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:
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:
- Start taking DHEA again, dose of 25, three times a day.
- 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.
- Figure out the sperm source.
- Take another one-time injectables class.
- Returning to heightened fertility diet consciousness.
- Taking baby aspirin.
- Taking Vitex.
- Going back to taking a prenatal vitamin.
- 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?
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:
- 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.
- 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.
- 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?
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.