Consult with the doctor today

[Gwenn]

DH and I scheduled an appointment with our RE to come up with a new plan, since after 4 IUIs we have had no success. I respond well to Clomid, with 3-4 good follicles most months, and DH has a great sperm count. We had a long list of things to discuss with the doctor, primarily the possibility of doing progesterone and femara. I was really expecting the doctor to suggest injectibles and IUI, but was wondering how that would work as I do O well on Clomid. Well - I did not hear at all what I expected to. Doc basically said that after 4 failed IUIs with a good egg response, he did not think it was worth trying injects as it would only increase the risk of higher-order multiples since I am O'ing well. Didn't feel it would be any more likely to be successful than the Clomid alone. He said I have three options - IVF, adoption, or trying without meds and hoping for a miracle on our own. Was NOT expecting to be told that at this point in my journey.

I was pretty much rendered speechless, but DH had his notes and asked about femara, which the doctor said he was happy to prescribe for us to take while trying on our own (no more IUIs). After the appt, DH and I had a long talk about progesterone and he put a call in to ask about getting progesterone as well. All the doctor said on the subject was that if/when we do IVF, he would give me a ton of progesterone so there was no point in testing me as I would get it anyway.

So that was my crappy day.

One good thing - I got an email from a staff member at work at another site who had heard through the grapevine that I was interested in finding a cat (my kitty love of 13 years was put to sleep this spring after a skin disorder which led to steroid injections and then heart failure). I have a co-worker who fosters cats and let her know I was interested. The woman who emailed me is looking for a good home for her daughter's cat as her daughter is moving overseas and can't take kitty. So I agreed to take her so long as she is able to cope with my dogs. So I am most likely getting a new kitty - slight positive for the day.

[JJorn]

That is a rough appointment! So he has no idea on why you aren't getting pregnant even though you are ovulating and your DH has a great sperm count? Crazy. I can't imagine what I would be thinking after an appointment like that. I'm sorry!

That's great about the cat, though.

[Gwenn]

I am pretty tough on the outside and I'm not a crier, but I'm feeling like I might have a good cry tonight.

[JJorn]

A good cry sounds like a great idea - I'm ready to cry for you.

[ktbelle97]

Oh Gwenn, I'm sorry your appointment didn't go as you had hoped. Did your RE think that the lining was an issue at all? That can be a problem with Clomid and that's why I thought you might be able to try different meds (aka Femara). I understand what the doc is thinking about the injectables -- but I would bet if you did a low dosage of injectables you wouldn't get more follies, but you could get higher quality ones. From what I understand, that's one of the big pluses about injectables. That being said, I am certainly not a doctor, but I have read a lot on the subject particularly when we were STC with #1. Which, FWIW, took us 7 IUI's to get pg. So there is not necessarily a magic number of IUI's to do, and after you hit that number it won't work for you. KWIM?

What do you think you are going to do? Try on your own, try IVF, get a 2nd opinion?

I'm really sad you didn't get good news today. But don't give up hope yet! You definitely still have options, even if they currently aren't the options you thought you had. STC is so tough, because it is always about adjusting your mindset to cope with the hand you are dealt. But I have faith that you WILL be a momma someday.

[Gwenn]

He didn't think the lining was all that big a deal. The lightest it's been has been 4mm, and he says he has had many patients conceive with 3mm or even less, so in his opinion I should be able to conceive with a 4mm lining. He was positive about letting me try femara, though, but wants me to wait to let the clomid find its way out of my system.

DH and I, given our preferences, would go for IVF - but financially that is not an option at the moment. One possibility is DH volunteering for deployment and putting his earnings straight into savings - but I'm not so sure I can handle that right now. We'll have to see. My mother has been eager to help financially with the IUIs - I know she can't swing IVF from her savings but I want to talk with her and maybe we can come up with a savings plan between the two of us. Just so much to process.

[ktbelle97]

Yes, you definitely have a lot to think about. I will be cheering you on as you try on your own for right now! How long would your DH have to deploy? A year? That's great that your mom is so willing to help! It is so nice to have family in your corner helping you out as you go through a tough time.

[Gwenn]

I'm really not sure about DH - he is looking into several different options, none of which I really like. We'll see. I love having family in my corner, but I don't want to ask to much of them either so it's a balancing act. I hate it.

