My second biopsy appointment was an
experience I will never forget. I went armed with a notebook of knowledge that
I gleaned from the 3T board, and questions I had for my OB regarding her plans
for my infertility treatment. She had talked a good talk at my first
appointment about monitoring and making sure I didn’t over-stimulate, so I was
excited to prove the 3T ladies wrong with a big “HA- Look at how awesome my OB
is.
Instead, I realized that while she is a great OB, she is completely ignorant when it comes to the diagnosis and treatment of infertility. Our conversation went like this:
Instead, I realized that while she is a great OB, she is completely ignorant when it comes to the diagnosis and treatment of infertility. Our conversation went like this:
Me:
so what are the steps from here?
OB:
Well, we need to get you ovulating. So as long as the biopsy looks good, we'll
start you on Clomid after your flow arrives.
I knew from the 3T board that starting
clomid without testing is a big no-no.
Me:
Will we do any testing first?
OB:
That is unnecessary
Red Flag: Totally necessary! The clomid
won’t do jack for me if my tubes are blocked. No point in going through all of
this is the eggs can’t get to where they need to be!
Me:
But what about an HSG for me and a SA for DH?
OB:
Those aren't necessary at this point in the process. Again, we want to do
minimal cost first. There's no reason
for that much testing this soon. You're worrying too much. We will do an ultrasound on Day 14 to see how
you are responding.
Red Flag: OB’s can talk the talk and make
it sound like they are “monitoring” clomid cycles to people who are not
educated on what true monitoring looks like
Me:
But no CD 3 ultrasound? What if there are cysts?
OB:
That's normally not an issue.
Red flag: Cysts can be a HUGE issue, and
starting a cycle with cysts can cause irreparable damage to your tubes
Me:
But what if there *are* cysts, since you said I have PCOS tendencies- I'd
prefer to not end up in the ER with a very large cyst rupturing.
OB:
It's not our normal protocol. That's a lot of money that doesn't need to be
spent.
Red Flag: It’s worth it to me! It’s my
health we are talking about. An ounce of prevention is worth a pound of cure
Me:
But what if I have a blocked tube? The Clomid won't do me any good
OB:
That's probably not your issue
Red Flag: The OB has never even done an
internal diagnostic such as an HSG. It’s highly presumptuous to say that I don’t
have a blocked tube.
Me:
But what if it is- how do you know it's not, and I don't want to waste one of
my 6 cycles of Clomid
OB:
The "6 cycles of Clomid" is a myth. As long as you respond well,
there's no max
Most doctors agree that more than 6
cycles of clomid can lead to incredibly thin lining making pregnancy nearly
impossible to achive, and there is conflicting evidence with a possible cancer
link.
Me:
My biggest concern is thinning my lining
OB:
Research shows that a thin lining has no effect on achieving a pregnancy
That’s a flat out lie!
Me:
But what about bloodwork and an SA?
OB:
The SA isn't necessary- you're clearly not ovulating
Me:
but what if we're in the 30% of couples who are dealing with issues from both
of us, again, I'd prefer to not waste time and resources if we don't resolve
all underlying issues.Plus, we're going on vacation in July, and if DH has any
sperm issues, I'd prefer he avoid the hot tub
OB:
That's not necessary. A hot tub won't affect his sperm count.
Me: And as for bloodwork, wouldn't it make sense to do a CD3 blood draw
with DHEA-s and LH/FSH to rule out adrenal hyperplasia, since we know I'll be
on CD 3 soon?
OB:
You present with typical PCOS symptoms. I don't think that's necessary.
ME:
But in ultrasounds in the past, they have not noticed the typical string of
pearls follies indicative of PCOS
OB:
you don't have to have cysts to be diagnosed with PCOS.
ME:
But if my DHEA-s is elevated, and it's adrenal hyperplasia, which presents with
similar symptoms, the treatment would be different
OB:
I don't think that's necessary- but if you insist... *sigh*
Infertility is expensive. I get
that. DH and I are 100% OOP for all treatment. But for me, the extra couple
grand is worth my long term reproductive safety.
OB’s specialize in keeping you pregnant, and making you un-pregnant at the end of 9 months. They are NOT fertility specialists- they’re surgical specialists. That’s why reproductive endocrinology is its own specialty. You wouldn’t go to a brain surgeon to deliver your baby, just because they also know surgery. This is the same thing!
OB’s specialize in keeping you pregnant, and making you un-pregnant at the end of 9 months. They are NOT fertility specialists- they’re surgical specialists. That’s why reproductive endocrinology is its own specialty. You wouldn’t go to a brain surgeon to deliver your baby, just because they also know surgery. This is the same thing!
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