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.
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? 🙂