[tanyachap]

I feel crying for you too. That's too much to take in. Do you think it is worth getting a second opinion? In any event, yay for a kitty

[Gwenn]

There is another RE here in town - that is always an option on the table as well.

[beanpop]

There is another RE here in town - that is always an option on the table as well.

That's what I was going to suggest. Get a second opinion. Fu-- this guy and his negativity. Of course he wants you to do IVF because he'll make a hell of a lot more money that way.

Big hugs to you honey. I'm so sorry.

[handsdown]

Fu-- this guy and his negativity. Of course he wants you to do IVF because he'll make a hell of a lot more money that way.

Big hugs to you honey. I'm so sorry.

I was just stalking and saw this thread. I am so sorry that this RE seems to be giving up so soon and telling you to move on to IVF. From how negative he sounds it reminds me of the first RE that I went to. This guy didn't listen to a word I said and told me my whole problem was how much I weighed. I wasn't that bad at the time, I was a size 14. He told me he wouldn't do anything for me until I lost 10 pounds. I ended up going back to my OB and using Femara with timed intercourse and got pregnant with my first DS. When it was time to TTC for Grayson I went straight to the other RE in town and it was like night and day. My weight was not mentioned once. We had male factor and unexplained with me so we went right to injectibles with IUIs. The 2nd RE & I just jelled better, he didn't seem to push me to the most expensive option right away.

I hope you do decide to get a second opinion. From the people I know that have STC they haven't needed to move onto IVF unless there is a major reason like male factor, low ovarian reserve, etc.

[Cosmosmom]

big Mandy. Seems like maybe giving femera a try while saving for IVF could be a good option. Do they have any of those shared risks one that you could qualify for? Like they give you so many tries and if it didn't work, you get most of the money back? Would there be a tax break if the medical bills are more than a certain percentage?

Oh and I would definitely want to get a second opinion. His thoughts on lining concern me a bit and I'm not sure why he would not want to try to give progesterone. I didn't even see an RE, it was an infertility clinic and they tested my progesterone more than once.

[Songbird_kay]

i would for sure get a second opinion before making any big decisions from here. Sorry you had a rough day

[Gwenn]

No, there is no shared risk option through this clinic so far as I know. He did send me home with a thick "IVF packet" that so far I haven't had the inclination to read through. There may be more details in there.

I can't make up my mind about him - he's very aware of research studies and keeps his own data of all his patients. He's definitely a "numbers guy" and the scientist in me loves that he is data-driven. On the other hand, he says some things very off-handedly that are different from what I hear in here - but always seems to have something to back it up (at least will cite a study anecdotally - I haven't seen any of the studies he refers to myself). So I just don't know if he's full of BS for all I can tell. My instinct is to trust him, though, and DH's is, too.

[ktbelle97]

My two cents, FWIW.... if you get a 2nd opinion at least you have covered all your bases. You may end up staying with your current RE if you decide you like him better. If it were me, I would, at least before spending all the $ on IVF. I agree with pp about the lining and progesterone concerns. I would ask the same questions of both docs and decide which one makes more sense to you. Thinking of you as you sift through it all!!

[Ourou]

Oh, Mandy. It sound like its time for a stiff drink or at least a nice hot bath. I remember the day we found out IVF was our best option. It completely blind-sided us both.

Take care of yourself, and I hope you soon find peace with the situation and whatever option you choose.

[Gwenn]

Thank you.

[TripMomma]

I would for sure get a 2nd opinion.
I think your lining could be an issue even if he does not...big difference between 4 and 10 (my lining when I got PG with Jericho) I would think anything under 7 is a problem.
I also did 6 IUI's...last 3 on Clomid to get the triplets. When we went back for our 2nd pregnancy Clomid wasn't doing the trick, so after 2 failed cycles (1 IUI that didn't work and calling off an IUI because of poor follies) we did injects and got PG on the first try. Are you doing ultrasounds and trigger shots? OPKs have never worked for me...my first 5 fails were because we were just using OPKs to time my IUI, timing is very important with IUI's.
I think your RE needs to run through some more meds before he just hits you with IVF or adoption. In the end he works for you, so if you want to go with injects and more IUI's I don't see how or why he would tell you no.

Wanted to add I really think your lining was an issue...everywhere I have seen it discussed said 7 is the MIN...with 10-16 being the best. Clomid can cause lining issues, injects cause less of a problem.

