Thursday, April 21, 2011

A Cancelled Cycle

Long time, no post.  I know. 

Today is cycle day 14.  I went for my baseline ultrasound CD 4 (due to a work/weekend issue and not being able to make it cd 1, 2 or 3) and left with a slightly tweaked medication regimen.  I returned to the clinic on Monday (CD 11), but the 3 follicles that were dominant weren't big enough yet, so I made an appointment for Wednesday (CD 13).  I got my favorite ultrasound tech and we got down to follicle-scanning business.  I had a 20, 17, 16, 15 and 2 14mm follicles between my two ovaries.

***Pause here for a reproductive endocrinology lesson for those of you confused about the above paragraph.***

A mature follicle is considered anything 18mm and above.  Follicles usually grow about 2mm per day.  My trigger shot I take causes ovulation about 36 hours after taking it.  Therefore, any follicles 14mm and above have the possibility of being 18mm at ovulation and, therefore popping off when I ovulate. 

Got it?  Good.

***Resume regularly-scheduled blog post.***

When the nurse came in the room, she said she was concerned with the amount of follicles I had 14mm and above.  (At this point, I only knew about the 20, 17 and 16.  The 15 and 14's hadn't registered with me.)  She showed me the paper and said that I had a total of 5 that could drop after the trigger shot and how did I feel about selective reduction?

I was floored.  Never in my life did I ever picture anyone saying the phrase "selective reduction" to me, yet there I sat, stumbling over some combination of the words "uh," "um," and "no."  What I really wanted was to say to her, "Are you asking me if I'd be willing to kill one of the children than I worked so hard for?  Are you on dope?"  She said the doctor was tied up in ultrasound, but he'd be in to talk to me in a little while.  She offered me the tv remote (after scribbling "would NOT reduce" on the aforementioned paper) and went on her merry way. 

So, I wrote a series of texts to Nick, which I then forwarded to my mom.  Both of them responded with some variety of "Are they on dope?!"  I killed the time checking facebook and playing scrabble on my phone while I waited for what seemed like forever for the doctor to come in.

Finally, he came in and basically said, "We're cancelling this cycle because there's too many follicles and we don't want you to end up with high order multiples."  I made it a point to tell him that I had 3 last cycle and none of them took.  I really wanted him to just say, "Well, you're probably right, lets do it!"  But instead I got, "I've seen patients like you who aren't pregnant after a lot of cycles and we get a cycle like this and boom, we have twins, triplets, or whatever, so I really don't feel comfortable going forward."  I asked him if the follicles would go on their own anyway and he said yes.  Then he started talking abstinance, condoms, the whole she-bang.  (My inner monologue went something like "Abstinance?  When I got married I really hoped people would stop using that word.  Condoms suck.  Who are you?  The bedroom police?!  Is your Russian self going to be there with a black light to be sure there was no exchange of fluids?")  He shook my hand and left, saying he hoped to see me under better circumstances at a later date (did I mention I'd never even seen this guy before?  There has to be a million doctors in this practice!). 

I cried some (hopefully) quiet tears and texted my mom and Nick and waited for the nurse to come in.  She came in and reiterated about the abstinance and condoms and was sure to tell me that sperm can live for up to 4 days.  She apologized and told me to call when my period started and we'd start over.

Obviously, we're both disappointed.  I've spent quite a bit on meds this cycle (although, I think I must have hit some sort of pharmaceutical deductible or something because it was cheaper than previous cycles), not to mention the gas money *insert mumbling about gas prices,* 12 hours I've spent driving back and forth to appointments and 4ish hours I've spent AT the actual appointments in the last 2 weeks.  The whole thing is enough to make me want to sit in the corner and cry.  I'd like to host a pity party about people who reproduce for free and will never have to hear someone say they're "cancelling your cycle."  That really seems like something only God should be able to say, doesn't it?  However, I'm slowly getting over it.

