IVF Scorecard

Right up front, here's the good news: although it didn't end up falling on a symbolic day, my egg retrieval did go well. It produced an egg. And, amazingly, that egg matured into a five-day blastocyst ... again.

Again, I'm shocked at this good news! And relieved that the choice to return to the far-away clinic seems to be working out. Here's my IVF scorecard so far:

• Nearby clinic: 1 IVF on max-dose stims  ->  2 unfertilized eggs
• Far-away clinic: 3 IVFs with no stims  ->  3 top-grade blastocysts

(source)

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Wow. I'd like to understand more about WHY these results have been so different.

My RE at the nearby clinic thought that the BCPs in the antagonist protocol may have "over-suppressed" me, making the cycle extra long and thereby damaging the egg quality.

As I understand it, some form of suppression is required at the beginning of a cycle, to keep the body from picking a dominant follicle and producing only one or two mature eggs at a time. On the other hand, too much suppression can make it hard to wake up the ovaries again. Choosing the right amount of suppression is always a balance. Maybe an estrogen-priming protocol would have been better in my case ... but each woman is different, and the only way to know what will work best for someone is to start experimenting.

For what it's worth, I've read lots of comments by women who believe that long, high-dose cycles "fried" their eggs. I've also come across this article (and another, similar one that I can't easily find now), which suggests that when high-dose meds are used, "the resultant eggs have a higher proportion of chromosomal abnormalities than would be expected in untreated women of the same age group."

That research is just getting started. But if high-dose meds are a concern, I wonder how much they can damage egg quality even in cycles much shorter than my epic IVF at the nearby clinic. And here's the main thing I wonder: if meds can damage egg quality AT ALL, then why wasn't I told much, much earlier? It was clear all along that I'd never produce many eggs. It was clear that the quality was probably already poor. Why not prioritize keeping what's left of the quality over (at most) slightly increasing quantity?

Medicated IVF maximizes egg numbers while—potentially—decreasing quality. Of course, no-stim IVF is not a perfect solution either, even for women with DOR. It takes a while to collect several eggs, and fertility keeps declining over time. Also, more egg retrievals will probably be needed than with medicated IVF, and retrievals have some risks. I just wish I'd been better informed about the egg-quality issues. With more info this summer, I probably would have made different choices.

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But back to the three embryos mentioned above.

The first resulted in my pregnancy and miscarriage last winter. The two from this fall have now been biopsied and frozen. There's still a very long way to go. I'll do at least one more round of no-stim IVF, then test to see if any of these embryos are chromosomally normal.

I can't forget that my first, doomed embryo looked "beautiful," too, according to clinic staff. It still looks beautiful to me, in the transfer-day photo I saved.

I should also remember that—even with the outcome so uncertain—the results of these last two cycles so far are as good as they could possibly be. They're the best-case scenario. They literally could not be any better.

For today ... let that be enough.

Thanksgiving Creations

Yesterday was the start of monitoring for my—uh, wow—fourth IVF (third with no stims).

If this cycle follows my body's typical schedule, the egg retrieval will fall on the exact same date as it did last year (that wonderful first time, which produced the short-lived pregnancy).

It will also be Thanksgiving. Wouldn't that be nice? The clinic is open and my holiday plans are simple; all I have to do is show up at a restaurant later with a few close relatives. So it would be no trouble to do both things in one day. In fact, with the Thanksgiving focus on family and gratitude, I can think of no day more fitting to conceive a child!

As it turns out, this November 28 will be special in another way: it will be "Thanksgivukkah," the only time in 70,000 years that Thanksgiving and the first day of Hanukkah will coincide. Though I don't celebrate Hanukkah myself, this convergence—with its hybrid recipes and other once-in-a-lifetime creations—totally makes me smile.

(source)

The Sadim Touch

Someone just pointed out this Slate article about a new website called Modern Loss. The article says:

"Americans love to talk about people who overcome the odds to survive serious injury or illness, but we don't cope with death very well. Enter Modern Loss, a new website dedicated to helping us stop treating death and grief like embarrassments to be hidden away, and instead have an honest conversation about what it means to mourn. 

The site was started by two women, Rebecca Soffer and Gabrielle Birkner, who lost parents at an early age and who are clearly opposed to the toxic forced optimism [emphasis mine, because I LOVE this phrase] of American culture that can make grief all the more difficult. They promise a website that will be free of people adjudicating how sad you're allowed to feel and a complete ban on the phrase, 'everything happens for a reason.'" 

