Trouble TTC

I kind of feel like my RE is blowing me off a little bit. What do you guys think?

pinkdoggiepinkdoggie member
edited December 2014 in Trouble TTC
Good morning girls,
so this is my first month seeing an RE and I just have a few questions for you. My RE is monitering me and offering me different treatment options than my OB ever did, but she never took any bloodwork or asked about previous bloodwork. I didn't think anything of this at first, but I find it kind of odd, since even my OB took all my bloodwork. So...is this odd to you as well? I feel like I have ran around in circles already so I worry about everything. She also doesn't seem too interested in listening to my questions; of course she will answer them, but I feel like half the time when I'm trying to ask her questions, shes already halfway out the door and answering behind her shoulder. I don't know, I might just be being sensitive because I know she's really busy. But I also feel like since I'm paying OOP I should be getting the best I can. What are your experiences with RE's?
Me: 25 Dh: 25 Married since July, 2011
Diagnosed with PCOS 2010
TTC since December, 2011 (SA is Normal)
2012-tried natural w/Metformin 1500 mg
11/12 -Saw an OB, bloodwork revealed everything normal except for highish blood sugar levels
1/13: Clomid 50 mg - No response
2/13: Clomid 100 mg O'd BFN
3/13: Clomid 100 MG O'd BFN
4/13-6/13: Clomid 150/200 mg O'd BFN 
Stopped treatment because of money issues and began to try naturally again from June-October 2013
Benched until November 2014 - Started seeing RE, discovered that lining was very thin
November 2014: Started Femera 5 mg -No response BFN >:(
December 2014: Upping Femera, injectables are the next step if I respond 
Also: Changed RE, first appointment on Friday, so treatment is subject to change this month


3T December Siggy Challenge - Favorite Holiday movie scene
The Christmas Story

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Re: I kind of feel like my RE is blowing me off a little bit. What do you guys think?

  • I don't have too much experience, but if you already started medicated cycles with this RE I definitely think it's strange they haven't done any bloodwork.  My REs office seems to take blood every time I walk through the door.  I won't lie, I'm not even sure what they're testing half the time, but I know they stick me!  I have CD3 and mid cycle bloodwork as a minimum with all monitored cycles.

    As for the RE not taking the time to really address your concerns that would bother me too.  I hardly even actually interact with me RE (and not at all right now since she's out until January), but rather various members of the team manage all the monitoring appointments and what not.  I only saw the RE during my diagnosis, pre and post op and then any WTF appointments.  That being said, she's always made herself extremely available to me via phone and email whenever I've had questions.  It's possible the RE just doesn't have a great bedside manner, but how is the practice setup?  Are there a lot of clinical extenders (NPs and PAs) who handle the routine stuff so the docs have more time?  That's how mine is.

    Sorry for the disheartening experience.  This is tough enough as it is.  The last thing you want is to feel unsupported by the doctor.

    Me: 31 (PCOS) possible right tube issues DH: 36 (SA normal) 
    Started dating in 2006, Married 2012 
    TTC since November 2013 
    First RE visit due to irregular periods: June 2014
    Lap/Hysto to remove polyps, cyst and tube blockage 11/6
    Cycle 1 (Dec. 2014) TI with Clomid, Trigger, & Progesterone CX due to no response
    Impatiently Waiting CD1 to try again with Fermara Back on the bench due to giant cyst,
    who know I'd ovulate on my own after a cancelled cycle and end up with a mega cyst :(
    All Welcome
     
    image
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  • I'm so sorry. You'd think REs would be among the doctors with the best beside manner! I wonder if your nurse is going to be your main point of contact during treatment. A lot of ladies only see the RE for initial and WTF appointments and if any surgery is necessary. Otherwise, it seems normal for the nurse to be the go-between for the RE and the patient.


    It does seem quite odd that they're not doing the bloodwork though. Did they receive your records from your OB office? Perhaps they feel like your OB did all the necessary testing and want to hit the ground running? I'm not saying that's the right way to do things, but its a possibility. I would think an RE would be more thorough than an OB, so its strange your RE isn't adding or redoing tests. My OB ran a bunch of tests before I was referred. My RE wanted to redo some tests and added some more, but didn't need to redo other tests.

    Me: 28  MH:35

    Married September 2012. TTC since September 2013

    June 2014 - Dx w/ significant PCOS and referred to RE.

