Paul and Dr. M. are so in tune, it's starting to make me wonder. Let me back up...
Our last superovulation cycle, in December, was a nail-biter...my body responded very slowly (my favorite line from Dr. M. that cycle was, "We seem to be missing the "super" in "superovulation..."), causing me to stress about whether we'd get our back-to-back IUIs in before Dr. M. flew to Canada for a family ski vacation over the holidays. We made it with two days to spare, but the result was a BFN, leading Dr. M. to state for the umpteenth time, "I can't believe you conceived twins in May with such low estradiol!" We later discovered, via blood test, that I have low AMH, thus, low ovarian reserve. It all makes perfect sense. (Well, still not that I conceived twins, but the slow/poor response to stimulation drugs, yes.)
Dr. M. plans a much more aggressive cycle this next time, in April, starting with me taking oral estrogen pills from cycle day (CD) 21 onward. This is called estrogen priming, and is a big hit with REs who are battling advanced maternal age [raises hand] and low ovarian reserve [hand still raised]. He prepared me by telling me over the phone what/how many drugs I'd be ordering for the stimulation portion. Holy cow...30 ampules of Menopur (a full cycle's worth...with what I have left in the fridge we'll have 35 total) plus 3 900iU Gonal-F pens (also a full cycle's worth, at 150 iU per dose, which is what I did the latter half of my December cycle...this was the drug that made our IUIs possible).
Paul has said twice now that his "dream" is to have me so overstimulated in April that we have to convert to IVF like we did in February 2011, and that my egg quality, and therefore our embryo quality, will be so great that we'll have 6 (!) embryos to freeze for later. Ha ha ha...and I've said, "I'd like to just respond better." (Aim low, that's my MO.)
And guess what Dr. M. plans for April? Yep...he's going to stimulate me so aggressively (that actually sounds nice, doesn't it? too bad about the needles) that we get as many mature follicles as is possible IN HOPES that conversion to IVF is necessary. Why? Because I will turn 38 at the end of the month, moving me into the next suckiest tier for getting pregnant through ART, and IVF has a better success rate for women in that age group. Sigh. But, ding ding ding, we're still proceeding as if we're doing superovulation IUI, so that if we do convert to IVF, it'll only be $3000 extra instead of the full $8500+ (without meds) a normal long protocol IVF would cost. Bonus. (I told him about Paul's dream. He thought it was great.)
It weirded me out a little bit that Paul was right on target...because this is the second time he and Dr. M. have been in sync. What in the world? See, when we did our IUI in January (non-medicated), it happened during our state's major snow/ice/power-outages-from-Hell storm, and Dr. M. was the only person in the office. (It's like he has the same motto as the USPS...he'll show up any time except when he's out of town at a conference or on vacation...or in the middle of delivering a baby.) Paul, on the way there, surmised we should maybe go pick his assistant, Sierra, up from her house (she lives one town to the NE of us), but we didn't...and so he said, "Watch, I'll get to assist during the IUI." Well, what a smartypants...he DID get to assist...if only to hold the gigantic cotton swabs Dr. M. uses to clean the cervix (with something that burns, like an acid or vinegar solution or ?? ouch!).
[As an aside, Dr. M., being by himself, then had to step out of the room to grab Paul's prepared semen sample for the IUI...leaving Paul to gape in wonder at my cervix. Um.... ??? Yeah, I got a little uncomfortable. I mean, most men will NEVER see their wives' cervix...it's not usually visible, you know? Mine? Hello, world!! I finally told him to step aside and stop staring!]
Anywho, Paul is feeling super excited about our upcoming cycle. I'm feeling hopeful today, since I also discovered that a) that ovarian cyst on the right side went away (whee!) and b) I have 8 pre-antral follicles (OMG!) and one dominant follicle for this month, so some or all of the DHEA/Royal Jelly w/Bee Pollen/acupuncture regimen is working!!
Perhaps we will end up overstimulated after all!
I'll close with this little tidbit from Dr. M.: "You know, your birthday this year entitles you to one extra embryo during transfer." (I looked it up on my iPhone...that would be THREE embies at transfer instead of two. Holy multiples (again), Batman.)