Hope takes a kick to the balls (but regaining footing)

Was an eventful week for the Brightsides, but not all bright unfortunately. Apologies in advance, dear readers, for another long post. Just skim if you want :)
  
Started Monday with the news that for the first time my FSH is sky high = 21.5. I actually shouted it back to the nurse I was so shocked. The last time I had it tested earlier this summer it was 11 (and only 8 the time before that last year), but it was kind of CD 3.5 instead of 3, so Dr. B thought that the timing might've made it start to creep just slightly above normal. So we retested this cycle, this time on CD2. I was prepared for it to be 11 again, a little high, but not twenty-f*ing-one. Like so many times before it, I found myself trapped in a conference room at work after hanging up the phone, my face hot, mind racing, stomach in knots, trying to not completely freak out and make it back to my desk without losing it. Good times.
  
Then Tuesday we met with new RE#3. We liked him and the practice fine, but I just didn't get a strong vibe that it was the right place for us, which was kind of a relief since we were already debating between two others. As the doc was reviewing our history I dropped the new FSH news, and you wouldn't believe how fast he changed his tune to donor eggs. Just like that, his whole approach to us changed. After we left, I turned to Mr. B. and was like, NOW do you see why this is a big deal and I was so upset last night? But new RE#3 did mention that in spite of all the tests we've had done, there were 2 more that he usually recommends for his RPL patients - a blood test for Celiac disease and another one I can't remember. Even though in my heart I knew we would not push forward with him, I was like "sure thing, where's the needle" to get these other tests. I'm starting to feel like a drug addict, playing my doctors off each other to get what I want.
  
And then the big finale was our trip west, which will henceforth be referred to Dr. Sunshine and Clinic Sunshine. (During the IVF orientation they made a reference to blogs and that if you were caught badmouthing the clinic, nurses, etc. they would drop you like a bad habit. I think they meant the community sites, but still, freaked me out a bit, and out of paranoia I've scrubbed specific references from my past posts, and forgive me, deleted a few comments.)
  
(Rest of post is about our "one-day workup" in case want to skip to the end...)
  
Was a long busy day, but I was really impressed with everyone we met with and generally how they run the joint, seems like they totally have their shit together. (And I'm not just saying that for the benefit of any spying eyes!) First we had an IVF orientation session - think conference room with 3 other couples, and a nurse handing you a giant binder and cranking through powerpoint slides. Then we met with Dr. Sunshine. Very personable AND reassuring in his expertise - the best combination. But also pretty concerned about the elevated FSH, reinforcing what I've heard that essentially you're only as good as your highest number (i.e., once it's high, might as well always be high in terms of response, even if fluctuates). He said that we should expect to be "poor responders" and not get a lot of eggs, which given our history and likelihood of abnormalities, does not bode well for us and playing the numbers game. But he's willing to let us take a shot and hope for the best. And that knowledge is power, and at least we know the FSH situation, and can plan our protocol accordingly.
  
Next up, business office paperwork, insurance, $, blah blah. Then Mr. B. providing, ahem, a sample. And then a very thorough ultrasound for me (including doppler and 3D). The tech was awesome, very gentle and totally talked me through everything she was seeing. Good news: size, shape, look of the uterus all awesome, as was bloodflow to the uterus. Bad news: antral follicle count a whopping 4 (2 on each side, though i had a big follicle ready to pop which apparently can hide others), and she worried that my left tube appeared to be filled with fluid. Which obviously sounds not good, but i asked, for IVF at least that doesn't matter much right? To which she answered, true, but the fluid can leak into the uterus and be toxic to the embryo. Awesome.
  
Next up, hysteroscopy with Dr. Sunshine. Which I totally had myself worked up about, after the horrible experience with Dr. B. His nurse was really assuring when I shared my fears, but the fear remained. When I was waiting in the room, I looked around - no video monitor, no heart rate monitor, no giant contraption - things were already looking different. When the doc came in, I seriously think the speculum was only in for about 90 seconds, start to finish. I barely even felt a thing. Afterwards, I asked the nurse why it was so different from before? I guess he used a flexible scope that only had an eye piece attached - he was just checking out the top of my uterus for the embryo transfer and a quick check for fibroids, etc., that's it. Versus the video recording kind which tends to be bigger and rigid, so can't contour to your cervix at all. And he also gave a little shot of something first to numb the cervix. Whatever it was, IT KICKED ASS and was no big deal at all. Before Dr. Sunshine left the room, he asked how the ultrasound went since he hadn't had a chance to look at it yet. I told him about the follicle count, and he was actually just excited that I had more than one follicle. And told me not to worry yet about the tube til he had a chance to look- he was skeptical about a problem with fluid since i've already had an HSG. And then he grabbed my hand in a really nice gesture and told me we'd be talking soon. Yeah, I definitely like him.
  
Next up, a meeting with our primary nurse. Who rocks. Seriously nice, organized, and patient. She went through a really clear checklist of all the tests we were having done that day, as well as our "homework" - some basic tests to get done at home, sending in my detailed results for my last pap and mammogram, and a big kit for doing Day 3 testing at home next cycle and shipping it back to them. (I'll make another post about all the tests - I know I'm always curious to hear what everyone gets done.) She also talked through what our calendar might look like. Which basically kicks off with my next CD1 (around 10/31), then Day 3 testing, then waiting for LH surge, then starting some sort of estrogen priming protocol. Then starting injectables with next CD 1 in late November, monitoring at home for a few days, then travel for retrieval in 2nd week in December. Then hopefully doing genetic testing on Day 5 embryos and freezing, worst case doing testing on Day 2 polar bodies and freezing if we only get a few and worry none will make it to Day 5. Then assuming we have some normal embryos, our transfer would be late January.
  
Next up (yes there was more), blood draws for me and hubs. And lastly, a meeting to review all the consent forms. And then were done, about 7 hours later. Phew.
  
Overall, we left feeling good about the clinic and making the decision to continue with them. I was also a little overwhelmed, worn out, and emotional. The 1-2 punch of my shitty FSH and Antral Follicle Count, on top of my already shitty AMH, really hit me hard. Anything that points to "you waited too long and are running of time" is my scariest place anyway. But it is also really discouraging to head into our first IVF cycle with low expectations for the egg retrieval. Doing IVF at all is a questionable call for us, but my gut in pursuing it was partially based on hope of enough eggs to play the numbers game of getting a healthy one, and dare i dream, a frozen spare for later. That hope has been greatly shaken. And looking at the calendar, knowing we have to make it to early February to know if it's all worth it, is daunting. Especially since this is 4 cycles that we could be trying on our own, another mind-f*ing "what if." 
  
I lost it big time on the way back to the airport, and again this morning. I feel discouraged, sad, scared, and tired. I'm letting myself wallow in this today, feel what needs to be felt, and soon will put back on a brave face. We have made the decision to move forward with this path. I will refocus my energy into being hopeful and positive and giving it everything we got. Tomorrow.