Did you hear me cheering at that last line? Please, oh please, can we get rid of that platitude?

There, now it's fixed!

So I had to check out Modern Loss, and right away I found a lot to like, especially one post: The Reverse Midas Touch.

While my recent string of losses hasn't been as drastic as what author Abby Sher describes, it has made me wonder if I'm—if not cursed—maybe attracting bad stuff into my life in some subconscious way. Short answer: NO, I don't believe in hocus-pocus. But still, honestly, there are times when I have kind of felt like a freak. There are times when I've been ashamed of my own apparent Sadim (the reverse of Midas) Touch.

Right after my miscarriage, I happened to see this video about stillbirth. The parts that resonated most were the parents who talked about feeling like a bad-luck charm, and those who said that the worst thing was when people refused to talk about their child at all. That is "toxic forced optimism" at work.

I do understand the impulse; I've been guilty of it, too. But I've come to see another way: simple, loving presence. Abby Sher offers it to a sick friend at the end of her post. Others have offered it to me.

One particular time stands out: after the baby’s heartbeat stopped and before the bleeding started, a friend put his hand on my belly and just held it there, silently, head bowed. That simple act of acknowledging that he/she was real and still mattered, even after death ... of coming closer instead of running away ... it was one of the most healing things anyone has ever done for me.

The Fog

After my recent burst of sunshine, I was shocked by how little time it took for the depressive fog to settle right back down. It's humbling. Whenever I dare to believe that I'm learning to live with or through it (if not "get over" it), there I am stumbling around, lost again.

Why now? No special reason, really. Winter is coming, with its darkness, cold, and relentless (family-focused) Christmas cheer. I just wrote another huge check to the RE. Right after that, the baseline ultrasound picked up a minor problem that meant I'd have to sit out this past cycle.

Of course, none of this stuff is tragic (well, maybe the check...) or new, so you might think that I'd be better at coping with it by now. After all, it's been five years since I started TTC. Then again ... it's been five years.

It just wears me down sometimes.

(source)

Sunshine Award

What a nice surprise! After several weeks away recently, I came back to find that Melissa from A Place Where I Can Be Me and Ask an Infertile nominated me for a Sunshine Award. Thank you, Melissa! :)

I'm honored to be in such good company. Your words have lifted me up this year, too. Infertility is a lonely situation, so it always touches me when something I write seems to resonate with others.

A Sunshine Award is given to bloggers whose posts brighten your day. The rules*:

1. Include the Sunshine Award icon in your post.
2. Link to the person who nominated you.
3. Answer 10 questions about yourself.
4. Nominate 10 bloggers to receive the award.
5. Link your nominees and let them know they've been nominated.

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Here are my answers to Melissa's questions from A Place Where I Can Be Me:

1. What is a quote that you live by or one that really resonates with you?
   "Perfection is attained not when there's nothing more to add but when there's nothing more to take away." (Antoine de Saint-Exupéry, author of The Little Prince and other books) He was a pilot, and this quote was about aircraft design, but the message of simplicity has spoken to me since I first read it decades ago. Lately, though, perfection has much less allure, so I'd better balance out that quote with this other one that's close to my heart: "Whoever sows sparingly will also reap sparingly, and whoever sows bountifully will also reap bountifully." (2 Corinthians 9:6)
2. What is your favorite word?
   There are so many. There are words that I like for their sound and words that I like for their meaning. For a meaningful word ... I'll go with "yes." To me, it means engaging with the world even when things are really not as I'd prefer.
3. What word or phrase do you overuse?
   Uh-oh. It's got to be something obscene, said in traffic. I'll spare you the details.
4. What is one of your guilty pleasures?  It could be a food, a song, a movie, whatever.
   Talenti gelato is my current guilty pleasure. Seriously, I'm embarrassed to take out the recycling bin sometimes.
5. If your life was a movie, what would it be called and who would play you?
   When my hair was more red, I was told that I looked like Nicole Kidman, but I doubt that she'd be eager to star in "Hope Drives Back and Forth to the Clinic"! It seems like my life has been so dull lately, with everything else on hold.
6. You have tomorrow off work and you can do anything!  Money is no object!  What are you going to do?
   My first impulse is to go on one last camping trip before winter. Apparently, I need to upgrade my fantasies.
7. Your going on a 14 hour flight somewhere.  Name three MUST HAVES in your carry-on.
   A long book and music, to help tune out the reality of being trapped on a plane so long, and also a snack.
8. What is the one thing you want people to remember about you?
   They'll probably remember that I'm thoughtful ... for better or worse. It's a good thing when it makes me see beyond the surface and live intentionally. It's a bad thing when it makes me morbid.
9. You can change your name tomorrow, no hassle. Would you and if so, to what?
   Probably not. I'm lucky to have a first name I really like and a last name that's OK. It has enough history that I wouldn't want to ditch it altogether. A few years ago, when my ex and I talked about marriage, we talked about combining some letters from our last names to make a new name, which we'd both adopt. I still love that idea.
10. Fantasy pet (responsibilities, cost, and all realistic things aside)--What would it be and why?
    I can watch birds of prey (hawks, owls, and falcons) for hours. In my fantasy, I'd build a big backyard aviary to care for some that are injured and can't be released. Then I'd hire someone else to defrost all the dead mice at feeding time!

