Daily Archives: October 29, 2009

She Says… Trial and Error

The most frustrating thing about struggling with infertility for me is not knowing what’s going on in my body or how to make it do what I want it to. As a self-proclaimed control freak, this constant state of not knowing drives me batty. When I knew something wasn’t right when I didn’t get my period after going off birth control, I looked to doctors to use their magic to decipher the truth. But in the end, it’s really just a game of trial and error. The bottom line is that they don’t always know either, even though they are supposed to be “the experts”.

So, in an effort to gather as much information as possible, I turned to the internet, Googling the heck out of every search term I could think of. And I started this blog. And I joined Rubyfeather, a group of women in the Boston area going through some of the same issues. And I read other peoples’ blogs. Lots and lots of blogs. As I read them, there is this little ticker running in my mind all the time: She’s doing this, should I be doing that?… Her doctor said this, but my doctor says that… And on and on. And as more people have started reading this blog, I’ve started getting emails from readers doing the same thing. Comparing stories, asking for advice, offering advice, suggestions, comforting words. I love hearing from each and every one of you.

Over time I have received a few emails/comments that address the same issue: they question the level of care I am receiving from Dr. P. They asked why I wasn’t more closely monitored with bloodwork and follicle counts/measurements every few days throughout my cycle. They countered Dr. P’s decision to not give extra progesterone supplements with the Clomid. They expressed disapproval of the order of tests that he ran.

At first when I read these emails and comments, they made me angry. I trust Dr. P; I chose him because he is a well-respected doctor at one of the best infertility clinics in the country. I’m putting my body and my future in his hands. So I ignored them. But then I started questioning why I blindly put so much trust in him just because he is a doctor. Maybe I was wrong to just do what I was told and not question him? Maybe I should be pushing for more aggressive treatment or certain medicine?

So today I called Dr. P’s nurse coordinator (the one who knows me and answers all of my questions), and I told her I had been talking with some other people going through this process and that they were being monitored more carefully (bloodwork and ultrasound prior to each Clomid cycle, more bloodwork and ultrasound once the Clomid was finished, still more bloodwork and ultrasound around the expected date of ovulation, hcg injections, post-injection check-ups, etc.), and I asked her why I wasn’t getting these daily check-ups. She said that Dr. P was following normal protocol. That he is an extremely cautious doctor who doesn’t like to disrupt his patient’s lives with daily doctor’s appointments. Given my young age (26), overall health (excellent), fertility history (only been off birth control since March, borderline “Lean PCOS” diagnosis), and timeline (only on second cycle of Clomid, still having “relations”, as they call it, not IUI or IVF), he likes to take things slowly. And since I am starting with the lowest dosage of Clomid and working my way up, there is only a very small chance that I’ll be overstimulated. Given the fact that there’s no evidence that I have even ovulated at all yet, and my almost-normal antral follicle count from my previous ultrasound, he does not see a reason to overwhelm me with monitoring appointments and bills at this point. And for that, I thank him.

The nurse’s answer assuaged my fears, but still leaves me with that icky not knowing feeling. I don’t know what the right course of action is. Why aren’t there hard and fast rules about these things? The answer, of course, is that no two bodies are exactly the same. What your doctor says about you may not be true about me, and vice versa. So I appreciate hearing from everyone, but please know that I am a firm believer in individualized care. What works for me may not work for you. And what your doctor recommends for you might not be good for me. And as much as we’re all searching for answers in each others’ stories, we have to realize that we have no idea. It’s all a game of trial and error.

What about you? For those of you on Clomid/IUI cycles, are you monitored every few days? Does it add stress to your life and schedule? How do you know if your doctor is taking the right course of action?