First Appointment with RE - Didn't Go How We Expected!

We had our first appointment with the reproductive endocrinologist today and it didn't go at all how we expected it would.  That said, it went very well and I feel really good about the clinic we chose.  Here's what happened (in blow-by-blow detail for those about to go through it themselves).

When I arrived at the clinic, I filled out the registration form and waited with Joe to be called in. When it was our turn, the medical assistant took us into what was called a Consultation Room. It wasn't a normal exam room, it was more like a small office with a desk for the doctor with a computer on it and two chairs for us. We left Joe there for a minute and then went and got my weight and blood pressure. That was it in terms of medical examination.

After I returned to the consultation room, the doctor joined us. He seemed pretty familiar with our file and pulled up Joe's semen analysis to go over the numbers.  He then started talking about trying IUI instead of going straight to IVF. We had originally thought we would go the IUI route, but the nurse practitioner had encouraged the IVF path instead.  We had been against IUI, because the success rates are pretty low for IUI and we thought the cost was several thousand dollars. Plus, we thought that with low morphology, we would be out of the running from the very beginning.

It actually turns out that an IUI cycle would only cost us about $450 and because all signs are that I am likely fertile, I wouldn't have to go on any medications - we would just do it on my regular cycle. So, we would have a few months to save up for the big hit if we have to go to IVF and we might get lucky in the meantime and not have to go to IVF at all!  The downside to the IUI is that the success rate is only 13%.  But, the doctor pointed out that trying naturally only has a success rate of 20%, so it's really not that low, comparatively.

AND: Since I don't have to go on medications, I wouldn't be at increased risk for multiples!!!

So, in terms of decisions, we've decided to try IUI for four months. To be honest, I don't think it will work due to our low morphology. However, it's worth the gamble and it gives us time to set up finances better for IVF. Plus, the removal of the risk of multiples is a huge plus.

Questions I had during the appointment and the answers:

1. When would we begin the BCP or stims?

We won't have to do the birth control pill or stimulating hormones because we switched to IUI for now. We can start our first round of IUI as soon as my next cycle begins (within a week or so).

2. What medications would I be on and can I get a list of them with a calendar for usage?
N/A

3. What are the side-effects of the different medications?
N/A

4. How much time might I need to take off from work in a cycle?
Very little - I only go in once on day 3 for bloodwork (can go in as early as 7:00 am) and once when I ovulate at about 8:30 or 9:00 in the morning. The procedure will probably take about an hour or so and I can go back to work afterwards.

5. What are the stats for success for male factor issues when a single embryo transfer is done?
N/A - no embryo transfer!

6. Should we do PGD?
No! Preimplantation genetic testing could be done, but it's very expensive and the older technology has been found not to be all that reliable. The newer technology could be pursued, but unless there's a known genetic problem in our family histories (I don't know of any, but I also don't have a full medical history on my side) it's not necessary and not indicated.

7. If we do PGD, do we have to pay for it again if we do further FET's later?
N/A

8. What can we expect to pay, bottom line, all-inclusive?
For the IUI, $450 per cycle, plus labs prior to the first cycle (~$300)

9. Do I need to change diet or exercise?
Not anymore than I already have - stay on prenatal vitamins, eat healthy, all the normal pregnancy precautions.


We actually had a pretty long conversation about the different options and procedures. When it was all over the doctor explained that I likely won't be seeing him for the actual insemination unless we happen to do it on a weekend day when he's on call.  It's more likely we'll see a nurse practitioner or another doctor on a weekend. I thought it was nice that he pointed that out - in reading reviews of other clinics, people get really upset when they don't see much of the doctor, but I can see why it would work that way. I appreciated that he didn't want us to be surprised.


I also really appreciated that he didn't try to talk us into anything and actually talked us out of more expensive options. We had thought we would do a refund plan for IVF, where you pay more up front and can get some money back at the end if it's not successful. He says that they offer that because some people want it, but really our chance of success is such that we would end up spending $6,000 more going that route.  He also talked us out of PGD, which would have been several thousand dollars. I really felt like he was being very straightforward.


So, different than I expected, but we feel great about the appointment and are ready to start the new cycle next week!


Amount spent:  $0.00 (still haven't gotten a bill for anything yet)