Really needing some advice from any ivf "in the know" folks. I had my first ultrasound today (I've done stims 4 days now) and we saw 9 follicles on the right (about 4 measurable and all under 12) and 7 on the left (only 2 measurable and both under 10). Apparently, this isn't a great response so I got the dreaded cancellation talk. My RE wouldn't tell me one way or another whether or not I should cancel. Apparently he believes I will get about 16 follicles at this point...he would prefer 18-20. They were so worried about me hyperstimming that they used too low of a starting dose---this is the only thing he would do differently the second go round. Obviously I'm ticked....and depressed. I've seen ladies with my antral follicle count get 25-30+ eggs on the interwebs so it's depressing that I'm looking at 16. If I had normal chromosomes, I'd be ecstatic...not so much with my crappy eggs.
I currently have $2500 of meds in possession (and have used a lot of them). The RE said if we cancelled insurance may cover them--but that was a very unlikely may. So, if we cancel I now have to pay them $2500 for meds plus $2000 for a new cycle and then get to start this crap all over again. I know for those of you that don't have insurance that this seems like very little to pay--but my dilemma this entire time has been donor eggs abroad vs. ivf with my own eggs. We decided to do ivf with my own eggs first because we could process so inexpensively. With the extra $2500 tacked in this cuts into our donor egg budget (back-up if this doesn't work). Our new cycle wouldn't start until October. As far as converting the current cycle to an IUI--the RE is against it. We don't want to get me pregnant with my crappy eggs. So, this would all be a waste of time, money, etc. Right now (since I'm already paying for the meds) we've decided to keep stimming until Monday and then go back and see if there is any progress. Beyond that, I'm just at loss for what to do...any advice would be greatly appreciated.
I just did my second IUI after 3 miscarriages. I saw an reproductive acupuncturist before my IUI and he was saying that infertility is not black and white. I would just go with your gut instinct. My husband and I question ourselves with every move we make with our fertility choices, so I am in no position to offer any advice!
ReplyDeleteI don't know if my endometrioma/dermoid cysts (one on each ovary) made it harder to measure follicles when they were small, but according to my records on cycle day 4, just like you I had 7-8 follicles on one side and 9 on the other. No measurements were given on that day, so I can't give you a comparison there, but clearly I produced a whole lot more eggs than the 15-20 that I was told to expect on CD4's monitoring ultrasound. Also, my follicle counts were done by different REs in the practice on different days and they were really inconsistent in what they came up with (I had a freakout about having lost follicles and then the next ultrasound I had way more again), again because it was really hard to measure follicles until they got really large.
ReplyDeleteSo, I'd say carry on. This is WHY they measure your estrogen levels and have monitoring ultrasounds - so you can be bumped up to the just-right dosage. My RE was very emphatic that it wouldn't make a difference that I got off to a slow start... and I don't think it did.
Also, like the previous poster said, it seems pretty crazy to me that you could predict the number of eggs so precisely based on the CD4 ultrasound, when follicles are still so small.
ReplyDeleteThanks to both of you...you seem to confirm what others on the internet are saying. I don't understand why he was soo gloom and doom today... It looks like other doctors don't even see patients this early and/or would never suggest to cancel at this point. Sigh..
ReplyDeleteFirst, I'm sorry. It's absolutely sucky to go through this and not have the payoff in terms of those numbers. I also realize that your situation is significantly different than the vast majority of us who go through this: the fact that a number will be chromosomally abnormal is a given.
ReplyDeleteI do think it's difficult to predict at this point, even as a doctor. My guess is that he's just preparing you. Not for a certainty but for a possibility. I've heard of many women who start slow, who are surprised by the final haul (a good friend ended up with twins from a cycle like this...she didn't have a BT, but still). Hard as it is, I think all you can do is wait until Monday and then decide. SO much can happen between then and now. I'm assuming that they're upping your stims? If so, truly the picture can change drastically. (I hope so...and I hope you get a lovely number from which to pick the ideal, chromosomally perfect ones).
PS: Further to my previous message. I actually don't think you're starting slow. It's a very good number for being at this point. But I know it feels slow when you want many more...
ReplyDeleteim hoping it doenst get cancelled..
ReplyDeletei had my scan yesterday.. not sure what number i had but they are all smaller... i stimmed heaps better last time and had more but mine too was early so im hoping they speed up.. i think 16 is great... my doctor here doesnt like even as many as that.. good luck love.. xx
Best advice, do what ever you need to so that you won't have the "what if" thought running through your head if things don't go your way. Good luck.
ReplyDeleteI agree with the other posters who say to go with what you feel the most comfortable doing. I think so much of IF treatment is doing as much as we feel we can at any given crossroads. So if you feel you can push ahead with this cycle, I say go for it. If not, stop and wait for better circumstances. I don't htink there's any "right" answer here so I recommend picking whatever you feel the most comfortable with.
ReplyDeleteI do wonder if your RE can be more aggressive with your meds if you do see this cycle through? If they'r worried about OHSS, you could always do an FET to give your body time to recover. I did that (had to bc of my CCS and PGD tests) and was fully recovered from the OHSS before prepping my body for the FET.