A kick in the head

       
I'm sorry it's been so long since my last post.  Unfortunately we don't own a laptop, so our only real Internet access over the last few days in NYC has been my iPhone, which seriously sucks for typing anything more than a few sentences. 

Anyway, so much has happened I've been struggling with how best to communicate it all.  In the end it seemed easiest to just do a day by day synopsis, so here goes (in Reader's Digest version):

Tuesday
In the midst of packing, I get a call from Dr. T.  He wants to reassure me that he's keeping a close eye on my situation even though he's only seeing me by way of my local doctor's ultrasound pics.  I'm actually feeling OK until suddenly I realize the real reason he's calling.

Because things are going really, really badly.

As in, "don't worry, there's still a chance we won't have to cancel you," badly.

Oh, um...OK.

I guess somewhere in my delusional mind I was still thinking of this as just a slowdown--something lots of women experience.  Nothing to worry too much about.  The growth rate will definitely pick up again in a day or two...

How is it possible that I allowed myself to forget the central premise? Never, ever underestimate the extent to which my uterus, ovaries and pretty much every other aspect of my under-achieving reproductive system are totally eff'ed up. 

OK, point taken.  We may be cancelled.  There's nothing to do now but head for NY and hope for the best.

Wednesday
As per Dr. T, we must have at least one follicle at 16 or larger to avoid cancellation.  We sleep late, enjoy a long leisurely lunch, and head for the doctor's office on Wednesday afternoon.     

Sixteen, sixteen, sixteen.  Maybe if I say it over and over again in my head enough times, it will happen?

"Who's been doing your ultrasounds?" the doctor asks as I'm laying on the table.

"Um, the nurse at my old RE's office?"

"Well, you have one at 18."

Eighteen!!  Eighteen!!  Woohoo--we made it!  See, my ovaries aren't so bad.  They may not be great, but at least we got......

"And three endometriomas."

"Huh?"

Yes, that's right folks.  We never had four follicles to begin with, which probably explains the wonky growth pattern.  The nurse was measuring endometriomas and calling them follicles.

Six-hundred to seven-fifty IU of  pure FSH per day, $1000 in Ganirelix, 7 ultrasounds, 13 butt shots, a full week off work, plus an expensive trip to NYC, and my ovaries rolled over, yawned, and produced exactly what they produce every other month.  One egg.

We leave the doctor's office and head straight for Soho where, within twenty minutes, I've purchased a $200 pair of sandals.

Take that, universe.

Thursday
Given my exceptionally poor response, and the fact that we have no insurance to cover repeated attempts, Dr. T believes we may need to modify our approach.  He suggests that we consider switching to a package of natural or mini-IVF cycles, which cost considerably less and--given my track record--seem likely to yield a similar result.  Our choices are as follows:

1) Cancel this cycle completely and try again with a different high-stim protocol.  

Pro:  This was the first time my body has ever been exposed to stims.  It's always possible that a different protocol could yield a better result. 

Con:  We'd be paying full price for a cycle that could--again--yield only one egg.  Dr. T is skeptical that a different high-stim protocol would be any better.  I tend to agree.

2) Cancel this cycle and move immediately to donor eggs. 

Pro:  A much better chance for a take-home baby, in what's likely to be a much shorter period of time.  Could ultimately be cheaper if my own eggs are doomed to fail.

Con:  Expensive and my eggs remain untested.  Could they have worked?  We'll never know.

3) Retrieve our one egg and consider this cycle the first in a package of 3 natural or mini IVFs.  

Pro:  If it works, the cost is much less. Given my beta-3 integrin problem, it seems fair to assume my eggs have never been tried in an environment that would actually allow them to succeed. We know the quantity is low but could the quality still be passable?  This would be our chance to find out.

Con:  The odds are low.  Moving straight to a donor probably makes better financial sense.

After much debate and discussion, we reach a decision.  As ridiculous as it sounds, I don't want to give up on the one lone egg we've worked so hard for.  I can't deny the lure of easy pregnancy with a donor but at the same time, I just can't let go of the idea that my own eggs have never been tested.  We decide to move forward with retrieval and the mini-IVF 3-pack.  I trigger that night.

Saturday 
I wake up from retrieval in a lot more pain than I had after sclerotherapy.  I'm bleeding copiously and the anesthesiologist has to increase my pain meds.  Luckily, the worst of the cramping dies down after an hour or so, and we leave for home.  It's now just a waiting game to see if my one poor egg can make it to freeze.

Sunday
The phone rings and I'm still in bed, exhausted from the day before.  It's the nurse, calling to tell me our lone egg has failed to fertilize.  Even with ICSI.

I've had so little hope from the beginning.  Why does it feel like the universe has knocked me down and now is kicking me in the head for good measure?