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Wednesday, June 02, 2010

CD1: The Bitch is Back

One day off of the progesterone p-pops and she's back right on time. Egad. No rest for the weary. My poor nether regions are subjected to stress upon stress. My other half looks at the end of a cycle as the restoration of our physical relationship - while I feel like I just want to send my uterus off to Jamaica for a vacation.

Thanks for your comments about this last cycle crashing and burning. I know that with IVF#7 failing, I started to talk in earnest about using a surrogate. Then I didn't go through with it. I got all Pollyanna that I could do it on my own. Silly me. What was I thinking? I know we all want to trust our bodies to do what it's designed to do. I'm no exception to this.

As I mentioned a few days ago, I'm having insurance nightmares. BCBSTX (my cobra plan) said they're in 2nd position and Aetna says they're in first. It's actually true that Aetna is in 1st position, which means that after Aetna gets through paying for this last cycle that I'll have two cycles left.

TWO left. Gulp.

I truly feel my back is against the wall. I can afford to pay for a few cycles cash beyond that: Aetna has a deal with my clinic that they pass onto patients after they've exhausted their benefit: $5000 for a cycle including assisted hatching but, for me, since I'm using donor sperm and the sperm is of "good quality", ICSI is out of pocket. It doesn't matter to them one hoot that I have older eggs with thick zonas, or that nearly every sane IVF clinic out there recommends ICSI to all patients so as to boost fert rates. Imbeciles. So less than $7K for a full cycle including meds (which are covered at $15K/year without limit on years). I've paid much more in the past.

So it's doable to cycle a bit more beyond the two, but really...can I? Should I?

I'll be 46 in November. I have fibroids. Endometriosis. Endometriomas. I clearly have a major implantation issue going on. Julize, thanks for mentioning the EFT and beta-integrin tests. I think that the research is cutting edge. I truly do. I am just not sure that I have the time to do the treatment that they require, and in the case of EFT, I'm not sure what the treatment is as I'll explain in a second.

I've considered EFT and beta-integrin tests in the past but doctors I've chatted with say that the beta-integrin test can vary from month to month, so it's not hugely reliable. If you test in a "good month" you may miss a true underlying problem. I think that the cure for a bad beta-integrin test is lupron (2 months of it). Dr. Nezhat (leading endo surgeon affiliated with Stanford) cautions against the use or lupron for endo patients. So what to do?

Now on the EFT (endometrial function test) test that Dr. Harvey Kliman at Yale is doing - I'm not sure what the "cure" is for a bad EFT test. Yale put out an informative video on their EFT test, but doesn't say what the cure is. They list 5 reasons for an endometrium to have "gone bad":
  1. endometriosis (check)
  2. hydrosapinx (check, tubes were removed)
  3. over or underweight (check. I could stand to lose a few pounds)
  4. perimenopause (check, I'm 45 and have one nonfunctioning ovary. I'm near certain that I am in perimenopause)
  5. stress (check, just had an 8th failure. I may feel calm, but who knows what my body thinks of it all?)

So I have every single one of the redflags for imlantation / endometrium issues that Yale has identified for putting my endometrium at risk for malfunctioning. I've fixed #2 by removing my tubes. I am a typically calm person but it's hard to gauge how my body is really responding to stress. I guess maybe testing cortisol / adrenaline levels might give me an indication if I am under more stress than I realize. I can lose weight and help #3. But #1 and #4 are vast unknowns. What can I do for endometriosis and perimenopause that will definitely change my endometrium?

My pelvic MRI is scheduled for next week. If they do surgery, they might be able to get the endo into a manageable state. The False Unicorn that I am starting to take (tastes horrible!) is supposed to restore balance to the female tract. Maybe I can help #1 and #4 a bit, but do I gamble my embryos on this?

I plan on calling Yale and asking to speak to Dr. Kliman, who is the author on the EFT write-ups, but hopefully he will (1) talk to me, and (2) have advise for what I can actually do.

So maybe there is hope. But still, despite hope, hope doesn't feel like it's enough anymore. I feel that it's a losing battle ladies. I honestly feel it's time for me to pay the piper and hire a surrogate. In the last 24 hours I've asked myself, "If I could just pay the $30K or so and have my own biological child right now would I do it?" The answer is yes. A resounding yes.

What is in my power is to make the best damned eggs my body can possibly make and then put them into a fresh young uterus where they are safe.

=====

Update: I think I've figured out the EFT test and subsequent treatment that Dr. Kliman at Yale is proposing. It's fascinating, it's complex, and it's convoluted. But I honestly think it might work. It makes perfect sense to my science-minded brain. But still, even if I explore this route, I'll be looking for a California-girl surrogate to carry my last embies.

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Comments on "CD1: The Bitch is Back"

 

Anonymous Anonymous said ... (7:44 PM) : 

Since you make such good embryos I'm thinking a surrogate is 100% the way to go. Can you go ahead and cycle now then freeze the embryos while you look for someone? Best wishes to you!

 

Blogger Julize said ... (9:13 PM) : 

Your post scares me because it taps so neatly into my greatest fear. I have an implantation problem. I have an egg problem. Which is worse? Which is the most surmountable?

You're giving up on your uterus and gambling on your eggs. I'm giving up on my eggs and gambling on my uterus. And our problems are so similar.

Scary, scary stuff.

Here's hoping we're both taking the right gamble.

 

Anonymous amanda said ... (9:45 PM) : 

Well, I can weigh in on the beta 3 integrin stuff. I had that test done after a few failed cycles. Total waste of time.

My results were: lining out of phase, integrin absent. My (first) RE was the one who suggested the test and who wanted me to do the Lupron "treatment" after the results.

Well, after doing some research (which I should have done before having the test done) I learned that there just isn't enough research out there to support this test as the be all, end all some make it out to be. Like you said, things vary month to month.

I didn't do the Lupron, did my last FET with that clinic (which failed, of course) and then moved on to the next clinic.

Embryos do decide to implant in my uterus, and I did have one embryo make it all the way, so I think that test was just not reliable for me.

I wish you the best of luck deciding whether to go the surrogate route or not. I know I always felt like I had to do something different after a failed cycle. Sometimes it's just a crapshoot and sometimes you need to switch things up.

As always, you're in my thoughts.

 

Blogger Adele said ... (9:43 AM) : 

I think considering all the possibilities is a good way to go and there are many, MANY worse options than surrogacy. I just wish this wasn't so darned hard. I'll be curious to hear what you turn up about Dr. Kliman.

Sorry the bitch is back:) But it sounds like your body really knows how to find its center.

 

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