Acupuncture Anyone?

To acupuncture or not to acupuncture, that is the question.

I first started acupuncture mostly because it offered another option we hadn't tried and a bit of hope. I think M was counting on this low cost (by comparison) treatment fixing me right up so we could forget all about IVF.

My acupuncturist, D was nice enough and told me how he had helped lots of other women become pregnant and that everything would be okay. He has all the qualifications the state of FL requires (and FL has some of the strictest requirements in the U.S.).

I filled out the ridiculously long patient history form and described in detail my period. Clots, color and all. I think he knows more about my period than my gyn-y or RE! I began frequent treatments at first, nearly every day, then just twice a week.

D’s goal was to regulate my period, than he said everything else would fall into place. The thing is, I have fairly regular cycles, 25 days-28 days. But whatever. He didn’t like that my periods only lasts 2-3 days not a full 5 so he set about changing that.

Well, five months and about $2000 later, my cycle had not budged and my bleeding was basically the same. If there was any improvement, it was miniscule. D would ask for a full report each cycle and proclaim that I was improving. Um, how? The way I see it, it's an all or nothing scenario. Either you get pregnant or you don't, so I wasn't all that impressed.

Not to mention that I absolutely did not enjoy being poked with little needles, those suckers hurt if they hit a nerve and that happened about every other visit. I don't know if that's normal!?

If you’ve been following along, you’ve read all about my high FSH drama. I dropped out of acupuncture (not that I needed much of an excuse) at this time. I explained to D what I’d just found out and he encouraged me to seek treatment with western medicine. No reassurance was given that he could help correct this problem or that maybe acupuncture was responsible in some roundabout way for my most recent fertility road bump.

I spoke with my mom about the situation and she in turn spoke with a friend that is way into acupuncture and eastern medicine. This friend is a strong believer and has had much success treating his own MS with this sort of thing. He believes that it is possible to affect FSH both positively and negatively with acupuncture.

I spoke with D again and told him about this theory and he totally dismissed it. I don’t know who’s right, but I’m not planning on doing acupuncture with D anymore. I just can’t risk that he’s causing more harm than good, especially from someone who doesn’t show confidence in his own treatment.

I’ve tried to do as much research on acupuncture as the good Dr. Google allows. I’ve read everything from acupuncture is a sham to it seriously helps with IVF. My (former) acupuncturist also gave me a book called Acupuncture and IVF. This book claims that it can improve IVF’s success by as much as 40-60%. Now that’s something I’d love to buy into, but I’m a skeptic.

So, here is my question, should I pursue acupuncture with someone else for my upcoming IVF cycle?

Update: Decision Made

Okay, so I finally heard back from my favorite nurse, whom I think I will imaginatively call Favorite Nurse. I figured I was being impatient, because she called me an hour after I started to freak, which is 30 minutes after the office closes. She’s so sweet, she said she’d never forget to call me. Awwwww.

So, she spoke with Dr. B and he is recommending the regular-old-fashioned-lots-of-needles-pump-me-full-of-drugs-IVF. M and I have already discussed our options and have come to the conclusion that it’s probably for the best. If my high FSH is an indicator, we might not want to mess around much longer.

Favorite Nurse reiterated this when we spoke on the phone. She also confirmed my fears that I am now ineligible to do Shared Risk. Damn you high FSH! The only way I’m eligible is if I use donor eggs. She politely told them no thanks, that I’m not there yet!

So…I have to run to CVS and pick up my BCP’s which I start tonight. I am stupidly excited to be starting the pill. It’s just that I’m finally moving on, there’s hope on the horizon.

My Drs. Practice has two offices. The main office is near-by (about 15 min. away) and the satellite office is a little further out (about 30 min. away). I started going to the satellite office in the beginning because I worked across the street from it. I bounce between the two depending on which is most convenient at the time or which one is open. The main office, which has 4 Drs. (including Dr. B) is very busy. The satellite office is smaller with only Dr. B working it p/t so I know everyone well (and just as important, they know me), including Favorite Nurse.

After the frustration of not receiving prompt phone calls and just feeling lost in the shuffle at the main office, I’m going to make the drive to see Favorite Nurse from now on. I think the extra time and gas money is well worth better care, especially if we’re going to be forking over huge sums of money.

