Talking To The Big Man Himself...

...and that would be Dr. Schoolcraft!

We had our phone regroup with Dr. Schoolcraft today at 9:30am to discuss what happened with the last cycle and where we were going to from here. It was very enlightening and I am always amazed that you think you know everything about your situation and then new angles present themselves.

First thing first - it is confirmed. Even though I passed all of CCRM's tests with flying colours, I am still a poor responder. No known reason. I filed that piece of information away in the same place that I filed my Unexplained IF diagnosis. For those of you who like numbers and getting into details, here were my results from the 1 day workup, which indicated that I should respond better to stimulation than I do:

AMH: 2.76 (CCRM likes to see it >1 so my score, pretty darn good. No DOR issues here supposidly)
Day 3 FSH: 7.3 (CCRM likes to see it less than 10)
Estradiol (E2): 39.3 (CCRM likes to see it less than 50)
LH: 2.52 (this s/b less than your FSH)
Antral Follicle Count: 14-16 follicles counted by the ultrasonographer

By all of their checks and measures, I should have responded well to the stim meds and produce around 20 eggs. My max on my best cycle? 10 eggs and they were the poorest quality.

I think I have to start facing up to the fact that I really do have poor quality eggs. The first time a doctor said that to me, I freaked out and I spent the rest of the day in bed, crying. I was in total denial that, at the age of 34 (at the time), I could possibly have genetically old and crummy eggs. However, the facts are starting to speak louder and louder to me. My DH asked a really good question to Dr. Sch this morning and that was "If we saw 14-16 antral follicles and that is the number that you realistically expect to recruit in any given IVF cycle, why do we only get about 7 of them?" His response was that the other 7 follicles that didn't come along were already defunct and didn't respond at all to the meds. There was already something wrong with them. Ugh. The first medical evidence that supports the crummy egg theory. Before that, it was only a theory, there was nothing concrete that we could point to that supported this so we willingly and quickly brushed it under the carpet, hoping that there was another explanation. I'm beginning to believe that there isn't another explanation.

Anyway, back to the call with Dr. Sch. We talked about the next protocol that he was going to put us on and that was the other one they use for poor responders - the Estrogen Priming Protocol (i.e. EPP protocol). Since I responded so poorly to the MDL protocol, he is going to try the other one on me so that was good news. Interesting enough, he said that a cyst wouldn't prevent a normal responder from responding well during a stim cycle but in my case, it really did have an impact on things. Ugh. Another nail in the coffin of the poor responder diagnosis. I had hoped after passing all of the 1 day workup tests at CCRM that all of the other doctors had been wrong and that I really was a decent responder, just hadn't had the right protocol yet. However, it really does seem that I will never get very many eggs.

My DH and I briefly considered getting all of our money refunded (you can do that if you don't go through to retrieval, you just have to pay for the b/w and u/s you had done) and cycling again here in Canada maybe twice for the cost of the 1 cycle in the US...but then we decided to stick with our original plan. A big part of the reason why we chose CCRM was to get access to the embryologists and better lab conditions and hopefully, maybe because my eggs are so fragile, this will be the difference that they need. Who knows at this point.

So, it looks like we will be doing the EPP protocol starting with my next AF in mid January and will be back in Denver sometime in February. Cross your fingers this is the magic try! There's something with the month of February for us...both times we got the chemical and then a BFP was in the month of February. Maybe this is our shot at last?