So I have a history of RE's who are VERY casual with monitoring.
I'm sitting here, the night of my 7th IUI...wondering if I should have asked for more monitoring of my follies. Here's why:
With no Fem@ra, on CD12 my follie would be 18mm.
When I start Fem@ra on CD3, on CD11 my follie was 27mm!!! A 27mm follie on CD11. Crazy.
This month I started Fem@ra on CD2, and I asked for an u/s on CD9. My follies were 19mm and 15mm. Still, though....a 19mm follie on CD9???? My RE had me wait until the next evening to do the HCG shot, then come in 39 hours later for an IUI.
I dunno, man. I'm starting to think my follies grow 4mm a day on Fem@ra, not 1. Why didn't they think to have me come in the next day, just to see how my follies were growing? There is a HUGE difference between 1-4mm growth a day. Perhaps they had me wait too long for my HCG shot, and I may have O'd much earlier than my IUI.
Do your RE's bring you in for daily monitoring on Fem@ra and/or injectables? I have no doubt that my RE will do the same thing next month, when I start injections. I'll have one u/s on CD9 or so, then my next appt will be for an IUI days later. Just seems wrong. I'd rather pay the extra $441 for another ultrasound, than to keep missing the optimal time to trigger.
I am SO over the medical industry right now!!!! Not one doc really takes the time to give me individualized care. It's 3 minute u/s and IUI appointments then they bolt out of the room, and a generic one-size-fits-all protocol. sigh
Monday, February 9, 2009
Should I ask for more ultrasounds?
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11 comments:
Carrie, you're in CA, right? I'm in Illinois, and it is the same way. I think it is partly because these are states where there is - in general - good fertility coverage on health insurance plans.So many patients. It becomes like a factory. I read with envy people in other states whose doctor's make individualized plans or make themselves available by email, or who actually do the IUIs themselves (not a nurse). BUT all that said, fight for what you think YOU need, and if it is more monitoring/more ultrasounds, you should get it.
Carrie, Lizzie makes a good point as I'm in NY and with excellent coverage. It does get a bit factory like. But I'll take that for the coverage.
I'm curious, what about the blood levels? Is your RE only dong ultrasounds or are they monitoring your E2 and LH everytime they do an U/S? Those are the biggies and without those levels being testing, I feel like they may be missing half the equation.
Either way, you know your body best. If you want more U/S, demand them. If you want to trigger and have the IUI earlier, do it.
Good luck babe.
I agree with them. If you feel like you need more u/s then demand them. It does get a bit factory like, even with our coverage... BFN after BFN just kinda takes the excitment away...
I agree with everyone...you should be getting the quality of care that you need. My new RE is having me come in for monitering everyday after CD8 for sonograms and bloodwork, which is very different from my old doc. I am hoping with the daily attention, we can get the timing of the IUI right. We all have to remember that it is our bodies, and we know how to listen to them...
My RE did blood levels every appt and ultrasounds every 2 days to monitor my progress while i was on injectibles. when she thought the blood levels and follicles were ready, i'd trigger that night and come back 36 hours later for the iui. if you're willing to pay for the extra ultrasound i can't imagine that your doc will object. i got pregnant only after i took control of my cycles and challenged my doc from time to time on her plan based on my knowledge of my body. they may be dr.'s but they're providing a service that you're paying for. there is a good bit of science at play that i relied on my dr.'s opinion for but with fertility there's just as much art and luck in play so that's where i felt comfortable presenting my suggestions/thoughts. it can definitely be intimidating to challenge the dr. but many appreciate someone who takes charge of their care so long as we do it in a way that doesn't offend. good luck!!
Extra ultrasounds are worth it. When I'm just on clomid the doc wants to see me starting on day 12 but with injectibles it's day 3, 8, 10, 12 and then daily until ovulation.
A one-size-fits-all approach is my biggest pet peeve too. I feel like a more individualized treatment would have had me preggo long ago.
My clinic seems pretty deluxe, and they only do CD3 and CD10 (or 11) ultrasound monitoring for Femara and Clomid.
With injects, though, I went in on CD3, and CD7, and would have gone every other day had my follicle not been huge. As it was, I had an u/s and trigger on CD8 and insem on CD9.
I say if you want more (and are willing to pay for more), they should be giving them to you. Can you switch clinics if need be?
Between my partner and I, we have seen a total of 4 RE's and 2 OBGYNs during this whole TTC process. Every one of them has said that the best way to get pg is to wait for the positive OPK then go in for an IUI after 24 hours. They say that u/s are not really necessary. I have always disagreed and we always requested at least 1 u/s. I say, do what makes you feel best. If you want another u/s, definitely ask for it.
what a shit! I have no idea as ours was an at home job... but wanted to send you our love and hope it works soon! xx
I haven't tried the same meds that you have but for my first try I went in almost daily for an u/s. Try 2 got cancelled, after the 2nd u/s and that is the extent of my experience.
I'm so sorry your RE's office has been so frustrating. Be more outspoken about what you want. If we don't look out for ourselves nobody else will. Good luck!
we did u/s every other day, starting on CD9 when on injectibles.
everyone is different though, so ask for what you need. one month i ovulated before my first u/s (while on clomid) and demanded they start monitoring earlier the next month. its important to feel like you are getting the care you need!
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