More Decisions To Make

I have almost gotten over the sadness and the hurtful feeling of the failed cycle.  I have also looked more into the details of donor egg cycles.  This act of research does not mean that I am hopeless about our situation.  I remain hopeful that one of the embryos could be our winner.  However, being a very realistic and pragmatic person, I think it’s good to start looking.  This process is going to be a post in itself.  I will write more about it.

An email from my nurse bright and early on Monday warmed my heart.  This is what she said: “I am sorry about this last cycle and we didn’t get to add to our inventory of embryos for you.  You did so much.”  It was really nice to read those words and to know that my clinic cares as they take the initiative to reach out to me.  And she continued with this: “Dr. No Nonsense has some time at 5:15 today to call you to touch base and go over next steps.  Are you available?”

Oh yes.  If the doctor himself wants to talk to me, I am all for talking to him, on the phone, for free.  I also wanted to discuss with him about the next steps.

I made myself available in the car at 5:15 so I could talk privately.  In the afternoon, I had jotted down some questions.  As usual, the good doctor’s phone call was ten minutes late.  The first thing he said was that he was very bummed about the cycle.  Me too, doctor, me too.  He always talked with the speaker phone on his side, which made it sound like I was talking to somebody in the outer space.  And then there is always an awkward silence before the real discussion comes.  This time it was no different.  His question to me was, “What do you want to do next?”

I told him that from my estimate, my next retrieval will be on Christmas day the earliest, which is right in the middle of the clinic’s lab closure for clean up for the holidays.  So my idea was to take a month off from medications and resume cycling in January.  Then he said, “Or, I could put you on birth control pill until end of December so we can do a retrieval as early as possible in early January.”

HUH?  Birth control pills?  Me?  Someone with diminished ovarian reserve?  I have always been told that I should NOT be put on BCP because it will shut down my ovaries to a point where I won’t respond.  I have this “fact” deep in my head.  This is why Dr. E never prescribed Estrace for me for estrogen priming or BCP because she did not want to over suppress me.

I was very confused.  So I asked him exactly that, if BCP would over suppress me.  He said that for some, yes it will, but for some people with DOR after a wonky cycle, BCP can actually help with rebooting the system.  I was still confused.  So I was like… doesn’t estrogen priming do the same thing and did the estrogen priming over suppress me last time?  He said yes estrogen priming has a similar effect and no, it did not over suppress me last time.  The cycle was weird because the cycle was weird.  He didn’t think that it had anything to do with the estrogen.  So the confused me asked him to explain the effect of BCP for me.  Guys, I still do NOT understand it, but I was embarrassed to ask for an explanation for the third time.  Basically, he believes that it’s worth a try… and the very conservative side of me wants to run away from it.  I told him that I’d have to talk to my husband about it.

Okay.  So here is the kicker of the phone call.  I told him that for financial reasons, the next cycle will be our last retrieval that will also include a fresh and thaw transfer.  Assuming that we’ll have one embryo from the next cycle (fingers crossed!!), we’ll have a total of six embryos.  How many should we transfer for the first time?  His answer almost gave me a heart attack.  He said, “Let’s put all six in there.”  What what what what what?  I almost fainted.  I was hoping that he would say three and three in two different transfers.  Six???  I know that my eggs aren’t good so many of my embryos will not be normal, but six….. I was taken aback from this number.  So Dr. NN said, maybe then we can do two more fresh cycles, transfer 4 for the first time, and try to make more embryos and transfer them all back the second fresh if I don’t get pregnant at the first transfer.  I reminded him that we have funds to do one more fresh and one more frozen embryo transfer, but not two fresh.  Although, I didn’t tell him the truth that my husband said he’d be okay with doing two more fresh cycles.

I asked him again why he suggested all six.  He said that he normally wouldn’t.  But in this situation and this circumstance with my very low reserve and my egg quality, he feels good about putting all six in.

Bob specifically asked two questions: whether or not we should wait it out if we have a wonky cycle again.  Dr. NN said that it depends on the situation.  If we have four follicles in a wonky cycle, he’d want to pursue and grow those four follicles.  Bob also wondered if there is anything we can do to improve egg quality.  Dr. NN said that as long as I am taking all the supplements that are supposed to help (including DHEA and CoQ 10), there is really nothing more we can do.

So friends, here are the decisions that we have to make:

1) Birth control pills or just take a break from medications for a month and wait for a natural cycle in January. (I have never been on BCPs before so I have no idea what effects it will have on me, plus the only advantage it may have is for scheduling convenience and the possibility that it may help reset my system)

2) one more fresh and transfer all of the embryos (could be six of them!!), one more fresh by transferring three to four and one more frozen embryo transfer for the remaining embryos, or two more fresh so we could have our final cycle to make our last embryos

Bob and I discussed about it.  One idea that Bob has is that maybe we can try BCPs and if it gives us something new to work with, then it’s all good. But if it shuts down my ovaries, given that it’s our last cycle, he said just screw it and transfer all of the five frozen embryos and see what happens.

And Bob also said that if we decide to do two more fresh cycles and not regret anything once and for all, he’s okay with it too.

But we both agree that we need to really seek the Lord’s guidance and direction before we make a decision.

Dr. NN is such a great doctor.  He asked me for my decision.  I said I have to talk to Bob about it so once we make a decision, I’ll email my nurse.  He said, “Okay, email the nurse and let her know if you want to talk to me on the phone again.  I will make myself available in the evening.  Sounds like a plan?”  I am so thankful that he’s willing to be available to chat again if we need it.

For those who pray, could you please pray for discernment from the Lord for us?

For those of you who have any insights in the effect of birth control pills on the already fragile ovaries, please enlighten me.

Don’t you feel that there is always a decision to make in this TTC or IF journey???