Tuesday, 13 August 2013

Save me from myself!

I need to have my Google privileges revoked.

I've always been a researcher.  It's something that I liked and was good at in school, and it's become a part of my job.  So it's no surprise that when it comes to infertility, I've Googled the ever-loving shit out of every test, diagnosis, medication, drug protocol, and procedure that came my way, and even some that didn't.  I like being prepared for the unknown, and having as many answers as possible.  Except I've found that in the case of infertility, being prepared generally amounts for crap-all and answers are practically non-existent.  I'm not even sure why I keep looking, but I do.

Lately, I've been searching Google for hope.

It's no secret that I'm going into this IVF without a lot of it.  But I'd actually been starting to feel ever-so-slightly better, reading about all of the supposed benefits of the estrogen priming protocol and DHEA supplementation for women with DOR.  (Although I'd be remiss if I didn't mention this wonderful analysis and counterpoint by The Infertile Chemist that might make you think twice about all the DHEA hype.) 

Then I started over-analyzing my past few cycles, looking for a hint of hope.  Last two cycles slightly longer?  Check.  Less spotting?  Check.  Flow still pretty minimal, but two out of three ain't bad.

What of the Day 3 bloodwork and baseline ultrasound?  15 antral follicles, which is borderline normal and has been my standard, despite my DOR.  Good to know my ovaries haven't totally crapped out in the year or so we've been pursuing treatment.  And my Day 3 FSH was within normal range at 8.3, so the cycle is a go.  Day 3 estrogen is still borderline high though, at 303 (82.5 US), which we all know can artificially lower FSH.  But it's not out of the normal range by much, and it's certainly lower than some of my past results.  Hope started to flicker.

And then I found this study* that says that with Day 3 estrogen over 80 pg/mL, I have only a 15% chance of success.  Back to that damn 15% again.

 

Must.  Stop.  Googling.

*Yes, I am aware this study is 18 years old.  Reaction may have been exaggerated for comedic effect.

32 comments:

  1. Dr. Google could be a dangerous thing. Plus my head gets dizzy reading studies. Looks like your AFC and FSH are good! So are you going to cut down on googling??

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  2. Well, 15% means a 50% chance of success in 4 cycles. Hard to say whether that's good or bad. At 30+, that's a fertile woman's chance of getting pregnancy in a single cycle. (1-0.85^4 ~= 0.5)

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    1. Wow, someone is good at math. That person is not me. I'll have to take your word for it!

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  3. I've always accepted that FSH can only help predict response. As high E2 levels can falsely suppress FSH levels, the cut off that gets applied is 80 (US) so even if we edge up your FSH a little bit as your E2 was 82.5 an FSH less than 9 is considered "expect a good response from stimulation" and an AFC of 15 is a little higher for expected age!

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    1. Strangely, I've always had decent AFCs despite my crap-tastic AMH. My cancelled IVF cycle, I had an AFC of 23!!! My RE almost changed my protocol at the last second. BUT none of them grew, soo...

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  4. Regardless of your E2, I would find hope in those great antral follicles counts and low FSH! xo

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  5. I would have some hope- I only had 12 antral follicles before my IVF cycle.

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    1. It's quality over quantity, though.

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  6. For all the hours I've spent Googling, I've hardly come up with any really useful information...

    I have no idea how many antral follicles I had. I think sometimes the less you know the better!

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    1. Totally agree. I am verging on telling my clinic to not tell me any numbers this cycle, and just call me with my meds instructions rather than telling me how many follies, how big, what my E2 is, etc.

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  7. I think you're doing great with an AFC of 15. Mine was a dismal 8.

    In the months leading up to my BFP I was taking DHEA - along with melatonin, fish oil, and vitamin D. I can't say for certain if any of these are responsible for me finally producing a good egg, but I do think it's possible.

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    1. It's so hard to know, right? It could be anything, or it could be nothing. It might just have been your one good egg! That's the incredibly frustrating part.

