what's next

I met with the RE this morning to review my failed IVF and to find out what the plan is for the next attempt. The good news is that she's submitted a recommendation for an IVF cycle to my insurer and fully expects the procedure to be approved. The bad news is that I turned 41 and have entered a whole new statistical bracket, full of very depressing numbers.

First, the recap...
I responded well to the gonal-F, but only 5 of the 11 retrieved eggs were mature. The RE normally likes to see 70%+ maturity. Three of the five mature eggs fertilized, which is acceptably "normal," and actually pretty good considering my age. A moderate amount of fragmentation was noticeable on all three fertilized embryos. Fragmentation is associated with embryos not implanting in the uterus. The transferred embryos were 10-, 7-, and 5-celled. Ideally, embryos should be 6 or more cells for a 3day transfer.

The plan...
Eleven eggs is roughly the goal of stimulation for an IVF cycle. In order to increase the number of mature eggs, I'll start lupron three weeks after my next CD1. The goal is to grow the eggs a bit more slowly and consistently so we end up with most of the eggs maturing at the same time. I'll be injecting gonal-F starting around CD5, 225units twice each day. The dose and frequency both increase over the last cycle to compensate for lupron's suppressive effect. So, even though I'll be injecting more than double the gonal-F of the last cycle, I should develop about the same number of eggs more slowly than last time.

There's nothing we can do to influence the amount of fragmentation, but my uneducated guess is that a more mature egg will develop less fragmentation.

I was a little disappointed to learn that the "start" of an IVF cycle is three weeks into a cycle. So, instead of taking one complete cycle "off," it'll be more like 1.75 cycles. That's seven weeks of doing nothing. We're looking at lupron starting around June 11th, with ER and ET in the week of the Fourth of July.

I hate that my mind does this... I immediately started thinking that the ultimate birthday gift for C would be a pregnancy annoucement. His birthday is July 18th, and our beta would be right around then if I counted this out correctly. Our due date (because I just can't shut off these thoughts) would be right before my 42nd birthday.