Thursday, July 27, 2006

Today's stats

Having visited my second-home, Shady Hell, for the FOURTH time in a week this morning, there are a few things to update about.

First, yesterday I had my consult with my RE so that we could talk about doing my next cycle as an IVF cycle instead of yet another boring IUI. We talked about the cycle I'm in the middle of now, and the side effects I've been experiencing with the Follistim. Apparently, I'm a rare duck in that Follistim makes me throw up. A lot. Every day. Whoo hoo! Provera, by the way, does the same thing to me. And the good news? If I respond so strongly to such tiny itty bitty doses of these hormones (no kidding... I take 50 IUs of Follistim every night... many women I know start with 150, 200, or 300 IUs every night), then odds are good I'm going to have incredibly awful morning sickness. Joy! When we'd finished talking about this cycle she reiterated that hopefully the IUI will work this time and the rest of the consult will be unneccessary. That's fine. I'm happy to pay for an IVF consult I never need. Seriously.

Then we moved onto the real topic at hand: IVF. My doctor drew me lots of pretty pictures (upside down!) and explained how the cycle would go if I started an IVF cycle. Mostly she didn't tell me anything I didn't already know, either because so many of my friends inside the computer have been through all this, or because I've been through much of it already, just by doing injectible FSH/IUI cycles.

What I really wanted to know was how PCOS plays a role in an IVF cycle. I know that even with my IUI cycle, they have to approach PCOS patients slightly differently, because we are the lucky super-responders to FSH. They have to give teeney weeney doses to carefully tease a follicle or two into the forefront, because otherwise they just end up with a bazillion little follicles and a canceled cycle, and, well, that's no fun at all, is it?

My main concern was whether I'd be at an increased risk of OHSS (Ovarian Hyperstimulation Syndrome) which is, well, kind of evil, from what I've read. The short answer is yes, there is an increased risk of OHSS with PCOS patients. The long answer includes a bunch of statistics that I don't understand which boil down to: "but it's still really rare." So PCOS patients, because they are SUPER-Responders, stay on Lupron at higher doses for longer than the average patient. Lupron, boys and girls, ain't cheap. (I'm a lucky duck in that I have insurance coverage for much of this, but I feel for the poor women who have to pay for this all on their own) Anyway, I guess the idea of staying on the Lupron is to continue suppression for a bit longer, and to help avoid early ovulation. No problem.

Okay, there's a problem. I was really hoping (as disgusted as I am by the idea) that even with an IVF cycle, they'd let me keep taking prometrium suppositories (yeah, I know, yuck) instead of PIO (progesterone in oil) IM injections. But no such luck. I do not know why, but this paralyzes me. Ridiculous, right? I can handle subcutaneous shots. I can handle the IM HCG Trigger. I can handle the oh-so-pleasant-sounding egg retrieval. I can handle HSGs. I can handle all manner of unpleasantness, so why am I so freaked out by the PIO injections? They sound so icky! And they seem so painful! And everyone I've talked to has told me how ridiculously EVIL they are. Crap. Have I come this far just to be paralyzed by one really huge syringe? Seems that way.

Well, I suppose we can always hope that this IUI cycle works. (Hah! I almost said that with a straight face!)

Speaking of this cycle, I was back at Shady Hell this morning for more monitoring. I have to say, it felt a lot more normal to be on the second floor. I swear when I was brought into my doctor's office on the fourth floor yesterday I almost took off my skirt, because well, what else do we do at the office? It was completely odd to remain fully clothed for the entire appointment. Today put the world back into balance, though.

Dracula had a hard time finding a vein in my arm, so she snagged blood from my hand. Actually, I'm grateful... it sure beat having to have her poke around in my arm. So even though it hurt like heck, there's no bruise and it feels fine now, and it only took one stick. I heart Dracula. She's way better than the other phlebotomy flunkies.

The doctor covering monitoring today is a nice Jewish doctor from South Africa. He is very soft-spoken and sweet, and has a delightful accent. Anyway, I was worried that they were going to tell me today to trigger tonight and that would just be sucky because that would have meant a Saturday IUI and that would so not work for me (I'm Jewish, and Saturday is the Sabbath and comes with a million and one rules, one of which is no driving, so getting to the clinic would be nigh impossible). Anyway, without me saying anything about it, he said, "Well, it looks like you probably need to go another day, so you'll probably come back tomorrow and trigger tomorrow night, you'll be good for Shabbat [Sabbath], and back on Sunday for the IUI." A call a few minutes ago from my nurse confirmed his guess, and I'll be going in on Sunday. Whew!

I have a lovely 16 mm follicle on the right side just begging to pop. I've been feeling pain on my right side for a couple of days, so hopefully after tomorrow, that pain will go away and we can move on.

I made the mistake of actually being a tad hopeful in my last cycle, so I was pretty horrified at my repeated negative HPT attempts and the eventual appearance of my period. Yes, I'm a pee-stick addict. I know I'm not supposed to test before the blood test after the IUI, but I can't help myself. I go crazy knowing that I'm doing nothing (Nothing!) during the two week wait. I hate that time. I spend so much time up until the 2ww going from one appointment to another signing one form or another, sticking myself with needles, getting up close and personal with the cooter cam every three days, calling my financial coordinator, writing checks, and then all of a sudden... Nothing. A black hole of hand-wringing, fidgety, nothingness.

Right. So I'm just happy to be finishing this cycle with a plan in place for next cycle, knowing that there probably will be a next cycle, and knowing that we'll likely be just moving on to the next step and saying goodbye to the IUI chapter of our reproductive lives.

Have I mentioned that I want a baby? I mean really, really, really want a baby so badly I can almost feel a baby in my arms? What's amazing is that when I see my wondermous husband with someone's baby, I think that sometimes he aches for a baby more than I do. I mean, I really, really, really want a baby. But my husband? Yeah, he does too, even though he doesn't talk about it much. We have an amazing foster son, an almost-three-year-old who is so much fun, but we never got to have a baby (we got our foster son when he was 13 months), and I just know my husband really wants to experience babyhood from a father's perspective. I just wish my ovaries would cooperate and I could give that to him. And me. Don't forget me. Because, you know, it's ALL about me.

No comments: