Jun 16, 2011

E2 never went up

According to the nurses, my E2 hasn't gone up at all since Tuesday and the rise between Sunday and Tuesday was very modest. Interestingly, my follicles continue to grow - today I had 21, 20, 19, 17, 16, and 16 on the left and 22, 16, 15, 15, 13 on the right with a lining of 13mm. Yet my E2 is still shy of 1000 pg/ml which just doesn't correlate with the follie growth. They decided we should still go through with ER, which will be on Sunday, so I will trigger at 11:30pm on Friday night. I will continue stimming right up until the trigger, taking my last dose of Gonal-F the same day as the trigger.

I already view this cycle like a failed science experiment but hopefully we will learn some valuable things for next time. It's safe to say that I would be absolutely shocked if this cycle results in a viable pregnancy - even if we do get a few half-decent embryos there is the whole issue of decreased endometrial receptivity that comes with stimming past the point when the lead follicles are in their prime. My lowered expectations are actually sort of comforting - I feel like a lot of stress and anxiety has been lifted from my shoulders now that I feel fairly confident in the outcome.

I do worry what my bizarre-o response says about my egg quality in general and what the future holds for us in trying to use my eggs, but then again, I am Jump to the Worst Conclusion Girl. At the end of the day, I will be really interested to hear what my doctors think of the E2 that doesn't budge despite growing follicles, but from what I've read it seems likely that my E2 isn't increasing because a lot of those eggs are of very questionable quality and/or that some of those follicles are empty. I am looking forward to the egg retrieval with a very detached intellectual curiosity at what will actually be retrieved. I think I am trying my hardest to emotionally distance myself from the cycle as a defense mechanism to prepare myself for failure. I just don't get it- this pretty much sucks.

7 comments:

  1. I'm so sorry things aren't going according to plan, but I still have hope for you! I can definitely understand how it may be easier to have low expectations. Still keeping everything crossed...

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  2. Definitely sucks. All you can do is hope for the best and go for it. Like you said, it will be interesting to see how many eggs are retrieved and fertilized. I'm really hoping for the best for you, you never know. I tend to treat this whole fertility treatment thing as a human science experiment as well. Lots and lots of data points, cross referencing the blood tests with the corresponding ultrasounds, plus all of it stored in the handy dandy health insurance website. I totally get the lowered expectations as well, I had thought that I was going to have to freeze everything so anything past that was a bonus. Good luck! Hoping that your follicles are doing lots of good growing (with eggs in them).

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  3. I'm so sorry to hear that things haven't gone smoothly for you... from my experience the first cycle is a big experiment in working out how we respond.. then each subsequent cycle is about adjusting things until it's just right. Thinking of you for your retrieval. Love to you always xoxo
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  4. Your lining sounds thick enough though, why the worry about the endometrium? You never know. It sucks when it does not go by the book, but it so often works anyway!

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  5. MrsH - My lining is awesome but they say the chance of success is greatly reduced when you allow the lead follies to get too big because they start producing progesterone which apparently negatively affects the implantation rate. My understanding is that the problem isn't the physical lining itself per se or the resulting embryos, just the hormonal environment itself is no longer as friendly for implantation. I still hope that I will be pleasantly surprised! And you are right that you never know...there are many textbook IVF cycles that end poorly and many cycles that almost get cancelled 10 times over that end very happily.

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  6. Timi - when you do treatments in Hadassah none of the blood or utlrasound results appear online in your Maccabi account! It's too bad...you can imagine how much I would enjoy having it all at my fingertips:)

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  7. My old dr. would get upset if insurance covered only one (or no) cycles because she believed the first one was often diagnostic. Hang in there and see what Sunday brings.

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