Tuesday 27 August 2013

Why you should never taunt your ovaries

I learned two lessons today:

First, don't taunt your ovaries.  Remember last post when I challenged them to put up or shut up?  Yeah, well, so they've responded.  With a resounding:

You're not the boss of us!

Second (directly related) lesson: never brag on the internet about your antral follicle count of 15 which is oh-so-awesome-despite-your-DOR.  Because the universe will goddamn well come and take it away just when you need it most, which is of course when you're doing an IVF cycle.

Today's AFC?  Grand fucking total of 8.  Lowest.  EVAR.  Oh, and a bonus cyst.

 
I get it, ovaries.  You win.  I lose.  You feel good about that?

I'm trying to make light of it now, but the truth is that we're both pretty devastated.  M came to monitoring with me this morning because we had to pay our cycle fee and sign a bunch of consents (again!  Can't they just keep the ones from last time??).  Even he knew that 8 was bad (for me) without me having to tell him.  We went for breakfast afterwards before heading to work, and I sobbed into my eggs.  How ironic.  We discussed options.  I called my RE to see if she wanted to postpone this cycle and hold out for one of my better months.  She wasn't in the office.  Her receptionist said she'd pass on the message, but when I got my drug instructions later in the afternoon the nurse's message didn't say anything about postponing.

And the cyst?  It's 1.2 cm, which is apparently small enough to proceed.  I'm actually wondering if it isn't my usual lead follicle, due to the early follicle recruitment that is standard with DOR.  Estrogen priming was partially designed to prevent this.  But the priming also makes it impossible to know if it's a cyst or a follicle, since my estrogen is already way up due to the Estrace. If it's a follicle?  It's going to suck up all my meds and leave the others in the dust.

Of course there's a million things going through my head.  That I wasted four months on DHEA only to go into my next cycle with 25% fewer eggs on deck.  That if I see my standard drop-off and fertilization rates, I'm looking at a retrieval of less than six and a fertilization of less than three.  Which means it's over before it even starts, because what are the chances anything will make it to a Day 5 freeze at that point?  And yeah, I know it's all about quality not quantity and blabbity blabbity blah blah, but seriously?  What the fuck?  Why even bother?

Sorry for the tremendously depressing post.  I totally get that those of you with much lower AFCs will think I'm whining over nothing.  And I might agree with you, if I didn't have to do a freeze-all cycle and could do a Day 3 fresh transfer, but that's not on the books for me.  I have to have something to freeze.  And the chances of that with an AFC of 8 are much lower than with an AFC of 15.  That's just basic math.  Although to be honest, I don't even think we'll make it that far.  If I was a betting woman, I'd say we're headed for another cancelled cycle since I've never had all of my antral follicles respond to the stims.

I don't know why I manage to keep being surprised and disappointed every time something else doesn't work out for us.  It's par for the course right now, and yet I keep getting blindsided.  You'd think I'd learn.  You'd think I would have figured it out.

Stims start tonight.  300 units Gonal F, 150 of Menopur, and a shot of Suprefact (which makes this a flare protocol in addition to estrogen priming).  No more Estrace.

Let's just get this over with.

28 comments:

  1. Sorry about your lower AFC, but I shouldn't have waited for a better month myself. My own AFC numbers were March = 12, May=10, July=6. Since they were trending downwards, I did IVF in July. I got 9 eggs, 3 were good embryos, but none implanted. I'm waiting for Day 1 again to try IVF #2, and I shudder to think what my AFC number will be now. By the way, I'm 38.

    --Ellen

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    Replies
    1. I also forgot to mention that your gifs are hilarious, even though the situation (for both of us) isn't. Best of luck to you!

      --Ellen

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    2. Thanks Ellen. A totally worthwhile point. I may be on a downward slide. Good luck to you too!

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  2. That blows. I'm so sorry. I know well that feeling of complete and utter surprise and despair that makes your heart hurt. But maybe the math will be in your favor this time, or maybe it won't be but the DHEA will have worked and you'll have higher quality eggs/embryos. Here's hoping.

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  3. So sorry to hear about the reduced follicles. DOR is a bitch. I am hoping hoping you cycle doesn't get cancelled and you find a way forward whatever happens. But it so sucks going into IVF feeling like the odds are against you. Really wishing things get better for you.

