Right: 19.6, 12.1
Left: 14.8, 13.1, 13.9, 13.4, 9.9, 9.8
Basically, my doctor is hoping that 19.6 just floats away and that MAYBE we'll get the others to grow enough by tomorrow to trigger. That would mean retrieval on Thursday, my 33rd birthday. And maybe get four eggs.
Four.
Originally, we were really worried about hyperstimming me. Don't get me wrong - I'm extremely happy that didn't happen. But... Four? Now, if I were forty, I'd take four joyfully. If I had premature ovarian failure, or even unexplained infertility, I'd take four. But I have frickin' PCOS, for crying out loud. Four?
What if we go through all this, retrieve four, at best, and then only 3 actually fertilize, and only one makes it to blast? Or what if none make it? Gah. There are too many "what ifs" involved here. I don't know what to do.
My doctor is inclined to go ahead with just four. But his original prediction of a 40-45% chance of pregnancy with an elective single embryo transfer (their normal rate of pregnancy with elective single embryo transfers is 67%) is now down to 30%. Me? I'm inclined to cancel. It just seems like an awful lot of work, time, money wasted for ... four.
I have three IVF cycles covered per live birth. If we cancel before retrieval, this doesn't count against my three. I get that I'm "only" on my first, but if that fails, I'm down to two. That's 30% down.
Oh, there was another option. We could have triggered today and converted to an IUI. Over my dead body. I would have been risking quadruplets if I'd agreed to that.
SuperDoc had students with him today, and while they were poking around at my ovaries I was being as lighthearted and joking away as I could. As he reviewed my previous cycle with them to see what they would think retrospectively, I mocked him a little "Oh no, this cycle will never work. We'll trigger you early, blow this cycle off - we know you're moving on next cycle anyway. No possibility you'll even get pregnant let alone with HOMs!" He said if I weren't back for more he might pay attention to me. A fair point. I apologized later to one of the students for being such a pain in the ass, but she said it was great comic relief.
SuperDoc was jovial and calming as always, but once I sat up, I got more serious and so did he. I wasn't happy. He was calm and seems comfortable with proceeding, but I feel like I'm being followed by a shadow. He did note that if we cancel and start over, we'll start my Follistim at 220 IUs and we'll be much more likely to see the 15 follicles we expected. Still, like I said, he's comfortable proceeding as is. Me? I'm not so sure.
I waffle. The Lupron sucks so badly I'd hate to think I took it for two weeks just to cancel.
Sigh.
Update: Thanks, Bean, for noting that I should double check my insurance - I did just that on my way out of the clinic this morning... I checked in with the financial counselor to find out what the financial implications of canceling would be and whether it would count against the three, and the long and the short of it is that each of the monitoring appointments would get billed separately to my insurance and I'd have my copayment for those and coinsurance for all the labwork. I had her double check to make sure that the cancelation would not count against the three cycles and it will not.
Another Update: the 19.6 is not the one. By Thursday, it'll be gone. Definitely good points for moving forward, but it's a lot of money I stand to lose.
Monday, January 26, 2009
Calling all Assvice
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8 comments:
My mantra has always been, "it only takes one."
My doctor only retrieves and fertilizes 3 eggs unless you agree to freezing. I've always agreed to freezing but some people don't...
It's obviously a decision you have to make, but you asked for assvice, so there it is. :)
Don't have any good advice, except to say I hope you're right (and if you are you're lucky!), but double check your insurance. I know for both the plans I've been under (which generally aren't as good as yours) they consider it a cycle once you start stimming. Thus, when I had a cycle cancelled because I didn't respond to stims it did cost me one of my three.
Thinking about you. Good luck whatever you decide
Do you not also have the other insurance if it does come to that?
Is there anything to learn from the drug regimen The Hatchery had suggested that could help now?
Might you also have other follicles like last time?
Can you take the drugs in such a way that would usually err on the side of hyperstimming just for the last day before retrieval?
On the other hand, the one large follicle reminds me that in the earliest days of IVF, the ovaries were watched for the one follicle that would develop naturally -- in women with tube and not ovary issues -- and then the doctors would go in and get it. Just one.
Maybe that 19.6 is the one.
My vote is to continue on. If this had happened once already and failed and now was happening a second time, I'd say to scrap it, but this is the first time, the very first IVF cycle, so you don't really know.
Thirty-three is "gal." Perhaps this signifies that your birthday would be an auspicious day for retrieval?
If I were in your shoes, I think I would cancel. I'd hate to use up one of your IVFs only to have nothing to transfer. If it weren't for your history, I would totally say turn this into an IUI (The IUI in which I had my sigleton there were 6 mature ones and maybe a few more that would catch up - we did have the SR talk...luckily I only ended up with one). But with your history that is a mute point. You asked for assvice, I don't think 4 is worth going through ER/ET (unless as you said, you were older or had POF) and using up an IVF... but that's just me.
PS - just discussed w/ Carey who also said she would cancel the cycle (as much as that would suck)
Another Update: the 19.6 is not the one. By Thursday, it'll be gone.
Ah, okay. Thanks. Sorry, please forgive my ignorance.
Before I would even consider cancelling, I would want to know what would be different in your drug protocol next time.
I know that you are a prime case for OHSS, and a cycle with few eggs will probably yield better quality eggs than a cycle where you hyperstimulate.
You have 3 tries with this insurance, plus you have your coverage. I think I would be inclined to go ahead with the cycle. I have been cancelled TWICE for poor response, so I really do know what it is like to be faced with that decision.
Ugh. Coming from someone who has also hyperstimulated and also tends to produce lots and lots of follicles (32 for the last one), 4 sounds super-low and maybe a disappointment? That said, with three rounds of ivf for almost free I would take the risk with the assumption superdoc is doing ICSI. It seems the stats would support the success of having a single embryo to transfer, which is what you want anyway. Well, that's my 2 cents, for what it is worth. :)
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