The compromise

This post is too long and all over the place (aren’t you dying to read it now? haha), but so are my thoughts so here goes….

We had a great consult with Dr. Awesome at the new clinic yesterday morning. The only downer: I went into the appointment with the mentality that Dr. A was/is our new RE. Apparently hubs missed the memo….for him, it was an exploratory meeting.  Dr. A is smart and mellow and aggressive and honest and chillaxed and positive. I’m hyper and type-A and a little gloom & doom and prone to freakouts and Dr. A’s qualities are an antidote to my crazy. I am ready for a fresh start and some more urgency with my treatment.

Hubs really likes Dr. A, too, but he (hubs) is being all academic and reasonable about the decision to switch doctors. He feels like my reasons for wanting to switch are “emotional and reactionary.” Is that possible? Ummm, yes. But geeeeez. I have been with clinic #1 for 9 months and spent 6 of them sidelined. I took Clomid three times even though it wreaked such havoc on my lining that I couldn’t have supported a pregnancy even if we’d gotten an eggie to meet up with a swimmer. The word surrogacy was uttered at a very premature stage! So. Yeah. I’m over them. And I have been for a long time.

Here’s what I like about Dr. A, aside from his demeanor that exudes confidence/mellowness.

  • He does not automatically bench patients with cysts. He considers each one (size, number, whether or not they’re secreting E2) and then either 1) lets you cycle through it, 2) watches it with monitoring every 7 days so you can jump back in if it goes down, or 3) tries to get it to burst (and maybe even release an eggie if it’s a viable follie) with an HCG shot. For someone like me who is SO PRONE to cysts, this is a pretty huge deal. It would theoretically eliminate a lot of my bench time. (And my friendly cyst would NOT have benched me this month. Sigh. Another lost month.)
  • He does not cancel injection cycles for too many follies. He lets the patient decide when the multiples risk is too high. He might strongly recommend canceling, but ultimately it’s up to the patient.
  • He gives patients the option of converting to IVF if they produce too many follies during injects.
  • While he does not employ it often, he thinks I’m a good candidate for a “step up” protocol…which basically means he’s open to tweaking the injects dose to a higher level if the response isn’t great at a lower level. (Clinic #1, as a rule, only lowers the dose. To me that suggests cycles could be a bust, like when I was on too low a dose of Clomid?)
  • He is the only doctor at the clinic, which means that he is ALWAYS the one making the decisions about treatment. (It bothers me that Dr. K is “my” RE at clinic #1, but two other docs are often making the decisions when she’s teaching or not on call.)
  • He has the best IVF success rates in town.

Aside from those differences, his thoughts about my protocol are pretty similar to clinic #1. He’d stick with the Gonal-F, starting with a lower dose and potentially building over the course of stims. He’s not a big fan of the Luveris, and doesn’t think it’s a big deal that I have trace amounts of LH. So he’d probably nix that part of the stimming. He also wants to repeat hubs’s sperm analysis, because he didn’t love the morphology number from the one back in October. He has a test methodology he likes better than the one clinic #1 used, which will shed more light on that subject. (I really believe it will be fine.) If it turns out morphology is an issue, he’d recommend we move onto IVF sooner rather than later.

Whew! Right?

So, over dinner last night, we hashed out our course of action. We will move forward with all of the testing Dr. A has suggested. (A new SA for hubs, bloodwork for me, including a metabolic panel, androgens, AMH and re-testing my TSH.) While all of those tests are being run and the results come back and Dr. A tweaks our protocol, we will do one more IUI with Dr. K. Hubs feels like she has learned a lot about my body and we should give it one more shot. He reminds me that both of us were sick on IUI-day last time, and maybe this one will go better. Even Dr. A concedes that my last injects cycle “looked great,” so it’s not like we’re wasting a chance by sticking with clinic #1. Plus, hubs feels like it’ll be easier on me to go to them this month…because I know the monitoring drill, I know the nurses, etc etc. And if it doesn’t work, I can jump over to Dr. A on CD3 and potentially not have to be benched as long next cycle since he will manage my cyst differently.

As you all know, I’m ready to pull the plug with clinic #1 rightthisverysecond, but I have been convinced that hubs does have valid points. Plus, it could take a little while for hubs’s SA results to come back and I’d like to move into the next cycle ASAP. It might take a couple more weeks to get the ball rolling at clinic #2. When you’ve been on the bench as much as I have, waiting a couple more weeks is just….ouch.

What do you think? Would you be frustrated that we’re not doing IUI #2 with Dr. A? Or do you see the benefits of sticking with Dr. K for one more go-round? And, isn’t it fun how my TTC life is finally heating up a little? 🙂

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20 Comments

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20 responses to “The compromise

  1. I think the current plan of sticking with the current clinic for IUI #2 and then moving on to the new clinic for the next cycle (if needed!) is a good one. That sounds like the least down time to me. And also, to give the husband a little control/decision making power in all this is probably a wise idea 🙂 Not saying that you don’t, just an “in general” statement.

    My fingers are crossed for you for this upcoming IUI!!

  2. Obviously I’m biased because Dr. A is my RE, and I really like him…BUT I think it’s definitely worth a shot to try another IUI with Dr. K. I think there’s a lot to say for comfort with the clinic, nurses, etc. Plus, being on the same page as hubs is key in all this. You don’t need marital stress on top of IF stress, that’s for sure!

