On Saturday morning, we returned to the Great Big Infertility Clinic, where a scan revealed that, despite my best attempts to jiggle it loose via an extended session on the Powerplate at the gym, the polyp still continues to cling stubbornly to the wall of my uterus.
How was I, asked Dr Approachable.
I explained that, after two poor responses, I was wondering how many more times I could put myself through all this. Was it perhaps time to start exploring other options, such as egg donation?
And then Dr Approachable uttered the magic words, 'Well, I'm not willing to give up on you just yet.'
Although he and I both now agree that my left ovary does not appear to be functioning as it should, the (Day 9) scan revealed eight follicles on my right ovary. Dr A considers this an indication that there is still clearly something left to stimulate, and so is not willing definitively to diagnose diminished ovarian reserve. He has a plan of action:
First of all, I need a hysteroscopy to deal with the polyp. I phoned my private health insurers this morning to check if this is covered under my policy. They will not pay if it is being done as part and parcel of fertility treatment (UK health insurers will not cover anything whatsoever to do with assisted conception), but will do so if Dr A is willing to recommend that it is an abnormality which should be investigated and removed regardless. If they won't pay, then we will have no option but to find the money ourselves, or else to sit it out on an NHS waiting list.
Once the polyp has been dealt with, we will then attempt to thaw and transfer the one embryo that resulted from this last cycle. Since I ovulate regularly, Dr A suggested that we do a natural cycle FET. I am more than happy to go along with this, as I am reluctant to pump myself full of yet more drugs - particularly when there is a possibility that that one embryo may not survive the freezing process.
If the FET doesn't work, then Dr A recommended that we try an antagonist protocol next time round. In contrast to many of our previous appointments at the Great Big Infertility Clinic, where I've barely had a chance to put my knickers back on before being hussled out of the door, he was in particularly relaxed and chatty mode (perhaps it being a Saturday had something to do with it), and explained in detail the different effects of GnRH agonists and antagonists on the pituitary gland. Given that I haven't responded particularly well either to a long or a short GnRH agonist protocol, he feels that an antagonist protocol may be a better option for us.
We also had a lengthy conversation about the pros and cons of urinary vs. recombinant FSH. Dr A remains a fan of urinary FSH, as he believes that it has the added benefit of LH, which may help with the quality - if not the quantity - of eggs produced.
I'm still struggling with the question, when is enough, enough? But I think I'm coming round to the idea that all any of us can do is take things one step at a time, one cycle at a time. So, first things first, I'm going to deal with the polyp.