The Best Laid Plans…

We met with the new RE last night. He is the only doctor at the closest location of this practice, and this practice is the only contractor my insurance (which covers 50% of most things) uses. So, we don’t really have the option of shopping around unless we want to pay out of pocket.

First up, he is super nerdy and comes across a little bit hard to relate to. We typically love nerdy. And awkward. He must have received feedback that he does not relate well to patients, because he spent about 15 minutes very deliberately trying to “get to know us.” He asked about our work, told a few funny stories from his, and made a solid effort at chit chat. I cannot imagine that he does well at cocktail parties. I do appreciate his effort to personalize his service, but it felt very … forced?

Next he asked for all of our family medical history and lifestyle practices (smoking, exercise, etc.). Then he asked for those of our donor, and that’s when things got a little weird. We have met the donor, we trust him and his intentions, and we have asked him all relevant questions about his health, family history, etc. The fertility clinic in LA did screening, testing, blah, blah, blah. When we told the new RE (let’s name him Beaker…he looks a little like that muppet) that we don’t know if the donor has a current partner, we started getting the side-eye. Why would it matter if he has a current partner, or 7? He donated the samples six months ago. He also asked about the legal agreement, which, frankly, is none of his business. What Beaker needs to know is that it exists, not what terms are included.

To make a long story short, Beaker told us that the FDA has extremely strict guidelines about donor sperm (duh) and it is extremely unlikely that this clinic satisfied all of the requirements, meaning there is about a 1 in 1,000 chance that we can transport our stock of 13 vials from LA to the new clinic. Beaker asked about the donor’s psych evaluation, drinking habits, family history, etc. Beaker wanted to know how we met him, which network specifically, and then proceeded to tell us that people offering their sperm often lie about their own health. To be honest, that kind of pissed me off. I appreciate Beaker’s caution, but we have already made a decision about this person, attempted an IUI with his sperm, and have a really good working relationship with him. Don’t sit across the desk and question my judgment about my body and my family.

The next part of the meeting was about the next steps. First he explained to us CD 3 bloodwork, which I have had done before, and which he can see in the file. Then he said we needed an HSG. I quickly told him that I had convinced my HMO to give me a referral for an HSG, even though the nurse practitioner didn’t fully grasp what it was. Beaker then proceeded to explain to me what an HSG test was, like I hadn’t just told him that I was very familiar. Then he jumped immediately to Clomid. What I find perplexing is that the LA RE poopoo’d Clomid immediately and said I was ovulating fine with big healthy follicles, so there was no reason to use medication. Beaker started pushing it immediately. I told him that we had concerns about multiples, but that our jury was out on Clomid. It left a bad taste in my mouth that he had my charts, everything looks super, including FSH, and he’s already pushing interventions.

Finally, he told me what I need to be doing now. As if I’m not fully aware. He already knows the vitamins I take, but he told me again to take them. He knows I sometimes drink 1 cup of tea or 1 cup of coffee once or twice a week, and he said to completely eliminate caffeine as if it was going to be this herculean effort. Like, Beaker, did you forget that about 20 minutes ago you asked me how much coffee I drink and I said a cup or two a week? Your script is showing. He also said to take fish oil, which I had already told him I do, and to drink no more than 4 alcoholic beverages a week, but only before ovulation. Whatever, bro. I’ve already told you I drink 4-5 beers or glasses of wine per week, and I’m pretty sure a glass of wine after ovulation and before implantation isn’t going to hurt anyone or anything.

The underlying issue was the paternalistic approach he took. This isn’t our first time to the rodeo, and he acted like we thought he had a zoo full of storks in the basement ready to start delivering bundles of joy to worthy parents.

Regardless, we left feeling frustrated and like this endless journey is continuing on. One of the more disappointing points is that no matter what happens with the sperm, he won’t try an IUI next month. I’ll start a new cycle around August 16th, have CD bloodwork (again), the HSG between 5 and 12, and then presumably wait for the NEXT cycle. When I asked if we ordered donor sperm from a bank whether we could try next month, he said that he doesn’t try an IUI the same month as an HSG, because it could have introduced bacteria into the uterus. What?? Why have I never heard that before? Anyone have insight?

