Monday, July 27, 2009

The Plan for Now

Well guess who showed up this weekend? Yep, good ole flow. I'm actually thankful that she came so quickly as I was worried I'd be the one who had to go on Provera because the drugs screwed me up. I have to say that this one is awful. I expected it, what with a great 12.75 lining this cycle. But in a general sense of things I'm feel good about getting this next cycle started. If it were up to me I'd be picking up my refill of BCP today but the clinic's protocol is to wait a cycle and then start.

We have our "what the heck happened" appointment next Tuesday. And (I am such a nerd) I've been looking up research articles on poor IVF response. What I've learned is that they define poor response based up on:

  1. The number of eggs retrieved (poor = <4)
  2. The amount of stims given per day (poor = greater than or = to 300 IU/d)
  3. The total amount of stims given in the cycle (poor = greater than or = to 3000 IU/cycle)
  4. And a cancelled cycle

We had:

  1. 7 eggs retrieved of which 6 were mature
  2. I took 225 IU of stims each day
  3. In total I took 2250 IU/cycle
  4. And we were not cancelled

So basically I think I just squeaked by a 'poor' response cycle and I think there is a good chance that my 'poor response' was that I was not on the right meds. That or I was totally over suppressed by the Lupron. I mean, hello, I started off with an E2 of LESS THAN 7!!! Does anyone else find that ridiculously low when they are just looking for anything below 80?

I also looked up poor response to IVF stims due to ovarian edometriosis. This is when endometriosis is found on an ovary. The effects are usually a smaller amount of follicles, typically on the side of the endometrioma, and a poor response in general with fewer follicles and fewer mature eggs retrieved. But in reading up on this I don't think I totally fit that picture either. What they found during my lap was:

  1. one spot of endometriosis on my right ovary (which was causing all my pain), and
  2. one spot on the back of my uterus

My GYN who did the surgery said I didn't even meet the qualifications for Mild endometriosis and that if there was a 'very mild' she'd 'think' about putting me in that category. Basically, she didn't think it was causing our infertility but is glad that my right side pain went away with the removal of the ovarian endometroma. And let's all keep in mind that if my right ovary is supposed to be 'effected' by my endometriosis it's always:

  1. Had the largest follicles (except this last cycle)
  2. The highest number of follicles
  3. And this round of the cycle had the most mature eggs retrieved

So righty defies all logic of an ovary effected by endometriosis. (Way to go righty!) Now lefty has always been a quandary because it does not always participate and then some times it surprises us, like this last cycle, and decides to pop out the best looking follicles of the bunch. But it still failed to produced large amounts of follicles. That is why I'm wondering if I was either sensitive to the Lupron or Bravelle was just not the drug for me.

I'm excited to try a new set of drugs to see how I do. And I don't know about you but I think 6 mature eggs when I only had 4 mature sized follicles is pretty darn awesome! Plus we made it to transfer once before which means we have a really good chance of doing it again. That and we just got word that Hammer will be getting a bonus in the amount that will cover our drugs! This part was a total shock to us but it could not have come at a better time when we were just trying to plan out fiscally what we were going to pull from to do the next cycle. Hammer is actually in corporate finance so we are well managed $-wise to do another cycle but it takes off some pressure and every penny saved means more in our savings and the longer I can stay home with our future baby(ies).

My favorite part about all this is that it looks like we'll start cycling again at the end of August. Which means that we will be doing BCP and Lupron (?) in September with a retrieval/transfer some time in October. And October is when our Florida vaca was cancelled because my work is not letting anyone travel in October. So now with a looming Oct IVF on the horizon we wouldn't be heading south anyway. Originally, I choose to let Hammer be mad for the both of us about our cancelled vacation because I didn't want to add more stress on our first IVF which was a good idea in more ways than one. I didn't hold a grudge and now I actually have to thank the head of my department because we can jump right into another try.

So I'm armed and ready with my list of questions for Dr. F and feeling good about Operation Hammer Babies Take Two!

12 comments:

Katie said...

You sound so positive and good for you for looking ahead and being proactive.I've often heard that sometimes all it takes is one IVF to figure out how your body responds to know what's best for you... and then the second one does the trick- hoping that's the case for you!

Shannon said...

Im glad to see you are armed with some good info for your appointment and cant wait to hear your new plan. Good luck, always thinking of you.

NeNe said...

I'm glad you're feeling positive and hopeful. Don't ever give up!!

Amber said...

Hopefully with the new medicines you will get your miracle! Congrats on his raise thats great news!

Jesse and Mandy Peterson said...

I don't know too much about IVF, but it doesn't sound so much like you squeeked by a poor rating, but that you did good. I, like you, try to be well-informed, and I think it's always a good thing to be armed with info before meeting with your doctor. I'm ready for "Operation Baby Hammer Part Dos". Wish you didn't have to wait until the end of August, but God knows what He's doing. I just want to see it in action!

Hillary said...

From my limited knowledge, I really do think they'll get you on the right protocol next time. I'm excited to stick around and see your next IVF...that hopefully ends with a BFP. :)

Hoping for our own Peanut said...

oh mrs. hammer, i hope you know how amazing you are.

you are so upbeat about this cycle, it radiates through the computer screen.

i have read SO many ivf blogs recently that had a success after the first round failing. i cant wait to put you into that "category!" :)

Hua said...

Hi Mrs. Hammer,

I'm glad to hear that you are so positive. With that attitude, you can do anything. Just keep holding your head high. You are an inspiration. I'm Hua, the director of Wellsphere's HealthBlogger Network, a network of over 2,000 of the best health writers on the web (including doctors, nurses, healthy living professionals, and expert patients). I think your blog would be a great addition to the Network, and I'd like to invite you to learn more about it and apply to join at http://www.wellsphere.com/health-blogger. Once approved by our Chief Medical Officer, your posts will be republished on Wellsphere where they will be available to over 5 million monthly visitors who come to the site looking for health information and support. There’s no cost and no extra work for you! The HealthBlogger page (http://www.wellsphere.com/health-blogger) provides details about participation, but if you have any questions please feel free to email me at hua@wellsphere.com.

Best,
Hua

Anonymous said...

what are the side effects of provera? what i've read scared me

have you worked with natural progesterone? google TTC progesterone or TTC prometrium

in my opinion, ivf is not good, and you should work on your health, as so many women do

you can try ivf, but if your body is unhealthy, you will miscarry :(

also, endo surgery helps many women

most gyns do not recognize all the forms, locations and stages of endo _ ALMOST ALL OF THEM do not

they will diagnose 'mild' when it can be quite severe

see a site like naprotechnology.com, endoexcision.com, endometriosissurgeon.com, centerforendo.com

Anonymous said...

oh also

makingbabies.com

endometriosis.org/nutrition

dian s mills endo book

marilyn shannon's 4th edition of fertility and nutrition, now at amazon

Sumer said...

Hey Mrs. Hammer!! Check out my blog - I tagged you for an award!! One Lovely Blog Award!! I follow your blog and think it is awesome! I should be starting my IVF cycle in September and am glad I found others out there to find comfort in.

Sumer

Melissa said...

Hi. I've been following your blog for about 2 weeks now and think you have an incredibly positive attitude. Good for you. It's hard to keep that in all of the things that we need to endure. Anyway, I've left an award for you over on my blog. Check it out!