I am excited to share that today's appointment went well.
CD3: which should be below 10, and mine has been as high as 12.7 was the lowest I have ever seen it, coming in at 8.4!! Thank you Lord for disgusting, daily wheatgrass shots! And my E2 was not artificially high to make up for the "lower" FSH, it came in at 46.
We did a baseline ultrasound to see how many resting antral follicles I had, these are important because they are an indication of how many eggs a woman has left, as well, they indicate a general number for how many eggs one can expect to get in a cycle. Any number below 15 reveals a "low" ovarian reserve, and this month I saw the biggest number I've ever seen - at an antral follicle count of 24. 24!!?!? Yowza.
They also did a doppler reading of the blood flow to my uterus to determine if my uterus was getting the blood supply that would be needed to carry a fetus in that little area ... and mine was perfect.
Dr. Schoolcraft did a Hysteroscopy (where they take a camera inside the yahoo) to see if there were any uterine abnormalities, and he confirmed that my womb will someday make a comfy home for a very lucky baby ;-)
Now my favorite part was the medical regroup, where I had 15 minutes to get as much info from the doctor as possible. And really, what I wanted to know was:
1. Are there any explanations as to why I am such a reproductive anomaly?
2. What would he do to change up my protocol for a better response?
And I was pretty excited about his reply.
1. When I say that I am a reproductive anomaly, the strange things are: that I get pregnant very easily, yet I miscarry very easily. I have poor blood hormone levels on certain (IMPORTANT) blood tests that point to a deteriorated ovarian reserve, yet my ovaries look very healthy. My body puts things into full gear and seems to respond well to stimulation medications - growing TONS more follicles that most women could ask for, yet when the retrieval comes around there are only a few eggs retrieved - and we find an abnormal amount of immature eggs in the cohort. Basically it doesn't make sense that a woman with my blood levels would have ovaries that look so "good" and a woman who has ovaries that look so "good" should be able to retrieve many more mature eggs.
When I asked Dr. Schoolcraft about this he surmised (because he was very clear that he does not know what's going on, he said he can only make a guess) that perhaps autoimmune issues are causing these problems. He pointed out that it's been proven that I have thyroid antibodies and ovarian antibodies, he's wondering if antibodies are affecting the whole process. He thought perhaps antibodies are getting in the way of the communication between the FSH drugs and the many available follicles. Perhaps they are blocking the reception of all those drugs we've been pumping in.
He suggested that we start Dexamethazone 10 days prior to starting stims. Dex is a steroid that immobilizes the antibodies. He also wants to have me continue the Dex throughout the cycle ... as he does for all of his patients.
He's also in favor of my using Lovenox as a blood thinner, due to my Compound Hetero MTHFR and it also works to combat antibodies in some way.
2. When we discussed protocol, he suggested the very vanilla antagonist protocol. He said that suppressing with birth control pills would be ok, but not using OCP's would also be ok. He does not want me to use Lupron in the beginning of my cycle because he wants me to use it later. Also on the autoimmune issue front/antibodies problem, he's surmising that maybe I have antibodies against HCG, so when we give me the trigger, the HCG is being absorbed properly into my blood stream, but my body is attacking it such that it's not as effective in maturing the follicles/eggs in the last stage of maturity. So he wants me to trigger with Lupron AND HCG, as Lupron initiates a natural LH surge - which is what matures eggs in their last stage. He wants me to do them both because if one doesn't work, the other will and vice versa. He did say that we would be aggressive with the med dosages, I was doing 750iu/day in my old protocols, but at CCRM their max dosage is 450iu. He also would like to have LH products (like Menopur or Bravelle) introduced to my protocol ... never had that before.
And lastly, I mentioned my good friend Annie and about the fact that when she cycled at CCRM, they pushed her retrieval to when her follicles were measuring 26mm or at least something larger than a typical 18-20mm. Dr. Schoolcraft said that they like to do this when they find women who have many immature eggs, I told him that in my last cycle I had 5 eggs and only 1 was mature and later a second one matured. Dr. Schoolcraft did suggest that perhaps we push retrieval 1 day to allow for full egg maturity.
So that's what he said and honestly, I'm not sure I could imagine it going any better. Weird as it sounds, I had such a great time going through all of these tests. I really feel like God is a part of this entire experience, and I am really looking forward to either getting some healthy eggs out of this or closing the door on using my own eggs. I feel so privileged that I get to go through this process (being able to come to the best clinic in the country). And I don't have a sense of "if this doesn't work, then what?" cause I know what that answer is ... we'll cry, hold each other, lick our wounds, be sad, cry some more, and face the loss of my genetics. Then we'll move on to getting excited about the opportunity of alternative family building solutions. And I think that being here at CCRM represents getting closer to one of those resolutions. If getting my own eggs doesn't work, I don't want to spend YEARS figuring that out, I just want to do this a couple more times and spend the 'saved' years enjoying my family (how ever my family gets defined) rather than waste these precious years losing time. I am taking my life back and it is so exhilarating!
I will let you know on Monday how the second half of the 1 day work up turns out. Stay tuned ...