July IVF – CD9 – Update

Well my scan went just as expected.

Doctor B said my ovaries were very busy (meaning lots of small follicles and cysts were visible on both) but nothing much had actually happened since she saw me last. None of my follicles have really grown at all, except for one on (I think) my left side which is measuring 9mm. It needs to double in size before anything can be done with it.

At least I’m hoping it was my left side, and my poor memory is not playing tricks on me, because that ovary is attached to my unblocked tube. Or at least it was unblocked 6 months ago. I had surgery in January to remove endometriosis and treat my PCOS, and while I was under anaesthetic they performed dye studies on my fallopian tubes. My right tube was blocked and could not be unblocked, but my left was only partially blocked and able to be cleared. I know there’s a chance it could have completely blocked itself by now.

Doctor B said we will keep stimming me with 100iu Puregon each day and I’m to come back on Monday morning for another scan. We will then decide what our options are. At this stage it’s looking unlikely I’ll be able to have an egg pick up this cycle.

The good news is Flo (the unfortunately named nurse) stocked me up on more Puregon and Orgalutran. Enough to see me through until Monday. She didn’t seem at all upset about the fact I’d wasted an entire vial of Puregon. I’m so lucky to live in a country where these medications are so heavily subsidised by the government.

If that follicle on my left ovary keeps develping but none of the others do, Doctor B said we might consider ovulation induction. It’s not a definite possibility yet, because she is concerned about the chances of infection. This is something that’s never actually been considered for me before, given the severe multiple factors causing my infertility. My chances of success with ovulation induction would be extremely low, but a low chance is better than no chance at all if we can’t even progress as far as egg pick up.

Assuming I don’t get pregnant, we will rest my body for a few months before starting another IVF cycle and this time only marginally increase my FSH dose (Doctor B described the future increase as one click of the epi-pen). Doctor B is extremely hesistant to increase the dose too much, given my past history of OHSS and the severity of my PCOS.

Doctor B is also concerned about the amount of stress my body is currently under. In the past 6 months I’ve been through major surgery, a cycle of IVF where I had 34 eggs picked up, “moderately severe” OHSS, an FET, a pregnancy which ended at 5 weeks, 3 days and now I’m on my second stimulated IVF cycle. She is concerned this is what is causing my memory loss and general spaciness.

The doctor said repeated cycles in a short space of time, where high doses of hormones are used, can cause memory problems. I’m thankful she has confirmed for me that I’m not going insane, which I originally feared to be the case. Memory loss I can deal with, insanity I can’t (or maybe that’s the other way around…).

We also had a chat about using frozen sperm. I explained that Doug has to travel most of next week, and his boss is being inflexible about him coming home to Melbourne when he is beckoned. Doctor B was much more understanding this time, and agreed we definitely need to be freezing a sample just in case.

Unfortunately she said every clinic is different, and this particular clinic has a low success rate with frozen sperm. Assuming we get to egg pick up she said we can still try IVF, however there’s a fair risk that none of the eggs will fertilise because the frozen sperm are slow swimmers. She said if we end up needing to use frozen sperm her advice is to go with ICSI again, though she is happy to take direction from us on this matter.

Doctor B knows ICSI is something I am against, based on recent studies (more info can be found here: http://www.bloomberg.com/news/2013-07-02/rare-in-vitro-technique-raises-autism-risk-study-says.html) that suggest when using ICSI there is a 4.6-fold increased risk of autism, and more than twice the risk of mental disability, compared with regular IVF.

My doctor strongly agrees that ICSI should be avoided if possible, and I am quite upset with my previous clinic for never warning me of any potential risks. In fact, quite the opposite, they assured me there are none. Doctor B said some clinics are quite dishonest, and use ICSI as their standard approach for no good reason. Some clinics have an ICSI rate of up to 90%. Our clinic’s ICSI rate is only 40%, as it is only used in cases where absolutely necessary. I think that’s the way it should be.

Where to next? Doug is currently at an expo for work about 3 hours drive away. He wasn’t meant to be home until the weekend, but now he is coming home early tomorrow to make a “deposit” at the clinic for the scientists to freeze. Then it’s just an anxious wait until my next scan on Monday morning.

I guess through all of this I’m coping ok. After I left the doctor’s office this morning and I was driving to work, I started to get bad chest pains, which I can only assume was the start of an anxiety attack. There were a few moments when I thought Is all this for nothing again? Am I going to come out of this empty handed again? Why am I putting myself through this whole ordeal? I tried to use some calm breathing techniques and slowly the chest pain went away.

I also feel very guilty that poor Doug has to drive home in a panic tomorrow morning because my ovaries aren’t responding as they should. If my body had cooperated, we’d be going to egg pick up on a day when Doug is in town. No one really bothers to worry about the impact all of this has on him, the focus is almost solely on me.

I know there’s no point in dwelling on any of this. I need to stay calm and positive, but that’s easier said than done given my current circumstances.

I’m sorry this update has been terribly long, sterile and boring. I’ll try and update properly tomorrow and fill you in on some of my experiences over the past week, particularly the way my memory has been wreaking havoc on my life. That is to say, I’ll update if I remember. 😉

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