I had to sign an authorization form so that the REI Clinic on post would release my records to the civilian clinic for our IVF consult next week. When I called the IVF coordinator on post, she sounded genuinely shocked that we were looking into other options, which totally blows my mind. For those who have been reading my blog for the last several months, you are familiar with the endless cycle of problems I have had with the clinic. For my new readers, I will do my best to explain:
Last summer, after 20 months of TTC, I finally got my referral to the infertility clinic but they had no availability until September. At my first appointment the 2LT looked confused when I handed him my 19 months worth of charts and looked at me like I had three heads. I was given the dx of unexplained infertility and they refused to do further blood work on me since I'm "young." There was no availability for my HSG until the end of October and when I expressed my frustration to one of the nurses she asked, "What is your rush?" Seriously? My followup after my HSG wasn't until 6 December due to lack of availability. The technicians who did my HSG told me that everything appeared to be normal and I never received a phone call telling me otherwise, but when I went to my followup, an idiot resident told me that I had an unknown mass in my uterus--something she'd never seen before. Because of my "abnormal" HSG I had to have a hysteroscopy and had to wait until January due to lack of availability. At this point we went to the Tricare office to seek a referral off post--we were sick of the waiting game and constantly being told that they couldn't see us. We were denied. In January, I had my hysteroscopy and there was absolutely nothing abnormal in my uterus and we were FINALLY given the all clear to start Clomid.The doctor said the goal would be to produce multiple follicles so that we would have an increased chance of conceiving.
On CD 1 in February, I called the clinic so that I could get my first prescription of Clomid. I was so excited to finally get some treatment started! I called the clinic several times but no one answered and I became increasingly concerned that I wouldn't get my Rx before the three day weekend (For those unfamiliar with Clomid, you have to start it on a specific day in your cycle.) After no one returned my calls, Mike called patient advocacy and explained that this wasn't the first time we've had issues with the clinic--the IF clinic called me back right away and was highly annoyed that we had called PA. We did Clomid Cycle #1 and I only produced one follicle. I requested more blood work and was once again told that I was "young" and didn't need it. When I questioned their Clomid dosage and only producing one follicle, I was assured that it was "quality over quantity." Clomid cycle #2 produced one follicle on my left hand side--that was in March and I have not produced any follicles on that side since. After four failed Clomid Cycles and two IUIs, we were "allowed" to move on to Femara. I saw a different doctor at this point and questioned (again) why I never had any other lab work done--he was more than happy to order CD3 labs for me as well as thyroid check as well as add us to the waiting list for IVF in July of 2012. My thyroid came back normal but my AMH came back at .87, suggesting DOR, but I was still brushed off when voicing my concerns. In July, I was going to start my first Femara cycle and when I went to the lab to do my urinalysis, there was no record of it in the system--the nurses never put in the order. My prescription wasn't in the pharmacy either so I had to make the 40 minute trek to post two days in a row because of their "forgetfulness." When I tried to schedule my monitoring ultrasound, they told me there weren't any appointments available and to just do OPKs to detect my surge. I insisted that I be monitored (I knew better thanks to all my boards!) and begged them to double book me--I would have rather waited than not be seen at all. Seriously, what kind of IF clinic prescribes fertility meds and doesn't do proper monitoring?! When I went in for my follicle scan, they had no record of my appointment. When we went back to the room the nurse had the entirely wrong information for me. ::head desk::
Femara cycle #1 + IUI #3 turned up a BFN and at this point the doctor finally sat us down and talked to our diagnose of unexplained infertility. He still gave my AMH and LH levels no credence but did give present us the opportunity to do a diagnostic laparoscopy. At this point I sought another referral to see a civilian clinic, to get a second opinion before proceeding with a surgery and more expensive treatments. Once again, I was denied. I was told to expect a call from Patient Advocacy but I never heard anything from them. We did decide to proceed with the laparoscopy in search of answers and we did get them--but not without complications. I received the diagnosis of Stage I Endometriosis and found out that my left fallopian tube is partially blocked due to left ovary adhesions, which is likely the cause that I never produce any follicles on my left side. The complication was the piece of plastic that the effing resident left behind in my vagina during surgery. Are you still wondering why we want to look into other options?
