Friday, August 29, 2008

Whoa there, Endo!

Well, we met with our doctor yesterday.  I wasn't feeling too hot, I've been menstruating for 17 straight days (sorry for creating a TMI moment).  He did an ultrasound and apparently my ovaries are responding too much to the stimulation phase of the Lupron shot.

If you're wondering Lupron has two distinct phases.  First, a stimulation phase which increases production of estrogen, specifically estradiol.  Second, a suppression phase which dramatically decreases my estrogen levels.  This is similar to what happens during menopause (hello, hot flashes!).

My endometriosis is still very aggressive and loved the stimulation phase a bit too much.  The doctor prescribed a progesterone-type pill to stop the stimulation.  It must be magic, overnight I've almost completely stopped menstruating. 

Now for the IVF update.  We've signed all the consent forms and legal agreements.  I get my next shot of Lupron on September 19th.  Then we move into the medication phase of IVF.  Here's some of the questions we asked Dr. Skywalker yesterday:

When specifically do we start IVF?
He hasn't decided that yet.  He wants to see how my endometriosis is responding to the Lupron on September 19th.  Then he will make a calendar for shots, egg retrieval, transfer, etc.  With no specific date, we are looking at mid to late October to begin the process.

What is our personal success rate?
He cautioned us that success rates were tricky because they are based on a population of couples and realistically every couple has either a 0% or 100% chance of getting pregnant (I thought of my dear Shannon when I heard this; she would love the practical logic).

Basically, he is looking for more than 10 follicles during IVF stimulation phase and at least 8 eggs for retrieval.  If we can achieve this, he feels we have a good chance at implantation and successful pregnancy.

Am I at risk for miscarriage?
Since I've never conceived, we don't know if I'm prone to miscarriages.  He feels we have a good chance at a healthy pregnancy.  He doesn't think my endometriosis will cause a miscarriage; partly because once the embryos implant the body will start producing hormones during the pregnancy that naturally suppress endometriosis.

Any suggestions for health and diet?
Aside from the standard, eat a balanced diet and exercise regularly, there was not much else he recommended we change.  I'm taking a prenatal vitamin, a calcium and an omega-3 fatty acids supplement.  

He's not opposed to acupuncture; he just hasn't come across a place here in Charlotte that he likes enough to recommend.  I will probably go back to Charlotte Acupuncture and Wellness Center.  I went there for 6 months last year.  I found them through a referral while visiting my sister in Boulder (the alternative medicine capital of the world).
We still haven't received our financial estimate for the procedure.  There is a program called Shared Risk Refund Program offered by our clinic.  Basically it's an insurance policy for IVF.  Under the program we pay the cost for 2 IVF cycles (roughly $20K) and get 3 IVF cycles.  If we do not have a successful birth after all 3 tries we get 70% of our money back.  

I don't think we are going to do this program (at least I think we aren't, not sure if Dave and I talked this one out yet).  We did agree to do cryopreservation of any healthy embryos left over from our first egg retrieval.  Cryopreservation (freezing and storing embryos) will cost about $1200 initially and then roughly $600/year to store them.  

Dr. Skywalker recommended saving any healthy embryos.  I'm assuming in the world of infertility, healthy embryos are very precious and the hardest hurdle to jump in the fertility race.  Not to mention if we do additional IVF cycles, we can skip the egg retrieval and harvesting/hatching phase including the associated costs (roughly a 30% savings).

There you have it.  Our IVF update.  

1 comment:

Amanda said...

I LOVE EMILY AND DAVE!!! . . . just sayin...