RE | The Saga of Becoming Fruitful | Expressing and capturing our journey of infertility in a blog. This is the saga of becoming fruitful and hoping to become pregnant and parents. This is our story.

Posts Tagged ‘RE’

My Doctor…

Written by Arpee on July 23, 2008 – 7:41 am -

I recently got a forum message regarding my RE, Dr H. The forum poster #1 was not happy with her and went to another doctor instead. I responded that overall, I was happy with her. Later, another poster #2 added her 2 cents not on Dr H but another Dr in the same center. I’ve culled some excerpts here but if you are interested in the whole context and everything, you can read it at SoulCysters.

Poster #1:

Arpee~ That’s interesting that you like Dr H. She was my RE for over a year and I had a different experience than you, unfortunately. I ended up doing 6 cycles of IUI, 5 on clomid with one BFP (ended in m/c). Even though I only ever got pg with a trigger, she constantly pushed for OPKs (though my records clearly showed a history of high LH and unreliable OPK results). We went in knowing we had relatively severe male factor and yet she did not change her normal protocol for us AT ALL. My m/c was horrifying at that office. DH and I went in to see the h/b at 7wk having had an earlier bleeding scare (so we were relatively ready to hear m/c). She just sighed and said, “Looks like you’ll have to try again with another embryo.” And her staff just walked out like rats on a sinking ship. She told me it would be like a heavy AF and to call after it was over and we’ll do another cycle of clomid. Needless to say, she was totally wrong. When we were told the numbers from DH’s post-wash count, we were never told the total motile. After I got the records, the counts were below 5 million for the last 3 cycles. These are well below the 10 mil threshold most clinics use for IUI. We could have just saved the money for the IVF that we now have to do. They never called when they said they would (which is scary early in pg when you’re waiting for beta and progesterone numbers) and you may have to explain your situation multiple times depending on who answers the phone. Needless to say, I’m over at Dr Y’s office and they are 10 billion times more compassionate and informative. I got (correct) statistics for our situation. I really hope you have a much better experience than I did!

My response:

Hey NerdyGirl,
…when I was looking for an RE, I searched the internet for reviews and got 1+ and 0-. Also, I wanted a woman RE and at that point, it was her and the new lady doctor at the same clinic. So I opted for the “older” one.

Just like I mentioned earlier, I like it that she is a straight shooter. Perhaps because I am so myself. They’ve been good at calling my stats to me, so that aspect is not a problem, either.

Your post and some recent experiences though gave me some things to think about:
1. When she saw that my cysts have shrunk already, she said that we were ready for the next Clomid cycle. Wrong…we were ready for our next Follistim cycle. (I realized doctors don’t typically review the charts before they see you.) (My blog details it more.)

2. She told me to use my leftover Follistim (from my 1st cycle) for my 2nd cycle without warning me about the 28-30 days allowed time in the refrigerator once the vial has been used. Good thing I called them today to ask about it. I should have not even used it for the 2nd cycle. The “good news” is that the med seems to be still working (at least until the 3rd Follistim day monitor) even if they have “expired”. Will see tomorrow if that “good news” continued up to the 6th Follistim day - although I use a new vial tonight that my husband will be picking up from her clinic later today.

3. She made a “deal” with me when we cancelled our 1st cycle (due to OHSS symptoms starting to show) that she will shoulder 600IU of my meds. Now that I am following up, her staff got back to me that what she said was that she was going to shoulder half of my meds - 300 IU. $300 worth - not too big of a deal. But that may be an indication that they do not track what they are promising their patients too well.

So you did 5 clomid and 6IUI cycles with her? Anyway, if things do not really work out with her, I may consider going to a male RE. Being of advanced maternal age and 2 miscarriages, it is possible I will be needing a perinatologist. So I like it the idea that they will be the one who will continue to care for you until you give birth - instead of being passed on to a next doctor, the perinatologist.

Thanks for the info! And I wish you health as you and your DH prepare for your next IVF cycle!

Poster #2:

I have to chime in on that center vs Dr. Y issue. I posted this some of this story on the other Austin OB thread, but I think it has relevance on this thread too.

