Infertility Is Successfully Unraveling Me (Part 1)

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.

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48 thoughts on “Infertility Is Successfully Unraveling Me (Part 1)

    • Yes, I am not feeling compelled to explore IVF with this clinic. Their 2011 stats were great–over 60% live birth rate for >35 yrs old. But their 2012 stats sucked–under 50% live birth rate for >35 yrs old. But I would do another IUI. Xoxo

  1. 😦 I’m so very sorry to hear all of this. Ugh. Your doctor makes me angry, so I can’t even imagine how you are feeling!!! I’m sorry that you and hubby were arguing. TTC is such an emotional process for everyone involved. Please know that you’re not alone. I’m sending lots of hugs your way!

  2. Wow. Your post has me feeling so angry on your behalf. How stressful. And what an A**! No wonder you feel like you’re unravelling. I’m so sorry. Sending you virtual hugs. xox

  3. I’ve got to say this so please dont get too offended but my personal experience has been that RE’s are not “typically” people persons. PERIOD. Dr. D is an ass. No two ways about it. WTF with the cod fish?! Really? We got the “some times your ovaries throw black marbles and some times white ones you never know which cycle is going to be a good one but the odds go way way down the older you get…”

    The bigger question is can he get you guys pregnant?! Would you want him to? How is the lab? Would you go straight to a frozen cycle where you can run genetic testing on day 5 embryos or a fresh cycle given how young you guys are? I think there’s good reason why IUI’s are capped at 6 attempts and IVF cycles at 3. This doesnt mean that more attempts wont work but it really may be time for you guys to explore your IVF options. Yes you are young. Yes the cost doesnt seem too crazy out of hand. You may also want to consider a hysteroscopy (WITH DYE) before your next IUI. (Dont recommend the lapro unless they really think you need it to see what’s happening) Just the hystero with dye to ensure that your tubes are open and everything else is looking good. IVF does “solve” at lot of the infertile issues that can be harder to track down and treat. You should look at the nationwide stats for lovely ladies your age I think they are super nice numbers! And yes there’s no one guaranteeing you a baby at the end of the cycle but even after one cycle you’d have much more information about what could be going on. How many eggs retrieved? How many fertilized – you guys dont have to ICIS if that’s a concern!! How many made it to day 3 – day 5? Rated? CCS results…You get the picture. Nothing is exact about this science!!!! Oh how I wish it were different. You may also want to talk with the finance office about “banking” and what that would look like. Then you may have more to test and more to freeze. Maybe it is time for some down time for you guys. I am not sure that I want to know what is worse than failing IUI #5 but I can only look back on our path and think that IVF isnt as scary as I thought it was going to be. I am routing for you both!!!!!!! Sending much love and support your way!

    • I’m going to lean on you, my friend. I know you went to CRA and their stats are great, prices fair, plus I have a friend (or two) I could stay with in Denver. We are not nearly ready to commit, but I have begun to research. XOXO

      • I really liked Dr. Swanson! He did my first retrieval and I wish I had known he existed. But they dont let you switch Dr.s once you start with someone. You guys have stuck with IUI so at some point you’ll either get pregnant or on the same page with IVF. I just want to nudge you to consider where you’ll have the best odds of “having a family”. You dont need another 16 month stretch of meds and heart ache… but we dont know what the future holds. I am here even if you just need to sound ideas out into the ether!

      • I was going to write something and then I read what missingmotherhood wrote and agree with her 100%. The stats, the lab, and other things. And your age is a big plus. One round of IVF cycle really tells you a lot about your eggs, how they fertilize, if they make it to day five, etc etc. Yeah your RE sounds like one of those gods that exist in the RE worlds. They are condescending and think that they know way more than you do. You don’t have to go with him. But it may be a beginning for you to think about IVF being the next step. It really isn’t that scary, although I often have to take a break for a couple of months before I start the next one. I hope that you don’t ever have to wait for the in between period because it means that the first round has worked for you. And… I am so sorry about all the tension between you and your husband… This is such a tough journey.

  4. So frustrating!!! I got the same answer on Metformin. And lots of similar answers since I changed doctor twice.. sorry things are so hard. I wish doctors were nicer and better at the psychology part.. big big hug!! xx

  5. oh.my.word! How on earth did you continue to sit through the entire WTF meeting? The cod story? seriously? The tick? wowzas! I also did not like his answer to exploring possible endo. He says that IVF will solve the problem?! Is he ignorant a bit? I have three close friends who have endo (one is stage 4) with no other KNOWN problems and each of them have done four or five rounds of IVF. No baby. What ever happened to doctors wanting to find and fix the problem so that you are not always pumping yourself with man made hormones each time you want a baby? I also found it interesting that your doc starting selling you ivf. Mine did too once he learned in one of our WTF appointments that we had reached our 2500 deductible and all IVF meds, scans, etc would be paid for 100 percent by insurance. It’s all about the money for them. I’m so sorry your appointment did not go well and you didn’t get all of the answers that you needed :/ sending you hugs. xo

  6. I’m glad you use pseudonyms. I really want to punch Dr. Diet in his pompous nose!

    Aside from that, I *heart* you and am sending prayers. You deserve so much better than this.

  7. That metformin stuff is bullshit. Lots of PCOS women without diabetes have benefited from met. My RE is probably going to put me on it and I’m so relieved, because I’ve been asking doctors for it for two years now. Definitely get a second opinion.

