I had my mid-cycle scan and follicle check today. Not the greatest news, but I'm staying positive. I didn't have any mature follicles, but I had one on the left side that was measuring 10. The largest one on the right only measured 5, so it's pretty much out of the game. I'm disappointed to only have one follicle on a medicated cycle - I mean, I can produce just one all on my own.
I'm not exactly sure what's going on, but Dr. Dunn explained to us some number of months ago how Femara and estrogen would interact in cycles where we used both. Femara is stimulating the ovaries and making them work harder to produce multiple follicles. Then we come in and add estrogen, and it confuses my body. During a natural cycle, estrogen levels increase after ovulation. So, by supplementing estrogen prior to ovulation (in hopes of thickening my lining), it confuses my ovaries into thinking maybe I already ovulated...so, they stop working so hard to produce follicles. This is a tricky balancing act, because we have to find just the right amount of Femara to get multiple follicles and just the right amount of estrogen to thicken the lining without preventing the maturation of the follicles. I think the issue is we don't have the balance figured out yet. I'm on extra estrogen this time, since my lining hasn't responded in past cycles. And now I think the estrogen is affecting the amount and size of the follicles.
So, I'm trying to look at this cycle as a learning experience. Now we have some additional information about how my body responds to the drugs. And knowledge is a good thing. I'm guessing some adjustments will be made, if not some changes in the drugs I am taking next time around. I feel like I'm getting pretty close to a point where we might move on to injectibles - which is kind of scary for some reason. I guess it's scary anytime we exhaust one of our options. Plus, injectibles carry a much higher risk of twins/triplets.
I don't really like my nurse. I LOVE my doctor...but the nurse is just not very compassionate. She pretty much said she doesn't think I can get pregnant this cycle. I appreciate a straightforward approach as much as the next person, but gosh, she could at least act like she cares! After all, this news is difficult to hear.
Anyway - she wanted me to come back on Monday for another scan and continue the estrogen in the meantime. She also wanted me to start OPKs to see if I could pick up a surge sometime over the weekend. If we can get that follicle on the left to grow a bit more, we can do the trigger shot early next week and still salvage things. At this point I am just ready to move on with this new information we've gained.