Resistance

I started stimulation on Sunday night and had my first monitoring appointment on Wednesday. I'm doing my monitoring locally but will be headed down to Long Island on Monday.

When I checked in at the front desk another woman was also checking in. I looked up to see Dr. K (RE and owner of the clinic) as he was saying hi to the other woman. I was so thrown by seeing him I didn't respond at all. That's just an indication of how frequently I see him around the office. I usually only see him at retrieval and transfer. The nurses serve as the buffer between patients and the RE and there's even minimal contact there. I guess that's what happens when your clinic does close to 3000 cycles a year. 

 I decided not to request any specific NP, but got stuck with Mrs. Bitch-Face anyway. I was so glad W came with me because as she had her back to us and was complaining or being ridiculous, W was making faces. it was good that I was able to smile about it rather than get pissed off. She obviously just doesn't like it when she's not able to make the decisions. 

The scan was fine and there were lots of tiny little follicles. I later got an email from the nurse Sandra at Dr. B's saying they were changing my protocol, completely taking me off Gonal-F. The plan switched me from 150 Gonal-F and 75 Menopur each night to just Menopur 225 nightly. 

As a result  of my being slightly concerned,  I emailed both the nurse and Dr. B to ask the reason for the switch. Dr. B quickly responded saying "It was due to the low LH levels that respond better to pure Menopur cycles." I then asked him the importance of LH during an IVF cycle and what the levels should ideally be and he said, "We like to see it over 2 and it is a necessary building block for estrogen production and follicular growth. We see this commonly when there is some resistance to FSH only stimulation."

I know at my last appointment with Dr. B the nurse mentioned something about resistance to Gonal-F. I didn't understand it at that point but I guess it makes more sense now. I wonder if it's from taking it so much, similar to antibiotic resistance. 

It gives me so much more confidence to have contact with my doctor. Regardless of how busy he is, he takes the time to respond to my questions. The nurse has also been much better about responding to my questions and emails. Last night Dr. B responded at 11:15, long past the point that I was in bed.    Things definitely feel different this time around, but only time will tell if there is a true difference.