IVF Cycle 4 - Stims Day 7

Richard and I returned to our RE's office for bloodwork and an ultrasound yesterday. This was our first check since the ultrasound we had on November 26, and we were on day 6 of stims. I think it's been a while since we had a Monday appointment, but the clinic was swarming! I guess everyone had some sort of appointment after not going in over the weekend. Our RE saw us instead of our regular ultrasound tech or the physician's assistant. Rather than watching the ultrasound screen, I chatted with my doctor about the podcasts I listened to while driving back from Dallas this weekend. He reported that although my right ovary had three follicles growing--a 12, a 14, and 16--there was not much going on with my left ovary. 

When we talked with the nurse, she wanted to get a pulse on how we might want to proceed if there were still only three follicles when we returned for our next visit, which she expected to be Wednesday. If we didn't see any new growth, the three options would be:

1. Go forward with the retrieval as planned
2. Convert the cycle to IUI
3. Cancel the cycle completely

The idea of this conversation was not to blindside us if we weren't seeing more follicles at our next appointment and needed to consider options 2 and 3, which is considerate of our care team...but it still didn't feel good. I learned from thinking through this that my arbitrary number of follicles where I feel comfortable is apparently four. We retrieved four in our first cycle and managed to have one blastocyst. Even though that one turned out to be highly aneuploid, it could have been euploid...so four seemed significantly better than three in my head. (This is all disregarding the third cycle where we retrieved seven, had six mature/fertilized, and still only ended up with one blastocyst that was, again, highly aneuploid.) 

After three failed IUIs this summer and years of trying to conceive without intervention, Richard and I were not thrilled about option 2 or 3. While doing an egg retrieval requires anesthesia and higher costs than IUI, we have already sunk so much money into medications and monitoring for this cycle that option 1 seemed like the best choice. Knowing that our numbers will always be low, it seems like a waste to stop at this point.

When my results were uploaded to my patient portal yesterday afternoon, there was one little 9 mm follicle listed on the left. I'm not sure if someone else took a look at the ultrasound and decided to count that one or what. So, that put us at four follicles, which somehow feels like it comes with much better odds than three follicles. Four is still low.

Needless to say, yesterday's appointment was yet another reminder that our follicle counts will probably always be low, and we will continue to need to have these difficult conversations and make expensive decisions. In the infertility world, a phrase that gets tossed around a lot is, "It only takes one," and it's seeming more and more like we need to set our sights on one euploid embryo per cycle. This is a strange place to be because some people retrieve so many more eggs than that, but others do not respond to meds...so it's all a bit of a crapshoot.

Somewhat surprisingly, I'm doing well with this latest batch of news. A friend sent me a devotion about trusting God the other day, and it made me feel totally seen.

Trusting God can feel hard when our life doesn't look anything like we thought it would.

But can you imagine how much less anxiety, fear, angst, and heartbreak we would have if we truly trusted Him?

I don't mean just saying we trust God because it's the Christian thing to say. I don’t mean just singing words of trusting God because it’s in the praise song. I mean having a marked moment. A real live moment we can point to and remind ourselves that we declared we will trust God with this suffering. With this disappointment. With this situation. 

Okay, ouch. Talk about getting called out...but also it's all fair and true. I think I might've finally had that marked moment of shedding some of the anxiety and heartbreak because I didn't cry yesterday, and I didn't worry (too much) while I waited on my results and the nurse's afternoon phone call. 

When the nurse called, she told me to continue our same medication protocol and return to the office on Wednesday. Richard believes my left ovary will rally before tomorrow morning, and I'm doing my best to mimic his hope and enthusiasm. As long as we have the same or more follicles tomorrow, I suppose we'll be looking at an egg retrieval in the next few days...but I will update about that tomorrow when we know more. Join us in hoping for more follicles tomorrow and a smooth retrieval later this week.

Something that made today great: The Junior League holiday social was fun!

Time I woke up: 8:40 am