Fertility Clinic Appt next week- what to expect?

ctnj · May 2009

My first appt with Duke Fertility Clinic is next week- can you tell me what to expect? I'm going b/c of my irregular cycles. I have already talked with the doctor on the phone and anticipate going on Clomid or Femara. Just curious what to expect! Thank you!

alchris · May 2009

Have you been charting? Do you have a diagnosis?

I would be sure to take your charts and to have done your research as far as these two meds. Personally, I had quite strong opinions about them -- they are different indeed!

Some doctors are more quick to prescribe than others, but IMO you want to have all of the testing done that you can before starting meds. I'd ask for an HSG and an SA if you and DH haven't had those. You'll also want to have some bloodwork done, depending on what you had done with your OB, and possibly an ultrasound as well.

Best wishes!!!

ctnj · May 2009

I've had some bloodwork done to look at Thyroid, Prolactin and SSI and it all came back "normal." The doctor is a family friend and basically said based on cycle issues I have an "ovulation problem." We talked about Clomid but he is willing to prescribe an alternative, which I'm probably more interested in trying first.

I chart, but he did not seem to care about that too much!

I HATE bloodwork. Oh well- guess I'll get over that- ha!

alchris · May 2009

Yeah, you'll likely be having a lot of bloodwork done! It's worth it though -- it can tell you so much!

That worries me if a doc doesn't want to see your charts. Charts can tell you SO much! Bloodwork is done on a single day, whereas charts show what your body is doing over time, and since it's all based on cycles, over time is key! Are you having a period? If so, cycle day 3 is a great time to have bloodwork. And about 7 days after you ovulate is the best time to check your progesterone to confirm that you ovulated. I can guarantee you that without my charts I wouldn't have my daughter; if I had listened to my first RE I would have totally shut down my natural cycle. (He wanted me to take progesterone in the first half of my cycle, not believing that I actually had a cycle since I wasn't menstruating, but I knew that was wrong and I waited 2 weeks! It was still a few more months before I got pg, but at least my cycle was regular that whole time b/c I hadn't messed with it just as I was about to ovulate for the first time.)

The reason for the HSG is that it'll check if your tubes are clear. The best ovulation in the world won't get through blocked tubes, so taking meds doesn't help unless you know you're all clear. Similarly, your DH will need an SA, since if he's having issues too, fixing just you won't get you to your ultimate goal, so I wouldn't take meds yourself until you know he's been checked out first. Meds are meds, alas, so I wouldn't take them without knowing they have good potential to help. Some doctors hand out meds like candy though...be warned. Fortunately Duke should monitor you with boodwork and ultrasounds once you start meds.

Until then, keep charting, take your charts with you, and I recommend requesting an HSG and an SA before preceding any further. Estrogen, LH, FSH, and progesterone are all useful bloodwork, especially if you can time them well.

Again, good luck!

802Forever · May 2009

i totally agree with the PP. I think it is completely careless of a medical professional to prescribe body/hormone altering Rx without a proper work up first up. My MD reviewed 12 months of charts, I had (tons) blood work throughout my cycle, and DH had a SA before we were put on Femera.

Femera is known to have less side effects than Clomid, lower twinning/multiple rates and also has a way less half life. I think any safe practitioner would want all of these things for their patients. that being said, having just finished my last round of femera - I had plenty of miserable side effects, so I would hate to have gone through all of this if I hadn't really needed it.

Best of luck.

Oh, and how long have you been trying? Charting? I wouldnt trust that just b/c your periods are irregular or absent that a prescription will fix it. Many couples have issues on both male/female sides and it would be a shame for you to go through all that the body goes through on these medicines if your DH has a problem as well.

alchris · May 2009

I hate that 802forever had miserable side effects on Femara. Most of us have no side effects from it other than ovulation!

The half-life was a huge selling point for me, along with clomid's effects on uterine lining. Clomid has a lot of nasty side effects that affect nearly all women it seems. My first RE wanted to prescribe clomid because "it has worked for 30 years." Seriously -- that was his reason. But even before starting Femara, I'd insist on everything mentioned above.

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