This month was our second round of Femara and now that most of the endo had been removed, we were given an increased chance of conception. We decided to try IUI one more time, post endo removal. When I called to schedule my monitoring appointment, I was once again told that they had no availability but this time I was able to say, "My left fallopian tube is partially blocked so we really want to make sure that I have follicles on my right side before paying for IUI." I went to my appointment and they had no record of it ever being scheduled. Sound familiar? I did end up having two follicles on my right side and we decided to go for IUI #4. It was a BFN. We are now at the point where we know that IUI is most likely not going to work for us and that we need to consider IVF. Yes, we're on the list on post (We've been moved up to the May cycle)and although the IVF would be done at a somewhat discounted rate, I would be just one woman in a large group of women cycling all at the same time.
As if all this wasn't enough, yesterday I was waiting on a fax with the paperwork I needed to sign to release my records. It never came. No one answered when I called the office so I couldn't get the fax number I needed. I ended up sending a fax to the OB/GYN department and had to request that they deliver the fax to the nurse in the REI Clinic. When I finally spoke with the REI nurse, she asked me if I'd like to be moved up to the May cycle and sounded annoyed and sincerely astonished that we would be looking into care elsewhere. I wanted to say to her, "Are you seriously surprised?"
There are plenty of women who have absolutely loved and raved about their experience with the REI Clinic. It's been my observation that the majority of these women were able to get pregnant within a few cycles of Clomid and I have yet to personally meet anyone who has made it "this far" with the clinic. Throughout my entire journey with the REI Clinic on post, I have felt like a part on an assembly line and have never received individualized care. We have had problem after problem and do not feel like we can fully trust the clinic or the doctors. I do not want to be part of a large group during an IVF cycle. I want focus and dedication and I don't want to have to fight to be seen. I want to be able to talk to someone the first time I call and not have to wait all day for someone to call me back. Am I expecting too much? Are my standards too high? I have been told repeatedly that I need to go in and talk to Patient Advocacy about all of this but I honestly feel like it wouldn't do any good. At this point, we are desperate to find a doctor that is truly invested in helping us become parents, to make our dreams come true, and I do not think that we are going to find that at an Army hospital.
Showing posts with label clomid. Show all posts
Showing posts with label clomid. Show all posts
Oct 22, 2011
Jul 8, 2011
This is It.
My appointment didn't start off so well. I arrived at the infertility clinic and it was really, really busy. I guess it is because they are doing an IVF cycle right now. When I gave the receptionist my ID she asked, "Did they just book this appointment?" She didn't have me down! This is the appointment I had to fight for last week, remember? I was about to lose it on someone but luckily they straightened it out and I had a seat in the waiting area. It's always so lovely when I have to wait for an extended period of time considering the OB booking desk is just on the other side of the infertility clinic. Whoever planned the layout of the new clinic is a total idiot.
While I was waiting I saw a lady come in once, get sent away and then come in a second time absolutely furious. They hadn't put in her labs---sound familiar? At least I'm not the only one having such a hard time with them.
Mike ended up being able to come with me since he finished at the range early so we both went back to the room and waited to see the doc. The nurse had me down taking Clomid, that I was 5' 6" and day 14 on my cycle. Double you tee eff. This clinic really needs to get it's shit together. My blood pressure was high and she asked, "Do you normally have high blood pressure or just when you come to see us?" Oh if she only knew.
Once again, my left ovary was taking the month off but I have several follies on my right. One 19.5 that is nice and ripe and several smaller ones that won't be doing anything. I got my trigger shot and we're going up to Seattle tomorrow for IUI #3.
