Re-introduction and problems with my RE (pregnancy and loss mentioned)

kistra · June 2015

Hello, I found this board fairly late in our journey originally and was not here very long before we got a BFP. However, my son was found to have numerous congenital anomalies and passed away at 22 weeks and 3 days. My husband and I have decided that we are ready to start TTC again so we met with our RE to discuss a plan going forward. The discussion that we had just doesn't make any sense and I have lost confidence in our RE. For some background, we conceived our son by IUI with clomid and a trigger shot. He did have a genetic condition but my husband and I were both tested and we are not carriers, it was just a random mutation. We have seen 2 genetic counselors and both agreed there is a very low, <1%, chance of recurrence. However, when we went to see our RE to talk about moving forward and when we could do a medicated cycle again he pushed extremely hard to do IVF with ICSI and pre-implantation genetic diagnosis just in case another random mutation occurred. After checking with the genetic counselors again they were very confused because if another random mutation occurred it would have an equal chance of occurring anywhere and for PGD they can only test for the one specific mutation our first son had. I'm not sure why we would do ICSI either as we conceived by IUI the first time and the RE discussed that ICSI would increase our risk for certain genetic conditions. In addition, he was willing to start stim for IVF 6 weeks post-partum which made me uncomfortable as my OB recommended waiting 2-3 cycles for my body to recover since delivery was after 20 weeks. The RE pushed IVF with ICSI and PGD very hard but said if I insisted we could do more rounds of IUI. There is another RE in my health system that I have had several people recommend highly but she is over an hour away. With my job I dont know that I could do treatment there so it would just be going to talk. There are some months we could make it work but it would add a lot of stress to our cycles to go there for everything. I think I would feel better after the second opinion but at the same time I feel like we know the reasonable treatment is to do more IUI cycles with the meds that work and we are just wasting this cycle by waiting for the second opinion. DH more strongly wants to the second opinion and was freaked out by the conversation with our RE. If we don't go for the second opinion I could still call today to start treatment for this cycle. Thanks in advance for any thoughts you guys have I'm really sorry this comes up as just a block of text, it is in paragraphs on the edit screen...

GoldenKeys · June 2015

Welcome and I am so sorry for your loss.   I completely understand where you are coming from, and as an IF veteran I think that you are more able than most people to trust your understanding of your own body, your experience, your own research to make the final decisions over your treatment.

I am very doubtful about the wisdom of stimming so soon after a loss so far into your pregnancy.   My RE makes us wait for 3 'normal' cycles before trying again for any losses beyond 9 weeks. I'm also thinking that you already have your second opinion, which are your genetic counselors.

I understand that you don't trust this RE's direction, but the next available RE is a significant distance away.    Are you comfortable enough with staying with your RE if he will follow your lead with treatment?   Don't be pressured by anyone into doing anything that doesn't feel right.   In your place I would say no thanks to treatment until I felt my body was sufficiently healed, and then I would have the existing RE perform at least a few rounds of IUI before moving on to IVF/ISCI.

Bottom line is that it's your choice, don't let the white coat make you doubt your own wisdom about your fertility!

lifeislove87 · June 2015

@GoldenKeys wrote it perfectly, you are the expert in your own health care and you don't seem the type to be pushed over easily. Continue to advocate for your own health. Also, I'm sorry for your loss, take time to grieve and be kind to yourself.

kistra · June 2015

Thank you guys for the statements of support and trusting myself.

MKLEWIS2010 · June 2015

I agree with the previous posters I choose to go to an RE that's was 1.5 hours away from home and about 45 minutes away from work but I am happy there. It is a stressful commute and I have to get up very early to go to the doctor and then get to work on time they have early 730am appointments. I would at least check out the other RE to see how you like him/her. I know the commute might stress you out but also arguing with your current RE over treatment might also stress you out. If you meet the other RE you might not like them and decide to stay with your current. Good luck and I am sorry for your loss.

kistra · July 2015

I appreciate your thoughts as well. I am going to see the second doctor. I figure i will feel better even if we go back to the first doctor just to have seen the second doctor and heard their thoughts.

wbird · July 2015

Wow, that makes me sick. I also had an infertility clinic push IVF on us, and I fired them as well. It's turned us off of doing IVF, so we've only done two IUIs. I'm still at odds if this clinic set us back another year? Or if I should just suck it up and try to find another RE like you are. Good luck!

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