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.

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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.
4-7	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.
8-10	Reduced count. Higher than average rate of IVF cycle cancellation. Slightly reduced chances for pregnancy success as a group.
11-14	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.
15-30	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.

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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.

Be careful what you wish for.

Disclaimer: There are no pictures in this blog entry. I didn't write this to entertain. I cried almost every second I was typing. This isn't about being bitter, this isn't about being sad, and it most certainly isn't about trying to make people feel better about what we're going through. This is about life. Real hard honest painful unfair life. If you're looking for funny pictures and entertainment, you're going to have to look elsewhere.

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Be Careful What You Wish For

When we got our male factor diagnosis, I cried. I told my husband that I would rather have something be wrong with me, so this didn’t have to be on his shoulders.

What an idiot I was.

Since I was a young teenager, all I have ever wanted in the world is to be a mom. All I have wanted to do is to take care of my babies. Raise them and have the best family I can have.

Now I’m 34 years old… and I’m being faced with the possibility that we might never have that family.

3 weeks ago, I found out that our first IVF cycle failed. I knew that I didn’t respond the way they thought I might. I knew that our embryos were pretty sub-par. But I also KNEW that I was over-suppressed from the lupron. I KNEW that with a different protocol, I would respond better, and my eggs and subsequent embryos would kick ass.

Dr Z had other ideas. Half way through my stims, he became convinced that I had diminished ovarian reserve (DOR), AKA really old sucky eggs. He said that if this cycle didn’t work, he was going to do some additional testing.

But I KNEW it wouldn’t be necessary.

I was so wrong. About everything. And as usual, Dr Z proves why we picked him as our doctor.

The tests came back. My AMH is 0.5. That sucks. It worse than sucks. It’s sucktastic.

He says that he's not ready to throw in the towel YET. He likened my ovaries to a baseball team. He said that I have the players, but it was difficult to tell what condition they might be in, and how many might be on the bench. I said, "Great, I'm the New York Mets" (and honestly, after being a Mets fan for my whole life, I should be used to the disappointment).

Dr Z said now that he knows what the problem is, he can treat me more appropriately. He said my ovaries are a lot older than I am... probably about 42 or so… and now he has to treat me like that. He wants to see how I respond to a new protocol (my nurse should be calling me later today with details). But he also said that if this next cycle doesn't work, his recommendation would be donor eggs (DE).

My husband and I had already had a LONG talk the morning before we spoke with Dr Z about where we were going to draw the line. I finally know where he stands with all of the options, and I'm relieved about that. He's okay with DE, but not donor sperm. Okay with domestic adoption, but not embryo adoption.

We won’t move on to DE until we get a second opinion. So, if IVF #2 fails, we plan on probably getting two second opinions: one at Colorado Center for Reproductive Medicine (CCRM), a leading center for ART, via phone consult and another at a leading medical center in Manhattan. Following those, we'll probably be moving onto DE.

However, DH is convinced that now that we know about these issues, IVF #2 is going to work.

I'm going to start acupuncture again, start seeing a chiropractor and we're going to try to go to an infertility counselor, because i'm really depressed. The IVF not working was bad enough - now I’m a devastated mess. There hasn’t been a day without crying since I found out. I don’t know how much more I can take.

There’s no question now that I’m in good hands. Dr Z clearly knows what he’s talking about. I can't imagine many people would have looked at me last cycle and said DOR. I thought I was just over-suppressed, but he saw my response and said, “Look, even with your normal FSH and normal antral follicle count (AFC), something is wrong here. This isn't because of medication. We need to run more tests.”

He was right. I hate it - but he was right.

He also said that my blood work came back positive for the genetic mutation MTHFR. I’m going to find out exactly which mutation tomorrow, when I get copies of my blood work. Dr Z says I don’t have to take any blood thinners, but he has me now on very high dose folic acid. I’m taking a total of 5mg daily. He says that he needs me on it for 4 weeks before we can try again, so we can still plan on cycling for March. I’ll have to continue taking the high dose folic acid as long as we’re TTC or pregnant… which right now feels like the rest of my life. Another complication of MTHFR is elevated homocysteine levels. However, my homocysteine levels are normal.

I’m sorry that this was so long. It’s all the information I have. I feel like all of my dreams are slipping away from me. It’s very easy for people to say “oh, it’s not bad news” and “oh there’s still hope” but this is the end of the world for me.

I’m 34 years old and my eggs are crap.

The worst thing about this is the not knowing. In the beginning, my evaluation was normal. Every single part of it. Dr Z says these tests are really expensive and the insurance companies won’t pay for them unless they can be shown cause, which the failed IVF cycle gave us. I wish we had known about this 2 months ago. Or 7 months ago when we went through our initial testing.

And I hate what this has done to me. EVERY girl I see whose only diagnosis is MFI, I think to myself “that’s what you think” or “for your sake I hope so”.

Because up until 2 days ago, MFI was my only diagnosis too… and I had all the hope in the world.

Now it will be a miracle if I can even use my own eggs.

From the top to the bottom in one phone call.

Be careful what you wish for.