Approaching a new clinic, and something about hope

Yesterday I emailed one of the local fertility centers which was mentioned somewhere as a good one to go for reproductive immunology issues. They have their first consultation free, which sounds just about right: we are in a tight money spot right now, and I would rather learn in advance what they can offer me, if anything. So I spent two days preparing my medical records and filling their extensive questionnaire, and getting more and more depressed by the minute.

What, realistically, anyone could probably offer me at this point? I honestly have no idea. I tried the anti-inflammatory protocol and failed. I tried Lethrozole and failed. Maybe some new twist on the first one could work. Maybe we could talk about the natural cycle IVF. Maybe it's just a matter of persistence and trying naturally, again and again. And hoping, hoping all the time.

Today, looking at the joyous faces and rainbow flags in the news, I remembered the famous Harvey Milk speech about hope. "You got to give them hope". At least someone didn't hope for nothing.

But me. Honestly, how do I even dare to hope. Me, with my 40th birthday just around the corner, with my shitty tests and 5 miscarriages, with first betas testing lower and lower every time? I know I need to stop obsessing about it, but when my Facebook feed brings new pregnancy announcements almost every day, I just can't. All those people getting their seconds, thirds, and fourths, but why not me? And my compilation of infertility blogs, which I made just few months ago, is full of happy reports, pregnancy complains, and ultrasound pictures. I am happy for everyone at these blogs, and I wish them all the best, I just want to be there myself as well. Hope is such a heavy burden.

Letrozole scan

Went for Letrozole scan. The Dr. on call who performed it gave me the impression of being quite pissed off because she had to be at the office on Sunday, and on Mother's Day, no less. She was professional, but brisk and unfriendly (and she refused to look for semen analysis kit, so my husband would have to drive there again to pick it up). She did not tell me the size of follicles, and I did not do my homework - so I did not ask. My impression was, they are not quite as big as she would want them to be, and there are only two of them. She outlined the protocol: few more days of Letrozole, trigger shot on Wednesday, BD on Thursday, estrogen and progesterone few days afterwards. I flat out refused estrogen. I questioned the idea of more Letrozole. I basically got very confused, since none of this was discussed as a possibility at my last week appointment, and decided I will have to think it over and talk to my Dr about all of it. As for my continuing spotting - she dismissed since my lining "looks good". 

Also, she told me there's a possible small cyst on my right ovary - the one that I had a surgery on. "Or maybe it's just the way your ovary looks after the surgery," she said, but I am so not convinced. She doesn't think this cyst appeared during the last 10 days. Does this mean they missed it while doing an ultrasound to rule out any cysts before starting me on Letrozole? Or is it a Letrozole sife effect? Too many questions, and no answers. 

There was a poignant moment today, while we were waiting for the Dr. to come and for the office to open. All three of us had to come to the appointment - the kid had a birthday party nearby to attend later, and we were going there as soon as the ultrasound was over. Another woman came to the door to wait. She was alone. She complimented my kid, we exchanged some platitudes about bilingual childhood. She mentioned that her husband was of different ethnicity. She mentioned her nephew. I just knew she was there for the same reason as me, but she had it much worse. And my heart was breaking for her, too.

It was also breaking for us. Two years. Two years, and we are visiting the same parties, same shows, same places. And I am still checking my freaking pantiliners and pads, peeing on sticks, and having nothing to show for it but few gray hairs. 

RE consultation

Yesterday we went for a consultation with our RE. On our way there, I was talking to my husband and feeling more and more frustrated by the minute. Frankly, I was feeling very confrontational and wanted so much to stick it out to her. However, as my husband correctly pointed out, we cannot afford a luxury of a confrontation. She cannot do anything majorly useful for us, but she can order routine tests, which are at least covered by our insurance. So we talked about that, and I agreed to try to be civil. My resolve wavered, though, when it turned out we still had to pay out of pocket for this consultation, since it's a repeat visit (wtf?!). I wanted very much to yell, "No way in hell I am paying that much to see this doctor! I'd rather pay for someone who's professional, dammit!" But we paid and we waited.
She started with a question along the lines of "what can I do for you", and I got very angry. I allowed myself to allude to her insufficient testing a year ago. Her response was, but then you were getting pregnant! Apparently testing for RPL is different from testing used for just plain infertility (yeah riiiight). Anyway, I asked what can we do now, given the situation we have. Basically she told us they can do two things: it is either IUI with Menopur and Bravelle ($3,000 - 5,000), or IVF with PGS ($25,000), using the antagonist protocol and ISCI. I asked why didn't she suggest donor eggs IVF. She replied that she remembered me being against it, and that the price is high, around $40,000.
By an unspoken agreement, we did not tell her we're seeing another Dr. and that I am on Letrozole. We did ask her about Clomid and Letrozole, and she told that my FSH is high and therefore more FSH does not make sense (and then I Googled and apparently Menopur and Bravelle work to elevate the FSH as well, wtf?). She also told us she does not do natural cycle IVF or minimal stimulation IVF ("I know about this, but we don't do that here").
And finally there was the icing on the cake. I asked her something about success rate for all the options she mentioned, and she said something along the lines of - oh but you cannot really do any of that, because your FSH is too high! This was priceless. Why did she spent so much time talking about the options that I cannot have anyway?! Her point was, I might have checked my FSH too early after the surgery, so let's recheck it in couple of months and see where we are. As much as I want to hope that there's some reason for this absurd number of 17.5, I cannot really count on that.
There were some relatively good news as well. As it happens, she did a follicle count in 2014 (she just chose not to tell me about it, and she did it on a day when I couldn't even tell where in the cycle I was - my period still hadn't returned after my 2nd miscarriage). I had the same 6 follicles I have now. My AMH is lower, but not "significantly", so it doesn't concern her as well. (I don't think she's concerned about my situation at all, though). So basically no drastic changes have occurred since the last year.
So, her advice is: go try naturally for couple of months, maybe try some acupuncture. Come back and redo the Day 3 tests, and then we'll talk.
What do I think about it? I am going to order wheatgrass and whatever shit there is out there to work with aging eggs. I am not sure I want to go to her even if my FSH gets down (because her estimate of IVF success is 10%, and while trying naturally we have just 2% chance - both numbers are too low for my taste). What we need is to find a clinic nearby (okay, at least in our state) which does natural cycle IVF, and talk to them about my options. I wish we could go to New York or Colorado, but travel is expensive (we hardly have money for IVF with PGS as it is), and there are some logistical considerations as well.