Wednesday, March 28, 2012

Overwhelmed. (IVF Consult De-Brief)

Ok, I'm overwhelmed.  I kind of hoped I was just dealing really, really well instead of holding some major fears deep down, but unfortunately, the latter is true.  (Personally, I hate the terms latter and former.  Every. Single. Time. I have to go back and figure out which one refers to which item.  Annoying.)

Because I am overwhelmed, I was unable to write this last night.  Just too much information to process.  I think I'm ready now, but I'm hoping it won't be just a confusing mess of thoughts and details.

I started to kind of freak out on my way to the appointment.  Muscles tight, slight shortness of breath.  But nothing too major.

We had to watch a stupid video at the beginning for like a half an hour, but it did cover all of the basics.

Then a lady came in to go over our calendar and protocol.

Here it is:
  • Continue Estrace 
  • Start Provera on 4/9 (with Estrace) - 10 days
  • Baseline Ultrasound 4/20ish
  • Start Bravelle 150mg with Menopur - 8-15 days
  • Start Cetrotide with Menopur - (7ish days after starting Bravelle)
  • Estimated Retrieval - First week of May
At the end of the appointment I completely blanked.  I had no questions.  

Part of the overwhelming feeling is it being "really-real."  Every month I have hoped to get pregnant, but now it's like literally planning a baby.  For some reason that feels different to me.  I think it's because I really will be expecting a positive i.e. a negative will be a shock whereas it was the opposite for the last 12 months or so.  (At the beginning it was different...I expected the positive.)

I'm also a bit upset about the timeline.  I am very tired of waiting.  But also, I've set it in my mind that I wanted to be pregnant by my sister's showers, as I wrote about here.  This puts me right in the middle.  There is a possibility to move things up a week, but there is a chance I will have my retrieval and/or transfer with my doctor out of town.  (He's gone on Monday of one week and then Friday through Monday of the next.)

Advice please:
What should I choose?  

Move everything up a week and potentially not having my doctor, but almost definitely know the result before the showers?


Keep everything the same and be in the two week wait during the showers?

Knowing that I am pregnant will obviously be easiest.  Not knowing yet will be second easiest.  Knowing that I'm not will make the showers very, very hard.

I emailed the office when I got home last night and asked the following:
  1. What is the reasoning behind no Lupron? 
  2. Am I on an Antagonist Protocol?  (I've gathered that no Lupron (with Cetrotide later) is the antagonist protocol.  It was originally given to "poor responders" or people with diminished reserve, but it seems to be more common among many people.  Please correct me if I'm wrong but Lupron suppresses the system and the gonadotropins stimulate it.  Sometimes you need more stim after Lupron to get everything going again.)
  3. Why am I on Estrogen instead of BC pill.  (I guess this is my RE's new protocol.  I've seen "Estrogen Priming" around the internet, but don't know if that's what this is or not.)
And I also asked to see if we can move things up as much as possible.

Oh and about the success guarantee.  My new FSH is 10.6 which is borderline high.  Technically that does not meet the guidelines for the guarantee.  But since everything else is within bounds, and since they it's "business" it sounds like they'll still do it for me.

Here are my other test results for reference:
Estradiol: 34.3
FSH: 10.6 (previously 8.5 - July)
AFC: 16
AMH: 4? (still waiting on new result - I don't remember ever having it tested, but they have one??)
TSH: 2.84 (July)
Prolactin: 8 (July)


  1. It is totally normal to feel overwhelmed. I definitely felt like fish our of water during our IVF last month. You'll feel like you have a better handle on the information as time goes by.

    I am also on an antagonist protocol this time. And I don't have low reserve issues. The way it was explained to me, some women just respond better to one protocol over another, and they don't fully understand why. It's worth asking why they chose this protocol first if it will ease your mind at all.

    I am on the BCP, but I think it contains estrogen, and maybe a tiny bit of progesterone? Good luck! I hope your questions are answered soon.

