Tuesday, March 18, 2008

Guinea Pig?

Did I say I was doing the big IVF? What I meant to say is we’re doing the mini-stim just for fun.

Let me explain. Today was the FINAL IVF CONSULT, which I find a little funny. Why is it refered to as final at the start of IVF? I certainly hope it’s not the last time Dr. B discusses our IVF options with us. Wishful thinking on the Clinic's part?

Anyway, M and I were in the exam room when Dr. B and the IVF nurse came in for the mock transfer. He said “we’re doing mini-stim, right?” Well, I was a little surprised and said "uh, no, you recommended the big IVF as the not-fucking-around-anymore solution." Okay, I didn’t say that exactly, but almost. I then proceeded to remind him of our previous discussions via his nurse and e-mail. I think he remembered me then, or at least he pretended to.

After much thoughtfulness on his part, Dr. B reversed his previous decisions and decided right there on the spot that age is more important than high FSH, so mini-stim is indeed a good idea. His reasoning is, since I’ve never had any experience with injectibles, I might do just fine with a low dose.

Yes, I too am impressed with the years of medical school and research it took to come up with this plan of action. A bold move.

We discussed and agonized for about 10 minutes between the four of us. I know how M feels (less $ makes him happy), and Dr. B made a fairly compelling argument about my age and more opportunities yada-yada-yada. So mini-stim it is. Clearly this is a big ol’ experiment with moi starring as the guinea pig.

Regardless of which IVF road we go down, it will be a big experiment, so the less painful, less expensive version won today. Did we make the right choice? Gah! I have no idea.

Plan B is…If I don’t respond well to the stims, my cycle will be canceled and I will only be out some medication (what’s a few thousand dollars?!). Dr. B will then have a good idea of how my body responds to the drugs and will hopefully be better equipped to treat me if a big IVF is required. At least that's what he said.

Part of me feels like I was tricked into changing my mind, after all, I had already come to terms with needing the big IVF and thought the benefits of extra embryos (if I was lucky) to freeze was worth it. On the other hand, not using gallons of injectibles is enticing, not to mention the smaller price tag.

In case you’re curious, here’s my protocol for now:

No more BCP’s, I only had about four days left, so I get to stop a little early. Yayyy

Friday I start 75 IU’s of Follistim and 75 IU’s of Menopur once a day. They get mixed together so I only have one injection. Also, M and I both start antibiotics and I take a low dose aspirin daily.

Monday I have blood work. After that, I’ll just have to wait and see, but there’s not much more to it than that, at least for now.


soapchick said...

Good luck with the mini stim. I have no experience or knowledge of that so I will watch from the sidelines and offer support! I hope you respond splendidly!

sara said...

Good luck with the stims girl. I guess I was a normal big IVF protocol. Yet some of our doses weren't that far off so maybe you'll still end in a big bang. If you're interested I did BCP for a month. Lupron 10 units SQ for a couple of weekes. Started AF then did Menopur 75 units on day three along with Lupron 5 units, and Follistim 225. Once I wasn't responding well around day 6 or so I did Menopur 75 units and Follistim 400units. So all in all the only thing that they did was up my Follstim. But to have high hopes and then to have the cycle almost cancelled like us can be a devastating nerve racking feeling. At least you know from the get go that they may transition you to another cycle. I wasn't expecting that so I was crushed midcycle when they told me that we may do that. For us things ended up working out okay, but if this doesn't work - in the future cycles they said that they will not suppress me with the Lupron BCP combo and I should have a better response. Like you this is my first experience with injectables so it's always a little bit of a crap shoot they said. Well not in those exact words. Our IUI's were non injectables because they posed too high of a risk for multiples with my unicornuate uterus which is something I can't do. I'll be thinking of you.

I'm sorry that this was so long!


sara said...

What I meant to say was our IUIs were some with clomid and some with femara.

Barb said...

Crazy! Well.. he just "knew" I had endo, but then I didn't have ANY. And then later, AFTER the lap that HE did, he said, "Oh, but you have a history of endometriosis right?" And i was like.. uummmm.. nooooooo. sigh.

He's a good doc.. a nice man, and very progressive. But I think that whole clinic needs to step up how much the doctors actually SEE their patients.. not just for consults and operations. sigh.

All that being said, I hope you respond well, and it IS a good thing to have a lower price tag and less emotional angst!!!!! HUUUUUUUUUUUGS!!!

Why don't I take you out for a (non-alcoholic) drink soon to help relieve stress?

Stephanie said...

Thanks everyone for the encouragement.

Soapchick, you're so sweet, thanks for all the well wishes and comments.

Sara, it makes me feel better that we have somewhat similar protocols, maybe mine isn't going to be so off base. I'd be thrilled to get five eggs (and five fertilized!)

Barb,I totally agree about Dr. B. He's a great Dr. but does he ever review his charts before exams? I don't mind that he somewhat forgets who I am, he sees tons of patients. If he would just pretend by doing his homework, it would be great.

Also, I don't think many of the RE's really know what to do, it's almost a matter of luck to get the right protocol from the start.

We definitely need to get together soon! Let me know when you're free. :)