Tuesday, February 5, 2008

Good to go.....I think...

Ok so I think I got the insurance thing squared away but I'm very nervous that I'll be stuck with the bill. At this point I really don't want to think about it.

SO I got my TSH checked today. It's a 3.76. They said that is "good" (they like to see it 4 or under). What ever. I called 2 places and both places said I need my RE to fill out paperwork and fax my records over to them. What crap. I don't feel like having my RE fill out paper work. Why can't the specialists office just do all the hormone tests for me? They are going to want to do it anyway.

I'm so sick and tired of doctors. I give up. Why even take my thryoid medication any more? What's the point. Oh my word I'm so sick and tired of this crap. I just might cancel my IVF.

update: so I've decided to suck it up and call my RE's nurse directly and tell her I want to go see an endocrinologist. I will voice my concern about getting my TSH down to at least a 2 and getting other stuff tested (T3, T4, free etc). I also think I'll mention my concern about my gonal f dosage. He wants to back me down to 150. I don't' have a great fertilization rate with ICSI and I don't think I'll get to many eggs with 150. As it is I had 8 follies with 225 (only 3 eggs retrieved). I personally don't want to go under 225 and I'd like to do 300 (that is what Boston IVF was going to do). But my Re is worried of me stimming to fast. All he has to do is start the ganerellix a day or two sooner then he would. By waiting till my lead follie is 14mm...it's to late. I always trigger 2 days after that. My follies really grow fast at the end. I've always stimmed 8 days (9 on rare occasion) regardless of the dosage of gonal F. *sigh*

I'm trying to relax and just do what he wants me to but there is this nagging in the back of my head "you know you want to call...pick up the phone...call your RE" *sigh*

what do you think? here is my history:

2005-2006 IUI's
#1 = clomid 50mg 3 follies
#2 = 150iu Gonal F. 4 follies (7 days of stims)
(month off in between on BCP due to OHSS/cysts)
#3 = 15oiu Gonal F 12 follies! (8 days of stims)
#4 150iu Gonal F/cetrotide 8 follies

IVF #1 Antagonist protocol 150IU Gonal F (8 days of stims)
8 follies -7 retrieved-1 crappy quality. 6 good/ICSI 3 fertilized. 2 made it to day 3
1 perfect high quality 8 cell and 1 5 cell.

IVF #2 Lupron and 225 Gonal F (oversupressed) 3 eggs/3 retrieved. 1 fertilized and died in lab-abnormal growth rate-10 cells by day 2 and then stopped at 11 cells.

IVF #3: antagonist 225 IU gonal F: 8 days of stims
7 follies over 16mm. (1 at 15 and 1 at 12).
3 retrieved all 3 fertilized. 2 made it to day 3. (2 five cell)

Clomid challenge test: 100mg clomid and I got 3 follies.

As you can see my response wasn't that much better with my last IVF. Should I ask for a med increase to 225 (I doubt he will go to 300). Or should I trust him and do 150? Honestly I could care less about having some to freeze. I've accepted the fact that it probably won't happen and that we have possible egg/embryo quality. All I really care about is 2 good embryos for a 2dt . So should I even care about a higher dosage? all I care about are numbers.

also I still need to talk to his embryologist. By day 2 all my embryos are always alive. it's from day 2-3 that they stop growing. Thus I'm VERY nervous about a 2dt.

also at my last IVF the RE doing the transfer said my 5 cell embryo's were good quality. When I had my after IVF failure "talk" with MY RE (he didn't do the transfer) he said they were poor quality...when I got my paperwork it confirmed it... two 5 cell grade C. however they told me they grade 1-3 with 3 being the best. *sigh*.


Anonymous said...

Good luck Amy! Definitely get the thyroid checked out by someone who knows what they are doing!

M said...

I'm glad you're getting an endo. Your RE won't care. It's good for you to have a good one now, but esp when you get pregnant. Your endo will want to monitor you closely, and in my experience they are busy people and and it can take awhile just to get an appt. Good idea to get one now.

I think if in doubt, you owe it to yourself to call your RE. Have a list of questions, and make sure he thoroughly understands your concerns. I'm sure you're not the only one who responds this way. He "should" know whether to take it slow and steady or max it out. I don't know, Amy. Just make sure you voice your concerns to him.

No matter what you and your RE decide, you can be confident you will have a major advantage this time finally getting rid of that infection and lowering your TSH.

M said...

Your RE should tell you to increase your dose starting today. It will take effect right away, it just takes awhile for it to show in your bloodwork (4-6 wks). Did your RE tell you to increase dose? If not, I'd FOR SURE book an endo. (I would anyway.) But, as of last year the new national thyroid guidelines say tsh should be between .3 and 3. Don't worry, you'll be ready in time. Not that far off now. Has he told you to increase dose?

M said...

Hmmmmm. . . .interesting. Let me know what you decide to do.