Today I had both my follow up meeting from my last cycle and preparation meeting for my next cycle with my doctor. Again, I got charged for this visit and I plan to call them later this week to hammer out what the deal is with getting charged for this appointment. Last time they said they charged me because I had a scan, but I didn't have a scan this visit. I should have argued when I was there but I wasn't in the right mindframe to do it. I've been incredibly stressed all day and I just couldn't deal with it. Probably a mistake. Whatever.
Here are the things we talked about in no discernible order.
Probably one of the most important is we discussed my results from the last cycle (4 eggs) compared to the first cycle (6 eggs). Of course this disappoints me somewhat, but then if I had 2 ovaries I would have 20 eggs total instead of 10 (lets say) and I'd be perfectly happy with that. So I don't feel like I can be that upset about it. I stressed this was my last possible cycle due to financial considerations. So the doctor said that as it was my last cycle he felt we could try to push the ovary a bit more and he's going to increase my Gonal-F and see how it goes. In both of my cycles there had been additional smaller follicles that didn't catch up or grow as fast and I guess he's hoping to catch them by upping the drugs. As with most of this process, I have to trust that he is basing this decision on his experience and expertise and I trust him. I'm conscious of having read other women who didn't respond well to higher drug doses, but I trust that my clinic scans me every other day, and will monitor me closely and he wouldn't suggest this if he didn't think it was a good plan. It's hard to feel like I'm gambling with my last cycle, but on the other hand, I've read about a lot of women on the higher dose of Gonal-F, so it's not like it's that odd or extreme. I'm sure it will be okay. I'll obviously keep track here of how everything goes.
In keeping with that, I got my prescription for all the drugs so I need to get in touch with Healthcare at Home to send it in and arrange the delivery. I'm going to remember to insist that they include the sharps bin this time!
We arranged my norethisterone prior to the cycle. As my cycle is about 30-31 days, I'm going to do 9 days of the norethisterone. For the first cycle I did 8, the second I did 7. So this is another change although one I'm more on board with. The nurse had suggested I do 9 for my second cycle but the drugs didn't arrive in time so I could only do the 7.
We talked about birth control pills. Specifically about whether or not I could go back on them after the third cycle and if there were any implications for future fertility. He said there is no indication that birth control pills affect ability to conceive and that I should be fine going back on and he had no reservations. So that was good news. I miss my birth control pills!
We talked about my period. Okay, skip over this if you don't want specifics. Basically I've noticed that as I've gotten older, my period is much darker, and lighter, and a bit shorter. Of course as I go through all of this I just panic that this somehow means my womb is an infertile place and I can't conceive. He said the color of your period means absolutely nothing. He also said that the frequency of your period and heaviness have more to do with your ovarian reserve than your ability to get pregnant. He pointed out that there are women close to 50 who get pregnant- they have no eggs left, but their womb can still healthily function. Obviously I am not planning on being 50 and pregnant, but this was comforting news.
We also talked about the counseling service that is available. I sort of wish I'd picked up on this sooner. They have to counselors who have an office space and I just need to call and arrange an appointment and they will often schedule alongside your scan if the timing works out. Although I might start this sooner seeing as how once my scans start there isn't much time left for any counseling. At any rate, it will probably take time to arrange it anyway. So I'm going to do that and will also have updates here.
So really, that was all great, other than being charged 120 quid for the visit. This irritates me to no end, but my comfort and trust in the clinic outweighs my annoyance.
The only other thing of interest is that they are doing some building works to the clinic and so I'm lucky I didn't try to schedule for this month as I don't think they would have done it. They're moving around some of the lab and clinical spaces on the ground floor although the doctors offices and scan rooms on the first floor aren't affected. The building works are supposed to finish right when my next cycle starts, so that allows an extra week and a bit for them to run over before it's a problem. I am just going to assume it's not going to be a problem.
Anyway, that's the update. One month countdown to the third and final cycle begins!