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04/12/2004

I don't even have to inject Lupron for it to make me crazy

A quick review:

IVF #1:
10 units of Lupron decreased to 5
2 amps Repronex / 2 amps Follistim
4 eggs retrieved, 1 fertilized

IVF #2:
5 units of Lupron decreased to 2.5
2 amps Repronex / 2 amps Follistim
Dominant follicle; retrieval cancelled

IVF #3:
10 units of Lupron decreased to 5
2 amps Repronex / 2 amps Bravelle
9 eggs retrieved, 2 fertilized

For IVF #4, I am told I will be on:

20 units of Lupron decreased to 10
4 amps Follistim

I'm concerned about the whopping dose of Lupron. My ovaries don't respond with enthusiasm even on half that — how much more intimidated will they be this time? How can I trust my ovaries to snap to attention after being so thoroughly stomped into submission? If we were increasing the gonadotropins I might feel more at ease, but it's the same dose I've been on every cycle.

I told myself I wouldn't second-guess anything this cycle. I'm in good hands, I know, and I'm paying other people, educated people, real live doctors, an awful lot of money to do the thinking.

But I also know I can't expect the kind of individualized attention I've had in the past. My new clinic is a busy place, overseeing hundreds of cycles a year — busy enough that I fear I'll fall through the cracks, that decisions about my care might be made without considering the context of my past response.

It's a busy enough place that I know I'll need to forego the kind of hand-holding I've relied on in the past. It's early for me to start decompensating; I haven't even started Lupron yet. I know there's a perfectly good explanation for the increased dosage, one so obvious and well-reasoned that I'll feel stupid for even asking.

Even so, I think a talk-me-down-from-the-ledge phone call is in order.

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