Sunday, May 16, 2010

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):

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.

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."


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.

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.

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.

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?


  1. The first series of words that came to my mind was:

    Chit. Chit. Chit.

    There are no other words. I'm glad you gave it a go with this one egg, though. After working so hard to get that far, I think you needed to know. I just wish it wouldn't have worked out this way.

    *sending love*

  2. Julize - I'm so very sorry to hear about this. :-( it just sucks so badly that this is happening to you. It sounds like you had a lot of hard decisions to make and I think I would have gone for retrieval too. I'll be thinking of you and hoping you take care of yourself over the next few days as you deal with this.

  3. I'm so very sorry to read this. My jaw hit the floor when you said 'three endometriomas'. Not to mention the rest of the story...sending a big hug to you.


  4. Oh my gosh, my heart aches for you. What an emotional week you've had. I am so frustrated for you that the endometriomas were mistaken for follicles.
    I really think that you made the right decision though, I would have wanted to continue with the cycle as well considering how hard you worked to make it that far.
    What exactly is a mini ivf? I know there are no guarantees, but I have to agree with you that you were probably just put on a protocol that didnt work for your body and it is definitely worthwhile to try again with a different mix of drugs/protocol as that can make all the difference in this game. Donor eggs will always be there but I think you need to know that you've given your own eggs a decent shot first. Whatever you decide will be the right decision for you but I'm so sorry that your cycle ended this way. Sending you big hugs and hoping you and your hubby are in a good space and looking after each other. It's so hard. x

  5. I'm so sorry. It really sucks - and that your local clinic mislead you like that. Ugh. I've never heard of mini-IVF, what does that mean?


  6. HUH??? I can't even believe this happened...I am so, so sorry! It's like the bad news gained momentum and kept on rolling - this is so crushing, pun intended.

    Question - you live outside of the city and are seeing a local Dr for monitoring and Dr T is directing your cycle, right? OR....? Who set up this last cycle protocol/med dosage?

    I think Dr. T can come up with a good protocol for you. I have a handful of friends going to him and they all seem to have "made-to-order" protocol - this is why I respect him so much, he treats the woman as an individual, not a number.

    So my question about intralipids - when do we have them done? Before the transfer and then after a (hopeful) BFP...right? It's just unclear how many times we'd get it done.

    Anyways, I am just sick about this past week and what happened with your cycle.

    I am here for you if you need anything, I'm just and email away...

  7. I'm sitting here speechless (commentless?). This just sucks so worked so hard, went through so much, not to mention the money. I cannot believe someone was measuring endometriomas as follicles--I'd make them refund your local monitoring money spent because thinking you had more follicles sent you to NYC...otherwise you might have canceled sooner and saved money.


    All I can do is say I know how it feels to be kicked in the teeth repeatedly by IF and it just plain f'ing sucks. I'm sorry and I'm thinking of you.

  8. I'm so, so sorry. I wish I could come give you a big hug. What a sucky weekend (besides the $200 shoes--I'm sure those were nice).

  9. OMFG. What a terrible week.

    I don't know how she could have mistaken an endometrioma for a follicle. Let alone three of them. The look totally different on an U/S screen. Follicles are dark (black on the screen) and fluid filled. Endometriomas are dark gray and look nearly solid to the untrained eye. Maybe that nurse's physician will reimburse you since you were mishandled by them? The least they can do is to pay for your meds.

    That SUCKS about the one follicle you have not fertilizing. Shit! How many mm was the follicle when Dr. T triggered you?

    Check on your insurance..maybe you have a bit of $$ left over? I noticed that Dr. T billed my insurance company for something like $13K for my IVFs (outrageous) but when I checked my benefit, I had loads left. So he has an agreement with my insurance (BCBS) that is pretty good.

    Well, if you are in town still, happy to meet you and the DH for a drink and give you both much deserved hugs over this.

  10. i cant believe that they were that wrong, and were measuring endo? wtf is that? im so so sorry julize, i can't even tell you how upset i am for you. i feel like a traitor now that we have had some growth :( but im with lastchance, you should definitely at least complain, and i hope it gets you somewhere. i just want to hug you, you must be just emotionally spent. i hope that you can pick yourself up and find your path again soon. ive said it before, but my doctor is awesome. actually has reversed menopause and gotten women pregnant. dr. jerome check. there is always an empty room at my house for you.


  11. That is fantastically insane. And not fantastic in the good sense. Sweetie, I am so sorry. Back to the drawing board? Honey, time for a new plan. There has got to be a way to make this happen for you without something like this happening again. Unbelieveable. Here to support you. (((HUGS)))

  12. Oh man, I am SO sorry. I can't even begin to imagine how much more complicated this would be with having to travel to another city for treatment. I'm sorry sorry sorry... I wish words could fix the pain and frustration.

    I'm trying a different stim protocol too to see if that makes any better response. So, maybe we will end up on the same schedule together.

    And ganirelix is really freaking expensive.

  13. oh my gosh, I am SO sorry this happened. FWIW, I would have made the same decision as you...

  14. I gasped out loud when I got down to Sunday. I know how you feel and the heartache & disappointment are unbearable. I think you made the right decision to try with your own eggs. Hugs to you during this very difficult time.