Conflicting Opinions from Doctors

Annie034 · November 2016

I’ve posted before about my situation…I’m on medication for PCOS and thyroid. My husband was referred to a urologist for severe MFI. In June, my RE told me if his counts went up, we could attempt IVF/ICSI. However-she didn’t believe they would and we would need to use donor sperm. After a few months of treatment with the urologist, counts went down (200,000) and motility went to 0%. My RE said our only option was donor sperm.

The urologist prescribed a new medication. We mentioned our RE saying donor sperm was the only option, and he seemed shocked to hear this, telling us he believes he can get the counts high enough that we may not even need IVF.

We decided to meet with another RE, and after reviewing our records, he doesn’t believe I have a thyroid issue or PCOS. He does not believe the new medication will increase my husband’s counts greatly, but said we could absolutely do IVF/ICSI-starting as soon as we feel ready.

Has anyone ever dealt with conflicting information like this? It’s hard to know what steps to take next when we’re being told so many different things.

Bababatty · November 2016

@Annie034 I'm sorry to hear about your situation. I can't speak to the advice you received, but my understanding is that REs are really more female-focused so their expertise in MFI is limited. Which is to say I would defer more to the opinion of a urologist on your husband's prognosis. Have you gotten a second opinion from another urologist? Does your current urologist specialize in fertility issues? If not, I'd definitely recommend getting an opinion from one who does. We did, and he just had a better overall plan for my DH than his regular urologist. Good luck!

JuliaAnn86 · November 2016

After getting ultrasounds, bw, and an hsg with my first doctor, he diagnosed me with hypothyroidism and PCOS (hubbys counts fine), He put me on metformin and told to me continue trying naturally and that I would have plenty of kids in time.

I eventually sought out another opinion. After an ultrasound and bw with him, he determined my thyroid dose was too low, and I did not have PCOS but Endometriosis stage 3, with endometriomas (cysts inside my ovaries). He did a hysteroscopy and found and removed 3 uterine polyps, discovered my left tube was blocked, that I had a stenotic(narrow) cervix and a retroverted (tilted) uterus. He believed this whole combination was possibly causing a decline in my egg quality and preventing my husband's sperm from reaching my eggs. He suggested we be aggressive and try IVF.

It was shocking to hear such a completely different diagnosis. I chose to continue with my second RE. He seemed much me knowledgeable and more proactive in getting to the bottom of my infertility issues. I had my transfer on 11/18 so fingers crossed it works.

Annie034 · November 2016

Our urologist does specialize in fertility issues. We've heard great things about him, but after 7 months it seems like we're actually worse off than when we started (lower count and no motility), so I'm frustrated and anxious.

JuliaAnn86- my fingers are crossed for you!

oxinfree · November 2016

You should be able to get enough sperm to fertilize using ICSI. I don't think donor sperm is your only answer if you really want to have biological children. I've heard of women who's husbands have almost zilch and they were able to be successful with IVF. I'm no doctor and they're the ones seeing the ins and outs of your chart, but if one doctor is on board with trying with DHs sperm, I would be inclined to work with them. I'm always cautious of docs wanting the easiest path just to save their clinic's outcome stats. Just my opinion, but something to be aware of. Big hugs.

KLake42 · November 2016

My clinic uses ICSI with frozen sperm, and with that, my doctor thinks they can do pretty much anything, even with terrible quality sperm.

Your first RE might feel that getting a good egg is challenging enough, that they don't want to face a sperm challenge on top of that. The second RE might just feel more experienced with sperm challenges.

On the other hand, the first RE might be more focused on getting a positive pregnancy, and the second RE might be willing to risk the challenge, so long as you're willing to pay.

It's really impossible to say whether the second RE is just better at dealing with sperm, or more willing to take a chance. But you should go with whoever your gut tells you to go with.

Conflicting Opinions from Doctors

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