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  8. Must stop googling!
    15 antral follicles sounds good to me. On the only ultrasound I've had done there were.....4. So from my perspective, I would jump with joy at 15. Of course I haven't googled as much as you, I don't think.

    I think at a certain point (and it's different for everyone) you just have to accept that you are doing your best and trust our body to do what it's going to to do. Statistics only tell you so much because you are not a statistic, you are an individual. So if you've made the choice to do this cycle, trust your choice and go for it.

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    1. I totally realize that my AFC is enviable when it comes to DOR, and I'm not trying to brag. However, the issue seems to be that other people have an AFC of 4, and get 3 or 4 decent eggs that all fertilize. I have an AFC of 15, manage to get 8 or 9 eggs, and only half of those fertilize, so I end up with the same number of eggs as if my AFC was 4 to start with. It's quality for me, not quantity. No good to have an AFC of 15 if they're mostly crap, right?

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  9. I kept telling myself that I wouldn't google, but I couldn't help it. Google is always there whispering to my fingertips to search SOMETHING! However, as your cycle progresses, it may be best to dump google. In the world of infertility, all of the research, data and analysis in the world can't really help predict your outcome. Focus on you and your positive thoughts to get you through it.

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    1. I KNOW this, and yet I still do it. Which is why I'm convinced I have a problem. I need a 12 step program. Is there a 12 step program for Google addicts?

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  10. Stop. Googling.
    Seriously, you can find research that counters other research, and my head spins everytime I try to analyze IF topics on the internet. I like MrsDjRass's comment above. So true!

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    1. I know I know I know! M wants to take my laptop away. I told him I need it for blogging (read: sanity).

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  11. Late to the party, but I think the general response is that if you keep researching one of us is going to drive to your house and pull a Mark Wahlberg.

    What I will recommend instead is focusing on the fact that you are doing everything possible to make this work. Because you are and that's nothing to sneeze at.

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    1. Toronto is lovely this time of year.

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  12. When it comes to infertility, the only stats you can really count on are your own. And it sounds like yours have improved! So I'd hold onto that and keep hope alive!

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    1. Very true. You are wise, lady friend.

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  13. i say no to goggling to. you have done everything asked of you and have made yourself in the best spot for success. you have every right to just be positive and hopeful not matter what the internet says. i am rooting for you!

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  14. I've always googled for so many things but like you infertility finally defeated me. Everytime I try to find some hope from google, AF inevitably comes and shatters it. Upto last month, even with DOR, I was producing atlest one egg. But this month I was to undergo IVF and even after some pretty good stimulation (17 injections of god-knows-what hormones plus numerous pills) my eggs simply stopped growing at 16 cm. I know the people who meet here are not doctors. But still please please please say if there is any hope for me yet. For God's sake, I'm only 27. Why is my body betraying me like this?

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  15. Freaking Google strikes again. Look, no matter what you're looking for, you can find support for or against it (my sister-in-law's brother's dentist was infertile for 20 years then conceived spontaneously at 55 and had a healthy set of twins huzzzzahh!) but that doesn't mean it will happen to YOU. I say you should try to harness as much positive energy as you have while simultaneously trying to manage expectations. We just DON'T know. Freaking ANYTHING can happen. All we can do is hope for the best and prepare for the worst. Right??!

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  16. In the end, it will work or not. No amount of googling will change that. I hope that it works for you. Hugs to you!

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  17. It sounds like you are starting from a pretty good place this cycle. I think having less info from your clinic isn't a bad idea. I was only ever told how many follies I had growing and their approximate size. I never knew my estrogen levels or how thick my lining was. At first it annoyed me that they didn't tell me that stuff, but in the end I think it helped keep me sane.
    So step away from google....slowly....hands off the keyboard....

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  18. Google can be a real jerk sometimes. I'm crossing my fingers and toes, and hoping for success this go round for you!

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  19. 1) Thank you for the shout out!
    2) Despite my pessimistic post, I'm right there with you taking DHEA and hoping-to-God it works!
    3) I'll be the last person to scold you for Googling. Anyway, I haven't seen a single study that shows willful naivete increases pregnancy outcomes! ;)

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