Bethpky - Questions for You... (Preg Ment) - Others feel free to barge in...

Bethpky - Questions for You... (Preg Ment) - Others feel free to barge in...

Joined: December 27th, 2010, 10:25 pm

March 10th, 2011, 12:51 pm #1

I have a few questions for you - if you don't mind.

If I remember your story correctly, you started with Cooper/Dr. Check and then switched to an awesome RE in Louisville.

I learned on the pink board that you got pregnant on gonal-f and trigger shot. I didn't realize. I thought maybe you had IVF or something. (Jumping to conclusions... bad me...)

Did Dr. Check know right away what protocol you needed?

I met with him last month and he thought I needed progesterone support. After a month of monitoring (three b/w and two u/s), he has decided to add a bunch of drugs into my system - actually $1700 worth - AND still with TI!

I'm confused because before DD was born, we did a lot of stimming drugs - with TI and IUIs and none of them worked. Actually - nothing worked until I had the IVF. However, I was never prescribed progesterone until the IVF...so that may have been the missing link??

Anyway - I'm still trying to process all of this. I wondered if maybe you could share your experiences. I am hoping that Dr. Check is right - I need some drugs and TI... but the thought of spending more money into something that may not work is... on the plus side - I love that Dr. Check is monitoring my cycle much more than any previous RE has ever had...

Trying to have a little faith...
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maureen
maureen

March 10th, 2011, 4:07 pm #2

Hi MargieD,

Dr Check is a firm believer in taking progesterone. Not all docs prescribe it for every cycle (TI, IUI, IVF) like he does, and for some people it is the magic bullet.

What I've learned is that Dr. Check will not push for IVF. We found that we had to push to make that step. He is very open to discuss your plan and I found that he is sensitive to the patient's out of pocket cost. Does he know that you will be paying for these drugs out of pocket? That could change his plan for you.

If I was in your shoes, I'd try progesterone on a natural TI cycle or IUI cycle if it's covered. Then if you feel IVF is your magic bullet, then move in that direction if you can afford it. The drug is 1/3 the IVF cost with Dr. Check, so if you are going to spend that much, and you have the remaining 2/3, then why not do IVF.

Don't hesitate to discuss your money and time and IVF concerns with Dr Check.

GL!
Maureen
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Anonymous
Anonymous

March 10th, 2011, 5:29 pm #3

and I agree 100% with everything Maureen stated.
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Joined: December 27th, 2010, 10:25 pm

March 10th, 2011, 5:43 pm #4

Hi MargieD,

Dr Check is a firm believer in taking progesterone. Not all docs prescribe it for every cycle (TI, IUI, IVF) like he does, and for some people it is the magic bullet.

What I've learned is that Dr. Check will not push for IVF. We found that we had to push to make that step. He is very open to discuss your plan and I found that he is sensitive to the patient's out of pocket cost. Does he know that you will be paying for these drugs out of pocket? That could change his plan for you.

If I was in your shoes, I'd try progesterone on a natural TI cycle or IUI cycle if it's covered. Then if you feel IVF is your magic bullet, then move in that direction if you can afford it. The drug is 1/3 the IVF cost with Dr. Check, so if you are going to spend that much, and you have the remaining 2/3, then why not do IVF.

Don't hesitate to discuss your money and time and IVF concerns with Dr Check.

GL!
Maureen
I don't want another IVF if I don't have to! Quite honestly - I don't even know if it's the magic bullet.

I did one month on progesterone suppositories and TI. I didn't like some of my b/w numbers. I had good lining, 3 good sized follicles, and about 6 small ones. Anyway - obviously - Dr. Check didn't like them either and prescribed the extra drugs.

I guess - after reading the boards - it seemed like a lot of women got success with Dr. Check after one or two months. I guess I expected him - quite naively - to have all the answers after the consultation - considering that he was my fourth RE. I brought in my paperwork from the three other REs and he didn't even bother looking at them. He did ask some questions, though. It is just making me wonder how much he understands my cycles or maybe he likes starting from scratch - seeing what the body can do without drugs - and starting from there....

I'm just trying to understand his approach a bit... that's all...


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Joined: December 27th, 2010, 10:25 pm

March 10th, 2011, 5:47 pm #5

The fact that he's not pushing IVF is making me feel like a woman again. (I hate saying this but DD will always be an "IVF baby"....)

I love that he's looking into it... but I just want to make sure that he's doing this right... then again - he is, after all, prescribing drugs that I've never had before... so that's a big plus....

