Sunday, November 29, 2009

Cycle #20 mid-cycle u/s

This morning's mid-cycle u/s showed a lead follicle of 30.5 mm and several other, smaller follicles, but no other follicles which are large enough to produce and release a mature egg. So in exchange for five days of Clomid and five injections of Follistim, at a cost of around $300, I got basically the same result I'd get in an unmedicated cycle: one egg.

Needless to say, I am not happy about the result. The doctor who did my u/s this morning (yes, I actually had one of the clinic's doctors and not a NP) agreed that this is not the desired response and that, assuming I am not pregnant after this cycle, I will likely be looking at a change in medication dosage for the next cycle.

I'm doubly irked when I think about the fact that last cycle I produced between two and four mature follicles. Why my RE felt that my dosing schedule should be changed is still a mystery to me, and it's now obvious that I did better on last cycle's protocol. I know that dosing is not an exact science, but I don't appreciate the guesswork involved when it translates to wasted money and time for us.

On the plus side, my endometrium was good: 13 mm. After completing the u/s, the doctor observed that some couples opt to do only timed intercourse rather than IUI when only one follicle is produced. After talking it over with MM, we have elected to do that this cycle. Why throw good money after bad? Our insurance will only cover a portion of six IUIs, lifetime. So I triggered when I got home and will have to do nothing more onerous the rest of the cycle than have sex with my husband the next three nights.

Another negative about my ovaries' response this cycle: because my lead follicle is so large, I will have to go in for a baseline u/s to rule out a cyst before starting the next cycle. Assuming that we need to do a next cycle, of course.

Today is one of those days when I am questioning how much more of this I want to do. I don't love taking days of injections even when they produce the desired effect--who does?--but I find it even less appealing when the time, money and effort spent don't result in an increased chance of conception.

I think back once again to the fact that the one-and-only BFP we have ever seen was during a break cycle. . . . and a cycle where my stress levels were through the roof, I was eating like crap and avoiding the gym, and on top of all that, I was taking high-dose ibuprofen! Just makes me wonder whether all this intervention is pointless for us. And why I am bothering to eat better, reduce my stress, avoid certain drugs, and all the rest when it doesn't seem to make any difference.

All these thoughts lead me to think about something even deeper: why am I not more committed to trying everything and anything in order to conceive? Do I just not want to be a parent as much as other people? I read and hear all the time about couples doing multiple IVF cycles, and borrowing tens of thousands of dollars, for a chance to have a baby, women going through much, much worse than I and for much, much longer and still being willing to keep trying. Yet here am I, annoyed at cycle #20, having done a few cycles of IUI and timed intercourse without the desired result.

It seems that many couples who are at our point in this process begin thinking seriously about moving to IVF. It's logical, especially when the woman is my age. That course of action has been suggested to me/us by more than one person. But I am no more interested in starting down that road than I was in May when I wrote this post about our feelings on IVF. MM's feelings on the subject have not changed either. We do not see IVF as an option that we wish to pursue, for all the reasons I talked about in my May post.

Today is CD 12, and I have had a headache on five days so far this cycle, including today. I don't know that I can definitely attribute any or all of those headaches to medication side effects, but I do know that, though I am prone to headaches, that is a much higher frequency than normal for me. And I know for sure that I have suffered with a lot of side effects from the progesterone gel each cycle I've had to use it: cramping, constipation, fatigue, vaginal dryness, breast tenderness.

I'm tired of (figuratively) beating my head against the wall. I find myself thinking, once again, that perhaps it would be better to just focus on other things and stop taking these drugs that don't seem to be helping and may well be causing my headaches. And don't even get me started on the emotional side effects of the drugs. I've gone from someone who has long been noted by family and friends for her calm stoicism--my sister has joked often that I'm "dead inside"--to someone who can barely make it through a day without crying.

If you've made it this far, thanks for reading. I'm not looking for advice. I realize that only I (and my husband) can decide when it's time to stop and whether we want to do more. There are no "right" answers to the questions in my mind.

I'm just venting my frustrations and thinking out loud.


  1. sending you a big hug. Your post reminds me that even though we can find others on similar journeys.....the journey we take is a lonely one, full of personal decisions that must sit right with us....crossing my fingers for you this cycle.

  2. I'm triggering tonight as well. I wish you luck. I know what you mean about trying new things with nothing happening. It's pretty annoying.


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