I do want to ask you all this, however: what would you do?  According to doctor's orders, we shouldn't be unprotected (Although, he didn't specify for how long.  I coud feign ignorance.), yet part of me really wants to just throw caution to the wind and see how it all shakes out.  On one hand I know that God controls the sperm and eggs (that's nothing like ham and eggs) and can do what he wants.  I mean, if sperm live for 4 days, who's to say previous sperm aren't waiting there for the eggs to pop even now?  I'm fully convinced He is in control of how many (if any) children we conceive and birth together, so why would this be any exception?  However, a small part of me thinks that God put the doctors in our lives for a reason and maybe I should listen to them.  I mean, yeah, last cycle I ovulated 3 eggs and got nothing out of it, so odds are pretty good that all 5 eggs wouldn't pop off, fertilize and implant.  But, what if they did?  I obviously wouldn't selectively reduce *shudder*, but how bad would I feel if I had to deal with losing one or more of my children all because I didn't listen to the doctor?  In the grand scheme of things, is waiting one cycle to try again that big of a deal?  Not really. 

Am I still leaning toward taking no special precaution and letting God be God?  Yeah, I am.

I really do want all of your opinions, though.


Missy Bennett April 21, 2011 at 8:04 AM  

You left out the part about me threatening to freak out on them...and my requesting to angry-blog about this! These are important details!

Coakley's Journey April 21, 2011 at 9:47 AM  

We had a cycle like this when we did IUI and we chose to let God decide. Unfortunately we had BFN. I know Dr have to say the things they do for legal purposes so you cant come back on them. But, you and Nick can decided if yall would be comfortable with multiples and allowing God to decide and with that discussion, you will get your decision.

Alex April 21, 2011 at 10:54 AM  

If it were me, I'd have sex and just deal with whatever happens. The likelihood of all five taking is so very little. Obviously you have to be comfortable with this, but if it were my choice, I would say go for it!

Anonymous April 21, 2011 at 11:17 AM  

my assvice- screw like bunnies!!

Honestly, if it were me in that situation I'd find it almost impossible NOT to throw caution to the wind and just go for it!

Que sera...

Anonymous April 21, 2011 at 11:58 AM  

Have sex, girl!!! God is in control...BTW, we have two babies now where I am pretty sure the sperm lived 7 days, what would your doctor say to that??? I say God decided that these girls were meant to be!!!

Haley April 21, 2011 at 1:40 PM  

I'll just echo the "are they on dope?!" sentiments.

God is so much bigger...and what better way than for Him to use this round w/o doctors' intervention to bring a little one (or more!) into the world if He so chooses. I mean, since the docs aren't to take credit for it due to their advisement against it, it would only display your reliance on God for the entire outcome(s). No?

You have my vote, of course.

Anonymous April 21, 2011 at 8:48 PM  

Get to gettin' bizzay ma'am! But seriously... If you've got the Ovidrel, you should go ahead and trigger too, to make sure they ALL pop. I don't know how you feel about twins, but I'd rather have twins than none ANY DAY OF THE WEEK (and I do have faux-twins (aka twin cousins) so I do know the work involved...).

Also, here's the probabilities for TIC with six follies:

1 - 99%
2 - 25%
3 - 5%
4 - less than 1%
5 - less than half of 1%
6 - I think you get the picture

Kim April 22, 2011 at 9:54 PM  

Given my past history with stimulated cycles and lack of success overall... I vote to throw caution to the wind as others have mentioned. I know they have to tell you the risks and so forth... but truth of the matter is it just wouldn't seem right to let all those little possibilities go away without a fighting chance. Screw the warnings and go all out. If it were me, I would regret abstaining or using contraception when a very really possibility of a viable pregnancy could be lost because of it.

Anonymous April 23, 2011 at 8:09 AM  

Ugh, how frustrating. I probably would be thinking the same thing as you and probably would go the cautious route, but would always wonder what if. Good luck with whatever you decide.