Friday, September 16, 2005

"When you get pregnant . . ."

This morning I went to Ginormous Fertility Clinic and as I waited to be called into Dr. L's office, I felt my spirits begin to sink. I looked around the waiting room, skimmed through brochures about Mind Body classes, Complementary Medicine programs, IVF Support Group meetings, and I felt my eyes well up with tears. I really couldn't figure out how I had gotten there, where had we gone wrong. Would this even work? Was my endo too severe for me to qualify for treatment? Would Dr. L wish me luck and send me on my way? Thankfully (mercifully) before I went into full sob mode, a nurse made a joke with one of the couples in waiting area and I was distracted from my self-pity.

Shortly thereafter, Dr. L walked by, picked up my file at the reception desk and walked back toward his office. He returned after a few minutes of refreshing his recollection of my files. Dr. L greeted me with a joke about my "impressive" laparascopy photos and this bit of levity seemed to lighten the mood. We sat in his office, called David at his office, and the three of us commenced a discussion about our family building options.

Dr. L mentioned two options: (1) adoption and (2) IVF. Since I was at the RE's office, speaking with the RE, adoption was tabled, for now. He explained how IVF would work (my insightful questions led him to quickly became apprised of my advanced degree in Googleology). He then described our protocol -- beginning with BCPs at the start of my next period, followed by Lupron for a few days, with stims shortly thereafter and so on. He talked about the "ideal" number of eggs for an IVF cycle (in his opinion, 15). I then asked about risk factors to our potential offspring and me from IVF, he concluded there were few, which he then proceeded to enumerate.

I also asked about the reduced possibility of success from IVF due to my endo. Apparently, Ginormous published a report a few years ago, which suggests that women with endo have a "statistically insignificantly" lower success rate of IVF than do couples that suffer with other types of infertility. I asked about the increase risk of miscarriage due to endo and fibroids and although he acknowledged that there is, in fact, a higher risk, he seemed unconvinced that it was significant. Statisically, he gave us a 38% chance of success after one cycle and an 80% chance after 4 cycles (yep, 4!). And stated that "when you get pregnant," twins would be one of our biggest concerns. (When I get pregnant? When I get pregnant? Is this some kind of weird RE-jedi-mind-trick?)

My questions then strayed down the alternate remedies route. I asked about changing my diet. I am dabbling in "The Infertility Cure" and "Healing Endometriosis Through Nutritition," which both seem to advocate eliminating everything from your diet except organic fruits, vegetables, water and cardboard. He suggested that I not do anything too extreme and confirmed that changes in diet do not have medically proven results. We also talked about acupuncture, which he seemed indifferent about. He suggested that I avoid herbs and other supplements (I've started taking Flaxseed Oil and Evening Primrose tablets). OK - I'm a bit of a nut . . . I know, I know. He reiterated that I should not consume too much soy.

He recommended another HSG (lovely!) to confirm that my lone remaining tube does not have a hydrosalphix. Personally, I think this is a bit unnecessary given that the lap clearly indicated that it was just blocked, not seeping infected fluid into my uterus potentially poisoning our imaginary child, like the right tube had been, but better safe than sorry I guess. Finally, he advised me that I'd need another lap to remove the remaining tube, if the HSG did, in fact, indicate another hydro.

From there I was whisked off to meet with Nurse Mindy, who cheerfully told me about the dates of upcoming IVF injection classes and IVF information seminars. She advised me of the meds I'd be taking and the tentative dates on which I'd be taking them. She suggested that I get a pap smear (I've had no annual exam since 6/2004). She gave me prescriptions for prenatal vitamins (2 types, my choice), HSG antibiotics, and BCPs. Finally, she advised me that one of the financial advisors would be calling with information soon (today, as it turned out). Nurse Mindy made me feel like a kindergartener, being walked through my first day of school. I guess that's what happens when you complain about your treatment to the right people, everyone tends to O-V-E-R-C-O-M-P-E-N-S-A-T-E.

I guess I shouldn't complain. I called Nurse Mindy with a follow-up question about locations where I might have the HSG performed locally and she very promptly returned my call. She even offered to walk us through the injection process, if we were unable to attend the scheduled injection classes. On our phone call, she even told me that she'd seen our address and noticed that her sister lives near us. Nurse Mindy was very nice, if not a bit patronizing, upbeat and extremely responsive.

I guess I've gotten everything that I could have hoped for -- a protocol that begins soon, no Lupron Depot, responsive and knowledgeable medical personnel and a supportive spouse. So in a couple of weeks, our journey will begin.

As always, thanks for all of your comments. I appreciate all of the responses about David's grandmother and the well wishes about my health. I can't imagine making this journey without you.

19 Comments:

At 8:09 PM, Anonymous Anonymous said...

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At 8:23 PM, Anonymous Anonymous said...

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At 9:20 AM, Blogger zhl said...

