CD6 Hell
Another 81 mile drive to Dr. Czech's office. It's my second blood run and ultrasound. So far all I'm on is 0.02mg of estinyl estradiol (EE2) a day. That's it.
Frighteningly simple cycle.
The ultrasound tech said I only had 1 follicle at 12mm. I freaked out. ONE? Wasn't there anything else. "Yeah, a couple small follicles too small to measure."
Me: "How many? Where?"
Her: "Two on each side".
OK, so a big one at 12mm on CD6, and two smaller ones on each ovary.
I dressed and went to the waiting room, sauntered up to the front desk, and said, "I need to talk to a nurse."
The receptionist said, "I"m not sure if anyone can talk to you for awhile" but go ahead and sit down and they'll call you. Not 5 minutes later I was called by Nurse M who walked me back to one of the other doctor's offices.
I told her, "I really don't understand what the strategy for my cycle IS at this point. The ultrasound tech said that I had one follicle. I am FORTY FIVE years old. 1 in 10 is normal at my age. If you guys are TRYING to just get one follicle I don't understand it."
I was shaking. Pissed.
She pulled out my CD3 bloodwork as it was still too soon for my CD6 work to be processed.
CD3:
FSH 15
E2 26 (my E2 has never been this low that I know of. Hmmm.)
My heart sunk seeing the FSH that high still. Apparently the endometrioma surgery that I did on June 30th really screwed up my ovaries. It hasn't touched 10 since then and right before the surgery it had consistently hovered around 7 or 8. Damned good for 45. But now it's gone to hell in a handbasket. I remember Dr. Italian warning me against the surgery for this reason and I turned him a deaf ear. My mistake. But I thought that the endometriomas would cause more damage as they grew and would slowly shut down my ovaries. Maybe this would have happened anyways?
Who the heck knows.
So Nurse M explained that the "follicle" on my ovary was not likely a follicle. Not with an E2 of 26 (value on CD3). Much too low to be a "functional follicle", more likely a cyst. She said that the other follicles that the US tech said were too small to measure were what they were going after.
OK. So why the hell did the US tech say that the big one at 12mm was "the follicle" and that the other ones were nothing to so small that she didn't measure them?
Holy crap.
You know, the same US tech did my scan in August when I cancelled myself due to having only two follicles...and know I find that she's completely inept? And I cancelled myself due to HER analysis of my US scan?
I am pissed ladies.
I truly love Dr. Czech, but this is reckless.
I was so upset that I was shaking as I spoke with Nurse M. SHAKING. I'm not the type of person that gets that emotionally flipped out. Pissed at crappy New Jersey drivers, yes. But to hear how screwed up things are with my US really gets to me.
Later this afternoon I got a call from Nurse J. She gave me the following CD6 values:
E2 18 (down from 26 on CD3)
FSH 6 (down from 15 on CD3)
P4 0.2
LH 3
Nurse J reaffirmed that the data seemed to show that the 12mm thing was a cyst, not a follicle. The protocol is to continue on with my EE2 until Monday morning, more bloodwork and another US to see if this cycle will kick off or not. Nurse J said that they need my E2 to rise to about 50 (some docs would say 75) or the cycle is over.
I guess that the EE2 that I am taking suppresses FSH, just like a high E2 value on CD3 can falsely lower a FSH value. OK. That worked. It went from 15 down to 6. Bravo.
But I'm not sure how the oral EE2 kickstarts my teeny tiny follicles into producing their own and getting the value up and over 50. Will have to go and read up on this a bit.
Guess I should have taken an endocrinology class when I was premed.
Sigh.
Frighteningly simple cycle.
The ultrasound tech said I only had 1 follicle at 12mm. I freaked out. ONE? Wasn't there anything else. "Yeah, a couple small follicles too small to measure."
Me: "How many? Where?"
Her: "Two on each side".
OK, so a big one at 12mm on CD6, and two smaller ones on each ovary.
I dressed and went to the waiting room, sauntered up to the front desk, and said, "I need to talk to a nurse."
The receptionist said, "I"m not sure if anyone can talk to you for awhile" but go ahead and sit down and they'll call you. Not 5 minutes later I was called by Nurse M who walked me back to one of the other doctor's offices.
I told her, "I really don't understand what the strategy for my cycle IS at this point. The ultrasound tech said that I had one follicle. I am FORTY FIVE years old. 1 in 10 is normal at my age. If you guys are TRYING to just get one follicle I don't understand it."
I was shaking. Pissed.
She pulled out my CD3 bloodwork as it was still too soon for my CD6 work to be processed.
CD3:
FSH 15
E2 26 (my E2 has never been this low that I know of. Hmmm.)
My heart sunk seeing the FSH that high still. Apparently the endometrioma surgery that I did on June 30th really screwed up my ovaries. It hasn't touched 10 since then and right before the surgery it had consistently hovered around 7 or 8. Damned good for 45. But now it's gone to hell in a handbasket. I remember Dr. Italian warning me against the surgery for this reason and I turned him a deaf ear. My mistake. But I thought that the endometriomas would cause more damage as they grew and would slowly shut down my ovaries. Maybe this would have happened anyways?
Who the heck knows.
