I don’t even know what to say…
Lets start with: I took Mr. MLACS with me to a “WTF” appointment with Dr. Diet this past Friday–it was Mr. MLACS’s first time meeting the doctor. I went armed with a list of questions and concerned (typed, with bullet points) and I made copies for myself, husband, doctor, and nurse. Here’s the document:
To re-cap, this was our first IUI with you, but our 5th IUI to date—our 7th medicated cycle (2 Clomid with TI + 5 IUI’s) and our 10th cycle since our last conception (a chemical pregnancy).
It is hard to accept that we had 2 spontaneous pregnancies but have now been unable to conceive since we began medical intervention 10 months ago. We wish we could understand what the issue might be, and here are some questions:
Does the fact that we haven’t conceived with these 5 IUI’s indicate anything? Or would you consider us “unlucky”? **We have done 2 “fresh” IUI’s with my husband present and 3 “frozen” IUI’s in his absence.
- Answer: “You’ve only done ONE IUI with me, so I can’t really say–it is possible to be ‘unlucky'”
- I haven’t conceived since I began Remicade infusions (began the day I found out I was pregnant) during our chemical pregnancy. Do you think this is a coincidence or a factor in our infertility? My last infusion was October 24th, 2013.
- Answer: “There is very little research on Remicade in pregnancy, so I can’t say.”
- Is it possible that my elevated testosterone is hurting my egg quality? I see that a lot of PCOS women conceive on Metformin—it would not be a great option for me given my gastrointestinal issues, but do you think it would help?
- Answer: “There is no evidence to suggest that Metformin improves pregnancy outcomes in the absence of diabetes. And results can be achieved through diet and exercise.”
Are repeated stimulated cycles hurting my egg quality? I know high levels of FSH can decrease egg quality. Could this be a problem for me?
- Answer: “No.”
Could this be an implantation issue? Do you think that my body is preventing implantation of fertilized eggs? I’ve always been afraid of this since my first miscarriage—when a high level of ANA’s were discovered post-miscarriage. Is my immune system sabotaging our attempts?
- Answer: “There are a lot of quacks out there who waste a lot of people’s time and money, when there is no evidence to suggest that any of this reproductive immunology actually improves outcomes”.
What can we do (tests, procedures) to find out what the problem is?
- Answer: “Hysteroscopy, Laproscopy–IVF is the ultimate way to get information about what the issues are.”
What is the likelihood that we will get pregnant from IUI? From IVF?
- Answer: “Hard to say, but ovarian response was great with this initial IUI cycle!”
And Dr. Diet was such an ASS. Like, full-on donkey mode. And…things went very badly from the get-go…
First, he has always treated me as if I have no f*cking clue about any of this process–he is condescending. He obviously likes to hear himself talk. And, he has this “tick” where he snorts and wrinkles his nose–this is distracting. So, it just became a bit much when he launched into how “ineffective reproduction is” and used a cod fish as an example, saying “A single cod fish lays 20 million eggs, so, if all those eggs fertilized we would be up to our ears in cod fish…” Like, WTF dude. We get it, not all of my eggs are good and the older the more my egg quality will decrease, because God forbid I should be procreating as an old lady. Why are you wasting our time with this ridiculous analogy? And furthermore, neither myself nor my husband need to see your f*cking chart detailing the decline of female fertility as she ages. Got it. NEXT. This, and so many other things, irritated and offended my husband, and I found myself trying to mediate between this blowhard doctor and my husband. The doc is from Jersey, my husband is from New York, and they were never meant to be friends.
I’m sitting here asking the doc “What do we do NOW?” and the doc is not giving me direction. He says we can do a laproscopy (which must be performed at the hospital) or we can do a hysteroscopy (which can be performed in his office). He says probably 40% of all women who walk in his office have endometriosis to some extent…but then he doesn’t seem overly interested in finding out if I happen to be one of them. And I said “Well, I don’t think I’d feel the urgency to do it before our next (last) IUI, but I would want to know what’s up so that it wouldn’t hurt our chances with IVF” and Dr. Diet says “Well you don’t need to worry about endo if you’re doing IVF, because IVF solves the problem” *This set off an alarm for me, cuz I’m like, but I would like to know if there’s sh*t in my uterus that doesn’t belong there, because it very well COULD make a difference in IVF*
And at that point, the doc switched gears and started “selling” IVF (after he had just sat there and told us that they are “not an IVF mill”). And the way he went about it was super shady. He used the name of a local family that has a lot of money and influence–I knew who they were but Mr. MLACS didn’t, nor did he care. When I asked Dr. Diet what our plan should be, he said “Well if you were the XYZ family, I would say definitely IVF. But it depends on your time and resources…blah blah blah” Which ruffled Mr. MLAC’s feathers and he piped up “Well we HAVE the money”. And then after that the doc just went on and on about IVF. Which we were not ready to seriously discuss. And I tried to switch gears and go back to planning our next (final) IUI, but when I asked the doc how we might coordinate my menstrual cycle with Mr. MLACS’s work schedule, he thought about it and wrinkled his nose and was like “Well it will be really difficult to move your cycle up by only 2 weeks”. Which might be true, but when I first approached him about it at my initial consult he never acted like it would be a problem. Oh but now that he’s baiting us for IVF all of a sudden it’s a problem.
