If someone had asked me the day I put my first post up 5 months ago what I think I would most likely be blogging about in the middle of October-I honestly would have said I hope it would be about being pregnant and how our first trimester tests were going.

Ha!!!

Had that person then whipped out the title of this post and said this would be what I was writing about today-I would have probably cried and puked in the closest trash can-and not necessarily in that order.  This is NOT the journey that any woman imagines when they think of starting a family.

Over the past 12 months our journey to becoming parents has cost us out of pocket  close to $7000 to loose a pregnancy as well as try to get pregnant again.  The tab our insurance has picked up in the same 12 months $38, 750.  It is no wonder I have not been able to add 1 cent to my “maternity leave savings fund” over the last year-because all of the money that was ear marked for that fund has now been diverted to the “get knocked up and hope the next one comes out alive fund”.

Each failed trying to conceive cycle right now is not only a kick to the uterus the day your period shows, but also a hit to the bank account to the tune of $300-500 bucks out of pocket to cover the co-pays for the 5-12 visits per cycle.  That’s not even taking into consideration the lost earnings from cancelling paying clients to make time for these visits nor the gas and tolls to get to the doctors.  What this essentially does is adds a whole other layer of shit that you weren’t anticipating to your already triple stacked shit sandwich that you have to eat the day your period shows up while digesting the idea that you have to do the whole damn thing over again (time, money, side effects from the drugs, waiting to see if you are preggo) next cycle because you’re still not pregnant.  The only thing that makes eating that shit sandwich over, and over and over again each month is the fact that you can at least wash it down with a bottle of wine.

That was a very long intro to paint the mental picture of where I am right now.  I am CD2, I ate my shit sandwich yesterday and have now moved on to what we need to do right now to get me pregnant this cycle.  Dr. G and her staff of incredibly nice and intelligent nurses at Brigham need to find out what my egg making potential is.  This is important because it is what they will use to figure out how much and when I will start injecting hormones to make these ovaries of mine start ripening up a bunch of follicles that will hopefully have some healthy mature eggs in them.  So this morning I was in the doctors office at 7:30am having blood drawn to see what hormone levels are at the beginning of my cycle, and to have an ultrasound done on both of my ovaries to see how many small follicles are visible.  They will take both my hormone levels from today’s blood work as well as my antral follicle count into consideration in order to try and predict how I will respond to ovarian stimulating drugs.

Again yet another fascinating visit for me because I learned that the number of antral follicles visible on ultrasound is indicative of the relative number of sound asleep follicles remaining in my ovaries. Each follicle contains an immature egg that can potentially develop in the future. So when there are only a few antral follicles visible, there are much less eggs remaining as compared to when there are more antral follicles. As we age, we have less eggs remaining, therefore we have fewer antral follicles on ultrasound.

Antral follicle counts are a good predictor of the number of mature follicles that DR. G will be able to stimulate in  my ovaries with the inject-able FSH (follistim or gonal-f) medications that are used for in vitro fertilization.

This is important because if the prescription medication I have to inject each night isn’t high enough, I won’t make enough follicles to ensure that I have at least 1 mature egg ready for fertilization.  Too much medication could mean my ovaries kick into hyper drive, and over produce a bunch of follicles which is a horrid medical condition called OHSS that means you not only are pretty damn sick, but you also can’t try to make a baby for a couple months until your ovaries calm back down again.

All of this is incredibly important to know BEFORE you ramp up for an IVF cycle because the very last thing you want to do when you have already begun to make those follicles for the egg retrieval is have your IVF cycle cancelled on you because of OHSS.  It is not only a monumental waste of money, and time but incredibly hard on your body and emotionally devastating.

I have found out that I have 16 antral follicles between my two ovaries-which shocked us all today because this means for my age I am in the “Normal-Good” (bordering on Normal-Intermediate) antral count group.  Sudies have shown that women with this count at my age have an excellent response to ovarian stimulation, I am likely to respond well to low doses of FSH product and have a very low risk for IVF cycle cancellation due to no mature embryos to transfer back in.  There is some risk for ovarian over stimulation (roughly 6%) but it is the group that has the best pregnancy rates overall!

With all of that being said-we are NOT doing IVF this cycle.  IVF is not to be taken lightly!  I simply can’t even begin to imagine the devastation we will have if at the end of an IVF cycle we are still NOT pregnant.  We want to make sure we have done everything possible before starting our IVF cycle to ensure we are in the 43.2 % that get a live take home baby.  Being the type A over researcher that I am-I picked Dr. G because her practice has the highest success rate around.  Although hard to believe, not all Reproductive Endocrinologists are alike, but thankfully every clinic has to report their statistics to the Society for Assisted Reproductive Technology so that you can actually make your decision based on the clinics performance!  Oh My god I love this!  She is great, and she is effective!

So hubby and I decided after a 6 hour conversation that we felt it was better to try a cycle of just the inject-able medication that they will use on me for an IVF cycle to actually see how my body responds-so that we don’t have any surprises when it comes to our actual IVF cycle.

The nightly injections begin tomorrow night CD3 and I will return to the clinic next saturday morning (CD8) at 7:30am for the first follicle count.  Once the “right” (depending on my blood work from this morning) number of matured follicles has been achieved we will go ahead and force them to pop out and try one more time to get pregnant with my hubbies supersperm via an IUI.

 

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