The Numbers, Good and Bad

I've gone in for blood draws a couple of times this past week. The news has been a mixed bag, although I do think the good outweighs the bad.

First, the bad: I had a CD 21 progesterone test, and my progesterone level was only 0.5. I was pretty sure even before the test that I hadn't ovulated, but then as soon as I got home, it became clear that CD 1 was on its way. The test result only confirmed all of that.

If I continue to not ovulate, that clearly puts a crimp in our plans to try naturally.

However, the good news: Since it's been 2 1/2 years since my last FSH test and CD 1 showed up, I decided to get a CD 3 LH/FSH test done. FSH was 4.1, LH was 10.3. That's a pretty typical PCOS ratio, which isn't great, but I'm too thrilled by the FSH level to be very bummed about the PCOS right now. (Apparently, somewhere in the back of my mind I keep hoping that maybe the PCOS will go away...)

At least that FSH lets me feel like I have a little bit of breathing room in terms of time. If I do start to ovulate, we will try naturally. However, I don't think we'll spend a lot of time on that approach if my eggs don't seem to be making regularly scheduled appearances.

I've been thinking some more about my consultation with 2nd Opinion RE. As much as some of his comments were totally thoughtless, I do think his overall approach to our case has significant merit.

Every time I've pressed Doc, he refuses to acknowledge (to me, at least) that perhaps 32 eggs were a few too many. He is also adamant that we should go with the same stim protocol as last time. I, however, do not see the merit in continuing to bang my head against the wall with the same approach while hoping for a different result.

2nd Opinion thinks that 32 eggs were too many and probably compromised egg quality, therefore leading to embryos that might have looked good but were likely chromosomally abnormal. He thinks Doc used a valid protocol (4 vials for the first 2 days, then 3 vials per day after that) given the information he had to work with and the fact that it was my first IVF, but at this point he would recommend an even slightly lower dose of stims and would aim for significantly fewer eggs. I feel much better about that approach, because everything I've found in my research says 32 eggs are too many.

So now hope is sneaking its way back in, and we may be doing another IVF sooner than we planned, though it will still likely be late spring at the earliest.

Random Thoughts...

There seems to be a constant mish mash of thoughts running through my brain lately, and every once in a while one of them makes me think "I should blog about that." So here they are, in no particular order.

...on Stupid Things REs Say

I'm still processing last week's consult with 2nd Opinion RE. A couple of things I didn't mention in my last post:

At one point, he said, "As long as you're having miscarriages, I'm happy." I mean it - he actually uttered those exact words. "I'm happy." Are you nuts, too?? I wanted to ask. He must be, because a sane person can't possibly think that's a smart thing to say to a cynical, bitter RPLer. But then again, maybe he figured it was safe since he's 300 miles away and I couldn't exactly smack him through the phone's airwaves. I know what he was trying to say, but there's a better way to word it.

At another point in the conversation, he also compared my five miscarriages to foul balls. Technically, yes, they are strikes, he says. But even if you have 10 miscarriages strikes, you're still up to bat and you should keep trying. Yes, that was meant to be encouraging. Really.

...on Clothes Shopping with 50 Extra Pounds of Infertility Flab

For a very brief time in my life, when I was starving myself and consequently a lovely size 6, shopping was fun.

I ventured out today to try to find clothes for a couple of upcoming occasions. All I can say is What the heck are fashion designers thinking these days??

The item I have the most difficulty buying are pants. Now, please understand that I'm realistic about my size. I'd be lucky if that slinky little size 6 red dress that I had 10 years ago would fit around one of my legs with much room to spare at this point. So I don't go trying on size 10 pants when I'm, well, not a size 10.

I ventured into the dressing room with about 5 pairs of pants, and came up with the same results on all of them: Pant legs with enough extra yards of material at the bottom that a search party sent to find my feet would still be looking for them two days later, while around my waist, stomach and hips I look like a stuffed sausage about ready to explode from its casing.

My ankles don't need that much material - they aren't THAT big. So, fashion designers, please take note: Shear off some of those extra yards of fabric around my feet and move them about three feet north, where I could really use the coverage. And while you're redesigning them, could you also please figure out a style that makes me look about 30 pounds thinner? Thanks.

...on The 'Let's Try Naturally' Approach

Yes, well, about that. In order to try naturally, you need an egg. And an egg is something that my body does not seem to be in the mood to make these days.

I had an 18 day cycle last month. This month, I decided to do a CD21 progesterone blood draw to get a sense of what's going on, because I didn't see strong signs of ovulation. I got poked yesterday morning, then came home, went to the bathroom and saw blood when I wiped. It hasn't been enough to call it CD1, but still, this does not bode well.

Maybe it's just taking my ovaries a while to adjust to an infection-free environment after all the antibiotic treatment. Let's hope, anyway.

There's more, and I know you're all waiting with baited breath, but I'm going to try to get to sleep at a decent hour for once, so that's all for now...

Hope Hurts

Hope shouldn't hurt, but somehow it does.

Even though we're not planning to start trying again for a couple of months, and we plan to try naturally at that point, I went ahead and had a phone consult with another RE this week. I wanted to get a second opinion, and I figure it's best to be prepared in case I don't seem to be ovulating regularly or R's numbers come back low when he retests at the beginning of the year.

2nd Opinion RE said all the right things - he doesn't think my age (33) is a concern, he thinks I'll respond well (based on 32 eggs retrieved in July 2006), he thinks our issues have been chromosomal due to too many eggs being retrieved and that that's easily corrected with a slightly lower stim protocol, he thinks it's a good sign that I've been able to get pregnant so many times, he thinks I'll be able to carry to term with a healthy embryo, he thinks it will happen for us.

All of those are very encouraging things, and I'm grateful for them. But (and isn't there always a "but" with me?) as odd as it sounds, part of me was also sad after speaking with him.

To be totally honest, in some ways it would have been easier if he (and Doc, and Antibiotic Doc, and Ob/Gyn) had said "I'm sorry, but you're not creating good embryos, your chances of creating good embryos are nil, and you should just give up because this isn't ever gonna happen for you." At least then I could begin to accept that and move on. It's been 5 long, painful years. At this point, if he (and the rest of the bunch) had a general consensus of something like that, I think I could be ready to hear it.

But they don't. Instead, they're all sunny, optimistic cheerleaders about our case. They all say that we're so close, that we're way too close to give up, that we should definitely keep going.

When you've been doing this for a year, that's good news to hear. That's motivating and encouraging. When you've been doing this for half a decade, as strange as this may sound, it's painful and even a little bit scary to hear.

Because instead of the ignorant optimisim of a newbie who thinks "They say our chances are good, they say this is going to work, soon we'll be holding a baby - yea!", a beaten down, loss-ridden vet thinks "They said that FIVE. YEARS. AGO. Clearly they don't know what they're talking about. Do we have 5 MORE years of losses and heartbreak in front of us before this purgatory ends?"

And sadly, the only way to find out is to keep going.

I know I could opt to throw in the towel now, that no one is physically making me continue. But there is a part of me that still has hope. Granted, sometimes it feels like such a tiny part of me, so small that if hope was a visible thing it would require a high-powered microscope to see at this point. But still, it's there. And even if it wasn't, I still want this for R, so I would keep going for that reason alone.

I just never knew that hope could be so painful.