On the way home we started discussing sperm options. We are anticipating that the supply in LA is lost at this point, but of course we would be thrilled to learn otherwise. We will spend some time in the next few days looking at online catalogs. If that’s the case, then we wasted 4-5 months waiting for the stupid 6-month FDA quarantine. And as an aside, we called this clinic BEFORE we started waiting, and they acted like if 6 months passed and donor was all clear, then we were aces. Nothing about KNOWN DONOR SPERM HAVE NEVER SUCCESSFULLY BEEN TRANSFERRED HERE BEFORE!! We could have gotten back to it in March, if we knew we had to go straight to the sperm banks.

Okay, I’m done grumbling, and I’m deliberately not thinking about how much money we spent to have the donor make deposits and get tested. We now just sit and wait for CD3 testing, and start picking Donor Plan C…


12 responses

  1. It kind of sounds like your doctor is annoying and judging you. Most RE take fda approved sperm. What if it was your male partners sperm? Then he’s object if you weren’t legally married? They can’t judge. I’d call and talk to a nurse or receptionist about that.
    My RE started me immediately on Clomid also “Clomid challenge” they called it. I wasn’t on it every cycle though. They seem to like to see how everyone responds and go from there. I did hear of the chances of bacteria after hsg and I’ve also heard it could help you get preg that cycle. Every Dr has their own thing about it. For the record, I tried the same cycle as my hsg and was not successful. This process with the insurance and weird rules works dubs me berserk. You seem pretty cool headed about it, though. Bravo!

    • Thanks for your insight! You’re right about the annoying/judging. I’m open to his insight as a professional, but I would receive it a lot better if it felt like he was helping, not directing us what to do.

  2. You can try on the same cycle you have your HSG as long as it happens before ovulation. My OBGYN said that there’s normally an increased rate of pregnancy that cycle and the next couple cycles.

    I didn’t find clomid to be bad, it only ever gave me one follicle though. I had signs of ovulation even without it. I regret waiting as long as I did to increase intervention (I did at home inseminations for 2 cycles, unmedicated IUIs for 3 cycles, and then 2 clomid cycles, if I try again, the RE wants me to do clomid/femara + injectables).

    • Right – I’ve heard the increased chance of success too. I just wish he would try the same cycle and not waste it. Alas, it’s become very clear that I have very little control over how this whole TTC thing is going to play out…

  3. Oh my goodness. Where to start, okay the dr seemed annoying. Didn’t meet him but reading was enough. You can totally do the hcg and IUI in the same month. We did with our first son, it worked the first month. I took clomid, as long as your on the proper dose which seems like 25mg would be for you if your already ovulating with nice follies. It may give you an increased chance. I know you don’t want to, but it could increase your odds of releasing more eggs=higher chance at pregnancy. I understand though with the twin scare. The trying to conceive part of this journey seriously sucks. The donor thing sucks, the whole freaking thing sucks. I hated that we even had to go through all of the issues with donor sperm. It was kind of depressing always having to wait for something that you have absolutely no control over. I feel like your on the right track, within a few months you two will be pregnant and this will be a far off memory. Do you guys by chance have a known donor that would donate. That route was soooo much easier for us. Hang in there friend!!

  4. There is NO OTHER doctor in your network?! Because this guy sounds like he didn’t even listen to a word you said, and if the sample was quarantined for 6 months, why in the world wouldn’t you be able to use it?! That just makes no sense to me at all! But either way, I hope for the best possible outcome for you ladies. This all just sounds really crappy to have to keep waiting!

  5. What a jerk doctor. I had an insemination 2 weeks after an hysteroscopy. I’m so sorry you’re having to deal with this. Maybe call and speak with someone that deals more directly with sperm storage? This doctor obviously doesn’t know how this shit works.

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