Monday, January 26, 2009

First Consultation Completed


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.


Soapchick said...

Glad you had a good appt. As soon as you absorb it all and are ready to go forward, I'll be cheering you on from Michigan!!!

Barb said...

Oh my. Lots of good info! I wish the RE here were more helpful and involved. I always just felt like a random patient he saw periodically. He kept forgetting that he had actually LOOKED INSIDE MY UTERUS and saw no endo. sigh.

as for the hsg.. as long as you aren't blocked, it shouldn't be too bad. It was like some of my worse periods, but much faster. And seeing it on the screen is really darn cool. The oldest doc at our clinic did it, and he was very good.

Myrtle said...

Great appointment! The HSG isn't the most fun you'll have all year but take 3 advil an hour before and you should be fine.