To Injectibles and Beyond!

First of all, thank you all so, so much for your supportive and comforting words yesterday and today. I feel like such a whiny little brat, complaining about a failed Clomid cycle when most of my commenters left Clomid in the dust long, long ago and have been using their bellies, thighs, and butts as pincushions since before I took my first dose of metformin. It really means a lot to me that you understand my pain, minor as it may seem in the grand scheme of infertility crap.

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Dr. Quixotic called this morning and we had a brief phone consult. It would have been briefer if I hadn't been forced to put him on hold while I crept off to my usual rarely-used crevice in a corner about twenty seconds' walk from my desk. Not that twenty seconds is a long time, but it probably feels like an eternity to the person on the other end of the phone. Anyway, Dr. Q called (and, thanks to caller ID, I believe I now have his cell phone number!) to go over our options. Given my utter lack of response to Clomid, and the associated visual disturbances, we're going to be scrapping that med.

He said we can move on to injectible medications, or if Ezra and I are not comfortable with that yet we could try letrozole, which has a "remote chance" of bringing about ovulation in patients who do not respond to Clomid. "Remote chance" does not sound very promising, and Ezra and I had already discussed this, so injectibles it is. Dr. Q was sure to warn me again about the increased risk of high order multiples that goes along with injectibles. He also pointed out that if money is not an issue, we could skip right to IVF, thereby minimizing the chance of high order multiples by transfering only one embryo. And, tempting as that sounds, we've decided to do at least one non-IVF injectibles cycle before moving on, if for no other reason than to be able to say that we gave it a shot. If it looks like I'm going to spit out too many eggs, we can always cancel the cycle. (Or convert to IVF? Is that possible without any special prep?)

Dr. Q did not sound dead-set on pairing IUI with the injectible meds, since we have no demonstrated male factor issues. However, my understanding is that IUI can significantly increase success rates (though they're still fairly low) over sex alone, and I'd rather not drug myself up and then have a cycle be "wasted" because sex wasn't quite enough. Also, Dr. Q said that most insurance companies will not pay for IVF until the couple has done at least three inseminations. By my math, we may have blown through our insurance coverage by then anyway, but why waste money (and emotional energy) on a non-IUI cycle when doing the IUI could put us one step closer to our goal? We have to explore this a little further, and I'm sure there are a few talks with Rabbi Spock in my future, but for now I'm inclined to say that we'll have at least one IUI with this first injectibles cycle.

Because of our travels around Passover, and the increased workload at both of our jobs before and after the holiday, we won't be able to have our in-office consult and start the cycle until the first week of May. Nurse Space Cadet called in a prescription for birth control, which I picked up on my way home from work. The irony does not escape me, but at least now I know I can go the entire month of April without seeing The Bitch (or wondering if maybe-please-maybe I'm pregnant).

Oh yeah, and, Nurse Spacey? When I call you for my fasting insulin results (6, within normal range, and Dr. Q also wants me off the metformin for now), it's not necessarily a good time to ask me what decisions Dr. Q has made regarding my care, because maybe I'm at my desk and don't want to talk about it right now. Like, you have access to my chart, just read it, ok? (Though, in all fairness, I should tell you that she had to put me on hold to get my file for the insulin result, during which time I slipped away again to my hidey-hole so I could give her the dirt when she picked up the line again.)

One last little complaint: while everyone else at the clinic has been very prompt about returning phone calls, Dr. Q's admin, who does most of the appointment scheduling, is...not so prompt. Her voicemail says that if you leave a message before 4:15, she will return the call on the same day. I called her around 11:30 AM. When I spoke with Nurse Spacey around 1:30, she confirmed that Admin Tardy (I dunno, I suck at nicknames) was in today. It's now after 6:00, the clinic has been closed for over an hour, and...no call back. Frustration abounds.