Hope

**Long post- wanted to get it all down for my records

I held so much anticipation for this consult. I know that this RE (Dr. Z) is highly regarded and many of his patients come to him with two or more previously failed IVF's. All I can say it that I felt real hope for the first time in quite a while. The consult was much better than I had even hoped for. I was so scared that Dr. Z would give me low odds like my past RE (Yeah- PAST RE- that's right...kiss my ass… adios Dr. Hand's off, no more money from me A-hole!)

Not only did he not give me low odds...he actually gave me high odds and he wasn't concerned about my FSH... I was sure that the entire conversation would be about my high FSH and likely crappy eggs. We barely talked about it. Dr Z said that it's more about age than FSH. He said I might have a lower reserve but that he seriously doubted that quality would be an issue. He even said that he thinks we'll be accepted into his shared risk program. He wants to do my FSH test again on my next CD3 and he said if its gone up he'll even let us have an agreement that I'll be allowed into shared risk as long as I produce 8 follicles and reached an estrodiol of 1200 and as you guys know I produced almost that many follies each time I did IUI's and always had an estodiol of more than 1200. His shared risk is different than many I've seen. You pay so much for just one cycle (approx $14,000, and you get 90% back if it doesn't work). Of course this doesn't include ICSI (which we'll need or all of the testing) But- I had completely accepted that we had ZERO chance of doing shared risk with my FSH levels and it looks like we could have a good chance of being accepted. And this shows that Dr. Z has faith in my ability to get pregnant based on the info he has. This is much different than what I was hearing from Dr. A-hole Hands Off.

Dr. Z spent most of the conversation going over our histories. He said he was happy to see that my Endometriosis hadn't gotten worse in the last year and that it looked like a very mild case. (I sent him pictures) He said that a mild case can still cause immune issues that prevent implantation so we'll have to have me tested for all kinds of immune stuff. He's a big believer in immune issues which is still a controversial topic in the medical community. I'll be tested for almost every immune issue you can think of. And all of them can be treated…but some are extremely expense treatments! He also said that my TSH levels (thyroid) are high (came back at 3.8) and wondered why no one pointed this out to me. He said we'd retest them and most likely treat that as well.

He said he'd give me 50% odds of having a take home baby after one IVF and 40% odds with a FET. His clinic has really high FET success rates... Sure sounds better than the 18% quote I was given from Dr. A-Hole Hands Off!!!!!!

He was also very pleased with all of the supplements I've started taking. I now take baby aspirin, a prenatal, lots of fish oil omega 3's (very good for immune issues), flax seed oil, L'Arginine, CoQ-10, Selenium, Bromelain, Evening Primrose Oil, Spirulina, Chlorella, and lots of Wheat Grass (the last three are pretty gross...I take them in pill and liquid form- but they're supposed to help egg quality so I'd take a bath in them if I had to). I have J on a multi vitamin, CoQ-10 and Fer*tility Blend for men. Dr. Z said that these are all very good for reproductive health. He said that Fertility Blend for men is something he recommends for all men. Women should not take Fertility Blend for women b/c it contains herbs that interfere with the infertility medications. He said some herbs are okay as long as your acupuncturist is knowledgeable and knows that you're ttc through IVF.

Dr. Z also said its fine for me to continue working out. He said it wasn't necessary for me to cut out running this past year. He said that once you become "uncomfortable and bloated " from the stims you should cut back and do lower impact athletics but that he thinks working out is good for you physically and emotionally up until ET. That was when we talked about medications for anxiety/depression and he was very supportive of this. He said constant stress/anxiety can cause immune issues as well and lead to reduced pregnancy rates, so you're better off being on something than trying to suffer through it. He said that Zol*oft, Cel*exa and Lex*apro are the three safest anxiety/depression medications for pregnancy (even nursing) that are out there. Looks like I'll be going on a low dose of Zoloft... (I don't think we always even realize just how uptight and anxious/depressed we are) I know I struggle sometimes but even J has pointed out that he thinks I need this b/c he says I always seem tense and anxious lately...

Let's see- what else. Oh... he prefers that we don't do local monitoring. He'd rather see me himself and not rely on someone else's finding. He does all of the u/s's, monitoring, ER and ET's himself. He works 7 days a week, 361 days a year (sort of scary- wouldn't you burn out big time). He only takes 5 days off a year for medical conferences. I guess he's dedicated his life to this and finds it very rewarding. I'm surprised that he is able to do all of this himself and have such high success rates. He does over 350 fresh transfers a year. The clinic is open 365 days a year and everything is done on site- even blood work.

He says we'll do a Long Lupron cycle unless my FSH comes back higher. Then we'll do a micro-flare protocol. We'll do a 5 day transfer if the circumstances allow for it. We'll do ICSI, but not PGD. I'll have to travel quite a bit. He'll expect to see me 5-6 times before ER. I'll have to drive 4 hours each way to his clinic (not looking forward to this part). I plan to commute most of the time unless I have to be there two days in a row. Then I'll stay overnight in a hotel. I’m not looking forward to the many hours in the car but if this works it’ll be well worth it. I'd like to keep the hotel stays to a minimum since we'll be staying up there for ER and ET... (trying to cut back some of the expense *sigh )Guess I should buy some books on tape - any recommendations?

I have a financial consult and a consult with a nurse coordinator early next week. The nurse coordinator will go over all of the testing I need. I will go up there for my CD3 u/s in the beginning of December and Dr Z expects to put me on bcp's soon after that. He estimates that I'll have my ER and ET during the 2nd week of January.

I just can't begin to tell you how kind he was. I immediately felt comfortable with him. I could tell he’d spent a lot of time reading my medical records and it's a pretty big file. I could actually feel my body relax as the consult went on. (I almost always ended up in tears each time I talked to Dr A-Hole Hands Off) Neither J nor I had any reservations about Dr. Z- not one! We plan to cancel the 2nd consult next week and save the $500 consult fee. (I want to hold on to it for a few days just in case I change my mind but I seriously doubt I will) It was such a relief to finally have an RE that was a take-charge type of guy. Dr Z took a lot of time to explain everything and told us what we need to do. He was positive and supportive and exactly the type of RE I need to help me get through this.

I feel hope... what a nice feeling.