Tough Decisions

My head is spinning...


We are on cd 9 and I just went in again for more b/w and u/s. 


I was so upset, I had gotten a call from the nurse yesterday that they had to lower my Gonal f to 37.5 because my estraidol came back high, more like sky high at 1,357...for cd 8 that is considered in the danger zone, probably also explains why I have felt so crummy over the past day or so.


So, this morning I went armed with concerns, questions, and lots of frustration.


My u/s technician was an absolute savior.  She answered all my questions, laid it all out on the table and told us we may have some very difficult decisions ahead of us.


Let me start by saying I am at an extreme high rish for developing OHSS (I had heard of this and expressed my concerns to Dr. P because of how well I had responded to the Clomid but she said she has never had anyone develop this with IUI at my clinic, and only one develop it from an IVF...so of course there would be a good chance it would happen with me) 


My u/s tech was one I hadn't had before so when she began talking to me she began to explain the IVF procedure, I had to stop her and say this was for an IUI.  She was taken aback, and very apologetic, she assumed with the crazy amount of follicles that they were priming me for a nice egg retrieval.  WRONG!


So...here is what we are left with while we wait to hear back on my b/w (estraidol levels)


1. Cancel cycle


I need to find out how dangerous OHSS is.  Again, because I am so tiny this is a real threat and because there are so many follicles, we don't know how many could actually mature after the trigger shot, or how many actually will release an egg.  There is also the chance that my estraidol continued to get too high.


Overnight I had two dominant follicles appear in my right ovary and a third one that doesn't look too bad either.  But there are also lots of smaller ones around 11-12, that we are assuming will just die off.  She said if this cycle doesn't work, they will most likely keep me on the lowest Gonal-f dose possible for the next one, probably 37.5 throughout.  The whole time she was talking to us, she reminded us, this is just what she thinks, the doctor could call with other info.   


2. IUI

P and I have discussed the possibility of twins and although we are not hoping for it, we can deal with that, my body can handle that, but what if there are more?  Then again all of this could be nothing beacuse like I have mentioned in the past, on top of everything else we are also dealing with MFI.  This could all just be a crap shoot.


3.IVF Cycle


Because I have so many follicles, this is an option for us. 


Whatever happened to let's try an IUI because it seems to be less stressful, less invasive, less everything?  No one can prepare you for the ups and downs of this journey, and taking it in stride is nearly impssible (for me at least.)


So, for now, I leave you with a to be continued...


3 hours later...


The doctor on call just called me with my results...my e2 came back at 2300 after cutting my dose of gonal-f in half. There is no way to slow it down, he suspsects my body is preparing to surge on its own which means it is probably already to late to convert to an IVF cycle, to double check he has sent out my bloodwork again to see if an LH surge was detected.  Waiting to hear back...


There are 3-4 follicles that will most likely reach maturity.  He said he feels comfortable with me doing the trigger tonight and going in for the insemination Tuesday morning (cd11). He couldn't believe how "robustly" I responded to these drugs and suspects the same thing would happen next cycle even if placed on 37.5 IUs so I would probably need to be monitored on a daily basis.


Chances of pregnancy at my clinic are 12%. Chances of people who become pregnant having multiples is 25%. Chances of triples and quadruplets are even rarer, but the possibility is there.