  8. I hate your doctor. And I’m sorry this has been so tough on you. IF is really, really rough on a marriage. I do hope you’re able to have a true heart to heart with Mr MLACS and figure out what’s best for your family. And find a new RE.

  9. Oh hon, I’m just furious for you! WTF!! I think Dr. Diet needs to be fired. It sounds like he’s seeing dollar signs rather than the right solution for you, and even if it turns out that IVF is the right next step, his approach is just wrong! I’m so sorry all of this has taken it’s toll on you and Mr. MLACS. Big hug sweetie. The only positive I took away from this is the cost is reasonable. My insurance didn’t cover anything fertility related so after 2 retrievals for batching we had dropped over $30,000, but if your insurance covers all the meds and scans, that’s huge! Sending you strength and positive thoughts. I’m still rooting for IUI with fresh sperm, but if you decided to proceed with IVF, I pray you find the right doctor that will work with you, not just push you into costly procedures.

    • My real issue with the doc was that he was a pompous jerk! And he dismissed my questions. I feel like he doesn’t have the scope of knowledge needed to give me the best possible chance at IVF, given my challenges and concerns. But I would be willing to do another IUI with him despite my feelings toward him…except, I have no idea when or how we would go about doing another IUI. Thanks. XOXO

      • He does sound like a pompous jerk! I don’t blame you for wanting to do one more IUI before moving on to IVF. It seems like if things can be timed for the Mr. to be in town so you can do a fresh sperm cycle, it just might work. Praying for you hon!

  10. Dr. Diet could be the most decorated RE in the USA, but that doesn’t mean he is the best doctor for you. I am furious on your behalf. How dare he pooh-pooh your questions and casually suggest you enjoy your summer!! What a cock. And don’t even get me started on the weight loss comment…

    If you do go down the IVF route, I wonder if it is worth exploring other REs. I think it’s important you be listened to and treated respectfully. If you do cast your net wider, let me know if I can reach out to my network for a recommended RE in the tri-state area (or wherever you live).

    • We live in the midwest–bout 12 hours from Denver, so my first instinct is to go there (because I’ve got friends there and there’s CRA and CCRM) although Chicago is only 5 hours away (but I dunno anything about their clinics except that Dr. Kwak Kim is there and she doesn’t do IVF, just immunology protocols). So Denver or Chicago seem like the most likely places, although I’m open to suggestions to anywhere at this point. Thanks Lauren! XO

  11. Ok what is up with comparing you to a cod fish? I don’t know about this guy…. Saying ivf will solve the problem if you have endo raises some red flags for sure. Doesn’t he know that infertiles read everything we can find on the subject?
    I could totally be wrong but I get the feeling Mr MLACS has been coping by keeping his head in the sand and he’s not ready to face the ivf music.

    • You are not wrong–Mr. MLACS has been “bottling” his feelings about our ttc attempts/failures (as have I to a lesser extent) and Part 2 is about what happened when we both exploded.
      Dr. Diet says if you do IVF then it doesn’t matter if you have endo (as though placing the embryo in an endo-filled uterus is perfectly acceptable and will not affect pregnancy rates). XO

  12. Some of the things I read on American blogs about health care and IVF makes me sick. Medical attention shouldn’t be a financial burden and the way it’s ‘sold’ to you seems barbaric to me. Sorry to hear you’ve had the *hard sell*, TTC shouldn’t be marketable. Good news it’s less than you thought though xxx

  13. I’m sorry I missed commenting on this earlier. That is a horrible follow-up but reminds me so much of our our last two WTFs with our old RE (note “old”, as in former). I’m really sorry, I would feel like crap after that (not to mention the fight that ensued after it). Forget Dr. Diet!

  14. I am sorry I haven’t been keeping up to speed on everyone as often as I used to. Reading your post made me realize we definitely are in the same boat. If you move forward with IVF, I hope we can be cycle buddies in September (but deep down I hope we both mysteriously get knocked up naturally before then). Dr. Diet does sound like a dick, but we all know super nice REs are few and far between. Do you find you lose any weight when you are off the fertility drugs? I’m not sure if it’s the fact that I’ve been eating less, playing ball or just going off the drugs, but my boobs have shrunk and I’ve lost almost 5 lbs in 2 weeks. My body seems to be enjoying it’s break – from emotional eating and fertility drugs. My RE mentioned it to me once that I could try to lose some weight and then said “oh well at your size it doesn’t matter THAT much”. I’m also a size 14, but isn’t the average US woman one as well?

    • Ha! I feel like I’ve lost 10lbs since CD1, so, YES, those drugs surely do a number on me (as I have a tendency to bloat–I can easily gain or lose 10lbs of water in a day depending on what I eat, my activity level, and if it’s hot outside). And yeah, size 14 is average in the US. And I don’t even eat junk food. XOXO

      • Lol, mine were gigantic too for a hot minute–I just wish that my boobs were the only thing that “puffs up” from the hormones! Mr. MLACS commented how much thinner my face is–I bloat from head to toe 😦

      • Yes ma’am! Likewise, I had to buy “matronly” bikini bottoms to accommodate my ‘pseudo-bump’ (compliments of OHSS). And I anticipate I’ll need those bottoms at some point (hopefully for early pregnancy). XO

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