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  4. So sorry for this disappointing news. That sucks. I know it feels like things are stacked against you, but maybe you'll end up surprised in a good way. I'm so hoping that for you!

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  5. :(. I'm sorry... Ugh, it's so frustrating to have a set back at the very beginning! BUT... I'm praying that those little set backs and frustrations don't get in your way and that you're on yor way to becoming a mommy! xoxo

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  6. I'm so sorry -- what a frustrating way to start a cycle. Thinking of you and hoping for an amazing response from those ovaries!

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  7. Oh Aramis, I'm so sorry to hear that things aren't getting off to a strong start. You are the one person I most want to feel hapulosy for! For what it's worth, I would still check in with your RE about this cycle and although I know there are lining issues, maybe she'll re-consider the day 3 transfer. Fingers crossed for you!

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  8. I am sorry to hear this. Sometimes things are so unfair. I hope that your doctor makes the right choice for you and something wonderful comes out of this.

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  9. I am so sorry that things are looking bleak at this point. I hope that all of those supplements you have been taking do improve the egg quality and give you that one magical golden egg you need. Thinking you you.

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  10. I'm sorry. Thinking of you, hoping and praying for you.

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  11. sorry for this disappointing news. thanks for the awesome gifs! do you want to have a little talk with the "you" that named this blog? I am hoping that things turn around and you having embryos for the freeze!

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  12. Oh I am so sorry, this just plain sucks!! I am truly hoping that this cycle is not cancelled and you have some magicly strong, healthy embryos! I am sending you tons of good vibes...

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  13. I'm really sorry. I don't have any experience with this particular issue, so I won't even try to speak intelligently, but I will say that I sincerely hope your cycle isn't cancelled and that you'll get a whole buncha eggs on your non-cancelled retrieval.

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  14. Oh honey! That sucks soooo bad. I'm so sorry. Thinking about you and hoping that this cycle turns around some how. I'm doing a freeze all as well so I hear ya about the Day 5. Ugh. Hugs. Hang in there lady.

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  15. Oh no, I'm sorry. This sucks. I hope your ovaries come back to their senses soon, and that you'll have great embryos to freeze.

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  16. Boooo! That sucks. I'm sorry. Maybe try telling your ovaries to do whatever the F they want, and see if you can trick them into cooperating?
    I hope your cycle isn't cancelled, and that you start getting better news than expected. Fingers are crossed for you!

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  17. In agreement with the other ladies...thats total crap and I'm so sorry! I'll keep being hopeful for you. And if I hear the "it's quality" one more time I will puke on that person (even if it IS true)...to me...it's the new "relax and it will happen".

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  18. That sucks donkey balls. Sorry this cycle isn't starting off better. My AFC was always higher on the months I wasn't doing IVF and it drove me crazy. This wouldn't be so bad if you could do a day 3 transfer. any chance you could do that or is freezing the only option on the table? I can't remember why you have to freeze. My RE wanted to do a 5 day transfer on my last one and I refused. I only had 3 fertilized and I was not taking any chances of there being none to transfer.
    Hope your ovaries start cooperating. Do you need me to give them a stern talking to?

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    Replies
    1. I'm pretty sure they need more than a talking to. Perhaps a good solid whuppin'?

      We have to do the freeze so I can go on Lupron to fix the lining issue they discovered at my endo function test. Although at this point I'm tempted to say screw it, put whatever we have back on Day 3 and take our chances. As per Jane's comment above, I may still talk to my RE about that, depending on the outcome of stims.

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  19. *sigh* sorry that the AFC is disappointing. I would be very disappointed too if I had more from before. You could be pleasantly surprised by your ovaries once you start stimulation. My AFC was 4 to begin with. And now I have more than 4 in running. They may not all result in eggs but again, that was a surprise for me. Yeah the day 3 vs. day 5 transfer is another question. I hope that this cycle goes the opposite way you think it's going and you'll get good news from now on.

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  20. Here's a thought, even though there are less follicles, what if the dhea has made them better quality so you might end up with a higher fertilization rate? I don't know if that will happen or not, but just throwing that out there. I know what it's like to hope for more follicles. I never was able to get more than 5 myself because if stupid dor. I was disappointed when we used donor eggs and only ended up with 9 mature eggs and 4 viable embryos. But, low and behold, that was all it took for us. I hope the same for you! Good luck Aramis.

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