feeling optimistic, but still being realistic ...

One week from today, I will be taking a pregnancy test (assuming my period hasn't started by then). I am still having some pelvic cramping, which is a good thing. While I am feeling hopeful and trying to stay optimistic, I am also thinking ahead. If I am not pregnant now, we have decided to move on to in vitro fertilization (IVF), which is the end of the road for fertility treatments. I have done quite a bit of research on IVF, and the success rate is 50-60%. The quality of my eggs has always been suspected as the cause of my infertility. I have read several research articles about the effect of radioactive iodine (the radiation treatment that I had in 2009 for thyroid cancer) on eggs. There is some speculation that this type of radiation can damage eggs, which is what I have been afraid of all along. With IVF, my mature eggs will be extracted from my ovaries, and that's when Dr. Schmidt will really be able to determine the quality of my eggs. While FSH levels (see this post) can be a good indicator of ovarian reserve, the quality of the eggs can't be determined until they are taken out of me. So, if I am not pregnant this month, it will be good to finally know what's going on with my eggs.

I left a voice mail for Dr. Schmidt's nurses this weekend, asking what I need to do to prepare for IVF, in case I'm not pregnant. Patty (one of the wonderful nurses) called me this morning and confirmed that Dr. Schmidt agrees that it will be time to do IVF if this cycle wasn't successful. She said that Brian and I will need to meet with Dr. Schmidt to discuss everything, and she scheduled that appointment for 3/2 at 4:00. Of course, I will be more than happy to cancel that appointment if I am pregnant, but I'm glad to have it scheduled. Patty told me that I will have to skip a cycle if I'm not pregnant, to get all of the paperwork signed, meet with Dr. Schmidt, and get of all the medications ordered. Plus, I will start taking a daily intramuscular injectible medication called Lupron about a week before my next period (after the one that will start next week if I'm not pregnant) begins, and continue taking it for at least two weeks. This medication completely shuts down my body's production of FSH and LH. That way, my follicle growth and subsequent egg retrieval can be controlled more precisely. Timing was very important with IUI, but it is critically important with IVF.

Patty told me this morning that my progesterone level from my blood draw on Friday was 12.4. If I remember correctly, that's the highest it's been since I started injectible meds. Patty said that as long as the number is over 3, ovulation definitely happened; as long as the number is over 10, pregnancy can occur. So, I am encouraged by this number. :)

If I am not pregnant this time, I will need to have blood drawn on the 3rd day of my period, to check my FSH level (see the first paragraph of this entry for more info about FSH levels ). My FSH was last tested in July, and it was a reasonable level at that point. It is possible that the number has increased since then. If it has increased too much, this will indicate that my ovaries are no longer functioning well enough to allow me to get pregnant with my own eggs. At that point, we will have four options: IVF using donor eggs and Brian's sperm; surrogacy; adoption; or deciding that we are ok with not having children. It's very hard for me to even think about having to choose one of those options, but it is always in the back of my mind.

For now, I am going to keep on keeping on for the next week, hoping that my period does not start, and wishing, hoping, and crossing every crossable body part that I get a BFP (big fat positive) pregnancy test next Monday. So, here's to wishing and hoping ...