Sunday, June 1, 2014

Part IV (A New Day- Not a New Perspective)

I started writing this last night and I got so mad that the tears were pouring down my face.

I went and hid under the covers and DH let me just sleep it out. I woke up this morning and tried to be better.  I tried to think maybe DH is right- shut up and let the Dr do his thing... but I know my therapist is against that. And I'm so tempted to text her and let her know I'm having a super hard time. But she has other Dr. M patients and I often wonder if she has way more reason to doubt him than I do.  Don't get me wrong- if this was another doctor I couldn't even have these open conversations- he respects me enough to make sure I understand... but for me the more I know, the more I question..

So here is where I am today... I'm going to list everything I know.. most of which is from my doctor.

Letrazole is limiting the estrogen but does this through a different mechanism than clomid.  Letrazole is a aromatase inhibitor.  Aromatase is an enzyme that is needed to synthesize estrogen.  Letrazole blocks that enzyme which therefore lowers estrogen level.  Clomid is an estrogen antagonist, which means it competes with estrogen so receptors do not see as much estrogen which in turn tricks your brain into thinking there is not enough estrogen around which causes more FSH and LH to be released from brain which then stimulates ovaries. 

This is why we are doing this protocol. (Discussed down reg low dose stim with letrazole in hopes of improving egg quality and lowering impact of SER inclusions) His notes in my file

So YES- I had too much FSH and an early LH surge.. so clearly I need to opposite protocol. (WTF)
But estrogen priming is what is recommended for patients with a low AMH and Lupron for those with normal AMH because Lupron suppresses follicles.

This is what I read:
Lupron (leuprolide acetate) is often prescribed for endometriosis because it dramatically lowers estrogen levels by regulating the body's production of follicle stimulating hormone (FSH) and luteinizing hormone (LH). The uterine lining is highly dependent upon estrogen for growth.

That kind of sounds like where I was 2 days ago.. High estrogen and FSH and must have been a high LH if I was about to ovulate since you needed a surge..
Maybe Dr. M didn't see my AMH quadrupled? Do I tell him that?? He order the test- he should know right? 
I really don't want to tell him what to do- I have no right to do that. But I get so emotionally wrapped up into this that I know it sounds like I'm questioning everything.

Trust me- I have parents that try and tell me how to do things- psychologists that write me about positive reinforcement- like of course I know that... I am a teacher.. Graduate degree in School Psych.. Taking ABA courses (probably more than you)..  I don't want to be that person... 

... but maybe I know a little too much....

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