4dpo: Schrodinger's Uterus

This Thursday, Ezra and I are meeting with Dr. Quixotic for this cycle's follow-up appointment. Yes, I realize that the cycle won't be over yet, but he schedules these things for about a week after ovulation so that: (1) he can check for symptoms of OHSS; and (2) we can theoretically begin the next treatment cycle right away, if it turns out that I'm not pregnant. Apparently, for the purposes of this appointment, I will be simultaneously pregnant and not-pregnant. And so, Ezra and I are compiling our list of questions to ask for both scenarios.

The first is pretty easy, I think. When do we do a second beta? When is the first ultrasound? When will I be released to an OB? What happens in between? And for just how much longer will I be shooting creamy white gel at the percussionists?

The second scenario, of course, is the real issue. We really want to make the most of this appointment, so any suggestions from all of you would be most welcome. Here's what (I think) we have so far:

• Review HSG results. Was there a blockage in my right tube?


• What is the effect, if any, of my retroverted uterus? Are there any other concerns with the shape, size, or positioning of my uterus?


• What was my E2 level on trigger day? What was the thickness of my uterine lining? What do these numbers mean to you?


• Do we have any way of confirming that I actually ovulated last week?


• Why do you test LH and progesterone levels with every blood draw? What information does this give us for the present or future cycles?


• If we choose to pursue another injectibles/IUI cycle, what would be my starting dose?


• How do you expect the next injectibles/IUI cycle to progress differently? What can we do to make me ovulate earlier and/or optimize the number of mature follicles?


• Given my response this cycle, how would you estimate our chances of success on another injectibles/IUI cycle?


• If we pursue a second injectibles/IUI cycle, when would it begin? Is there any medical reason not to begin with my next period?


• Would it have been better to start stims earlier than Day 4? Would you recommend doing so on a future cycle?


• I was on metformin previously, and was taken off after my first round of Clomid. A blood test showed that I do not have insulin resistance. However, I've heard that metformin can be useful in PCOS patients without IR, both to improve egg quality and to reduce the risk of miscarriage. Can we talk about this? Is there a medical reason why I should not be on metformin?


• If we decide to move on to IVF, what is the general schedule and drug protocol we're looking at?


• What is the target number of eggs you'd aim to retrieve in an IVF cycle?


• What's the typical (or target) number of eggs that would be fertilized? That would grow to transferable embryos?


• How much notice will we have before retrieval day?


• In a fresh-transfer IVF cycle, what are our chances of sustainable pregnancy with transfering one embryo?


• In a fresh-transfer IVF cycle, what are our chances of sustainable pregnancy with transfering one embryo? Singleton vs. twins?


• By when do we have to make our decision about what to do next? How do we notify you?


• What do you recommend?

So, really - any comments? Any specifics on metformin research? Anything to add, at all? Are there too many questions there? Are we losing focus? Are we losing our minds?

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I know I'm terrible about responding to comments, and for that I apologize. So, a bulk response: thanks for the support; I haven't decided yet whether I'm going to post pregnancy test results immediately; and the wedding was lovely, though I was bloated and uncomfortable the entire time.