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Anonymous
Anonymous

March 10th, 2011, 5:53 pm #6

I don't want another IVF if I don't have to! Quite honestly - I don't even know if it's the magic bullet.

I did one month on progesterone suppositories and TI. I didn't like some of my b/w numbers. I had good lining, 3 good sized follicles, and about 6 small ones. Anyway - obviously - Dr. Check didn't like them either and prescribed the extra drugs.

I guess - after reading the boards - it seemed like a lot of women got success with Dr. Check after one or two months. I guess I expected him - quite naively - to have all the answers after the consultation - considering that he was my fourth RE. I brought in my paperwork from the three other REs and he didn't even bother looking at them. He did ask some questions, though. It is just making me wonder how much he understands my cycles or maybe he likes starting from scratch - seeing what the body can do without drugs - and starting from there....

I'm just trying to understand his approach a bit... that's all...

I remember frantically staying up until very late the night before the consult and when I got there he didn't even look at them. I asked him if he wanted to and he said no need, by me telling him the clinics/REs I'd been that was enough for him to know what my treatment/protocols had been like. I know some others have experienced the same.

To some extent, some of those records are irrelevant if they are from some time ago. Six months down the line your body could have changed (whether for the better or worse) so you want to know what's happening with your body right now. Sometimes the drs. just want to see with their very own eyes vs. accepting a prior dr's findings.

If I were you I'd refer back to the follow up transcript/letter from your initial consultation. You'd be surprised at the nuggets of info you find in there that you forget. Regardless, I think you need to speak to him directly to find out why the use of some meds now.
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Joined: December 27th, 2010, 10:25 pm

March 10th, 2011, 6:03 pm #7

My E2 numbers were low for the number of follicles I had and I obviously needed a trigger shot. None of these were mentioned or discussed at the consultation or in the letter.

I don't have the drugs yet...but if I remember correctly - he prescribed Centronide(msp?), Revel, and hCG... going to do some research a bit when I get the drugs...

I am really ok with it... I was just praying for an EASY solution... It would have been nice to go back to the old RE and say - "Well - DUH!! If you had given me progesterone, I would have gotten pregnant!" LOL



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maureen
maureen

March 10th, 2011, 6:34 pm #8

From my translation, it appears he wants you to be on Bravelle, cetrotide, and an HCG trigger shot. Bravelle is fsh and will stim your ovaries to bring out more follies. The cetrotide (sometimes ganarilex is used, but they are both the same) is added when your biggest follie is 14mm. This slows down the grow and prevents and LH surge so that the smaller ones catch up.

Dr. Check didn't look at my records either. Now when I go to a new RE I write up a short summary in bullet format of my history. I figure the least they can do is read that!

I totally know what you mean by an IVF baby. I got pg on my first ivf, and even though I was over the moon at finally being pg, I felt that I didn't ace the feminine test. Now I would do anything for another pg. Screw feeling feminine! I hope you can find peace even though there was a little bit of rerouting done to get to the goal. And who doesn't cheat a little today? Think about contact lens wearers, nose jobs, make-up, hair dye, sneakers with springs in them, and the list goes on.

Maureen
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Bethpky
Bethpky

March 10th, 2011, 6:57 pm #9

I have a few questions for you - if you don't mind.

If I remember your story correctly, you started with Cooper/Dr. Check and then switched to an awesome RE in Louisville.

I learned on the pink board that you got pregnant on gonal-f and trigger shot. I didn't realize. I thought maybe you had IVF or something. (Jumping to conclusions... bad me...)

Did Dr. Check know right away what protocol you needed?

I met with him last month and he thought I needed progesterone support. After a month of monitoring (three b/w and two u/s), he has decided to add a bunch of drugs into my system - actually $1700 worth - AND still with TI!

I'm confused because before DD was born, we did a lot of stimming drugs - with TI and IUIs and none of them worked. Actually - nothing worked until I had the IVF. However, I was never prescribed progesterone until the IVF...so that may have been the missing link??

Anyway - I'm still trying to process all of this. I wondered if maybe you could share your experiences. I am hoping that Dr. Check is right - I need some drugs and TI... but the thought of spending more money into something that may not work is... on the plus side - I love that Dr. Check is monitoring my cycle much more than any previous RE has ever had...