And the thing is, I asked the doc about the costs and my eyes got big when he said $8,000 to $10,000 for a cycle, because that is less than half of what I had suspected it might be (cuz I was so in denial that we might need it, I had never even googled prices). Because we most definitely CAN afford that. But then…there is no guarantee. And I asked the doc if he did the Attain program or something like it, and he wrinkled his nose saying that those programs are a rip-off for most people so he doesn’t participate (which may be true) but I’ve seen enough of my bloggers friends “fail” their IVF cycles to know that $8-10k DOES NOT promise us a baby. Not at all. And the doc was bragging about PGD and how we might want to do it…well I finally looked up the difference between PGD, PGS, and CCS. And PGD is really only useful if you are testing for a specific genetic flaw. We would want PGS or CCS, if anything.
And we were like “But what if we just want to do another IUI? Like, this month?” And the doc switched gears and said “Lets go do a scan to see if you have any leftovers (cysts) from your last cycle” and we reluctantly went into the ultrasound room. And the moment Nurse Cutie found my ovaries I was horrified to see that they were bulging with “leftovers”. So, we couldn’t do a cycle this month, even if we wanted to.
And then I’m thinking, me and Mr. MLACS would like to try naturally…but I have NO IDEA what my menstrual schedule will end up doing and no idea IF or WHEN my menstrual schedule might match up to Mr. MLACS’s work schedule to even allow for us to attempt to procreate without medical intervention.
And good ‘ole Dr. Diet piped up and said “Well you guys should do IVF in September! Take the summer off and enjoy yourselves” then he turns to me and says “And you can work on losing some weight!” Which just infuriates me because I HAVE BEEN working on it and I’ve lost a dress size since CD1 (just from the bloat) but he knows good and damn well that it’s impossible to lose weight during a cycle so it is SO unfair of him to point at me as though I haven’t been trying. M*therf*cker. It made me feel really self-conscious and patronized. I had made it very clear to him that I desired to lose weight, so why needle me about it at my “WTF” appointment on CD2? And what’s more I’M NOT OBESE. I’m 5’9″ and a size 12-14, with big bones and more muscle than a lot of men. I’m only 30-35lbs heavier than my fitness modeling weight, maybe 27-29% body fat (which is not good but it’s not obese). And I’m very fit. Oh, and in the last year I’ve battled chronic illness (hypothyroid, ulcerative colitis, lichen sclerosus, etc.), 2 miscarriages, and 7 cycles of fertility drugs. Not to mention everything else life threw at me. F*ck off Dr. Diet.
And then after the scan they handed us their “intro to IVF” packet and we met with the finance lady. And without ICSI or drugs or scans (which insurance covers our drugs and scans) a cycle would cost us $7500. Which just thrilled me! But also scared me. But I tried to keep my enthusiasm under wraps, as I sat next to Mr. MLACS and felt his anxiety, confusion, and anger…saw the sweat stains under his armpits (as this day their air conditioning was not working properly–old building–this does not make me want to give them my money). And of course I would not just go to this clinic for IVF without thoroughly investigating my options and what will best meet our needs, but…
I am 34.5 years old. It has been 16 months since my first miscarriage. I have done 7 medicated cycles, including 3 heavily medicated IUI’s with Mr. MLACS’s frozen sperm. His work schedule is keeping us from ttc’ing naturally. And he makes plenty of money doing what he loves, so… how long am I expected to keep beating myself up and living my life in anticipation of motherhood before he wants a child badly enough to accept the costs and risks of IVF? Because there must be a trade-off to this job, like the doctor said, “If you don’t have the time, but you have the money, then do IVF”. Well he doesn’t want to take a family-friendly job. And his job pays well. And ALL I WANT to do is be the mother of his children. So…
And this is where THE FIGHT begins…even before we left the parking lot…even before I opened my mouth to say a word…Mr. MLACS was on the offensive…
So do you know what’s worse than failing IUI #5? Stay tuned.