Wednesday, 14 December 2011

Information Overload

The appointment today was a bit of a surprise.

I anticipated the normal routine: when I go in the doctor says "Ah hello... um" glance at the notes "er ... Elizabeth.  Now you last IVF was" another glance at the notes "unsuccessful.  You had two embryos transfered on day three"

At which point I intervene explain that no it was a five-day transfer, and then launch into my history because they clearly don't know me from Eve.

(Even the worst doctors can tell me from Adam.)

(I hope.)

But today's doctor, who I'd met before IVF number three, was properly on the ball.

She'd discussed 'my case' (I am a 'case' now) with another doctor and had Ideas, Plans and Suggestions. I took copious notes but I'm not sure I got everything but here goes:

So what are her suggestions? (That was rhetorical, I'm going to tell you).

Don't hang around, my womb lining needs to be controlled so they don't want to leave it to its own devices for too long. They want to treat it with progesterone for 14 days out of every 28 starting next week (more on that later).

Then much the same as before, grow me some eggs and harvest them for fertilisation.

The difference is what comes next. Regardless of how the womb lining looks they aren't going to put anything back in, they want to freeze what they get for a later date.

The following month will be womb-lining month. Start with another full-on scrape, check the results for any nasties. Then oestrogen pills and sniffers to get me to regrow an optimal womb lining.

Also, this time I'd get intralipids. Do you remember this was offered to me before? It never happened because when it was supposed to start they had decided my womb lining was too thin to proceed - that they changed their minds later was irrelevant, by then it was too late to start.

If all goes well, they defrost the embryos and put everything back in.

My worry is that there is a lot to go wrong. I'm particularly concerned about the idea of freezing my embryos - nothing I've produced so far has made it to frozen (admittedly I have always had two to put back in the womb so theoretically they could have been frozen). But I do worry about losing anything I have produced along the way.

The Doctor reassured me that they lose less than 10% of embryos when defrosting.  She also recommended the husband and I both get karyotyping tests. This should pick up any abnormalities lurking in my eggs or the husband's junk. It could also explain why when I get 21 to 18 eggs each time  I have egg collection, I have only ever ended up with two embryos.

In addition she suggests a cheeky thyroid test, more to rule it out as an issue than because she is concerned about it (I've passed this before).

The next thing to decide was when to start. The womb lining regrowth is a major concern. I am on day 19 of my cycle today so the doctor decided to scan me right then. Which is great, because I don't feel like I've had a proper appointment until I've been impaled.

The scan confirmed what my daily ovulation tests have been belligerently trying to tell me for the past two weeks. Ovulation just isn't happening, and if it hasn't happened now who knows when, or if, it will happen. This natural cycle isn't going to work so if I am going to start the progesterone there is no time like the present.

Except there is.

If I start now, I'll be ready to begin IVF straight after Christmas. At which point the clinic is closed for their annual deep clean.

Hence the plan to start the progesterone NEXT week, to start IVF mid-January.

As soon as I start the progesterone then I need to go back on contraception. But that is fine, prior to Paris the husband and I had been using the barrier method anyway. The barriers mainly being our moods and thermal, unsexy, pyjamas.

If any of you have kept up with that then give yourself a star and buy yourself a Doctorate from the internet.

So lots of plans and ideas.

The only question that remains is are we going to go with them or will we, as I was so sure we would yesterday, look elsewhere.

I've got until next week to decide.



16 comments:

  1. Wow, to be taken seriously! Most excellent development!

    I remember what my RE said our very first appointment: "Jem, it takes three things to make a baby - good eggs, healthy sperm and a receptive womb." So glad they are taking your lining under consideration.

    Oh, and your description of your "barrier method" made me literally laugh out loud!

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  2. Your appointment actually sounds successful, which I know you were thinking would NOT be the case. It sounds like a good plan to me, but I can also understand wanting to get another opinion.

    PS, I choked (and nearly vomited) when I read this.. "But that is fine, prior to Paris the husband and I had been using the barrier method anyway. The barriers mainly being our moods and thermal, unsexy, pyjamas." Your humor kills me!

