Friday, April 28, 2006

Going Forward

We’ve moved on. Or, we’re moving on. I’m back to my blasé state about this IVF cycle.

As it played out, the urologist called back both D and me Wednesday afternoon. I had called there and didn’t take the “Emily Gilmore” approach of berating and yelling at the assistant who answers the phone and can’t tell me anything, but rather the “please be nice to me and help me because I’m on the verge of tears and will really lose my mind if I can’t get answers” approach. He’s a very nice man, and did his best to appease me.

But what it comes down to is that, since we don’t have the results of a recent semen culture (NOT analysis – which is what the stupid lab had done), we don’t know what D’s white blood cell count is, nor if there’s an infection present. It very well could be that the antibiotics wiped out the infection and his wbc count is normal – in which case ICSI should certainly work. Of course, that may not be the case. But, the urologist went on to explain that although D’s wbc count was high at 2 million (normal is 1 mil.), there are actually some people who think that having a wbc count between 2 – 4 million is good – so just having an elevated wbc count is not reason enough not to move forward with IVF-ICSI. In addition, the lab at Cornell that did D’s first semen culture that gave us the 2 mil. wbc count, doesn’t stain the cells – so in reality some of the 2,000,000 wbc could actually be immature sperm cells because immature sperm cells look like wbc. Can you even follow all this?

None of this, of course, factors in the possibility of the infection still being present in the semen. He told me that there appeared to be some streptococcus (or some such coccus or other) in D’s last sample – and if it’s still present, it may or may not be eliminated from the new round of antibiotics D is currently taking (normal IVF protocol calls for the male donor to take doxycycline leading up to retrieval, but the urologist is having D take erythromycin instead). Furthermore, even if some bacteria remains, there is no conclusive evidence one way or another to prove whether or not ICSI will work. The urologist’s gut feeling is that it won’t be an issue. And so we slog ahead, none the wiser.

Meanwhile, Wednesday morning we arranged to deliver another sample to be tested - this time to the regular old Quest lab not the Cornell lab. I brought it there myself, along with the paperwork that the urologist’s office had faxed over. When dropping it off I made sure that they understood which tests were to be done – at which point the lady taking everything looked closely at the prescription I had brought and said she didn’t know whether it was a “semen culture” test or a “semen analysis” since the doctor had only written “semen” on the script. I pointed out to her that below that there were specific instructions for various cultures – so didn’t that mean it was to be the culture and not the analysis? To which she replied – “Oh no – those tests are done by swab at the doctor’s office or from a urine sample.” And so I call my new best friend, the urologist’s assistant and explain that the lab can’t understand the instructions given. She, of course, needs the doctor to call and explain but he’s in with a patient, but she promises she’ll have him call the lab to explain. So I wait. And wait. 45 minutes later I call again – he’s still with a patient. The only reason I’m okay with waiting is because I’m pretty confident that the sample needs to be cultured – and therefore timing is not of the essence. If it was supposed to be a semen analysis I would’ve been screwed. 10 minutes later the lab gets a phonecall and the urologist explains to the lady – who was very nice to me, just apparently didn’t know all that she thought she did – that indeed it was to be a semen culture and that all those specific cultures listed can, in fact, be tested from a semen sample. It seems that I spent an hour at the lab because the lady at the desk was wrong and created a problem when there really shouldn’t have been one. But in the end it got straightened out – no harm was done and we should have the results next week. Not that the results really even matter given everything I wrote above.

SO…our second ivf cycle is here. Today is considered Day 5. I’ve been taking my 200iu of Follistim since Wednesday night. This time around I’m giving myself all the shots and this time I’m just doing it in the abdomen. It’s been okay. My numbers from the Day 3 blood draw were good:
E2: 18
FSH: 3.2
LH: 1.2

It’s all going to come down to how the fertilization goes. Maybe I should start a blog pool – you know, the person who comes closest to guessing how many viable embryos for transfer we end up with could win all my left over medication! Anyone want to wager a bet?


Blogger Kris said...

I really hope that things work out for you and I'm glad they have given you some answers and that this cycle is moving forward.

I'm not going to join in on the pool... I don't need your extra meds. I start my Follistim tonight and this is my last cycle- with or without success.

April 28, 2006 1:35 PM  
Blogger UtRus said...

hey, sounds like things are progressing a bit. good. glad you cycle is still alive & kickin. good luck!!

April 28, 2006 3:01 PM  
Blogger Thalia said...

Wow. You sound like an angel of calm in a crappy situation. Well done. And those numbers rock. Hoping that all those doctors get their asses in gear quickly.

April 28, 2006 3:21 PM  
Blogger Stephanie said...

i have no idea how you had the patience to deal with the lady from the lab ontop of all the other cr@p going on. i am glad that your cycle is still "on" and sounds promising.

btw-enjoy the DRay/BoSox sereis this weekend....that should be entertaining!

April 28, 2006 3:26 PM  
Blogger Donna said...

OMG, the incompetence is overwhelming. I would have been leaping over the desk! I'm glad things are moving forward.

April 28, 2006 4:44 PM  
Anonymous Jenn said...

I'm impressed at how calmly you handled it. I hope you get plenty of viable embryos.

April 28, 2006 5:03 PM  
Blogger fisher queen said...

Good God. I would have been tearing out entrails by now.

April 28, 2006 6:51 PM  
Blogger Larisa said...

"or some such coccus or other" = despite all your frustration - I got a giggle out of that line.

I hope that you get fantastic fertilization - though I won't join in the pool - my dr doesn't use follistim.

Good for you for your patience...

Hoping for you.

April 28, 2006 8:22 PM  
Blogger Jamila said...

OK, following all that kinda makes my head hurt, but thanks for the update. Lord, what a roller coaster. I got the jist, which is that IVF is off and running. I will say you'll get....8 viable embryos for transfer!

April 28, 2006 8:30 PM  
Blogger sube said...

Argh. What frustration, but sounds like you handled it very gracefully. Glad to hear your cycle is moving on.

April 28, 2006 8:55 PM  
Blogger MoMo said...

Mellie, I thought I left a comment about this post, but I guess not. You are being very brave and I am so proud of you! I am glad that you moving forward with this cycle and it seems like your urologist is coming around.

Good luck I will be thinking of you. I hope that we will both be celebrating in the coming weeks! Hugs!

April 29, 2006 10:06 AM  
Blogger Mony said...

2 to transfer.
2 to freeze.

We're not greedy.
Well Mellie, I'm strapped in & ready to ride. Blaze the trail!

April 29, 2006 12:18 PM  
Blogger Mel said...

your week sounds like my week. Sometimes the incompetance of the medical world is staggering! You handled it with grace.

April 29, 2006 1:05 PM  

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