Friday, January 11, 2008

Sleeplessness

I've been having trouble sleeping since January 1. That's when I started the BCPs to quiet my ovaries. Not entirely convinced that they needed that extra help before starting the more powerful drugs, but that's the protocol my RE uses. I worry that — like so many IVFers I've followed online — I will respond better to a different protocol. Clinics have to start with the procedure they feel is best for most and then tweak from there. I get that. There is no telling how I'll respond until we try it.

But thinking about the astronomical costs, both financial and emotional, makes me ill even on the premise that every part of the cycle plays out perfectly. The meds cocktail might be exactly what I need. I might produce a fair number of eggs (*cough,* for my age). Maybe some of them will fertilize properly — 2, 3? — and turn into viable embryos or blasts that can be put back into my uterus. If there are more than 2 survivors, perhaps there will be 1 or more to freeze for a later FET . . .

Notice how I don't carry that through to a positive outcome? I can't take myself there. That kind of hope is too painful for me. Over the years I've trained myself to tamp down my hopes, to stay as neutral as possible.

So, if I respond well to the protocol, we will have a complete IVF cycle. If I respond poorly early on, we can stop and convert to IUI (a procedure nobody recommends we try under other circumstances). If I respond poorly in an ambiguous might-be-okay-but can't-tell-yet way and we make it to retrieval and transfer, AND the poor response leads to a poor result, well, we are SOL. (Not in my acronym list, but you know that one.) We're also out of tries.

Should I hope for an early indication that the meds won't work? A small part of me does, because I almost never see 40-somethings succeed on the first IVF try. Meds, procedures, approaches get adjusted after that "dry run" cycle.

It don't come easy, Ringo. Sleep, I mean.

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