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  3. The thing is I read it and understood and thought about other possible suggestions. Liking the bazooka lady. Not only does she have big boobs she is on the ball.

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  4. Whew - sounds like a plan! Seems like that busty doc has done her homework, and that's a great thing. So now you have something to look forward to in the New Year!

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  5. I'm liking the sound of this plan. It sounds like they are really tailoring every step to your personal needs, and really taking care to give you guys the best possible shot.

    P.S. I also had to giggle out lour about your "barrier" methods.

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  6. I think it's great this doc seems to have a plan after reviewing your "case." It has to make you feel good this doc isn't just going to ramble on about nothing. She actually thought this through and gave you options.

    I really hope this plan works....keep us posted on your progress...I'll be thinking of you and as always keeping you in my thoughts and prayers.

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  7. Don't you hate it when you're all set to make a change and the people you are changing from step up and make you reconsider? Ugh. I hope this plan, should you choose to accept it, works out well.

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  8. Wowza, didn't see that coming at all! Tough decisions (to stay or go)...my 2 cents is that a second opinion NEVER hurts...that said, I do happen to like holy bazooka lady's suggestions. I know several other bloggers that it was suggested do the same thing for various reasons (freeze the embies and put them back later). It could be exactly what you need! I'm just tickled pink for you that they actually have a theory! Woo!

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  9. Seems like there is a real plan in place. I hope whatever way you decide to go, you are happy. Sending good thoughts and prayers.

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  10. Delurking here. I think the plan sounds really good. My doctor is also a huge proponent of frozen transfers. He seems to have really good luck with FETs and he also says that all you have to focus on is the lining. Fresh IVFs are really not the best thing for your lining to begin with and if that's where your difficulty is then I think this plan really sounds like a good bet. Definitely better than just banging your head against the wall doing the same thing over and over. Good luck, wishing you the best.

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  11. Give yourself time to think all of this through - maybe consider delaying to Feb? There are lots of options and you shouldn't feel rushed into making a decision.... A second opinion from another clinic might be good too, if only to confirm that you're making the right decision staying where you are.

    By the way, if they're going to do a scrape, ask them if they can create implantation points whilst they're at it (basically notches in the womb where they can then aim the embryo at during the next ET).

    Take your time - you're investing a lot of money here and you need to feel confident that you're making the right choice.

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  12. that sounds like a great appointment - it is so rare that a doctor actually takes time to read your file and have a plan of action. As a note on the womb lining - my doc had me taking baby asprin (81mg) once a day till transfer to aid in thickening the lining.

    I recommended it to my SIL who was warned her transfer may be cancelled due to thin lining and 4 days of taking the asprin helped her thicken up too.. you've probably heard of it, but i thought it can't hurt to ask your RE if you hadn't.

    good luck with your decision *hugs*

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  13. Tricky one. The new strategy is a good sign, on the other hand, hrmm.

    What does your gut say, if anything? Sometimes it can be helpful, but not if it is just saying it wants spaghetti for dinner.

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  14. This sounds fantastic - they are actually devising a strategy to do things differently instead of just 'trying again'. You have become a 'case' - don't give that up! They are building up experience with you and your specifics and I think that is completely invaluable going forward. Unless of course you don't have the necessary faith in them because of how the previous cycle went.

    All the best to you in the difficult decision-making!

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  15. Wow. What an incredible appointment. No matter what you decide to do, it is just so nice to have someone really thinking about you and caring.

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  16. Not sure if you've decided yet but it does sound like they have really thought about what happens next and put together a plan as opposed to my consultant who I never see during a cycle and who starts the failed cycle debrief by asking me what happened then proceeds to try to get me out the door in 5 minutes flat by giving me one word answers (usually "no") to all of my carefully thought out questions. This looks pretty encouraging. In your shoes I'd be tempted to give them one more shot. They know more about you than any other clinic could at this point. x

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