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Go with the flow

I haven't said much about the follow-up consultation I had after IVF #3 for the very simple reason that it yielded almost no new information.

When Paul opened his notebook at the beginning of the meeting, my doctor's eyes landed on the Cornell letterhead with the fixity of a soaring condor spotting a choice heap of carrion way, way down below. For the rest of the hour, his sights were locked.

So we got to hear a lot about what he imagines they'll tell us at Cornell, his impression of the doctor we'll be seeing, and his opinion on the cost of their program. When I was sufficiently bored beyond politeness by all this, I finally barked, "Thanks. Now. Less about their approach and more about yours, please."

As expected, he warmly embraced my idea that stimulated IUIs might be worth a try. Although I had several unsuccessul IUIs with Clomid, the only way I've ever achieved an intrauterine pregnancy was with gonadotropins and an IUI, so it seems worth a couple of tries. I can't tell if my doctor's enthusiasm is due to a sincere belief that it might work, or relief at the prospect of shifting the burden of conception back onto my body instead of his lab.

He assured me, by the way, that his embryologist was not drunk when she did ICSI on my eggs.

Speaking of my eggs, he took vigorous exception to my characterization of them as garbagey. I contented myself by scowling and muttering under my breath, "They're my eggs and I can call them whatever names I want."

I'm pretty much the epitome of maturity.

He allowed that the zona problem I have is uncommon, and offered no opinion on whether my eggs might perform better in vivo than they do in vitro. This pretty much cemented my conviction that going to Cornell for a second opinion is a good idea — I'd like to talk to someone who's seen a hundred patients like me. I know no one can offer any guarantees, but even an educated guess would be an improvement.

We had a long and confusing conversation about whether I should have another lap before further treatment. I was finally made to understand that my doctor's opinion is that if we're ready to forego future tries with IVF and just concentrate on IUIs and/or natural conception, I should consider a lap. But if we're willing to consider IVF in the future, we should leave the depths of my pelvis unplumbed, for fear of removing functioning ovarian tissue. "...Unless," my doctor concluded, "you really want a lap."

For the girl who has everything, I presume.

So the consultation didn't offer us anything much beyond confirmation of what we already knew, and had already considered trying next. Inasmuch as there is a plan, here's what we've decided, in helpful flowchart form: