Tuesday, May 21st, 2013. CD10.
…That is the question.
So I just got back from my dildo-cam appointment (where they also took around a gallon of blood – rather unexpectedly, mind you), and I have some concerns.
First, I’ve done five days on 5mg of Femara, followed by three days on 75IU of Gonal F.
As of today, I have only two measurable follicles: an 11 on the right, and a 14 on the left.
This seems on track with my first injects cycle, where I had just slightly smaller follies than that on CD11. That cycle took 10 days at 75IU of Menopur to get me to a mature follicle. I triggered on CD17 in that cycle, and ovulated on CD18.
I got my BFP that time, but, well… you know the story of how that worked out.
Issue one: So, I have smallish follicles for CD10, and the doctor (read: not MY doctor, but the fill-in doctor) wants me to continue with the 75IU dosage tonight and tomorrow, and return to their office on Thursday.
Issue two: I started this cycle with one 450IU Gonal F pen in my possession. I have used 225IU thus far. I can either use 150IU over the course of the next two nights, and have 75IU leftover for a “just in case” dose, or I can push to do another 75IU tonight, and 150IU tomorrow, and have no safety net. Also, I’d have to hope and pray that my 14 got itself to maturity by then… and maybe a spare prayer for the 11 to catch up.
Question one: Should I call the nurse and give her the sad story of my first injectables cycle, and let her know that I would really like to do 75IU tonight, and 150IU tomorrow to ensure these bad boys grow fast?
Issue three: My lining is also measuring only 6.5, which is a bit low for me. In previous injects cycles, my lining was measuring around 9 by CD10 or 11.
Question two: My doctor will let me use Prometrium for an IUI cycle, but hasn’t said anything about using it for timed intercourse cycles… Should I press her for a prescription regardless which direction we go for insemination?
Question three: Am I a crazy person? Already? This soon after a lengthy break in which to come down from Mount CrazyPants??
*le sigh*
So anyway, now you see what I’m mulling over in my mind. I don’t know whether to keep on the path of least resistance, or stand up and risk becoming the Crazy Patient so soon with this new clinic.
I do know this much:
I know myself, and I know my body.
I know my history.
I know that my body has sometimes responded slowly to meds, and sometimes responded more quickly.
I know that I’ve never used Gonal F before, and am aware that my body may react differently to a synthetic FSH rather than an FSH/LH mix.
I know that I should also probably wait until the results of my Estradiol labs come back before making any grand statements…
I also know that there are many of you out there in the Readerdom who have been through this, and who have much more scientific information to go on than I do at present.
If any of you would like to offer your advice or counsel on this topic, I am ALL EARS, sister!
Please help me, for my CrazyTrain is getting dangerously close to derailment. 🙂
Update: I called and chatted with a super-friendly nurse (or at least she’s friendly NOW… just wait till she realizes the depths of my crazy…), and she gave my Estradiol number, which was 106. Nice Nurse also talked me down from the ledge, telling me that at CD10, everything looks pretty good in the eyes of medicine. I shouldn’t compare this cycle to previous cycles, because so much is different now, like the supplements I’m taking, the dietary changes I’ve made, and the new meds I’m trying like Gonal F and Metformin.
She agreed to call in a Prometrium Rx for me, and said that I can start taking it 72 hours after IUI (if we go that route – if not, I can start it around 3DPO). Nice Nurse doesn’t think I need to do anything to get my lining thicker, and that it will thicken well enough on its own once I have more mature follicles. Mature follicles produce more E2, therefore my E2 will go up as my follicles mature, and my lining will thicken as a result. Or so she says…
Anyway, I feel better. I’m going to be a good patient (for now… mwahahaha!) and continue with my 75IU dosage for today and tomorrow. That will leave me with a “just in case” dose for Thursday night if necessary. Hopefully I won’t need more Gonal F than that, but if I do, Nice Nurse knows the pharmacies in town that have it in stock for emergencies.
Best case scenario looks like this: Final Gonal F shot on Wednesday, u/s Thursday shows mature follies, trigger Thursday, IUI Friday (maybe), covert ops baby-making Saturday and Sunday.
Here’s hoping!
just give yourself the meds? you dial it up anyway, right? Def call and ask about the prometrium. you are NOT crazy!
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LOL, you know I thought about that… But if I randomly ended up with OHSS, I’d have some serious ‘splainin’ to do. 😉
I think they’ll be okay with the Prometrium, but now I’m wondering if I should ask about Estrace too? Guess I’ll see what the estradiol levels have to say.
And thanks. I do feel crazy, but it’s nice to know at least one other person doesn’t think I am. 😉
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Yea, I meanyou have to be careful. But, I did once give myself like 2 extra clicks. 😉 It doesn’t hurt to ask anything. As much as we like to think they know our file inside and out, sometimes they need reminders. We need to be involved patients.
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I say ask the questions you need answers to and listen to your body. You know what you need.
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I’m glad that you talked it through with nice nurse and that you’re being “good” for now. I honestly think that’s the right choice. It’s still quite early in your cycle and if all looks good on Thursday you’ll be triggering CD12, which is pretty much perfect. ALSO, I think you can hope for and possibly expect some pretty good follicle growth in these couple of days. In my experience (of 6 injectables cycles) 14mm is sort of the beginning of the final push – follies that size almost always grow and grow quickly (I’ve had anywhere from 1.5mm/day to 4mm/day, with faster growth towards the end.
And, finally, i don’t actually know this to be true for Gonal-F, but Follistim always loads extra meds in the cartridge. Usually somewhere in the 100iu range. So you might have that “just in case” dose in there anyway.
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Oh, look! I just found this online –
One Gonal-f® RFF Pen contains 415 IU to deliver a minimum total of 300 IU/0.5 mL
One Gonal-f® RFF Pen contains 568 IU to deliver a minimum total of 450 IU/0.75 mL
One Gonal-f® RFF Pen contains 1026 IU to deliver a minimum total of 900 IU/1.5 mL
Source: http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=18103
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That’s amazing! Thanks so much, friend! 😀
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Before I read your update, I was going to say: There’s no harm in calling to ask your questions and state your concerns. But, as hard as this may be, especially for a take-charge-I-know-my-body-better-than-anyone type person (like me), I strongly recommend letting the doctors do their thing. I’m glad the nurse was able to address your concerns and make you feel comfortable with the course of treatment.
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