Last night, we had our consultation with Dr. Ahlering. He is the RE that practices in Tulsa and Columbia, Missouri, but currently lives in St. Louis where he is about to end a non-compete contract.
The first bad news we received is that he does not plan to do anymore cycles (after the one he is here for this week) in Tulsa. He’s going back to doing them only in St. Louis until at least 2015. Oh, buggers! That means we would still use his OBGYN, Dr. Nilson, to do our blood work and ultrasounds. Then, we would have to travel 6 hours to him for the retrieval and transfer. It’s not the worst option in the world, but it sure makes you wonder. I just wish there were more than 2 options for clinics in Tulsa. Le sigh.
The good news is that was the only bad news we received last night. Yippee!
Our appointment with Ahlering went really well, overall. He’s very long-winded, which we didn’t know going into the appointment but loved. It was kind of humorous after the appointment how overwhelming all of the information was. We spent almost TWO HOURS with him. Sadly, he had an appointment after us, so I have no idea how long they were waiting by the time we left. Oops! Sorry, mystery couple.
Anyway, as I said, he gave us a lot of great information! Basically, he thinks I was stimulated all wrong in my previous cycles. He would start me on a Lupron shot for 7-10 days before moving to the stim shots like we have done before. When he said that, Todd said, “Oh no!” (Remember, I was on Lupron for 4 months at the end of 2012. It was a miserable time in our lives with my depression kicking in at an all-time worst for our relationship. Other fun side effects were hot flashes and night sweats. Todd still tells people he’s surprised I didn’t spontaneously combust during that 4 months. Ha!) Anyway, Ahlering quickly reassured him that this would be a much different form of Lupron with much different side effects. I think he meant that this round, my head would just spin in circles. No big deal. Much better than some sweating. J Also, he would change the amount of stim shots I would take in order to produce more eggs than what we have in the past.
He said he does not believe my endometriosis has done anything to harm my eggs. He does not believe I have PCOS, which I have been told I do and I don’t by different doctors. He thinks my eggs are just fine, but we need to get more of them in the right follicle size to improve our chances.
The other big change he would make would be Todd’s side of things. During our first cycle, they used MESA (Microepididymal Sperm Aspiration) to obtain his sperm. Second cycle, we used frozen sperm from the first cycle. Dr. Ahlering prefers to use TESA (Testicular Sperm Aspiration). This is more invasive and painful. Poor Todd. Without going into a whole lot of detail, he thinks that the quality of the sperm they extracted before was poor. He thinks that getting younger sperm from the testicle instead of older sperm from the epididymis will give us sperm with better DNA make-up. He said something about the DNA quality can start to lower when the sperm is stuck in the system for so long due to the blockage of the vasectomy. It’s hard to remember his exact words, but it was the first time that an RE has talked to us so much about the sperm. He seems to be more into researching that than the others we have met. Our only concern was that he couldn’t remember the name of the urologist he uses in Tulsa. That is because they have only done approximately 2 TESA procedures in the last year. However, he did know the urologist’s name we would use in St. Louis for our actual procedure. I’m not sure if that gives me any extra confidence or not.
Also, he told me to just take an over-the-counter pre-natal vitamin. I’m pretty stoked about lowering my number of daily pill intake. Whew! Plus, he said that he doesn’t believe acupuncture, massage, hypnosis, yoga, or any other relaxation technique increases your chances of IVF working. He said that if they lower your anxiety and make this process less stressful, go for them. However, don’t do them if you think it’s going to improve your chances. I asked him to insist I still get my massages, though, to which he smiled.
I think the one thing we really learned last night is that there are no reproductive endocrinologists that are alike. So far, we have been given three different stories. If we were overwhelmed before, we are more overwhelmed, now. The good thing is that I woke-up this morning with a peaceful feeling. We have one more consultation next Friday with a doctor that does cycle in Tulsa. After that, I have a feeling that we might be throwing a dart at a dartboard to decide who to use. If that doesn’t work, we’ll choose a different doctor for our fourth cycle. What’s hard is when you realize you’re starting to discuss cycle 4 before cycle 3 has even happened. Is that us losing hope and being pessimistic or us learning to be realistic and go into these cycles with back-up plans? I like to think it’s the latter. Back-up plans may be what helps me keep my sanity! Plus, the better prepared we are, the less wait time there is in between cycles.
On a completely different note, I decided to do some research into Colorado Center for Reproductive Medicine. My cousin brought them to my attention this week, and I’ve been following the blog of a girl who goes to them. They are supposed to be the most well-renowned IVF clinic in the states. Maybe the world. ??? Anyone want to guess what they cost? $25,000-$30,000 for one cycle, not including Todd’s MESA/TESA procedure. That’s roughly $12,000-$17,000 more than we pay in Oklahoma. What?! I’m putting them on the list for cycle 10. If we haven’t found a Midwest doctor to get us pregnant in the first 9 cycles, we’re going to Colorado! Ski trip, anyone?! J
|I might have used this one before, but I like it.|