Wednesday, June 20, 2012

Bad news bears

A nurse from the Nashville clinic called to say that the AMH test results had come through-- mildly gentling my general hostility towards Dr. King's lab and clinic.  Oh, and they're bad.

Not bad bad, she said.  But a good score would be 1 or just over (this apparently is measured in nanograms per milliliter, or ng/mL), and Heather's is 0.64. 

Per the Mayo Clinic, "Studies in fertility clinics have shown that females with higher concentrations of AMH have a better response to ovarian stimulation and tend to produce more retrievable oocytes than females with low or undetectable AMH."  Various other Google results say that AMH indicates what kind of "ovarian reserve," or egg supply, a woman has, so a low AMH level would suggest that she has a smaller supply.

The nurse told me that .64 isn't a death sentence; she's seen healthy babies from women at that level.  The difference is that Heather is going to need a "more aggressive" treatment, starting with 20 units of Lupron, twice each day, instead of the 10 units in the basic plan.

I guess the nice thing here, and with IVF in general now that our plan has been set, is that we have zero control or input.  Heather takes the meds and gets a lot of tests, and all the rest of it just happens around us.  The plan lays out the dates of each appointment and what procedures will occur on those days.  The big-ass suppression check will be July 5th, making for an interesting cap to a week of planned vacation. 
And, looking at the plan they sent, I have no idea if my whole fucking post yesterday about drug timing and purpose was even correct.  Why do we have a suppression check before starting Lupron?  Isn't Lupron supposed to be part of the suppression?  If Lupron is suppressive, what's the point of overlapping it with FSH, which is what Lupron suppresses?

I don't know!  I don't.  Today's news caught us off guard, because all of Heather's tests have come back looking great, and we never expected to hear otherwise.  The surprise, and the subsequent realization that I not only don't know what's going on in Heather's body but don't know what these unending medications do, has left me feeling eagerly passive.  By all means, make the decisions for us; we clearly don't know what we're doing. 

Heather's napping on the couch.  I'm not sure how she's feeling about the whole thing.  She sounded frustrated but accepting when we first heard, and I wonder if she's as ambivalent about control and information as I am. 

I also wonder-- but will not inquire-- whether she's thought about how this impacts the post-IVF future.  We'd talked about going back to IUI and ICI if this didn't work, but if there's a real problem (not, as Heather has insisted, an issue of "not getting enough sperm in [her]"), both of those might be a waste of time.  And we'd be done.

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