First Consultation Completed

Whew.

We had our first consultation with the NY Dr. this evening. It went rather smoothly, only 30 minutes behind schedule. ;) That's pretty impressive actually!

I printed out the questions I listed on my last entry and had them ready for him, although I didn't ask him every single one. But here is a run down of his answers:

• Do you think my FSH is too high for IVF? He practically scoffed at that. He considers my high of 11 to be in the "grey" area and still completely acceptable. He treats patients with FSH in the 20's! Whew, sigh of relief.
• Is there any testing to determine my most likely outcome, Clomid challenge test or Inhibin B testing? No, they are predictive, but he said he's seen enough people do poorly and still succeed, so he wouldn't bother. IVF is the real test.
• Do you believe in doing an antral follicle count before proceeding with IVF? Yes, he likes to see an antral follicle count. He said it gives him a heads up on how much medicine to give, but that he wouldn't cancel based on the count alone.
• What do you think of my poor response to Follistim/Menopur (especially since it was no better than my cycles with Clomid or Femara)? He advised trying more drugs, that will be the best indicator of my fertility. If I don't respond, well then I have serious issues. I didn't ask him this directly, he answered it on his own.
• Would you be more aggressive with the same drugs or recommend a new treatment? He said he'd stick to the same, just up the dosage. The same thing my local RE was planning actually. He seemed pleased with the information from my last IVF so I guess it wasn't a total waste.
• Would you recommend doing a microflare protocol, estrogen priming protocol, or an antagonist protocol? He recommended the antagonist, which I believe is the same as before. He said the microflare is the last ditch effort and hopefully it won't come to that. He didn't seem to be behind the estrogen priming protocol, it sounds like it's not something he's done before, or at least not often.
• Will I need to spend the entire treatment in NY ? The Dr. said he's comfortable with having my local RE do all of the monitoring and I can just come up for the retrieval/transfer or whatever combination works for us. I just wonder if the local RE's are down with that or not?! I know some of you have experience with the multi-clinic scenario, any advice?

The Dr. also recommend that I have an HSG to rule out any polyps that could have developed since my laparoscopy...bleh, from what I've read, they're no picnic. M and I also have to have all of our screening labs done again since it's almost been a year and they're required by the state.

M wants to start ASAP, but next month seems too soon to me. I haven't had enough time to process the idea but I guess I could be back on the cycling bandwagon again -soon.

More on Medical Records

The medical record saga continues (and hopefully concludes)...

I went up to MD for a long weekend to visit family* (can you say freeeeeezing!) and returned late Monday night. I was really hoping to have my medical records from my local RE show up in my mailbox (as was agreed upon) Tuesday, but instead I got a phone call at 3:55 pm letting me know they're ready for pick up. Of course they lock the doors at 4:00 pm, and wouldn't open them for me if I drove over straight away. Grrrr.

Anyway, I picked them up yesterday and thankfully decided to double check them while I was still in the office. It's a good thing I did, because they neglected to include any of the Drs. chart- notes, all I had were lab results and a drawing of my uterus from the mock transfer! Niiiice.

On the bright side, they printed out my charts at no cost and I've mailed off all 54 pages of my IF medical history. The New York office should have it by Saturday, in time for Mondays consult. :)

Of course I poured over the most recent information and the reality of my situation came back to me with a side of hopelessness. "Mini-stim IVF cancelled due to less than expected response of 2-3 dominant follicles. Day 3 FSH 9.9. She and husband have no other complaints or issues." Gahhh, it sucks to see it in black and white!

I'm just going to keep moving forward until I hit a wall, it shouldn't take long LOL. I guess I need to figure out what questions I want to ask the new Dr.

Here's what I've come up with so far:

• Do you think my FSH is too high for IVF to work (aka, am I a lost cause)?


• What is the cut off point for you/your clinic?


• Is there any testing that can be done to determine my most likely outcome (do you have a crystal ball)? Clomid challenge test perhaps or more FSH testing?


• Do you believe in doing an antral follicle count before proceeding with IVF (would it have saved me from doing my unsuccessful mini-stim)?


• What do you think of my poor response to Follistim/Menopur (especially since it was no better than my cycles with clomid or femara)?


• Would you be more aggressive with the same drugs or recommend a new protocol?


• Do you think my main fertility issue is endometriosis or low ovarian reserve or both?


• Do you have a strong opinion about treating endometriosis with GnRH before proceeding with IVF?


• Would you recommend doing a flare protocol or antagonist protocol

Any suggestions?!

*My uncle is not doing well at all. I hate so much that he has cancer, it's such a fucking miserable way to die.

Annoyance Subsiding

I finally heard back from my local RE's office. The woman who called me was very sweet and apologized for turning me into a stalker. She said that the woman who handles the medical records is no longer there. I guess that explains a few things.

Anyway, I faxed in a formal request for my records and should hopefully have them by next week. That will give me just enough time to make copies and mail them off to NY along with all of the forms the new RE needs.

I guess I need to start working on a list of questions to ask the new Dr. when I speak to him. First and foremost on my list will be questions about my egg quality and his opinion about even going forward with IVF. I would like to have a few more tests to help determine if I do have low ovarian reserve/poor egg quality or not.

I know it's probably unlikely, but I still wonder if my high FSH could have been caused by the accupuncturist. It seems so strange that my FSH suddenly spiked as I started the treatment that I really disliked.

I guess we'll see what he says in two weeks!

Annoyance

We have a phone consultation scheduled for the end of the month with a new RE in NY.

Yayyy?!

