February 21, 2010

There, but for the grace of Tampax, go I.

Ah, to be in the house of Dandelion.

I'd love to say that the road to IVF #2 is fraught with blood, sweat and tears - but mostly, it's just blood.

I've been on my favorite devil pills for 6 weeks now. I just started pack number 3 of the desogen. At least I know I only have to take 5 pills from this pack - because my last devil pill will be this friday. Usually, after you stop taking the devil pills, you expect a period. However, i've already been bleeding for almost 3 weeks. Isn't it just fantastic? Usually, the ONLY benefit to BCPs is NOT bleeding. Not in Dandelion land... not this time, anyway. The good news, is that my IVF nurse says I might not bleed like I did last time i came off the devil pills, since i've been bleeding for so long. But I've been through almost 5 boxes of tampons. So, enough is seriously enough already.

I had my baseline ultrasound this past wednesday. The good news: my antral follicle count is 11. So - that's not great - but it certainly doesn't suck. Our only question is how many of those eggs aren't geriatric. I guess time will tell. I found this chart (below) online... explains a little bit more about AFCs. I think my AFC last time was 14 or 15.

Total number of antral follicles
Expected response to injectable stimulating drugs and chances for IVF success
Less than 4
Extremely low count, very poor (or no) response to stimulation and a cancelled cycle expected.
Should consider not attempting IVF at all.
Rare pregnancies if IVF attempted.
Low count, we are concerned about a possible/probable poor response to the stimulation drugs.
Likely to need high doses of FSH product to stimulate ovaries adequately.
Higher than average rate of IVF cycle cancellation.
Lower than average pregnancy rates for those cases that make it to egg retrieval. The reduction in success rates is more pronounced beyond age 35.
Reduced count.
Higher than average rate of IVF cycle cancellation.
Slightly reduced chances for pregnancy success as a group.
Normal (but intermediate) count, the response to drug stimulation is sometimes low, but usually adequate.
Slight increased risk for IVF cycle cancellation.
Pregnancy rates as a group slightly reduced compared to the "best" group.
Normal (good) antral count, should have an excellent response to ovarian stimulation.
Likely to respond well to low doses of FSH product.
Very low risk for IVF cycle cancellation. Some risk for ovarian overstimulation.
Best pregnancy rates overall as a group.
Over 30
High count, watch for polycystic ovary type of ovarian response.
Likely to have a high response to low doses of FSH product.
Higher than average risk for overstimulation.
Very good pregnancy rate overall as a group, but some cases in the group may have egg quality issues and somewhat lower chances for pregnancy.
photo credit

Okay - so the question on everyone's mind... what the heck is causing the bleeding? .... what about the fibroid? Here are the answers to those questions....

The bleeding, as far as they're concerned is just an unfortunate and messy side effect of the BCPs. They are 100% sure that it is NOT from the fibroid, because the fibroid "has not deviated the uterine cavity". In other words, my lining appears on the ultrasound as a straight line. If the lining were interrupted, because a fibroid had broken through into the uterus, the line would be separated, interrupted or deviated in some way. It is not. So, Dr Z is NOT concerned at all. Therefore, I am not concerned at all. However, there isn't just 1 fibroid anymore. Now there are 3. Nevertheless, as long as they all stay outside of my uterus, where they are now, Dr Z could care less, and isn't even considering taking them out. Totally works for me.

I also discussed another concern with him. It seems that the majority of girls I talk to have an ultrasound guided embryo transfer and all have had a mock embryo transfer prior to their cycle. I hadn't had either - and I was curious as to why. Mr DB told me just to ask, so at my appointment i said, "Dr Z, i'm in a support group (he doesn't like that I go online all the time, so i figured he'd take it better if I told him this all came from a support group), and some of the girls were talking about their transfer experiences. I was wondering why it seems that some doctors do mock transfers and u/s guided transfers, and some don't?" He was SO awesome with his answer. First of all, I DID have a mock transfer... it's just that mine happened during my retrieval while I was unconscious. That works for me! Then we talked about the u/s guided transfers.

Apparently, they did do them for about 4-6 months when they first came in vogue. However, their pregnancy rates dropped by almost 15% during that time. Dr Z said that it is a matter of learning new technique and personal preference. He said that in his experience, you can focus too much on the picture, and even a minor movement can cause you to lose embryos. Furthermore, he felt t he full bladder was very uncomfortable for patients. He said as soon as he stopped doing the u/s guided transfers, his pregnancy rates went right back up, so unless he has a patient with a particularly difficult mock transfer, he prefers to NOT do them.

As his pregnancy rates are already above the national average, without u/s guided transfers, I say, "if it ain't broke, don't fix it".

What 8 grand worth of meds looks like

So, where we are now:
  • Last devil pill will be this friday
  • Suppression check Friday, March 5th
  • Stims start, at max dosages, Friday, March 5th
  • 1st monitoring appointment Tuesday, March 9th
  • ER/ET will be the week of March 14th
This time it is going to work - POF be damned.


Barb said...

Hey cycle buddy! Your bcp issues sounds very similar to mine. At my suppression check, my RE was very surprised at the amount of bleeding I've had on bcp. I've basically had flow for the past 3 weeks - it's annoying. My ER is tentatively set for the 11th, so we're very close. My thoughts and prayers are with you. ~Babsie7

Dandelion Bud said...

Babs - isn't is SO annoying. I've been charting "spotting" because I didn't want FF to start a new cycle until I was off the BCPs, but i've been writing in notes the actual flow.

We're really close! I'm keeping my fingers crossed for both of us!

Sooz said...

Just wanted to drop by and say hello!

I'm also on an antagonist cycle and I'm 34. My doc also told me I have old ovaries (boo..). You did better than me at the antral follicle count -- I only had 9 little follicles.

I'm starting the stims tomorrow (225 follistim and 150 menopur). Wish us luck!!



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