Friday, July 16, 2010

Where were we?

In brief: next attempt in August, same protocol but with placebo sauce.

Oh yes, of course, chalking up PG colleagues (another, indeed) and not
thinking about quitting ART. Quite the opposite, I've gone so far as
to plan another attempt this August.

We had a consult with Bigger Clinic in June (and then promptly went on
vacation). We chatted a bit about the previous cycle. Odd, the doctor
remarked, only 5 of your 10 follicles were harvested. I remember
finding that odd as well at the time, but the doctor that had
performed the procedures said the other were too small, the eggs in
them wouldn't be mature.

Then we moved on to talking about next time. In terms of trying
something new, there's little on offer. The doctor suggested changing
the protocol to a short one with different medication (Folli.stim).
I recounted the tale of our second IVF attempt, the only time with
Gona1-F, where we had 6 follicles in stead of the 10 to 12 with
Meno.pur, and asked whether this was the same. Not exactly, but

So we decided to stick with what we know (and have stashed away in the
fridge). Once we left, I felt a niggling doubt though. Should we have
tried a different protocol? Sure, the doctor SAID he only suggested
the short protocol because it's easier on the patient. But, what if

Meanwhile, I saw my RE at the Local Clinic, who reassured me that one
protocol or the other wouldn't make that much of a difference. He
agreed with Bigger Clinic's assessment, the choice we have is to keep
trying the same or quit (that was the gist of it).
He could only come up with one other thing for me to try, being an
endometrial biopsy. Not quite scientifically validated (insufficient
data), but based on more than anecdote (a few papers in Pubmed, that I
found). Supposedly, the slight injury caused by the biopsy causes a
response that is beneficial to implantation in cycles soon after.

On the scale of placebo*, it rates moderate. It's intrusive, but not
more so than a pap smear, not painful, not very costly and too quick
for much theatrics. Extra points if the test results are positive for
infection, then pills are involved.
So, I'll just hope its for real, cause naturally I agreed to trying it.

Fun studies have shown that different methods of delivering placebo
have an impact on their perceived effectiveness, depending on these
criteria. Saline injections 'work' better then sugar pills, ...


At 16 July, 2010 23:08, Blogger Bea said...

One of the fascinating things about the placebo effect is that it can still work when people are fully aware of what is going on. Apparently. I don't know - I heard it somewhere but I can't remember whether it was a reliable source.

Anyway, let's hope the placebo works wonders for you. One of the hard things about infertility is that after a certain point you have to start making up your own answers. There's not much left to tweak, and if you do it's just fiddling anyway.


At 17 July, 2010 02:32, Anonymous Anonymous said...

Hope the placebo works.

Would something like DHEA help?

At 17 July, 2010 14:17, Blogger Heather said...

At least it is something, I always feel better when we are doing something - anything.

The biopsy isn't more invasive than anything else with a speculum but I did find I was more crampy. Have some advil ready.

At 18 July, 2010 16:30, Blogger Roccie said...

I heard about this biopsy. My RE says it shows success with some folks. She didnt think I was a candidate for it (doh!) as we dont seem to have a problem with implantation (hurrah). I think it sounds like a great move.

I am not sure I follow however. Are you changing protocols for August with Bigger Clinic? I need to read some history to make sure I follow you better.

Cycle with you in August, Momma. Come on. Let's do this thing.

Siblings rock.

At 18 July, 2010 20:56, Blogger Thalia said...

I think DHEA is worth a try. Results I've heard from the ongoing canadian trial are very good. I took it for 2 months before getting pregnant with Junior. Who knows, but it left me with a positive impression.

Short protocol really is just as good. Lots of studies on that.

Hang in there.


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