Phone Consult with Dr. Generous

On Monday I had my phone consult with Dr. Generous from the clinic in the big city north of me. I had basically forgotten that she was going to be calling and was deep in my research at the county records when the call came in. I was immediately anxious that I hadn't charged my cell phone and hoped that it wouldn't cut out on us partway through our conversation.

As you may know, Dr. Generous used to work with Dr. Moustache, and so their protocols are quite similar in that they also do the MD Flare protocol, which worked fine for me the first two cycles. I explained our sordid IF history to her and recounted every offbeat therapy we've tried thus far: heparin, IVIg, lovenox, humira, the laparotomy to remove 5 fibroids/endometriomas/2 fallopian tubes/scar tissue/adhesions, two trips to Mexico for LIT and, of course, the therapy with Dr. Hungarian. She reminded me, "We do not do immune therapy here" to which my reply was "Yes, I realize that" but inside I was thinking, "But of course I'll do what I have to on my own." I think I'd still do lovenox and IVIg as they're not contraindicated in any way, shape, or form in an IVF cycle. That's not exactly true, now that I think of it. I have read many cases of heparin and lovenox causing subchorionic hemmorhages (SCH) in placentas, but that happens once pregnancy is established. So I can always ease off of the lovenox once (knock on wood) pregnancy occurs.

On the topic of my laparotomy last June, she expressed concern that if my ob/gyn (Dr. G) had used excessive cauterization in the removal of my endometriomas that it could cause permanent damage and make it so that follicles weren't able to form. Scary thought. I'll have to call Dr. G to see what she did while she was in there.

I asked her the typical "So what would you do differently question. After a bit of conversation, it was clear that she'd return me to the MD Flare protocol but would add in some femara to help with my endometriosis issues. She explained that femara can help to restore beta-3-integrins in women that are lacking them. Okay. This is good. Something new. Exactly up my alley so to speak.

I told her that I presently have a 30mm cyst on my left ovary and that my right ovary is enlarged with at least one 10mm cyst. (All measured on CD3 when things "should" be nice and quiet). She said that on CD1 I should call her office for an appointment the next day and that they'd do an U/S, and if those pesky cysts were still there that they'd just aspirate them. I do worry that Dr. Pompy said that aspirating cysts doesn't get rid of the problem of the cells that are IN the cyst in that they produce hormone. So I'm not sure that I'm yet on board here. More research is required. (And if any of you readers are up on this sort of thing, I would so appreciate hearing from you!)

One thing that I didn't expect from Dr. Generous was that she nearly immediately brought up the issue of egg donation. I told her that I was open to it, but realizing that if we went that route, it could be done at ANY time in the next 20 years. Dr. Moustache has proven that quite well. For now, I want to focus on trying with my own eggs till they've petered out completely and all hope is essentially gone. After reading the article about the doctors at Harvard that have debunked the the "theory" that us womenfolk are born with a complete set of eggs at birth, I have hope that I'll have a bit longer to try. Actually, I'm just praying that these docs will find a way to get those ovum stem cells out so that I can have a continual supply of eggs from which to try with. Of course they'd have to PGD the hell out of them to make sure that they were usable, but if I never had to go through another bout of Gonal F/menopur and retrieval it would suit me just fine.

So I'm in the typical holding pattern for the time being. I can tell I'm near ovulation, much good that does me, as I've got the typical FCM going on but it's tinged with blood so I'm concerned about infection once again. I'll probably start popping flagyl any day now and I'll add in the zithromax once we're in cycle.

So is this IVF#3 or IVF#4? We canceled ourselves just a couple days before retrieval. I guess I'll call it 4 even though we didn't make it to retrieval just for the sake of keeping cycles clear in my head, and in my blog.

I so can't believe that it's this fucking hard to get pregnant.

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Note: In the comments section a reader graciously left me a link to an article on whether aspirating functional cysts during an IVF cycle has any effect on the outcome of the cycle. Great reading. (Thank you!)

What is the sound of 7 follicles exploding?

As I write this, it has been roughly 40 hours after my hCG trigger shot on Saturday evening and I feel like my ovaries have been kicked. Hard.

It's one thing for the good doctor to go in and clean out the follicles with a needle, under anesthesia, but to actually ovulate all 7 of them? Egad.

In a normal month my mittleschmertz pain is enough to feel like someone is sticking an icepick in my side. Make that times 7 this month.

Dr. Pompy's office is supposed to call today to talk to us about our next cycle. AF is two weeks away and at the CD3 point we'll do another baseline U/S to count antrals (and also look to ensure that there aren't any cysts AGAIN). I hope that I am right, and Dr. Pompy is wrong, in that my numbers fell from 12 to 7 this cycle due to overmedication with lupron. I mean, I DID have 12 follicles at some point. This losing-of-follicles business is unprecedented. Never happened before in my body as far as records show.

So why now? Why should my body just start doing random shit?

If my body wants to slip into perimenopause, why doesn't it just start off with 7 follicles. Why start off with 12 and then let 5 wither? It doesn't make biological sense to me. Maybe there's an explanation but I just don't know what it is.

I'm baffled.