Thursday, June 23, 2011

Decision Made

We had our second opinion appointment on Monday June 13th.  It was about 2 1/2 hours to get down to the clinic so we gave ourselves plenty of time.  The clinic was in a very nice office high rise and appeared new and modern compared to our old clinic which was a throw back to the early 90's.  But looks aren't always everything and they needed to do more than win us over with their wood floors, comfy waiting room chairs, and track lighting.

We first met with a financial coordinator who explained that since we have to pay out of pocket they reduce the costs.  But we noted that it will be about 2,000 - 3,000 more than what we had been paying at the other clinic.  From what we can tell it's mostly due to the cost of the egg retrieval because they have an anesthesiologist on staff and they actually knock you out  Unlike our last few cycles where I just got a shot of dilauded and got to watch (and feel) the whole thing.  Although I'm fascinated by watching that sort of stuff so it didn't bother me too much.  (I was the crazy girl who requested a hand mirror so that I could watch the dermatologist remove a mole from my neck; it was so cool.)

After this we were taken back to the RE's office.  He was finishing up with a patient so we had time to read all his accolades and there were many.  So he certainly won us over with all the awards and credentials: three time winner of the city's best fertility doctor, three degrees, two specialities etc.  Finally we were able to meet him and he spent a long time going over the massive medical record we had sent ahead of time.  He made several suggestions for a possible future cycle, confirmed things that we had been thinking, and overall made us feel very comfortable.  He did do a physical exam and confirmed that everything looked good, normal and that I had ovulated a few days prior.

We left with a lot to think about, which is why I haven't posted.  We decided to take some time to discuss what we had learned and where we felt we were being led.  And while I love you all, Hammer is dead on right that I'm totally influenced by what I  read about all of your successes rather than focus on what is best for our family.  I just want to believe this will work and so I want to be told this by anyone who is willing.  So, while it was difficult, we took our time to talk things through and pray about what would come next for us.  And we have come to a decision......


We are going to do one more cycle!

So here is the plan:
  • Begin taking 75mg of DHEA a day.  I take 25 mg three times a day which has been difficult because it makes me very nauseated.  It doesn't matter if I take it with a meal or not.  I hope it's worth it but the funny part is, if it works I'll probably still be nauseous; but it would be the best kind.
  • Increase folic acid to 1,600 mcg.  He is of the school of thought that any MTHFR should increase folic acid and it won't hurt.  He said I didn't need to the Folgard brand because he trusted that I would know what to do here.
  • Take baby aspirin 3 days a week and increase to every day after transfer.  Same school of MTHFR thought here and I'm ok with that too.
  • Endometrial biopsy/irritation scheduled for July 13th.  This was suggested by our previous RE and we brought it up to the new RE to get his thoughts.  He said that it could only help and was happy to add it to the protocol.  It is supposed to be similar in discomfort to an HSG although slightly less painful but since my HSG was a horrific experience I'm not looking forward to it.  Thankfully Hammer will be there and can stay in the room.  The theory about this is that if they irritate the lining it will cause it to react by 'repairing' and hopefully in this active state make it more likely for it to grab onto an embryo. 
  • Antagonist protocol.  Yes people, there will be NO lupron!  Or birth control pills!  After reviewing my starting estrogen levels he feels I was WAY over suppressed on the long lupron protocol.  With start of new cycle at end of July I will begin Gonal on day 2-3.  Compared to my last cycles, this should be like putting the pedal to the metal.  Whether my body responds better will remain to be seen but he hopes that my overall estrogen levels will improve for better egg quality.  I also won't be taking an LH drug like I did last time (Luveris) either.
  • Hammer does his 10 day 'prep' for day of retrieval.  This is the game plan that Dr. Russell told us to do.  We did mention that he had a fever but the RE said that by the time of retrieval he would be into another sperm cycle so it shouldn't be an issue.
  • Do assisted hatching.  This is what we did with the last cycle so he wanted to continue that since it got us our best results.
I'll keep you all posted when I get my official schedule but that won't be until my July 13th appointment.

While I'd like to end on a positive note I do want to mention that another reason prevented me from posting.  One of my IRL friends who struggled with many miscarriages finally welcomed a beautiful little baby girl at the end of April.  At just 9 weeks old she developed severe jaundice this past weekend and was rushed to our children's hospital.  Yesterday her parents received devastating news that she was born without a bile duct, a condition known as Biliary Atresia.  While there is a procedure that they will be doing this Friday to create one for her out of her own intestine it's only about 30% successful.  And regardless of this procedure she will have to have a liver transplant before she reaches 20 years old.  This hit us very hard because they have become such close friends as they fully understand what we've been through.  It made me question if we should move forward with this cycle.  It just seems so unfair that they would have to go through this after such a long and difficult road just to have her.  I would just ask for your prayers for this precious little girl, so loved, so wanted and so in need of a miracle.