New Year, New RE

Once Arthur and I started slowly attempting to navigate life again, there was the big, ugly question in the room that had to get dealt with: where did we go from here?  There were a fair number of moving parts in all of this, plenty of unanswered questions, and a ton of anxiety.   For starters, there was the low number of eggs that had fertilized even with ICSI.  This, along with the miscarriage, had caused me to start wondering about egg quality.  There were questions about protocols, questions about whether the two embryos we had frozen were any good, and in general, just a lot of WTH hangover from the whole IVF.

The first thing we both recognized: we needed a new RE.

It’s a long story, but the fact is, Dr. D and I did not communicate well.  It’s not that he had done anything wrong regarding protocols or my treatments, but more that we had a series of misunderstandings.  Each one was fairly minor in and of itself, but together, they added up to a fair amount of frustration for me.  None of this makes Dr. D a bad doctor, it just wasn’t working out.

Arthur and I debated for awhile, then decided we wanted to switch over to Dr. D’s partner Dr. E (my doctors are identified here by alphabet in chronological order – Dr. A was the first physician on the case, Dr. B the second, and so forth – not by their actual initials).  The thing was, Dr. E had been very helpful and kind when I miscarried.  He’d also worked with me on several other occasions when Dr. D was gone.  I’d always had good interactions with him.

Neither Arthur nor I was entirely sure what we wanted to do beyond that switch, however.  We had no idea exactly what we were facing at this point.  If egg quality had entered the equation, we needed to talk about moving forward.  I also wasn’t sure about what tests would need an update to start a new cycle when we were ready.

So we went ahead and scheduled a consultation.  I spent the next several weeks worrying about it.

I was so nervous about the whole thing that I actually took the time to put on make-up, coordinate my jewelry, and come up with an outfit.  I seem to get the most upsetting news when I’m lying half-naked on tables with my feet in stirrups.  It’s how I usually found out my cycles weren’t going well during follicle check ultrasounds.  It’s how I found out I’d miscarried.  It’s where I was when I had my disaster of an HSG about a year ago.  It may sound silly, but the half-naked factor just makes me feel even more vulnerable and exposed when the crap hits the fan.  At least this time, I thought grimly, I’d make sure I had on an outfit I liked.  Armor, in a sense.

After the visit, however, I felt much better.  For starters, both Arthur and I knew we had made the right choice in switching to Dr. E.  He’s very thorough, measured, and calm.  I had brought an enormous list of questions which he went through with us one by one.  Dr. E took every one of them seriously, and answered them carefully.

One of my greatest concerns was the two frozen embryos.  I was loathe to spend a large amount of emotional and financial resources on a cycle that might have a low chance of success.  At the same time, neither Arthur nor I wanted to abandon the embryos.  Dr. E told us that he was fine with planning to thaw them during a frozen cycle and then attempting to culture them out to blastocyst stage.  He warned us that this meant we had a higher chance of having nothing to transfer.  To me, despite that risk, this was a good solution.  It meant we’d have at least some assurance that if we were able to transfer the embryos that there was a reasonable chance of success, and if the embryos stopped growing we didn’t have to go through the torturous two week wait when there was a very low chance of it working – plus we get a bit of the cycle cost back.

As far as the egg quality, the short answer is that there is a problem, but it wasn’t quite the type I had been worrying about.  It’s not an issue with the age of my eggs or diminished ovarian reserve – it’s the PCOS.  The PCOS apparently affects the egg quality – I may have plenty of eggs, but fewer of good quality.  It’s something Dr. E and I will discuss further in terms of the ovarian stimulation protocol if I have to undergo another fresh IVF.

We also talked a bit about the restrictions I’d had during IVF, and that those had significantly impacted my life.  Dr. E and I talked about how I can continue some of my exercise regimen during the frozen cycle.  As far as he was concerned, since it’s a habit that greatly helps me to diminish my stress, while he told me I’d need to be more moderate than usual, he’d work with me the best he could to allow for my routine.  That, I appreciate.  I know there may be a time where he’s got to tell me I have to stop, but I’m grateful that he’s taking it into account as much as possible.

The next step is a saline sonogram to evaluate my uterus, which I’m having next Monday.  Hopefully there will be no scar tissue from the D and C.  If that goes well and no issues, then we’ll start talking about the timing for the FET.

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