For number one: The RE or team of REs where I went for my first IVF worked in a big hospital with a lot of bureaucracy, paperwork, departments, divisions and little communication internally to ensure there was a continuous continuum of care for the patients. I hated that environment. Furthermore, they had a nearly one size fits all approach to treating infertility with a standard IVF protocol for everyone without truly looking at other factors with the person. It was like being in a kitchen - "Okay, we'll put you on a little of this and a little of that and then we'll check you in three days and hope for the best!" I quickly learned that's not the type of care I want. If I'm paying out of pocket for these services, there is a quality of care I demand and advocate for...
For number two: The new RE believes I may have diminished ovarian reserve. He realizes that there is a reason why I didn't respond to the dosage of medication and that it isn't always as easy as amping the meds up...but what is causing the underlying issues? No one has ever connected those dots. Plus, we had an interesting conversation about how my thyroid disorder and my spleen enlargement - all diagnosed in 2008 - may or may not be related... At this point, we don't know for sure. But, I was interested in learning more.
For number three: Have you ever heard of a AMH test? Interested in learning more? Here it is:
AMH (Anti-Mullerian Hormone), also called MIS (Mullerian Inhibiting Substance) is produced directly by the ovarian follicles. Women with lower AMH have lower antral follicular counts and produce a lower number of oocytes. AMH level testing can also be very useful for young women who want to postpone childbearing, but want to check their fertility potential before doing so.
It is as simple as a blood draw and I'll find out next week. I had heard about this test two years ago, but it really wasn't the standard practice and it wasn't pushed or encouraged. This was the first thing the new RE wanted to do...so I had my blood drawn before I left the office today to check it. I look forward to the results. Good or bad, at least I'll know. If it's bad, we won't pursue IVF because we don't want to walk down the donor egg avenue. At least we'll have some answers.
Next steps: Unfortunately, my old RE didn't send my stimulation report to this new RE and I couldn't remember (I know...sad...) the dosages of the meds I took. As such, and with the results in hand from the AMH, we're going to meet again for a follow-up consultation in two weeks. He wants to order several more tests depending on how this goes. So, the next appointment is on Feb. 16.
He also suggested that I take the following in the meantime...
- DHEA - 50 milligrams (DHEA is now used worldwide, benefiting thousands of women every year who, otherwise, would have had no choice but to resort to egg donation.)
- C0Q 10 - 100 - 200 milligrams (A study reported in the September 2009 issue of "Fertility and Sterility" by researchers from the Toronto Centre for Advanced Reproductive Technology looked at the role of CoQ10 in improving egg quality in female mice.) Interesting huh?
- Back on a multivitamin
I like this doctor because he shoots strait (funny analogy for an RE).... he's realistic. He said, "Listen, if these numbers come back and the tests show you have diminished egg reserves, I will recommend you don't move forward with IVF unless you have donor eggs. I will be honest with you whether you like the answer or not." I like that... the other place would simply say, okay, let's try round two...and three and four. He's thinking thoughtfully about me...and my condition...and my infertility - not just infertility.
Doing a little research last night, I found this body of information that sounds like what he's interested in pursing...
Doing a little research last night, I found this body of information that sounds like what he's interested in pursing...
So, that's where we are. Any questions? Any experiences to share? Let me know...still soaking it all in right now... :-)
Interesting appointment. I never knew there could be a connection between an enlarged spleen, thyroid problems and DOR. I hope your AMH levels give you some answers. And whether it works or not, I agree with how important a great clinic is. When we got on that roller coaster i am glad one of the best REs in the country was at the helm.
ReplyDeleteBest wishes getting some answers and making decisions.
I can't believe they didn't test your AMH, that's one of those basics! My first clinic was also like your first clinic. And for many people that one size fits all approach does work... however it doesn't work for many as well.
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