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Yellow, not green!

We finally had our much anticipated regroup with Dr S today. It went by pretty quick and was sort of anti-climactical. I mean I obviously knew, basis the test results, what he was likely to say but somewhere our last failure has left me so wary I was prepared for the worst.

He started by discussing our test results and I believe he mentioned the word ‘good’ when describing my ovarian reserve even though my FSH is borderline high (10.3) and my AMH is below what they consider normal for my age at about 1.4-1.5 (mine’s 1.3). APA testing revealed only one slight elevation on the IgM (mine was 13, normal’s <11) so he said I did not need any blood thinners (interestingly this is something he told us on our first phone consult itself without any testing!)… phew! Uterine x-ray showed an AFC of 13 and normal blood flow to ovaries all of which is good. DH’s numbers also look good with his motility at 55% even though morphology is low at 2% (he did remind us that they use very strict criteria so, with 4% being the normal, this wasn’t too shabby). His sperm DNA fragmentation results will still take another week or so to come in.

So, he is sticking with his earlier prognosis and his recommended protocol for me is

****drumroll****

EPP–Estrogen Priming Protocol

He also wants to add in a growth hormone (saizen??) and probably an antagonist to prevent premature ovulation. He thinks we should wait on taking a call whether to do embryo banking or not depending on how the ER goes. Anything above 6 eggs and we should not need to bank, according to him.

We asked him a few questions which he patiently answered. He will be using a double trigger for me (HCG/ Lupron) and closely monitoring estrogen levels even though I am unlikely to hyperstimulate. When I asked him how I can improve egg quality he asked me if I was taking the supplements prescribed by them and I said no, I am taking then of my own accord. He told me to ask my nurse for a list and then hung up with the promise that a nurse would contact us soon to discuss scheduling.

So, from the above, it would seem that this went pretty well, right? Well, perhaps its the exhaustion from last evening’s yoga class but truth is, I don’t feel too spirited somehow. Perhaps because I am still, somewhere in the back of my mind, coming from a DE perspective whereas he was pretty clear right from the get go that I should try again with my own eggs. Perhaps because I was anticipating getting rejected by them basis my AMH (which had been much lower at 0.48) and my FSH (which I had never tested before). Or perhaps because I just don’t trust my luck anymore! I kept asking K whether he thought we’re in and he said of course silly girl, this is it; we will be cycling at CCRM.

Really?

All I could think about was one strange comment Dr S made–something about this being a yellow light, as opposed to a red one. Why not green, my mind asked? I categorically asked him if there was any further testing to be done or any issues to resolve before we could start and he said no, it all looks good. Then why yellow? K reasoned with me saying that he is probably meant that about the whole process, especially since we made no chromosomally normal embryos last time. He’s probably right. Perhaps I am just being silly and over-thinking things (surprise surprise!).

The nurse is yet to call. I hope she gets in touch with us soon. I need to see my calendar to believe this is real!

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CCRM test results

As I return to cyberspace after a long hiatus, there is so much to write about… bear with me as I attempt to fit in the chaos of last month in my next few posts all of which are in danger of being regurgitated today itself (don’t say I didn’t warn ya!).

As if the battery of tests I got done at Zouves’ wasn’t enough, CCRM graciously offered some more to add to the merry cocktail. Some of these (AMH, hubby’d SA) were repeats which they just prefer to get done at their lab while others (amazingly enough!) like the hysterectoscopy, day 3 bloods etc. had not been done before. Also, for all patients above the wonderful age of 35 (which already seems so far behind… sigh!)… they require a baseline mammogram… just in case you’re not wrung out from all the poking, prodding and accompanying stress, here’s a little something more to add to your overflowing cup of joy 🙂

Everything went off smoothly. The mammogram did cause me some anxiety (and not for the procedure itself which turned out to be merely uncomfortable and not hugely painful as I had feared) as the lab tech told me I had dense breast tissue and should not be alarmed were I to be called back for additional testing. Apparently, roughly 50% women have this condition and it makes it difficult to detect things on a routine mammogram. Obviously not thrilled at this revelation, I spent the next week freaking out every time the phone would buzz, convinced that I would be called in but it never did happen! Oh and the whole shipping thing with the day 3 bloods was a little nerve-wracking (esp. since I got my period over a weekend and there are strict missives from HQ to NOT ship blood over weekend) but the local Quest lab stepped up to the task and everything worked out just fine. In fact, the day CCRM received the bloods is the same day they tested and called with the results which I thought was pretty awesome!

So, here are the numbers:

AMH: 1.3 (previously 0.48… yippee!)

FSH: 10.3

Estradiol: 65 (could be artificially suppressing FSH)

LH: 6

AFC: 13 (stayed the same from March testing)

Mammogram: normal (whew!)

Antibodies: only 1 slightly elevated, all other normal

DH SA: Motility back up to 54% (yayy!), Morphology: 2%

Karotype testing for both of us: normal

Genetic panel testing: one indeterminate value for DH (beta thalassemia). However, since I am not a carrier, chances of our baby being affected vlow/ nonexistent)

TSH: bounced from 2.7 back to 2.3 (the first one might have been high cause I skipped my meds a couple days before OWDU. However OB advised upping Levothyroxine dosage to 50mcg from 25mcg. Here’s hoping I don’t lose more weight!)

Phew!

So overall, things are definitely looking up from last time when it seemed to be all doom and gloom. I was ridiculously excited at my AMH going up (even though I get that different labs might yield different results) and more than a little pissed off at Dr Z for stubbornly maintaining that AMH cannot go up! I think the surgery, continued Vit D, acupuncture etc. may have all contributed. Of course, it’s possible that the first result was a freak incident.

The FSH number does concern me. I know it’s borderline (CCRM prefers it to be under 10) but with the high estradiol, the nurse said it’s more likely 11 or 11.5 (not hideously bad but not great either). I’m hoping, praying, begging that my egg quality is not affected.

For now, though, I am going to be happy with these results (which are some of the best I have had ever since we started TTC) and await our next consult with Dr S on Sept. 10.