The day finally came yesterday for the follow-up, the what-the-heck-went-wrong and the what-next meeting with our Reproductive Endocrinologist.
a) She blames egg quality all the way. Her recommendation, CoQ10! What good luck I have already been taking it, although not at the dose she wants, for a month. Recommendation 2, add growth hormone during the 10 days of injections.
b) She says the sperm we have frozen is fantastic so it's fine if we want to try to use fresh too, they will take the sample on the day and inspect it. But the frozen is still there as back up and we should think of it as top-quality.
c) She still wants to push for day 5 transfer, but transfer 2 if there are 2 to transfer. Transferring on day 3 is a gamble if there are lots of good looking ones as there were with my last cycle, and there is no reliable way to pick the best ones until day 5. When day 3 embryos result in a viable pregnancy, there is no way to know whether or not they would have made it to day 5 in the lab, this is the point that people keep arguing. It's also where I get more conflicting opinions, including from embryologists. So I don't know, we will just have to discuss that question again when we get there.
She's on board with my super-anal-planner schedule I mapped out after I took my basal body temperature to confirm ovulation this cycle. I was worried she wouldn't but she liked it and said absolutely we can work with it. The big unknown will be when my period actually arrives (I've got it pretty well nailed to this weekend) and then after stopping the 3 weeks of birth control pills, when it arrives again (both of which screwed my timing last time). Otherwise, same 10 day injection protocol expected, so my schedule works, and gives an expected retrieval date of March 26!
The growth hormone I was warned is expensive, about $1000. We also agreed we will do ICSI again. So we are planning this cycle to cost $6500 - $5G for the meds and $1500 for ICSI. I've never gone to the casino with a wad of cash that big and been willing to gamble it away, but that is what I'm doing. Round two, and I'm all in because this is the last shot.
We had a long discussion about transferring multiple embryos. My attitude towards this has changed, simply because the circumstances have changed. When I started on this journey, I had visions of frozen embryos that could be used in the future, and that maybe I could get more than one pregnancy out of that one retrieval. Fantasy world. Now that this is really and truly my last go, the reasons I wanted a singleton are irrelevant. I wanted a full-term vaginal birth and to have another go at breastfeeding. I still want this, but one of the reasons was that a second c-section would mean a third would have to be c-section, and a fourth would be very risky. Unicorns and rainbows are more likely to shoot out of my butt than me giving birth a third let alone fourth time. The full-term vaginal birth isn't out of the question for twins, and increasing breastfeeding success will be largely a function of going full-term. Singleton or not, getting to full-term or as close as possible is my goal, and if it means 3 months of bed rest I'll do it. The remote possibility of triplets freaks out my husband, but I figure if I mentally prepare for it, twins would be easy. I've already considered it, and the more I consider it the better prepared I will be. But one step at a time.
First step, period due in a few days and the five week endocrine roller coaster starts again!