05 February 2013

All Systems Go!

I've just returned from my meeting at the clinic.  Had an ultrasound scan of my ovary to see if it's good to go, and it is!  So had a chat with the doctor to answer some of my questions, he prescribed the drugs, I met with the nurse to collect my drugs and learn all about how to inject myself.  Got a blood test for sexually transmitted diseases and so now it's just a matter of waiting for my period to start.  Last norethisterone is tonight!  I start injecting on day 2 of my period, and need to go in for a scan and possible blood work on the 4th day of the drugs.  I'm nervous, but I'm actually really excited.  I felt really positive about it today!

So I'll do another post with all my drugs but I wanted to also record here some of my questions and answers, in part so I won't forget, and also because maybe it might help other people.  So in no particular order:

  • How am I supposed to understand AMH numbers against having one ovary?
    • The doctor told me this is a two part answer.  He said if I want to know how many eggs I have left, I should stick with the number as it stands.  But if I'm trying to understand how my ovary might respond to medication, then I should consider the number to be doubled.  Of course I will only get half of what one would expect from the doubled number, so again, tempering my expectation.  But this is kind of great news because it bumps up my AMH to a better bracket.  So that was good news.  Actually, he said my one ovary was actually very promising.  So I felt really good about that (I may regret these words later!)
  •  If I think I'm going to need two cycles, how much time should I prepare to leave between cycles (if any)?
    • The doctor said they recommend to take a two or three month break in between cycles.  Now on the way home I realized I still didn't understand this perfectly.  I'm having a February cycle now.  March would be one month off.  Then is April possible?  Or does a two month break mean not to do it in March or April?  May won't be any good for me as I'm traveling to the States to see family for the annual trip home so I guess I'm looking at June.  If I want to do a third cycle, and need to take a break, that means my third cycle will happen when I'm 39.  I'll cross that bridge when I come to it, it depends on a number of other factors.
  • Is there a way for them to know if an ovary has twisted?
    • I was reading up about how you shouldn't do any impact activities or twisting activities while stimulating.  Because when I lost my other ovary, it had twisted 3x, I'm a little worried about it happening to this one.  Twisting cuts off the blood supply and is pretty much bad.  I mean, why does it twist??  So apparently there is no actual way for them to 'see' if it's twisted and the only way for them to know would be if it was very painful.  He said that as the ovary gets larger, that's what might make it twist.  Now my cyst, that was large- around 15cm.  He said under stimulation, the ovary will grow to between 7-8cm so hopefully not so large to make it twist, but large enough that I need to be careful.  That's fine.  I plan on being very careful.  They said to call of course if I had any pain or worries during the treatment.
  • How many eggs should a woman freeze to have a very good chance at one future baby?
    • Okay, this one has been bothering me because a lot of the egg freezing stuff I'm reading have women talking about freezing 10 or 11 eggs.  When I met with the doctor the first time he said ideally I would really want around 20.  I saw a different doctor today who will be managing my process and he actually said 20-30!!  But that 20 was probably a good number to have a very good chance at one successful baby.  His rationale was because the clinic results (see chart below for 2011) show a 33% success for clinical pregnancies with women 38-39.  So because I am 38, the eggs I am freezing now will give me about a 1 in 3 chance of a successful pregnancy.  He said that one IVF cycle will use about 7 eggs. So 20 frozen eggs accounts for 3 cycles and the odds show one of those would be likely positive.  It's important to note that for live birth the number drops slightly.
Patients age <35 35-37 38-39 40-42 43-44 >44
% clinical pregnancies*  44% 37%  33%  13% 6%  -
Clinical pregnancies per cycle commenced 72/165 27/73  20/60  11/84  2/32 0/12

No comments:

Post a Comment