The visit with Dr. RE went remarkably better than I anticipated. Of course, all of my worries were the product of my over-active, trained to always look for the possible risk, brain. There are times when being an eternal pessimist can work in your favor; in this case, I got to be pleasantly surprised.
Even though Dr. RE was over an hour late, he spent about 45 minutes with us. Part of it was follow-up from our successful cycle. How did the pregnancy go, delivery, etc.? He wasn't surprised about the GD due to my PCO. He was looking through my file as we were talking, and he was kind enough to point out that Son was the result of our fifth cycle of injectibles. Fifth. Now that I am sort of removed from the whole thing, that number sort of shocks me. It certainly didn't feel like we had been through the ringer that many times. That isn't counting the five cycles of useless clomid that we did with my OB/GYN either.
He has labeled me as clomid-resistant. Big surprise there. Only ovulated once on 150 mgs. We both agreed, without a whole lot of discussion, that he won't subject me to that again. Believe it or not, I actually felt worse on Clomid than on 150 umg of Gonal-F. The plan (oh God, we have a plan!) is for me to come in and get a progesterone draw sometime after Thanksgiving just to make sure that I haven't spontaneously ovulated (like that would ever happen), and then he would give me a prescription for 7 days of Provera. Come if for a baseline sometime on days 1-3, get my drugs, and off we go. The only issue about doing a cycle in December is that they close on Christmas Day (bastards, want a holiday off, the gall!), and he doesn't want that to be one of the days that we would need to do an IUI. Just be safe, since we aren't going to be able to go anywhere for Thanksgiving, I might just get the blood draw right before Thanksgiving.
The only negative that he brought up was that since I am one of the infinitesimally small group that doesn't respond predictably to Gonal-F, we may need to play with the dosage again. That was the part that really wasn't that pleasant last time. On the cycle before we conceived Son, I was extremely close to developing OHSS. The scary thing was that we had just adjusted the dosage a small amount after a less than optimum response the cycle before.
Soooo....I guess that we are back in the saddle again. He didn't seem concerned about my age (yet). He did make the disclaimer about the increased risk of multiples. I've accepted that a long time ago. For him, it seemed to be a bigger deal because of the two OB ultrasounds that he had done that day (both for IVF patients), the outcomes had been twins and triplets. Both had only two embryos transferred. He said the twins patient was OK, but the triplets one, well, they were struggling a bit. How strange to have one set of identical twins, with a fraternal thrown in. I know that it happens, but still. I think that I would be freaked out with anything more than twins. I know from Blogland that twins carry their own risks, but more than that seems to raise the stakes even higher. He also pointed out that when we conceived Son, we had four mature follicles. Basically, the subtext was that we dodged the multiple bullet that time, but not to think that we would necessarily do it again.
All in all, it went well. Son was an angel through the extended wait, and was even better once we got into the office. I'm still a little scared to contemplating all of this again, but every time I look into those big blue eyes, I know that he needs a sibling. One way or the other.