Cautiously optimistic

Things appear to be progressing nicely, the follicle on the left is now 19 mm and there are now 3-13 mm follicles on the right, with my estradiol level up to 753. I am to take another 150 units of Gonal-F tonight and then go back in tomorrow morning for monitoring. When I pressed the nurse for more details (I'm getting much better at this) she said we are aiming for 3-4 follicles that are at least 16 mm in size and that she "wouldn't be surprised" if I used the trigger shot tomorrow night. I asked if the larger follicle on the left was problem and she said that it is likely to be re-absorbed and that we are really only working on the 3 on the right. I can't remember the exact details of our first IUI cycle, but I think we were in a similar boat with 4 follicles but one much larger than the others, except that time around using twice as much FSH. So far, so good.

In other news, I found the results of this study to be sobering. They were looking at the rate of live births in a cohort of women undergoing up to 6 cycles of IVF at a clinic in Massachusetts. In the paper they claim that they picked 6 cycles because Massachusetts has a mandate that fertility treatments must be covered by insurance, and that typical coverage in this state allows for 6 cycles. I live in this state and I definitely don't have enough coverage for six cycles of IVF: my insurance caps my coverage for fertility related treatment at a dollar amount that might pay for 2-3 IVF cycles, which is one of the reasons I insisted that we start with IUI (the main reason being that our doctor said we were good candidates). Anyway, the main findings were that the chance of having a pregnancy resulting in a live birth after six full cycles of IVF were between 65 and 86% for women under 35, but only 23-42% for women over 40. That's less than a 50% chance that I will take home a bio baby after a lot of treatment, much of it that will not be covered by insurance. I never really believed the statistics about the rapid decrease in fertility after the age of 35 because it just wasn't part of my life experience. My mom had a surprise pregnancy at age 37, one of my best friends just had her first baby at 40 after barely trying. I know their experiences don't mean anything for my odds, but hey, when you're not trying to get pregnant you really don't pay attention to these things.

I don't know how far I want to take this. Personally, when it comes down to whether or not I would pay out of pocket to continue trying to get pregnant after my insurance runs out, right now I don't feel inclined. Given my odds (I'll definitely be on the other side of 40 by then), I think I would rather spend the cash on adoption fees, assuming my husband is on board. Hopefully I won't have to make that choice, but hey, I like to be prepared.