I went for acupuncture last night and she did "e-stim" to see if we couldn't goose my third follicle into getting big enough to mature. I was laying there on my back on the table, pants down, needles everywhere, with mini jumper cables running from my legs to my belly. I could feel the electricity pulsing in my calves and both sides of my belly like a little heartbeat - bzz-bzz, bzz-bzz, bzz-bzz - and I started to cry. The tears were running down the sides of my face into my ears (which also had needles in them). Thank God I didn't electrocute myself.
This morning things looked pretty much the same (E2 618, 16/14.5/8.7). My doc did my scan even though he wasn't on scan duty - he had told me to have the nurses come find him - so I asked a bunch of questions. The answers I got:
- It looks like I will have two mature eggs. Tiny chance of a third, but probably not.
- If I do an IUI and it's negative, I would have to take one month off and then I could try again. He would do something different with the stims next time but he's not sure what yet - just that they generally don't do the same protocol twice in a row if it doesn't have great results.
- He thinks my response will vary by month in a largely unpredictable way due to my age. Translation: this was not a great month. If I stim again a different month things might (or might not) be different.
- He does not think the cyst on my left ovary (or the paraovarian cyst on the right) had anything to do with my poor response. It was small and has stayed small - even shrunk a little - so he doesn't think it sucked up the meds or otherwise interfered. Regardless, aspirating the cyst would not help because all it does is remove the fluid, and if the cyst wall is still there it'll eventually fill up again. The only way to permanently remove a cyst is through laparasopic surgery, which seems not warranted given that my cysts are very small.
- He does not think that IVF would improve the fertilization or hatching rates for my older eggs, even though I'm using frozen sperm. He says that success rates for women my age are exactly the same for IVF and IUI, unless they have 4 or more eggs.
- I have to make up my mind by the day of HCG trigger, which will probably be tomorrow.
At one time I had thought I'd use up my insurance, then use half of my IRA to do a Hail Mary cycle. But since my IRA is only worth half of what it used to be, that doesn't seem like such a viable plan anymore. So really when I use up my insurance I am probably done.
I also have to think about the cost of meds if I cycle again for IVF. The thing is, at max meds I pay SO much for a stim cycle. I've been very fortunate up to this point to be able to cover whatever my insurance doesn't pay for with donated meds. But I am now 100% out of meds insurance and will have only a few meds left at the end of this cycle. If I'm lucky I will find some med angels out there to help me do another cycle, which would make that easier. It could happen.
You know, when I first went to see this RE two years ago he said to me that given all the odds he'd recommend I go straight to IVF, but he understood my reluctance and respected my desire to try naturally and then via IUI first. I didn't listen to his expertise then, so I'm thinking maybe I should trust him now on the whole older eggs / frozen sperm thing. If he says the odds are the same, maybe I should really believe they're the same. And if they truly are, it makes no sense to use my precious insurance money on an expensive retrieval and transfer.
The upshot: last night I was leaning towards going ahead with the IVF; today I'm leaning towards the IUI.
And where she stops, nobody knows....
That's a really hard position to be in. Good luck making a decision. {{{{{Hugs}}}}}
ReplyDeleteDamn! I wish I knew what to say. Wanna get drunk with me?
ReplyDeletetough decision :-(
ReplyDeletehoping for the best!
That's so hard. I know it probably doesn't help to hear that but I got nothin else. (((((hugs))))) for you
ReplyDeleteI just wandered onto your blog and had to make the same decisions you are making. Twice. January and February. The first round that I stimulated successfully (Jan), I was on the miniflare protocol. (the previous round was the agonist protocol and that failed miserably) Probably because I was over suppressed. My E2 never got over 70.
ReplyDeleteAny way in January I had 6 follicles but really only 4 of decent size. My husband convinced me to do the retrieval. (they only got one) Nobody has any idea what happened to the other 5, but apparently they weren't cysts because they obtained cumulus cells from each follicle. The eggie didn't fertilize. In February, did another round using injectables (microflare procedure again), only had three follicles. We went with the IUI this time. Didn't work.
Take home message, I felt like the IUI had a better chance. Especially after the weird failure to get any eggs. IVF has too many variables that can go wrong with only 2-3 eggs. The only advantage is that it lets you know if your eggs can get fertilized, but as you said it differs every month.
Whatever you decide I am pulling for you. I turn 42 in April, btw/
That's a tough call. Sometimes different protocol can make all the difference in the world, but it's still a gamble. I wish this stuff came with clearer directions!
ReplyDeleteThinking of you and wishing you clarity.