Initial IVF Consult

Initial IVF Consult, that’s what the receptionist called it when I booked the appointment, it sounded so formal.  From that title I assumed that I would be consulted.  Since I tend to over analyze every aspect of my life, I’ve thought about the appointment at least a million times in the last month.  In my day dreams I walked in and the doctor rushed me through my history, from here it continued on either as a dream or a nightmare.  In the dream version he says great, we’ll start your IVF as soon as Blue gets home, I’ll call you in a few months with more details.  In the nightmare it went like this, sorry but you haven’t done the customary 6 IUIs yet, come back down here once you have and we’ll consider IVF.  In real life it went nothing like my dream or nightmare, it went more like a fairy tale.

I was apprehensive at first because he shares a reception area with another office and it all looks like a public health clinic out of the late 70s.  It was worse when we got back to the consult room because the table (the one with the stirrups we’re all so fond of) was a relic in the 70s.  My mom and I immediately shot each other frightened looks, I had to take a picture!  They had set it up so that Blue could conference call in from Afghanistan which was amazing but I wish I had taken a picture of the phone, definitely a first generation push button, but at least it wasn’t a rotary dial! 

Before my appointment I had a chance to talk to a girl who used Dr. BFP for her second IVF miracle, for her first she went to Seattle to a fancy clinic.  This is how she described the difference, “Seattle was the equivalent of a 5 star hotel, Dr. BFP was a Motel six, the service was great in both but just don’t go in expecting a spa with cucumber water.”  Due to this very apt description I was expecting what I walked into but didn’t expect what came after!

Dr. BFP walked in and it was a little awkward at first since he’s a little lacking in the social skills department, but once we got started it was like we could finish each other’s sentences.  We were on the same page about everything.  He agreed that IUI does nothing for women with endo.  He reviewed my surgery report and agreed that I had enough mechanical blockages that moving forward with IVF was the smart move.  He also said that in a lot of women with endo and sluggish tubes it may appear that their tubes aren’t blocked but they are full of small endometrial implants which are just as bad as completely blocked tubes. 

After reviewing Blues S/A of 140 mill/ml and 60% motility he made a funny face and said sometimes counts that high can actually be bad, there is no research that proves this, its just something I’ve noticed over time.  Because he’s a little worried about Blues swimmers he is going to fertilize a few eggs with ICSI.  In most clinics ICSI costs $3000-4000, he charges an extra $500 for a total of $2300 for a cycle with ICSI. 

During our almost hour long talk he listened to everything I had to say and didn’t rush me.  After he finished with what he wanted to cover he spent another 15 minutes answering all my questions in detail.  Then he told us we’ll be moving forward with the long lupron protocol.  The only thing we didn’t agree on was immunological testing, but after hearing him out I decided that we’ll try one cycle before pushing that issue.

The last question I asked him was why is it so cheap?  He laughed and said “I do this for fun, I love helping make families, I’m pretty sure we actually loose money on IVF but we love it so we do it.  We do most of our IVF stuff during non-clinic hours.”  He also talked about how he used to be a military doc and how sad it was to see couples come in that desperately want kids but couldn’t have them. 

So then he said, “Ok, well let’s go to the other room and we’ll see if you have any cysts and make sure your Uterus isn’t crooked.”  This is when I got the deer in the headlights look!  I was not even expecting an exam today let alone a mock transfer!  We walked into a room much like the last except sitting next to the table from the 70s was a shiny, beautiful, top of the line ultrasound machine.  It looked totally out of place!

There was good news and bad (but expected news).  My uterus is fabulous, but I’ve got two cysts.  There is a 1cm diameter cyst on my left ovary and a 2+cm complex cyst on my right ovary (it was ugly looking).  The bad news is that I can’t have any cysts over .5cm when we start the cycle and complex cysts don’t usually go away on their own.  The great news is that I have a 2cm complex cyst and I am in no pain!!!  That is truly a miracle and I believe in this diet more and more every day.

What we’ll do with this nasty cyst is a question for another day because even it couldn’t ruin my perfect IVF consult.

After the mock transfer we met with his nurse, we’ll call her Smiley.  She was smiley and enthusiastic and answered all our other questions.  She went over the protocol in detail and over the different dosages of meds in detail, and then gave us a full tutorial on how to administer all the shots.  We spent an hour with her and I felt great when we left!

So now you know the long version of my perfect day!  Now the dilemma is IVF as soon as Blue gets home or Europe for 3 weeks and then IVF?