So, this cycle didn't start out much better.  Only 3 follicles seen on the initial u/s, but we charged ahead anyways. 
Not much has happened and the doc's wanted to cancel us yesterday.  Estrogen has not been rising as much as it should.  But, I feel why bother cancelling?  What's cancelling going to get me.  It's certainly not going to get me pregnant!  
So, there were 2 good follicles today and 3-4 little ones. I have good 
insurance and meds are only a $40 co pay. So, I talked the doc into 
continuing on at a lower dose to try to get those 2 to grow and either 
doing timed intercourse or an IUI. None of this makes any sense. We 
never had a problem getting pregnant. The longest amount of time to conceive was 4 months!
I'm trying to figure out what went so wrong and there were only 2 things
 that changed from testing to cycling. That was the addition of 
dexamethasone and the birth control pill. I'm starting to suspect the 
dex even though the doc says it can't be the problem. If DHEA is so 
important to older women (and lots of studies say it is), dex is the 
anti-DHEA. http://www.ncbi.nlm.nih.gov/pubmed/9221990
 Dexamethasone causes DHEA to fall. I asked the doc today about DHEA and
 he felt it doesn't really do anything, but if I want to try it go 
ahead. Well, I know the studies show it does do alot for women with DOR.
 Here's a list of the studies in case anybody's wondering: http://www.centerforhumanreprod.com/dhea.html
 So maybe after a few months and the dex gets out of my system... After 
looking that up, the half life of dex is only 36-54 hours, so it should 
be all out of my system. The more depressing theory is that since DHEA 
seems to work at improving the follicular environment, the dex may have 
damaged the follicular environment. Since folliculogenesis takes months 
it may be a long time before the follicular environment has recovered 
from the assault. I'll know I'm right if my AFC recovers over the next 
few months.
So, doc also ordered an AMH test. That's fine I've never had one. If the
 AMH comes back low, we'll know it's DOR. If it comes back ok, the doc's
 other theory is that some women's bodies just don't respond to 
exogenous FSH. So, all the Follistim in the world wouldn't have that 
much effect on me. In that case, the only other answer is to use my 
body's own hormones through a Lupron flare protocol or clomid.
So much to think about...
Do you have any concerns using Clomid or other protocols? I wish I understood this stuff better. I need to do some more research.
ReplyDeleteHoping, hoping, hoping this is your month,
Hi Zub! No, I don't have any overall concerns with using Clomid. That's one of the doc's recommendations if this doesn't work. The big problem with Clomid is it damages the lining. My lining looks good, but I wouldn't want to risk it overall when the injectables do a better job anyways. :)
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