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Thursday, April 11, 2013

Reproductive Endocrinologist

As I said last time, I was very hesitant to admit that there was something wrong with me, and couldn't figure out why my regular doctor couldn't help me get pregnant.

I knew seeing a RE would be expensive. Very few states offer infertility insurance coverage, and our state isn't one of them. I knew my HSA would be quickly wiped out and we would be left to pay out of pocket.

When I was finally ready to admit that I needed the RE, I made the appointment, and to much disappointment, we weren't able to get in to see him for months. We don't live in an especially rural area, but we also aren't a buzzing metropolis. There are a few doctors in our area, but this one is the best we have. He has an office where we live and another in Indianapolis, so he isn't always available. However, we are very fortunate in that his office is only five minutes from home. I've heard of lots of couples who have to travel pretty far to see their doctor.

For our first appointment we met with the doctor and discussed what we had going on. He looked over my medical records and the results of Josh's semen analysis and gave us his recommendations.

I was to start Metformin, Provera, and Femara.

I've said before that I have PCOS with absent periods. Two weeks before we were to see the RE my period decided to make an appearance. And in true form, didn't want to leave. The flip side (for me) of PCOS is a never-ending period. I'm all or nothing, people. By the time we got to this appointment I was on day 18 of (sorry, not sorry for this next part) extremely heavy bleeding. For example, Mr. P and I went to a movie after our appointment and I had to get up to go to the bathroom three or more times. It was horrible, and even though I knew the horrible side effects I get from Provera, I couldn't wait to take it.

The Metformin was prescribed to control my metabolic syndrome. I'm not saying it isn't possible, because I have lost weight before (hello, white wedding dress) but it is hard for women with my type of PCOS to take weight off and keep it off. The extra body weight adds to the hormone imbalances that make up PCOS and it becomes one of the most vicious cycles ever. Many women are prescribed Metformin as a way to lose some weight. I'm convinced that this only happens through the diarrhea it causes (again, sorry, not sorry).

Josh's only instructions were to not smoke his weekly cigar and to cut back on his nightcaps (and basically to not do anything at all he might enjoy), and to standby.

The RE wanted to use Femara because of the side effects I felt with Clomid. He was willing to start our first cycle right away and prepare for our first IUI. I was pumped. I just knew I was going to get pregnant. I even had my BFF on standby for a celebration recipe of cheesecake stuffed strawberries dipped in chocolate, because, you know, yum.

I started the cycle and was disappointed to find out that nothing happened. Not only did nothing happen, even less happened than would have if I had taken Clomid. Literally, nothing happened. I was down $1,000 and all it bought me was an extremely uncomfortable baseline ultrasound (you know they do those WHILE you're bleeding, right? Awkward.) and an extremely overpriced blood draw.

But, I needed to get pregnant, so we went for it again. I had a higher dose of Femara and just knew it was going to happen.

To make a long story short, it didn't happen that time, or the next. Or the next.

By the time my Femara chances were maxed out, I was desperate to try Clomid again. The headaches weren't that bad. I could handle it.

After our last failed attempt at oral medication, the nurse called me and suggested we consider IVF, and I lost my mind. I was mad, I was sad, and I was heart broken. I felt ripped off, and taken advantage of. I felt like my doctor was just trying to make money instead of doing what I needed. I was mad that I hadn't seen my RE once since our initial consult. I felt abandoned.

IVF is an amazing option, and an incredible opportunity for those who choose to use it. I don't have any religious reasons to not try IVF, but I've always known that it just isn't for me. I have lots of blogging friends who have had healthy and successful pregnancies through the beauty of IVF, but when I was told that I was at that point, I broke down.

In my mind I knew I wouldn't ever go that route, so it felt like the end to me.

I called the office back and told them that I couldn't do IVF. I asked the nurse to speak with the doctor about other less expensive options.

When she called back she said the doctor wanted to move to IUI with injectables. When she told me the cost, I knew we couldn't do it.

It wasn't so much the cost, because we could have made it happen, but it was the point. We have a lot of student debt already, and I began to consider what kind of life we would be welcoming our child into if we created even more debt for ourselves with fertility costs.

I asked the nurse to talk to the doctor about another Clomid cycle, and Josh and I decided if it didn't work we were going to take a break for a few months to reevaluate and gather funds.

That Clomid cycle didn't work, and I haven't been back to the RE. I don't think I have officially quit using his office, but (read this next part like Ross Gellar) we're on a break.

What is your relationship like with your RE?

1 comment:

  1. I'm on a break with my RE as well. I will go back if I randomly get pregnant, because he knows my history, but I'm done with the medicated cycles and trying. If it's not going to happen naturally, I don't think we're going to pursue anything else. I can't afford to. This adoption will eventually exhaust everything we have I think...

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