    July/August 2014 - Testing complete: Testosterone & AMH very high, FSH slightly high, Vitamin D low, tubes and lining all lovely. DH SA: A+

    Cycle 1 (Nov 2014): 2.5 mg Letrozole/Ovidrel/TI = BFN

    Cycle 2 (Dec 2014): 5 mg Letrozole/Ovidrel/TI - BFN

    Cycle 3 (Jan 2015): 5mg Letrozole/Ovidrel/TI - BFN

    WTF consult scheduled for 1/29

  • I agree with PP that it's extemely strange that your RE hasn't done bw. My office is definitely on the lower end in terms of monitoring (for IUI cycles they don't do CD 3 or mid cycle bw, just betas and they did one progesterone test after I asked for it), but they still did a whole host of blood tests before they began treating me (like, honestly 12 vials). If they hadn't done that they might not have discovered that I have an under active thyroid, which I am now being treated for. There are so many important things to look for in blood work, I would definitely ask your doctor for specific reasons why she isn't ordering any, and/or push her to send you for it asap.

    Me: 27 DH: 35

    TTC #1 Since July 2013

    Started RE Testing July 2014

    2 HSG tests: Right tube is blocked, possible endo.

    TSH elevated, started Synthroid 25 mg daily.

    October, 2014: Femara 5 mg + TI ---> 3 follies on blocked tube side ---> BFN

    November, 2014: Femara + Ovidrel + IUI#1--2 follies (on the good side), 46 mil. motile sperm=BFN

    Nov-Dec 2014: Femara + Ovidrel + IUI #2 (1 follie, 76 mil. motile sperm) + Endometrin=BFN

    January, 2014: Femara + Ovidrel + IUI #3 (1 follie, 38 mil. motile sperm)=???

    New RE appt. scheduled for 1/14.


    3T January Siggy Challenge: New Years Resolutions

    Mine: Lose the weight I put on from booze and cookies over Christmas.

    image


  • Thank you ladies, I knew I should have went with my instincts on the first appointment, I am definitely going to be thinking about finding a new RE. I did just buy my fertility meds though (which were a little bit expensive) so do you think I should just hang on to them and change or stick out one more month with her and demand b/w as you guys suggested? I feel like I am lost in the woods right now as far as thi treatment stuff goes.  
    Me: 25 Dh: 25 Married since July, 2011
    Diagnosed with PCOS 2010
    TTC since December, 2011 (SA is Normal)
    2012-tried natural w/Metformin 1500 mg
    11/12 -Saw an OB, bloodwork revealed everything normal except for highish blood sugar levels
    1/13: Clomid 50 mg - No response
    2/13: Clomid 100 mg O'd BFN
    3/13: Clomid 100 MG O'd BFN
    4/13-6/13: Clomid 150/200 mg O'd BFN 
    Stopped treatment because of money issues and began to try naturally again from June-October 2013
    Benched until November 2014 - Started seeing RE, discovered that lining was very thin
    November 2014: Started Femera 5 mg -No response BFN >:(
    December 2014: Upping Femera, injectables are the next step if I respond 
    Also: Changed RE, first appointment on Friday, so treatment is subject to change this month


    3T December Siggy Challenge - Favorite Holiday movie scene
    The Christmas Story

    image

  • I agree with Ketchup. I think that you should definitely be having some kind of blood work. Every single time I go I have blood work done. Also if you feel that your RE isn't giving you the time that you need try to be your own advocate and stand up for yourself if it continues consider getting a new RE. I never deal with nurses at my clinic. The RE does all the ultrasounds, meetings, questions, etc. I know all clinics are different but you are definitely entitled to having someone care about your questions and concerns.
    Married: 12/15/2012    TTC: 08/2014
    Husband: 26 SA: normal
    Me: 23 Low AMH and damaged ovaries due to chemotherapy.
    No AF or O in 3 years. HSG showed a slight T shaped uterus.

    High Risk OB 9/29- got the ok to get pregnant.
    RE Appt:  10/28/ U/S showed follicles, but also small damaged ovaries.
    B/W results CD0: all normal except low AMH at 1.3
    Cycle 1-November (TI)- Femera 2.5mg, 2mg Estradoil, and Trigger=BFN
    Cycle 2-December (TI)- Femera 2.5 mg ,4mg Estradoil, and Trigger= No O
    Cycle 3-January (TI)- Femera 5 mg, 2mg Estra
    doil, and Trigger=


  • I'm so sorry for your experience so far! Could you look for a new RE? I haven't been to my first RE appointment yet, but it's disappointing that they are treating you the way they have!

    Me (31) & DH (29)
    Dog Momma to 2 labs
    Married: September 2010

    May 2012 Officially TTC; 5/2014 cervical scar tissue removed from cervical dysplasia surgery 10 years ago; 9/2014 DH's SA low by WHO standards, but deemed OK by doctor; 9/2014 low progesterone CD21 (3.3); 11/2014 HSG ordered and 5 mg Letrozole prescribed


  • I'm sorry you encountered this experience, it's already stressful enough having to deal with IF and not having a doctor thoroughly hear your concerns is disheartening and frustrating.