I’m nervous, but excited to be moving on. I know there’s no guarantee that IVF will work, but it’s our best hope for now. I just have to call on Monday to schedule my final IVF consult, oh and figure out how to pay for everything!

No Real Decision

Still no real decisions made yet. I thought for sure I’d have an answer now that I’ve repeated the FSH test. I took it on day 2 this time, so there is no reason for me to worry about its validity.

I went in on Wednesday morning, and was told to check the e-mark voicemail for my results that afternoon. I’m surprised I didn’t crash the system calling so often. I was pissed when I didn’t get my results the same day.

I decided to wait until 12pm the next day to call the office, just in case they were slow getting the results or leaving the message. I thought maybe the nurse was waiting to discuss my results with Dr. B before phoning me with some sort of decision.

Well, no call or voicemail by 12pm, so I called and left a message for Dr. B’s nurse to call me with my results -please. So I waited, and waited, and waited. At about 5pm, I finally got a call from my favorite nurse. She apologized for the mixup and gave me my results, which were just okay.

My FSH is 9.9 this month. So, technically it’s within the normal range, but barely if 10 is the cutoff. She was very optimistic, and said not to worry too much.

I discussed my concerns with her about the day the previous test was taken, and she confirmed that taking the test on day 4 would not have skewed the results that much. She couldn’t offer any explanation for why my FSH has seemingly jumped so much in a years time. Although I have a small theory.

I also asked her what she thought I would end up doing? The real deal, or the mini-IVF? She said she wasn’t sure, but she thought I might need more meds to stimulate so that I would end up with the regular old IVF.

I even brought up my concerns about finances with her. I love her, because she gets it. She understood immediately that we’re in limbo waiting for a course of action, and that we can’t plan financially without knowing.

She couldn’t offer any real solutions, but at least she gets it.

I know that we need to plan for a full IVF. It just makes more sense to go the safest route when so much money and emotional energy is involved. I’d love to be brave and take my chances with the mini-stim and prove that it can work just as well for women with high FSH. But I don’t want to take the financial hit if it fails. I also don’t want to think “what if” because we weren’t aggressive enough.

I’m waiting impatiently for another call from one of the nurses. I hate the days of waiting, I feel like I can’t get anything done. I’m so easily side tracked, wondering when the phone is going to ring, what the news is going to be. I know I should try to keep busy so the day will go by faster, but I can’t do it.

I start to worry that they’ve forgotten about me or that they didn’t get my message. The office usually starts returning phone calls in the afternoon, sometimes after the office has closed and they’ve switched the phones over. That makes me so nervous, what if they did forget me this time and I have to wait a whole month more. Gah!

I want to call right now, and make sure that they didn’t forget, take charge of the situation. But of course I don’t want to be annoying or be one of those patients that piss’s off the staff. What's a girl to do?

IVF?

I'm just waiting around. Today is cd 20, so I have anywhere from 8-10 days before I can repeat the day 3 FSH test. This is almost as bad as a 2ww! I'm dying to know what's going to happen next. Can you say impatient?

I caught an online broadcast that discusses infertility today. I tuned in because my very own Dr. B was the guest and the topic was of all things, mini-stim IVF. I was happy to hear more on the topic in general, there just isn't much out there.

It sounds like my clinic may be moving towards using less drugs in general. Dr. B said that they have higher success rates with fewer drugs. They're not entirely sure why, but think that higher quality eggs result therefore better quality embryos are created.

That said, he gave an example of when he would not recommend using the mini-stim protocol... if a 31 year old has a day 3 FSH of 14. He would want to use more drugs to stimulate. Well, I'm 30 and have a day 3 FSH of 11.9. Damn.

He did say that some Drs. still believe that mini-stim is appropriate for women in my situation, going back to the theory that quality over quantity is the ultimate goal. But he said that not enough scientific data has been produced to back that theory up. Hmmmm...do I want to help prove this theory?

I also looked up the shared risk plan. The idea being that you pay a lump sum larger than one IVF (around $18,000) but you get three IVF's and three frozen transfers. If it doesn't work you get 70% of your money back. It's great if you need a couple of tries, but not as great if you get pregnant on the first try. But that's a risk I think I'd take, because the downside is a baby.

