MicroblogMondays: Surprising Decision

I was going to write about something light, like how I chopped off six inches of my hair, or Bob’s birthday week fun activities.  But yeah, the agony that I had last week over choosing the next step occupied my mind so much that I have to write about it.

So much went through my head last week.  It was debilitating to not be able to have peace with decision making.  It simply stressed me out so much that my shoulders took the brunt of it.  I constantly felt my shoulders rising up to my ears.  I hadn’t felt so stressed out since we last had to choose a donor.  I think the information that I received from Dr. E and gathering data on cost was just too overwhelming for me.  I was basically on an overthinking overdrive.

What was going on in my mind?  Well, I was weighing the different options of working with my own clinic, working with Dr. E., going to a clinic in San Diego, or going to a clinic in Oregon.  In regards to the cost, it is still the most reasonable to go with my own clinic.  Although the sperm test is extra expensive, the cost of the ERA testing with biopsies on both day four and day five is going to be less expensive than doing one biopsy with Dr. E.  Being a boutique clinic, her fees (except for the sperm test) are higher across the board in comparison to my current clinic.  Cycling with her for a DE cycle is more expensive than at my current clinic.  Since she is an independent doctor not affiliated with any clinics, there is no SART data to support her success rate.  The success rate of my own clinic is similar to those two clinics in Oregon and San Diego.  Then why do I have to spend extra time and money to become a patient at these other clinics?

Why do I have to decide which clinic to go to rather than doing all the testing first?  Well, for the ERA test to assess the receptivity of my lining, the test results will only be relevant when the test transfer protocol for the biopsy is the same as that of the real embryo transfer.  I already know what protocol Dr. NN will put me on and I know that this particular medicated transfer protocol can grow my lining well.  If I go to Dr. E, she may use a different protocol. And if I have her do the ERA testing but don’t go to her for my DE cycle, my real transfer protocol may be different and the ERA testing results would be rendered useless.

My nurse’s calendar for me showed that the biopsies will be done in end of March, which is great timing.  If I wait to make a decision about going to Dr. E, other clinics, or back to my own clinic, then we may have to wait another month to do the ERA test.  That cuts very close to our Maui trip end of April.  If we don’t do it in April, then we do it in end of May.  I would like to get something going with the new DE cycle some time in June, right before my in-laws come in mid-June.

There were some other things that made me uncomfortable about working with Dr. E, which is surprising to myself.  I had never felt uncomfortable with or intimidated by Dr. E when I worked with her in the past.  However, the way she answered my questions this time just made it overwhelming and intimidating to me.  She insisted on seeing my uterus even though I sent her reports and images of my hysteroscopy and my most recent saline sonogram done only two months ago.  The scan clearly showed that my uterine cavity is clear.  She said she wanted to look at it with her own eyes with a simple pelvic scan.  Remember she mentioned about adenomyosis?  My dear friend in this field told me that adenomyosis is usually confirmed only through a pathological report, often after a hysterectomy.  You really can’t see adenomyosis from a pelvic scan because it is in the myometrium, or the middle layer, of the uterus.  She did say that from the pictures of my scans, it did look extremely reassuring, but she would still want to take a look.  I just don’t know what else she could look at.  Doing a scan with her is not cheap.  I pay out of pocket.  So yeah, I don’t know why but I felt very intimidated.  I also felt that one test to check on my receptivity is enough, and two (both the ERA test and the beta-3 integrin test) might be an overkill.

Something else about her also made me feel uncomfortable.  I am interested in a proven donor who worked with another Bay Area doctor and Dr. E for her first two DE cycles.  The first cycle she had 26 eggs.  The second cycle with Dr. E (which is such a coincidence that she had worked with this doctor) yielded 55 eggs.  I don’t know about you but I feel extremely uncomfortable that Dr. E overstimulated this donor so much.  The end results of both cycles were similar: 7 blastocysts and 8 blastocysts respectively, with a successful pregnancy for both.  This piece of information about Dr. E just complicated my feelings.

I emailed my nurse to see if I could do one biopsy instead of two, as well as if Dr. No Nonsense recommends the beta-3 integrin test.  The answer is yes, I can do just one biopsy, but they recommend doing both days 4 and 5 so we could save time.  Dr. NN said that I could do the beta-3 integrin test but he thinks that the ERA test is superior over the other test and he does not recommend it to any of his patients anymore.

My husband got mad at me because of this whole thing.  I had been trying to gather all the information about various tests from the different doctors, nurses, and financial people.  I didn’t want to present this whole thing to him in bits and pieces.  Since I was still trying to wrap my mind around this whole thing, I was waiting for a good chance to talk to him.  Given our busy schedule last Monday and Tuesday, we didn’t get a chance to talk.  When he came home on Tuesday, he saw that I was chatting with a friend online about it.  Wednesday morning, instead of a usual happy man coming home from fitness bootcamp, he came home unhappy.  He felt left out that I asked everyone else for their opinion but him.  I was at first very upset that he didn’t understand why I waited to talk to him.  However, I put myself in his shoes and thought about my behaviors and actions in the previous few days, I started to understand why he felt the way he felt.  So instead of my original plan of going to work early, I took out my little chart that I had drawn for myself to make sense of this whole thing and used 15 minutes to explain to him what had been bugging me.  I am glad that my life partner does not hold grudges in silence but instead voices his frustrations and concerns with me.  I am grateful that we had a chance to smooth things out.

My trusted therapist helped too.  That same evening I had a session with her.  In that session, I learned that I was back to being cerebral with my decision making.  I was over thinking, which drove me to a point where I couldn’t make decisions.  I was afraid of regrets.  She listened to all of my dilemma and asked me deep down what I believed in.  I told her that deep down, I believe that I have a uterus that is good, I will get pregnant with a good embryo, and I will become a mother.  She told me that whatever decision that we make will be the best decision for our path.  She would like me to consider making a decision that stresses me out the least.

That same evening, Bob and I talked about this whole thing at home.  He asked me if I had made a decision about which doctor/clinic to go with.  I have learned to listen to his opinion.  I asked him to tell me first which doctor he would like to work with.  He thought for a few seconds, and told me that he would still like to work with Dr. NN.  I am so glad I asked him because that was my answer too.  I just feel that it is the simplest right now for me and Bob to not worry about starting all over with another clinic again.  Going with Dr. NN again really gives me the peace that I didn’t have in the past week.  What a relief that Bob and I are on the same page.

So yeah, after a lot of prayers for clarity and peace, I will start Lup.ron next week in preparation for two biopsies at the end of March.  I am finally at peace with this decision.  I cherish this sense of peace so much especially after feeling so paralyzed by the inability to decide.  I based my decision on my emotional responses to these doctors.  Sometimes that’s just what we have to go with.