Monday, December 17, 2007

Disney Dreams

I recently returned from a conference in Orlando. I decided it would be just wrong to go there for any length of time and not go to Disney World, so I did. I was 10 or 12 and accompanied by my parents and younger brother the last time I went to the Magic Kingdom. Needless to say, things have changed a bit since then--for me more so than the Magic Kingdom I discovered.

"When you wish upon a star...anything your heart desires will come to you," just didn't have the same ring it did back then. I spent some time trying to come up with new lyrics to the Disney tune that are more reflective of life's complexity. You know, something like, "Please don't wish upon a star, it won't get you very far, sometimes you'll get what you want, or you may not."

Granted, it's not very catchy, but it's more honest. Maybe the whole Disney thing is a necessary stage of development, I don't know. When are kids able to understand and accept the somewhat ordered chaos that is life without fearing that they'll be overcome?

It feels like a lot of adults want to escape to the land of Disney too--to go to a place where everything is magical and your wishes come true. Not that I've stopped wishing or hoping, but I'm putting some action with my hopes.

Saturday, December 8, 2007

Second Opinions

My appointment with the Repo Endo at UCSF was surprising…but good…or at least not bad. Granted, it was a terrible time for the appointment (I’m highly emotional pre-menstrually), and I cried at regular intervals (I didn't even make it through the "how long is your cycle" question--no kidding).

I really just wanted to talk and get a second opinion, but of course I got another complete intake exam, including my favorite--transvaginal ultrasound with antral follicle count. It’s not your average ultrasound. When they’re probing around deep and looking for follicles in your ovaries, it can get a little painful. Not to mention the anticipation of watching the screen for any signs of follicles, and hearing the count—8 (that’s 4 less than my other doctor saw 6 months ago).

I was sure she would agree with my other doc's recommendation and give me her blessing to go forward with IVF. When she didn’t, I was stunned. You’d think I’d be happy to hear that I may not be as bad off as I thought. But when she said she thinks I should do two more cycles of clomid (or letrozole) with IUI before moving on to IVF my heart dropped. I was so ready to go forward, pull out the “big guns” and get some answers. I already had a week off work and have been telling everyone February is the month.

I asked a lot of questions and she was very patient with me. She showed me some concrete data and talked about research that she is involved in. She said that FSH is not predictive of pregnancy rates (for IVF cycles) in women under 38. She's also seen cases in young women who don't respond to aggressive stimulation (as in egg donors), but can produce one good egg and have a successful pregnancy.

She also wants to actually see the films from my HSG. Depending on where the adhesions are she felt like surgery might be helpful.

When I left her office I was totally confused, but over the next few days things settled out a little. There's really not much to loose with two more cycles, and there's a lot of potential gain (less cost, less stress, less risk) if it works. I know the odds are still only 8-10% per cycle, but my acupuncturist is sure we can bump the odds up a bit with acupuncture and herbs. I also think I need a little more experience with disappointment before I potentially face the BIG disappointment that a failed IVF cycle would be.

So, I'm waiting to hear about possible surgery, then gearing up for a few more IUI cycles before the big IVF.