Well, due to my abnormally high FSH, I won't qualify for that anymore. Unless we can some how make that test invalid (assuming that I have normal results next time), I'm going to have to look at other options to help finance, especially if we do the big IVF.

I guess I'll know something next week.

Generous Friend

As I've mentioned before, I was sad and pathetic after learning about my FSH results.

Naturally, I called my best friend, K (whom I've known since middle school) to share my bad news. Like always, she was so sweet and said all the right things to comfort me.

This time she went above and beyond friendship. She offered the most generous gift ever, her eggs.

Now, I know this isn't the sort of thing to take lightly. I'm aware that there are a slew of moral, legal, and psychological issues that would need to be considered before dragging her off for a visit with Dr. B.

For those reasons, I'm not even sure I would ever take her up on the offer.

Although...she is the perfect donor, we're the same height, weight, coloring, etc. No one would ever know that I'm not the biological mother if we did go down this road.

Serious issues aside, I can't tell you what a relief it is to have a backup plan. I feel like no matter what happens, she has my back. I can't believe how lucky I am to have such a wonderful friend.

Tyra Banks outdoes Oprah!

I just recorded and watched the Tyra Banks show on infertility. Or as they called it, “Motherhood At Any Cost”. For what it’s worth, the show wasn’t half bad. I think they did a decent job (considering the type of show) of discussing the general concept of IF treatment and the emotional toll involved.

For anyone who didn’t get a chance to see the show, I’ll go over the basics. They brought on a quasi-celebrity couple to share their infertility struggles. Not that it should make a difference, but when celebrities speak on an issue, it gets more attention so I think it was a bonus.

The couple, Trista and Ryan from “The Bachelorette” didn’t discuss in great detail what they went through. They just did an overview of the whole process from difficulties with conception to a difficult pregnancy/delivery.

I was happy that Trista was well versed (unlike Alexis Stewart on Oprah) and used words like hysterosalpingogram when discussing the treatment she went through.

Trista and Ryan also mentioned the emotional difficulties they endured with infertility. They discussed how shocking it was to have their near perfect lives go off track.

Ryan also admitted that having sex on a schedule for two years wasn’t as fun as it might sound. It’s been my experience that most people think a man would be happy to perform on a schedule, because it’s guaranteed sex, and hey, what man wouldn’t want that. Those folks aren’t thinking about how stressful it can become if one person isn’t in the mood, or doesn’t feel well, or even worse has to be out of town making that month a missed opportunity.

I was happy that the show brought to light the commonness of infertility. I was also pleased that “just adopt” was never uttered or the desire to have children (biological or adopted) was never looked down upon! That alone put's Tyra's show a step above Oprah's shows on IF.

Unfortunately, the show did go off track with a ridiculous ‘Jerry Springer’ guest. The offensive woman was having unprotected sex to become pregnant against the wishes of her boyfriend…stupid. Since that had nothing to do with infertility, I’m going to pay it no mind.

Endometriosis (my specialty) seemed to be the common theme. I was happy to see it discussed, but thought the show could have been better rounded. PCOS, low ovarian reserve, or maybe male infertility could have been brought up as additional factors. The ill-informed masses might get the impression that endo is the only disease causing IF, but then again it was only an hour long show.

Also, the different methods of treatment weren’t fully explained, although most were mentioned at some point. They did speak of sperm banks, IUI (referred to as artificial insemination) and adoption in a very positive light.

A couple in the audience stood up and discussed not only the difficulties in conceiving due to endometriosis, but the financial burden pursuing IVF is and through tears how difficult it is to lose not one, but two pregnancies. The shocker is that they shared with the world that they just found out she is pregnant again. Whoa.

Another guest, a 29 year old single woman explained that she has severe endometriosis which has required multiple surgeries. She is aware that her window of opportunity is closing and that if she doesn’t act now, she may never have a biological child. To the disappointment of some of her family, she is pursuing IUI with donor sperm in hopes of conceiving before it’s too late.

It may be a bit dramatic on its face (which is why, I'm sure she was chosen as a guest), but it brings to the forefront the difficulties facing women who are affected with a disease that causes infertility. Tyra applauded her for being so aggressive in going after what she wants, another contrast to the ‘O’ mentality of letting go.

