Well, today is Friday, and we met with Dr Calm on Tuesday, and I just am not quite sure what to say.
She was shocked to see us--when we talked in the am, she'd said come in before Xmas, and when we talked to scheduling, that was her only appointment, so there we sat.
She said, basically that it is most likely that my ovaries are aging, and not putting out many (and at the last cycle, not any) good eggs. That isn't to say that we couldn't get pregnant with another IVF, but that it is time to think about egg donation. We were expecting that.
We talked about what we'd read on the SIRM website, and how it related to my situation. Essentially, the protocol that Cat, of Galloping Cats, is on would work in part for me, but not in totality. I am easily over suppressed, so a long lupron protocol, including BCP's won't work. As far as I know they are adding dexamethosone, which has shown to help with poor responders (here is more about that), and I'm taking DHEA for the next two months which is also supposed to help with creating more estrogen and thus more FSH receptor sites on the ovaries. I hope so. I hate taking Adrenal products. Beasty bits I call them. Also, she is reducing my menopur down to 75IU's to decrease the amount of LH that is in my system, because that can cause the ovum selection process to happen too early, decreasing the amount of eggs that mature. She is also considering lowering my Gonal F dose back to 300 a day, with the thought that too much GF might have caused the ovaries to shut down a bit.
Essentially, poor responders are right on the edge of what Reproductive Endocrinology knows. Also, because of the Restrictions at the Federal level on reproductive medicine, a lot of what is floating around out there is from small studies, and some of them not very well controlled or reported. It seems like the big issues is that they have some ideas about how to get the ovaries to respond better-ish, but not to increase pregnancy rates. I know, you are going to point me to some one some where who says otherwise, but this is my story, and I'm sticking too it.
So as far as I can piece together the plan is this:
Start(ed) DHEA 2 months prior to IVF (Dec 16th)
Wait a cycle, just do what comes naturally (like eat etc)
Have my period, test for ovulation, call my lovely nurse and get day to start the estrogen priming, and maybe the dexamethosone?
Get my period and then start the extravaganza of needles.
I think this is right.
My calculation is that I will have taken DHEA for 60 days by the time I get my second period of 2009.
Now onto the Donor Egg Portion of our post:
Last week, when the cycle was clearly crashing, my husband finally said out loud that donor eggs are a real possibility for us. As you know, I've been processing this for a while, but he has been much more single minded about the IVF with my eggs until now. Lordy it was a relief. I feel sad to see him have to cope with this, because it is bad enough if I'm just being a Cassandra and predicting doom, but if he's truly entertaining it, it is real. ya know?
I have some deeper thoughts about existentialism and other stuff, but for the moment I want to talk about a funny about face I've done inside of myself.
On Tuesday, I had therapy and talked about my fears about being disconnected and distant from a donor egg baby, and my therapist pointed out some sage things (which I will share later), and then told me a story about a person she knew who adopted and said "Now I worry if I could love genetic child as much as I love this one!" And I thought "that sounds nice, but really, that will never happen to me!" and then a few hours later, after we were returning from Dr Calm's office, my husband started talking about the IVF with my eggs and I realized I had already gotten attached to my donor egg baby (who is alive and kicking in my mind), and a genetic baby seemed to pale in comparison! I guess there is hope for me yet.
I've been slowly coming to life. I was sort of out of it on Wednesday morning,and I talked my mom into going shopping with me. I got a faboo new coat and a couple of sweaters, all at a deep discount. Yesterday I had a very full day at work, which went a long way to reminding me that I'm more than my ageing ovaries.