What's the plan, Stan?

Yesterday we had our final meeting of Dr. B(alls). Wisehubby will continue to go to him to be monitored for his hormone therapy, but we have beaten down the limited doors available to us on the male fertility end. Dr B(alls) admitted that although so many things have improved for Wisehubby--his ratio of estrogen to testosterone, count, motility, density--the morphology issue is likely to remain a permanent one, even with an otherwise mostly successful varicocele repair. He says that Wisehubby's case still indicates IVF with ICSI, and referred us back to our reproductive endocrinologist (RE).

I think Wisehubby is still disappointed that he went through so much pain and suffering, and we are still in the same place we were a year ago. I get the sense that he sees this as his problem that I must pay for with my body undergoing harsh procedures. Of course, that's not how I see the whole thing--it's OUR problem that we must work towards fixing through every possible treatment--but my opinion is neither here nor there.

Wisehubby is dreading the return of the twice daily sticks and frequent transvaginal ultrasounds because he loves me dearly and would gladly go through varicocele repair again if meant that he could spare me the pain and discomfort. Fortunately, after eight years together, I love him more deeply than ever, so I am down right eager for the twice daily sticks and frequent transvaginal ultrasounds because I know that the pain and discomfort is something that I can do to help us both achieve our dream of a family of three (or maybe even more!).

That brings me to today, where we met with our RE, the male Dr. B, to plan for our second IVF cycle. He remembered that we're both teachers, and made a point to honor our time and financial limitations in the creation of our plan. He spent time carefully reviewing the spreadsheet of medicine that Wisehubby had compiled so as to not spend money on unnecessary prescriptions; he "donated" some progesterone gel to us. We felt better about his bedside manner this time around, but maybe we're just used to his gruff, matter-of-fact nature. Maybe we were just so ready for a new plan that we over looked his less pleasant features.

So, what's the plan, Stan?

Our new plan will start with a fresh mock transfer, an ultrasound procedure done with a full bladder. There was a looming threat of some sort of uterine "stretching" which I hope does not come to bear. After that, it will be a waiting game for my next menstrual cycle, where I have my blood drawn for my FSH levels and then start on birth control to regulate my strangely short periods, and blood thinners to protect me from blood clots from my Factor V disorder. About three weeks later, I will start lupron to prevent ovulation. At the onset of my second menstrual cycle from now, I will stop birth control and start two different daily stimulation injections. We're going lower and slower with the dosing this time to avoid the hyper stimulation that lead to the removal of many immature eggs that did not lead to good, healthy embryos. After about ten days of stimulation, I will stop the lupron and blood thinners, and take one shot to trigger egg maturation. 36 hours later, the male Dr. B will remove about 15 eggs (the sweet spot amount) for fertilization in the lab, via needle. At that time, I'll start back on the blood thinners and add vaginal progesterone gel to my regimen--no progesterone in oil this time! Huzzah! Hopefully, about a week and a half later, a blood test will confirm that I am pregnant, and we will begin to plan for a pregnancy and then for a baby.

Did you follow all of that? Can you keep track? No? Honestly, I'm impressed that I can follow it myself.

My suggestion? Stay tuned to my Twitter and blog for updates as we go! If I've learned anything, it is that our quest for Wisebaby is full of twists, turns, and surprises. Let's just hope that this fall, we don't have our house coming down on top of us!