The appointment went like this.

First, we went through our file with the nurse, who did a quick audit of our embryos. Six two-day-olds and two blastocysts - all frozen in pairs. The FS asked if we'd like to do a single or double transfer, and we said we'd lean towards a single, but since they're all frozen in pairs, if we ended up with two on the day we'd transfer them both rather than discard the "leftover". And then he said, really? they usually do freeze them singly, because we like to promote SETs. They only freeze pairs if they're not good enough to fly solo. Let me look at your file... oh... well... don't worry, we get a lot of pregnancies from all types of embryos. But what we'll probably do is thaw out some day twos and grow them on a bit and then see, just in case. But we'll also note down that if we have one decent embryo, that'll do, and we won't go crazy thawing lots more to ensure that we have a double transfer.

Then he said how is my cycle because isn't it a bit screwy, and I said well, not really, only when it sees you coming. For example, it has been like clockwork for over twelve months, set your calendar by it, except for this month, when it has decided to get, yes, screwy. I am on day I've-lost-count-maybe-fifty-something. (I've actually accrued enough years' worth of data now to suspect that I'm only seasonally polyoestrus, because I really don't cycle much from mid-Autumn through to the winter solstice, but then otherwise I am pretty much ok, unless I'm living near the equator, in which case I'm fine all year around, but I didn't mention this because it sounds whacko which, as an interesting aside, is how I get by February if I'm living in the UK over winter.) Anyway, to his credit he didn't make me do a pregnancy test, he just asked me what sort of protocol I'd like to start out on when I begin my next cycle.

Not much has changed. He still recommends a natural cycle for those that naturally have textbook cycles. He said I might like to choose a medicated cycle, though, which involves a protocol of the usual - basically oestrogen, followed by progesterone. Then I said, what about the OI cycles we were doing last time? and he said, we did what? oh right, flick flick flick, yes, so we did, I wonder why...? but everything did work very nicely didn't it, except that one time when we bumped the dose up and started a bit early and got too many eggs... so yes, if we did the same thing as we did those two times and look, you actually did get a bit pregnant, which is encouraging, isn't it? And I said that, all other things being equal I would stick with what I know, and he confirmed that all things were indeed equal - that the real reason they usually don't use OI with puregon is because (given that ovulation is not required for an FET and that women respond to such a wildly different range of doses) it's easier to take over the whole cycle than to tweak the FSH so you ovulate only a single follicle, and that as long as the oestrogen is right and the lining is good and the progesterone is afterwards what they'd like to see it is all the same, which I can understand, and so since, in our case, we seem to have figured out how to manage an OI/FSH cycle with approximately as much accuracy as a fully-medicated cycle and more than a natural one, that was that, except for the bit where we all laughed and said how my ovaries will probably respond completely differently to the FSH nowadays and therefore throw it all out the window.

And then I asked about clexane, and he said why the hell not.

And he wrote down FET, 1-2 embryos (from day twos), OI with FSH, clexane.

And then he said call me on day nine of your next cycle, and I said we were going to wait til after our July ski holiday because I don't want to be pregnant on the ski fields, and we laughed, and then I said no seriously though, we're going to start after the holiday, and he said fine, whenever, he's away for a week in July but after that he's all mine and I said good.

And then we left.

No wait - first we signed some new paperwork and paid more for our consultation than I remember paying several years ago.

Then that was that, til August.


Betty M said...

That sounds like it went pretty well and that you have a good plan in place for August. Skiing in July just sounds weird for us northern hemisphereans though!

Vee said...

Good, good, good!

Heather said...

I'm glad it went well.

Lut C. said...

Sounds like a laidback appointment, where you were well prepared. :-)

It's good to have a plan of action in place.

MrsSpock said...

August! That's our next try too. Hope they will both have the same result they did 3 years ago.

Jess said...

Oh good luck!!! Glad things went well!

Lollipop Goldstein said...

It sounds like you were just chatting and scheduling a dinner party. Does it feel different to be back this time around? Different to be in the office?

Thalia said...

Sounds like a plan. How very dispassionate and logical it all seems. Does it really feel that way?

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