Tuesday, August 7, 2012

Next Steps

We're doing our treatment at the same large university hospital where I was treated during my pregnancies with Sam and Eva. It has a reputation for being both innovative and impersonal, and I've definitely been painfully aware of their "take a number and move to the left" approach to managing IVF patients. At the same time, I understand that the reason the RE practice operates this way is so that the maximum number of patients can make their way through the system. If I was getting all the hand-holding and open-ended appointments I'd like, someone else might not be able to get an appointment. So I'm making peace with it, while also making an appointment for a consult at a smaller clinic.

To his credit, though, my regular RE did call me twice last week, once as a purely "social call," as he put it, because he knew we were disappointed, and then again to tell me that the team had reviewed my cycle and decided that it would make sense to give me another shot at IVF with my own eggs using a slightly different protocol. I'll have more details about that next week when we meet with him in person, but I appreciate that a) he took the time and b) they haven't given up on me yet. He also said that we should discuss "other options," including donor gametes, which I expected.

Meanwhile, I've started taking 2.5 mg of Melatonin, 75 mg of DHEA, and a prenatal vitamin each night and 400 mg of Coenzyme Q10 and some fish oil each morning.I'm also embarking on a calorie restricted diet. Because when this is all over, I need to be able to tell myself that I did everything I could.

I'm a little concerned about the Melatonin because I hear it can have a dampening effect on your mood if you're at all prone to depression. But I'll try it for a few weeks to see what happens.

One thing that certainly didn't help the mood: We did a consult yesterday with another doc (I am being nothing if not thorough). This guy didn't come particularly recommended, but he is affiliated with my health plan so I didn't have to get a referral to see him. And I'm not sure if he was trying to discourage me so as to not blow his stats with another 41-year-old marginal responder on his rolls, but he couldn't have been less optimistic for us. "You were on the maximum dose of stims," he said, "And I would've done the same protocol with you, but if you want to do another cycle, we can do that, just so you can say you tried your best." I wanted to talk to other docs to see if they would suggest different stims or a different protocol, but this guy had nothing to offer. And I cried a lot last night, feeling like it's time to grieve the end of my fertility.

But maybe it's not time quite yet. I'm going to make a deal with myself: I may well end up having to grieve for that, but not until later this fall when I have more info. And I'll try to be hopeful until then.

Meanwhile, we'll have to decide if we should try to cycle in September or in October, when the supplements, accupuncture, and diet will have had more time to take effect.


Lorraine said...

I just wanted to stop in and say good luck. Your blog is still in my reader from - three? four?- years ago, back when I was trying so hard for a second baby after a devastating 22 week loss.

I accidentally quit blogging when I finally ended up with a real baby, but I've been checking back now and then since some of my peeps are onto their #2s and I want to cheer them on. I figure it might be seredipitous that you are showing up in my feed, so I'd like to cheer you on, too.

I was also 41, on a giant dose of stims, a poor responder. I know how it goes, how you don't have the luxury of endless FETs or saving up for another try in a few years. But we somehow made it, after throwing everything we could at our last attempt. I think I just had to know that I had done whatever I possibly could, so that if I never got that second baby I would at least not beat myself up about the maybes.

Anyway, lots of good wishes to you!


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