This cycle was canceled...

...but I am hoping for new hope. 

This month would have been my third cycle on Femara and sixth medicated cycle with IUI overall.  When I went in for the CD12 ultrasound on Friday, there was only one lead follicle and it was pretty small, measuring only 16mm.  Even after the two day recheck on CD14, it wasn't looking good and even the RE said that we would need "a lot of luck this time."  Given the size of the follicle and that I wasn't feeling very "lucky," we canceled the IUI.  I figured that there is no need to fork over the money for the trigger shot and IUI with only one rather skimpy follicle. 

On a slightly lighter note, we made an appointment today to go over the terms of a study that Penn is offering.  In the study, they are looking at the occurence of multiple gestations (i.e. twins, triplets, etc.) comparatively with Clomid, Femara and Menopur.  Unfortunately, it is a blind study and the medication will be assigned randomly.  Obviously, I would prefer to be in the Menopur group considering that this is the only one of the three medications that we have not tried already.  It is also not covered by our insurance and is expensive, so this may be our only oppurtunity to try it.  If we are assigned to the Clomid or Femara group, we will not know which medication we are receiving, and I am not overly optimistic considering that we have tried these before.  (Even though the study is blind, the Menopur group will know because it is the only injectible medication of the three.)

According to the statistics originally given to us by our RE, injectible stims are only 5-10 percentage points higher in success rates than oral medications.  She generally skips the injectible step because they are only marginally more effective, but significantly more expensive than the oral meds.  I am very willing to try injectibles, however, if the cost is covered by the study. 

I am trying to remain hopeful for the study, but I have a few concerns, mostly related to my return to work.  Within two weeks, I will be back to work full-time and will have to work our fertility treatments around my work schedule.

In the past, the middle school has operated on a six-day rotating schedule so that I always taught the same number of classes per day, but the time of my free periods varied.  In this schedule, I could often work my appointments around the class schedule so that in the 2010-2011 school year, I literally missed only two classes for RE appointments.  This year, however, the schedule has been made static so that we will have the same classes each day at the same time.  My most recent conversation with my boss indicated that my reading and math classes will be first thing in the morning each day, making it impossible for me to come in late too often.  I will also be working with a new co-teacher this year who is only in her second year of teaching and first year of sixth grade.  Last year, I worked with a seasoned veteran whom I could trust to take the lead when I needed her.

The study at Penn is also based out of their Philadelphia location instead of the Radnor satellite office that I have been visiting.  The study coordinator said that she would try to accommodate me at Radnor whenever possible, but this may be an additional complication that hinders our ability to fully participate.

I am trying to remain hopeful for the study, but I can't help but think that it could have a negative impact on my work.  Also, if it doesn't work and I have to move on to either IVF or adoption, I will have already set a bad precedent for needing time off.   

A good friend at work once told me that "family always comes first, and right now fertility treatment is your family because it is the way to a family."  As much as I believe this and want it to be true, I don't think that it will be as easy to work testing and monitoring into the schedule.