This morning I went to Ginormous Fertility Clinic and as I waited to be called into Dr. L's office, I felt my spirits begin to sink. I looked around the waiting room, skimmed through brochures about Mind Body classes, Complementary Medicine programs, IVF Support Group meetings, and I felt my eyes well up with tears. I really couldn't figure out how I had gotten there, where had we gone wrong. Would this even work? Was my endo too severe for me to qualify for treatment? Would Dr. L wish me luck and send me on my way? Thankfully (mercifully) before I went into full sob mode, a nurse made a joke with one of the couples in waiting area and I was distracted from my self-pity.
Shortly thereafter, Dr. L walked by, picked up my file at the reception desk and walked back toward his office. He returned after a few minutes of refreshing his recollection of my files. Dr. L greeted me with a joke about my "impressive" laparascopy photos and this bit of levity seemed to lighten the mood. We sat in his office, called David at his office, and the three of us commenced a discussion about our family building options.
Dr. L mentioned two options: (1) adoption and (2) IVF. Since I was at the RE's office, speaking with the RE, adoption was tabled, for now. He explained how IVF would work (my insightful questions led him to quickly became apprised of my advanced degree in Googleology). He then described our protocol -- beginning with BCPs at the start of my next period, followed by Lupron for a few days, with stims shortly thereafter and so on. He talked about the "ideal" number of eggs for an IVF cycle (in his opinion, 15). I then asked about risk factors to our potential offspring and me from IVF, he concluded there were few, which he then proceeded to enumerate.
I also asked about the reduced possibility of success from IVF due to my endo. Apparently, Ginormous published a report a few years ago, which suggests that women with endo have a "statistically insignificantly" lower success rate of IVF than do couples that suffer with other types of infertility. I asked about the increase risk of miscarriage due to endo and fibroids and although he acknowledged that there is, in fact, a higher risk, he seemed unconvinced that it was significant. Statisically, he gave us a 38% chance of success after one cycle and an 80% chance after 4 cycles (yep, 4!). And stated that "when you get pregnant," twins would be one of our biggest concerns. (When I get pregnant? When I get pregnant? Is this some kind of weird RE-jedi-mind-trick?)
My questions then strayed down the alternate remedies route. I asked about changing my diet. I am dabbling in "The Infertility Cure" and "Healing Endometriosis Through Nutritition," which both seem to advocate eliminating everything from your diet except organic fruits, vegetables, water and cardboard. He suggested that I not do anything too extreme and confirmed that changes in diet do not have medically proven results. We also talked about acupuncture, which he seemed indifferent about. He suggested that I avoid herbs and other supplements (I've started taking Flaxseed Oil and Evening Primrose tablets). OK - I'm a bit of a nut . . . I know, I know. He reiterated that I should not consume too much soy.
He recommended another HSG (lovely!) to confirm that my lone remaining tube does not have a hydrosalphix. Personally, I think this is a bit unnecessary given that the lap clearly indicated that it was just blocked, not seeping infected fluid into my uterus potentially poisoning our imaginary child, like the right tube had been, but better safe than sorry I guess. Finally, he advised me that I'd need another lap to remove the remaining tube, if the HSG did, in fact, indicate another hydro.
From there I was whisked off to meet with Nurse Mindy, who cheerfully told me about the dates of upcoming IVF injection classes and IVF information seminars. She advised me of the meds I'd be taking and the tentative dates on which I'd be taking them. She suggested that I get a pap smear (I've had no annual exam since 6/2004). She gave me prescriptions for prenatal vitamins (2 types, my choice), HSG antibiotics, and BCPs. Finally, she advised me that one of the financial advisors would be calling with information soon (today, as it turned out). Nurse Mindy made me feel like a kindergartener, being walked through my first day of school. I guess that's what happens when you complain about your treatment to the right people, everyone tends to O-V-E-R-C-O-M-P-E-N-S-A-T-E.
I guess I shouldn't complain. I called Nurse Mindy with a follow-up question about locations where I might have the HSG performed locally and she very promptly returned my call. She even offered to walk us through the injection process, if we were unable to attend the scheduled injection classes. On our phone call, she even told me that she'd seen our address and noticed that her sister lives near us. Nurse Mindy was very nice, if not a bit patronizing, upbeat and extremely responsive.
I guess I've gotten everything that I could have hoped for -- a protocol that begins soon, no Lupron Depot, responsive and knowledgeable medical personnel and a supportive spouse. So in a couple of weeks, our journey will begin.
As always, thanks for all of your comments. I appreciate all of the responses about David's grandmother and the well wishes about my health. I can't imagine making this journey without you.
