Yesterday was our second appointment with my fertility doctor, Dr. M.
I got my Fertilome test results back. I have two genetic variants that are associated with a moderate risk for disorders associated with infertility – one for premature ovarian failure, and one for endometriosis. I don’t have the latter (as far as we know) but oh yes my ovaries are prematurely something. Dr. M says they are functioning like a 40 year old woman’s ovaries (I’m 34.)
The test results are good as far as we’re concerned because we already know I have diminished ovarian reserve (DOR) and now I know it’s not my fault. Now I know it’s not because I’m fat or because I used to smoke cigarettes.
We also reviewed my latest lab results. Dr. M says that my FSH (follicle stimulating hormone) of 2.2 is probably suppressed by my elevated estrogen, and that my true FSH is probably closer to an 8 or 9, which is actually good, and from what I’ve read, not the norm for people with AMH as low as mine. But since my AMH is so low now (<.03) Dr. M recommended IVF with preimplantation genetic screening (PGS). Great! But I’m too fat for IVF at the moment, which I already knew, which is why I am working on my weight.
So the treatment plan is to do IUIs starting with my next cycle in two weeks, until I either get pregnant or lose the weight to do IVF. My IUIs will be with Follistim, HCG trigger, and progesterone suppositories.
The upside: we have a treatment plan, my DOR is being taken seriously, I’ve only got 18 pounds to lose before I am eligible for IVF (though ideally I will lose more than that), we are going to get to see how my ovaries respond to stimulation, and we’re not wasting any cycles while I lose the weight. Also, I’ve only been taking DHEA for a month, and only been doing acupuncture and wheat grass/antioxidant smoothies for a month, so my eggs need this extra time to get into better shape, too.
The downside: My AMH is so low that the best time for IVF was probably two years ago. I have serious pressure to lose weight and I feel angry with myself that my weight was never too high for IVF until the last year or so really. Also, I know that our chances of success with IUIs is slim. I know that our chances with IVF are slim, too. While I feel like I have some resolution because I have a diagnosis and a treatment plan, this is far from being resolved and while I feel like we have the solution, we’re actually just starting the next chapter in our infertility journey. We may need to eventually move on to chapter three: donor eggs, and my husband and I both need to make some peace with that along the way in order to be able to stomach my own eggs failing us, in case that possibility becomes a reality. I also know that if we do conceive with either IUI or IVF I have a history of miscarriage and I don’t know at what point during a pregnancy will I ever feel safe from that again. My husband is confident that we will get pregnant with IUI. He is always the optimist and I tried to talk to him about our chances of conceiving and he just has complete faith this will work. I am worried he will end up feeling very let down again.