[Gwenn]

Yes, we did Clomid, ultrasound monitoring, and trigger shot with all 4 IUIs. First IUI, 4mm lining, 3 good sized follies, good sperm count, no pregnancy. 2nd IUI, 6mm lining, 4 follies, sperm count of 160+ million, did conceive but it ended in a chemical. 3rd IUI, 6mm lining, 1 follie and triggered at the last minute. Did not get pregnant but the whole thing felt rushed. Last IUI, 4mm lining, 4 follies, good sperm count, no pregnancy. So the only cycle that everything was where it should be I did conceive. And he has no idea about my progesterone.

[TripMomma]

I would try again, switch to injects and take Estrace to help thicken that lining, if 7 is the very min they want to see you haven't even hit that it could very well be the or at least a big part of the problem. Injects doesn't have to mean multiples, look at me triplets from Clomid and a singleton on injects. I would do a low dose like I did and monitor often. If he won't do as you wish, find someone that will. Good luck!

[Shannon214]

I would try again, switch to injects and take Estrace to help thicken that lining, if 7 is the very min they want to see you haven't even hit that it could very well be the or at least a big part of the problem. Injects doesn't have to mean multiples, look at me triplets from Clomid and a singleton on injects. I would do a low dose like I did and monitor often. If he won't do as you wish, find someone that will. Good luck!

I agree with this completely. 4mm is not considered an acceptable lining at my RE, anything under 7 is iffy. You can respond beautifully to Clomid and only wind up with 1-2 good follicles even with injects. I responded with 2-4 mature follicles to every round of Clomid, and I only had 1 mature follicle with injects (75iu dose of Gonal-F). I would get a 2nd opinion based on the fact that he thinks 4mm is acceptable and didn't supplement with estrogen or test your progesterone after.

[Gwenn]

I really appreciate your experience and advice. Thanks.

[Krystal5]

Oh honey... I know we don't know each other, but it sounds like we are in the same boat. I'm on my 4th IUI, and everything has failed. It worked the first time for my first try, though, so this has thrown us for a loop.

I respond REALLY well to Clomid, too. 50 mg gives me 2 - 5 eggs, so my doctor doesn't want to switch to anything stronger. But, I am on estrogen for my thin lining- my doctor tells me 8 is minimum. So, I am with Katrina on this one, I think it could be a big issue (though it hasn't helped me keep a second child, but we are also dealing with male factor).

But my doc is very laid back. Basically, if I ask for it, I get it (within reason, of course). I love that about her, I hope that, if you do look for another doctor, you find one like that.

I have quit trying for now, but will probably take up the battle again in a year or so. I imagine it will only make things harder, since I'll be a year older (and probably a year less fertile), but I need time to heal from my miscarriage...

Anyway, I don't have much advice to give you, but I do have a lot of hugs and sympathy for you. I'm so, so sorry you are going through all this.

And yay for a kitty!

[Gwenn]

Thanks and to you, too. Emotionally I'm just thrown for a loop right now and it sounds like you are in a similar place. Definitely take the time you need to heal.

[SweetTinkerbelle]

I'm so sorry...I would definitely get a second opinion.

[Yellow]

sounds like a tough appointment. I think maybe a second opinion might be helpful for you. I would be uncomfortable with your current RE's opinion on your lining issues and his resistance to at least checking your progesterone levels. But you need to do whatever you and your DH feel is best....and we are here to support you in whatever that may be. I would say that I think you should take a few days to really think over what was said before you both decide on what the next step is, it will give you some time to get over that shock factor and be able to be more objective.

I am sorry you had such a hard day....but hope the new kitty thing works out for you!

[fourgulls]

I am sorrry Gwenn. I agree that injects should be an option for you. I always responded well to clomid but adding the injects really increased my odds. I wish no one had to go through the pain of infertility and am sorry this road has been so rough for you. Many kind thoughts coming your way.

[The J Team]

I agree with pp that you should try to get a second opinion. A fresh set of eyes and a different perspective can't hurt. Also, check out financing for IVF through capexmd.com. That's what we used- no way could we ever have done it otherwise. Good luck!

[Cosmosmom]

Mandy I am thinking that the lining could be a problem. Everything I keep seeing suggests that it should be 7 or greater. I sent an article via FB that looked like it had good information.