There are a handful of you that know that I was doing my second round of IVF this August and so I thought an update for everyone was in the cards. Long story short; it failed. If you want to hear the long story, here it is...
Before I started this round I sat down with my Doc and we went over how she was going to change things this cycle. The last time I used Letrozole for suppression and then two gonadotropins (Menopur and Gonal-F) to grow my follicles. I had a bit of overstimulation and my estradiol levels went up above 9,000 (that's not good). It could be why the most of the eggs they retrieved didn't make it to blastocysts and why the two that did were less than stellar. This time we suppressed with birth control pills only and then she said we wouldn't do the Menopur, only the Gonal-F and some late cycle suppression with Cetrotide. Lovely you say, who cares what drugs you take? This will be important later in the story, so write it down. Also, if I didn't overstimulate, Doc wanted to do a fresh transfer. I was for it since maybe the freezing and thawing affected my embryos more than we thought. But they did a saline-infused sonogram (SIS) to check out my uterus and she thought she saw something still in there (there always seems to be "something" in there...) and the new Backup Doc said that she thought we should do a hysteroscopy to view the uterus again and maybe take back the septum more. Really?! Why does my uterus need to look like Angelina Jolie to put an embryo in there?! But fine, whatever. So we were back to a freeze all transfer. I reminded them that they had the pictures from my last hysteroscopy in October 2014 and there was an MRI of my uterus from February 2013. They didn't have the MRI images, so I went back and got them from the hospital in Yakima where they were done. I was hoping that it could convince them NOT to do anymore reconstruction of the last piece of my reproductive anatomy that seems to work. They agreed to put off the hysteroscopy until after the IVF cycle and we had our plan, so everything was a go.
In early August I had my first suppression appointment and my hormone levels and ovaries were looking good. I started my Gonal-F (150 IU) on Friday and then didn't have another appointment until Tuesday. That was the weekend we drove down and saw Nicole and family and then drove back up to stay over in Seattle. Things were progressing pretty well and Backup Doc said I should dial back my Gonal-F just a bit to 125 IU. I ended up seeing Backup Doc for most of the cycle because my Regular Doc was on vacation (which was sorely earned, she hadn't had a real day off in two years!). The next time I saw Backup Doc on Thursday she said she wanted me to start Menopur. I said that Regular Doc wasn't going to use Menopur and the nurse backed me up. Backup Doc said she thought that maybe Regular Doc wasn't going to use it in the beginning, but she probably would have eventually. Right.... So I started Menopur, decreased Gonal-F to 75 IU and started Cetrotide. This continued through the weekend and my estradiol was rising slowly and fairly evenly, but my follicles seemed to be growing slowly. They want them to be an average of 20 mm in size before they take them and so far they were about 13 mm average. Mine were increasing slowly, but we had said we wanted them to grow low and slow this time around, rather than so quickly as they did in the first cycle. So I figured they were doing okay. Also during this week Backup Doc got really concerned about my blood pressure. The top number was running around 135 and the bottom around 90 to 95. She said that with a bottom number so high I could be pre-eclamptic. I said, "Don't you have to be pregnant for that?" She still wanted me to do a 24-hour urine protein. Great. Add another thing to keep track of. She also wanted me to see another doctor to adjust my blood pressure meds. I told her I would talk to my primary care physician about it. I wasn't going to add another cook to this kitchen. We had gone home one of those days, so I just called early and got an appointment for that afternoon. Primary Care Physician and I talked and we adjusted the meds. Done and done, just like that. The next day when I saw Backup Doc my blood pressure was more like 123/81. She was surprised when I said I'd seen my Primary Doc and shocked that I could get an appointment so quickly. That's what it's like in po-dunk hunny; it's called customer service. So back to the gonadotropins. Backup Doc continued the lower Gonal-F dose all weekend and my follicles seemed to stall. On Monday she raised the Gonal-F back up to 150 and because I was already on the Menopur it continued. Tuesday, I got to see Regular Doc and the follicles were still stalled, averaging around 17 mm. She increased the Gonal-F all the way up to 225 IU. That didn't seem good to me. It turns out that the estradiol went from 854 on Sunday to 1175 on Monday and then dropped to 847 on Tuesday. That's really not good. On Wednesday, Regular Doc came in and said as much. The follicles weren't getting to that 20 mm average and the drop in estradiol was a bad omen. She said that when that happens the recovery of eggs is poor and that it would be in my best interest to cancel the cycle. I felt like I was prepared for this eventuality. I didn't have a lot of faith in what Backup Doc had done through my cycle and Regular Doc even said the same in so many words that the cycle was messed up. Regular Doc said that if I had remained at a steady amount of Gonal-F through my whole cycle I would have gotten the same amount but not been on a roller coaster of up and down. I knew that the up and down meant that the follicles I'd made were probably starved and there would be no sense in progressing forward.
So we cancelled it.
This also meant that each ultrasound would be billed out separately and we'd be getting money back to try for a third cycle. We are going to have to have some time to pull the money together for another try, but Regular Doc also wants me to be on a regiment of high dose supplements for three months. She said they help with people like me who have PCOS (Poly-Cystic Ovarian Syndrome) have better IVF outcomes. So it's back to the grindstone of working out and dieting. Maintaining my weight or losing some more is important to me and nothing gets me going more than being disappointed. When I'm content I don't seem to have the passion to work out and diet. But get me fired up and I can do things that I look back at and am surprised I had the time for. So here's to January.
Don't feel sorry for the things that don't work out how you hoped. Feel more passionate that you can change it the next time around.
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