29 January 2013

(Not) Understanding Numbers

I look around a few IVF/egg freezing places and of course everyone wants to compare their numbers.  Follicle Count, AMH, and FSH.  Here's the problem.  All of the numbers and charts provided are based on a woman with two ovaries.  I have no idea what the numbers mean with my one little ovary.

In my quest to find information, I found something else of use that is not so easy to find- a comparison of US to UK AMH readings and brackets for what they mean: http://www.drmalpani.com/amh.htm.

Based on this, my AMH at 9.4 pmol/l would put me in a low fertility bracket.  Although if it was doubled, I'd be in a satisfactory fertility bracket.  Of course, following that logic, even if I was satisfactory, I'd only betting half of what a satisfactory person would be getting, but I still think it makes a difference based on how many eggs you might be able to get from a single ovary in terms of trying to temper my expectation.

Similarly, I found this: http://www.advancedfertility.com/antralfollicles.htm regarding Antral Follicle Counts.  Now my count was 9- in one ovary and here there is an even bigger difference.  As a single ovary I'm looking at a reduced count but if that were doubled, I'd be skipping a bracket right into a normal or good count.

These will be questions for my meeting on the 5th.  Unfortunately however, UK doctors are just not as forthcoming as American ones.  By the way, if anyone comes across this post and knows the answer, even if it's months from now, please feel free to illuminate.  I will update the blog if I find an answer.

First Pill

Popped my first pill this morning.  Two a day until my scan and meeting on the 5th.  I'm excited and nervous.  I can tell that this whole egg freezing thing is going to be fairly emotional.  I can't predict what's going to happen obviously, but I would have to be some sort of grand master to keep my mind from occasionally wondering if it will go well (ie, a good number of eggs collected) or if it will go badly (ie, a poor number or even no eggs collected).  When these thoughts come upon me I just need to take some deep breaths and remember that whatever it is going to be is what it will be and the best thing I can do is stay calm and positive.

15 January 2013

The Schedule

I thought I'd put the egg freezing schedule here for two reasons.  First, so I don't have to keep looking up the email, and also because I found it very difficult to find a clear "schedule" of the process when I was looking up egg freezing and IVF.  I'm sure it's actually all over the place, but one more can't hurt.

  • On the 19th day after the first day of your period, you start taking Norethisterone (5mg) twice a day for 8 days. For me, this starts on the 29th of January.
  • On the 8th day (last day of the Norethisterone) you come in for a scan to assess the ovaries.  If the ovaries are okay (or in my case, ovary), you are given your stimulation medication to start on day 2 of your period. For me, this is the 5th of February.
  • Your period should start 2-5 days after finishing the Norethisterone.
  • Start stimulation injections on day 2 of your period.  Day one is considered the day of a full-flow period that starts before noon.  If your period starts after noon, then the following day is considered day one. For me, this is around the 10th of February.
  • On day 4 of your injections, you start with an additional daily injection of Cetrotide. For me, this is around the 13th of February.
  • 4-7 days after the start of Gonal F/Merional and as needed until follicles reach the correct size- takes approximately 3 scans.
  • The trigger shot (hCG Ovitrelle) is done at exactly 37 hours prior to egg collection.
  • Egg collection! For me around the 22nd of February, if everything else goes to plan!
And that's it for egg freezing.  If you are continuing on with IVF there are other steps and stages for embryo transfer.  But for egg freezing, that's where the story ends.

All Systems Go

Alright.  Lots of back and forth from the clinic.  Back from my trip to Australia.  All systems are go for egg freezing round one.  This starts with taking Norethisterone on the 29th of January 2x a day until my first scan on February 5.  On this day I have my nurse appointment and get to learn all about giving myself injections and will also collect the rest of my drugs, as well as be tested for a slew of STDs.  Collection is tentatively scheduled for around February 22 depending on when periods start and how scans are going.  This works fairly well with my schedule though it looks like I need to move one appointment.  I'm both nervous and excited for it all to be underway.  In some ways it doesn't seem real.

So current issues are:
  • Get to the 5th of Feb and ensure that all planned scans, etc do not conflict with my rather hectic back and forth schedule.
  • Move that one appointment that is likely to conflict with collection day.
  • Try to find someone to meet me at the clinic on collection day as they don't want you to go home alone.
Although I asked and they said if I really can't find anyone, I just need to arrange a taxi to take me home and not take public transportation which seems fine.  It's just that I'd be asking someone to take off work and that seems unlikely.  I have one friend I can maybe ask, but I'll try for that as it gets closer and I have a better idea of the actual collection day.

In other news my mother started freaking out that the treatment was going to create another dermoid cyst and that I'd lose my last remaining ovary in the process.  She lost both ovaries to dermoid cysts and I lost one.  So there is a fair worry there, but I reminded her that I asked the doctor specifically about this issue and he said it was very unlikely.  On top of which, given all the scanning I'll be having, if any cyst starts to develop, I imagine that they will be able to notice it and stop the process.  Also, early cysts can be dealt with, without losing the ovary.  It's a risk, but a minimal risk.  And my only option is otherwise not to proceed.  The doctor did not think it was a high risk.  I think I need to go with his experience on the matter.

So that's where I'm at.  Now I'm getting nervous that it's all going to fail and there won't be any eggs or not enough eggs.  It's really kind of amazing the mental ups and downs you go through.  I mean, I understand it, and it all seems a bit text book.  But being typical doesn't change that I'm still going through it!  Deep breaths.  Calm thoughts.  After all, if I meet someone in a couple of years, and we wanted kids and tried IVF then, it would be worse then.  This is the best I can do, doing this right now.  We'll see what happens.

11 January 2013

Periods and Planning

So I did hear back from the clinic finally and they suggested that a cycle will take approximately two months- as I start the first round of pills on the 19th day after my period, and the collection is on the cycle following.  So they asked me to let them know when I got my period so they could send me a time-schedule of how this should all play out.

I have just gotten my period, so two months from now puts me into March.  I'm slightly stressed by this as I have a commitment out of London the week of the 18th which technically should be the week after my period (and collection??) but if not, I'm going to have a problem.  I'm going to have to see if they can keep me on the control pills an extra week.  What a mess.  Or I wait yet another month.

However, as discussed previously, I don't really want to put it off.  I do get that stressful feeling that now that I've decided it, sooner is much better.  Younger eggs!  By a whole month!  I know it's silly, but I think it's understandable why someone would feel like this.

Anyway, I'll update again with the proposed schedule from the doctor and we'll take it from there.