On Wed., Nov 2nd, Hubby and I made the trip to my Doc's office to talk about our last IVF cycle and to discuss future plans. Many of my fellow bloggers call this the WTF Appointment and this is actually pretty accurate!
Our Doc greeted us, shook our hands very sadly, and we all sat down in his office. He simply looked down at my charts and shook his head for a minute. He said he was baffled. He had thought IVF #1 was going to work and just knew that this IVF #2 was going to work. I responded well to meds, my bloodwork looked great, we used 2 great looking embryos again this time, and I did everything that I was supposed to do. He said that he was completely shocked it didn't work this time. I'm glad I'm not the only one...
He immediately dove into what could've gone wrong. He said that there is a possibility that there might be something wrong with my lining - that it was thick enough - but perhaps there was something else wrong with it. He said the only way to tell is to do an endometrial biopsy. The problem with that is that you cannot do one on the cycle you're using. So, you'll never be able to tell for sure. He didn't think there are enough signs to warrant this anyways.
I asked if dealing with OHSS would have caused problems with implantation and he didn't think so. I told him that it sucked and further, this whole round sucked, from more meds, a very painful retrieval where I felt everything, and OHSS. He said that he could give me more pain meds and apologized for hurting me.
He went on to say that since we have 3 embryos frozen, we should try a Frozen Embryo Transfer (FET). He said they'd have me take birth control pills for 3 weeks just like the fresh cycles. Then, I'd go on Lupron to shut everything down. He said I'd have to travel to his office once for an ultrasound to make sure everything was quiet and my lining was "pretty" - not the first time he's described it this way. Then I'd take some estrogen and I'd have the transfer. In all, it would be about a 7-week process from CD 1.
He said he'd recommend thawing all 3 embryos to evaluate for use. He'd probably recommend using 2 if all make it through thaw and re-freezing the 3rd. He said if we wanted to use all 3, he wouldn't fight us too hard on it. In my mind,I thought I'd like to use all 3 and then quickly told myself not to worry about it. The last 2 times I have fretted and stewed about how many to use and the answer has been easily handed to us both times. He said it'd be an easier process on my body with no retrieval or OHSS. He said it'd also be much cheaper than a fresh cycle. Given that I'm out of allowable expenditures for drugs for the rest of 2011, that's good news.
He also mentioned that when I start the next IVF cycle that I should take a baby aspirin daily. He said that they used to do this all the time with patients, but stopped because there is no definitive data that says this helps. Hubby asked him about acupuncture and he said that if we can afford it, we should go ahead -it can't hurt and may help.
Then he asked me how I'm sleeping and if I'm experiencing sadness. I told him I'm probably not sleeping enough, but that's just because I'm busy and go to bed too late and get up too early. I told him I'm not overly sad - that it really hits me hardest when I see someone I haven't seen in a long time and they ask if we have any good news about IVF. Other than that, I think I'm ok. He said that's normal and just wanted to make sure I wasn't suffering from any depression symptoms.
On the way out, he had us stop at his Nurse's office where he gave her instructions to make note that we are going to do an FET. My CD 1 should be sometime around Nov 6th (tomorrow, my b-day). Counting 7 weeks from then would get us right in the heart of their Christmas break. So that's a no-go. :-( I could have a giant 2-year-old meltdown about how their vacation should no make me wait another month after we've already waited for so long - but where would that get me? So, I have to call on CD 1 in December and transfer would be in mid-January. This part made me sad. Another birthday, Christmas, and New Year's with no good news about a little one to share with family and friends. But I guess it is what it is, and so we wait...
In all, it was really a visit that I could've scripted before I went, except for the waiting part. I was pleased at my Doc's response - he's as baffled as we are and wants to make sure we're ok. He's getting us to do an FET as quickly as he can. He's a good Doc, for sure.