  3. Egg, this is an awesome post! I am so excited that you are taking control and moving forward. Maybe your reasons for wanting to switch are “emotional” (though better IVF results are nothing to sneeze at), but what isn’t emotional in this hideous process? And why not do whatever you can for both your body *and* your mind?

    I agree that staying with clinic #1 makes sense for now, especially because it will make your husband feel like he’s an equal process in this. All joking aside, it must be a little hard for them to feel like incidental sperm factories.

    And Dr Awesome loved your response to the injects! He is living up to his name already!!!

  4. Mara

    First, I’m so glad that the consult went well! And I think that bullet point list is a pretty convincing one.

    I think that’s a good compromise, too, for the IUI this month. I can see what you mean about being totally over Dr. K, but I can also see wanting to just jump in again and also be on the same page as the hubs.

    Yay – I’m so glad it went well!

  5. I totally get wanting to jump ship and head to the new clinic. I’d feel the same way if I was in your position. Still, by staying for the IUI at clinic #1 and getting the testing done at clinic #2, it’s like you are getting the best of both worlds. So excited to see what this next cycle brings for you!

  6. I like the plan of doing one more with clinic #1 while taking all the steps to move to Dr. Awesome. Seems like that wastes the least time while also moving onward and upward and all that.

  7. Kate

    Go with your gut. I know waiting SUCKS (believe me), but I think the protocol at Dr. A will more likely result in a successful cycle. I think you should always avoid the worst case scenario: You stick w/ current RE, it doesn’t work, then you have to spend more time switching to Dr. A and you will just be kicking yourself for not switching in the first place. I’ve tried shooting for the best case scenario and found that it rarely works and I am devastated that I didn’t change course sooner. (See current experience w/ 3 clomid cycles failing, FET failing, and now full-on IVF. This is my own personal worst case scenario. Optimism got me here.) Plus, if morphology is an issue, you are going to end up doing IVF. We have to do IVF b/c my hubby has morphology issue. That is THE ONLY reason we have to do IVF.

  8. I totally think it’s about time you hightailed it out of clinic #1. They did not treat you right. They did not respond to your own unique needs. And I’m SICK of them benching you.

    That said, squeezing an iui in with them may not be that bad an idea since it’s seems like there’s a little ramp up time needed at Dr. A with all the testing.

    Very excited for you to move and get things going!

  9. So excited for you! I think the plan of action sounds great- the greatest part for me is that it IS a compromise of what you and hubby are thinking. In cases like this, where the hubby feels strongly one way about something ttc, I think it is hugely awesome if we can respect what they think/want to do, because it’s not that often when they are actually involved with all this treatment stuff, and when they can be, I think it is great to does wonders to let them have some influence on how things go.

    Praying for you!

  10. I agree with everyone, this is like the perfect compromise!!! And you’re basically getting 2 clinics working for you at the same time. And this way you don’t lose any time at clinic #2 waiting for the results plus better cyst management when you go there next month! Very excited the consult went so great, he sounds like an excellent RE!!

  11. sienna

    i think what you’re doing makes perfect sense. i’m sure you’re old RE learned a lot from your last iui cycle, so this is both a good compromise, as well as a good strategy. no more sitting on the sidelines for you!!

  12. Jeanna

    Current plan sounds like a good balance between your “let’s get out of here” and your husband’s “wait and see” instincts!

  13. I think you and your husband have a great plan. May as well give it one last kick in the can with clinic #1 while you wait for all the testing to happen. But the new clinic sounds much better for future (hopefully not!) cycles. My RE was very aggressive right from the beginning and I appreciated it a lot. And a personality that is calming and trustworthy will go a long way in a doctor.

  14. If I were you, I would stick at the current clinic to finish out this IUI and then switch to the new clinic.

  15. That sounds like a good plan so you don’t have to wait until all the test results come in. Finish this cycle with clinic 1 and then switch over. Good luck!

  16. I say stick with #1 and finish this cycle, then after or even during can you start with the new clinic. I agree with you that you need to cut our losses and go with a different RE.

  17. hollytraveling

    I’m with the majority. One more try and then move on. I have to say I never understood why they didn’t pull you off Clomid with a thin lining. I had one month of it being thin and I got yanked immediately.

    However, I’m a fan of Dr. K and I don’t think you have anything to lose with one more shot. If they try to bench you again, time to move.

  18. I feel like you are making the correct choice by sticking out with clinic #1 until this cycle is 100% over and ends in a BFN. Your DH makes great points and I totally understand your want/need to get the heck out of dodge with clinic #1.

    I would be frustrated as well but knowing it’s the correct choice – it’s a catch 22 at it’s peak. What do you plan to do if you end up with a BFP with clinic #1? Stay or move?

  19. I would have had the same reaction as you and my husband would have had the same as yours. Aren’t men so logical. How long will the tests that the new RE wants to run? Can you continue cycling one last time with the old RE while the new one finishes his tests and gets the results?

    I’m surprised about the “step up” thing. I had never heard it phrased that way. My clinic does that. I wasn’t responding to 50iu of follistim so I went all the way up to 50iu plus two clicks at the end of the cycle. That is why I like injectables, if one dose isn’t working they can up it a tiny bit. I also like that he is willing to work with you and your cysts. I hope the new RE does the trick for you!

  20. Pingback: Let’s make a deal « Such A Good Egg

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