Thursday, July 29, 2010

Holding Pattern

Glad you haven't given up on me yet!

I've been in a bit of a holding pattern these past few weeks, drifting in and out of that peaceful (yet wholly unproductive) land called denial. I'm doing a really good job of this break thing, so much so that I'm not even reading up on your blogs as I usually do because I've almost forgotten that I'm infertile.

My body hasn't forgotten, though, and my cycle started as usual. It was a little shorter this time around, which means it's actually approaching normal - wonder if it's the acupuncture or the hour-a-day of heavy breathing in a room with a bunch of other female yogis that's doing it. Whatever it is, I hope it keeps up.

Introducing Dr. H.

So I finally had my consultation with Pacific Fertility Center last week - leave it to me to sit on the data for a whole week before reporting it these days. Dr. H. was really warm and friendly, and I enjoyed my conversation with him a lot and got some rather interesting but not overly helpful data:

  • He's not a big believer in mycoplasma/ureaplasma as a cause for IF, and he doesn't think that cultures are particularly helpful. So if I want to proceed in looking into ureaplasma as a potential factor, I'll probably have to push testing and treatment through my urologist. There's enough inertia in me that makes me not want to do this at the moment. Bleh.
  • He thinks I should give Letrozole/Femara a try because it won't thin my lining like Clomid would. Dr. G had not been a proponent of Femara, saying that the pharmaceutical company that makes it issued a letter saying that it wasn't meant for infertility treatment. Dr. H said that PFC uses it regularly without any major causes for concern and that doctors in the South and Southwest tend to be more conservative around using it.
  • Dr. H also interestingly encouraged that after Femara, we go straight to single-embryo-transfer IVF if I'm concerned about the rate of multiples with moving on to injectibles. He said that their success for single-embryo are almost as good as their rates with doubles at their clinic. I think that if I were to do IVF, I'd do single-embryo anyway - the thought of multiples completely terrifies me, and it's one of the big reasons why I didn't pursue IF treatment earlier.
  • Lastly, he said that we could do further testing like a 3-day FSH and antral follicle count to double check ovarian reserve, but he felt that because I ovulated on my own and was still young (Ha! I love it that he says I'm young!) that it wasn't a big concern. He also wasn't big on getting a laparoscopy since I have no symptoms of endometriosis and my chances of having it were like, 20%, so there'd be an 80% chance I'd be undergoing surgery for no reason.
So, Now What?

Well, I don't really know. I'm tempted to sit out for the next few months still and then pursue treatment back in Texas this fall for the following reasons:
  • Mr. Stick's new job has pretty decent insurance that covers IF treatment, but PFC is not an in-network provider, where Dr. G is. Ironically, if the insurance didn't cover IF, I'd have just proceeded with PFC because I like their style, and the cost would've been close to the same. But I can't just ignore the fact that we'd get 50% of our costs with Dr. G covered if I stick to doing treatments with him. 
  • The timing is such that I can squeeze in one Femara cycle in California, but it looks like I will ovulate around the time we leave, which would make doing the IUI shuffle rather difficult.
  • Mr. Stick is ridiculously overworked at the moment, so even if IUI were an option, it'd definitely create more stress on him to do the procedure on my next cycle.
So I'm kind of resting somewhere between patience (wait until October, and well, maybe get pregnant by then...ha!) or persistence (screw it, call PFC and do a Femara with intercourse cycle). My window for the persistence option is closing soon, so I pretty much need to decide over the next few days whether I'm going to live on "Take a break Island" for a little longer or take the ferry back to "Trying-ville."


  1. For what it's worth, it sounds like waiting would be a hell of a lot less stress, which could in the end improve your chances...but go with your gut. :)

  2. Interesting points that the new doctor made......I really hope you guys get some answers soon. I know how hard it is waiting in between treatments and then wondering what the next step will be once that treatment doesnt work :(

  3. I think getting more info and a 2nd opinion is very valuable! No matter what you decide, doesn't it feel good to be armed with some more knowledge?

    I go absolutely crazy in the months in between treatment (too much time to imagine horrible scenarios)....but if this cycle doesn't work we're benching ourselves for a month to re-charge, travel and see our families. All such great things but I'm already dreading the time off! That's me, tho. Those are very very valid points you raise about your sked, the cost and the travel stuff. Keep us posted on what you decide. xo

  4. Sounds like you have a tough decision on your hands. But you are a smart woman and will make the right choice. It is a great thing that you are not rushing right in, I think that happens too much. Good luck in your decision!!!

  5. Good luck making the decision - it's tough because you're juggling so many variables: timing, money and insurance, doctors and clinics. It's good to have options (and I agree that the more feedback/information you have, the more you know) but it can be difficult choosing among them.

    Take a Break Island is awfully pleasant, and I imagine it's especially so on the West Coast and with hour-a-day heavy breathing:)

  6. My dear Stickles!!! I moved my blog and wanted to let you know:

  7. New reader here...

    I'm in the Bay Area and have friends who've used PFC.

    My pre-IVF doctor *strongly* prefers Femara - in fact he never uses Clomid since he feels Femara is superior in every way (and I prefer it because of no hot flashes!)

    At any rate it's good to have multiple perspectives and options to consider. Good luck!