|I came prepared. With a barrage of questions. He only laughed a little :)|
My IVF consult went well yesterday. Quite, well, in fact! We talked for a while about our TTC history, and the RE was fully supportive of moving on to IVF at this point. No "ehhh, you may have success with an additional IUI or two" or "geeee, you haven't really earned the big guns yet." Just a simple "From my perspective, I would recommend moving on." His main reasoning is that with the number of cysts that my ovaries present with (yesterday had 25 on righty and 20 on lefty), they aren't comfortable taking a more aggressive stim approach for an IUI. Afraid to wake the "sleeping giant" or something like that. So no WONDER we haven't had very good stimming for our two IUI's- their hands were tied, lest we populate a baseball team all in one go. Move over Octo-mom, Multiples-Meier-Mama is coming to town!
Because of my super cysty ovaries, he also recommended we go with the Antagonist protocol, which involves stimming with both Menopur and Gonal F or Follistim, and a Lupron trigger. He thinks that I'll have a great response to the stims given my "loaded gun ovaries", and wants to try and avoid OHSS by using the lupron trigger instead of an HCG trigger. I'll get more details when I talk to the coordinator. Oh, and he did say that it's our choice whether to use PIO or Endometrin during the TWW, and that the research suggests that they're equally effective... but he just feels more comfortable with PIO.
So with all that, the decision was pretty much made. We've stressed over this long enough. The fact that we got to this point sucks, but I have to put the doubt over what could have been behind me and get to my happy place. My happy "I'm going to have a needle shoved through my vaginal wall to retrieve mah behbehs after my ovaries have been inflated to the size of softballs" place. Ummm... that's a happy place, right? Right? <crickets>
He didn't see anything that he thought would indicate a need for more testing in terms of preemptively diagnosing an implantation failure. The only supplements he recommended were OTC prenatals. Dr Boy does need to go in for a repeat SA, mainly so they can do a much more in depth look at morphology. Our clinic requires that sperm hit a certain threshold for morphology in order to try to fertilize naturally, otherwise, they require ICSI. Either way, that's not a problem. He had fine morphology before. (side note- any supplements or other things he can do to improve morphology? 'Cause it'd be nice not to have to spend that $1500. Just in case.) I need to have a saline sonogram to check out the condition of the cute ute. That's pretty much it though!
We then had a date with wandy to check out the cyst. And to see if I can skip my period this round and go strait to BCP! I have about 7.2mm worth of lining built up, but NO dominant follicles. And it's CD19, so really? We can put this one in the books as annovulatory. Even better though, no cyst either! That sucker went away all on its own.
Because of the lack of a dominant follicle and the fact that the cyst shrunk down to nothing, he cleared me to start the BCP right away, without waiting for a new CD1. Which works WONDERS towards the whole getting on the calendar for a December cycle goal.
Long story short- we're good to go. I'm waiting to hear from the clinic's IVF schedule coordinator, but I will most likely be starting BCP this week to get ready for a Dec cycle! AHHHH!!!! Which means that by New Year's, I'll either have a BFP, or a really friggin' good reason to drink :)