I have finally had enough naps to get my brain working again. MrBeep and I went in today for our cycle review appointment with DocO. I had my spreadsheet with all of my lab values printed out and a few questions ready, along with a pen to take notes. DocO greeted us in the lobby and walked us to his office. He was really nice and started out by asking us how we were doing. We said we were doing fine and were glad to be there to find out more. He said that the cycle review is an appointment that they never want to make because they really want to get their patients the ultimate goal, a healthy baby. I appreciated that. He didn’t have to say it.
We got down to business. The biggest problem, he explained, was the fact that I had an LH surge early in my cycle. The Centrotide, just didn’t work on my body to suppress a natural LH surge. Unfortunately, the drug isn’t effective on a small percentage of people. (Why can’t I instead be in the small percentage that wins the lottery, or finds change in the couch cushions?) So as a review dear internets, I was put on the antagonist protocol due to developing cysts when taking clomid. I was beginning stimulation Day 7 of my gonal-f/menopure medication when my morning blood work showed the LH jump. DocO explained that something happens when LH surges that affects the eggs. You can’t delay once it happens because the eggs start to go to the next phase of their development. In the antagonist protocol, patients generally take stimulation medication from 10 to 13 days. Now if they have to trigger one day early, it’s no big deal. Two days early can have some problems, but you generally get good eggs, but three days early is a big problem. You want the eggs to get to a certain level of maturity before the LH surge happens. I was 3 days early. They didn’t really get enough time “to cook”. He said the fact that we got 10 eggs with 6 (relatively) mature and all 6 fertilizing was a really good sign. He also explained the fact that I got pregnant was also a very good indicator of future success. He said that the embryo that implanted was just not a good one (DNA wise) and that if it was, I would probably been able to stay pregnant and have a normal healthy baby. Next time we will hopefully have more fully mature eggs to start with that have had time to properly develop all the necessary bits to have better success. He said if we had been able to stim for a couple of days more, the outcome would have been much better, including maybe having some make it to Day 5 for better selection, or even have some left for freezing. I hope he is right.
So now on to THE PLAN. DocO suggested that we do a lupron based protocol next time. This is normally their preferred protocol and they have good success with it. There is no centrotide used in this protocol. He was very positive on the outlook and gave me a good prognosis. He isn’t sure if it will be long lupron or micro-dose. He said that they always talk through these things in a group meeting with all of the professionals present to get as much brain power on the cycle plan as possible. So we won’t know until we get closer to the date at hand. We are taking this month off at his recommendation (Yay! I get to visit my family in So. Cal.) and will start stimming in late July for an estimated August retrieval/transfer.
After the meeting, DocO walked us to the waiting room and we chatted about the books we are reading/listening to via Audible. He and MrBeep started to talk about their favorites and some military history books (DocO is a Navy Veteran), those two also should go on a playdate some time. DocO didn’t have to be his awesome nice self. I can tell he really cares. He could have just been matter-of-fact/doctor like, but everyone in that office is just wonderful. MrBeep and I knew this may take more than one try, we are still quite aware that we may never be successful, but all signs are pointing in a positive direction for now. I have read that many folks have problems trying to get their protocol nailed down with IVF #1 and later ones work out the wrinkles.
I left the meeting feeling SOOOOOOOO relieved. I didn’t do anything wrong (in terms of med dosage, monitoring, etc), my little monsters achieved so much despite the odds against them. I know they are hanging out for better raw material next time. My heart was light and fluffy. I am filled again with hope.