    1. I will definitely ask why and then let everyone know.

    2. The first time they did up a protocol and were going to have my IVF #1, I was 29 and 9 months, and they had the same protocol they gave you for the stims (I was on the Pill before, not estrogen) with no Lupron. The second time they did up a protocol and were going to have my IVF #1, I was 30 and 3 months and they had changed to a protocol that included Lupron (which kinda annoys me because it's only a 6-month age difference and I was hoping to avoid Lupron from what I've heard about the side effects!) So definitely still ask, but my guess is because of your age, since me crossing the 30-year mark was the reason they gave for the change in my case.

      Also, I would suggest being in the 2ww during the shower, especially since you're expecting a positive. I don't know if I'll be able to describe myself as Pregnant Until Proven Otherwise during my 2ww, but it sounds like you may be able to, and that's a good mindset to be in for the showers.

  2. IVF is an overwhelming procedure. Lots of drugs, lots of time points and all of it needs to be done on a specific schedule. Add in the fact that most protocols are around 2 months and I can't imagine someone NOT being overwhelmed. I actually ended up dividing my meds into separate containers with "Do not open until X" for each of the different parts of the cycle. A couple of days before switching to the next phase, I would re-watch the videos in order to remember what I was suppose to do. It helped lower my stress levels, but I'm also an out-of-sight-out-of-mind kind of girl.

    It sounds to me like you're on an estrogen priming protocol. The whole point of this protocol is to help protect egg quality while allowing you to stim longer. In short, you're going for quality eggs.

    Regarding whether to push things up a week. Well, that's really up to your body and how you respond. I completely understand wanting to make your goal of being pregnant at your sister's baby shower, but I would also be prepared for not having the results by then. Unfortunately, biology usually has it's own agenda and it rarely follows our own.

    Hang in there. I'm hoping this cycle brings good news and joy!

    1. Thanks for the detailed response! I realize that once I start I have very little control over the actual it's just whether I want to give myself a chance to have it done by then. I've been on Estrace for about 2 weeks already. I don't know if it matters how long I'm on it before starting, I'll have to ask.

  3. What I've learned is don't try to manipulate life around fertility, or the other way around. Things just happen as they should, and changing the dates may stress you out in the long run. I would definitely want everything to go as planned with my doctor.

    I think it would be nice not to know at the showers. You can be positive and happy and know that you have a little bun baking and you'll be mommy soon, and if the worst happens, the showers are over and you can deal with it on your own later without social obligations.

    I hope you find some peace with your decision and feel good about it because that is the most important thing about going into a cycle. Just making sure everything feels right and you're in a good head space.

    Good luck :)

    1. Thanks. I think I'm ok with stressing about the dates a little this week. But when it's set, I'll totally let it go. I also don't want to totally plan my doctor and have that not work out anyway since there are always changes and things that come up. So I'll see what they say and then it is what it is.

  4. I agree 100% with Lanie. Don't try to plan life around fertility it just makes life more stressful. And I also think it would be nice to be in the hopeful 2ww during the showers, you won't be depressed but you also won't be busting at the seems ready to tell everyone your secret if you should be pregnant. Good luck!!!

  5. This is a quote from the response I got from the IVF coordinator about the protocol.

    "Yes, cetrotide is an antagon so you are on an antagonist protocol. Our physician’s prefer it over the Lupron primarily because it is much easier for patients. With Lupron, you are taking it approximately 10 days before you start your stimulation injections, adding 10 days of shots. With an antagon, you take it 1-4 days while on the FSH (so you will have 2 injections a night when it is ordered.)Dr. --- likes his patient’s on estrace instead of birth control pills because there are studies that demonstrate birth control pills over a long period of time can affect the endometrium adversely, while estrace does not."

  6. I agree that knowing you are pregnant would be the easiest of the situations with the shower - but being in the TWW, especially knowing that there is a good chance you are pregnant would be ok too. At least you could possibly enjoy the shower with the idea that you're right ther with her... even if you didn't have results. I don't know about you, but during the TWW I get really hopeful and really set on the idea that I"m pregnant.

    Good luck with the decision.