Friday, June 25, 2010

now for the rest of the story

[originally saved as a draft under the title "my gut says ... this feels right"]

Wow, didn't realize it had been so long since I posted. The new schedule of juggling work and school has me busier and more sleep deprived than I've been in that last two years of the From Hell work project, but I am so much happier. At least when I'm in lab/class or studying. Work I have a hard time giving a fig about. Except when I remind myself that a lack of income is looming fast on the horizon.

Friday (okay, now last Friday) I had my appointment with the new RE, Dr. W. I like her. The office was quiet, low key. but very friendly, and not at all the rushed, you are just a mouse in the lab feeling that I had from the other REs office. I was an actual human being here. It could be because this is a satellite office for a big city clinic with lots of smaller offices, and only one doctor on staff here.

Or it could just be because they are awesome and have a different approach to it all.

First thing was it was the doctor who came to the waiting area (right on time) and called me back with a huge smile on her face. She is cheerful, bright and enthusiastic. And realistic. She also gave me the usual, "You are here on your own? Where are the men? Look at you, you are beautiful, professional, why no partner?" If you could figure that one out as well as my fertility....

We sat in her office and reviewed my history and medical file, and finally got to those pesky numbers. Mind, they only have the CD3 testing that had been run last March (09) as part of my clomid challenge. I was not about to offer up, "Oh, hey, my midwife ran CD3 tests last month too, and just to let you know, my FSH was up to nearly 40 now!"

And this is where the doctor was realistic: my numbers suck. They are basically saying that someone who should not be facing diminished ovarian reserve yet is. It's a fact. But where she differed from my prior RE is she mentioned donor eggs or donor embryos with enthusiasm, and asked very gently, "How important to you is it that this be genetic child of yours?" I know my answer, but the power of the emotion still caught me off guard, so I was more than a bit choked up as I answered. I've been on this road a long time. Sometime in college I decided "I'm adopting a baby" and having a husband never entered my mind as part of that picture. I've fought the adoption fight for close to four years, and came out feeling beat up and worthless, and basically like there was no hope as a single woman. I know, it does happen, but it is few and far between. Being turned away from agencies, nearly scammed by others, all the rest I won't even get into right now. I'll go back if I have to, but I want to give the chance to carry and birth a child one hell of a fight first.

When my prior RE had given me the "It's hopeless with your own eggs" speech, she rambled right into, "You'd have to consider donor eggs, and that's just so expensive, you really don't want to go down that road when in the end it wouldn't end up being your child."

Yeah, she said that. SHE. A woman. In the reproductive field. I think that is pretty much when my heart said "Bitch! I'm done with you!"

Is donor egg/donor embryo easy or inexpensive? Hell, no. But I'm sorry, when you take a cell or a small handful of cells and nestle it into your womb and feed and nourish and grow those cells through the miracle of it all with every bit of life force from you, how can you dare say it's not your child? How can you say to a child that you adopt, and look at the first time and know instantly that this is the child that has been waiting for you and meant to be and give that first hug that forms the start of that bond and say it's not your child? Anyway, I don't want to get sidetracked with this, but it really struck me the difference in how the two female doctors approached this.

So I said I was certainly open to donor eggs/donor embryo provided we are not talking about a $40K egg. But I wanted to give my body one last shot. One good kick in the pants to see if there was a good egg that could be shaken out. The RE smiled and said, "Good. We're going to get you your baby." And that was a phrase she said a couple of times. In her words, it takes three things for a pregnancy: a womb, sperm, and an egg; but people often mistake that a womb is just 1/3 of the equation -- it is much more.

In reading through the land of IF in the last year plus, you find there are two types of REs -- those who look at FSH, see one high number and say, "Nope, that is what your body is saying, and it's over" and those who read FSH month to month, and look for a low FSH month to try an IUI or IVF. Happily, new RE is in the latter camp, believing fully that FSH varies from month to month, and that doctors and acupuncturists can lower it and get a good egg. She agreed that my scarred and stunted right ovary may very well be affecting the FSH number since all others numbers looked good. But she also cautioned that endometriosis is very strongly connected to DOR. Research suggests that inflammation in the abdomen and the stimulation of the body's immune defense to that probably has a lot to do with destroying the primordial ovarian reserve.