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Here are my answers to Melissa's questions from Ask an Infertile:

1. Where did you come up with the name of your blog (this intrigues me)?
   It comes from the Leonard Cohen song "Anthem," which has these lyrics: "Ring the bells that still can ring; Forget your perfect offering; There is a crack in everything; That's how the light gets in." I know, it's not short and snappy like a blog name is supposed to be. But I love how those lyrics acknowledge that pain and action / growth can coexist.
2. You have the chance to be told 5 significant events that will occur in your lifetime (what will happen and when).  Do you want to know and why?
   It's a tough choice. If I know, I can prepare for the predestined outcome and not waste time fearing all the other possibilities. But my heart says no—a sense of wonder and hope are essential, too.
3. If you could do any job, regardless of money or talent, what would it be?
   Nature photographer!
4. What was your favorite Halloween costume when you were young?
   One year I dressed up as a houseplant. I got to dye my hair green (which may have started the lifelong habit of messing with my hair) and stick leaves and twigs all over myself. No worries about someone else having the same costume that year.
5. Has infertility changed you?
   For sure. It's made me more compassionate, as I've come to see that everyone goes through truly awful things if they just live long enough. On the other hand, I'm sometimes too freaking depressed to act on that compassion. Now I have this disturbing habit: I start to think about something I like, something I could get excited about, and I'm automatically on guard against "getting too attached," in case it doesn't work out. Thwarting our own desires has a way of sucking the energy out of life.
6. What is your favorite thing about yourself?
   Why is that so hard to answer? I guess I'd say this: I try to find beauty in places, people, and situations where it's easy to overlook.
7. You can eat one thing every day for the next month.  What is it?
   Probably salad, because there are so many variations of it (or is that cheating?) and because I won't feel awful at the end of the month.
8. If you had a superpower, what would it be?
   It would be awesome never to get tired, physically or mentally. I wouldn't need any special strength. No need to lift cars with one finger. Just more hours in the day (with less sleep required) and the alertness to enjoy them.
9. Would you rather live one 1000 year life or ten 100 year lives?
   Definitely ten 100-year lives. Living through 1,000 years of change sounds overwhelming.
10. What is your best piece of advice?
    Don't believe everything you think!

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Now here are my nominees:

• Sadie at Invincible Spring
• Wolfers at Baptism by Fire
• Shannon at Chasing Rainbows
• Amelia at Searching for Amelioration
• Maria at From Gutter to Stars
• Waiting For Baby
• Not when, but IF
• FormerlyMMM
• A Road Less Traveled
• I'm almost out of room, but there are others whose writing I love. Some have been nominated already. Some are in the middle of very hard, non-sunshiney times (A Single Journey and The Unexpected Trip come to mind). It didn't feel right to call everyone out "officially," but please know that I'm thinking of you, and if you're up for it, definitely DO consider yourself nominated!

Here are my questions for you:

1. Where do you feel the most at home (other than, you know, in your actual home)?
2. What song brings back good memories?
3. When did you know that you were ready to have children?
4. What's your next big (non-child-related) goal?
5. What's one of your pet peeves?
6. What's one of your favorite keepsakes?
7. Cats or dogs?
8. If you could live in any other place or time, what would it be?
9. If you had money to give away, who would receive it?
10. When was the last time you laughed really hard?

Though it took me a while to complete the Q&A (Sorry, Melissa!), it's been fun getting to know each other outside the usual focus.