Of course I need to gather all of my records from the local Drs. office. I called last Monday and left a message on the record departments v-mail, several days go by and nothing. I called Thursday afternoon and they'd switched over the phones early, so again nada. Grrrr. I called and left a message again Friday morning, zip. I called and left a message again this Monday (yesterday), still nothing. I called again today and pushed zero to talk to a real human being, she had me leave another message for the records department. In case you've lost count, that's 5 phone calls and 4 messages over the course of 9 days and as of 4pm today I still haven't had a returned call.

I hate when Drs. offices put the patient in the awkward position of stalking them to get results!!!

The office staff sure is making it easy to move on to a new RE! I don't know if it's because I'm no longer an active patient, or because medical records are low priority, but it's pissing me off! M wants me to go to the office in person to get my records...it might make an impression, ha ha. Probably not a good one though. ;)

Does anyone else have this much trouble communicating with their RE's staff?

600 IU of Follistim Anyone?

I was poking around in my fridge today and decided to have a peak at my stash sitting in the deli drawer. I opened up the Ziploc bag where my Follistim has been chillin' and looked over the expiration date. To my horror, the 600 IU pack expires this month!!!

So...that means I'm giving away a 600 IU cartridge of Follistim to anyone who wants to claim it. Please realize that the expiration is 1/2009 so I recommend that you use it ASAP, if you're cycling now this is for you! I live in Orlando, Fl, the closer you are to me, the better! Put the word out :)

Please let me know by this Friday, as I am heading out of town to visit family.

Getting Back on the Horse

Okay, so I haven't kept my New Years resolution to blog frequently. I'll try to post at least once a week, that seems like a reasonable goal. :)

I guess it's mostly that my life isn't very interesting these days. I'm not sure that it ever was, but at least I had IF treatment to share. Since I haven't been to the RE since about May 2008 I haven't had much to blog about.

My job prospects aren't looking any better, the company that I was going to interview with has layed off a majority of their employees, so I'm not expecting an interview anytime soon. I've come to basically accept that I'm going to be (very) underemployed for probably the next year or so. Maybe longer if Obama goes through with the "bail out"/government expansion.

Hopefully M and I will be able to survive reasonably well on our 1 and a 1/4 salaries until things turn around. It really makes me wonder if it's irresponsible to keep trying to build a family with the state of the economy as it is. M doesn't want that to stop us, and I think he's probably right. It will eventually pass and we will be okay.

So I guess I should share how we would proceed with the IF situation, seeing as how we aren't exactly rolling in $. M finally announced what everyone in his family has been gossiping about for some time. He told his grandparents (and everyone else) that we will probably need to do IVF to have children. Gasp!

His grandparents have generously offered to spot us the obscene amount of money required for said IVF. They want more great-grandchildren, especially from their only grandson that could carry on their name. No pressure or anything.

That said, we *might* try this spring sometime. I'm still somewhat ambivilant about the whole thing. I'm slightly excited, but mostly apprehensive about what it all means. I hate that his family is now so involved. I don't know if they'll be chill about it, or expect a play by play. If it fails, I'll probably feel horribly guilty. Both for letting them down (again) in the baby making department, but also if we waste their money on an unsuccessful attempt. That would just plain suck.

I've basically taken a somewhat detatched position on this for now. I'm letting M do most of the decision making. I hate that when we fight about things, it's usually about the stupid decisions I've made and how he would have made the "right" decision (like buying a house sooner or choosing a different neighborhood, or not adopting the dog we did, etc).

So...he feels like this is the thing to do, and I don't want to hear how I made the wrong decision by not doing IVF now when we have the option. Also, he doesn't want to use the Drs. in Orlando, so again, I'm not going to fight it, I'll go to NY and see the Dr. he chooses. It's his turn to be in charge of this, so I'm going with the flow.

Hello 2009!

Happy New Year to everyone out there in blog land. I know I've been missing for quite some time, sorry about that. So for a New Year's resolution, I'm going to try to return to blogging with some frequency again.

I'm also going to try to have a better outlook on things. I've allowed some of the situations outside of my control really affect the way I see myself, and not for the better. Namely the best-friend saga. Nothing more has come of that and it really pisses me off. It's too late, even if she decides to apologize etc. the friendship has been ruined. So...I'm going to let it go and move on.

Happily, I am filling that void. It's not easily done of course, but I've become closer with some friends in Orlando, and I've met some new friends through M. One is even a former IF so she gets it. What a relief to hang with someone who does. BTW, Barb, we should try to get together sometime ;)

The holidays have been good, M has had some time off from work and it's been wonderful to hang out with him. Last night was fun, we went to two parties and have been recovering on our sofa all day. I made our traditional New Years dinner, collard greens, blackeyed peas, and pulled pork. I guess our time in Savannah has made an impression lol.

I'm really hoping that 2009 is an improvement on 2008. I can honestly say that 2008 was probably my worst year ever.

I'm not sure what to expect in the way of IF. I've come to the realization that I'm not going to spontaneously become pregnant, so there is no longer any hopefulness each month. There is a strange relieft that comes with that, so it's not entirely bad.

That said, M still wants to have a go with IVF. I don't really know how I feel about that. Part of me still likes the idea of trying and having a baby. The other part of me doesn't want to deal with the rollercoaster and probable dark place that I will end up in. I really don't have too much confidence in my body's ability to get pregnant anymore.

Even though it could really suck, I'm willing to do it. I want to satisfy my curiosity and give it a chance, because you never know. But mostly I want to do it for M. He wants this so badly and thinks it will work. I can't deny him this after the last three years of trying.

Well...this has been a random post, not my most cohesive, but you'll have to forgive me as I'm very rusty. I promise to get better...I'm already feeling better as I'm typing this. :)

Talk to you all soon.