Re-evaluation: Time for IVF?

Today is CD2, and I had my baseline with Dr. S this morning.  I went in feeling pretty hopeful, actually; and I was not disappointed.  That's not to say that we heard fantastic news or anything, just that I feel like we got a very honest, straight-forward answer that is leading us toward our future decisions.

As I wrote previously, my p4 (7 DPO progesterone) blood work came back at an 8.  You'll read all over the Internet and in books and in online forums for IF, varying numbers for what a "good" p4 result is and what the numbers mean for possible pregnancy.  I had been told time and again that if you don't show up higher than "10", you're out.  No embryo could survive with less progesterone, yet it happens every day.  So, what's the truth?

Dr. S explained to us that progesterone is just the last "step" on the journey for a woman's cycle (which I knew, but hadn't really thought of properly).  The only reason progesterone shows up is because follicles with eggs inside were stimulate properly, they released properly, and they in turn created progesterone properly.  Without the first few steps, progesterone cannot even be created, let alone be of any good quality.

Essentially, Dr. S thinks that the issue isn't just that I have "low progesterone"; but rather that perhaps I'm not stimming good quality follies that are therefore able to ovulate well.  Once he explained it, a light-bulb clicked in my head; it all made sense.  So, this means we needed to re-evaluate what meds I was on to start everything in the first place.  Last cycle I used nothing but Bravelle injects to stim, but they took a long time and they seemed to produce a less than desirable result.  Clomid, while it did stimulate follicle growth, wrecked my lining so badly, not even estradiol suppositories could help it out.  So we're moving on to Letrozole.  Letrozole is not an estrogen blocker, but rather an aromatase inhibitor; so, it shouldn't damage my lining while stimulating follicles (*fingers crossed*).  Then, I will supplement this treatment with Bravelle injects and estradiol suppositories.  My next f/s will be Thursday, the 19th; so, hopefully we'll see some good results then!

Dr. S did say, however, that he wanted to be honest with us and tell us that we could be on the road to IVF.  We kind of knew this was coming, and we've been preparing as much as we can (emotionally, financially, research-wise, etc.).  Luckily, I have a friend from high school who has gone through IVF twice now who has been passing on some good advice; unluckily Dr. S's office does NOT offer IVF services.  We would have to travel to Little Rock, Arkansas to do this.  Little Rock is several hours away.  Our lives have already been disrupted by our bi-weekly jaunts to Springfield (45 minutes away); I can't imagine what hours on the road will be like. *le sigh*

I really never thought we'd get to the point where IVF was our only viable option (or the most obvious option); but then again, I can't say it surprises me.  We made a decision a while ago that if we were going to go down this path of TTC full-force, then we were going to fight as long and as hard as we could.  We were going to do everything possible and go until we could go no more.  Then, if we've tried everything and we're still left with nothing, we will at least have the peace of mind that we tried and fought and didn't give up until the bitter end.

I'm so blessed (beyond belief) to have Mr. C at my side.  I don't have a huge support system through all of this; so, I just thank God every single day for sending me this man who doesn't shy away from sadness, pain, and struggle; but stands up boldly next to me and steadies us both for the fight ahead.  I am so lucky!

At the end of our meeting with Dr. S I have to say that I felt extremely peaceful.  I know that it sounds strange to say that, but I really feel as though at least now we know exactly what we're up against...if not this cycle, then we have only one door left open: IVF.  Odd as it seems, I'm slightly comforted by that.

On a side note, I bought two books recently The PCOS Diet Plan: A Natural Approach to Health for Women with Polycystic Ovary Syndrome and PCOS and Your Fertility.  I haven't started reading the second one, but the first one (by registered dietician, Hillary Wright of Boston IVF, the most successful IVF clinic in the nation) is (so far) fabulous!  I'm learning much more about PCOS; which really just means I'm learning that pretty much nobody really understands it or knows exactly how to treat it 100%.  Dr. S thinks Boston IVF is very reliable; so, he was pretty positive that whatever Ms. Wright said would be trustworthy.  Following the book's suggestion (and what I was doing before pretty much anyway), I've gotten into exercising pretty hard again; and I'm going to be a little more "hard-core" about my diet.  I'm going to try to stick to Ms. Wright's suggestion of a 30:40:30 diet (relations of proteins:carbs:fats).  It's a carb reduction diet, without being as restrictive as the Atkins Diet; which I think is too restrictive and unrealistic for true life, day-to-day realities.

So, that's where we find ourselves today.  It's not exactly where I'd like to be, but at least it's an answer.  I'm not putting much into this cycle...it will be whatever it will be...all I can do is pray and keep on keepin' on.

Hugs and Hope to YOU,
*mandie*