Okay, so here it is, the ODWU review. I'm still kinda loopy from what ended up being a very long day so please forgive any rambling or grammatical errors.
Got into Denver the day before yesterday around noon. My room wasn't ready yet so I drove into downtown Denver and had lunch in Larimer Square. Ended up buying Keith Richards' new book "Life" at the Tattered Cover Bookstore (good place to check out if you haven't been, ladies).
Went back to the hotel and managed to get a workout in before dinner. Tried to go to bed early to make up for a bad night's sleep the day before and had an even worse night's sleep - tossed and turned all night. A sure sign that while I felt calm on the outside I was harboring some stress about this day internally.
Woke up very tired the next day but got to the appointment on time. The clinic was all that everyone has reported - attractive, well-organized, with exceptionally friendly staff. A completely different feel than my last clinic, which was no less attractive and organized, but had that intense New York pace and was all about business. No one asked you how your day was going or chatted about the weather. Less smiling faces, more people crowded into waiting rooms. That never bothered me - I'm used to that sort of thing in New York. But in comparison this seems like a kinder, gentler place to cycle, which will be a nice change.
Some highlights of the day:
Meeting with Dr S: Went well overall, he was very kind and patient with questions. He reiterated most of what he said in the initial consult in terms of the approach. Re: protocol, he's leaning towards doing the "kitchen sink" method, with no BCPs, estrogen & testosterone priming, and adding Clomid to the stimulation process. I asked about Saizen and he said we could add that too - won't help with quantity of eggs but possibly quality. He also recommended taking supplements for a couple of months before IVF. While he said that their effectiveness was somewhat speculative and he knows many doctors don't believe in them, he also said that vitamins and amino acids are a critical part of cellular development so he feels they are 'legit.'
Overall, what he's trying to do is make sure we throw everything at this cycle so we can feel we've tried everything. That way if it doesn't work, we will be able to move on with less regrets - I am wholeheartedly on board with this approach. Importantly, I asked him about what he thought of me cycling in November, doing PGS testing and freezing, and then cycling again in January. He said he thought it made sense for me, and could help improve my chances and/or give me more information to make decisions. I asked if he thought I needed further testing of my endometrium, and he said no, as long as my uterine ultrasound looked normal, my hysteroscopy looked normal, and all of the related blood tests came back normal. He did say that I should get an HSG before I cycle, to rule out any possibility of a hydrosalpinx.
Ultrasounds and Doppler: The most depressing part of my day. While my uterus looked fine and blood flow looked excellent, she only counted 3 resting follicles. 3! My stomach plummeted into my shoes. This was even worse than my worst fears - I was thinking I would get at least 5 or 6. Ugh, I'm getting depressed just writing about it so I will move on.
Hysteroscopy: Wasn't so bad, and everything looked good except for a slight bowing of one of the walls of my uterus. Dr S reviewed my ultrasound and said it wasn't a fibroid so everything is okay. He also asked me how many resting follicles she counted. When he heard the answer his brows went up a little and he said, "well, we have our work cut out for us then." We do indeed, argh.
Meeting with Nurse: Went well, she seems great. We reviewed all of the tests I needed and which ones they could do vs which ones I need to do locally. I ended up with a pretty daunting list of things to do over here, which I need to get cracking on if I'm going to cycle in November. These include: Mammogram, annual physical, HSG, Day 3 blood draw, Varicella immunization, and I'm sure there's more but I just can't remember right now. One of the best parts of about the day was hearing that I don't have to do those PIO shots! As annoying as the suppositories are, I would way rather do them than the shots, which my last clinic insisted on.
Blood Draws: The least painful I've ever had! That alone is worth the extra cost to cycle here...
So all in all (except for the horrible resting follicle count), a good and productive day. The most important thing is that I feel good about our plan. I get to cycle earlier and not wait until Jan, which you all know by now was bugging me. If we stim and I have (by some miracle) a better than expected result, then I can just do a transfer in Jan. If we get a middling result, then we can cycle again in Jan and hope to add to whatever we got. If we get a horrible result, then we can either cycle again and hope for better or just abandon my eggs altogether and go to Plan B. Whichever way it goes, doing a cycle in Nov will give us visibility into what our next step should be.
Now we just have to see how the rest of my results come in. I am fully expecting a higher FSH than I got a year ago (it was 6.7 then), would not be surprised to see it over 10. I am also expecting an even lower AMH (last one was 0.35). While that will be depressing, it won't change anything with regards to the plan (unless perhaps my FSH is over 20 or something.) We already have crappy odds, so we just have to work with what we have.
Thanks to everyone for the encouraging words. It's so nice to have some support through this craziness. I'm signing out now so that I can drink the rest of my juice and get to work making appointments!