    When I saw my 2nd RE he redid bloodwork my old RE conducted, and for the monitoring appointments, bloodwork is 99.9% drawn. CD3, at monitoring u/s appointments, leading up to IUI to make sure the meds are working and I'm not overstimming. I agree with the ladies, look for another RE. Can the meds be refrigerated until you meet with the new RE? 
    image
    3T January Siggy Challenge: New Years Resolutions 
    TTC since 10/2010 (Rhythm method since 2007)

    Me (33) Sept 2012 - DX Low ovulation/progesterone, Luteal Phase Defect. HSG 5/2012: both tubes are open, cervix and lining look good;
    September 2014 DX Hashimoto's; November 2014: PCOS IR

    ***
    DH (37) Sept 2012 SA Normal; October 2014 Mild MFI count 42 Million, Motility 36%, Morphology 2%. Clomid 50mg,
    ***
    2004 Cyrosurgery, LEEP
    May 2012 - HSG Clear; June 2012 - Appointment with RE
    July 2012 - October 2012 - Clomid 50mg W/ TI & Progesterone 3 mature follicles- BFN
    January 2013 IUI #1 (900,000 post wash) Clomid 50mg, TI & Progesterone 2 mature follicles - BFN
    February 2013 IUI #2 (1.3 Mil post wash) Clomid 50mg, TI & Progesterone 4 mature follicles - BFN
    March 2013 IUI #1-3 (2.5 mil post wash) Clomid 50mg, Baby Aspirin (lining thinned) TI & Progesterone - 2 mature follicles BFN
    April 2013 Benched due to cyst, May 2013 WTF appointment
    June 2013 DH SA mild MFI break for 2 months to re-test; August 2013 - DH SA 36 Mil count, 36% Motility, Morp 2%
    September - December 2013 - Mental sanity Break
    January 2014 - IUI #4 switches to natural due to scheduling conflict Femara TI & Progesterone - 1 mature follicle - BFN
    May 2014-June 2014 - DH Appointment w/ Urologist to check Bi-lateral Varicocele; 2nd opinion w/ another urologist - bi-lateral varicocele dx is slight no surgery
    July 2014 DH starts clomid 25mg daily SA 53.8 Mil count, Motility 37%, Morph 3%;
    September 2014 DH Repeat SA after being on clomid for 3 months 42 Mil Count, Motility 36%, Morph 2%
    October 2014 Me: Hashimoto's DX, DH taken off clomid;
    November 2014 Me: new RE PCOS IR Diagnosis
    December 2014: IUI #4 Follitism 75iu 7 days, TI, IUI & Progesterone, BFMFN

    January 2015: IUI #5
    Gonal-F 75iu 7 days, TI, IUI & Progesterone, Another BFMFN onto IUI #6
       image

  • Thanks you guys, I'm so glad I found this community. I am looking around now at RE reviews. It sucks because the next closest RE is nearly an hour away, but oh well. Whatever it takes right? ;)

    Me: 25 Dh: 25 Married since July, 2011
    Diagnosed with PCOS 2010
    TTC since December, 2011 (SA is Normal)
    2012-tried natural w/Metformin 1500 mg
    11/12 -Saw an OB, bloodwork revealed everything normal except for highish blood sugar levels
    1/13: Clomid 50 mg - No response
    2/13: Clomid 100 mg O'd BFN
    3/13: Clomid 100 MG O'd BFN
    4/13-6/13: Clomid 150/200 mg O'd BFN 
    Stopped treatment because of money issues and began to try naturally again from June-October 2013
    Benched until November 2014 - Started seeing RE, discovered that lining was very thin
    November 2014: Started Femera 5 mg -No response BFN >:(
    December 2014: Upping Femera, injectables are the next step if I respond 
    Also: Changed RE, first appointment on Friday, so treatment is subject to change this month


    3T December Siggy Challenge - Favorite Holiday movie scene
    The Christmas Story

    image

  • Wow, I'm so sorry! I'm sure our RE must be super busy too, but he never lets me feel like he is. He speaks patiently and checks that we understand, gives us numerous opportunities to ask questions. I would not accept the kind of treatment you're getting, when it's a combo of terrible manner plus lackadaisical testing and treatment. A doctor who doesn't remember your name? Crazy. Our RE has pretty much memorized our chart - last time we had a WT.. appointment, he was able to discuss a comparison of every bit of data from our 4 medicated cycles, included sperm counts, lining and follicle measurements, ovulation days...he knew way more than I did. That's pretty much what I'd expect from someone who is that much of a specialist. Everything is important, and I want to know that he is analyzing our best options even more carefully than I try to.

