4/03/2012

Moving forward?

I went to the Kai.ser RE doc yesterday.  It started out in frustration, as he gave me the "your old and your chances are low" speech.  :-(  Yeah, after several years of trying, and researching, and reading other people's journeys, I'm well aware of that doc. 

He did the antral follicle account and it hadn't changed in almost two years, so I guess that's positive.  The number wasn't great though: about 9 follicles. 

I expected him to strongly recommend IVF, but he didn't.  He did say it had the highest chances, but that the chances were so low for me at this point that I may not want to make that level of financial investment.  I think it was around 15-20%.  I'm counting myself in the 40-42-year-old range because my tests are generally good, I've lived a healthy lifestyle, and I'm still in the first half of my 43rd year.  He said he didn't think I would qualify for shared-risk programs. 

In any case, I can't move forward financially with IVF on my own.  So in discussion, he thought the best option for me would be a flare protocol medicated IUI.  I found this information online:

"GnRH agonists (lupron®) have been the standard for ovarian stimulation in IVF for the past 10 years. However, traditional "long" protocols where the agonist is administered for 10 days or longer, followed by gonadotropin stimulation, may be a poor choice for the poor responder. This initial pretreatment with agonist may remove endogenous gonadotropins from the system and "suppress" the response of the ovary so that adequate stimulation is impossible. Problems with this long protocol led to the so-called flare protocol whereby the agonist is started on the menstrual cycle concurrent with the use of gonadotropins. Unfortunately, standard doses of agonist result in elevated levels of androgens, LH, and progesterone, in the follicular phase, before ovulation. These effects are detrimental to oocyte quality and endometrial receptivity. A modification of the flare protocol by pretreating patients with birth control pills and lowering the doses of agonist to "microdoses" has eliminated the negative effects of the flare and resulted in a better recruitment of oocytes and indeed significant improvements in pregnancy rates." 

The Resolve link for this article written by a well-known doctor in Colorado, School.craft, is here:
http://www.resolve.org/diagnosis-management/infertility-diagnosis/poor-responder.html

This is talking about IVF, but I guess it's similar for medicated IUIs?  I want to bring up the modification part to my doctor but am hoping he's aware.

So assuming that where we're headed, he wants me to take these next steps:
  1. Start taking DHEA again, dose of 25, three times a day.
  2. Get my thyroid tested again on my new dose in about a week (giving it a month to alter levels). *He feels my levels were really wacked out (5.7 or something) when I was tested in December, which was not the message I got from my doctor at the time.  I remember feeling really lethargic in the fall and this explains a lot.  My levels were better when taken a few weeks ago (3.8) but still significantly higher than they want.
  3. Figure out the sperm source.
  4. Take another one-time injectables class.
I am taking these additional steps:
  1. Returning to heightened fertility diet consciousness.
  2. Taking baby aspirin.
  3. Taking Vitex.
  4. Going back to taking a prenatal vitamin.
  5. Maybe taking iron. *I tend to be low on iron and I understand this is important to fertility.  Anyone know about this link or have a good source of information?
Ahem.  Going back a bit to number three in the doctor's list of steps....  Yeah, that tricky sperm source thing.  Perhaps I sound emotionally disconnected around this right now.  Maybe I am.  But I feel strongly that I want to make one more big push for a biological child.  At least as big as I can manage all things considered. 

Using S as the source would be the easiest, since he is listed as my partner.  I was partially honest with the doctor by telling him that we have been fighting and things are uncertain.  S may consider giving a last "donation."  But this would not be emotionally healthy for me at this time, and I don't want to parent with someone I don't trust. 

Next option is donor sperm.  Less chances of success, more expensive, but, still, I'm grateful to have that choice.  The doctor is on board with that too. 

The third choice is a co-par.ent.  I don't know if I've talked much about my adventures in that realm on this blog.  A year and a half or so ago, I explored co-parent.ing with a couple of people from the co-paren.ting website.  I really like the idea of parenting with someone else and sharing the responsibilities on all levels: emotional, financial, logistical, etc.  It's a more doable option for me, all things considered.  So there are three people I've connected with this week:

  1. A 42-year-old man, I think Chinese, who works for a well-known local university, has his  PhD, and seems like a nice, balanced person.  He is gay and after a 12-year partnership broke up, he decided having a child was his highest priority.  I'm meeting with him on Friday.
  2. A psychotherapist (around 50 I think), partnered but his partner (female) does not want a child but looking forward to being an aunt.  He's quite short at 5'4' but I don't think I care about that.  He seems very intelligent and thoughtful but perhaps somewhat controlling - like he wants things to be exactly even.  One of my previous co-par.ent candidates was like that and it didn't work for me at all.  We are in the process of setting up a meeting.
  3. A 60-year-old on the East Coast; has a female partner, lives in intentional community.  I know, he's probably too old (sperm health, parenting longevity) but we share values/worldview and I could totally see it working.  Except he lives on the East Coast... This really doesn't make sense, does it?
The tricky thing with a co-par.ent is that I would need to convince the doctor that they are my partner if we do IUI.  Otherwise, we could possibly do a home insem.ination but I've never done that and am scared of the logistics etc.