Dr. C sat and talked with us for a long while, which was very much appreciated considering everything that is going on. He talked to me about my low AMH and said that it does mean that we're working against a clock but that we shouldn't be too concerned just yet. If I don't get pregnant this cycle we will do CD3 labs at my request though he feels like they unnecessary because of my everything else in my cycle is normal. Because I'm 27 he would expect the quality of my eggs to still be good but obviously this is only something we can figure out once we get to the IVF stage. For now he presented us with a few options:
#1 Continue to do ovulation induction and IUI. We could definitely continue doing this but the cumulative success rate for IUI decreases each month. He feels that there wouldn't be much point in continuing this protocol after IUI #3 since most women who achieve pregnancy do so in the first three months. Plus, that's money that could go into our IVF fund.
#2 Diagnostic laparosocopy. This is highly recommended before pursuing IVF and there is the chance they could get in there and be able to "fix" whatever it is that is keeping me from conceiving on my own.
#3 IUI with stims. He doesn't normally like to do this because the risk of OHSS is so high coupled with increased risk of multiples. He said that IUI + stims shows no increased chance of conception when compared to clomid or femara cycles. It'd basically be a more aggressive protocol than what we're doing now but without an increased chance of getting pregnant.
#4 Move straight to IVF. Well, not really. There's still the long ass waiting list of course. We did find out, however, that IVF without ICSI is closer to 6k and with ICSI is around 8k (I'm guessing the 7,500 that Dr. B. told us about last time.) The wait time may actually decrease because they are going to start doing cycles more regularly plus people PCS, get pregnant on their own or just decide to take themselves off the list entirely. Dr. C said we might be able to cycle as soon as 6-8 months. Until then, I guess we'll be trying the old fashioned way. It didn't work for us for the first 20 months so there's no reason to think it'd work now.
Overall it was a great appointment. I really appreciated the time he took to sit and talk with us about our concerns; I just wish he'd done it sooner. Who knows? Maybe he doesn't talk to his patients about all the options because most of them get pregnant right away? I really wish the logistics of the clinic would get worked out though. They seriously need to work on scheduling and following through with things.
It's so bizzare to be moving forward with IVF and feeling total okay with it. I remember how upset I was last summer when we thought Mike had low motility and that we'd have to do IUI to get pregnant. The idea of not being able to get pregnant on my own was heart wrenching and now I can talk about IUI and IVF in my sleep. Mike and I have talked about it and agreed that while the idea of surgery completely sucks, that is the option we need to go with for now. Surgery will most likely be late August or September. At this point, we've also agreed for this to be our final IUI and to start saving for IVF. If I don't get pregnant I will be calling the clinic on day one and scheduling my lap. After that, we'll see where to go from there....
While I was waiting I saw a lady come in once, get sent away and then come in a second time absolutely furious. They hadn't put in her labs---sound familiar? At least I'm not the only one having such a hard time with them.
Mike ended up being able to come with me since he finished at the range early so we both went back to the room and waited to see the doc. The nurse had me down taking Clomid, that I was 5' 6" and day 14 on my cycle. Double you tee eff. This clinic really needs to get it's shit together. My blood pressure was high and she asked, "Do you normally have high blood pressure or just when you come to see us?" Oh if she only knew.
Once again, my left ovary was taking the month off but I have several follies on my right. One 19.5 that is nice and ripe and several smaller ones that won't be doing anything. I got my trigger shot and we're going up to Seattle tomorrow for IUI #3.
Dr. C sat and talked with us for a long while, which was very much appreciated considering everything that is going on. He talked to me about my low AMH and said that it does mean that we're working against a clock but that we shouldn't be too concerned just yet. If I don't get pregnant this cycle we will do CD3 labs at my request though he feels like they unnecessary because of my everything else in my cycle is normal. Because I'm 27 he would expect the quality of my eggs to still be good but obviously this is only something we can figure out once we get to the IVF stage. For now he presented us with a few options:
#1 Continue to do ovulation induction and IUI. We could definitely continue doing this but the cumulative success rate for IUI decreases each month. He feels that there wouldn't be much point in continuing this protocol after IUI #3 since most women who achieve pregnancy do so in the first three months. Plus, that's money that could go into our IVF fund.
#2 Diagnostic laparosocopy. This is highly recommended before pursuing IVF and there is the chance they could get in there and be able to "fix" whatever it is that is keeping me from conceiving on my own.
