Why stay?

Thanks Nina for stopping in and leaving a comment and sorry your are working such long crazy hours. I hope there is an end in sight. You bring up a valid point about why I don't try to travel to Cornell or CCRM or another big out of town clinic for an IVF attempt. Instead of just commenting back, I decided it was a topic worth of a post in and of itself.

So, why do I stay where I'm at now that Dr. N is gone and I am basically left to my own devices. There are several reasons really. One of which is even if I wanted to go to one of the out of state biggies, it is very unlikely they would take me as a patient. I could spend a few hundred dollars to meet with them for them to tell me so. Even if they did take me and said they had this miracle protocol, just for me, guaranteed to at least get me to retrieval, I wouldn't believe them. Because I truly do not believe that IVF is the answer for me, I could not spend the time and money and logistics to set it up again. I can't take another IVF cancellation. I've been cancelled twice both times on good solid protocols that "should" have at least gotten me to retrieval. I really have to laugh in a self depreciating envious way when people talk about their poor response. I was cancelled because each time I had one and only one viable follicle. Now, one of those resulted in Max as my miracle baby. I wasn't so lucky the second time around. I figure I would need to get over 6 follicles in range for it to be worth my while to even attempt IVF. Actually, even if I got 6, I still think my odds are better with IUI since egg quality would be an issue and I would transfer everything back that fertilized anyway. I can and have gotten pregnant, three times with one take home baby. The sperm is compatible with my egg if it is a good enough egg. My tubes are open. Implantation doesn't seem to be an issue. The issue is really two fold that is tied together. At my age, egg quality is an issue. If I had a better response each cycle, my odds would increase that one of the eggs would be a good one. One of the big deciding factors in buying 10 more vials of sperm was the realization that if I am ever going to get pregnant again with my own eggs, it is going to be by trying an IUI over time to get to the odds someone else may have in one month because they have a better response. It's like taking the hard way, except the easier way doesn't and hasn't worked for me. The more stims I do, the more they fry my ovaries. After my last IVF attempt, it took months and months, I'd have to count them to find out how many, for my ovaries to produce even the one measly follicle it has been. They completely shut down and I was getting nothing, which is why I started seriously considering and researching donor egg. Then, I started getting my one and only follicle again, which led me to buy the extra sperm and my current, in it for the long haul even if I don't like it strategy. My FSH was typically really good, until it spiked with a 19.something and then an 11 or 12, then back down in the 6 range. But, FSH regardless of the number, really isn't a show stopper for me. The problem is my Inhibin B is so darn low. I can shoot up high amps and thousands of dollars in stims and it is like flushing money down the drain because my body can't and won't absorb them because Inhibin B is the conduit that helps/is needed for your body to absorb the FSH and LH. Estrogen Priming would probably been my best bet and that is what I attempted on my last crash and burn IVF cycle. Because my IVF cycle started a week after Dr. N was killed, I'll probably at least try it one more time before I run out of sperm and either give up or move to DE. Loosing Dr. N, I can't even tell you how much that has affected me. His wife, my OB, last time I saw her made a comment that she felt like we both lost our husbands. The comment made me feel uncomfortable, because I really didn't have a crush on him or think of him as an intimate partner or even ever fantasize about him. However, I really did love the man and have such respect for him. He wasn't perfect, but he was the absolute hands down perfect RE for me.

Anyway, to make a long story short, I stay where I am because no one else would take me and going someplace else just doesn't make sense. Even if I went to another local clinic for IUI's, they would want me to follow dr.'s orders and I'm sorry, I just know way to much for that at this point. The bad news is that I have to manage my own case, the good news is that Dr. N gave me enough of an education that I can manage it better than most RE's could at this point. And, my clinic lets me do what I want, when I want. One might argue that going someplace else and following another RE's protocol or system may be just what I need, but even if the RE was brilliant no protocol is going to fix what is currently broken/not working/get me to have a response good enough to make IVF worth while.

So, I stay and I'm sad the Dr. N is gone and I hope and pray that one of these months, if I just keep at it and keep trying, a good enough egg will be released and fertilized and give me another miracle. It's not a lot, but it's all I have unless I want to move to DE and I'm just not quite ready for that yet. I fail 10 more cycles leaving 2 vials in reserve and I'll be ready to either move on or give up.

There really is no other option. There is no way around the Inhbin B/poor response issue regardless of clinic or protocol. I'll keep trying, just in case. My clinic isn't one of the top 3, but it probably is in the top 5. They are solid, have good protocols and practices. I can get a consult with Dr. A when I really need to consult on a new protocol like I did for the one I'm using this month because while he is busy, I've been a patient longer than or as long as almost every single person on the staff. That counts. A lot. It isn't as good as having Dr. N would be, but it is as good as it gets. I wonder a bit if Dr. N is here if he would see something I've missed or he would have some radical thing to try that may help, but he was a very good teacher. I know a lot, probably even more than some RE's. I'm sure not more than the RE's in one of the big 3, but enough to know that they will tell me ... the odds aren't good enough to attempt another IVF and DE is my best option.

I challenge anyone who reads this who knows anything about fertility to show me where my logic is flawed, poke holes in my argument, tell me what you would do differently if you were in my shoes. I'd be happy to be wrong or for another perspective and to see something I've missed. Hell, anything would be easier than cycling until I just can't take it anymore waiting to see if I can get a good enough egg. An out of state cycle would be a heck of a lot cheaper than moving to DE. I just don't see it. I just don't think there is any other solution than my current one right now.

Nina, thanks again for the questions that prompted this post. I hope that explains it, if not let me know or help me see the error of my ways and where I am stuck in my thinking.

And, that's why I stay.