Hi Chee Chee,
I'm glad that the RE visit went well. Sounds like you and I have done many of the same things, like dabbling in changing your diet. I've tried both but I must have missed the part about limiting soy. Is that because of the endo? Best of luck. I hope to be right behind you.

 
At 11:27 AM, Blogger K|nneret said...

Hey Chee ... this is good news. Do you feel better now that you've spoken to him?? I sense hesitation still. But it sounds like he is on top of things and that you're in good hands.

 
At 2:33 PM, Blogger k #2 said...

Chee Chee,

A plan! You have a plan! I am so excited that your appt. went so well and it sounds like they took thorough time to discuss your options.

I'm looking forward to hearing how this goes for you!
Kate

 
At 5:20 PM, Blogger Spanglish said...

Hey Chee Chee,
I'm glad that your appt. went well. I totally understand your skepticism... IF does that to us, makes us a bit cynical about success, but Hope clings on...

 
At 8:29 PM, Anonymous Lori said...

Sounds like an overwhelming appointment but one that went well. Did your RE mention why you should limit soy? And how much do they think is limiting?
Best of luck!

 
At 12:33 PM, Anonymous Lori said...

Chee Chee,
Thanks for the scoop on the soy (and for leaving a comment on my new little blog!). I'm hoping my cup of soymilk with cereal won't be too much. I'm just so tired of switching up my diet! The things we do...
Thanks again!

 
At 3:01 PM, Anonymous thalia said...

I've never had a doctor suggest adoption as an option. I'd have gone straight into a gibbering wreck and stayed there. How did you handle it?

Glad you have a plan. Looks as if we'll be on similar timings.

 
At 5:18 PM, Blogger Chee Chee said...

Thalia --

I think you're right and we will be cycling at the same time. I'm expecting my bcp/lupron cycle to begin around the end of this month.

As for your question -- my RE has a tendancy to talk as he writes. So he began by saying, "I don't know if adoption is an option for you" and then wrote the word "adoption" on his paper.

Neither David nor I responded. David and I have talked about adoption but we haven't come to a decision. I feel like my RE's question was more rhetorical than anything else. He moved on to our IVF discussion without skipping a beat.

 
At 5:38 PM, Blogger Chee Chee said...

Lori -- Actually, I asked Dr. L the soy question. He said that I didn't have to eliminate it completely but should simply reduce my intake. I used to drink soy milk with cereal, added soy protein powder to homemade smoothies, ate inari (tofu sushi), put tofu in salad, and ate those luna bars. At the moment, I've eliminated it completely. But since he says that some is fine, I may begin adding soymilk to my cereal again.

 
At 5:56 PM, Anonymous Lori said...

Thanks Chee Chee! I saw your response over at my blog (and here as well). Maybe I'll stick with my cereal and soymilk but lay off the smoothies (I forgot about those until I saw your response).
Thanks again!

 
At 6:00 AM, Blogger betty said...

It's all happening! Sounds like a good plan. 80% after 4 cycles sounds promising! There always seems to be a clash between natural practitioners and doctors. It must be good to be mindful of natural therapies whilst doing the scientific stuff.

 
At 6:28 AM, Blogger Larisa said...

Sounds like the visit went well. I'm excited that you are on your way!

 
At 8:48 AM, Blogger Ova Girl said...

Congrats chee chee, it's all happening! I take the flaxseed oil too and am meant to be taking the e.p oil but keep forgetting. (for another medical condition)

It's amazing how your spirits start to lift when you're on a plan! We'll be right here cheering you on!

 
At 11:20 AM, Anonymous Jen said...

Chee Chee,

So glad your visit went well & you now have a protocol set up.

Also, I have to say I giggled slightly at your tiny lapse into lawyer speak--about the doctor refreshing his recollection of your file. I got this image in my head of you cross-examining him: "Doctor, do you remember anything about me, my uterus, tubes, or ovaries?" "Um, no, I don't." "Would it refresh your recollection to review my file?" "Yes, thank you." :)

 
At 2:04 PM, Blogger Mellie said...

Chee -

It seems to me that you're off and running (well, at least in the starter's gate) and that's great. I'm also impressed that gino clinic is able to provide you with such personalized service. You're in a good place and in good hands!

 
At 2:50 PM, Anonymous Alex/Infertile Gourmet said...

Good luck!

What were the problems that IVF can cause for you or the embryos? Other than the typical OHSS....

 
At 3:45 PM, Blogger Chee Chee said...

Alex -
To answer your question, my RE mentioned 4 possible risks to the mother - 1) multiples, 2) OHSS, 3) bleeding, 4) infections. He says that 3 and 4 are extremely rare and they've only had one hospitalization for bleeding/infection in their nearly 20 year history.

He said that statistically, birth defects occur at the same rates as with fertile couples. I believe he said 97% normal births for fertiles and 95-97% normal for IVF (singletons) and 93% normal births for fertiles and 91-93% normal for IVF (twins).

 

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