In October, 2004, I started my first IVF cycle.
I was on the Lupron Flare protocol, with the max dosage of stims: 450 Gonal-F + 150 Repronex per day (600 IU of FSH plus 150 of LH) and 10 units of Lupron twice per day. The cycle was preceded by 2-3 weeks of birth controls to quiet my ovaries down.
I was the perfect IVF patient, I tell you. I did all of those shots exactly right. I managed to get every damn flake of that Repronex powder properly dissolved in saline vials, drawn into a syringe without so much as a bubble, and injected into my roll of stomach fat (I knew that my love handles would be good for something one day…). All shots were given exactly 12 hours apart, give or take 5 minutes, even though I traveled to Chicago twice and needed to mind the time difference. I even managed to briefly adjourn a business meeting with a customer and colleagues at precisely the right time to shoot up in the women’s room.
I shot up on an airplane from my seat during turbulence - not in the bathroom because the seat belt sign was on – and probably freaked out the person sitting next to me. I shot up in restaurants and movie theater bathrooms as well (I missed almost the whole leper colony portion of The Motorcycle Diaries). I shoved those creamy white Viagra suppositories as far up into my vagina as I was able, four times a day, even though they made my nether regions itch and burn like the yeast infection from hell. I put aside my misgivings about using Viagra for such a clearly off-label purpose, and the fact that very little, if any, health testing of Viagra on women has been done. And let’s not forget the oral meds – baby aspirin, pre-natal vitamins, and Synthyroid.
But despite my perfection and enthusiasm, the cycle did not go well. Although I had a few antral follicles on both ovaries during my day 1 baseline ultrasound, by cycle day 5 all was still quiet. Dr. Blond said maybe I was just a “slow starter” – it would be much worse if there were only one or two follicles. In this case, zero follicles were actually better than one or two.
But by day 8, one and only one follicle appeared and it was clear that no others were going to show up at the party this month. So, this was pretty much the worst scenario. Just one lousy follicle. And after being on the maximum dosage of stims, at age 34 – a relatively young age in the ART world. All that medication, all those shots - $4500 worth (covered by insurance, thankfully) - for nothing. I would have produced one follicle on my own naturally (I know I ovulate). Many 45-year-old women have a better response to fertility meds than me.
I was officially termed a “poor responder” - not entirely unexpected since I’d failed the Clomid Challenge test and had high FSH (14.9) on day 3. But the Big University IVF docs were quite surprised at just how poor my poor response was – I mean, just one follicle on max stims is about as bad as it gets.
Anyway, I was pretty devastated. I had fantasies of producing 10-15 perfect follicles. I think Dr. Blond had those fantasies too, because she had been recommending PGD to choose the best embryo for my single-embryo transfer. Well, we didn’t have to worry about that anymore.
Dr. Bigshot was covering for Dr. Blond on day 8 and he broke the news to me. He said he was sorry and strongly recommended I cancel the IVF cycle and change it to an IUI, but it was up to me. They would do the IVF if I requested, but it had only the slimmest chance of succeeding. Typically less than half of the eggs in follicles successfully fertilize and make it to day 3.
I burst into tears, and Dr. Bigshot mumbled something and walked out of the room. I had so many questions for him – why did this happen, might it be different next time, what were the odds for success with an IUI versus a one-follicle IVF – but he ran out of the room so quickly I couldn’t ask them. An IVF nurse remained behind, and stroked my hand – there, there – while I blubbered. And after about 3 strokes she ditched me too.
I was absolutely devastated. I had been sure that IVF would work for us; I had been very, very optimistic. So I felt like the wind had been knocked right out of me, leaving me gasping for air. I was KO’d – out for the count.
So there I was, sobbing and sobbing on the examining table, abandoned by the doctor and the nurse. I was shaking so much I felt physically sick. But after about 10 minutes and a cell phone conversation with T, I finally managed to collect myself and get dressed. I had no idea if the doctor or nurse was planning to come back, no clue if they even wanted to know my decision (continue with IVF or switch to IUI), and no inkling when my next appointment should be.
It didn’t matter. I couldn’t face them anyway. I couldn’t face anyone. I was afraid I would burst into tears if anyone spoke to me. So I snuck out of the examining room, averted my eyes as I hurried through the waiting room, and went to my car. I called T again, and I was so distraught that he left work and drove 30 minutes, just to give me hugs and get coffee with me. He was clearly worried about my fragile mental state. He was - as he always is for the big things - the perfect, supportive husband. But alas, he had to go back to work.
Knowing I would likely break down crying if anyone even looked at me, I called in sick to work. I spent most of the rest of the day crying on my couch, and felt very sorry for myself indeed.