Moving On Up...

My last post left off with the hubs and I deciding that it was time to call in the big guns, it was time to see a specialist.  A true infertility specialist is called a Reproductive Endocrinologist.  Don't be fooled by OB/GYNs who claim to be "infertility specialists" they haven't had the extra training that a RE has had.  Don't get me wrong OBs are great at taking care of pregnant women, you just shouldn't rely in them for infertility treatments.  Learn from my experience.

::Steps off Soapbox::

Now, where were we?  Oh yeah, we decided to move on to se a RE.  The first step is finding a RE.  I start my search by checking my insurance to see which REs are listed as in network.  Just in case I need something that will not be billed under the diagnosis of "infertility," I want to make sure my doc is in network.  I also ask for some names from my OB/GYN.  I cross reference these names and then start my Internet research.  I scour SART data, online reviews, websites, etc. until I decide on a doc.  We'll call her Dr. A.  I call Dr. A's practice and the earliest we can get a consultation is 6 weeks.  Then we wait.  Finally consult day rolls around and the hubs and I take off work and head to see Dr. A.  We arrive a few minutes early, I sign in and we take a seat in a nice waiting area.  So far so good. A few minutes later I am called back to get weighed, blood pressure taken, etc.  when I'm done I head back to the waiting room.  After a little more waiting, we are finally called back to see the doc.

How do I describe my first impression of Dr. A?  Fake.  I pride myself  on being a good judge of character on first impressions and I knew from the get go that Dr. A wasn't what I was looking for.  You could tell her "niceness" wasn't genuine.  Anyway we sat down and started going over my test results and the medical/family history forms we brought with us.  Things seem to be going smoothly and I try to bury my uneasiness about Dr. A.  Then her cell phone rings and she explains that her sister is sick and that she needs to step out to take this call.  She steps out of the office.  I assume that her sister must be pretty sick if the doctor is going to step out of our consultation to talk to her.  When she comes back in, I let her know that I am sorry that her sister is sick.  She gives me a strange look that tells me that maybe her sister's illness is not as serious as I had assumed.  Well ok, she puts her sister's sniffles as a higher priority than our consult.  Good to know.  We get back to our consult and Dr. A recommends that I have some blood work done to check my rubella antibodies and she also recommends that I get screened for cystic fibrosis and they have a lab that will do the screening for like $25 if your insurance won't cover it.  Sounds good to me.  Then we get to her treatment plan, drumroll please...... Unmonitored Clomid + IUI.  Wait, what?! I leave the care of my OB/GYN, wait six weeks for a consultation and you want to do the same thing he was doing?  I start asking about monitoring and she says it's not necessary, she wants to keep it low cost since I don't have insurance coverage for infertility.  I ask her about cysts and she says that she will worry about cysts if I show symptoms.  I ask her about thinned lining and she writes me a prescription for estrace.  She goes over IUI instructions and recommends digital ovulation tests and let's me know that they are open every day but Sunday and basically I am supposed to come in the day after a positive ovulation test for the IUI.  If I get a positive on a Saturday, I come in Monday morning (which I know from temping is probably too late).  Awesome, at least my OB did IUIs 7 days a week.  Age goes on to tell us that if we are not successful in 3 or 4 cycles, that we should move on to IVF.  She then gives us a ton of info on IVF.  I leave the appointment with blood work orders, a prescriptions for Clomid and Estrace, and a sinking feeling in the pit of my stomach.  I go ahead and do the blood work and then the hubs and I have a serious talk.  I tell him that I am not at all comfortable with Dr. A's "plan."  He's not too happy at first (he's convinced that I spend too much time researching stuff.  He might be right, but not in this case.  Reluctantly he agrees that I need to feel comfortable and I start my RE search all over.

For RE #2, who we will call Dr. B, I went with a recommendation of a friend of my sister.  He also had mostly good reviews online.  I call up his office and get a consult in a week and a half.  So the hubs and I take another day off of work and meet with Dr. B.  this consult could not be anymore different.  Dr. B is so warm and friendly.  He takes time to explain everything in basic terms (not necessary for me but helpful for the hubs).  He gives us his plan (3 monitored Clomid + trigger + IUI cycles, then we should move on to IVF) and then he takes me back for a surprise ultrasound (u/s) and post coital test (PCT).  I had just ovulated the day before, so the u/s didn't show much.  The post coital test also showed that the hubs' swimmers weren't moving much.  The doc orders some more blood tests and tells me to call when I start my period.  One of the blood tests is a CF screening for the hubs since I got a call saying that my screening had come back positive as a carrier.  We go get our blood work done and both agree that we like DR. B.

I takes a few months for us to start treatment with Dr. B since he is very thorough with his testing.  He monitors a few of my cycles repeating my PCTs, which pretty much all come back bad.  He thinks that I might have hostile cervical mucous, so we move on to IUIs.  I did one unmedicated and two Clomid + Trigger IUIs with Dr. B.  All of them failed.  Dr. B recommended that we move on to IVF since IUI wasn't working.  In July of 2013 we refinanced our house and pulled out cash to pay for IVF.

In August of 2013, we did our first cycle of IVF.  It was actually a lot easier than I had thought.  I started off on birth control pills (BCP) to suppress my cycle and sync my cycle up with everyone else doing IVF in August.  I added a drug called Lupron a few days before stopping BCP.  I continue taking Lupron injections every morning.  After I start my period I go in for blood work and an u/s to check for cysts.  Then a few days later I started injections to stimulate my ovaries. After a few more days I go in for an ultrasound to check how many follicles are growing and more blood work.  When the follicles are big enough I take a trigger shot.  When I triggered, I had 9 or 10 follicles and was told to expect 7 or 8 eggs.  Dr. B only got 6 eggs at my retrieval.  The next day the clinic called to tell me that out of the 6 eggs 5 were mature and 3 fertilized normally.  Then we waited for our day 3 update of our 3 embryos (aka the 3 stooges).  That call was my worst nightmare come true, all 3 of our embryos were slow growing and poor quality.  We were told that we would that we would have to wait and see what happens, but hopefully they would catch up by day 5 our transfer day.  All morning, we waited by the phone.  The clinic would call if our transfer was cancelled. About 45 minutes before we would have to leave, Dr. B calls our embryos have stopped growing and our transfer is cancelled.  He admits that even he was shocked at how bad our embryos did.  We are devastated.  How can two young relatively healthy people make such poor embryos?  We make an appointment for the following week to meet with him to talk about what happened and to make a new plan.

And that brings us to the present.  Our appointment is next Tuesday.  Right now we just hope that Dr. B has a good plan to make our next IVF cycle much more successful.