January 21, 2009

Kickin it up a notch

At this morning's monitoring appointment the sonographer saw at least four follicles per side with the largest measuring under 10. She said there were definitely more little ones hiding so I wasn't too concerned. Ignoring previous nurse's advice, obviously I was going to compare this to last cycle, when there were five per side all under 10 at the day 4 scan. So this didn't seem too far off to me, but they just called with E2 levels less than a third of what they were in 2007 at 58.3 (182 in 2007). I see now why the scan is not enough info and blood work is so important.

So we're increasing Gonal-F and Menopur and dropping the 5iu Lupron. In 2007 I was borderline for hyperstimulation. I didn't need to be hospitalized but I had some trouble breathing and other symptoms and went on a strict peanut butter, tuna fish and gatorade diet for three days. That combined with the fact that I had 16 eggs after 9 days of stims convinced my RE we could back it off a little this time and aim for a slower but steady pace, understanding that if monitoring revealed less than ideal progress, we would ramp it up a bit. And here we are. Increasing Gonal F from 225iu/day to 300, and Menopur from 75iu/day to 150. (This is now higher actually than my 2007 doses although I'm not sure how closely Gonal-F compares with the Follistim I used then.)

This further strengthens my belief that all those failed IUIs back in 2005 weren't just a waste of time afterall. I could have passed on the 3 Clomid cycles and three ensuing cycles cancelled due to cycsts (due to Clomid), but I really believe we got the meds just right on IVF #1 because we'd already learned a lot about my response on the IUI/injectable cycles. It turned out we needed ICSI to fertilize, but having the right response from the start certainly helped a lot. If we hadn't had such a great follicle response we might not have had enough eggs for the rescue ICSI to have saved the cycle.

I'm fairly confident that increasing the meds will do the trick, especially since she definitely saw more than four per side already. Now I'm just hoping we don't go too fast because I don't want another brush with hyperstimulation. Also, I'm still very much hoping not to have ER before a major work commitment on Tuesday, so let's take it slow and steady in there okay guys?

12 comments:

Jamie said...

I think I had OHSS my first cycle too. Definitely not something you want if at all possible.

It sounds like you are on the right path this time though! :)

Valerie said...

Wow this all is happening so fast. OK maybe not for you but to me. I hope you manage to avoid OHSS this time.

Lorraine said...

Everything sounds good, despite the E2 levels. As long as the information is there it's amazing how much can be manipulated. And it does seem that a lot of early treatment is basically fact-finding - I wish I had known that back when I thought a few IUIs would solve my problems!

Good luck with the slow and steady course!

My Reality said...

Fingers crossed!

Mrs G said...

I don't really know much or understand much about IVF, but it sounds like you and your doctors are all over it. Sounds positive.

Maredsous said...

I agree that knowing how you respond and knowing your body is an important part of the process. It is also great that your clinic is changing your stims to optimize the best response.

Here is hoping you all the best.

lostintranslation said...

Thanks for stopping my at my blog and letting me discover yours in return! Good luck with this cycle, I hope it all works out great.

Kate said...

I will be sending you lots of 'slow and steady' vibes. Hopefully increasing the meds will increase E2 just enough--but not too much.

Cibele said...

Thanks for the info

Cibele said...

Thanks for the info

Furrow said...

woosh! that was the sound of all of this going way over my head, but I've got my fingers crossed for you.

Grade A said...

It sounds like you are in a good place about everything. Maybe you don't need that map after all...

Good luck!