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A good RE will make appropriate reccomendations depending on your diagnosis. They want to make sure that they have the best possible outcome for you, as well as for their business. They'll usually start out with the simplest treatment and go from there. Depending on what the issue is though, more aggressive treatment may be necessary. (for example, prescribing Clomid and TI to the woman with blocked tubes isn't going to do anything, but for somebody with weak ovulation, it might be a good start.)
As for us, we knew that I had issues going in, so we started with acupuncture and TCM before we even started TTC. We then moved on to progesterone supplements. Finally we saw a new RE (because we'd moved since we had TTC our DD) and had a complete workup done. Again. Turns out we're dealing with severe MFI now as well, so she reccomended that we move directly to IVF/ICSI. Even though that's what she reccomended, we didn't do that right away and sought treatment for the MFI first.
In the end, the level of intervention is almost completely up to you. Your RE can make reccomendations, but if you're not comfortable with something, then you can decline it. Likewise, if you want to be more aggressive, then your RE will go over the pros/cons with you about that as well. (Like talking you out of transferring 8 embryos in an IVF cycle or something . Just sayin' is all.) A good RE will make a plan together with you, rather than dictate what is going to happen with your body. Educate yourself on what your test results mean, ask relevant questions, and speak up for yourself, and you should be fine!
Me: Autoimmune (Hashimotos and Fibromyalgia), vitamin D and calcium deficiency. Treated with Synthroid, supplements, TCM and acupuncture.
DH: Severe MFI (low counts, low motility, poor morphology and high antibodies), likely caused by poor liver function. Treated with Clomid to increase total counts.
DD: Conceived after 1 year of TTC with progesterone to correct LPD (likely caused by undiagnosed thyroid dysfunction). Born Aug 2009 via c/s after an induction due to pre-e and HELLP.
TTC #2 since Oct10 with an early loss in Aug 2011. Post-wash counts are too low for IUI to be successful, so moving on to IVF/ICSI in May 2014!
IVF/ICSI #1 (May 2014): Estrogen priming and antagonist protocol, including acupuncture and prayer!
17/05/14 - Baseline looks good, start Gonal-F 225iu and Luveris 75iu
28/05/14 - 18 eggs retrieved, 14 mature
29/05/14 - 13 fertilized!!! All are looking great still on day 3, so we're going to blast!
02/06/14 - Transferred one 1BC blast, with 3 other blasts and 3 morulas to watch and freeze
03/06/14 - All embryos have arrested. None to freeze
09/06/14 - Faint BFP at home at 7dp5dt!!!!!
10/06/14 - Beta?
My RE, whom I finally fired, pushed IVF pretty much from the start, and blew off most of what was wrong with me. So.... yeah. I'm waiting on Tricare to give me the go ahead for another RE. Until then... good luck!!!
~ * ~ * ~ * Always believe that something good is going to happen * ~ * ~ * ~
I went in with a plan in mind and we kind of met in the middle.
I have found them to be willing to compromise for the most part. I have never been told no. But some have been more agressive than me while some less.
Wow that was helpful huh?
I have deal with REs 2x with my boys and now dealing with an OBGYN this time around so that's why it seems so vague. All in all I have had a good experience (hated one RE but loved his NP and only dealt with her) with all of them.
Do research and get an idea of what you think should be done. offer that up and see what they say. I feel a good Dr won't get worked up by you educating yourself and offering up ideas even if they come from Dr. Google
Due with #3
10 IUIs= one confirmed /IVF= BFN / FET= / FET2= Baby! My blog
I had to push for it, but I was going to an OB/GYN at the time. He only did clomid IUI's without trigger or bloodwork. I had to Push him to let me trigger. I felt like the IUIs were not timed well (he wasn't open on Thurs or weekends!) - So we moved on.
I think it's obviously a truly individualized process and if you don't feel like things are going well, or how you want them to go, you'll know...and you can take steps to finding a new Dr or clinic that will be a better fit.
I do take supplements, EPO, Maca, Vit E, Bee pollen/propolis/royal jelly, baby aspirin, prenatal, b-complex, CoQ10 and d3 to help with Egg quality.
Best of luck to you!!
__________________ TTC#1 since 10/2006, 5 failed IUI's, 1st IVF successful BFP!! Baby Girl 2/2011
TTC#2 BFP 9/2011, Natural Pregnancy! 3/30/12 M/C'd on 5/15/12 (9 weeks)
IVF#2 BFP 4/2013 M/C 6/2/13 (8 weeks)
FET #1 BFP 8/2013 - Chemical Pregnancy
IVF #3 - Retrieval Oct 31st, Txferred 2 on 5d - a Blast and Morula - Chemical Pregnancy
IVF #4 - ER scheduled for 4/4/14 retrieved 4 eggs. Txferred 3 embryos 4/7/14!....BFN...NOW WHAT?
Check out my NEWBORN Hats and Baby Items
For the most part I just went with what my doctor wanted as she seemed to be increasing treatments appropriately. Unfortunately we can't be as aggressive as I would like because of finances. I did push a little to switch from Clomid to Femara as Femara isn't something she normally prescribes. Thankfully I'm friends with her daughter who has similar issues, and the daughter had been taking Femara with a different doctor. She switched to her mom and convinced her to give her Femara so then I just had to call and say hey can I have Femara now too? So that worked out pretty well.
I had to push for everything and with my ob he was so clueless with my suggestions and kept saying there were no need for that. Then my Re wanted thousands of dollars b4 he even ran tests to c what's wrong. I've been on clomid n femara with progesterone for about 3years.
My first RE pushed for IVF right away because of my age. We went ready and wanted to try other things. The office was cold and I could never talk to someone when I needed to and the RE always made me feel like doing less aggressive treatments where a waste. So I fired him.
Moved to second RE who did want to try a couple of things but also agreed IVF was out best option. He totally waited for our time frame though and wasn't pushy and gave us the personal touch we needed. We are now doing IVF and hopefully a BFP and we can put all this behind us. Well not you guys of course just out painful journey.
Good luck to you - this is as much a medical journey as it is an emotional journey. In my mind, both have to be lined up the same for each cycle and procedure.
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