Monday, 7 January 2013

A whole lotta "meh"

I had my baseline bloods and ultrasound today, and it looks like we're going ahead with this IVF cycle.  But that didn't stop my body from taking yet another opportunity to fuck with me.

The way my clinic works for an IVF cycle is this: first thing in the morning, I get my blood drawn and then have my ultrasound.  Then I meet with a nurse who reviews my ultrasound results and writes a prescription for my drugs for the next few days.  Then I wait for a phone message in the afternoon with the results of my bloodwork and the final instructions for my drug protocol and my next monitoring appointment.

This morning after my ultrasound, the nurse informed me that I had 13 antral follicles, 9 on my left and 4 on my right.  This matches the lowest number I've ever had, and while it's still not terrible it's significantly less than the 23 I had going into my last IVF cycle.  I guess maybe all that CoQ10 and Royal Jelly I've been taking hasn't been having the effect I'd hoped.  But worse than my AFC was the fact that, while most of the follicles were tiny, I had two lead follicles at 11mm and 9mm on the left.  My last IVF was cancelled because a dominant follicle sucked up all my drugs and the others didn't grow...so I figured that this would mean another cancellation or at least a delay until next cycle.  However, the nurse didn't seem overly concerned and said they'd still go ahead with an 11mm follicle already in place as long as my bloodwork came back OK.

Of course I was on pins and needles until about 1pm, when I called our clinic's message line to retrieve my bloodwork results.  Surprisingly, the message said that everything was ok and I was to go ahead and start taking my stims as planned tonight.  At first I wasn't even sure they were going to give me the actual results, but the end of the message went something like this:

"And your bloodwork results are E2 77 (US 21), LH 7, Progesterone 5 and FSH 13.  So go ahead with your Gonal F and Menopur tonight..."

Hold up.  

Rewind.

"...FSH 13..."

What the WHAT?  

Up to now, I've only ever had high E2 on my day 3 labs, never high FSH.  Even when my E2 was within normal range, my FSH didn't seem to be artificially suppressed since it never went above 6.  Now all of a sudden it's 13???  According to Dr. Google, some clinics wouldn't even let me cycle with an FSH this high.  Apparently mine will.  But it still doesn't take the sting out of the fact that my body has now graced me with the full trifecta of DOR shittiness: low AFC, low AMH and high FSH.

Thanks for that.  You shouldn't have.  No, you really shouldn't have.

So now I have a whole host of new questions.  Are those two lead follicles really follicles, or are they just cysts since they clearly aren't producing any estrogen?  Should I even be going ahead with this IVF cycle given my lab results?  I mean, obviously my RE is charging ahead but it's not her money.  Then again, last IVF cycle everything looked perfect at baseline (high AFC, low E2, low FSH) and it turned out terribly, so maybe it really doesn't matter how things start out.

Either way, my enthusiasm for this cycle has just diminished considerably.  It feels like the odds are even more stacked against us than they were before.

18 comments:

  1. if it helps i know my re always tells pts that fsh can change every month for no reason,,it just fluctuates it is not well understood. my fsh has always been normal as well but i am prepared for a month like yours...focus on this, if it wont change your plan then dont worry about numbers. believe me i know it is hard but at the end of the day those with normal fsh struggle and some have high fsh and get preggo naturally and never knew. this whole thing is just craziness!!!

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    1. You're totally right, lots of people with worse FSH get pregnant all the time. It was just a bit of a shocker, even though I probably should have expected it at some point.

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  2. If your RE and clinic don't have a problem with it I think you should trust that. Easier said than done, I know. Can you call and talk to your RE tomorrow to calm your nerves?
    I'm cheering for all your follies to share the drugs and grow nice and big. :)

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    1. I didn't bother...I'd already started injections so it's full speed ahead!

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  3. I am trying (trying, trying, trying) to go with the flow and just do what my doc tells me to do. I haven't asked about numbers because I knew that would just give me something else to stress over. I know the money is a huge deal and obviously you don't want to go through injecting yourself with hormones if there's no chance it'll work, but it sounds like your doc/clinic has faith in your body. I hope you can find a little of that faith, too. Best of luck!

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    1. I actually think it might be better for me too if they didn't give me the numbers, that way I'd just have less to freak out about. I may ask them next visit to just limit the info they put in their phone messages to the very minimum.

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  4. I have some stats in my office, which I can verify tomorrow, but I believe the prediction based on FSH (in US Values) is <10 Expect normal response (to Stims) FSH 11-13 Fair response (may have lowered birth rates) 14-17 indicates poorer response, lower birth rates >18 and >20 is usually the no-go cut off. This is from memory, but 13 is not out of the game!

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  5. Ugh. I am so sorry! I hope that you get some answers soon.

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  6. Man, I think obsessing over these numbers can seriously throw us IFers off our game, and usually for no good reason. To echo what a couple others have said here, I was also under the impression that FSH can fluctuate a lot, from day to day, and REs often don't know why. And you also just cannot predict what your follies will do. The one IUI that actually led to a pregnancy for me (ectopic, but still) was the one where my numbers were at their worst... so you just have to accept a certain lack of control, really. I'm excited you're moving ahead! :)

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    1. I know FSH fluctuates, but from what I've read your eggs are only as good as your worst FSH. Anyway, given that my perfect numbers last cycle didn't do anything, maybe you're right and bad numbers will do the trick. It's opposite-land!

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  7. This is from Adv Fertility Center of Chicago:
    Day 3 FSH
    <9 good response to stims
    9-11 Fair, slightly reduced response
    11-15 expected reduced response
    15-20 more expected lower response to stims AFC is more important variable
    >20 no go
    Given that the AFC is more important with a higher FSH, I would take yours as an encouraging sign

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    1. Thanks J! That sounds about right, as I had a reduced response last time too. We'll just have to see how many of those 13 follies come to party.

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  8. Unfortunately I don't have enough background on FSH numbers and IVF (despite my 42 lb. medical chart). I would suggest adding a glass of wine to your protocol though. I'm guessing that would quickly take care of any wonky numbers. All kidding aside, a call to your RE might be best to settle those nerves. You need to feel as confident as humanly possible going into this. xo

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    1. Yes! Wine is an essential part of this protocol. Strangely, after the initial gut punch of the high FSH I managed to kind of shrug it off and just go on with things. Got a workout in and everything, instead of just feeling sorry for myself. Best I can do for now!

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  9. Sorry you got the trifecta of shit today. :(

    I understand your worries about the lead follicles. I have had this happen in the past. But the other ones seemed to catch up. Maybe they want you to take the drugs for a few days to see what happens? It sucks that they aren't giving you more explanation.


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    1. Thanks for sharing, it's always good to hear stories where things kind of worked themselves out. I'm hoping that since it wasn't making estrogen it's not really a "lead" follicle and just a small cyst. Either way, next appointment is Thursday so we'll find out then!

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  10. Take a deep breath. It's always exciting and so scary to start a new cycle. I wish you nothing but success! Hugs!!!

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I'm needy and your comments validate me. Help a sister out!