My CCRM IVF Journey

Our successful journey through IVF #2 at one of the world's top fertility clinics

The Great Mix-Up

Posted by auntiem10 on May 3, 2010

This afternoon I drove 30 minutes to a local RE’s office for my endometrial biopsy. I had scheduled this appointment on April 22nd, the first day of my LH surge. When I got to the office, the receptionist spent a lot of time second-guessing me about my testing “window,” which I thought was strange. I explained to her that I had confirmed with my CCRM nurse that my “window” was from Saturday, May 1, to today. She then disappeared in the back for awhile before returning with the bombshell: there was a scheduling mix-up.

Apparently the original scheduler was under the assumption that an endometrial biopsy could be performed by a nurse in the office. The RE himself was already gone for the day, and the nurse did not know how to do the test. They offered to let me come back in the morning, but by then I would be 12 days after the LH surge, meaning there was a chance my sample would be “out of phase” and I would need to have a second biopsy next cycle.

I called CCRM, and the receptionist was able to flag down my primary nurse. She told me that at 12 days post-LH surge, there was a good chance that my sample would be out of phase. I asked her to talk to Dr. Surrey about just letting me do the Depot Lupron treatment. I requested this for several reasons:

* the ultrasound scan at CCRM showed three endometriomas, which will probably continue to grow if I’m not on Depot Lupron or birth control pills.
* it will probably take a few months to get my thyroid hormones under control, during which time my endometriosis will continue to grow.
* my hubby is still accruing the vacation time he will need.
* many patients with endometriosis also lack the beta-3 integrin, according to Dr. Surrey.

My CCRM nurse called back this afternoon to tell me that Dr. Surrey thinks that is a good idea. Therefore, I guess I can skip the biopsy completely! I’ll start the Depot Lupron treatment three months before September or October, when we are going to start stimulating my ovaries. (The hubby and I need to sit down and figure out which month we will cycle.) This means I’ll be starting the Depot Lupron shots either in June or July. It’s going to be one long, hot summer!

I’m annoyed by the mix-up (PMS is not helping matters), and I think the test would provide valuable information, but I’m happy that I can still do the Depot Lupron treatment. I guess I will need to decide if I want to do the endo biopsy with my next cycle, just to get some answers!

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13 Responses to “The Great Mix-Up”

  1. Oh my… sorry to hear abt the mixup. I am glad that things turned out all well at the end. Especially given that you wanted to do the Depot-Lupron. I have to do the depo lupron too!! Looks like you and I are following the same route. Oh and one more thing… the depot lupron has to be done on the two months before the transfer. I was told that I would cycle month 1, get ER done, month 2 and month 3 are depot lupron shots, and finally month 4 is transfer. (You probably know this already but I couldn’t tell from this post… so figured it can’t hurt!) So that is something to keep in mind while trying to decide when you want to cycle.

    And you bring up a good point abt the summer and the lurpon!! I am so not looking forward to this summer! I better get a air-conditioner for the house!

    • auntiem10 said

      Thanks for the comment! : ) I definitely agree about needing air conditioning! I think we are leaning towards waiting until October to cycle, because by then my hubby will have 80+ hours of vacation time (vs. 24 hours right now!). My IVF nurse said that I would start DL with AF in July, do the second shot in August, and then do BCPs in September. Then we would go straight into the fresh cycle. We are planning to just do a fresh cycle, so maybe that is why our timelines are a little different. I am a little nervous about suppressing my ovaries so heavily just before the stimming process, so I plan to ask Dr. Surrey lots of questions during our regroup.

  2. R said

    Sorry that things didn’t work out. I am SO used to that. Yay, for getting to skip the biopsy altogether!

    • auntiem10 said

      Thanks for commenting! Ugh, I was so mad at that RE’s office yesterday that I yanked all of my CCRM orders out of the receptionist’s hand (Ha!), but today I am feeling calmer. I’m happy to skip the pain and expense of the biopsy, but I was curious to see if a possible reason IVF #1 failed is b/c I lack the protein. I could still do the biopsy with my next cycle, but I’m not sure I want to bother with it at this point. I guess I’ll have about a month to think it over!

  3. mo said

    Major bummer about the mix up. That must have been so frustrating. I am going the same route as you – just opting for the depot lupron without undergoing the biopsy. Dr. Schoolcraft recommended it b/c I have stage III endo as well as some other lining issues that were turned up in an endometrial function test I had done at Yale. I figured even if I have the beta-3 integrin protein, I’ll still feel more protected if I do the depot lupron. Anyway, wanted to let you know you’re not alone.

    Mo

    • auntiem10 said

      Thank you for letting me know I’m not alone out here. I think it makes sense to just do the DL treatment in our situations b/c of our endo issues!

  4. Ok.
    I’m in NY on vacation but I saw this post, and I debated putting this comment because I do NOT want to sway you/influence you. I am just going to honestly tell you my experience with depot lupron before a fresh cycle. But understand that everyone is different.

    When I went to CCRM I had confirmed stage III/IV endo that had been removed by a lap previously. They suggested the biopsy and I, too, just said “give me the depot lupron.” So I did two months of it and then the MDL protocol. Of all my cycles, local and CCRM, that was the worst cycle. I asked later if they thought suppressing my ovaries completely for two months so much that they were in menopause and then heavily stimming them wasn’t a good thing. My doctor sort of agreed. Although I had a good response in terms of eggs retrieved (20) they were crap quality and hardly fertilized. They LOOKED dysmorphic, which had never happened before. But eggs are forming in the three months prior to a retrieval, so it seemed odd to me that it could be ok to starve them of hormones during two of those months.

    I posted on IVFconnections and found a few others who’d had bad cycles when doing depot lupron prior to a fresh cycle, but others who’d had great cycles. I think depot lupron is wonderful pre-FET for resetting the lining, and it doesn’t affect the eggs.

    Again, everyone is different. I just wanted to let you know my experience. Email me at lastchanceivf@gmail.com if you want to talk further…

    I’m wishing you the BEST and just want you to have success!

  5. Mag said

    I so hope this cycle will work out for you!

  6. […] So even though I didn’t have the endometrial biopsy to test for the sticky proteins due to a mix-up, Dr. Surrey decided to take a “better safe than sorry” approach because of my history […]

  7. […] So even though I didn’t have the endometrial biopsy to test for the sticky proteins due to a mix-up, Dr. Surrey decided to take a “better safe than sorry” approach because of my history […]

  8. […] 2010: Decided to undergo Depot Lupron treatment after ER no matter what after local clinic messed up scheduling of endometrial biopsy, diagnosed with Hashimoto’s hypothyroidism, shipped Cycle Day 3 […]

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