Thursday, May 21, 2009

Big Fat Negative Doctor!

I have a very pessimistic RE.

It's rather unfortunate, though I believe that it is inherent in his personality and may not necessarily be indicative of our potential for success with assisted reproductive technology.

Case in point -

I had an appointment today with him to further discuss my upcoming cycle (did I mention that we received the coveted "Call" off of the clinic's waiting list last week and we are poised to begin another IVF in early June?) Things weren't sitting well with me about what we were about to do - based upon the nurse's description of how my cycle was to evolve, it didn't sound like I was doing an Antagonist with Estrogen Priming cycle, the way I had originally thought. A few clicks of the old mouse and some posting to Dr. Hannam in Toronto helped me to learn that what was planned for me was far from the Antagonist/Estrogen Priming plan. Hence, the visit to my own RE to find out what the f*ck was going on...

It turns out that he has something even more special planned for us - we are being put on the Agonist/Antagonist Conversion Protocol with Estrogen Priming. This got me excited, as I had read about this at length and knew that it has proven to be quite effective with women who were poor responders. Pioneered by Dr. Geoffery Sher at the Sher Institute for Reproductive Medicine, the focus behind this protocol is in improving the environment that the egg grows in through promoting estrogen dominance in the ovary (read more here). Sounds great, right? So where does the pessimism come in?

Despite the fact that my RE is placing me on this protocol, he made it very clear that he doesn't necessarily believe that it will improve our chances - but that he was doing it because I had asked for it. Wait a minute, now - who's the doctor here?? If I had known that I could call my own shots like this, things would have been waaaay different waaaay earlier on!

In any case, my perception is that he is being negative because this protocol is relatively new to him (I don't believe he's done this with anyone else before). He said that there are some things about the protocol that seem unconventional to him. Clearly he is not a risk taker. Despite his penchant for repeatedly saying "This is what you've asked for..." I wanted to have a clear understanding that I wasn't totally off the beaten track (his unwillingness to assume accountability for making the decision to try this protocol was fine with me, as long as I was assured that it was the right direction to go in...) so I flat out asked him to tell me if this protocol was the wrong thing to try. He indicated that it wasn't - that it wouldn't hurt to go in this direction, that it did incorporate the antagonist protocol (which he originally recommended) and that it would allow us to say that we had tried everything. That was all that I needed.

I have written to Dr. Sher at SIRM to ask for his input into my situation - here's hoping that he writes back to me. Poor guy must have thousands of women writing him each day! I just wanted to hear some optimistic news about the journey that I am about to embark on. Everyone could use a little good news now and then, right?

Friday, May 1, 2009

"Priming" Up for Another Cycle...

I can't believe that it's been an entire month since I last posted! The days seem to fly by, which has been fine and dandy for me since each day brings me closer to my next IVF cycle. The funny thing is, the clinic called me this month to offer me a cycle - but I declined, knowing that the retrieval and transfer were far too close to the end of the school year for my liking. Considering everything that I have gone through, the last thing that I wanted was for the success of this next cycle to be affected by the stresses of closing out a school year. DH and I decided we would defer until the following month, which brings us to a retrieval/transfer during the second week of July. Summer holidays will allow me to really put my feet up and relax during that dreaded two week wait!

Despite the fact that we turned down the cycle this month, the nurse very patiently walked me through the entire protocol that I'll be on - Estrogen Priming with Antagonist Protocol. Geez - talk about complicated. Twenty-one days of birth control pills, coupled with Suprefact. Then, good old Auntie Flo should arrive and I start stims with estrogen patches on Day 2 or 3. After approximately 12 days of stims, they go egg hunting, make babies in the lab, put them back inside and boom - I'm pregnant! Ha! If only it were that easy!

If I understand things correctly (and I'm still not sure that I do, even after reading a gazillion different things on EPP...) the estrogen will ensure that my FSH levels are not too high, which in turn will help the quality of the eggs. I must admit, I have high hopes for this protocol - I requested that my RE put me on it, as it is known to be very effective for poor responders. He's never done it before (and I'm a little nervous) but I'm channeling all of my positive thoughts toward this being a great success!

Just this week, I figured out that the bill for my last IVF cycle totaled approximately $17,000.00! Thankfully, my insurance plan covered 80% of the drug costs and DH's plan covered the rest - so really, we were only out of pocket about $7500.00. But this, added on to the $1550.00 we have spent on IUIs makes this one expensive adventure!! I would have preferred a trip around the world...

Sending a special "hello" and cyberhug to all of my cyberfriends - hope you are well and feeling peace in your hearts.