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Starting Over with the RE


Forum: Trying to Conceive with Medical Assistance

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  #1  
January 17th, 2012, 10:11 AM
mistletoe's Avatar Mega Super Mommy
Join Date: Dec 2011
Posts: 1,248
So tomorrow I go back to the doctor: same practice, at a major medical center, but new doctor. (Our first RE retired.) I'm a bit apprehensive. I'm basically going in and telling this guy: Your colleague really sucked and I hate this AI assembly line. So, I'm trying to prepare myself with exactly how to phrase what I want and how to counter any resistance.

We have Clomid Challenge blood work for me and DH's SA on file, also my annual pelvic exam/PAP smear, although the first RE never did a physical exam. (I know!) And there are notes from the one failed IUI. (We were diagnosed with "unexplained infertility" after the clomid challenge and directed to a clomid-medicated IUI.)

My plan is to say I'd like to start over with the fertility EVALUATION. Ask the new doc to evaluate our existing results, and explain to me what they say about my condition. Then ask not for specific tests (?), but ask him what additional testing he would consider to at least rule out specific common infertility factors. (And try again, this time with more firmness, to ask why he would not perform a particular test.)

I am trying to figure out phrasing. I want more information so that I can make better informed choices about our treatment and procedures going forward.

OK, I feel a little better just getting this down. Does anyone have any suggestion on both how to get the doctor to really listen to what you're asking for, how to have him take you seriously (and not like a hysterical lady)? And any specific things that you would bring up if you could construct a perfect first-consult with a new RE? Also, would it be useful if I listed some of our test results (which ones?) for you to better suggest questions or concerns I should raise?

Thanks.

Last edited by mistletoe; January 17th, 2012 at 10:19 AM. Reason: additional question
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  #2  
January 17th, 2012, 11:23 AM
Mega Super Mommy
Join Date: May 2011
Location: Chicago!
Posts: 2,426
I think you should just be straight with him. I mean he's either going to listen to you or he's not, so don't back down and make sure what you are looking for is heard. Be respectful and don't bad mouth the other doctor, but make sure that he knows you know your stuff. One thing that I would've asked if I could go back in time is what their typical treatment options are and how long they stay with one treatment. Meaning, are they a clomid doc office? Would they try Femara? Do they do injectibles only for IVF (like my RE)? I would just like a little recap of their ideal methods. Anyways, I really hope he's awesome and we get a very good update soon. Good luck!
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Always remembering our angel babies - 4/2011 (ectopic), 4/2012 (chemical) and
Angel Twins 5/23/14 (at 7 weeks 2 days)



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  #3  
January 17th, 2012, 11:44 AM
mistletoe's Avatar Mega Super Mommy
Join Date: Dec 2011
Posts: 1,248
Thanks for the support and ideas. (I need to add in the bit about timing -- when and why then's, -- which is sensitive given my age (35).) And yes, I will be tip-toeing around (ignoring) the whole previous doctor thing, and going with more of, I didn't come into this well enough prepared, would like to start over with a different set of eyes/perspective. Thanks again.
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  #4  
January 17th, 2012, 12:55 PM
kayakr's Avatar Persuaded by POAS’ers
Join Date: May 2011
Location: Midwest
Posts: 3,748
I would first begin with because of your age you would like a aggressive approach (if that is what you want). You do not want the same protocol as a 20 something year old. You're not looking at starting IVF next month or anything, but you wuold like to start right away with tests and proceedures that will get you some results or some answers as to why you haven't conceived yet.

