Today I had my suppression ultrasound and bloodwork. I'll have to wait until this afternoon for the E2 result, but if it's less than 20 (indicating "suppression"), I'll be good to go. Dr. G did my ultrasound this morning. As Ms. Polycystic Ovaries (without full-blown PCOS), I had a whopping 26 follicles on the R side, and 17 on the left. Yes, that is 43 antral follicles. It's really an approximation because he was counting them really quickly. He could see that there were plenty.
So, my initial doses -- starting tomorrow -- will be 5 units Lupron and 75 IU Menopur every AM, and 100 IU Follistim every PM. I get the sense that the Follistim dose is really small, probably because they don't want to overstimulate my ovaries. At the same time, I am a bit concerned because they kept me on a small dose of Clomid (50 mg x 5 days) through 3 IUI's and I only got 1-2 follicles each time. I'm worried that I'm less easy to stimulate than they seem to think.
I expressed these concerns to the nurse, C. (Dr G was in and out of the room so fast that I really didn't have a chance to ask my questions. Grrr.) She tried to reassure me that this is the reason that I will have bloodwork literally EVERY DAY starting on Sunday (4/20/08), and ultrasounds almost EVERY DAY starting on Wednesday (4/23/08). They will adjust the dose every day to try to get a good result. She then taught me about reconstituting the Menopur from it's powder, and how to use the Follistim pen, etc.
My bill at the pharmacy today was $1450.66. My insurance covered part of the doxycycline, Medrol, and Vivelle patches. I had to pay full price for the Follistim ($$$), Menopur ($$$), HCG ($), and progesterone ($). This is a small (non-chain) pharmacy on the first floor of my RE's medical office building, and they are very used to dealing with my RE's patients, so that part is good. There was an older man in the line next to me who gasped when my total bill was announced. His cashier said to him, "See, doesn't that make you feel better about yours?" I smiled over at him and thought about telling him that it was for IVF (since I am sure that he was curious!), but I decided against it. I may need to buy more Follistim later, depending on whether my dose goes up. So far, I have a 900 IU cartridge.
Overall, I'm feeling cautiously optimistic...