So, we just got back from our monitoring appointment to check on how my follies have been growing the past 4 days on stims. Mr. B and I were sitting in the office before Dr. K came in, placing bets on how many follicles we would have this month. Based on my AFC (antral follicle count) back in June of 14, and our more recent one of 10 in September…I chose the lucky number 15 while Scott settled on 17. We had high hopes…especially since I’d been talking to my ovaries lately (weird, I know) telling them that I needed lots of healthy follies to grow big and strong this month. What? Doesn’t everyone talk to their ovaries? No…just us infertiles then, huh?! Well, they certainly didn’t listen to the encouragement and pep talks. We got a a bit of discouraging news today. Ugh…can any part of this process ever just be easy and worry free? Apparently not.
At my appt on Saturday, Dr. K was unsure of my AFC because the follicles were still so small (since I had just started my cycle). Well, today they were visible and easy to count…because there are 5. Only 5 . I am so discouraged. We went from 14, to 10 to a measly 5. We asked if we should just pull out this cycle and wait for a cycle where I have a higher number of follicles to start with. This would mean that we would be out the money we have spent on the ultrasounds, the bloodwork and the meds so far (still a boat load of money)…but would save the cost of the full cycle if this one ends up being a bust. He said that he wanted to wait it out a few more days and see how things progress. He upped my menopur from 75 iu to 150 iu and kept my Gonal-F the same at 225 iu. The fact that he was upping my meds was a discouragement in itself, especially since it will cost us an additional $750 for the additional medication. Ugh. I thought we were done handing over the credit cards. He said my ovaries seemed to be in an bit of “distress” and he wanted them to be responding quicker than they are.
What really worries me is how much my AFC seems to be decreasing from cycle to cycle. Each cycle is different and you never know how many you will have to start…but mine doesn’t seem to be going up at all, quite the opposite actually. So, who knows, maybe if we decided to cancel and wait until next cycle, I’d only have 3 follicles to start with. Dr. K said that my low follicle count coincides with my high FSH that came back at 13 a couple months ago. And even though I had it re-tested and last month it came back at 7.8 (this also fluctuates from month to month) you are usually only as good as your highest FSH number. High FSH indicates a dominished ovarian reserve, which would make sense as to why my body would be producing a small number of follicles each month. You see, God designed our bodies perfectly and we are born with all the eggs we will ever have. It makes sense that if you are running low, your body will become stingy with the eggs it produces each month, in hopes to keep the reserve up and not send you spiraling into menopause at an early age. Dr. K also said that maybe my tubal surgeries could have compromised my ovaries. If my ovaries are compromised that means my eggs could be compromised…and if there are no healthy eggs then there will obviously be no healthy babies. Oh God, please don’t let that be the case.
I feel like suddenly we don’t have as many options. Sure, it only takes one good egg and one good sperm to make a baby. So you may be asking, why am I so upset about having 5 possible eggs? Well, for starters, the average 32 year old will have between 10-20 follicles at the start of each cycle. Each follicle usually contains an egg. The follicles begin to grow and then only 1 (or sometimes 2) is chosen. This chosen follicle will continue to grow and this is the one that your body will ovulate. The rest (that were not “the chosen ones” are dissolved back into your body). In IVF, they stimulate all the follicles in hopes to get a mature egg out of each one. However, not all of them that are retrieved will be mature and not every follicle will even house an egg. If you are starting out with 20 follicles and get 18 eggs, maybe only 15 of these will be mature, then maybe out of those 15, 12 fertilize, then maybe out of those 12, 8 make it to healthy embryos by day 5. This looks like a typical and decent picture of the outcome of an IVF cycle. Now, in our case, starting with only 5 follicles, you can see how this picture becomes a bit discouraging. Maybe, if we’re lucky, they’ll be able to retrieve 5 eggs (best case scenario), then say that 3 of those are mature, then only 1 or two of them fertilize. See what I mean…out of options.
We had hoped to get enough eggs to be able to freeze at least a few. That way, down the road, we could opt to do a FET (frozen embryo transfer) as opposed to an entirely fresh cycle in case this one doesn’t work or in case we want to try for a sibling in a couple years. This would be loads easier on my body and our pocketbook, since FET is a fraction of the cost of a fresh cycle and you don’t have to use nearly as much medication. We also had hoped not to have to do ICSI, which is where the sperm is directly placed in the egg to ensure fertilization. We had hoped to let the eggs fertilize naturally, you know, the way God and nature intended. Survival of the fittest. And since Mr. B’s SA (semen analysis) came back good, this was an option…or at least it was an option. Now, that may not be the smartest play. If we only have 5 eggs, I’m not sure I want to take the risk of some or all of them not fertilizing. With only a possible 5, at best case scenario, we can’t mess around with such a low number. See, our options…gone…just like that. Ugh…I hate this! I am so mad at my stupid body and sucky tubes & ovaries!
The last thing we asked Dr. K before we left his office is if he thinks we should have signed up for the 3 cycle package instead of the 2 cycle. He said that it probably would have been a good idea…considering these new developments. He said to call Monday and he would see what he could do about getting our plan changed. I guess I wanted him to say something like, “No, this is going to work. We’ve got 2 tries, and because you are young, those 5 eggs are going to be great quality. Really we are looking for quality over quantity.” That is what I wanted him to say. That is what I needed him to say. I know he can’t make promises, but I needed something that was reassuring. Especially since I was in his office bawling. Thank God Mr. B came with me today. He almost didn’t since the appt was so early, but after receiving tough news…I’m sure glad he was there to hold me and tell me it was going to be okay. What would I do without that man? He is my rock and my biggest cheerleader!
Family and friends, my next monitoring appt is Tuesday morning. We need so many prayers right now. Please say lots of prayers that these 5 follies grow big and strong and produce 5 perfect and healthy eggs for us to work with. Pray that at Tuesday’s appt it will be clear what to do with the cycle, either move forward or cut our losses. Please also pray for Dr. K and his wisdom and expertise to know what is right for us and this cycle. Lastly, please pray that I will continue to hold onto hope. I am always such a positive person. But this appointment today, well, it really took the wind out of my sails. For the first time I truly let myself think, what if this doesn’t work? What if this fails us? What if my body fails us? Please pray that I will get back to a positive place where I can be excited and optimistic again.
As always, thanks for all your love and support,
~ xoxo Mrs. B