What cycle day will you be in when you go? Because that would depend on what kind of proceedures they start you with right away. At bare minimum, you should have an exam, bloodwork and ultrasound regardless of what cycle day you are.
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Gretchen
Me (43) DH(33) 12 years together - ttc our first together-I have 14yr old DS
Cycles 1-6 = BFN
Cycle 7 SA results abnormal morphology 2%, 50 mg clomid = BFN
Cycle 8 sonogram normal 50 mg clomid + trigger = BFN
Cycle 9 SA results abnormal morphology and motility. Count 200 mill, 100mg clomid + trigger = BFN
Cycle 10 natural = BFN
Cycle 11 hsg tubes clear, natural + trigger+IUI = BFN
Cycle 12 repronex + trigger + 2 IUI = BFN
Cycle 13 natural ovaries to stimulated for more meds = BFN
Cycle 14-22 natural cycle with Acupuncture and planning ivf/icsi/DE = ALL BFN
Cycle 23 Clomid 50 mg & Progesterone = BFN
Cycle 24 Natural = BFN
Cycle 25 BCP, SA result 7% morphology = BFN
Cycle 26 BCP and Lupron preparing for IVF
Cycle 27 IVF Acupuncture, DE Retrieval April 7, Transfer April 12 =
7 eggs retrieved, 3 fertilized, 2 transferred - zero snow babies
BETA # 1 16DPO or 11dp5dt = 569
BETA # 2 19 DPO or 14dp5dt = 1078
BETA # 3 22DPO or 17dp5dt = 2414 TWINS!
BETA # 4 30DPO or 25dp5dt = 12,685 6weeks 3days 2 heartbeats! 114 & 116
Clayton and Colton Born @ 34 weeks 11/22/13
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  #5  
January 17th, 2012, 01:23 PM
ccartanddesign's Avatar With Faith
Join Date: Dec 2010
Posts: 997
I agree- be respectful and don't bad mouth the other dr. Be very fact-driven when talking to the new RE. I know its emotional but this dr. will write you off if you are emotional, especially about his or her partner.
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Me-38 DH-38. TTC #1 since August 2009
2/2011 - IUI + Femara + HCG trigger and Progesterone injection BFN
3/2011 - IUI + Femara + HCG trigger and Progesterone injection
4/2011 - not doing IUI - DH out of town
5/2011 - IUI with Femara and HCG trigger. In hospital due to infection from IUI.
Took a break from all meds this summer.
9/2011: - Start with new RE - testing begins.
10/2011: - Hysteroscopy - determine tubes are blocked.
10/2011 : - Laparoscopy - clip blocked tubes, determine right ovary is adhered to pelvic wall, cut adhesions
11/24/2011: IVF cycle #1 begins. Start stims.
12/2/2011: End stims. HCG trigger.
12/4/2011: Egg Retrieval. 9 eggs, only 1 embryo.
12/7/2011: Transfer.
12/20/2011: IVF #1 failed.
1/16/2012: IVF #2 first scan
"Humanly speaking, it is impossible. But with God everything is possible." Matt. 19:26
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  #6  
January 17th, 2012, 02:10 PM
Veteran
Join Date: Aug 2011
Posts: 165
I would say that you feel this new doctor is a better fit for you guys. When I switched RE's within our practice I stated that I wanted a fresh look and to see where my hormones and stats looked at the moment not from something 1-2 years ago. Our new RE was very much on the same page as us He was alot younger than our last RE and up to date on infertility. Many doctors just say oh your age you will have plenty of time.. or you are a bit older than most... and go down the path that does not need to be taken based on other cases. My new RE stated, " Although women's ages are the same, the genetics and make up are not. Each woman has their own problems and each fertility case is completely different. I wish I could say each case was the same it would make my job easier but that is biology. IF we were all the same there would be no need for doctors like me." I was completely amazed
When DH and I decided to stop treatments and head down the road of adoption, he referred a great agency to us and also gave us paperwork for grants for funding. He wrote a letter of character for both of us explaining our struggle. Ethically I do not know if he should have but he said it was the least he could do to help us have our family. HTH!
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  #7  
January 17th, 2012, 02:39 PM
mistletoe's Avatar Mega Super Mommy
Join Date: Dec 2011
Posts: 1,248
I'll be CD 11, but I wouldn't expect this place to be prepared to do many tests the day-of anyway. But I would like to get out of it better answers and a plan. I'd also like the doc to look over the blood tests and SA that we have done already and just talk me through them. Even if he says "normal," I want him to explain to me what that means.

I got upset the first time I met with my first RE, and -- like you say -- it didn't help my case with the doctor. So with your help I am trying to steel myself against the push-back that I experienced on that first visit. Thanks to all your experiences and information, I feel like I'm going back a much better informed and secure person.

And I wanted to clear-up my lack of writing clarity: I certainly never intended to criticize directly our past doctor, but by asking for a re-do, I feel I am implying that. (In dealing with doctors at other times for family members, I've hit the insecure "What's wrong with my medicine" doctor response when asking about complementary alternatives. SO I understand that doctors are people too and few people -- certainly myself included -- respond terribly well to even implied criticism.) So presenting myself just-so to avoid ruffled feathers is part of the nerve-wracking-ness.

Thanks again everyone!
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