* Of course, it's all optional. The main rule is no guilt! We all have some intense things going on, so I'll understand if you don't have time right now, or if you pick just a few favorite questions to answer. If you do participate, please post a comment that links to your answers and nominees, so that others can go check them out.

More Not-Awful News!

After the fertilization report, five more days dragged by. The nurse had told me that no news was good news, and each day I sighed with relief when 5 PM passed with no phone call.

I'd expected to feel excited and cautiously optimistic, as I did the one other time I've made it this far. That time, having a fertilized egg—the first ever—felt momentous. I felt responsible for it. Didn't like the thought of it being so far away. I imagined bringing tiny booties to the lab, fussing and brooding over it like a huge mother hen.

Seriously, though, I was desperately curious about this embryo, not just in terms of whether the cycle would succeed, but in terms of its identity. Who might it become? What wonderful tapestry was its genetic code weaving right now? The medical staff and I had set things in motion, but now came the most miraculous part, the part for which we hadn't and couldn't have written a script.

I remember that feeling of awe. During the last five-day wait, I had the excitement of a fresh transfer to come right afterwards, and the innocence of never having had a pregnancy loss. This time a longer road lies ahead, and I'm more aware of each step. This time what I mostly felt was tired and numb—preemptively depressed, as if feeling bad now could keep me from feeling totally wretched if the embryo did not survive.

I KNOW that this is pointless. There's a magnet on my fridge that says, "Worry is like a rocking chair. It will give you something to do, but it won't get you anywhere." I'm not even sure how much of what I felt this week was worry. It had even less clarity. It was more like defensive withdrawal.

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On Day 5 I knew that, whatever the outcome, someone from the clinic would call. It was hard to focus on anything else as hour after hour ticked by. I considered writing a post about the wait, then thought, If you write about it, you'll jinx it. I heard a song with sad lyrics and changed it, thinking, If you listen to sad songs, you'll end up sad. I thought of taking a break and calling the clinic myself. If you call them, it will be bad news.

Although I'm grown up, sane, and mostly logical, no, apparently I'm not above magical thinking now and then. I just try not to give into it, since it leads to nothing but more of the same fantasies of control in situations where, clearly, there is none. So I went ahead and called the clinic anyway. And eventually they called back.

Turns out there was more good news. The embryo made it to Day 5, and they were able to do the biopsy and freeze.

I'm in shock. I'm incredibly lucky.

It was Thursday evening when they called. I said a prayer of thanks but still felt mostly numb for hours. Then the tears came and, with them, the thaw. Slowly, the fog of preemptive depression has lifted. Now I'm able again to connect with the wonder that has been here underneath it all along.

Believe me, I know how far this stage is from a birth or even a pregnancy. A five-day blastocyst has, what, about 200 cells? I can't use the word "baby" to describe it, but all the same, these lines from the old nursery rhyme have been echoing in my mind and heart, putting words to the wonder that's there:

Where did you come from, baby dear?
Out of the everywhere into the here...

Into the here.

It's Not Awful News!

Overall, this cycle has been very low-stress, except for the clinic commute. I wasn't oversuppressed on BCPs, so things moved fairly fast. There were very few medications to order, and they cost under a hundred dollars. No need for five or six FedEx orders per cycle like last time, when I was so anxious about making sure that I had all the necessary meds on time, without wasting a single precious, insanely expensive drop.

Best of all, there was no breathless rollercoaster ride, no wondering if (despite all the meds) I would end up with two eggs, or four, or none at all. There was the daily grind of the commute, but it was a mindless, emotionally neutral sort of grind. One day at a time. Breathe in, breathe out.

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The most "interesting" moment came the night I did the trigger. (Although I used no ovary-stimulating drugs, a trigger shot was required for precise timing of ovulation and egg retrieval.) If you're squeamish, this would be a good time to skip down toward the bottom of this post!

I've done a few intramuscular shots before, and while the needles are, um, impressive, they're also very sharp, which is a good thing.Truly, most of the time, there's been no pain at all. There's just that instinctive resistance to doing something your body KNOWS is wrong (stabbing itself) even when your mind says, No problem, it's cool. I imagine that skydivers have to overcome the same instinct when they jump out of airplanes.

Anyway, everything went according to plan. I drew the target, hit the bullseye, pulled back on the plunger, saw no blood, and injected. Then I pulled out the needle and ... instantly, blood poured down my backside. What the...?? There was so much that it ruined my bathroom rug (which was ugly, so no big loss) and ruined my pajamas (which I'd made myself, so grrrrr). I clamped a paper towel over my behind and tried to clean up the mess with one free hand. Bear in mind that it was now after 11 PM, because that was the precise time I was told to do the deed.

