I have several bigger 'issue'-type posts brewing, but mostly when I'm nowhere near the computer, so sadly not making any progress on getting my thoughts clear and written down. In the meantime I thought I'd answer some questions on protocol and other science-y stuff from the comments. Because you know how I'm a geek about that.
Why won't you trigger til next Tuesday?
We don't know yet whether or not it WILL be Tuesday, it might be Monday, but either way I seem to stim so damn slowly. They didn't do retrieval til Monday (day 15 of stims) last time, and Tuesday will be day 16 of stims this time - the equivalent retrieval day to that of cycle 1. They will discount the follicle that was 16 yesterday as it is too far ahead of the others. What they want is a crop of similarly sized ones. Dr Condescending (did you notice how the three docs I see most at the clinic all got C names? Do you think I should be busy psychoanalysing myself on that one?) is estimating that they will grow between 1 and 2mm a day, so hopefully on Friday they will be around 16-18mm. I guess that might mean Monday retrieval, we'll just have to see. Last time on the Friday (day 12) there were 13 of them between between 11 and 20mm, and on the Monday we got 9 eggs, so I guess the little ones were too little still by the Monday, and I know two were empty.
Why did Dr Condescending ask if I was happy with her wanding
See, that wasn't exactly what I typed. What I typed was that she asked if I was happy for her to wand me instead of Dr Casual doing it - seeing as how he wasn't there. It was a permission thing - she was being respectful of this special continuity-of-care thing I was supposed to be getting. Yes, I didn't exactly have loads of choice, but at least she asked. And I wanted to be clear - because clearly it didn't read that way to some of you - it wasn't like she wanded me, then asked if I liked it. That would have been weird. Maybe there's some English phrasing I used that doesn't make sense in American?
Does Dr Condescending have short skirts to go with the high (red) heels?
Nope, she was wearing a tight-ish but reasonably modest calf-length dress. Which was different from when we saw her from afar last week when she was wearing a very short, tight, flowery wrap dress, again with the red high heels. Perhaps part of her maternity leave involved shoe shopping? And she's got no bloody stomach left from her pregnancy, the cow. No seriously, I do actually rather like her now. But it's funnier to be snarky.
Why does symmetrical embryo development matter?
I think the answer to this is that they don't know WHY but they do know THAT symmetricality relates to better pregnancy rates. It was one of the studies I quoted from the ESHRE meeting. In addition, I found this article. There isn't a lot of agreement here, but some factors do seem to be helpful - and not always the ones that clinics tend to score for. Just to be clear, symmetry doesn't mean going 2 cells, 4 cells, 8 cells, it means that the cells that the embryo has are spaced symmetrically within the embryo - the right relationship to each other. This is such an imperfect science that I wouldn't worry too much about it. However, given I got pregnant last time from a nice symmetrical 4-cell, I hope I'll be forgiven for feeling a bit superstitious about this.
Why is E2 not reliable on an antagonist cycle?
I'm hungry so am not going to spend the time right now to get this right, but basically in an antagonist cycle you are affecting directly the LH level (the antagonist turns it off), and that affects the oestrodiol level directly. In an agonist cycle, you've shut down the pituitary and hence LH etc indirectly by over-stimulation, so the oestrodiol level is independent. I know, that doesn't make great sense. I will read more and get back to you.