Tuesday, March 5, 2013

Jumping to Conclusions

It's likely that our decision (to IVF or not to IVF?) just got a little easier. Not easier emotionally, but easier from an actual decision-making standpoint. Because when something is completely swept off the table, well, you can't decide on it any longer, can you? The decision is out of your hands. 

I went in for routine labs last week. I emailed the nurse for the results and she simply replied, "they are all normal!" (with the requisite exclamation mark, of course). Hmmm...what exactly does 'normal' mean? As you may or may not recall, I like my numbers, so a subjective description of my ovarian functioning just doesn't cut it, not when so much in on the line. So, I followed up: "what was my FSH?" In the flurry of emails conerning other matters, she managed to not answer this particular question. This is a HUGE pet peeve of mine. I hate it when people don't read the whole email and you must come back and ask the same question again, but while this could have been the case, it also seemed almost deliberate, like she was actually avoiding the question and had in fact not missed it. So, I asked again. And there was radio silence for a good long while (despite the fact that she's usually fast on the draw). And then she replied, "your FSH is 'under review' with the doctor and I cannot release the number yet. We'll call you Monday."

Wha-wha-what? What does that mean?

That was Friday and I tried my best over this already lousy weeekend not to read into it too much. A nurse called me Monday and prefaced the numbers by saying that it was probably a 'lab error' because there is no way it could possibly be that high. How high, you ask?


Yeah. Just in case you're not versed on FSH numbers, let me give you my subjective descriptions:

Piss poor.
Practically pre-menopausal.

At first I believed her. Maybe it was a lab error. But then my inuition (or that's maybe my pessimism) set in and I felt, deep in my gut, that the number is totally accurate. My doctor can't imagine how it would be, but stranger things have happened. It's not impossible. My Mom went into peri-menopause at 39, full menopause at 45 (of course, she was a smoker and RE#4 said that accelerates menopause but hey-there's obviously some genetic component).

If my ovaries are this dusty, logistically, what does this mean? This means that our decision has been made for us. There will be no free will in the matter of our assisted reproduction (what little free will we had to begin with). There will be no IVF. That'll be off the table. My biological connection (whatever that's worth) will end with my only child. Although I was hesitant to go forward with IVF for a number of reasons to begin with, there's something about possibly being stripped of that option altogether that's more devastating than I ever anticipated. There's a helplessness that exists with infertility and everytime I'm dealt a blow, it only compunds.

They're having me repeat with an AMH test today, which will be a more reliable predictor. Quite honestly I assumed that they were also testing AMH when they originally drew my labs as that's now more the gold standard, but they didn't. Because of the snail's pace our lab takes, it'll be 4-5 days until we get results back. In those 4-5 days, I have made the conscious decision to plan for the worst.  Maybe that's the not healthiest response, but I'd rather be pleasantly surprised than float along happily assuming a lab error only to lose the wind out of my sails once more.  No, 'wind out of my sails' is too pretty of a description. Plummetting to the earth and smacking head first into a cliff is more like it. 

Yes, I realize I may actually be freaking out over lab results that are wrong, but this is how I do it, folks. I expect the worst, so even when I meet 'bad', it doesn't seem all that awful because, alas, it's not 'the worst'. What can I say? It works for me. It probably produces a series of unnecessary mini-panic attacks, but still, it works. For the past month, I had been mentally preparing myself to hold onto hope, even going so far as to convince myself there was a chance our IVF might work. So, my expectations were beginning to climb. The distance from before that call to after was a long way to fall and I didn't have a moment to gather myself in preparation. I don't want that again. I don't do surprise well, so when they call next week, you better be believe I'll be prepared in full SWAT gear.


AnotherDreamer said...

Oh no. I completely understand expecting the worst- I'm the same way.

I really hope it's a lab error, although I know that having it taken off the table would simply things... but I don't know if that would be any better. I'm sure it would feel like another thing taken out of your hands, another choice taken away.

Did they redraw the FSH to double check?

Shelby said...

They only tested AMH this time, which, as they have said, is a better indicator of ovarian reserve. AMH is also stable while FSH can fluctuate month-to-month (and obviously ovarian reserve, while declining steadily, does not change wildly as my FSH might have). I feel comfortable going on just the AMH.

Lorraine said...

Well, crap. But at least you'll be getting a more definitive result this time. As always, you can't plan for the unknown - but I get that you just want to be ready for the worst. I'll hold out hope on your behalf, though, if that makes it easier for you!