The meeting this morning with the RE was OK, at best, but I'm not certain another clinic would do anything differently (aside from the bizarre social worker requirement, which I still do not understand) so my thoughts of transferring to another office remain just thoughts. I'll stay put for now.
I brought my list of questions, and the RE answered most of them without my asking.
1. Heart rate- There is some evidence to support the theory that babies are smaller if the mother's heart rate during pregnancy is frequently very high. The RE knows of no evidence linking an elevated maternal heart rate with infertility or difficulties conceiving. Nurse TMI is full of crap.
2. Monitoring- Based on my consistent and fertile-seeming hormone levels (as measured in the CD3/CD22 and clomid challenge blood work), plus the fact that I have no trouble detecting an LH surge each month, the RE believes nothing can be gained by monitoring while I'm on clomid. She feels it is safe to assume that the follicles are mature when I ovulate because it's the hormonse released by the follicles that naturally trigger ovulation to begin with. Monitoring makes more sense in combination with injectibles, when the dosages can be tweaked as the cycle progresses to achieve desirable results. With clomid, there is no opportunity to adjust the dosage, so the information gained wouldn't be useful. She said she would schedule a CD12 u/s if I insisted on one, but that it would be completely unnecessary.
3. Next step- For insurance reasons, we cannot move on to IVF immediately if this cycle does not succeed. My carrier requires two cycles of FSH/OI (ovulation induction)/IUI before they'll authorize an IVF cycle, regardless of my age. My RE prefers to do an injectibles/IUI cycle before moving on to IVF anyhow because it gives her the opportunity to see how a patient responds to the drugs before getting into an IVF cycle... a rehearsal, more or less, before the big show. If I am not pregnant by 3/24, we'll do FSH/OI/IUIs in April and May. If I'm still not pregnant by Memorial Day, we'll take the month of June off from TTC (like that's possible) in preparation for a July IVF. I'll be 42 before my first child is born, if that's the case. I'm keeping my focus on NOW. I don't want to think about next year already.
4. Rh-factor- The blood type of our donor has no affect whatsoever on our chances of conceiving.
5 & 6. Maintaining a generally healthy lifestyle and diet are all the dietary advice she provided. Odds are that my lack of success to-date is simply attributable to my age and the fact that not every egg is viable/fertilizable. I didn't specifically ask if there were foods or supplements that she would recommend.
Throughout the meeting, the RE kept saying things like, "If you continue with us," and "The other clinic does this the same way." The nurses recorded in my chart that I'd hung up on one of them, and she asked me about that. I explained the conflicting information I had received, coupled with the stress of an extremely tight timetable which no one in her office seemed concerned about. She defended the nurses, but also seemed to understand where my frustration came from. I told her I have no plans to move to another clinic (especially since the next-closest one is 12 miles further away and their weekend office is yet another 20 miles beyond that, AND more than half their staff are men).
So, staying put, for now. And now that we have the word on Rh, we're hitting the catalogs once more.
4 years ago