update from the first appointment… really, really long

This will be TMI and boring for most of you, but I know some people are interested in all things infertility and IVF related, so read what you want, skip the rest, it’s up to you.

We had the big appointment yesterday and several hours later, walked out the door with smiles on our faces, bursting with confidence in our new team.

We were originally scheduled for a one-hour consultation with our new doctor, plus infectious disease screening (blood draw) for both of us (required in the EU). The one-hour appointment plus blood draws turned into several hours.

Our new doctor is fabulous. He had already looked over my chart and the medical records I sent in, so he had a lot of questions for me. I was really impressed with the questions he asked and some of the peculiar, medical aspects he picked up on. Of course the first and most obvious question was why in the world did they let me do back to back cycles (IVF and FET). I didn’t want to get into the entire story and tried to give him quick answers about needing to transfer the last two embryos because of the possibility of leaving without much notice. He seemed really interested in the Belarus situation, so he and my husband had a nice chat about “our life”.

Then it was back to business, he’s concerned about the autoimmune issues and it’s highly probable that the autoimmune issues caused the miscarriage of the triplets. He said that in addition to the aspirin and Medrol I was taking to suppress my immune system for the first IVF, that I would definitely be on daily heparin injections, another med, and probably intralipid therapy. Apparently IVIg is being phased out at most clinics, news to me.

In August I’m having a saline sonohysterogram, so he can look at my uterus. He wants to be sure there are no fibroids, polyps, or a septum. He said that while the quality isn’t great from the HSG films I had in Minsk, that he wasn’t going to repeat it. Depending on the saline sonohysterogram, he might do a pelvic MRI and/ or laparoscopy.

After meeting with him, we were introduced to his IVF nurse. She is just lovely. Her clinical skills are excellent and she has such a warm, bubbly personality, yet is also serious when she needs to be. She explained all of the blood tests the doctor ordered and started explaining the IVF process, then said, “Never mind, you’re already a pro”. Not something I want to be a pro at, but what can you do. She took blood from my husband, took several vials from one of my arms, taped me up and then realized she needed another vial for something else. She felt really bad, but it wasn’t a big deal, I'm quite used to blood draws and needle sticks by now. She even made a joke about how much blood she had taken, again, love her personality.

They are doing all of the usual blood work for a standard infertility workup, IVF preperation, AMH, infectious disease screening, and a full autoimmune panel that’s being sent to France. Depending on what the lab in France says, they will take more blood and ship it to a lab in Chicago, which is apparently one of only three labs in the world that does some particular type of test. There’s also something being sent to Belgium, but I can’t remember what it is. The same day in August that I’m having the saline test, my poor husband will do another SA, in addition they are doing a sperm DNA fragmentation test. My new doctor is quite the detective and wants all of the answers before we do IVF again. I really like his approach. I liked my RE in Minsk too, and I firmly believe that he took excellent care of me, given the limited equipment and medical infrastructure he had available. I don’t regret starting treatment with him and will be forever grateful for the time and care he provided me.

Back to the current situation, I’m having some additional blood work done at my GP's office this week and at the hospital next week, since it will be less expensive.
::shakes fist at insurance for lack of infertility coverage::
If all goes according to plan (not that it usually does in my life), I’ll start IVF meds in September. Speaking of which, for the first IVF I was on Diphereline injections for suppression, basically a European version of Lupron. Apparently there’s a nasal spray available. I was REALLY excited for about a minute, nasal spray versus shots, sign me up. Well, since my body seems to choose every way possible to fail me, I’m not a candidate for the nasal spray because of the amount and seriousness of my allergies, nice huh? Oh well, I was expecting the shots anyway, not a big deal.

So, that’s what I was up to yesterday. I’ll update as things progress, until then there will probably be a lot of recipes, cat pictures, and randomness on the blog.