Productive Phone Consult

After my post yesterday, my very proactive nurse called and scheduled a phone consult with my RE for today.  I am very appreciative of her.  The time she suggested fit right into my very busy schedule today, during the one hour down time I had.  I responded to her saying that the time would work as long as Dr. No Nonsense calls me on time.  Her response was, “Thanks for being flexible and taking the consult on such short notice.”  Oh I’ll take being able to talk to the doctor himself any day.

The phone call was good.  Dr. No Nonsense called this cycle a “failed Clo.mid cycle”, meaning follicles did not result from the effect of Cl.omid.  It doesn’t mean that I will or won’t ovulate on my own this cycle.  It may be a natural cycle when my ovulation is later than usual.  Or it may be a cycle where I won’t ovulate.  We won’t know until we do a scan and monitor.  As long as Bob and I are okay with having just one follicle and the possibility of one egg and one embryo or no egg and no embryo, Dr. NN is okay with that too.  We discussed the next steps.  He invited me to return tomorrow for an ultrasound scan to check on the follies.  Depending on the state of my ovaries, he may say to return on a weekly basis until we see activities.  He may even prescribe Letro.zole to me just to help push things forward.  Bob and I are scheduled for an appointment tomorrow at 8:15am.

We discussed the cause of the lack of growth this cycle.  He said that it’s very hard to predict the state of my ovaries at this point.  It could have been the Estrace.  It could have been the Cl.omid.  It could have been an off cycle for my ovaries.  There is no way of knowing.  So we just take whatever information we can get and move on with the cycle.

I asked whether he still recommends transferring next month even if we don’t have embryos this month.  He suggested making decisions on a scan to scan basis so we don’t go ahead of ourselves.  I like that.  So we won’t look too far ahead.  And I am determined not to let the uncertainty of the timeline affect my emotions negatively.

One thing that I am pleased about is that Dr. NN seems to have softened up on his stance on using Clo.mid.  I have always been a bit leery of using Cl.omid during a fresh and transfer cycle due to the possibility of thinning the lining.  Dr. NN had been adamant about using Cl.omid I guess because of my good response the last two cycles.  When I asked him one more time, he said that we can use Fema.ra during our transfer cycle which is more favorable for my lining.  I am so glad he said that.

I also asked about PIO as I have never used it.  He said it doesn’t matter what form of progesterone I use for a fresh cycle but he’d recommend using PIO for a frozen embryo transfer.  I didn’t ask him why.  I just jotted it down.

Since I had him on the phone, I asked a few more questions that had been on my mind.  Yes we’ll do assisted hatching for our transfer cycle (meaning extra $300 for the cycle).  No he does not suggest doing herbs to thicken the lining during a fresh cycle but he’s okay with using herbs during a FET.  And yes I should continue with all of my supplements including DHEA until I’m pregnant.

It was a productive phone call.  I did my homework and asked my questions.  I am so happy to get some answers and a plan.  We’ll see what happens at the scan tomorrow.

 

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23 thoughts on “Productive Phone Consult

    • Bob said, “Females always produced better results for me too”. HAHA. I knew what you meant. I had used Femara before for my hybrid cycle (oral meds + injectibles) and I often got one follicle. But thanks! I hope that maybe next cycle if we change things up we can have a couple more follicles.

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  1. Sending good luck wishes for your scan. The reason PIO is “better” for a FET is because there is no corpus luteum contributing “natural” progesterone the way it would with a fresh retrieval. I actually prefer PIO bc it can be measured in the blood and crinone/supps can’t. I always hear Dr Check in my head saying “older” women need more progesterone support so I like to see the number in the b/w.

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    • Thank you! Your explanation about PIO makes sense. I just can’t get over the fact that it’s an IM injection. I am not so sure how good I am with those. Hey can’t wait to hear an update from you on your babies!

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  2. I’m so grateful that Dr. NN takes such good care of you. I’m also proud of you for not letting this cycle derail you completely. It’s so easy to feel defeated and forecast our minds into negative places when the hiccups happen. Silver lining (pun intended) is the shift from clomid to femara (letrozole) for your transfer cycle.

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  3. Femara worked well for me but since I didn’t take clomid, I can’t compare. Had some wicked 5 second dizzy spells though, so watch for those if you take it. I absolutely hated PIO. I got horrible, tender lumps. The suppository was messy but painless, but you seem to have a pretty good pain tolerance.
    Don’t you just love talking directly to the doctor? So much better, even when you have great nurses like yours.

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    • I had taken femara before and I usually just got one follicle. I am really scared of the PIO. It just feels so hard to do. I have good pain tolerance when a medical professional is doing something. but I’m not so sure if Bob is up for that challenge day after day…. but I’ll count myself lucky if we need to do it day after day because that’d mean I’m pregnant!

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      • That’s a great attitude! The shot itself isn’t so bad, at least mine weren’t. I warmed it up first which is supposed to help, being in oil and all. I got horrible tender spots and lumps afterwards though. But yes, you’ll be happy because it means you’re pregnant. 🙂 That was how I felt about my lovenox injections those eight long months too.

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  4. That sounds like a reasonable plan. Sending you lots of positive thoughts for those ovaries and that you see a good size follicle at your scan today.

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  5. My DE nurse tools me that I could only use Crinone or PIO, not the extra Endometrium i have lying around. (I really should have asked why, though). I went with Crinone because the thought of that IM shot everyday was to much. PIO is much cheaper, according to my nurse, while Crinone is $200/week. Hopefully you won’t need the frozen embryo protocol andwhatever progesterone you use for your fresh cycle will be all you need.

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  6. First of all, I love this nurse for setting up this phone call! I’m sorry that this cycle hasn’t gone as well as hoped but it sounds like you are in good hands. That’s great the doctor said you could use femara. And I am no expert but since PIO worked for Tiffany, I feel like it is the best to use LOL! Those shots are rough but it will be so worth it when you are holding that perfect, sweet little baby! I am going to be praying that all falls in line for that transfer in December! I am still just so excited for you! I want it to be here already so I can hear about some amazing news you have to announce!

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