Monday, March 12, 2012

Getting the ball rolling....again

Today was the day to get the ball rolling again.  In spite of the fact that this is our third go round, we were still in for a few surprises. 

Our first surprise came right off the bat -- the clinic had moved!  Granted they had only moved to the building next door and up one floor, but this move is actually very good news for us.  In addition to completely remodeling the waiting area, our doctor told us that they brought in an engineer to help them re-design their labs.  From a new air purification system to updated lab equipment to making the lab more closed off (fewer doors to open and close), the clinic is very state of the art.  This in turn has had a positive influence on their success rates -- a statistical jump of nearly 10%!

Our second surprise was equally as pleasant.  I knew I would have to repeat some blood work, mainly to see where my hormone levels were at, but the good news is that they have a new blood test for their IVF patients -- the Ovarian Assessment Report.

According to the handout provided to me by my doctor "the Ovarian Assessment Report provides women with the most accurate assessment of ovulatory egg supply available through the use of a single blood sample.  Ovulatory egg supply is the quantity of eggs a woman has available for collection through controlled ovarian stimulation, commonly referred to as an egg retrieval procedure.  The report provides women with their Egg Retrieval Score which is a unique index score that more accurately estimates the ovulatory egg supply by combining age with multiple ovary-related hormones." The blood for this test is drawn on cycle day 3 (day 1 being the first day of a woman's period).

This means my doctor will get a better picture of how my eggs are doing and how they are aging.  Very useful when it comes to determining the proper protocol for IVF.

In addition to this blood work, I will also have to repeat the Saline Infused Sonogram or Sonohystogram (SHG).  In this test, the doctor fills the uterus with saline and uses ultrasound to check the shape of the uterus.  In addition, she will take a look at my ovaries and see how many potential follicles there are.  For my age group, each ovary should have 9 to 11 potential follicles.  (One of these follicles develops into an egg that will be ovulated.)  This test is done on or after cycle day 10 but before ovulation occurs.  (Ovulation on average occurs on cycle day 14 or 15.)

Our final surprise was the doctor's assessment of my previous IVF cycle.  In a previous post I had mentioned that years ago I had been given the diagnosis of Diminished Ovarian Reserve. This was my opportunity to ask the doctor more about this condition, specifically to how it related my previous IVF cycles, and what it could mean for my future.  Her opinion was that I did not have this condition, but rather possibly a condition call Ovarian Resistance.  Her thinking on why I was given the previous diagnosis was purely based on a number of characteristics that had occurred.  It was purely a clinical dignosis, based on experiences.  Diminished Ovarian Reserve is lumped in with what's called peri-menopause, the decade or so before menopause begins, whereas Ovarian Resistance is generally what can happen in the decade or so before that.  In her words, ovarian resistance means that my ovaries don't like to play so we are forcing them to with the IVF meds.

This left me with a much better hope and a brighter outlook on the success of the cycle.  My Use By Date no longer seems right around the corner.

So we are ready to go again, ready to hunt for that missing piece to our puzzle, and no longer feeling like that piece will be difficult to find.

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