#3 IUI with stims. He doesn't normally like to do this because the risk of OHSS is so high coupled with increased risk of multiples. He said that IUI + stims shows no increased chance of conception when compared to clomid or femara cycles. It'd basically be a more aggressive protocol than what we're doing now but without an increased chance of getting pregnant.
#4 Move straight to IVF. Well, not really. There's still the long ass waiting list of course. We did find out, however, that IVF without ICSI is closer to 6k and with ICSI is around 8k (I'm guessing the 7,500 that Dr. B. told us about last time.) The wait time may actually decrease because they are going to start doing cycles more regularly plus people PCS, get pregnant on their own or just decide to take themselves off the list entirely. Dr. C said we might be able to cycle as soon as 6-8 months. Until then, I guess we'll be trying the old fashioned way. It didn't work for us for the first 20 months so there's no reason to think it'd work now.
Overall it was a great appointment. I really appreciated the time he took to sit and talk with us about our concerns; I just wish he'd done it sooner. Who knows? Maybe he doesn't talk to his patients about all the options because most of them get pregnant right away? I really wish the logistics of the clinic would get worked out though. They seriously need to work on scheduling and following through with things.
It's so bizzare to be moving forward with IVF and feeling total okay with it. I remember how upset I was last summer when we thought Mike had low motility and that we'd have to do IUI to get pregnant. The idea of not being able to get pregnant on my own was heart wrenching and now I can talk about IUI and IVF in my sleep. Mike and I have talked about it and agreed that while the idea of surgery completely sucks, that is the option we need to go with for now. Surgery will most likely be late August or September. At this point, we've also agreed for this to be our final IUI and to start saving for IVF. If I don't get pregnant I will be calling the clinic on day one and scheduling my lap. After that, we'll see where to go from there....
Jun 14, 2011
Yay for proactive doctors!
For those of you who aren't military you probably get to see the same doctor every time you go to an appointment, right? The nurses probably know you by your face and maybe the receptionist even knows you.....When I go to my appointments I always see a different nurse and most of the time I see a different doctor as well. Doctors and nurses who have to ask ME what medication I have been taking because they aren't familiar with me. Today was no different. Dr. B. walked in and asked what I was taking. because it wasn't on my chart. I explained my protocol and laid back for my date with the Dildo Cam. My uterus lining looks good and I have one ripe 19mm follicle on my right ovary. Leftie was hiding today and he had to push my belly to get my ovary to move down so he could take a look which was weird. I didn't know ovaries could be so mobile!
Dr. B was great! He sat with us and answered all our questions. He did not brush us off for being young or having unexplained infertility. I asked him if we could try something other than Clomid next month if this month doesn't work and he agreed that it was reasonable to move on to something else. We'll be moving on to Femara + IUI next month if I don't get pregnant. He also said that it was totally reasonable for us to start considering IVF, which on one hand was good to hear but on the other hand really difficult to know hear someone say that. He said that based on statistics he recommendds six IUIs before moving on. We could continue IUI after those six but our probability of sucess decreases. Right now we have a 10-15% chance of achieving pregnancy. He said a lot of unexplained couples learn the reasons for their infertility once they get to IVF and that about 30% of his IVF patients have unexplained infertility. So...we're on the IVF waiting list and have a spot for next July just in case IUI doesn't work for us. We'll need to save up $7500 by then. If we want to do IVF on our own before next July it will be about $15k. Yowsers!
I also talked to Dr. B about my brother's recent diagnosis of azoospermia and asked if there could be any co-relation between the two of us having infertility issues. He said it would be really rare but to be on the safe side he put in an order for a Cystic Fibrosis Gene Mutation test. 99% of men with CF are infertile due to a congenital defect of missing vas deferens. In women, the CF mutation can cause cause infertility issues such as thick cervical mucus and other issues as well. He also put in an order to have my thyroid levels checked. Yay for proactive doctors!
So just one follicle this month but that's okay. I'll trigger tonight (Mike will give me the shot) and we go for our IUI on Thursday at 1000. Fingers crossed.