The blood didn't stop. I saw more droplets pattering on the floor and realized that the paper towel was now saturated. Not good. Suddenly I felt a little light-headed and queasy. Maybe I'd had my blood drawn too many times in recent months. My blood pressure is always low, so it doesn't take much to make me feel light-headed. I decided that the cleanup could wait and lay down until the feeling passed.

My biggest fear was that this weird occurrence (which I still can't explain) might affect the outcome by letting some of the medication leak out, or whatever. So the next morning I took a home pregnancy test. They measure hCG, which is the same hormone in the trigger shot. A positive test result would mean that I didn't totally screw up the shot. And sure enough, my pregnancy test turned up a strong positive, which (fake though it was) was lots of fun.

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Then came the egg retrieval. That was interesting, too. Because this type of IVF retrieves just the one egg that the body normally produces on its own each month, they gave me just a form of "twilight" sedation. In other words, I felt that shit. Feeling someone muck around in your ovaries with a needle isn't great. On the other hand, full anesthesia adds more cost (and risk), which I could do without.

The room had a painting on the ceiling. I guess it was meant to give the person on the table a more distracting, calming focus than a sea of blank ceiling tiles. This painting showed a street with people strolling and French flags hanging from balconies. As the nurse slipped the medication into my IV, she joked, "Are those flags waving now?" I laughed, despite the fact that I was trussed up in knee stirrups (What do you call those things?) and splayed out on the table like a Thanksgiving turkey. "Are the people on the street speaking French now?"

I felt light-headed and spacey, a little more relaxed than I had been, but fully awake. Then came the speculum and needle. It wasn't awful, but it was worse than my first no-stim IVF retrieval. That time, just when my toes were starting to curl and I was starting to think, "Well, this sucks," it was over. This time it went on longer (still probably <30 seconds), because the doctor saw two mature-looking follicles on the ultrasound and cleaned them both out. "Usually, the body picks a dominant follicle and the other egg withers, but you never know..." he explained. As it turned out, there was only one egg. I'm glad he tried both follicles, though. Wouldn't that have been a super-mega bonus prize to get TWO eggs naturally!

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The next day, I was out of cell range for a while. When I checked voicemail, there it was: my clinic calling with the fertilization report. I punched in my code, shaking, having flashbacks to that last awful time. But this time it wasn't awful. Oh my God, it WASN'T AWFUL! It was good news! I sat down on the ground in shock—GOOD shock!

Whatever happens now, I feel validated that my choice to return to this clinic was the right one. We've already gotten farther than with last month's "throw the book at it" medicated IVF.

Moving On

Lately I can't seem to make decisions. Like, about anything. Maybe it started with burnout over medical choices, but now this indecision is filtering down to the smallest details.

In a store tonight, I was trying to decide which type of mouse toy to buy for my cat. There were only two choices, but the first style was kind of ugly, and the second style might be too small. It might get lost under furniture and doors. And who knew if my cat would think the first style was ugly just because I did? Also, BOTH types had small parts; could they come off and be a hazard?? No, probably not. But I still could not decide. I mean, what if I wasted $1.99 ON THE WRONG MOUSE?

Well ... what if I did? With that thought came laughter and instant release. I really don't have to obsess over every single thing, after all. I really can just toss the closest toy into my cart and move on, secure in the knowledge that my cat will be happy tonight and I won't have to waste any more brain cells on this choice. How refreshing.

After agonizing over last month's huge decision for a while, I'm finally moving on medically, too. I'm trying no-stim IVF with my other clinic again. They're the place that got me pregnant last winter. It was a scary choice, because this type of IVF goes against most conventional wisdom, but I think it's the right choice for me.

I've never responded well to stimulation, and the increased expense of full IVF just isn't worth the increased number of eggs produced (if any). More importantly, I'm afraid that the meds may harm what's left of my egg quality. Far better to have one good-quality egg than two bad ones at three times the price. Also, unlike IUI, IVF ensures that the sperm and egg meet. It bypasses problems with the egg entering the fallopian tube or the sperm penetrating the egg. Finally, I'd like to do genetic screening on the embryos, to help make sure that they're healthy before transfer.

