So here's the latest...

I realized today that with all my whining about early morning appointments and money and broccoli juice, I really haven't said much about where we are in our cycle, so it probably would be good if I provided an update. 

I think I mentioned the baseline ultrasound I had a week and a half ago on CD16.  Luckily the doctor didn't find any cysts (other than my ever-present endometriomas, of course) and my progesterone levels looked good, so we were cleared to start the Estrogen patch, which I was expecting to do for the next 10 days or so until AF showed up.

Ha, ha--wrong!!  Four days later, AF arrived. 

Yes, that's right folks, if you're doing your math that was a 20 day cycle. For the record, I don't really know what that means but I'm pretty sure it isn't good.

So the doctor had me come in again on Day 3 (last Thursday) for another ultrasound and, to make a long story short, I already have a dominant follicle that's measuring at 12mm.

Now given my history of short cycles, I'm not terribly surprised.  The last few years, I've been ovulating earlier and earlier.  I'm sure the whole problem has something to do with aging, but so far no one has really been able to explain (to my satisfaction, anyway) the exact reason why it happens.

In any case, the result was a fairly abrupt change in plans.  Instead of starting stims as I should've this week, the doctor added Ganirelix to my daily regimen of estrogen patches, and it looks like I'll be taking it from now till retrieval.  The point of the Ganirelix is to degrade the 12mm follicle, so we'll be back to baseline and don't have to worry as much about a dominant one.  I'll go back for another ultrasound this Thursday and hopefully at that point I'll be ready to add the Femara and the Gonal-F.  Tentative target date for retrieval--May 10. 

Of course, Ganirelix would be the one drug my insurance only covers at 50%, so that little change will cost us about $500 but hey, what's another $500 when you've already spent $12,000, right? Ha!

Isn't it odd that insurance would cover IVF meds when it doesn't cover IVF?  I can't quite figure out the logic behind that one but I guess I won't complain since the Gonal-F alone would have cost us $6,000.  With the insurance, we paid only $35.

Anyway, I guess this means we're now doing a modified Agonist/Antagonist Conversion Protocol (A/ACP).  Has anyone else ever tried this approach?  If so, I'd be curious to hear your experiences.  From what I've read, it's a protocol SIRM developed and likes in particular for poor responders (why does this term feel like the medical equivalent of a dunce hat?).   

In other news, I think we've finally decided to go forward with (gulp) a 3-Cycle banking package at our clinic.  As it stands now, we've paid for a single cycle but we have until the day of retrieval to change our minds and write another big check for cycles 2 & 3.  Of course, that won't be the end of the expenses because we'll also have to pay for ICSI x 3 (extra) and CGH (lots extra) but the remaining expenses would be spread out a bit more over time.

The up-side of all this is that I'm feeling a little less stressed about our current cycle.  While it's far from a sure thing, succeeding in three cycles seems much more within the realm of possibility than having to succeed in only one, right? (Can you hear me trying to convince myself?)

The downside is I'm feeling a lot more stressed about money--particularly the amount we'll be losing if we fail.  Not to mention, we most certainly won't be taking any vacations this year (ouch).  Or working on the house (big ouch).  Or buying any new clothes (really, really big ouch).  :(

But with the CGH at least we'll know before shelling out for an FET whether we have anything viable. 

And if it so happens that we're out all that money with nothing to transfer, at least I won't have wasted my time sweating through 3 months of medically-induced menopause.

That's something, right?