IVF: My Waning Hope
A yo-yo in the wind—that is what I am. I rise, fall, and sway between bitterness, anger, indifference, and hopefulness. It is not working out exactly as I hoped. I’ll explain why in just a moment. First, let’s catch up.
My baseline appointment went fairly well. I had approximately 14 follicles on deck, primed and ready to grow (potentially). Once that was behind us, I only had to endure the drug and shot-administering class. Aside from my fidgeting husband, who was relieved to see the needles were not as large as those I used for my IUIs (heh, he was relieved), it was only slightly anxiety-inducing. When the doctor offered us the opportunity to stay after class to practice giving ourselves actual shots—I passed.
The thought of having to give myself so many shots each day was daunting. While I have administered subcutaneous shots to myself before (for four IUIs), I was uncertain about the four-shots-a-day (sometimes five) regimen the IVF called for. I mean, come on?! It is counterintuitive to inflict pain on oneself. Right?
A couple days following the baseline, I faced my fears. I washed my hands thoroughly as if preparing to perform an intricate surgery on some poor soul, set up the syringe, gauze (just in case I had a bleeder), and alcohol wipes on a meticulously cleaned section of our dining room table. I slipped the front of my pants down to reveal my abdomen, swabbed the top of the vial of medicine clean, inserted the needle, filled the syringe, flicked it a few times to rid it of air bubbles (my arch nemesis), cleaned off a prime spot on my belly, and paused. What the heck was I doing? Are you really going to do this, Tammy? Darn tootin’! I had not come this far to let a few itty-bitty needles stand in my way.
I slowly sunk in the needle to the top of its shaft and depressed the fluid into my belly. In a swift motion, I pulled it out. No blood. Yay. I had administered my first shot. I was thrilled. The first day was the easiest, as I only had to take one shot of Lupron twice a day. The following day, I started the Gonal-F pen and Menopur shots in conjunction with the Lupron. They, too, were much easier than I had anticipated. I was so thankful my first few shots were positive experiences. They renewed my self confidence.
Now back to my waning hope…
Four days following my first injection, I returned to the clinic for blood work to check my estradiol (E2) levels. That afternoon, the nurse notified me I was to increase my dosages. I already seemed to be on a fairly high dosage (150 IU and 2 vials of Gonal-F and Menopur respectively). I switched to 300 units and 3 vials.
I have since learned two things: I am taking the highest, permissible dosage of each drug and my ovaries are taking their sweet time to respond to the drugs. It turns out my slightly elevated FSH level, which they do not like to see higher than 12 (mine was 13.9), were a good indication I have diminished ovarian reserves for my age after all. What does this mean? Well, essentially, it will take me longer (more shots, yikes) to produce multiple follicles and, when compared to other women, I still will not develop many follicles. Needless to say, it has been a frustrating climb up the follicular hill.
The first sonogram following the start of my injections showed approximately 10 follicles. A subsequent sonogram revealed only seven had continued to grow. Yet another sonogram showed five follicles. I am quite concerned. It is difficult not to compare myself to the other women in the program. Other women have anywhere from 10 to 20-plus follicles. Here I sit with my measly five.
What’s the big deal? It only takes one, right?
Yes, but when the doctors are telling me they are concerned about the few I have and explaining what they would recommend in the event of a cancelled IVF cycle for fewer than six (or four, depending on the doctor) follicles, I cannot help but to worry. Statistically, only a percentage of the follicles will produce a mature egg, of those mature eggs only a percentage will fertilize, and of those fertilized only a percentage will make it to the day of transfer. The fewer you have, the more likely you are to end up with nothing to transfer.
As for a canceled cycle, that is not even an option. We are no longer candidates for an IUI procedure (no Fallopian tubes, remember?). Whether or not we have less than six follicles, we must still proceed with the IVF. It is our only hope to have a biological child.
My egg retrieval date, while a few days later than expected, is quickly approaching. Soon, all will be revealed. Will we or won’t we have an embryo to transfer?