So Nurse M explained that the "follicle" on my ovary was not likely a follicle. Not with an E2 of 26 (value on CD3). Much too low to be a "functional follicle", more likely a cyst. She said that the other follicles that the US tech said were too small to measure were what they were going after.
OK. So why the hell did the US tech say that the big one at 12mm was "the follicle" and that the other ones were nothing to so small that she didn't measure them?
Holy crap.
You know, the same US tech did my scan in August when I cancelled myself due to having only two follicles...and know I find that she's completely inept? And I cancelled myself due to HER analysis of my US scan?
I am pissed ladies.
I truly love Dr. Czech, but this is reckless.
I was so upset that I was shaking as I spoke with Nurse M. SHAKING. I'm not the type of person that gets that emotionally flipped out. Pissed at crappy New Jersey drivers, yes. But to hear how screwed up things are with my US really gets to me.
Later this afternoon I got a call from Nurse J. She gave me the following CD6 values:
E2 18 (down from 26 on CD3)
FSH 6 (down from 15 on CD3)
P4 0.2
LH 3
Nurse J reaffirmed that the data seemed to show that the 12mm thing was a cyst, not a follicle. The protocol is to continue on with my EE2 until Monday morning, more bloodwork and another US to see if this cycle will kick off or not. Nurse J said that they need my E2 to rise to about 50 (some docs would say 75) or the cycle is over.
I guess that the EE2 that I am taking suppresses FSH, just like a high E2 value on CD3 can falsely lower a FSH value. OK. That worked. It went from 15 down to 6. Bravo.
But I'm not sure how the oral EE2 kickstarts my teeny tiny follicles into producing their own and getting the value up and over 50. Will have to go and read up on this a bit.
Guess I should have taken an endocrinology class when I was premed.
Sigh.
Labels: Elevated FSH, Evil RE Staff, IVF9, The Hell that IVF Is
posted by linda at 9:55 PM
Comments on "CD6 Hell"
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Anonymous said ... (2:03 AM) :
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linda said ... (2:21 AM) :
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musicmakermomma said ... (2:41 AM) :
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Anonymous said ... (12:15 PM) :
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linda said ... (1:21 PM) :
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Anonymous said ... (11:11 PM) :
post a commentLinda, sorry to hear this. Let me just say that I have started IVF cycles with E2 of 19 on day 3 and ended up getting nine follicles one cycle and eleven another. It just doesn't mean that much on day 3. I don't want them telling you otherwise.
Also, I did IVF with Dr. Check in March and had a chemical, then did IVF with my local RE in June/July and have a 19 week ongoing pregnancy. I love Dr. Check, but his office is a disaster and you have a hard time getting a straight answer from anyone. You have to seriously be your own advocate there and keep pressing them to have Check review your chart any time you have some sort of interaction. Sorry, I wish I had better news about them.
Dear Anonymous,
It's interesting to hear from another Dr. Czech patient who has similar comments on the office organization! I would have indeed pressed him to review mine today but I hear he's out of town on for a seminar or something.
I have to zip back over on Monday for a CD9 check in. I am so frustrated with them. I have no calendar, no idea of what my protocol could even look like. Nothing to go on at all. I need to order my DS and I don't want to do it until I know whether the cycle is going to happen, because if it doesn't happen, then I wind up being charged for DS handling fees, freezing, storage, etc, prematurely. And then if I change my mind and decide to cycle elsewhere, then I've lost a bunch of money.
I am going to sit down and have a heart to heart with him over his office staff. He has got to be told how they are really a thorn in his practice. I think he is likely just unaware.
OMG. I am furious with your nurse and her casual misinformation, like what she says makes no difference! Finding a fabulous nurse is such a blessing, I am so sad my wonderful hard-won 3rd nurse left my clinic...now I'm feeling all adrift again. It is so tiring to always have to double check everything, wish you had someone looking out for you. Take care - sounds like the 2nd nurse was competent, and maybe they'll be more attentive/careful now that you've called them out. Good luck!!! Really sounds like this could be a good cycle.
I'm not sure he's unaware, since the office has such a reputation as being an organizational disaster and I know numerous women have complained to him about it. I think he just doesn't have the money to hire a top-notch practice manager to whip things into shape. That was the huge difference between going to him and going to my last RE--he was cheaper ($4K for IVF vs. $10K at local RE) but local RE's office was on top of everything and really took care of me. I could just trust and relax. At Czech's you have to be your own advocate and keep pushing until you get what you need.
Hi Anonymous,
I never knew about the office's reputation for disorganization before going there. He is a very nice man and I would intuit that he would have a bit of difficulty laying down an iron hand with the staff. I know that his son is the office manager at his other office (not sure if he manages the IVF office remotely?). I wonder if he would be a better person to speak to quietly about things?
L.
Oh wow, yeah, on the high FSH board that office is notorious for disorganization and there are some posts specifically written on tips for navigating his office and how to handle them.
I think another thing is that he is like the stereotypical mad scientist and not as into the practicalities of running that kind of a practice. He's brilliant but he probably isn't the best manager. I know Dr. Cohen was brought in to try to resolve some of the disorganization but she's been on maternity leave and I don't know how much progress she has made.