The last guest was the founder of Conceive magazine, Kim Hahn (she adopted after several IVF attempts). She briefly went over when ovulation normally occurs in a cycle and the fact that women’s fertility declines as she ages. She even mentioned FSH as an indicator of ovarian reserve and egg quality. Whoa, real factual information.

The final moments featured a woman who (I think) works on the Tyra Banks Show, showing off her brand new baby through adoption.

So overall, I was pleased with the tone of the show. They focused mostly on the positives and showed women (and couples) as normal people dealing with a difficult medical condition. Not as crazy, pathetic or selfish.

Way to go Tyra Banks! (I can't believe I just wrote that, ha ha)

FSH Results

So I'm nearly done the pre-IVF gauntlet. I had the final blood draw to test my FSH last week. As I mentioned before, that was the last test required before beginning the FINAL IVF CONSULT!
That's when we’ll meet again with Dr. B for a scan, mock transfer and to solidify my protocol. Oh, and how could I forget, I'll learn how to give myself injections!

As luck would have it, it wasn't so simple. My period threatened to start on Friday afternoon, which would make day 3 Sunday (not normal business hours at the office). I called the nurse and explained the situation. She was a doll and said that I could come in on Sunday, but if my period started “full flow” after 6pm, to consider Saturday day one.

If only it were that easy. Late Friday afternoon, I started full flow for about five minutes and then stopped for the rest of the evening. That night, around 1am I really started. So I just counted Saturday as day one and did my blood work on Monday.

It dawned on me last Wednesday to check my medical voicemail (my Drs. Office has a nifty retrieval system for passing along messages from the nurse) for results of the blood work.

Everything is okay except for one thing. My FSH is… 11.9! WTF? Check this out if you are wondering what a normal day 3 FSH should be. Yeah, it's that bad.

I still can’t believe my bad dream might be coming true! I don’t know for sure what my previous FSH was, but I think it was nice and low, I went back through my medical history and found a FSH result of 4.1 from a year ago.

In the message the nurse mentioned that 11.9 is high (you think?) and that it indicates low ovarian reserve. She also said that it’s good that I’m preparing to do IVF.

I was (and am) in disbelief, so of course I turned to Dr. Google for some answers. What I found was not very reassuring. It all but said that I was screwed. Donor Eggs is a hot topic among women with an FSH above 10!!! Seriously, I’m only 30, how could I be running out of eggs? How could my numbers plummet in just one year’s time?

Naturally, I freaked the hell out and then called the nurse back. By the time she returned my call I was in a near panic. She was so calm and vague about the whole deal that it was only making me crazier. I kept asking her if it’s as bad as I think it is and she would only say that it indicates low ovarian reserve. I then asked her if I would still be doing mini-stim IVF or if that was off the table.

She talked with Dr. B and called me back an hour later. Basically he told her to tell me that mini-stim is still a possibility, but he would like to re-test my day 3 FSH. Unfortunately that wasn't really reassuring, and I had more questions than answers.

Barring a mistake at the lab, from what I’ve read, retesting doesn’t really make a difference. It’s possible to get lower results, but the highest numbers are often considered the most accurate snap shot of ovarian reserve. Even if my numbers come in nice and low how will I know which test to believe?

I e-mailed Dr. B that night, to ask him the above questions in hope of some concrete answers, and he wrote back that it’s possible the lab made a mistake, or that the test was taken too late in my cycle. Okay, maybe it was a mistake. But I have a hard time believing that half a day would make such a big difference; it’s not as if I took the test on day 6 or 8. It was day 3 and a half -maybe.

But he’s the Dr. so I’m going to wait another two weeks and take the test again. Gah! Dr. B also wrote that I might want to consider regular IVF if the numbers come back high again, but that we can discuss all of the options at the Final IVF consult.

Now that the news has settled in, I'm doing okay. But those first few days were awful. I just couldn't believe that I’d heard the message correctly. I should know better by now, but I still can’t believe this is happening.

I hate how one little test can overturn all of our plans. The Drs. Office is treating it as a simple change in protocol. It seems to me that they’re missing the bigger picture, at least from our perspective. For them it is a simple change of protocol, but for us it’s a difference of $6,000 or more. Not exactly pocket change and sad to say, money is a big factor in the decisions we make about treatment.

I think we really need to hammer out a game plan before I get back in the stirrups. I just don't know how to go about that right now.