Had 1st appt w/ new RE today

IBackBevo · April 2013

He was referred to me by the Fragile X Clinic as being an "expert" in FX-POI. He is also (besides being an RE), an MFM and an REI. He is on medical faculty at Baylor College of Medicine. I see why they referred me to him...he did a year fellowship (or something) in genetics at Yale Med School.

Basically, he didn't really seem to have any new insight into the Fragile X/reproductive issues other than what I already knew. So I guess the research I have done over the past two years has pretty much covered my bases.

He did say that the undetectable AMH and especially since it had gone from being 0.54 to undetectable in 1.5 years was an indication my fertility was going downhill fast. He explained that even in women with normal fertility they continue to have menses for about 5-6 years even once their ability to conceive has ended...which I knew. So, I guess, it is similar even for those with undetectable AMH...it is an indication my fertility is declining quickly. He could not say whether it would be a year or two or give, but he felt like waiting more than a few months to try would not be advisable.

He also did not recommend IVF because of my undetectable AMH and low AFC (he did an AFC and it was 5). He felt like my best bet was Clomid/IUI. He basically said with my stats, the success rates were no better for IVF than they were for Clomid/IUI so it would be more economical to go Clomid/IUI...plus, I had success with it before.

I also questioned him about the IVF freezing idea. He felt like at best I might get 1 to 2 embryos a cycle that would make it to the point of being able to freeze (day 5) at and I could get none...and then they may not make the thaw. . So, basically, he felt like I would probably have to do multiple rounds of IVF to get a decent number to freeze and have for later...and even that was very risky. In other words, he felt like it would be a lot of money, putting me through a lot for what was at best only a "shot."

I will say this about him that I really, really liked -- he CLEARLY was not all about the money because he was advising me of the most economical routes as opposed to pushing IVF on me.

I think after hearing all this DH is more on board with the idea of not waiting..and I am, too.

The doctor also said that I have no greater risk of Pre-e now then I would waiting. He said ideally I should wait a year due to the C-section, but he said that given my stats that sort of goes out the window.

He was encourage my FSH is (currently) normal. He seemed to think AMH usually goes down before FSH...I had never heard this before so it was an interesting take and would explain why there are a lot of women with low AMH's and normal FSH's...which seems very common on this board.

Edit: Another thing I liked was that for an initial appointment (which lasted about 1.5 hours and an ultrasound, it was only $308 cash pay...at my old RE's office, this would have probably been $600!)