To Stim or Not to Stim

I am awful about keeping up this blog, I know. I have spent much of the past few weeks deliberating over whether to postpone fertility treatments and seek treatment for my endometriosis more aggressively or give IVF another try. It has been a really hard decision. I haven’t been 100% since my lap last August and although the prospect of another, more invasive, surgery is daunting, the prospect of being “sub-well” indefinitely seems worse. I got a recommendation for an extremely well renowned gynecological oncologist. The idea there is that someone with experience dealing with severe conditions should be well equip to fix me right up. I have an appointment with her on August 1st.

In the meantime, I got the green light to begin stimming today at my baseline u/s and b/w appointment on Monday. I must admit that Dr. L didn’t give me much (any!) comfort about treating my pain nor did he seem to be completely on top of my case. I know, I know, there are so many cases that it’s impossible for these doctors to keep track but would it kill them to take two minutes to review the patient’s records prior to the exam rather than entering the u/s room completely clueless about the patient. I think I expect too much. Anyhow, of course, the endometrioma are still hanging around but the cysts are smaller. Also, Supernurse told me that my e2 level is much lower than last cycle.

In terms of pain, Dr. L had no answer but believed that the pain was understandable given the endometrioma, endometriosis and fibroids. He suggested that I return to Dr. NHB for a consult. (The suggestion that I return to my gyn for pain management while being treated for infertility made me feel like Dr. L was just brushing me off. I was not pleased.) Dr. L thought the idea of a gynecological oncologist would be a pretty effective route for treating my endo. Unfortunately, he advised against another surgery suggesting that it may result in diminished ovarian function. He suggested that pregnancy (HA!) may be the great miracle that cures my endo. Then he rushed off to his next patient.

When David and I walked out of Ginormous Fertility, I was pretty convinced that I would be hanging up my syringes for a few months. My best infertile friend and my parents encouraged me to focus on my health and leave the fertility treatment behind me for a while. David left the ultimate decision to me, giving me the pros and cons of both options but not weighing in on either.

So after much deliberation, I decided to go for it! I started stimming this morning with Follistim and will take more Follistim and Menopur tonight. If the next surgery may reduce our chance of success in the future and I don’t see the new doctor until August 1st anyhow, why not go for it now! What’s worse thing that could happen? I don’t stim well? Been there. I am in too much discomfort to make it to transfer? We’ll have to wait and see but for now I am running off to acupuncture and trying to stay positive this time around. As David said, this way I won't look back and question my decision not to pursue another cycle, if surgery somehow leaves me less fertile (as if that's possible). And I feel pretty good today too!

Thanks to all of you for checking in on me. You are awesome!

Cysts 5, Chee Chee 0

As you can probably gather from the title of this post, our baseline ultrasound and bloodwork on Thursday did not go well, to say the least. It seems that I have 5 large endometrioma or cysts (the technician could not definitively tell me how many of each I had). All five measured over 30mm and one was over 40 mm. Also, my estrogen level was over 600 and so we are on hold for, at least, another cycle. It's back on the pill on Wednesday and hopefully, things will look better in a few weeks. Needless to say, I was totally stunned. I didn't ask any questions, nor could I find any words at all. Thankfully, David was with me and had the presense of mind to ask some good questions like -- Could this have been caused by the stims from last cycle? Do we need another rest/suppression cycle? What are our next steps? I felt like (and still feel like) I am on a continuous road to nowhere.

As it turned out, things only went downhill from that point. I had the most excruciating menstrual pain in recent memory. I popped every type of pain pill in our house. I rolled around in agony for most of Friday and Saturday. I begged one of the doctors at Ginormous Fertility to prescribed something, anything, stronger than the stuff I had at home. Thankfully, mercifully, he did and two short hours later, I was on the road to recovery. I returned to Ginormous on Sunday morning for another scan and their thoughts on my situation. The doctor, who happened to be doing monitoring on Sunday morning mentioned that surgery (SURGERY!?!?) might be my best option. It just keeps getting better.

After learning of this weekend's events, Dr. L and Supernurse called today to check on me. Dr. L advised me to take the BCPs and return to Ginormous in three weeks for monitoring. He confirmed that it had been difficult to distinguish between the endometrioma and the cysts and that although the endometrioma would not be affected by the BCPs, the cysts should re-absorb. (We know that the endometriomas hadn't been so large and numerous at the start of my last cycle, so hopefully they are mainly new cysts and not new endometriomas). He also mentioned that the pain was "to be expected" given the cysts and extent of my endometriosis. That's easy for him to say with his male parts and office full of family photos! (Down, girl). So I made an appointment to return to Ginormous on Monday, June 26th. Dr. L is scheduled to do monitoring himself that morning.

In the meantime, my best infertile friend suggests that we travel to NY and seek second opinions with the fertility doctor to the stars. I am having difficulty making any sort of decision right now but maybe it couldn't hurt . . .