I went to that clinic in February 2005 from a referral from my old GYN at Women Partners in Health (she’s since moved out of state, so no reason to state her name). I saw Dr. V, and neither DH or I were very impressed with him. My GYN had been seeing me for several years, and we had been trying to get pregnant. She ordered an u/s to “check” for PCOS, and I just happened to have the one cycle that I ovulated in about 3 years during that u/s. So, they ruled out PCOS because I was ovulating. She did the standard fertility workup, and found that my progesterone was low and my estrogen was high. So, I had a hormonal imbalance and she sent me to TFC.

Dr. V met with us, and told me that based on my records from WPinH that I had a hormonal imbalance based on me being overweight. That’s it. Nothing else. He didn’t do any tests, didn’t look at other factors like my overall family medical history, my appearance, etc. He said that I needed to go on BCP to regulate my hormones, I needed to lose 40 pounds, and then, and only then, would he start me on Clomid.

I started seeing a new Family Practitioner in April 2005, and she diagnosed me with PCOS right off the bat from medical history and my appearance (where I carry my weight, hair growth/loss, hormone profile from the GYN tests, etc). Her blood tests and putting me on Met confirmed the diagnosis.

I started seeing Dr. Y in November 2005 on my old FP’s recommendation, and at his office we finally saw the string of pearls cysts on my ovaries during an u/s. I talked to him about starting Clomid, and we elected to wait until after the beginning of the year (DH’s benefits started covering infertility then) and for me to try to lose 5% of my weight. I had an appointment on Feb 28, 2006 to talk to him about starting Clomid, and I got my BFP for DD#1 on Feb 24 from Avandamet alone.

The moral of the story is that I went for 3 long years not being properly diagnosed, and I feel Dr. V at TFC was part of that. I don’t know if I would have had a different experience if I had seen a different doctor at TFC, but if nothing else, the attitude I got at TFC and Dr. V regarding my weight put me off of them entirely. My FP who diagnosed me thought that putting me on BCP when I was TRYING to get pregnant and needing infertility treatment was the dumbest thing she had heard of. She was also not happy that a fertility clinic/reproductive endo office missed the PCOS diagnosis when I exhibit pretty much all the clinical symptoms.

In the interest of “balanced” views here, I am adding excerpts from other forum regarding Dr H and the center she has her practice on:

We used Texas Fertility (Dr H) and really liked them. They are really good about making you feel at home & comfortable asking questions. I was sad when we got ‘promoted’ to a regular ob since everything went so good. Dr V (one of the physicians) was on one of the local news channels recently and is very well known. They also have a class (free) once a month that is super informative. Their statistics were very good when we checked although right this minute I can’t recall where we looked but I think it might have been through the Tx center for Disease Control? Anyway, hope this helps and just fyi….we are 18+ weeks w/ twins!!!
- MedHelp

I am currently going there. We had our 2nd IUI today. About half my class from last year was concieved through them. (IUI’s, IVF and donor eggs) Everyone has been really nice and personable. There office staff is great. They try to squeeze you in when they can and are always patient. I am seeing Dr. S but have also seen Dr V and Dr H for ultrasounds.
- Mothering.com (This one has more related posts, so just go there if you are interest in more.)

I think we all have to take these varying inputs like these with a grain of salt. This is where “different strokes for different folks” is very applicable. None is right or wrong. It’s just that there are some things you are looking for and some doctors you just can’t work with. To each her own, just like the many churches one sees around, they cater to different people.

That is why it is so important and proactive to research and do the rounds when looking for an RE (or any health care specialist for that matter). I would really, really, really think twice in setting up a first meeting if my research had shown consistent negative feedback on a particular doctor or center.

In my case, my research on Dr H’s practice’s SART stats vs other centers makes me feel more comfortable with theirs. So from a numbers standpoint, I like them. I know it is more than the numbers…but so far, my actual experience has been well.

I’m pretty happy right now with Dr H. I have no compelling reason for me to transfer to another RE at this point.

How about you? Have you switched REs in the past and what was your breaking point?