This is going to be a long process. I'll do several cycles, do the testing, then—I'm hoping with all my heart—do an FET. Strangely, the fact that it will be a long process is making it feel less stressful, not more so.

The most stressful part is the commute. This clinic is in another state, and the drive there is at least a three-hour round trip (more if there are accidents) through two metro areas. Normally, I like driving. I've driven cross-country (2,000+ miles) several times, but this ... this just sucks. So I leave home at 5 AM to avoid the worst of the traffic. Thank God for audiobooks. They pass the time and calm me down. When I made this trek last winter, I was listening to The Worst Hard Time, a great book about the Dust Bowl and Depression. That sure put my stress into historical perspective!

five lanes going nowhere
(Yes, officer, I came to a complete stop before taking photos.)

Remembrance Day

After being away for a while, I just realized recently that today is Pregnancy and Infant Loss Remembrance Day, a day intended "to help families live with their loss, not 'get over' their loss."

Today, I'm thinking of my Baby P, who would have been 6 weeks old now. I'm also thinking of a good friend, whose miscarriage ten years ago I virtually ignored in a clueless attempt to help her "get over" it. I said that I was sorry, then focused on her next pregnancy and never brought the first one up again.

Later, I apologized. She basically shrugged. Everyone grieves differently, and she said that my reaction hadn't felt hurtful to her at the time ... but it wasn't helpful either, I know now. Of course, she may have preferred not to talk about details. Still, I wish that I'd reached out and just asked, you know, "How are you really doing?"

Today, I still try to respect people's privacy, but I'm no longer afraid that simply talking about a loss causes grief. The grief is there anyway. For me, talking about it can feel better—more alive—than the dullness of trying to distract myself with less-important things.

So to all who've lost babies before or after birth, I'm thinking of you and them tonight.

source

This Month's Huge Decision

Another month, another huge TTC decision to make.

I'd really appreciate any input that anyone wants to share. There won't be many more tries, so I'm tied up in knots with wanting to make the "right" choice now.

Sometimes answers come best when I gather the facts and then set them aside for a while. Between thinking about work, lunch, and other regular stuff, I find myself naturally more drawn to one option than another. My heart and head agree. Unfortunately, that's not happening this time.

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Yesterday I spent the morning helping a friend with her move to a new house, where we had a great talk about the need to ask for help sometimes. Then I spent the afternoon at a party with other women who were TTC or had recently given birth. They were all around my age. I was hoping that someone in a position similar to mine would be there, that we could help each other—you know, trade info and advice.

It turned out that no-one there had been through more than two IUIs. I didn't realize it at first, so when they asked where I was with my efforts, I rattled off a few facts: gearing up for cycle seven (as an SMC) after last month's failed IVF. They asked if I'd done all those cycles without a break. "Well, no," I said. "There was the miscarriage..."

Luckily, I didn't say much more. There would have been no point, and I didn't want to discourage the ones who were still trying. I don't want to be a bummer, a cautionary tale, the worst-case scenario. But I am. I'm their nightmare.

It sure is weird. I remember when I first read all those IVF terms—FET, ICSI, dp5dt—and thought, No. Way. It seemed as foreign and complex as astrophysics. I had zero interest in it. It would never have any bearing on my life ... until it did. Now I have to remember that what's become normal to me is still foreign to almost everyone else.

Even so, it was a fun afternoon. Everyone was friendly, of course. It does my heart good to talk with other women about lighter things and to be around kids. After all, it's important to look up from my TTC notes sometimes and remember just why I'm doing all this.

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Now, though, back to the notes and decisions.

The options are another medicated IVF with a different protocol or another natural-cycle (no stimulation) IVF. The former is what most people would consider the logical choice. The latter is what got me pregnant last winter on the first try. You can probably guess which options my head and heart prefer.

I was going to lay out all the pros and cons here. But you know what? It will make my brain explode, and it will put you right to sleep. Instead, here are some questions for those who are familiar with this stuff:

• Have you used an estrogen-priming protocol after an antagonist protocol? How did the results compare? Was the second one shorter? More effective? (My RE thinks the first one may have "over-suppressed" me, made the cycle extra long, and thereby damaged the egg quality.)
• I'd never heard the theory about long cycles degrading egg quality. Now I'm wondering: Is the quality degraded by the meds themselves and/or by the extra time it takes the eggs to mature? If meds are part of the problem, how much damage do they cause in a regular (not extra-long) cycle?? I'll ask the doctor next week, but meanwhile I'm very curious.

Which way do we go?