There have been some moments in my life that I wish I could do over. I keep thinking back to when I was sitting in my RE's office after he projected that the retrieval would only yield 6-8 mature eggs. Actually going back a little further, I wished I had asked more specific questions about what they were looking for with my estrogen levels. I knew it was a function of how my ovaries were responding to the stimulation, but I would have felt less blindsided if I had known that the peak levels (~1500) correspond to 200 points per mature follicle. I felt such an overwhelming sensation of doom. My RE grew quiet as he was studying my chart. This led to a long silence and very awkward pause. I was tempted to ask what he was thinking, but at the same moment, I was too afraid to hear the answer.
I know what I was thinking at that time. I was wondering if we should cancel the retrieval; even as I acknowledge that does sound a bit ridiculous as 6-8 mature eggs is a workable yield. I was hoping that he would find a few hidden eggs during the retrieval. Maybe we would discover that none of the eggs would fertilise or progress into decent embryos and thus, we shouldn't waste any more resources in a second cycle. Of course, I was also hoping that we could get at least one good embryo that would come home as our baby. We just want one. We only want one. I never asked the question about cancelling. I figured my RE would reply that it was my prerogative, but it would be reasonable to proceed with the retrieval. We would have been out for the cost of meds and the monitoring, so roughly $4K for a mock stimulation cycle. I also feared that we could cancel, repeat a stim cycle and produce the same number of eggs or less, thus wasting more time and money. However, after hearing my RE discuss that there is room to adjust my protocol to generate better quality with my eggs (although I question if that is something they say to all patients repeating a fresh cycle). I now feel tempted to ask if he had any thoughts about suggesting cancelation.
New Girl shared some of my RE's notes with me at the start of my stimming. He was anticipating a possible over-response and was tentatively planning to trigger with Lupron. Knowing that it was forecasted that I could be a hyper-responder, it really resonates that I came up short. Personally, I think he had too many expectations from my ovaries and was a bit too cautious. As I had to hold and decrease my Menopur, I can't help to wonder if it would be a better strategy to start off on a lower doses and increase as we progress. I started fighting back tears as soon as I heard "6 to 8 mature eggs" as I felt I could predict everything that would happen next. Maybe half would fertilise, not enough to make it worth doing PGD testing. Need to do a desperation day 3 transfer. Discover on pathology report that the embryo was abnormal. Wash, rinse, repeat if desired with another fresh stimming cycle. The little voice inside my head is giving me so much flack. If I knew then that we would need to try to do better with a second cycle, why not proceed with it? Does anyone know the formula for ovarian aging? Is it like dog years, where six months could translate to two years?
The one unexpected variable was the two fro-yos that resulted from our first retrieval. Although, I've been regarding that we only have one, as the other barely met criteria for freezing. Even as I was receiving the beta results confirming that a pregnancy resulted from my day 3 transfer, I had regrets about not holding out to see if any embryos made it to day 5. Not only because I had compromised on the number to transfer and could potentially be pregnant with twins, but I felt that we missed an opportunity to use a higher quality embryo. As it turned out, I was right. Although I don't know for sure if our good looking blastocyst is euploid, hindsight confirms that we should have waited (and done the PGD testing). I'm truly glad the pregnancy ended as early as it did, as I wondered how much longer if would have thought about that other embryo if the pregnancy progressed. While we were holding our baby? Watching him or her grow into an active little toddler? Would my mind ever flash to the thought -I wonder how the other embryos would have faired?
Perhaps it's just my inner perfectionist. Always seeking to improve upon my previous effort. I'm falling into the allure of something better. The promise that the grass is greener in another pasture. If a fresh retrieval didn't have the pesky $20 K price tag, I'd start mixing the Menopur straight away. Thus, I've been trying to fight my initial skepticism and find some faith for this embryo. Yet at the same time, I feel sustained by the belief that if this transfer is not meant to be, something better is waiting for us.
I went in for a visit on CD9. Dr Somebody that I Used to Know had recovered from the bug. I was a little concerned about how the patches would hold up with my swimming and running activities, but they seem to be doing their job as my lining was 10.7 mm. "Beautiful" my RE described, and it was, even if I say so myself. My progesterone level was 0.3, so my transfer has been scheduled in about two weeks. New Girl left me a voice mail confirming the day, but reported they won't know the exact time until a day or two before. When the date was still tentative, I had our office administrator hold any open appointments with a note 'provider may be out'. Recalling the experience from my last transfer, when I unexpectedly learned that we needed to do a transfer while I had three patients waiting in my rooms and an emergent D+C to coordinate...I decided to request to have the entire day off. I may be able to go to the gym, perhaps swim a double session if we're scheduled for the afternoon...Enjoy a leisurely day... At least there will be one aspect that will be better this time around.