1st RE Appointment Today!

renbee · January 2014

So I have my first appointment with the RE this afternoon. I am anxious, but excited to get some answers from someone who really knows what they are talking about! DH has a snow day today, so now he gets to come with me, which is good.

Want to hear something crazy though? We had dinner with some friends of ours this past weekend, and found out that the doctor we are seeing is the same doctor that their good friends are seeing. The good new? Their friends love this doctor. The crazy news? Their friends just got pregnant with TRIPLETS on clomid. They were being well monitored - they just decided to go for it on a cycle with 5 follicles because it was their last shot before moving on to IVF.

Anyway, a couple questions. I just started my provera-induced period yesterday. Will they still do any exams/ultrasounds? My other question is about DH - he is very squeamish when it comes to medical stuff, so I would like to have him go to the waiting room for the exam parts of the appointment. Will that be weird/unusual?

Thanks for letting me be an AW about this!

ashtownyeah · January 2014

I don't have any answers, just wanted to say good luck!

mockingjay1 · January 2014

I just wanted to wish you good luck today! Someone I work with had triplets with clomid too (monitored, had 4 follicles).

I'm not sure what the answer is regarding ultrasounds/blood work, but I don't think there is anything weird about your DH leaving the room during your exam if that is what makes him/you guys comfortable. That would be more important than what is "normal" to me.

Jpinky9 · January 2014

I have no experience or advice to share but I really wanted to send you lots of luck!! Fingers crossed it all goes well!!

nikiz628 · January 2014

Good Luck today!!!

mander82 · January 2014

I can't really help with your questions, but wanted to wish you luck and FX for you getting some answers !! Not sure how you feel about twins or triplets, but I always thought it would be awesome

renbee · January 2014

WhoCanItBeNow said:

I would run the fuck away from an RE that would sign off on triggering with 5 follies. That's not acceptable.

You have to have an ultrasound every cycle on day 3, so no, that doesn't rule anything out. And it's highly unlikley they will do much more than that. Due to the timing of your cycle, they might do your CD 3 testing. Maybe.

It is a consult. You talk. And it's a good thing your husband is there because he has to be set up as a separate patient for his tests and they will need his medical history and that of his family.

Yea, it definitely concerns me. I'm also not 100% positive that is the actual story, since I was hearing it second hand. I will definitely be asking him some hard questions about it! DH and I are hoping to wait a few more months before considering clomid, both because we are completely OOP, and because I am working to get healthier to see if that can regulate my cycles naturally.

Irishcurls · January 2014

mander82 said:

I can't really help with your questions, but wanted to wish you luck and FX for you getting some answers !! Not sure how you feel about twins or triplets, but I always thought it would be awesome

Oof sounds like my fucking nightmare. My BFF just gave birth to identical twins conceived naturally and she had weekly ultrasounds and an enormous risk of placental rupturing. A real picnic.

TJD12 · January 2014

No advice here, just wanted to wish you good luck!

Pintobean39 · January 2014

My first appt was just talking and bloodwork for myself and my husband. I was on CD3 so they started testing. My second appt I was on CD1 and he had a plan for us so we decided to start and I had more bloodwork and an us. If your husband is uncomfortable with something he can just walk out. It's not a big deal.

KrissyLeighN · January 2014

Good Luck! I think they may do CD3 testing and transvag ultrasound.. my husband was there at all my appointments and it's been fine, it is nice to have the support.

Re: multiples, when discussing various possible treatments they can do (prior to learning my dx), my RE did mention Clomid, and at that point he openly admitted that with that comes risks - one being multiples which takes pregnancy to a higher risk. If your RE blows over multiples, or doesn't even mention it, that would be concerning. If you don't have many REs in your area it makes it tough to be choosy, but see how you feel with him/her and come back with any questions.

Siamese253 · January 2014

Yeah, it's lots and lots of talking plus an U/S. It's nice having your DH there because men have some strange ideas about how babies are made. Having a doctor explain it to him will save you the trouble of trying to convince him how important timing is later.

Also, my bloodwork and DH's SA were done at later dates, and for that matter, at different locations. I don't know if that's normal.

I would really try and get him to stay in the room for the U/S. It's not like he's standing next to the doctor looking at your vag, he'll be right beside you and the doctor will explain what you're seeing on the screen. For us this was important because my preliminary diagnosis of PCOS was during the U/S (later confirmed by bloodwork) and if DH wasn't in the room he would have missed the whole conversation.

I third the comment about running the fuck away from this RE though... go in, talk to him, get the testing done (and get copies of everything!!) then make an appointment with someone else :P

BabyCowbell · January 2014

No advice really, but good luck!

sunlavender · January 2014

My first RE appointment was mainly discussing medical history. I did not have a physical exam, although I was mid-way through my cycle at the time.

