The RE Consult - 3rd time's a charm?

I had the dreaded RE consult today. Tom and I had a 4:30PM appt. The last appt. of the day. I have been so nervous and so anxious over this appt. We got to the office a little early and decided to stop at Dunkin' Donuts for a cup of decaf and 3 chocolate munchkins. The Dunkin' Donuts didn't have any chocolate munchkins left. I was bummed. I guess it was someone's way of saying you don't need to eat your stress away...

We entered the office and got greeted by Lily, the receptionist. She and I always got along and the first thing she said to me was it is so good to see you again! I missed her. She has such a bright and cheery face and is always friendly. It is the atmosphere of this office I love so much. I am not a number. I am Nina. They know all their patients my name and you don't feel like you are at a baby factory even though it is one.

Tom and I sat down and waited to be called in to see Dr. R. I picked up a Conceive magazine and started to read it. Well, browse through it. Who could concentrate and read? A million thoughts were racing through my head. A ton of questions. I wanted answers. The bottom line...why the hell can't I get stimulated in an IVF cycle?

Dr. R greeted us with a smile and shook our hands like he always does. I told him about getting a second opinion and what the other Dr. R recommended. Funny....I just realized both RE's have the last name beginning with R.

I told Dr. R I had lost almost 20 pounds since January and he thought that was great and to keep up the good work. It can only help. We discussed doing IVF try #3. Our biggest problem is I do not stimulate well and talked about the pros and cons of various protocols. We discussed what the other Dr. R said as well.

Micro flare protocol - May work, but tends not to produce high quality eggs.

Add in Repronex to the mix of drugs - This has both FSH and LH in it. The problem is my LH was 5.2 at the beginning of the last IVF cycle. If you get too much LH, you won't produce eggs either. I said that the other Dr. R said she has found Repronex tends to work with "poor responders". Dr. R said we can do it if we want, but hesitates.

Estrogen Priming - Technically, I do not have an estrogen problem. My estrogen levels are good. They correspond to the number of follies I produce. My problem is that I just don't produce follies when stimulated with fertility drugs. Going on BCPs can help to lower FSH levels and estrogen (so I'm told by Dr. R) and that is a form of estrogen priming.

Change the drugs - Up to this point, I have been given a recombinant form of FSH (Gonal-F). Gonal-F is man made from Chinese Hamster Ovaries and modified for human use. Dr. R suggested using Menopur which contains not only FSH but also LH. It is derived from the urine of post menopausal woman. Dr. R feels the using a human made drug may the answer, but didn't know for sure. Nothing is guaranteed.

Dr. R started talking about "voodoo"; myths/truths; those things you try because you heard from so and so this is a good way to get pg. Dr. R mentioned something about eating a lot of tomatoes because of the antioxidants....he heard it from a patient who was told that my her MIL. He suggested changing some things I eat and adding more antioxidants into my life. And hey....they come in this magic set of 8 pills per day and only cost $120 for a one month supply....not convered by insurance, thank you very much. It can't hurt, right?

I guess nothing is cheap when TTC.

Has anyone ever told you that you have small ovaries? Needless to say I was shocked when Dr. R said my ovaries were small yesterday. And when you have small ovaries, you will not produce many eggs. Hmmm....I have been seeing Dr. R for 1 year now and this has never been mentioned. Was he reaching for straws to make me feel better that SOMETHING is wrong with me? Over this past year, I have been told that my cervix is small. I have been told my cervix is slightly twisted and sits tilted. I have been told I have a very long vaginal canal. Now I have small ovaries. All of these things apparently make it difficult to get pg from an anotomical standpoint. But somehow, someway, I DID get pg and had a beautiful and healthy DS. I just don't get it.

We talked some more. We tossed ideas around. My RE's office has a weekly meeting to discuss various cases. Dr. R said he wanted to discuss me at their meeting which happens to be tomorrow. He wants to discuss my drug protocol. He wants input from the other RE and nurses on staff. OK. The more the merrier I say.

After much discussion and the passing thought of using donor eggs, it was decided to give it 1 more try. I know Tom is all for it. I am still not quite on board with it. I wanted SOME kind of reassurance I would stimulate, but didn't get it. I did get reassurance that if I do stimulate, my chances of conceiving though IVF were very good....everything is in my favor....but I have hear that before.

Dr. R and I were talking about when to proceed with try #3. We talked about my last cycle that was 33 days long. And we talked about how I think I O'd early this cycle. Leave it to Dr. R.....he asked if we had intercourse at the right time....LOL! I said we did and he said he hopes to see me in about 2 weeks for a beta test. Dr. R is still hopeful for us.

I digress. If AF should come to visit me this month (due on my birthday of all days), I can either try another "natural" cycle on my own or go on BCPs. I would stay on BCPs for 2 months this time. It gets me past my busy time at work. It also allows me to drop some more weight in hopes that will help things. Dr. R says it can't hurt. At the end of April or beginning of May, we will try IVF #3.

My drug protocol? Well, as it stands, it will probably be a combination of Follistim and Menopur. I won't be on Lupron (thank god) and he will use antagon to prevent O from happening early.

I am to continue to take 50mg DHEA, 1500mg Metformin to be dropped to 850mg Metformin XR once my pills run out, a Citracal prenatal vitamin, a baby aspirin, and the 8 pill $120 month vitamin/mineral/vegtable/antioxidant formula.

May is 3 months away. This will be IVF try #3. 3rd time's a charm?

I don't know about anything right now except I have time to think about it. A lot of time. 3 months seems like an eternity right now.