Friday, May 15, 2009

RE update

Some thoughts from my most recent RE appt:

1. Apparently my diagnosis is “ovulatory infertility,” which, when she described it, sounded an awful like unexplained infertility. She doesn’t think the male factor is that big a problem given hubby’s second SA results. Even though the lab that did the test called his motility and morphology “low”, she thought it was pretty normal. So either the first SA was a bad test or the vitamins he’s been taking have worked. As for me, she is concerned about the variable length of my cycles and short LP phase which would indicate not very good ovulation. She doesn’t think I have endo and as for PCOS which she previously thought I had, said I have only a mild variant of it.

2. Her clinic recently moved locations to this brand new facility. Still part of the same university hospital, but in a different location. Actually, the hospital converted a shopping mall to a medical clinic where the big stores on the outside on the first floor are still retail (so you can move straight from your OB appt to Babies R Us…less helpful if your visit is for IF). The inside of the mall on the first floor are hospital administration offices (billing, etc). The second floor is where all the clinics are, plus a bagel shop. This was quite a strange experience although it seems to work. I was tempted to stop by Michael’s on my way out.

3. This new clinic is all state of the art. Very high tech. The doctor spends the whole appointment typing away on the computer, which is kinda weird but then you can see the impact when she can easily review your status and know your whole history at the follow-up appointment. And I like the online system where you can message your doctor. But sometimes all these high tech goodies really seems unnecessary.

For instance.

When you show up at this clinic, instead of checking in with the nice ladies at the front counter, there are automated kiosks like you see at airports. They check you in, verify your current contact information and insurance, and can take any co-pays by credit card. It does not seem to me like these functions take all that much time or the lines are so long that taking this function away from real live people saves all that much. Especially since the next thing you do after using the kiosk is talk to the lady at the counter. She gives you the medical info sheet to complete and--get this--a buzzer! to let you know when the nurse is ready to see you. You get the fantastic experiences of both an airport and an overcrowded restaurant all before someone starts shoving things into your private parts (which, if you think about it, kinda goes with the airport theme).

4. Since I’ve had 3 unsuccessful cycles on clo.mid and this cycle I appear to have O’d without clo.mid, I had some blood drawn to check my progesterone levels. My temps definitely indicate I O’d on my own, but hopefully this will confirm that. The next step is to schedule an HSG for the first part of my next cycle.

5. She gave me a prescription for letrozole (Fem.ara). I’m a little worried about using a drug off-label. Need to learn more about this. I'm especially worried that it might cause birth defects.

6. When they designed this new clinic, apparently they thought people have gotten larger because the chairs are super wide. The chairs in the waiting areas seem normal enough, but once you are in the treatment rooms they get oddly wide. Not wide enough to be called a bench. Only one adult could sit there, or two little kids. But you can’t really sit there comfortably because they are so wide that the arm rests are too far apart.

7. She said we could go straight to IUI if we wanted, but since I’m young there is no need to rush and we can give it a few tries on another drug. I at least want to get the HSG done before we start with IUI.

8. She also said I could stand to lose 10 pounds to help with my ovulatory infertility. Ugh, I’ve been trying, really.

9. This appointment was both frustrating and encouraging. I left feeling like I had a plan and might see a baby at the end of this relatively soon. But frustrating because she took my diagnosis away! Unexplained IF is not fun at all (not that any IF is any fun).

9. I asked my hubby if it was weird to give the semen sample in a dr office, but not specifically about showing up in a OB/GYN's office. While I was sitting in the waiting room, a man shows up by himself and checks in. Why else would a man be at a women's health center by himself? The entire shopping mall clinic does have other offices, but this section was at the end and most definitely focused on women's health.


  1. I understand you hesitation about using an off-label drug -- though I have heard from other women (mostly on IV and other blogs) that it has worked... you might ask around and see what others (and Dr. Google) say. The HSG seems like a great next step. Do you know if the IUI cycle she discussed with you would be w/injectibles and if so, would you be monitored? Sorry for all the questions! I am excited for you to take these next steps and get your BFP!

  2. I'm sorry that you have been moved into the 'unexplained' column. Hopefully, with access to all this new technology, your RE will be more able to help you achieve your goal!

  3. Your doctors "office" sounds like such a trip!I love the check-in kiosks and buzzers LOL.

    Frustrating that you didn't get a concrete answer why you aren't pregnant yet but at the same time it really all sounds so fixable/positive. Good luck deciding on the Femara and on the HSG.

  4. Whoa, your the new clinic is CRAZY high tech!! So interesting!

    It sounds like you have some excellent next steps for your treatment...but I'm hoping you get pg before doing many! :)

  5. hi missy, thanks for stopping by my blog. i work in a pharmacy, generic drugs are exactly the same as brand name drugs, the only difference is that they may have some inactive indgredents that are not the same, and it is the ACTIVE ingredents that are important. in order for a drug to be considered a generic for a brand name it MUST have the same active ingredents. taking letrozole instead of femara is the equivalant to taking ibuprofen instead to advil. you can request the brand name if you prefer it, but it is silly to do so because basically all you are paying for is a name, not a better drug. also, most insurance companies will not pay for a brand name drug if there is a generic available. i wish i could make more people understand this becaue it can save you a lot of money, even on otc (over the counter) medications. if you are in a store and you want to find a generic for an over the counter medication just flip the box over and look at the active ingredents, if they are the same, then it is the same medication, it's just less expensive. i NEVER buy brand name medication if there is a generic available.


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