October 25, 2010
First of all, thank you all so much for the thoughtful and insightful comments about my post yesterday. I hope you know that it wasn’t intended to make anyone feel guilty, but was just my attempt at honestly recording my feelings at this point in my life. I completely understand if there are people who need to stop following my blog, and if that’s the case, just remember that I will be rooting for you – all of you.
I have been holding off writing this post because I don’t want to jinx ourselves, but I thought that other IF-ers might be interested to know what we did differently this time around. For background, I’m a high-responding, severe PCOSer with primary amenorrhea. My problem has always been a quality issue in terms of growing and maturing follicles at a steady rate (and regularly get put on the lowest dose any clinic has ever seen). So here’s what we did for lucky cycle #5:
- Met.formin. I’ve been on Met.formin off and on for the full four years we’ve been TTC, and always on during active cycles. That was one of the few things that all of the Drs and REs agreed upon and absolutely required for me.
- Gonal-F and Repronex. My first two cycles we used Follistim, and had to deal with a lot of seesawing of meds. In fact, seesawing was characteristic of most of my cycles, with the exception of this last one. This time, my RE chose to start me on a super low dose and then tried to keep the meds consistent, just for a longer time. I honestly think that this was the biggest change – I didn’t have any majorly huge E2 rises or drops and I feel pretty confident in saying that the slow and steady growth led to better quality eggs, and therefore embryos. I also think that the combination of LH and FSH in the Gonal-F led to a more balanced response.
- ICSI and assisted hatching. We did ICSI and AH for our fourth and fifth cycles, and I know that at least the ICSI made a big difference. With our first two cycles, we only had one embryo fertilize (of approx. 16 eggs), whereas with our fourth cycle, we had seven embryos, even with the lower quality eggs.
- Medrol, baby aspirin, and estrogen patches. My second clinic (where I did cycles 3, 4, and 5) prescribes everyone steroids (Medrol) for the four days following retrieval to aid in implantation, and baby aspirin for the entire 2WW to avoid clotting. They also have their patients use estrogen patches (Vivelle) for the last week and a half of the 2WW. I’m still not quite sure what this is for – besides to try and mimic a “normal” woman’s “normal” hormones – but these additional meds definitely couldn’t have hurt.
- No acupuncture. When I was on my year-long break (between cycles two and three), I did acupuncture regularly, and really liked it. We were never able to regulate my cycles, but I did have one non-medicated ovulation which was a huge accomplishment. But I stopped due to a conflict with my acupuncturist, and then switched to a practioner who was loosely affiliated with my RE’s office. I didn’t have a great experience with him – in fact, I’m fairly certain that he’s the reason my third cycle had to be cancelled. When I first met him, I tried to emphasize that my problem is over-response, rather than the more common under-response, but I always felt like he was just doing the regular fertility points and not really trying to get to know me and my body. I chose not to do acupuncture with my last cycle and I think it was the right decision.
- Diet. Many of you know that I have previously done a no-sugar, no-dairy, no-gluten diet, and also that I have not chosen to maintain that diet long term. I found my body missing dairy too much, and never felt like the no-gluten made a difference one way or another. The one thing that I know did help was the no-sugar – I felt much more energetic and generally more healthy – but I missed it too much to continue that forever. What I have tried to do is cut way back. I gave up all sugar in my tea/coffee, and switched almost completely to water and flavored seltzer water over soda. I also cut back on sweets and cookies and tried to use real dark chocolate when I simply had to have a fix. I also have gone completely natural/organic with my meats and eggs, and stopped eating anything with artificial flavoring or coloring. Oh, and I switched to 1/2 decaf coffee and tea, and tried not to have more than one caffienated drink a day. I honestly don’t know how much of that made a difference, but I know that I feel healthier since I’ve shifted to this more natural diet.
So, that’s everything that I can think of…besides my “giving up” that I’ve referenced a few times ;-)…is there anything else that you’re wondering about? I’d be happy to answer any questions you might have!