Trying to have a little faith...
I started trying to get pregnant in the summer of 2009...noticed that I had a couple of really short cycles that summer (19 and 21 days), but my OB tested my P4 level and assured me I was ovulating. I think I had a chemical in July, b/c I had a very light positive FRER and then nothing the next day. Started my period on CD 28 (August 5th). Got pregnant that cycle. Found out on the 8 week ultrasound that it was twins. Unfortunately, at the 12 week ultrasound, we learned that one of the twins had total body edema and wasn't going to make it. We lost Baby A at 14 weeks. Had an amnio at 15 weeks, and everything case back normal for Baby B. Unfortunately, Baby A was located near the cervix, and I developed an infection in the placenta which caused PPROM at 17 weeks. Baby B lived for 23 minutes.

After the loss, I noticed strange mid-cycle spotting. My OB said this was normal after a delivery or MC, but I had this strange feeling something wasn't right. Made an appointment with Dr. Henry Bohler at UofL. CD 3 testing revealed an FSH of 21.9 and AMH of 0.3. I was in perimenopause and was completely devastated.

Then I found this board. I starting reading all the posts and everything I could possibly get my hands on (books, internet articles, medical journals, etc.). From this board, I learned about Dr. Check, and DH and I made an appointment in July 2010. Dr. Check conducted the usual testing, and I already had a mature follicle on CD 3. That cycle was pretty much a bust, b/c I ovulated so early. However, Dr. Check felt confident that I could get pregnant with hormone balancing. He prescribed Lupron for the luteal phase of that cycle, along with estrace, estinyl and P4 support. DH's sperm tested off the charts excellent (and he's 50). The next cycle, I took at few days of estinyl and did local monitoring with Dr. Bohler's office. Dr. Check had me take a Gonal-F boost (75 units) for a couple of days and then a trigger shot. We did TI, and I got pregant. Unfortunately, the betas never doubled appropriately and rose very slowly. Dr. Bohler's office did an endometrial biopsy at 5 weeks, and I finally MC at 6 weeks.

After that, I spoke to Dr. Bohler who suggested that I take a month off and do BCP to keep my FSH low. I also insisted upon having an HSG since I'd only done the saline sonogram before. At the beginning of my next cycle (October 25th), I took a couple of days of estinyl to keep my FSH low for CD 3. My FSH came back at 8 or 9. Then, I kind of copied Jamie's protocol and started with a higher dosage of Gonal-F on CD 4 or 5 (I believe I did 300 for couple of days and then down to 150). At the first ultrasound, only one follicle was growing. Dr. Bohler bumped up my Gonal-F to 250 units, and a second follicle starting growing. When the largest follicle got to about 16 or so, I insisted on doing one or two days of Cetrotide to try to get the second follicle to catch up (I also increased my Gonal-F to 300 units). I went in on a Saturday, and my largest follicle was 18. Dr. Bohler wanted me to trigger that night, but I waited until the following day at about 11 a.m. to try to get the biggest follicle to grow slightly more. DC and I had timed intercourse a couple of days prior to ovulation and the day after the trigger shot (DH was sick on trigger day). Started P4 support and estrace after ovulation. I had a very light positive on a Wondfo (internet cheapie) at 10 or 11 DPO. Went in for the first beta at 11 or 12 DPO. I was 37 years old at the time; turned 38 in January. Also, I probably only had one mature follicle despite the higher dosage of Gonal-F.

Let me know if you have any other questions. I received such great advice from the women on this board that it's nice to be able to pay it forward. Good luck to you!
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MargieD
MargieD

March 10th, 2011, 7:13 pm #10

I remember frantically staying up until very late the night before the consult and when I got there he didn't even look at them. I asked him if he wanted to and he said no need, by me telling him the clinics/REs I'd been that was enough for him to know what my treatment/protocols had been like. I know some others have experienced the same.

To some extent, some of those records are irrelevant if they are from some time ago. Six months down the line your body could have changed (whether for the better or worse) so you want to know what's happening with your body right now. Sometimes the drs. just want to see with their very own eyes vs. accepting a prior dr's findings.

If I were you I'd refer back to the follow up transcript/letter from your initial consultation. You'd be surprised at the nuggets of info you find in there that you forget. Regardless, I think you need to speak to him directly to find out why the use of some meds now.
Thanks for telling me that he doesn't always look at your old records. I remember reading somewhere here on this board that someone mentioned to BRING your records. That's why I got a bit nervous. Wondered if I was an anomaly. Sounds like he has no "normal"...
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