It was a good thing, that second opinion appointment. I paid $210 for a doctor to back me up and that felt good. I arrived and supplied my enormous medical IF history. We chatted a bit about why I was there and I explained some of the issues I had with my clinic - the protocol choices made so far and advised for the future. Then I sat back and listened.
He said I have done my research well and asked if I had a background in embryology. I said no, in neuroscience and then he remembered meeting me months ago :o)
He said I should do an antagonist cycle with 450iu FSH next - exactly what I self-prescribed for the last cycle but got talked out of. He said he wouldn't recommend trying an antagonist with clomid protocol until we've tried antagonist with higher FSH. I shall not waiver this time! Appointment booked next Wednesday with my clinic to see a doctor about the next protocol.
He said acupuncture can't hurt, trillions of Chinese can't be wrong and that German study (see previous post, paper in link 4) was rigorous and showed significant results. Acupuncture booked for next Thursday.
He said try to relax and definitely, definitely have a cycle off between stims. He also said to try having s.ex the night before transfer because there was a study that showed improved pregnancy rates when that was done.
He said DHEA can't hurt so give it a go at 75mg/day. Off to the compounding pharmacy to purchase it tomorrow.
He said not to bother with corticosteroids; one, because I am negative for immune issues and two, because the studies showing efficacy are small and the effect of the steroids is not well understood. He said no aspirin as it has now been demonstrated to cause cleft palates and other deformities in utero and is thus contra-indicated. I test negative for clotting factors, so no heparin either.
He said that my
AMH level of 6 is what he would expect for a 37 year old woman and not to think of it as bad. 1 would be bad, 6 is normal. And that I should remember that it's not an indicator of oocyte quality.
He said our 100% fertilisation was great (4 eggs so far, 4 embryos created) and the 50% transfer rate was also good. He added that the chemical pregnancy from IVF#1 was also good.
He said that if we got more than 4 embryos he would recommend growing to blastocyst before transfer rather than day 2. If less than 4 then transfer on day 2 like we have previously.
He said that the Medicare changes wouldn't be so bad, that they've introduced new item numbers to bill under - he sat on the advisory committee so was fairly comfortable telling me this. This means that my darling, wonderful Big Guy has said that maybe, if need be (please god we don't need to) we can do another cycle after the next. So I can stop feeling all pressured by this next cycle as my last chance!
He said we even could actually, really, truly conceive naturally so to keep on doing the deed appropriately just in case. The 92% abnormal morphology is not a death knell and my tests come back normal so it might happen. Not to give up on that anyway. Because I was thinking that if IVF#3 doesn't work (please god no) then that would be the end of the baby dream for us. He says no. Keep on trying naturally anyway.
Lastly he said good luck, stay positive and try to de-stress-ify. I'll work on that.
So that was grand. Except I left the office feeling weirdly unhappy. I mean, he told me good things and it was useful but I feel like the last 2 cycles have just been a big waste of time and money. I wish I had pushed harder to get an antagonist at least last time. The doctor de jour would have done it if I'd insisted. I just didn't insist. I caved to the authoritarian wisdom of the doctor, but I really did know what I was talking about as demonstrated by Super-Prof's recommendation.
I drove 45 minutes home, slowly and sadly. Called a few friends who were all uncontactable, called my Pa who was home. He told me what he'd been up to and then advised me to tell my procrastinating "I don't want to write" self to Bugger Off and just commit to writing my thesis up. And write it. So then I spoke to my supervisor and arranged a meeting with her. None of which helped me feel any better.
I went into the supermarket to buy fish for dinner and stood there reading the trashy mags that I won't buy but will happily read in the store given half a chance. Mum called while I was in the store, she's been away since the day of the egg pick-up. So I chatted to her miserably, sharing my IVFy business with all and sundry who bothered to listen as they collected their flour and sugar. Poor shoppers.
And then I went back outside to find it was late late late and the clearways were in full force and my poor little car was sitting blocking traffic for a mile back. So of course, waiting for me on my windshield was a $117 parking ticket. Which sucked.
Ahhh, life, it's a balancing act of highs and lows. I want more highs please.
Oh, and AF arrived on Wednesday (12dpOPU) which made this cycle a 26 day cycle.
