Options, Options, Options...

So this afternoon, hubby and I had an appointment with our specialist. We got a few things out of that appointment, and we're relatively pleased.

I think we have a course of action that we're ready to follow. That said, he presented us with a bunch of options that he felt were still open to us at this point. And he explained a few things that I was unclear about. THAT'S always a good thing.

First of all, bloodwork results. CD3, FSH: 4.6 (less than 6 is good). Estradiol: 181 (more than 150 is good). Those numbers mean that I'm ovulating and I'm fertile. But get this... my CD23 bloodwork? Gone. "Deleted" was the comment from the lab when the doc phoned them using the speakerphone while we were there in the office. And as far as they knew, only "normal" tests were run. "CBC" was the code that she used, whatever that means. If you work in phlebotomy in Canada, and you know what this could mean, by all means, do get in touch! The doc disagreed with her, and it was evident he wasn't thrilled. Nor was I. You can bet your a$$ on that. Not after ALL that I went through to give the d*mn blood in the first place. I was NOT a happy camper. And I let him know that. But it wasn't his fault. And I knew that too. Anyway, I know not to bother with that hospital again if I need bloodwork.

So all that to say... we have no idea if there is a hypothyroid issue, or a blood glucose issue that is over and above the mild PCOS. He doesn't believe so. But again, he can't be sure.

Okay, set that aside a moment. Other things to talk about.

He explained a great deal about the process we are doing now. IUI/ICI. In essence, he let us know that while it CAN work and does for many (with a fresh sperm sample) for us, given that he has to extract it via a syringe, he is not getting the best quality sperm. He could be getting "old" sperm that has been in there for ages. Or a lot of "dead" sperm. And of course, there is not enough quantity to do a semen analysis with. Oh well. Not very good.

He did say that he doesn't see any reason why I can't get pregnant. Again though, back to the bloodwork. We don't have the CD23 results. Might look this again. *gulps*

So, what ARE our options?
1. Superovulation. Full on Superovulation. Using BCP for one month, then FSH injections for CD1-12 (Puregon or Gonal-f, I think). Yield is up to about 15 mature eggs. This is the method used for IVF or ICSI (see option 3 below) to get the most number eggs to work with.

2. Mini-superovulation. No BCP. Clomid on CD3-7. FSH injections for CD8-12. Yield is usually 4-5 mature eggs by CD 12 or 13. Something to think about. We could do this almost any month, whether we use hubby's sperm or donor (see option 4).

3. IVF/ICSI. For $9000, we can have three shots at IVF/ICSI at a place about an hour and a half from here. Our doc is a satellite office for them and he works in conjunction with them. He can do the legwork here but final procedures would be there. (Tricia, that would be in your city if you are reading this.) This would require MESA or TESA for hubby as well. In that surgery, they would essentially retrieve a wedge of his testicle (ouch!) to get SUPERB quality sperm to work with. All fresh, no "bad" quality stuff. And of course, two surgeries for me. One retrieval, one to reintroduce the embies into the uterus. And of course, no money-back guarantee. Because I'm in Canada though, the cost of the meds (supplementary to the $9000) would be reimbursed by our health care plans. Only the $9000 wouldn't be covered. And there are payment plans and loans that are possible with various banks. We could do this. The success rate is about 50% at the hospital he mentioned.

4. Donor sperm. The doc seems to think that it is a sperm quality issue that we are dealing with. And he wanted to discuss how we felt about donors at this point in the game. He was reassured by our responses. He laid his hand on mind, as hubby was talking about how "okay" he is with it, and when hubby was done speaking, he looked at me and said, "Gil, are YOU okay with that? How do you feel?" We discussed the fears. Issues. Etc. He told us that in 1998, he was on a board that was working with legislators. He did a survey of 100 of his donor patients. Of those 100, only ONE couple had revealed to anyone that the child was biologically the result of a donor, rather than the wife's partner. He also told us that less than 20% of prospective donors make it through the protocol. I read online that it was 3% at one of the clinics he uses for the donor sperm. So we're investigating this option too. We could use Donor sperm combined with mini-superovulation (option 2 above) for a good chance as well.

I also asked him for a prescription for Clomid for next month. No, I don't yet have AF this month. Yet. But my BBT is dropping like a stone. I had printed my Fertility Friend charts (see the links on the right) for him, and he examined them carefully. Given that my BBT is dropping, I'll likely have AF in a few days. If not before. But he is still optimistic because the BBT is still above the coverline. Ah, we'll see. I am not holding out hope. Hubby thinks it's possible. Either way, I got the Clomid prescription, and the doc looked at me and grinned, saying, "You won't fill it today now will you?" I said, "No, I promise I'll wait until AF arrives. And then I'll fill it. I won't jinx it. Promise." He laughed.

And do I have symptoms? Yeah. I guess. Some... VERY slight. No, I will not be one of those obsessive women poking at her nipples and breasts in a bathroom stall at the office every half hour to see if they're tender! Nor will I be doing the POAS at CD20 or so, hoping and praying and wasting my money on drugstore tests! I will just wait. The few little things I notice right now could very well just be the progesterone. I'm refusing to be too hopeful, because I know how that turns out. At least we have a plan for next month and I know where we're going from here. That feels good. I needed some "good" today. I really did.