So the protocol we decided on was to see if my body would respond to FSH suppression with estrogen (Estrace). This would help my pituitary relax since it was thinking the ovaries were busy doing their job, help to down-regulate my FSH receptors (which are most likely shot and exhausted after be yelled at so loudly month to month), and it would also give my follies a nice vacation to sit around in a pool of happy estrogen, and fat and strong. Sound like a win to me! So two weeks of Estrace, stop, I'd get my period and then we would do CD3 testing and go from there. If it could be lowered to 15 or under, IUI was possible. If it got to 12 or below, oh, we're talking IVF.

I left feeling good, but also realistic. I really don't think estrogen is necessarily going to do anything. After all, haven't I had a history of estrogen dominance? I tried to not let my logical brain take over, and started the Estrace on Saturday. It was about then, too, that I just seemed to let out one last held breath and said "whatever". It is what it is, I can't control it and change it. But I can move on to contingency plans and just not be so wound up in it all.

Which means I felt really good this week. Well, at least until class on Wednesday and the surprise period explosion after only 4 days of Estrace. (is it really a surprise if your cycle was 30 days long? Yeah, I didn't think so...)


And so we come to today and CD3 testing. I had/have a migraine to beat the band today, but stumbled out to the REs office for blood work and a scan. Nurse H who was driving the dildo cam today was excessively cheerful for 7:45am, but I'll take it. I didn't get to see the screen, so was a wreck over what my terrible antral count would be. Until she reminded me that I was on a suppression cycle, and they weren't expecting to see much. As expect, old Righty is a dud, still tiny, and absolutely void of follies. But Leftie apparently had 4 nice ones sitting out on pool floats, soaking up the rays. Nurse H chirped that this was an excellent reading for a FSH suppression cycle and sent me off with a huge smile.

I managed to keep from barfing at work (migraine) until noon and then packed it in. As I got home, my cell rang, and Nurse P was calling with my blood work. The AMH wasn't back yet, but she had the rest. My jaw hit the floor:

TSH - 2.87
Prolactin - 11.9
LH - 5.6
E2 - 36.7
FSH - ....... 14.2

Say what?!? I made her repeat the FSH a couple of times. She said she was quite pleased with the response and though the doctor is on vacation and I have to schedule a follow up with her to confirm anything as far as how we are proceeding, she said hopping back on the Estrace for a couple weeks would not be a bad idea.

So I should really go and call the office to schedule that follow up, and take a nap to chase of this migraine, but good golly, it looks like we may be on to something here!


  1. Excellent!!! I'm so glad you found your RE soul mate -- this is all such good news.

  2. I am cheering over here! That is freaking awesome. Everything sounds great - your RE, you, your estrace cycle. Man, you are on it! Can't wait to hear more and yes, it has been a while since you've posted. Glad for the good news though!

  3. YAY! I'm loving your new RE! And it sounds like you do too. Great image of your follicles hanging out on their pool floats, soaking up the sun... love it!
    Can't wait to hear what happens at your follow up appt.

  4. Yay! So glad to hear some positive news for you :)

    And I am dead serious when I say that if you needed a donor egg, and I was in the same country as you, I wouldn't hesitate to donate to you for free.

  5. Thank you all -- it still feels very much unreal, and I'm not getting my hopes too high since egg quality may be an issue, but I do feel now like *something* can and will happen.

    Oh, Steph!! You know how to make me cry! From someone as talented, gifted and gorgeous as you, and a connection with that little bub Liam, I'd take you up on it! Careful, if things don't work out, I might see if I can schedule some classes down your way.... ;)

  6. Oh wow! This is fantastic news!!!! I'm so glad that you found an RE that actually has a clue, and that the FSH suppression did what it was supposed to do!

    Are you taking any supplements? After my m/c last month I started taking 300mg CoEnzyme Q10 - it's the only non-vitamin supplement I take as it was the only one for which I could actually find good scientific evidence to support its use. It's supposed to be good for decreasing the chance of chromosomal abnormalities; it doesn't improve egg quality as much as embryo quality.

  7. This sounds so great...count me on the cheer wagon! Big Hopes & Hugs for you.

  8. Oh YaY for you!
    And thank you for teaching me to find an RE like your current one when the time finally comes!