Tuesday, July 28, 2009

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.


  1. Hi there!! delighted to read your appointment went well! at my clinic (I have the feeling we may be at the same one) they have the same super-thorough approach as well. There's no point in undergoing treatment without all the knowledge on our side. I am currently doing the intralipid infusion, I was borderline on some preliminary immuno tests so the doctor said even without the Chicago tests which are quite expensive (yet 100% definite) he did recommend the infusions (3 of them are cheaper than the tests). And yes, most RE are moving away from IVIG as it had so many side effect it's currently used only in very special cases. The DNA fragmentation will also tell you alot, mostly if you can go ahead safely with IVF or if ICSI should be done instead. It's all go go go now for you, I'm very happy! If you need someone in Ireland to talk to about this you know I'm available! Love, Fran

  2. Fran, thanks so much for your kind words and encouragement! I would love to chat with you privately. Please contact me at the email address listed on the blog. We are quite possibly at the same clinic ;)

    All the best to you!

  3. Your new RE sounds really thorough and that's great!!! I'm glad to hear that the ball is rolling.

  4. Glad to hear the appointment went well, and I think it's great that the clinic has a "leave no stone unturned" approach. I don't have any personal experience of IVF, but I'm also in Ireland (the midwest). If you would like to contact me, I have an email address on my blog. I wish you the very best with this course of treatment. If successful you will have to pick at least one Irish name ;o)

  5. hi - i just found your blog. LOVE the cats.and the fact that your new doc is so thorough - wow that is some serious work-up - I wonder if it's as expensive as it is in the US over there? I am English but live in the US for 14 years and am going to be doing my second IVF with donor eggs ( I have OF) or eggs past their sell by date. Sounds like you are managing to have fun in between all the blood draws:)

  6. tireegal68, unfortunately it is just as expensive here. All the best to you with your second IVF.

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