After our appointment we applied for on-post housing. Thankfully we qualify for a 3br based on Mike's rank alone and we put our names down for the new housing. Our lease in our rental house isn't up until 1 March but the wait for new housing is 6-9 months so it should all work out. Why are we moving on post? The #1 reason is that after 14 months here we still don't have any friends. It is SO hard to meet people here. The military community is a very small percentage of the population here so we are not surrounded by a military support system where we currently live. #2 It takes Mike about 40-45 minutes to get home from work even though we only live about 13 miles from the gate. Moving will also make it easier for me to deliver orders to people who live on post. #3 Deployment rumors. If these rumors are true, I don't want to be off post all by myself with no support system when he leaves. #4 If I do ever get pregnant I will not have a 45 minute trip to the hospital when I'm in labor!
So we'll be moving in mid-February and even though we'll be sacrificing our large yard and two car garage I think it will be a good decision for us. It may also help us save up that $7500 we need to save up but hopefully won't need! =)
Dr. B was great! He sat with us and answered all our questions. He did not brush us off for being young or having unexplained infertility. I asked him if we could try something other than Clomid next month if this month doesn't work and he agreed that it was reasonable to move on to something else. We'll be moving on to Femara + IUI next month if I don't get pregnant. He also said that it was totally reasonable for us to start considering IVF, which on one hand was good to hear but on the other hand really difficult to know hear someone say that. He said that based on statistics he recommendds six IUIs before moving on. We could continue IUI after those six but our probability of sucess decreases. Right now we have a 10-15% chance of achieving pregnancy. He said a lot of unexplained couples learn the reasons for their infertility once they get to IVF and that about 30% of his IVF patients have unexplained infertility. So...we're on the IVF waiting list and have a spot for next July just in case IUI doesn't work for us. We'll need to save up $7500 by then. If we want to do IVF on our own before next July it will be about $15k. Yowsers!
I also talked to Dr. B about my brother's recent diagnosis of azoospermia and asked if there could be any co-relation between the two of us having infertility issues. He said it would be really rare but to be on the safe side he put in an order for a Cystic Fibrosis Gene Mutation test. 99% of men with CF are infertile due to a congenital defect of missing vas deferens. In women, the CF mutation can cause cause infertility issues such as thick cervical mucus and other issues as well. He also put in an order to have my thyroid levels checked. Yay for proactive doctors!
So just one follicle this month but that's okay. I'll trigger tonight (Mike will give me the shot) and we go for our IUI on Thursday at 1000. Fingers crossed.
After our appointment we applied for on-post housing. Thankfully we qualify for a 3br based on Mike's rank alone and we put our names down for the new housing. Our lease in our rental house isn't up until 1 March but the wait for new housing is 6-9 months so it should all work out. Why are we moving on post? The #1 reason is that after 14 months here we still don't have any friends. It is SO hard to meet people here. The military community is a very small percentage of the population here so we are not surrounded by a military support system where we currently live. #2 It takes Mike about 40-45 minutes to get home from work even though we only live about 13 miles from the gate. Moving will also make it easier for me to deliver orders to people who live on post. #3 Deployment rumors. If these rumors are true, I don't want to be off post all by myself with no support system when he leaves. #4 If I do ever get pregnant I will not have a 45 minute trip to the hospital when I'm in labor!
So we'll be moving in mid-February and even though we'll be sacrificing our large yard and two car garage I think it will be a good decision for us. It may also help us save up that $7500 we need to save up but hopefully won't need! =)
Jun 13, 2011
Follie Check. Cycle #29.
This is our fourth cycle of Clomid and I'll have my ultrasound tomorrow to check my follicle size. I'll only be on CD10 so I'm not sure what to expect. The nurse told me they'd send me home with the trigger shot. We'll do IUI one day later this week too.
I'm going to talk to the doctor (again) and request 7 dpo blood work (again) and pray that he doesn't say no (again.) Ridiculous, isn't it? We're also going to talk to him about moving on to other drugs if I don't get pregnant this month. Considering that 85% of women who become pregnant on Clomid get pregnant within the first 3 months, we're ready to try something else. Wish us luck for a good appointment tomorrow.
