Friday, February 20, 2009

Slightly Uncomfortable Conversation

One of the nurses from my local RE clinic called me today. When I saw the number on caller ID I thought it was the scheduler calling to schedule our meeting with our RE before we cycle there again. I called a couple of days ago and left her a message that I wanted to having a meeting with our RE to discuss a couple of thing with him prior to cycling there again--namely, our results of our one day work-up at CCRM.

DH and I have all but decided for sure that we will cycle again locally since we have paid for one more cycle locally. With the logistics of running two businesses and having our busy work time be in the summer, we thought it would be best if we cycle locally this summer instead of flying to CO to cycle at CCRM. We are about 95% sure that this is what we will do. If we don't have success with our local cycle, we will cycle at CCRM next winter when work isn't so busy and we will be able to run both of our businesses long-distance.

When I picked up the phone it was actually the head nurse calling me. She was curious as to why we wanted to schedule a pre-IVF consult and asked if we had some specific questions. She said that our local RE would meet with us, but that he realizes that the consult would be more $$ out of our pockets and wanted to avoid having to charge us by getting our questions answered over the phone.

Since I had not yet thought of how I would approach the situation with our local RE I was a little tongue-tied (which rarely happens to me!). I ended up telling the nurse more about our one day work-up with CCRM. I told her that it is not my intention to tell our local RE how to do his job, but that after having L and now having four failed IVF cycles that I wanted to have more answers. I explained that I didn't want to step on our local REs toes, but that I wanted to help them make me a success story of someone who cycles three times and gets pregnant (yep, I was laying it on thick).

I told her that CCRM found that I had restricted blood flow to my uterus and that they recommend that I do electro-acupuncture and mentioned the study on Randine Lewis's website. I also mentioned that I had read in an article that Vi.agra could help with blood flow too. She looked at my meds order and noted that my local RE was going to put me on Vi.agra for this cycle in addition to heparin and baby aspirin.

I also mentioned that I was waiting for my endometrial biopsy results to come back to see if I had the beta 3 integrin.

She was curious as to what protocol CCRM would recommend putting me on. I told her that I would ask when I have another phone consult with Dr. School.craft in March. She said to call her when I got the biopsy results and we would go from there. She told me also that she would touch base with my RE regarding our phone conversation.

It is a really fine line working between two clinics. ART/IVF is a really competitive business out there with lots of $$ involved. I was taken off guard by her phone call because DH and I had not fully discussed how we would handle our meeting with him before we cycle. I did tell my local RE in December that we were going to get a second opinion from CCRM and I don't think he was too pleased about it. Actually, I think he was surprised and shocked. I really do respect my local RE and I actually told him that I loved him during one of my transfers (yes, val.ium does weird things to you!). I also think that if I am logistically unable to transfer with CCRM until the winter months that it would be a long wait if I couldn't cycle locally. Even though I don't have high hopes of it working locally, I figure, Why not? We've already paid for the cycle and it is one more chance to make it work.


Sue said...

I think that sounds like a great plan. RE's do tend to have pretty big egos but if he is open to learning someting, this might help his success rates..I have heard of viagra - a friend of mine (I think I told you about her already) did that and e-acu and finally got pregnant on IVF #5 (after 2 local IVF's and 1 with SHER in NYC and another with SHER in LV, she came back to our poor local IVF center, did all this, and got pregnant). (oh,and keep in mind, my local RE has 37% success rate with ICSI). So, I think you are being smart!

kayjay said...

I think you are making a very sound and well thought out decision and remember, YOU are paying your RE's salary and HE works for YOU. I had so much trouble with the same attitude problem up here. The RE's here really act like you're betraying them and that it is a personal stab to their heart when you leave the clinic. It's not that their methods are bad, they just didn't work for you. A lot of the doctors here will even give you the run around when you ask for your records which is ridiculous given that our health records are our own property by law. I stayed with my first clinic FOREVER (4 of the 6 years we've been trying) and in the last 2 years, I have become quite the clinic hopper (since leaving the first clinic, I have consulted with 5 other REs!). It never hurts to get a second opinion and a fresh set of eyes, perspective and different approaches can make all the difference in the world. Don't apologize or feel bad - your RE will benefit from the info Dr. Sch is going to give to you.

P.S. And I would do the same thing you have done as well - do the last cycle locally since it has already been paid for so why not? At least Plan B is already in motion so you can just simply change gears and keep going forward instead of cooling your heels.