So that sounds pretty smooth, right? I thought so, too, until the technician told me, with a tone that indicated she was disappointed, that I've got a lining of 4 mm.
Yup, 4 mm.
What the.... oh, that's not good...
Not what I'd hoped. At all.
I mean, not a HUGE surprise, I suppose, as last cycle I had a 5.5 mm lining on CD 9. But 5.5 mm sounds a heck of a lot closer to the ideal range of 8-12 mm at ovulation than 4 mm!
After my ultrasound, I asked to speak to my nurse. She made the same face when I told her, and said, "That's not good." Then I asked about Estrace, as I've heard online of others taking it to beef up their uterine lining. She said her old clinic used it all the time, but they also used Clomid which can thin lining, and the medications I'm on shouldn't be thinning my lining (nope, I probably just have my own body to thank for that one). She said she's never heard of this doctor prescribing Estrace, but that it didn't hurt to ask.
I felt good about being my own advocate, doing my research and speaking up when I felt there was an issue.
I held it together okay at first, but the more I thought about it, the more I realized that we're looking at doing an IUI with a thin lining, and that just doesn't help our chances at all. It's $650 for the IUI itself, and at least another $60 in gas for both my husband and me to drive there and back (he has to take his own car and can't wait around for the IUI procedure since he has to get back to work). And my husband has to take a half day off work. That's a lot to put into a cycle with a diminished chance of success.
Our money isn't buying great odds, anyway. At best, we've got a 20-25% chance each cycle if everything is perfect. That's about $1000 per month (and thankfully not more as our insurance covers some of our monitoring and medications) for a 75-80% chance of simply having to do it all over again the next month. Especially as the IUI itself gives us the best odds, but also costs the bulk of that money, it's a big factor.
I realized that if my lining doesn't thicken up, it's probably the best financial decision to cancel the IUI and just do TI again. That thought, of course, made me sob.
I went to Whole Foods as there's one right near my doctor's office, and none closer to me, and I wanted some almond butter and brazil nuts. Well, I underestimated the weight of the brazil nuts, but didn't have the emotional strength to tell the snooty cashier (who rolled her eyes at me that I hadn't written the code on the bag - sorry, I was too busy trying not to cry over my empty, emaciated womb) that I didn't want to pay $25 for nuts, at least not without risking ugly tears in the middle of the store. So I bought the dumb nuts, and went out to the car, threw myself on the steering wheel and had a good old ugly cry in the middle of the parking lot.
Pretty much exactly this.
At 1:30pm, the phone rang. I expected my nurse; it was the doctor himself (which feels like a privilege when you see the doctor very rarely, and you always wonder if it's bad news).
While I appreciate his concern in addressing my worries directly, he made me feel kind of like I was overstepping by asking for Estrace to thicken my lining.
"Unless you know something I don't, there's no proof that there's a connection between uterine lining thickness and the ability to conceive for IUI."
How do you respond to a question like that? Obviously I don't want to challenge the knowledge and experience of my doctor, but there's a plethora of studies that show there's likely a correlation between CHANCE of success and uterine lining. Am I wrong to be worried?
He goes on to tell me that he's seen pregnancies result from as little as 2 mm thickness at the time of trigger. Great, I believe miracles happen, but does it justify me spending over $700 when I could save it for another cycle where my lining is thicker? I'd like more hopeful advice than "it has happened once or twice in the past."
Essentially, he does not want to prescribe me Estrace. He doesn't believe it helps thicken lining, or doesn't believe thick lining is necessary, I can't remember exactly how he phrased it. But pretty much, no Estrace. Just keep taking Follistim for two more days, hope that the follicles grow which produces more estrogen to thicken my lining before trigger.
I told him that if my lining doesn't thicken considerably, I'd really strongly consider cancelling the IUI. He asked me to follow through with the cycle, told me that I'm drawing an arbitrary line in the sand by choosing an acceptable level of thickness. I get that, I really do. But it's a lot of money, and I can't justify throwing it away on a cycle where our chances simply don't look very good. I don't need perfect, but I'd like to be at least a little better than "a chance in hell" range.
So... we'll see. I'll do two more days of Follistim, and walk a lot and do yoga to try to encourage blood flow to my reproductive organs. I go back on Saturday for a scan, and hopefully my lining has grown to a 7mm or greater (or at least a 6.5 mm!) and we can go ahead with this IUI.
My nurse called shortly after, and she seemed disappointed that the doctor won't prescribe Estrace. "What would it hurt to give it a try?" she said.
I broke down crying on the phone with her, explaining why I felt we might cancel an IUI. She seemed to understand my reasoning and worries, and it's nice to know she'll be there to help when/if (because, come on, it's going to be "when" and we all know it) we have to try again next cycle.
Not feeling very hopeful at the moment, obviously. It doesn't help that we've got just this cycle and next cycle before we take a break for a cycle or two. I feel like I'm working against the clock, though I know logically we can resume treatment at any point after our one month break for a vacation (and hey, it's a vacation!) and that I'm young and time is on our side. That there's nothing stopping us from resuming treatment after the break.
I'm just so sick of being sad and hurt all the time, and trying to act like nothing's wrong and that I'm not breaking inside.
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