Finally baseline - start the stimming!

Dr. B's nurse finally called me back at 4:45 today, causing me to harass their office twice and ponder the merits of a nervous breakdown. Turns out she was waiting to call because she wanted to talk to the RE about my pathetic antral follicles.

This nurse is new to my case, as the doctor has 2 nurses: one for IUI/Clomid and one for IVF. Since this is my first IVF, I just started working with her. So while I knew I was a deadbeat in the antral follicle realm, she apparently did not. I like her very much, so it was nothing about her specifically, but it was like rubbing salt in the wound when she said that the RE may opt to cancel this cycle and see if the next baseline looked better. I suspected the RE would not be surprised at my scans and poor number of antrals and we would go ahead, but what would a cycle be without a little added trauma due to misunderstandings and turnover of staff?

After waiting another hour for the follow-up phone call, worrying that my already poor prognosis has gotten even worse, she called back and confirmed that my RE was not surprised at what he saw (or, rather, didn't see). So, the plan is still on and off we go!

As I've posted before, the RE will be happy if I can muster 5 good follies. Less than three and we'll convert to IUI. 150IU of Menoupur + 450IU of Gonal-f, ay caramba. If this can't stim me, nothing will. I go in on Friday morning for my next u/s and b/w to check on follie progress. Talk about TGIF!

Delayed

No biggie, my "baseline" u/s and b/w on Saturday came back as not-quite-yet baseline (progesterone was still mid-LP level) so they had me come back in this morning to try again. Will post details when I have them later this afternoon.

As usual Ol' Leftie was not cooperative this morning and I had to restrain myself from getting annoyed at the tech who seemed perplexed by it since she's the same tech I've had many, many times in the past. I know I shouldn't expect her to remember me and my ovaries and the bizarre contortions I need to get into in order to force Leftie into the spotlight. I'm sure we're all a blur since it's just 'insert, scan, wand, press click' over and over again. Why I'd think my ovaries and their quirks are anything special is silly, I know! ;P

A little more info...

OK, for anyone following this for details on the Estrogen Priming Protocol, I found out a little bit more.

1) The reason for ganirelix in this priming part of the cycle is because the increased estrogen (from the patch) can sometimes cause your body to start increasing LH, so they want to nip that in the bud. Also, it lulls the FSH receptors in the ovaries and gets them ready for stimming in the early part of next cycle -- like lupron for better responders. More a gentle, swaying suppression over a rock concert suppression. All makes sense and is what I thought, but I started getting concerned that I was filling in the blanks with my own - not necessarily factual - explanations. Good thing it's now backed up by some degrees ;).

2) My concern about starting the priming on CD14 is legit, according to the nurse. But she explained that my hormones are actually a better indictator of where I am in my cycle than a bleed (i.e. period). I may be the kind of woman whose progesterone drops slowly rather than plummets, which is what triggers a period. And this actually jives with my weird hormones in the past few cycles, where hormonally I never seemed to be where I should be in the cycle according to what I thought was CD1. So, while I think I'm CD14, I may actually be hormonally in mid-luteal phase. Sooo, the solution is that if I don't get my period by next Monday, June 1st, I'll call the nurse and they'll bring me in for bloodwork. They're suspecting that my hormones will show that I am baseline even if I haven't had a bleed yet. If the hormones jive, I'll get started on the stimming, and the nurse assures me that a bleed a few days later won't affect anything - that the ovaries percolating is an independent process to the uterus clearing its lining.

I trust the RE and nurse and 100% believe that listening to my hormones over my period is the right thing to do. I just wish my body behaved predictably sometimes. Oh well, at least I work from home and can nag my nurse with all sorts of personal questions all day long without fear of my co-workers overhearing. I am always, always friendly and polite with the staff and try to crack jokes on the phone with the nurse, so I'm hoping that I'm not one of those dreaded patients despite my love of calling multiple times a day when I have questions. I read a blog by an RE a few weeks ago where he wrote about how the nurses in his office fight over getting to be the one letting their "favorite" patients know when they've gotten a positive pregnancy tests. I wonder which bucket I fall in to - are my questions endearing and make them feel closer to me? Am I a favorite? Or am I the pain in the butt they all punt around to each other? I hope the former, but either way, I can't stop the calling when I have questions, so I guess the answer doesn't really matter. Except to my need to be liked, which I'm trying to make take a backseat in this process.