Angry

I'm not sure what those "classic" stages of grief are, so I may be encountering them out of order, but I have definitely entered the anger phase. 


Note: some expletives are used below (well, pretty much just one, actually). I'm apologizing up front to those who may be offended by the F word. Also, as an aside, I am fully aware of my overzealous use of "quotation marks" today - my use of them is intentional. When used in a sentence such as, "six of the 'naturally' combining eggs look like 'something' 'may' be 'going on'", they are meant to convey the fact that I think every fucking word out of every* fucking person's mouth today is bullshit - particularly those persons phoning me from my IVF clinic. I guess am feeling the need to explain my writing "conventions", after reading Sarah's blog review. 


Sorry, back to my anger: I am angry that the BE-OTCH of a "reproductive endocrinologist" that called me today suggested that the problem with this cycle was MY beautiful, sweet, overachieving EGGS, to the point that she half-heartedly suggested that they might be able to tweak the dosage of Follistim in a future cycle, but barring that I'd really probably want to look at donor eggs. To that, I would like to give a giant FUCK YOU to Valerie S. Ratts, MD. How come after a 25 minute consult with Dr. Google, I find discussion of several options for dealing with immature eggs in IVF cycles in patients with PCOS? Options she couldn't propose with her fucking MEDICAL DEGREE from JOHNS fucking HOPKINS, such as:

1. IVM - in vitro maturation. I realize this is experimental, but did they HAVE to throw away the 13 immature eggs they stripped? Wouldn't those have been perfect candidates for a little experimenting? Also, in this vein, I know their "plan" was to do "partial ICSI" (meaning they would do ICSI on about half of the eggs and let the others combine with the sperm "naturally"), but when they saw that 13 of the 14 eggs they stripped were immature, couldn't they have continued stripping them to find all of the mature ones and do ICSI on all of them to give them the very best chance? If it's because I had only "signed off on" partial ICSI, couldn't they have picked up the phone and discussed it with me YESTERDAY!?!?!?
2. Two HCG trigger shots - apparently women of advanced maternal size (ha ha, I am soooo very funny) could possibly benefit from two Ovidrel injections to induce maturation of the oocytes.
3. More closely aligning the number of follicles on ultrasound with E2 levels - while I know it's a tricky business to ramp those estradiol levels up into the several thousands, it is generally recognized that E2 levels should be about 200 for each mature follicle. The day they had me trigger, I had 34 measurable follicles (1-18, 1-17, 2-16, 8-15, 5-14, 4-13, 7-12, 2-11, 4-10), but my estradiol was 3,519. This E2 level should have meant about 17 mature follicles, but only TWO of the 34 were at least 17 mm (the generally recognized size of a mature follicle). I would think this would have told them that I had 2 mature follicles and 32 immature ones and that I needed to stim another day until the numbers matched up better.
4. They could consider treating my underlying PCOS with metformin, which can increase IVF success rates.

Basically, it is my conclusion that they triggered me early, hoping to avoid OHSS, but instead resulting in a giant, expensive, painful (emotionally and physically) waste of time. Not to mention decreasing their IVF success statistics (since they probably care more about that anyway). And, instead of treating me on the phone like I am a freak show, I'm thinking she could have acknowledged that this situation is not totally uncommon in PCOS IVF cycles. I am trying to decide what to do. I am extremely irritated with this clinic and I feel like they did not tailor my protocol to my situation - it was more about when my stimulation fit into their schedule. I am thinking about continuing my stirrup hopping and getting another opinion. I am also thinking about giving up. I am tired and sad and am feeling like God hates me/this wasn't meant to be/etc... Sigh. I hate this. 


*Not you guys of course, your comments echo the voice of my heart, and I love you. Muah.