Advice Needed (somewhat XP from IF board)

winofairy

Hi Girls!  Happy Friday!

As you all know IF is a total mind ***!  And right now I can't even think straight...GAH!

This morning was my 3rd monitoring appt. and I wasn't expecting things to turn out the way they did.

When I went for my baseline u/s on the 10th I had a pretty large cyst in my right ovary.  They checked my E2 and it came back at >15 which they told me it was a "simple cyst" and non-active.  And that we were good to go with the cycle.

When I had my monitoring appt. on Monday after 3 nights of stims they said the cyst had started to collapse and my E2 was 303.  I was told to stay on my same does of meds (300iu follistim and 150iu or menopur).

When I went on Wednesday the cyst seemed to have gotten a litter bigger but they didn't seem concerned.  My follies were growing normal and we were hoping for 4-5 on the right and 5-6 on my left.  All were less >14mm so they wouldn't tell me for sure how many they thought I would get because they don't normally count them until they hit 14mm.  My E2 came back at 707 and again they kept me on my same does of meds.  They said my ER would be on the 26th/27th.

I go in this morning and now I have 4 lead follies one at 20mm and a couple others at 18mm and the cyst is now 24mm.  I had "major' growth in 2 days.  And now my smaller follies won't have much of a chance to catch up as they are only around 10-11mm.

They have me coming back tomorrow for another u/s and had me sign the consent form for the ER.  They will call me with my E2 and progesterone and let me know about my meds for tonight.

I am so worried we will only have 4 eggs and with my AMH and AMA I'm afraid my eggs won't make it to transfer.  Plus I am taking twice the meds I took with my IUI cycles and I'm going to end up with the same amount of follies.  GAH!  I am so upset!

I am so bummed as this is a ONE shot deal.  After this IVF we won't be able to do another cycle.  We are IF treatment poor.  I am in tears as I type this.  Plus I don't know if I can find more follistim, menopur, and ganirelix.  We were given a VERY generous donation for this cycle (w/o the donation I wouldn't even be here typing about this crappy cycle).

Why didn't they wait until the cyst was gone.  I would've rather have waited to start this cycle than have it turn into a complete bust!  GAH!

I know it only takes 1 good egg but at 40.5 what are the chances that my eggs will be any good.  I've read all the heart breaking statistics.

I've been thinking (also suggested on the IF board) maybe we should cancel and wait for the cyst to be gone or maybe do another lap and remove it? 

What do you think?  Advise? Experiences?

Mrs.McIrish

I personally don't think 4 eggs is bad. I've had 3 retrievals with less but obviously they didn't work.  If you cancel, can you afford to try it again?  Not sure how the billing works if you cancel before the ER. I'm guessing you still have to pay something for the cycle.  If you can't afford to pay for a new cycle, I'd just go ahead since you don't really have anything to lose.  Unfortunately, a lot of IVF is trial and error and you may respond better next time with a different protocol.  It doesn't really sound to me that the cyst is a problem.

winofairy

Thanks Mrs.McIrish!

I just got off the phone with one of the IVF nurses.  My E2 came back at 1527 and the progesterone at .08.  She said the 1527 is a good number and the progesterone shows that I haven't started to ovulate on my own so the doc may push out the meds a couple more days. 

She said I have 5 good size follies with 3 smaller ones that may catch up.  She said with my baseline AFC of 7-8 my numbers are good.  And that this maybe the best response my body will ever give.  Who knows!  Like you all always say it's a big science experiement... all trial and error.

She also said that they will know more tomorrow and to have all my questions written down for the doctor.  She said if worse comes to worse we could always convert to an IUI.  I'm not sure I would even go through with the IUI since the other 8 I had didn't work.  I'd really rather not spend the money on something that hasn't worked for us before.

I can only pray that with the ICSI and assisted hatching we can make a few embies good enough to transfer. 

I read this morning that tomorrow is a new moon and the best time to make wishes that may just come true. 

We shall see I guess.  I have lots and lots to think about.

Gregermis

Oh boy.... (((HUGE HUGS)))... I wish financials wasn't something we had to deal with on top of IF.  That is such a hard decision!!  I think if it were me and I was in your shoes, I'd probably very seriously consider canceling and trying again. 

But FWIW, They thought they'd only get 15 eggs from me and we wound up with a lot more (28,26 mature)... so some of those smaller ones maybe contain some eggs.  If you decide to go forward, make sure they check there just in case!

((more hugs))  Good luck hun!

ETA: Didnt' see your response!!  8 sounds much better!!  Hang in there!

BeeBee08

Huge ((hugs)).  I wish this was easier.  I don't know what I would do, and I would hate to make that decision.  Like worms has said, 4 really isn't all that bad.  I hope the extra coule of days lets you grow a few more!  Good Luck.

LaLe09

Hey girl. sorry to hear things are so stressful right now. Sounds like you have 5 good follicles and your E2 sounds pretty good too. FWIW- I had a 35 mm cyst on my left ovary for both of my IVF cycles (it was a dermoid- i've since had it surgically removed). My RE was never concerned about it affecting the cycle. Hopefully yours isn't either.

I know it's hard not to criticize every little thing during this time. There is so much riding on these cycles. Anything less than perfect gets us all worked up! I hope your follies keep growing and that that they turn into beautiful embies. I know there have been many, many success stories with less than what you have, so try not to give up hope yet!  Hang in there and good luck!

mdluv21

Sorry it is so stressful right now!  Rooting for you!

winofairy

Thanks so much ladies!

Mrkyrain

I would move forward.  Your estrogen level is fantastic and totally indicates that there is more than four eggs.  I would bet that some of those smaller ones definitely have eggs.  However, if you go in and there are only four I wouldn't lose hope.  I just turned 40 and have always had five or less eggs during ER.  This last time I had five and four fertilized.  We have had positive betas with this cycle so I am hoping for good things.  I know it seems discouraging because I was there cycle after cycle (5) but as others have said it's a big science experiment.  You just have to hang on and do the best with what you have.  BEST OF LUCK TO YOU!

kekis

I would definitely continue the cycle.  I was 43 when we cycled with crappy AMA/AMH and produced 0 follies on 750 of follistim for 10 days.  My advice?  If you are 40 with low AMH & AMA, 4 or more eggs is a good number for retrieval.  Are you doing PGD or CGH?  That would definitely help you determine the best quality for transfer if you are.  GL!