-go that the Campfire list is, by its very nature, intended to be impermanent. It will probably shuffle often. In some ways that's the whole point of the exercise. Therefore, please do not be offended if your blog is there one day, and the next time has been replaced by another. That does not mean that you are suddenly no longer interesting, or that anyone has been kicked out of the fire circle. It just means that like life, all is in a constant state of flux.



Let me tout Cyclesista a little too. This is a blog that lists which lucky ladies are cycling at this moment and what kind of cycle they're going through. It's a great place to start for new blog readers, though of course it isn't representative of the entire IF blogosphere.

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Monday, September 18, 2006

The perks

After a very relaxing holiday, I'm back where I belong, behind my computer.

We spent 10 days in splendid isolation, in a cottage in the middle of nowhere, surrounded by vineyards and orchards. Lovely, but awful quiet.

Being childless has it's perks, and we took advantage of them. Going on a last-minute holiday for one, or taking long tours to see cute villages or wonders of nature, visiting museums, dining in or out as the mood takes us ...

After a while, I could picture myself choosing to live childless*, and if not loving it, appreciating it at least. There would always be a regret, for sure, but it wouldn't be right underneath the surface as it is now. Or so I imagine.

You can tell I succeeded pretty well in taking a mental break from IF, and found it much to my liking. Not that I forgot completely, there were times when a feeling of melancholy descended upon me that was hard to shrug off. Actually, whenever I let my mind wander, it headed straight there. That, and seeing a PG women or young mother amongst all the vacationing pensioners (rare occurrence luckily).

I was a little sad to leave, because it meant going back to the grind of IF (and work).
The landlady cured me though, by innocently asking us whether we had any little ones waiting for us at home. No. Well, perhaps you'll have a little Vineyardian soon, she added. I just laughed, and thought IF ONLY. Thus, reality came to find me and I was ready to go home.



* This is not on the table right now, but it could be in the future. I have to try IVF at least once.

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Wednesday, September 06, 2006

Going forward and going away

I'm in the midst of hurried packing for a well-deserved holiday (if I say so myself). While I rest my weary feet, let me tell you how the consult went. THE consult, yes!

We started with a recap of what we've learned so far.

Female factor:
- irregular cycles suggesting problems with ovulation,
- excellent response to stims, but no luck with 9 cycles of induced ovulation.


Male factor:
- SA results were satisfactory, if variable. Though all the samples were well above the 5 mio motile mark.

As obstacles to getting PG go, these are pretty weak. There are plenty of couples like us, who do have children without ART (my interpretation). The doctor put it this way, the reason why 9 stim cycles haven't work could just be bad luck. Basically, we're still unexplained.

Then it was Q&A time:

How do we know I ovulated?
Since this wasn't monitored by more blood draws, technically we can't know for certain. However, it is exceedingly rare to have a mature follicle and not to ovulate after a trigger shot. With the Cl0mid cycles (no trigger shot) ovulation of mature cycles occurs 80% of the time.
Should I worry about my ovarian reserve?
No, based on my good response to the stims and my age. (Yeah, yeah, nothing but an antral follicle count will put my mind at ease).
Do I have PCO?
Yes. The only symptom I seem to have is irregular cycles, but that appears to be enough. I forgot to ask him whether I need metf0rmin.


Finally, it was time to talk about a plan. Very, very gently, dr. A broke the news to us that it was now time to consider if we might want to do IVF. (Kind of funny, considering I was so worried he wouldn't want us to move on to IVF yet. It was all I could do to keep myself from jumping out of my seat and shouting "YES! IVF! NOW!".) Some people find IVF problematic, he said, and there were still other options we could explore. We could do a lap and check for endometriosis or other anatomical problems, which he could then correct. This option is one he wholeheartedly believes in as a viable one, he assured us. For a second, I wavered, but only for a second.
I'm ready to try IVF, was my response.

Satisfied with that he started to explain IVF in detail. I take it most of his patients don't have a Google U degree, nor do they attend IF night school in blogland. Joking aside, I appreciated his willingness to take the time to educate us. He did remark that he was going into deeper detail, because he sensed we could follow.

This would be the protocol (rough overview):
- 1 month of BCP
- An unnamed nasal spray for a number of days
- Stimming with Men0pur 2 vials, between one and two weeks I suppose.
- Pickup
- Transfer on day 2, 3 or 5, depending on amount and quality of embryo's.
- Progester0ne suppositories and a drug of which I didn't catch the name.

The last burning question left was WHEN? To my utter surprise, the answer was immediately. Come next CD1, I start a course of BCP. I predict that will be sometime at the end of September or the beginning of October (unless I have an exceptionally long cycle this time). I will be getting more info through the mail and there is some paperwork to handle, but not much.

And now, back to packing!

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