I think it's great that your H will be able to go with you. Good luck.

colacrock · January 2014

I just want to say good uck to you today and I wouldn't worry about DH going to the waiting room. I'm sure he's not the first person to be squeamish about these things and he won't be the last!

renbee · January 2014

Thanks so much for the advice and support everyone! We'll see how it goes - if he doesn't have a satisfactory answer about his approach to monitoring and the risk of multiples, I'll be looking for a different doctor.

LokiTTGP · January 2014

I doth speak from experience. Thou doth not want a multiples high risk pregnancy. Have three babies. None of whom are awake or wake each other at the same time. With one child you get little to no sleep. With three sleep is a distant dream.

nswain85 · January 2014

Can't offer up any advice but wanted to wish you lots of luck!

renbee · January 2014

NariaDreaming said:

Aaren91011 said:

Thanks so much for the advice and support everyone! We'll see how it goes - if he doesn't have a satisfactory answer about his approach to monitoring and the risk of multiples, I'll be looking for a different doctor.

Good for you for advocating for yourself. I can't see any responsible RE signing off on an IUI with that many follies, but I can absolutely see a couple going home and triggering on their own and doing TI after a cancelled cycle.

My RE just talked to me about that yesterday since they upped my injects dose and at this point my ovaries are either going to do nothing or a whole lot of something all at once. Before we started cycling we had to sign off on a patient waiver stating that we understood the risk of HOM pregnancies, and that if we chose to ignore the advice to cancel a cycle and to trigger+TI against medical advice that they would not be held liable.

From the (again, second hand) story I heard, this might have been the case.

ETA: And @LokiTTGP re: multiples...

mander82 · January 2014

ok, maybe awesome is not the word for it. I don't know anyone that has had twins or anything...I just thought it would be neat to have 2 and be done. my bad, my bad

renbee · January 2014

So I just got back from the appointment, and I was not impressed. I just really did not get a good feeling from this doctor. He was very rushed and almost seemed like we were bothering him. He at least confirmed I have PCOS, and begrudgingly gave me an ultrasound when I asked about it.

He agreed with our plan to wait three months and see how I respond to metformin and lifestyle changes, although he said I only have a 30-40% chance of ovulating on my own so will most likely end up needing clomid. He also recommended that I take Pregnitude, which I am really not sure about...need to do more research on that.

Then the red flags. When I asked about monitoring that they did on Clomid cycles, he said that I would take the pills CD3-7, and then sometime around CD10-13 I would come in for an ultrasound, and if everything looked good I would trigger. I asked about bloodwork, and he said something like "if you want we could do bloodwork afterwards to test your progesterone levels and see if you ovulated". So no CD3 bloodwork/ultrasound, and apparently he doesn't think it's that important to make sure that I actually ovulated. Yikes.

Then I asked about canceling cycles for too many follicles. He said that he would cancel if there were "more than 5 follicles". Which apparently means if I have four or five he would risk me having quads or quints. Double Yikes.

I also asked about having an HSG, and he brushed it off, saying there was nothing to indicate that I needed one, and if I didn't respond after 3 clomid cycles he would maybe have me do one.

So all in all, the only good things I got out of the appointment were a confirmation of the diagnosis and a prescription for the extended release metformin to make it easier on my stomach. We're going to check out a different RE in a couple months if I don't start ovulating on my own.

tl;dr version - I am running away screaming from this RE because he doesn't properly monitor clomid cycles and wants me to be Aaren + 8.

joshua+rebecca11 · January 2014

Yikes. I'm glad you got some answers, but I hope you find a better RE in the next couple of months. Hopefully you will ovulate on your own and won't have to worry about it though!! Good luck!

Edit: spelling

Pintobean39 · January 2014

@aaren91011. I'm sorry you had a bad appt. Maybe you can keep looking and find one that you are comfortable with. That's crazy about the HSG, I don't understand wait 3 months. My RE made me get one even though we pretty much knew my tubes were open because I had 2 back to back pregnancies. My RE told me he just wanted to cover all the bases even though he pretty much knew there was nothing wrong.

renbee · January 2014

WhoCanItBeNow said:

If you trigger, there is no point in a P4 test. Some do it anyway, but it's kind of a moot point. Without CD3 labs and an ultrasound, how the hell did he confirm PCOS?

Sucks that he sucks, but at least you knew to run away. Definitely give the met a try, it may help, and see if the other RE's give you a better vibe.

Good to know about triggering and not needing a P4 test.

I've already had CD3 bloodwork from my gynecologist to diagnose me. He looked at it and said I was textbook PCOS so no need to do more bloodwork - don't know why my gynecologist was so unsure about it. He did give me an ultrasound today and again saw "textbook" PCOS string of pearls and enlarged ovaries.

I was talking about doing CD3 bloodwork/ultrasound during a clomid cycle to check for cysts. He doesn't do that - I thought it was part of best practices for a monitored clomid cycle.

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