So if I can move forward cycle after this coming one, likely starting the second week of May, then that is what I plan to do.  There are factors yet to be determined, but I'll keep moving forward if at all possible.

* Brief request for donations:  I have some donated medicine, but if anyone has extra gonado.tropin (folli.stim) or ago.nist (lu.pron) medication, I would really appreciate it. 

13 comments:

  1. I'm glad you went through with the visit. Your AFC is better than mine. Nearly three years ago (the summer of 2009), my AFC was SIX. This Flare thing sounds interesting. :-)Good luck!

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  2. I'm really curious about the world of co-parenting, and the logistics/legal issues involved. Either way, it sounds like you will have an interesting journey in the next few months!

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  3. I too am very glad you went to the Dr and are looking at some agressive treatments in the near term :-) Glad you are researching your options and asking questions. Good luck with your co-parent meetings.

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  4. I had also looked into co-parenting when I began this journey on my own, but I couldn't find a match who lived near me. The idea held a lot of appeal for me, though. Your choices sound interesting. I hope one of them proves to be compatible with you.

    I wish I could help out with the meds, but I've never been on injects. (I'm sure I'm headed that way, though.)

    Good luck! I'm looking forward to your updates as things progress. :)

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  5. Co-parenting sounds interesting, but lots of legal issues poetentially. In any case I can't wait to hear how your meeting with the poetenial co-parent goes. Good luck to you and I'll be cheering you on as you try. There are lots of us out in cyber space sending you good thoughts.

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  6. Glad to hear you are moving forward. I agree trying to use S would be emotionally complicated, and if he decides he could make custody/life hell in the future. I guess, that's why I'm more comfortable with ADI than KD, for me it's not worth someone showing up later and trying to take away or tell me how to raise my child. Your co-parent descriptions are interesting... I wouldn't be comfortable with #3 due to age and the fact he lives completely across the country from you... the logistics of co-parenting would be difficult and expensive.

    Excited to hear more.

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  7. Co Parenting sounds as a good alternative. And about home insemination it´s a cheap way to get pregnant. I know a woman who did it and now she has a beautiful boy!

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  8. Don't forget to do acupuncture. A single mother by choice friend who had a few failed IVF. Got some major DHEA from Amazon. I think it was time release. She was 42. She also did acupunture. She moved and now her insurance covered IVF. But you had to do a so many IUI. She is 6 weeks pregnant with IUI. Anything is possiable!!

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    1. Thank you for this story! :-) And thanks for the information, I appreciate it.

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  9. Also as a cheap alternative to sperm donation if you go that way. Try Northwest cryo bank. If that isn't it just email me. The sperm $275. They will also send to you house with no doctors note if you want to try some home inseminations!! You can also look into a midwife group that does inseminations. Cheaper than RE clinics. I found one in MA that does them for 190 bucks!! Or you can do it yourself also.

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  10. You sound good, Kristina - like getting the ball rolling is energizing you. It sounds like a difficult decision to me - sperm donor vs. co-parent...Something I can contribute around the co-parenting option: I met my husband when he had a one-year-old baby from a prior, very short, relationship. They dated for 2-3 months and surprise - she got pregnant. And, to be honest, while I adore my stepchild, the co-parenting part of this situation has been extremely difficult - and he KNEW her for a few months beforehand. And they thought they liked each other. Now, they didn't intend to become parents together, but still - over time, there were just so many differences in how they parented (from diet to hygiene to manners to education priorities to medical decisions to their choices in partners (who end up step-parenting the child even if they call themselves an "aunt") - the list goes on), and that was very hard on the child, and on the adults, too. I would enter into such an arrangement very carefully - I am not sure if this is the norm, but I would recommend protecting yourself with a legal agreement on paper that indicates you call the shots re: certain kinds of decisions.

    Re: iron - here is a good link someone shared with me:

    http://www.sensible-alternative.com.au/nutrition/dont-forget-iron

    Take care, and I wish you all the best with your meetings and mulling everything over.

    Love,
    Maddy

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    1. Thank you for sharing your perspective on co-parenting, Maddy, I appreciate hearing your experience. I will definitely do a co-parent contract/agreement....I have been told though that these don't necessarily trump other factors/laws in court. But at least our intentions and agreements are on record. I am thinking that someone's "history" and what you can objectively see about their work and their life counts for something - like with this East Coast guy, all that stuff lines up. But he's on the East Coast. :-/

      Thank you for the iron link!! I really think some of these factors have been affecting my ability to conceive (I hope so because I can control them!). My thyroid being so off and then my iron has always been low but I haven't really dealt with it. So thank you for sharing information that is so detailed and clear about how it affects things. Love back to you, Kristina

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  11. Depending on your clinic's policies, you might ask them about using your co-parent as a "known donor." I briefly considered using a friend as my donor and my clinic was helping my work on the logistics using their known donor protocols.

    Good luck!

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