    To me, it would be worth the extra hour drive. Still, since it's so far, I might give the current RE one more chance - have a sit down and say what you expect and what she needs to do to earn your confidence.
    January 3T Siggy Challenge - New Year's Resolutions
    image
    imageimage

    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
  • I will echo everyone else that the lack of bw is weird. even when just getting a second opinion with another RE who had my paperwork I had to do bw, like 10 vials worth. Bw is part of monitoring and part o f any meaningful assessment of your case. I would ask questions before switching practices altogether, especially since the other office is far, but you should feel confident in asserting yourself here. GL

    Official diagnosis: Unexplained IF. I am 32. I have low ovarian reserve (low AMH), and poor egg quality. I've also been diagnosed with mild glandular developmental arrest (lining problems, detected with EFT).

    We are using open ID donor sperm. IUIs #1-7=BFN. IVF September 2014 antagonist protocol, 8R,5M,3F, 5 day transfer of 1 morula = BFN. IVF#2 planned for January 2015 (antagonist protocol + HGH).

    Image and video hosting by TinyPic image

  • emmuffy said:
    I will echo everyone else that the lack of bw is weird. even when just getting a second opinion with another RE who had my paperwork I had to do bw, like 10 vials worth. Bw is part of monitoring and part o f any meaningful assessment of your case. I would ask questions before switching practices altogether, especially since the other office is far, but you should feel confident in asserting yourself here. GL
    Thank you. I gave myself plenty of time (two weeks) to think about just confronting her or changing altogether. It's a hard decision when it comes to your reproductive health because you don't want to wait anymore and you don't want to risk it either. *sigh*.
    Me: 25 Dh: 25 Married since July, 2011
    Diagnosed with PCOS 2010
    TTC since December, 2011 (SA is Normal)
    2012-tried natural w/Metformin 1500 mg
    11/12 -Saw an OB, bloodwork revealed everything normal except for highish blood sugar levels
    1/13: Clomid 50 mg - No response
    2/13: Clomid 100 mg O'd BFN
    3/13: Clomid 100 MG O'd BFN
    4/13-6/13: Clomid 150/200 mg O'd BFN 
    Stopped treatment because of money issues and began to try naturally again from June-October 2013
    Benched until November 2014 - Started seeing RE, discovered that lining was very thin
    November 2014: Started Femera 5 mg -No response BFN >:(
    December 2014: Upping Femera, injectables are the next step if I respond 
    Also: Changed RE, first appointment on Friday, so treatment is subject to change this month


    3T December Siggy Challenge - Favorite Holiday movie scene
    The Christmas Story

    image

  • I suspect my RE is a vampire with the number of times a cycle I get blood drawn.  And my very first visit I had a full blood make up done - it was like 4 vials.  You are right to question the lack of tests!
  • I am glad you decided to look into seeing a new RE, even with the extra drive time. I agree completely with what everyone else has said. There is no excuse for him not doing due diligence with your blood work. And, dismissive or indifferent doctors should not be tolerated. I was in the same situation (and it sounds like a lot of other ladies have been too). I understand that doctors are busy, that isn't the problem, but they need to treat you like a patient and not an inanimate object. When I started seeing my RE it was like a breath of freaking fresh air. She spent an hour and a half answering questions at the initial consult, and personally called me on the phone when an issue came up. When I am not dealing with her directly, I am in contact with her nurse, who is compassionate and effective. It's a 3 hour drive for us, but it is soooo worth it. Not everyone has the same needs when it comes to their interactions with their RE, but if you are not comfortable with the treatment you are getting then it isn't the right place for you. I hope either that your old RE gets his act together or that you find a new place that is perfect for you. Good luck :)
    ****SIGGY WARNING****

    image





    TTC since May 2013

    Me: 31, blocked tube
    DH: 35, azoospermia :(
    IUI #1 (50 mg Clomid, Ovidrel) on 9/7/2014: BFN
    IUI #2 (100 mg Clomid, Ovidrel) on 10/3/2014:
    BFN
    IUI #3 (100 mg Clomid, Ovidrel, Estradiol) on 11/1/2014: BFN
    First RE appt. on 11/11/2014
    November 2014: Benched due to cyst :(
    IUI #4 (5 mg Letrozole, Follistim, Ovidrel, Crinone) on 12/26/2014: BFP!!!
    Beta 1 (1/9/2015): 292     Beta 2 (1/12/2015): 843


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