Friday, May 11, 2012

RE consultation to try for baby #3

Last week we met with the RE to discuss our plan to ttc#3. 
Our doctor had reviewed our file and said that we could have had triplets because in addition to the 18.5 and 18 mm follicles I had when I triggered, I also had a 14 and he counts everything over 12.  He however was on vacation when I triggered and another RE there was monitoring/advising me.  No one mentioned that to us last time!  Now Mr. W is totally freaked out about doing Follistim again. I'm so frustrated that this has come up as an issue completely after the fact because it kind of changes everything about how we proceed.
The RE said that the lowest dose now for Follistim is 50iu (I was on 75 iu the first time and stimmed for about 8 days) so if we wanted to do Follistim again we could try that. He also suggested I could try Letrozole. That would certainly be a lot less expensive, but I have two concerns:
1) I HATED clomid.  I was like a crazy, evil person on it and I worry that I could have a similar reaction on letrozole (I had no side effects from follistim.) 
2) I worry that I'm working backwards here going from injectible to oral meds. I had 3 unsuccessful clomid rounds ttc#1 and 4 unsuccessful ttc#2.  I'm 36 so I'm not getting any more fertile, and I wasn't very fertile to start with! I feel like I have less time to mess around with options that could work and would rather stick what I know worked in the past.
Since it has been 2 yrs since I was trying to conceive, he wants me to do a clomid challenge test which I'm less than thrilled about, but figure I should probably do it.  It would be good to verify that in two years I haven't ventured into severe ovarian reserve territory thus making the expense of follistim a waste of money.
The other controversial thing we talked about was Family Balancing.  Do we want a daughter? Yes.  We were hoping to see about doing the sperm spinning for sex selection.  The RE however doesn't do it and doesn't have any faith in it.  He said we could do IVF for family balancing, but I feel like that is a really dumb idea when we are at the end of our family building journey.  I don't want extra embryos left over and frankly am not comfortable with the moral responsibility of dealing with embryos anyway.  Having a daughter is very important to me, but I don't think it is that important.  Plus I don't think we could afford IVF anyway.  I won't lie though, the thought of never having a daughter is depressing to me; I just can't imagine my life without one.
I realize that I seem to be contradicting myself.  I'm willing to 'play God' to increase my chances of getting the sex I want, but not willing to 'play God' to create embryos that I will likely not use.  I realize it is an incredibly fine line, but I'm trying to stick to allowable fertility treatments for Catholics.  I feel like any pursuit of treatment puts me on a slippery slope.  One thing I have learned from my infertility journey is that I need to refrain from saying, "I would never do that!" because frankly, I have no idea how desperate I may be and how much I may be willing to bend my rules.
So, if I can't do sperm spinning for sex selection I don't want to do an IUI and would rather stick with follistim, trigger, TI.
I think Mr. W is leaning towards trying the letrozole because the RE freaked him out.   He really only wants one more, not 2.  He is ambivalent about IUI because he is not Catholic and doesn't have all my hang ups. 
So I'm overwhelmed now and don't feel confident about how I want to proceed. Infertility is so confusing!

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