Plus ca change

Dr Shoes did her usual thoroughly good job and managed to find seven eggs from eight follicles, although two of them were from pretty small follicles so they are unlikely to fertilise. So we have the five decent looking ones we saw on Monday. Let's hope they all fertilise and give us something decent to transfer on Friday.

One signal that I'm not taking this as seriously, or that I'm more relaxed, or that I have less faith in it working, is that I asked Dr Candour to prescribe me the progesterone suppositories instead of IM progesterone this time. And yes, they are suppositories, and not pessaries. My clinic recommends using them in the 'back passage' not in the vagina, although they say you can do either. We've used IM progesterone on each cycle since my first one ended in lots of blood at 8dp3dt. And I've come to understand that the research, as well as my personal experience, says that both IM and internal progesterone help support a pregnancy, but the IM progesterone will keep away a period even if you aren't pregnant, while the internal progesterone won't. So it may be more depressing, but it isn't any less good in terms of pregnancy support.

So I've made an intelligent decision, informed by science, to do something which is much less painful and intrusive, and traumatic, and do the easy version instead. Some part of me feels that I'm wrong, that I should have stuck to the IM progesterone - after all, I was on that the time I did get pregnant from IVF. And part of me knows that's nonsense. Which wasn't helped necessarily that all the nurses today had me down as doing IM progesterone. Ironic, since every other time when I have been on IM progesterone, they've assumed I'm on the suppositories and have had to be persuaded of the converse. I felt I had to keep explaining my decision to revert to the easy version of progesterone support. Which is silly and I'm sure they didn't care, but you know what it's like on retrieval day when you're feeling fragile and hungry and everyone keeps asking you your name and date of birth, and you realise just how bloody old you are compared to all these teenage nurses, not to mention the couple in the next bed who looked about 15 and turned out to have had 8 miscarriages.

Umm. Run on sentence. Sorry. Off to catch up on the work I didn't get to do today. Onwards and upwards.

Comments

[Kath]

Dear Thalia, it's good to hear that it went well. And please try not to worry about the progesterone -- you are absolutely right, and it was a good decision. Now I'm sending you good thoughts for the fertilization. XO

[Betty M]

I was a suppositories girl myself. I took the view I needed to know asap if it wasn't happening. 5 decent eggs sounds excellent.

[katie]

I have seen those 15-year-old couples, too, with the many many miscarriages - in some ways perhaps it's better to be old and not get pregnant as quickly because you can't have as many miscarriages, I think.

[filmgal30]

Well, I really wish you well and hope this works out for you. Being in the states I'm sure we do things differently, but with my one RE and four IUI attempts they always gave me progesterone suppositories for vaginal use. No one ever mentioned IM shots (and I also was told only to ever do shots in my abdomen with all my drugs for the IUIs) and no one ever mentioned suppositories being used non-vaginally so now I again question that doctor. Four times with the same drug regimine each time and no results....maybe that's why I have an appointment for a second opinion with a new RE in March (earliest I could get in with her). So if you don't mind please e-mail me or post to my site any more information you can give me about this if possible. I don't have endometriosis, but I have PCOS and a thyroid issue and just can't seem to ovulate to fruition with a partner who has some morphology problems on his end as well. It's always good reading your blog and picking up lots of information my doctor's office never seems to share with me. Again good luck with this retrieval/transfer process...I'm pulling from you way across the pond!

[Calliope]

not having to do PIO sounds awesome. For some reason I always felt the suppositories were more direct. & they sure don't give your ass lumps and welts!
Will be thinking of your eggies and hoping for a kick ass fertilization report.
xo

[Summer]

Hoping for some nice embryos for transfer on Friday.

[marie baguette]

I thought no one had IM in the UK? Anyway my new clinic does not believe in IM and they do have excellent stats. I think you made the right choice. I am only taking vaginal pills (yeah, they look like pills, not like suppositories and they are much less painful and less messy to use). I am keeping my fingers crossed for you

[Geohde]

I often toyed with the idea of IM progesterone for my cycles,but my clinic is v reluctant- for the reasons you mention. I did the research, too and came up with the same conclusions.

Excpet that in a subset of women vaginal progesterone does not work as well (as bourne out by endometrial biopsy), for unclear reasons. I'm one of them. I ended up having to do a rather wonky ovulation induction protocol for my frozen cycles, with BOTH hcg boosters and the pessaries to keep the red tide away.

I'm not sure what we'll do with the next fresh cycle, if there is one, because I make too many eggs to use hcg boosters in the luteal phase- OHSS is not on my 'to do' list....I suspect we'll not transfer and go with FET's only, even though the odds are lower per cycle.

Sigh.

Lucky me...

ANyway, good luck,

J

[Amyesq]

Right on with your bad self! Seven eggs!

Don't you *hate* the 15 year-olds?

Oh, and if it makes you feel any better, I did the IM religiously and never got PG. Well I did get PG but never carried a baby to term. Hey wait, I don't think this is coming out the way I want it to. OK, skip what has turned out to be a horrific analogy. But GOOD LUCK!

[Aurelia]

My doc doesn't believe in IM progesterone because he thinks it's just torture to do, and he can find another way usually to get the levels up. I did this like Marie-Baguette, progesterone pills (prometrium) used in the vagina. The stickiness of the gelcap kept them staying in as opposed to the suppositories which slid right out of me after doing a couple of vaginal births.

Anyway, I did try it the way you will be doing it, but I found it a little uncomfortable because I ended up having to run to the bathroom pretty quickly afterward and I'm not sure it absorbed much.

Do you have a progesterone patch in the UK? I tried that as well, great for blood levels, but I'm one of those people who pick at things like band-aids, and I ended up picking at it way too much.

[Larisa]

Wow - how'd I miss this?! Retrieval already! I hope you get the 5 you are hoping for, and that even just one is perfect.

My doc has apparently switched to a vaginal progesterone just recently. Good luck - nice to not have the really painful shots.

[Hetty Fauxvert]

Keeping fingers crossed for you!!! BTW, the time when we did IVF and I actually got pg, we did our own version of that Israeli study about clowns and IVF (I think maybe I read about that on your blog?) and listened to a Jeff Foxworthy comedy album during the rest period after transfer. And I got very VERY pg, as opposed to our previous IVF try when we listened to some sort of new age crap music during the rest period, and got nada. So. Just a thought.

Oh, and I meant to mention that I used the progesterone suppositories vaginally, no shots. Seemed to work fine.

Extremities crossed! :)

[Rachel Inbar]

I did both and had success and failure with both. Personally, it seemed the internal ones were more effective, but they can monitor your progesterone & then if it's too low you can switch to IM.

You may have too, but I had a post about IVF & clowns - http://www.fertilitystories.com/fertilityblog/2007/02/clowning-around-with-ivf.html