It is Easter Sunday and, while I haven’t gotten any eggs yet, we now have a plan to get me some. I had an appointment with my Dr. today to go over all my blood test results from March 22nd and to figure out our plan going forward.
Again, he told me that he has no idea why I am not ovulating or growing eggs. ALL of my blood work looks normal. We tested my cholesterol, hemoglobin, estrogen, LH, FSH, fasting glucose, vitamin D, prolactin, and more. Everything is normal and I don’t have any STIs (thank goodness). The only thing they didn’t test for is my cortisol and he wants this so I am going to be doing a 24-hour urine sample to get that in the next week. My uterine lining is now at 4.9 mm which is better (it was 2 mm a few months ago), but things are still not fully working.
We tested my AMH which is the test for egg count and mine is 1.4. He said this was okay. Not great, but not awful, and since I have 9 follicles on my right and 5 on my left we should be okay.
So what is the plan? I assumed that I would be starting the injections like tomorrow…but apparently, it doesn’t quite work that way.
If we do the injections, there is a risk that I will over-produce eggs, if this happens, and I ovulate over four, then we need to cancel the cycle – you cannot do an IUI with more than four eggs otherwise you risk multiples. So you have to cancel the cycle which means a huge waste of all of that money.
If you don’t cancel it, you can do an egg retrieval to take out some of them and leave only three or so, but he said that this is invasive, expensive, and in that case, you would have been better off spending a bit more but doing a full IVF and getting LOTS of eggs (ideally) vs. just retrieving a couple to potentially freeze (we don’t want to throw out any eggs!).
We can always jump right to IVF, but again, that is costly.
The other option is that we try Letrozole once more but at 10mg/day and see if I ovulate. We can add injections with the Letrozole as well. He thinks that we should try this medication once more as he really doesn’t like doing injections if you don’t have benefits coverage, but I am okay with the cost if needed (he said up to $6,600/cycle).
So this is what we will try first. And to do this properly, he said I need to take birth control pills for one month to force a bleed. On day one of my bleed, I will call the fertility clinic and they will bring me in. We are going to do a monitored Letrozole cycle so I will go in for monitoring on day 3, 6, 8, 10, etc. and if I am growing an egg properly, then yay, but if not, we will add in the injections at that time, and he will hopefully be able to have a better idea of the amounts to give me (vs. giving injections now and just guessing the dose and risk the over-producing).
SO, on the one hand, I am really happy that we have a plan, but on the other hand, I just want it all to happen now. Having to take BC for a month, then Letrozole for five days and then hopefully ovulating 5-8 days after that, just seems so long. But I have already been in this process for 8 months, and if this is the right way to do things then it will hopefully be worth it.
It is interesting that my old clinic just randomly started me on Letrozole, on a random day. We did that twice. Dr. V said that is not the right way to do it, you are supposed to take it days 2-6 of your cycle, so just taking it randomly doesn’t really make sense. I am so happy that I am now with Dr. V. He really takes so much time to talk, answers every question, is so patient, responds to my constant IG messages, and really seems to care.
I really hope this works. I mean, knowing that even if the Letrozole isn’t working, we will add the injections, makes me feel better because I am pretty confident that we will get me ovulating in May. I just hate the idea of taking BC pills because it seems so counter to everything I am doing. I keep hoping that I will magically ovulate on my own, and the thought of taking the pill is the complete opposite of that, but I need to remember that this is only for one month and it will make it so that I can take the pills that WILL help me ovulate. So at least there is a specific purpose.
Now, I just need to make sure the sperm from my donor is what it needs to be. He has gotten a semen analysis and we are waiting on a couple of the final results to come in.
I am hopeful and happy that we have a plan, but I am also just tired of it all. I know that my journey is not as long as some, but it is also longer than others who don’t struggle with infertility, and everyone’s journey is valid. I am just tired of my body not working and tired of not knowing why. I know that even if I do ovulate, there is a chance I won’t get preggers but I don’t want to think of that yet. One step at a time.
Happy Easter