I've started blogging about our time in the North of England but still have to finish it--never fear!
I'm going to talk to the doctor (again) and request 7 dpo blood work (again) and pray that he doesn't say no (again.) Ridiculous, isn't it? We're also going to talk to him about moving on to other drugs if I don't get pregnant this month. Considering that 85% of women who become pregnant on Clomid get pregnant within the first 3 months, we're ready to try something else. Wish us luck for a good appointment tomorrow.
I've started blogging about our time in the North of England but still have to finish it--never fear!
May 3, 2011
Big Fat Fucking Fail
I woke up this morning to a full bladder and was so certain that I was going to get my BFP today after yesterday's temperature. Wrong. That's what I get for hoping, right? My temperature went down and when I got to the bathroom I had a first row seat for AF's pre-game show. Cycle 27 is over and just in time for Mother's Day. I haven't been this upset about AF in a long time. I felt like we actually had a shot with the IUI. Even though I know I have no control over what is happening with my body I feel like a failure.
Sobbing, I called Mike to tell him and I immediately started apologizing but he told me to stop. He said he doesn't blame me and that it's not my fault. Why do I feel so guilty then? Why is my body failing month after month?
I just walked into the bathroom and infertility decided to play a cruel joke on me. There was a second line on this morning's test. My heart skipped a beat even though I KNOW that those results aren't valid after ten minutes. Maybe there wasn't even a second line. Maybe I've been staring at all my negative pregnancy tests for so long that my eyes are playing tricks on me. I keep going into the bathroom to look at the second line even though I know it's not real. Pathetic, right? A second line, however inaccurate, was just a cruel, cruel joke.
So today isn't officially CD1 since I'm only spotting so I'm not going to call the IF clinic just quite yet. I'm hesitant to waist one of my three remaining Clomid cycles when Mike might not even be here during my fertile time to do IUI this cycle. He is determined to try again this cycle though so he wants me to call to get my next prescription of Clomid. So....moving on to IUI cycle #2 and this time we'll be in a foreign country when we find out if I am pregnant or not.
I hate that infertility has robbed me of so many joys. My husband and I will be spending our seventh wedding anniversary in LONDON in three weeks and all I can feel is the pain in my heart that we're not taking a baby with us. Mike and I will be celebrating seven years of marriage. Some have been worse than others (those who have been through multiple deployments know what I'm talking about) but for the most part they have been seven wonderful years yet all I can think about right now is how we've been married for seven years and have zero children to show for it.
Apparently pregnancy is an elusive disease and this cycle was one big fat fucking failure.
Sobbing, I called Mike to tell him and I immediately started apologizing but he told me to stop. He said he doesn't blame me and that it's not my fault. Why do I feel so guilty then? Why is my body failing month after month?
I just walked into the bathroom and infertility decided to play a cruel joke on me. There was a second line on this morning's test. My heart skipped a beat even though I KNOW that those results aren't valid after ten minutes. Maybe there wasn't even a second line. Maybe I've been staring at all my negative pregnancy tests for so long that my eyes are playing tricks on me. I keep going into the bathroom to look at the second line even though I know it's not real. Pathetic, right? A second line, however inaccurate, was just a cruel, cruel joke.
So today isn't officially CD1 since I'm only spotting so I'm not going to call the IF clinic just quite yet. I'm hesitant to waist one of my three remaining Clomid cycles when Mike might not even be here during my fertile time to do IUI this cycle. He is determined to try again this cycle though so he wants me to call to get my next prescription of Clomid. So....moving on to IUI cycle #2 and this time we'll be in a foreign country when we find out if I am pregnant or not.
I hate that infertility has robbed me of so many joys. My husband and I will be spending our seventh wedding anniversary in LONDON in three weeks and all I can feel is the pain in my heart that we're not taking a baby with us. Mike and I will be celebrating seven years of marriage. Some have been worse than others (those who have been through multiple deployments know what I'm talking about) but for the most part they have been seven wonderful years yet all I can think about right now is how we've been married for seven years and have zero children to show for it.
Apparently pregnancy is an elusive disease and this cycle was one big fat fucking failure.
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