Things just never go as planned, do they?
Today is CD9, and my follicular ultrasound revealed disappointing news: those six resting follicles (which, were actually 5 with a possible 6) have turned into 4...3 around the same size (11-12mm) and the fourth lagging (8mm). This after 5 days of, apparently, the highest doses of stims Dr. M. has ever heard of. My uterine lining looks beautiful, apparently, but my estrogen level had dropped to 75 as of yesterday. He said that was ok, they just don't like it to drop such that the patient starts to bleed. Funny...I was spotting a bit yesterday. Frick.
He left me to dress and said to come across the hall to discuss when I was done.
It took me a few extra minutes to erase the signs that I'd been crying.
He said, basically, that we will likely have a choice of back-to-back IUIs or converting to IVF when it's time...meaning either way would be a gamble. Our only experience with IVF was when we had 6 follies and got only 2 eggs. Would that happen again? Who knows? We'll have to decide whether it's worth it to gamble another $3000 to know for sure how many eggs I produced, what quality, and whether we're actually sending embryos back to nestle into that perfect lining, or NOT pay that money and hope I *do* release multiple eggs of good quality, that at least one fertilizes, divides properly, makes it safely down to my uterus and nestles into the lining.
Before I left, I asked him to write a prescription refill for my Metformin, since we switched from the HMO and I'm almost out. His eyes got big and he said, "Stop taking that!" OMFG #2 of the week: he apparently forgot he prescribed that in July 2010 and never told me to stop taking it...even though I mentioned in, oh, October that the HMO had reduced my dose and I went back to normal because that's what he prescribed. He said back then it was fine...but now he says that could absolutely be contributing to my poor response, because it, um, inhibits insulin (a growth hormone!!). So, no more Metformin, but I am to start taking 1 baby aspirin per day to aid blood flow to my uterus and ovaries. I go back daily now for estradiol blood draws (hoping to see increases indicating those follies are growing), with another ultrasound on Thursday. He said he might increase my Gonal-F, depending on the results of today's blood work...and then dropping the Menopur all together as the follies get bigger to escalate their growth.
I spent a lot of my 20 minute phone conversation with Paul at the start of my lunch hour sobbing. I feel a bit of relief that maybe my body isn't 100% the reason behind this and December's poor response, that maybe it was the Metformin. At the same time, I am deeply frustrated and upset at that fact, the "what if's"...what if I could already have been pregnant again if I was taken off the Metformin sooner? What if we hadn't just used $1000 worth of drugs in the last 5.5 days for what feels now like an experiment due to error?
We are going to go ahead and make another consultation appointment with OHSU's fertility clinic in Portland, just to see what they think, if they would have done anything different.
I feel a little better for having partially cried this out, for now. We can't keep throwing money away due to experiments or errors in judgement.
At the same time, I do feel a bit vindicated for having fought his attempt to charge us for full IVF. This is exactly why we didn't agree to that route...no idea if I'd respond.