Keeping Things Interesting and Getting Creative (Cycle Day 11)

To bring you up to speed, I was scheduled to see Dr. Sacks last week for a follow-up appointment to my cancelled EPP cycle (in which I had stimmed for 10 days (CD12)). The appointment was supposed to have been a check-up to see if I had ovulated (it would have been CD19). It turns out that that ovulation check-up became a surprise CD4 baseline check-up since it appeared as though I had gotten (a very light and short) AF just three days prior to the appointment (just four days after the cancelled EPP cycle which made that cycle just 16 days). That estrogen priming really must have confused my body, as evidenced by my difficulty in plumping up my lining (an issue that I had never experienced prior to this cycle) and by the lack of response to the high amount of stims.

Unfortunately, due to too high FSH (26) and E2 (94) levels, Dr. Sacks did not give me the green light to start stims for another cycle (which likely would have just been a plain ol' Ganirelex protocol with possibly lower dosages of stims. However, my nurse told me that Dr. Sacks wanted to see me today (on CD11). When I asked why he wanted to see me today, she told me that Dr. Sacks wanted to see what my body was going to do without any meds. I thought that was nice that he wanted to check that out, but I really didn't get too excited about coming in today since it wasn't likely that I could get even a natural IVF cycle in since CD 11 would probably be too close to (if not past) my ovulation day. So, I almost didn't go to today's appointment because I figured there would possibly be just one lone folly that was getting ready to ovulate - why go in to see Dr. Sacks today if I'm not going to be able to do an ER anyway?

To my surprise, the ultrasound showed that I have two follies on my left ovary (which is usually my tough ovary that never really produces much under stims) -- one that looked "really good" (a 12) and a smaller one (a 9)) -- and one that didn't look very "clear" on my right ovary (a 9). I told Dr. Sacks that was about the same response I get when I'm on a high dose of meds and here I wasn't on anything this cycle! He said that the stims from the prior cycle and my higher FSH were likely the culprits and explained that one of the reason a lot of older women have spontaneous multiple pregnancies is because the higher FSH encourages the body to produce more follicles and eggs (however a lot of the multiple pregnancies don't end up that way due to the bad eggs). When I asked what the plan was, Dr. Sacks said that RE said that he's going to "get creative" and depending on what the bloodwork showed, there was a chance that I could go to ER this cycle! Dr. Sacks is great - he really doesn't seem to care that I'm a tough case who is likely to bring down his clinic's stats. He seems to be willing to pull out all of the stops to see if I can get pregnant.

My nurse Amy (who is my new favorite nurse) called later in the afternoon to report that my E2 was 227, but she unfortunately didn't have my P4 or LH levels since there was some error with the lab. I believe this error was actually the clinic's fault since I noticed that the E2 was the only item that had been circled on my check-out sheet. I was going to call to ask the the staff about this after I left the office, but I didn't want to be the pesky patient who is calling them out on possible mistakes...I just assumed that if the E2 was circled, they probably would check the LH and P4 as a matter of standard procedure. Note to self and others - don't worry about being perceived as a high maintenance patient - you're paying a lot of money for these services and the staff really needs to be at the top of their game.

So now what? Dr. Sacks wants me to come back in in two days for another check-up. I just hope that I won't have ovulated by then. I believe I typically ovulate between CD9-13 on non-medicated cycles. But since Dr. Sacks didn't tell me to start Ganirelix today, I am hoping that he knows I won't ovulate based on the size of my follies and doesn't need to know my LH and P4 levels. I was tempted to just give myself a Ganirelix shot to prevent ovulation from happening, but I should just relax and see what happens. Everything happens for a reason, right?