Jeff and I went to see a new doctor today. I'll call him Dr. Arrow, since he drew arrows on his notes the entire visit. By the time we left, his papers looked like a football play book. We kind of felt like he thought we were there just because we are impatient, but I think he realized we had some valid reasons after talking with us. He was very thorough and answered all of our questions, which was nice.
Basically, he was appalled that Dr. Wiz wanted to do injectables. Dr. Arrow didn't even like the he put me on Clo.mid. He said that one cycle (our first) of no meds and not ovulating was not enough to put me on meds. He said sometimes that happens, and that the Clo.mid was a premature step. He thinks we should do a few unmedicated cycles, just me and the sp.erm.
Now, I am sort of at a loss of what to do. I am 3 days in to 150mg of Clo.mid, and have already paid for our IUI cycle at Dr. Wiz's office. Do we cancel the cycle now, and get half our money back, or go ahead and finish out the cycle? According to Dr. Arrow, 150mg of Clo.mid is actually hurting my chances, since he says I shouldn't be on it anyway. I have no idea. Jeff is all for cancelling the cycle, but I feel like I should go ahead and finish the Clo.mid and have the sonogram to check for follicles. He has a good point, in that if we cancel after that, it takes another $200 from our refund. But I figure that if the Clo.mid is working and we cancel it, we lose our chance this cycle. I hate seeing wasted months.
Dr. Arrow did say something interesting today that kind of threw me for a loop. He said "Just to be clear, you've been trying for 21 months, but have really only had 1 opportunity to get pregnant?" He's right. We've had one cycle where we had both eggs and sp.erm. That thought really sucks.
In other news, I just finished the new Lynn Kurland book. If you've never read one of her books, go get one. Don't read them in public though. People look at you weird when you laugh out loud or spontaneously start crying.
Happy Summer Vacation! I'm so jealous :)
ReplyDeleteWe put off getting a second opinion for a long time because we just knew that the second doctor would give us just that - and we weren't prepared to have to make a choice between two totally different approaches. It is like a double edge sword.
I hear you about not wanting to miss another cycle, and I would probably be inclined to want to finnish this month with Dr Wiz, then make the switch
I've had a lot of time to think about the IUI protocol of starting with natural cycles, then moving to medicated ones. While in theory I'd agree that starting natural makes sense, I am going to want the highest possible chance of conceiving with each IUI we do. The emotional impact of negative cycles is too much to think about, and I am going to find an RE who will pull out the big guns for me from day 1.
The financial side seems significant too - We've been told that our IUI's will cost between 2-3k per cycle... Which makes me panic a little thinking that we would use up our funds on unsuccessful cycles.
I was caught too by the comment about trying for so many cycles, but not actually having had one real opportunity to get pregnant. sheesh. I can't wait for this fall when we get to start actually trying.
Enjoy you day!
I think I'd want to finish this cycle too. And wow about his comment- we haven't had a single chance to become pregnant! Kinda hits you in the face.
ReplyDeleteOh and love the name you gave him. Our RE drew time lines all over the paper. Guess we'd call her Dr. Time Line. Which is ironic with IF. haha.
I would also be inclined to finish the cycle.
ReplyDeleteYour chances with clomid and IUI are, like, waaaaaay higher than your chances without treatment. This doctor thinks they might not be exactly optimal. I'd like to know how many extra percentage points he thinks he can give you with an unmedicated cycle? 1% more chance? 3% more chance? Without actually knowing the figures, I doubt he can give you such a huge jump in chances that it's worth cancelling something you've already started. Switching afterwards, perhaps, but in this case you've already started.
As far as I know, clomid might cause a slightly thinner lining (well, you can ask if it's within the normal range when you get your scan so you can manage that one) and also there's a worry that you get more eggs, but perhaps lower quality ones (but really, for an IUI, they shouldn't be pushing for heaps and heaps of eggs anyway, so the difference in quality should be negligible, if even measurable).
I think it is a matter of different approaches. He obviously has a more conservative approach, and personally I am also inclined towards that approach (why spend more money or take more risk than you need to?). But I don't think Dr Wiz was wrong, exactly, and I don't think that's the lesson to take home.
At the end of the day, it's what you're comfortable with, emotionally, finanically, etc.
Bea
I don't have any experience with Clomid, but I think Bea is right about the thinned lining. Could that be why Dr. Arrow thinks it lessens your chances?
ReplyDeleteIf it were me, and if the money weren't make-or-break (i.e. if I was going to be able to pay the rent either way, which I would imagine is the case, or you wouldn't have signed up for this cycle in the first place) I would finish this cycle as planned, then start to digest what Dr. Arrow is telling you. If you're not pregnant, that is.
I think I'd finish up this Clomid cycle and then switch to natural cycles for a while. You've already exposed your body to a drug and its risks so you may as well get the advantage out of it. I don't think it hurts your chances -- I'm confused as to why the doctor would say that.
ReplyDeleteLFCA
As a clomid user, I would finish the cycle.
ReplyDeleteEvery doctor is different in their approach and I think the medicated IUI cycle might help to increase your chances of conception, which is why the doctor jumped to that senario. The only reservation I have is that he immediately prescribed 150mgs of clomid. I was on 50mgs of Clomid and ovulated fine, and I would be concerned that he immedidately jumped to that high of a dose (the highest is 200mg)without trying a lower dose before.
If I had to take a gander as to what he may be thinking, since you are self pay he is probably trying to get you the best possible shot, even if it is a bit aggressive.
Good luck on whatever path you decide!
Amanda (LFCA)
I would finish out the cycle if I woke up in your shoes. I just can't even think about having to take clomid without getting to try! I'm guessing that the RE is referring to the fact that clomid can thin your lining and reduce your chances by making it thinner. But I would think some REs would disagree with him and say that the more targets (eggs!)...the better as long as the lining stays thick enough! Find out at your mid-cycle ultrasound the exact measurement of your lining and how many mature follicles you have too. In my opinion (and obviously I'm no RE!), I would continue with medicated cycles if your lining is still nice (over 8 if I remember correctly??!!) and if you produce more than one mature follicle per cycle. Hope this helps!
ReplyDeleteCourtney (here from LFCA!)
Stopping over from LFCA. I don't have any experience taking Clomid, but my own RE, one of the more well-known REs, never prescribes it for two main reasons: 1) it can actually "be bad" for women who ovulate on their own (i.e. don't have PCOS) and 2) it can really thin out the lining and actually prevent successful implantation. So I tend to agree with Dr. Arrow. Unless you have an ovulation disorder such a PCOS it might not be good for you and decrease your chances at success. Also, while his statement was a bit blunt and would have felt like a slap to me too, it makes sense. Most REs wouldn't put someone on clomid after TTC for one month.
ReplyDeleteThat said, some women do have success with it, so I'm not sure I'd abandon the cycle completely. I wish this could be easier for us!
Best wishes.
Have you had normal regular cycles before this? If so that is one thing. I hardly ever ovulate on my own and would definitely go for finishing the cycle. You have a much higher chance this way.
ReplyDeleteI concur with Bea, as I often do...about the cycle. What hurt does finishing do??? None....:)
ReplyDeleteI am sooooo jealous of your clean car (mine has goldfish and graham crackers all over it) and your summer vacation. Lucky girl.
I did a lot of Clomid (and I hated it) I think I would just finish this cycle and then move on with Dr Arrow's suggestions.
GOOD LUCK, as always!!!! HUGS