2nd opinion appt

Long time, no blog! You may notice that suddenly tonight there are posts in the last month that weren't there before. I've been typing them, but just haven't felt much like posting. Not sure why really, just wanted time to myself.

Anyways, I know some people were wanting to know how my 2nd opinion appt with Dr. M went today, so here is a copy of an email I sent to some.

Also the 4G4G thing I mention is a blood clotting genetic thing that we got back in some lab results last week.

The appointment went really well - we really really like Dr. Moghadam. He really took the time to meet with us (1 ½ hours), got to know us, went through our chart, showed us nifty diagrams on his laptop, made sure we really understood things, etc. It put him in a tiny rough position, just because until we met he hadn’t seen the history. When we sat down he said that we had the thickest “new patient” chart that he’d seen. :) There were definite things that Dr. S did that he didn’t really agree with, or thought was pointless. He doesn’t particularly care for the use of Repronex – says it’s “old school.” He also isn’t a fan of the European drugs. Now a lot of that was because Dr. S was trying to save us money, which we appreciate.

I really appreciated that he acknowledged (more than once) that we’ve been through a lot – we’re “pros” at it – we’ve “been through the ringer.” He knows that we’re not newbies at this and that starting at the beginning is not an option. Also, because of all that we’ve done, he knows that we’re not ready for more IVF. He thinks that waiting on the FET is a good idea too.

I think that he was honest with us. He said that while he would change the protocol and use different drugs, as far as egg count goes, he probably wouldn’t get a different response. I am what I am. He agreed that I’m a mystery. He does think that my egg quality is good, which is nice. My FSH was good and while the lab we used is really good – they can only use what we give them to work with. He was very pleased that we had 4 make it to blast. He did an antral follicle count (tiny follicles at the beginning of the cycle) and I had 12 total. That’s low. It means that for whatever reason I just don’t have the quantity of other people. So where’s the breakdown? He’s not sure. He ordered some more b/w (things I’ve had done before – but in Aug of 2007.) We’re too late into this cycle to do anything so it’s another break one (which is what we wanted anyways.)

He would like to try a combo of Femera (pill, like Clomid, that I’ve been on before) and Follistim (an injectable.) The Femera would be taken on CD3-7, and the Follistim on 6-10. I’ll have a baseline u/s and then go in around CD11 or 12 to see what’s going on. We can try on our own or an IUI. He sees a lot of success with this protocol. It’s not that it may develop more eggs, it just may all happen in a different way. If this doesn’t work, then he most likely wants to do a laproscopy. He said he’ll get insurance to cover it – I’m almost thinking I may call back and talk to him about doing the lap first. I can understand where he’s coming from though – he’d like to see for himself how I respond, what’s going on before he does more tests and digs in deeper.

He’s willing to code things like Dr. S – painful periods/whatever – so that insurance will cover what it can. I don’t think he’ll do it to the extent of Dr. S, but hopefully enough that we can actually go to him.

He’s not sure that he sees a huge reason for me to stay on metformin. He’s checking fasting glucose/etc levels but then might take me off of it. I’m not sure how I feel about that and really, he said he’ll leave it up to me. I guess I feel like maybe I should meet with an endocrinologist?

On the 4G4G gene thing, he doesn’t think it’s relevant in TTC, other than I need to take a baby aspirin daily. He does think that I may have to take daily shots (heparin?) whenever I DO get pregnant, so it’s at least good to know. I may make an appt with a hematologist anyways since the lab results recommended it and I’d feel better.

So I think that we will give him a try. He was so nice and knowledgeable and I feel like he’s more with the new stuff than Dr. S is. After we left though I got more and more depressed. He DID give us hope, but I’m still so frustrated that no one can give us what we want. Answers. I want to know what’s wrong, I want to know how to fix it, etc. It’s not his fault, I just don’t think anyone can tell us. So anyways, that’s my update!