Wednesday, December 23, 2015

Deciding Our Next Step: Meeting with our RE

I was lucky to get an appointment with not too much of a wait - RE's offices are typically so busy with the day to day monitoring of patients actively cycling, there are a limited number of slots available to just talk. Our RE is an extremely nice guy and really spends time with you during your appointment. During this visit, we spent about an hour with him. 

We discussed all of our options. We could continue to do Clomid, since I haven't had any negative side effects and responded very well to the 100 mg dosage. We could do injectable IUI cycles. Or we could to IVF. Since we got pregnant once through IUI, he thought that was our best option. He mentioned that while injectable IUIs have higher pregnancy rates, they are much more expensive. In my case, he said I would need very little medication and would only need to buy one Follistim pen, so that wouldn't be too bad. But with all the monitoring ultrasounds and bloodwork, that quickly raises the price to roughly $4,000. For comparison, our IUIs with Clomid and limited monitoring only cost us $550. The base price for an IVF cycle (no meds included) is $8,800. So his reasoning was that if we wanted to do injectables, it would be better if we just did IVF because the chance of pregnancy is drastically higher than the IUI. We totally agreed with this!

Together we ended up deciding on three more cycles with Clomid at 100 mg and IUIs with limited monitoring. If we are not successful after three cycles, we will revisit the plan. Our RE also mentioned that my AMH level, which is 3.7, was excellent and indicated I would respond very well to injectable medications. But it also meant there was no rush to be pregnant immediately - I have plenty of time. So if we don't feel comfortable moving past IUIs, he wouldn't have an issue with us doing three additional IUI cycles, but just switching to Femara instead of Clomid. 

We also discussed IVF a bit. He felt that if we chose to do IVF, which he was very clear to say he didn't think we needed it at this point, that he predicts that I will produce many high quality eggs and have a very good chance of having enough eggs left over for freezing that I will never have to worry about fertility again. I have to say, that is such a nice thought! 

It also feels great to have options. Our doctor really let us decide what path we wanted to take. He gave his recommendations and listened to what we wanted, giving the positives and negatives of each approach. We had our heart set on doing more IUIs, so this is exactly what we were hoping to hear!

I'm cleared to start our next cycle on Clomid as soon as my period arrives. Unfortunately, my cycle is a bit off still after the early miscarriage. This looks like the longest cycle I will ever have! Yikes! Just can't wait for this cycle to be over with so we can move on and try again.

Wish us luck!

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