Showing posts with label appointment. Show all posts
Showing posts with label appointment. Show all posts

Sunday, July 11, 2010

Records

I need you advice. We had our first appointment with a new RE a few weeks ago. At that time, the appointment was not as useful as it could have been since he had not yet received my medical records from my previous RE. He did get my husband's and did an ultrasound and medical history from us, but wanted to see what my lab results and post op notes from my lap. I went back to my previous RE to get them to send the records again, but as of Wednesday, they had not yet gotten them. Long story short, my first attempts to request the records went to the wrong office and then I used the wrong form at the right office. I think on Wednesday I finally did it right, but am not sure if that is enough time for the records to make it over to the new RE.

In the meantime, DH had his sperm penetration analysis. Our follow up appointment is Monday afternoon, when we will get the SPA results and decide what our next steps are. DH thinks we should reschedule if my records did not make it over there yet because he does not want to pay this doctor if he won't have all the information he needs to be really helpful. I am hesitant to put off this appointment. What would you do?

Tuesday, June 15, 2010

New doctor

We had our first consult with a new doctor today. This clinic is basically our only other option in this area. The bad news is they are more expensive with our insurance. The good news is hopefully they are more successful.

The appointment didn't get off to a good start since they didn't have my medical history from my current doctor. Another thing I need to check up on because I know I asked for them to send it. Anyway, he did an ultrasound and exam and of course asked a bunch of questions and did have some of DH's medical records from the urologist he saw. He didn't have much new for us in terms of a diagnosis. There is still our swimmer problem and not so good ovulation for me, but no identifiable (and thus potentially correctable) cause of the problems.

He recommended we go straight to IVF with ICSI. He said we could try IUI with FSH stimulation. His reasoning was that for most people the IUIs have lower success rates, so you end up spending all this money on IUIs and then need to spend money on the IVF anyway. When pressed, he did think we could potentially do another cl0mid plus IUI cycle, mainly because although technically we did it twice, the circumstances were such that I feel we only gave it one good shot.

Since I am leaning towards the IUI route, he recommended we have the sperm penetration assay. Anyone familiar with that? Basically it sounds like they try to see if DH's sperm can penetrate hamster eggs. If not, then there is little chance they could penetrate my eggs without ICSI. We have that scheduled for next week.

He also brought up getting screened for cystic fibrosis. While neither of us have CF, we could be carriers (Caucasians have a 1/25 chance of being a carrier). And if we are both carriers then any child would have a 1/4 chance of having CF. What do you guys think? DH is not inclined to get tested for this as it is not something most couples do and the test is expensive. And the chances of two people who don't have CF having a baby with CF is pretty low. I'm more inclined to get one of us tested and hope it comes back negative.

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.

Wednesday, April 29, 2009

Anyone know a good urologist?

Ugh. I'm convinced there are no good urologists in our area. My RE who first did hubby's SA and then referred him to a urologist once we got the poor results back. This guy barely gave hubby the time of day, hardly did any exam and then just said to take a multivitamin and come back in a few months. Hubby was completely deflated about being dismissed.

So he found his own urologist who was supposed to specialize in male infertility. After his appointment today, hubby is doubting whether this guy specializes in anything. This dr did seem to do a thorough examination and said he does not have a varicocele (which I'm not sure is a good thing or bad thing, if he had one at least it would be fixable).

But when they started talking about next steps and solutions, hubby asked about IUI. This guy's response? What's IUI?

Umm, how can someone who says they specialize in infertility not know what IUI means. I mean, upon clarification it appeared he just didn't know the acronym, but still. It's not like IUI is some arcane term or pure blogging leet-speak.

So who knows what our next steps will be. This dr did do another SA and we should get the results back in a few days. I go back to the RE in a few weeks. The dr. also mentioned putting hubby on clomid. I guess I did it for a few months so maybe he can try it now?! Anyone have any experience with putting men on clomid?
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