How much care coordination do you expect?

Hunter11 · 10-12-2009, 04:30 PM

I am really irritated with how my RE handled my last IVF cycle, but on reflection, I'm not sure anyone else's would have done better. I'm curious to hear anyone's thoughts about how/whether their REs coordinate their care. Here's how mine went: I knew by ER day that my September cycle was a bust - only one follicle. We converted to IUI but no one expected it to work, so I made an appointment with my RE for one week after the pg test to discuss next steps. I knew that by that point, I'd have started the October cycle, so there'd be no chance of IVF in October. No problem - I'm not sure whether you can do back to back cycles anyway and I figured we'd aim for November. When I came in for my appointment, she informed me that before she would consider another IVF cycle, I needed to take another clomid challenge. But today was day 4 and the clomid challenge starts on day 3. I asked if I could take the day 3 blood test on day 4 and she said, no, we wouldn't know how to interpret it if it came back abnormal. Great, so I missed doing the clomid challenge by 1 day in October, and now the earliest I can do another IVF cycle is January (Nov for the clomid, Dec away for the holidays). Super. After all those lectures about how given my age, I need to to do this as soon as possible, I'm missing 3 months because my doctor's office can't be bothered to call me and tell me to take a blood test. I get the feeling she doesn't give me a moment's thought unless I'm sitting right in from of her. Does anyone get the feeling their RE is doing a good job of really thinking through when each step should happen or are all REs like this?

Dailystrength · 10-12-2009, 07:16 PM

I had a similar experience and was very upset as I don't want to wait to cycle again. This process is hard enough!! I finished my 1st IVF cycle a few weeks ago (didn't make it to ET due to 7 embryos not making it to day 5). My RE said on day 3 of next period (10/7) come in and we will start baseline u/s and b/w. Everything looked good so I was thinking we would be doing a ER in November because of the RE wanting to do the short Lupron cycle. The nurse called to say it wouldn't be until the beginning of Dec. because of holidays. I was not happy as the RE had previously said I would be on BCP for 2 weeks due to migraines, but the new schedule would put me on BCP for 6 weeks!! I am waiting to hear back from the nurse because I said I wasn't sure if we were willing to go through that and that at other clinics the cycle would be a 4 week process (not 8). I totally get how you are feeling. They try to keep all the patients on the same cycle for some reason. What is the reason for repeating the clomid challenge test? I only had to do it prior to any treatments. Sometimes you have to fight for what you want in your treatment.

Hunter11 · 10-15-2009, 07:17 PM

Wow. That would irritate me too. "Because of the holidays" should not be an acceptable excuse for a fertility clinic. What medical professionals don't work holidays?

I'm not exactly sure why I have to repeat clomid. I did it in May and got poor results, but we went ahead with IVF anyway. My doctor said it was because I turned 40. I'm not sure why a person who is 39 and 11 months with a bad clomid test is less of a risk than a person who is 40 and 1 month. Maybe it has something to do with the insurance rules.

Dailystrength · 10-16-2009, 01:17 PM

Sometimes they are just looking for ways to charge you for more services. I would press the RE to see why it is needed. It just seems like more time that could be used to get to a BFP. I have found that you have to research everything and ask tons of questions to get to the right solution. I don't think the insurance puts stipulations based on age, but I guess it depends on your area and your plan.

10-12-2009, 04:30 PM	#1 (permalink)
Hunter11 0-99 post 2 of hearts Join Date: Jul 2009 Posts: 17	How much care coordination do you expect? I am really irritated with how my RE handled my last IVF cycle, but on reflection, I'm not sure anyone else's would have done better. I'm curious to hear anyone's thoughts about how/whether their REs coordinate their care. Here's how mine went: I knew by ER day that my September cycle was a bust - only one follicle. We converted to IUI but no one expected it to work, so I made an appointment with my RE for one week after the pg test to discuss next steps. I knew that by that point, I'd have started the October cycle, so there'd be no chance of IVF in October. No problem - I'm not sure whether you can do back to back cycles anyway and I figured we'd aim for November. When I came in for my appointment, she informed me that before she would consider another IVF cycle, I needed to take another clomid challenge. But today was day 4 and the clomid challenge starts on day 3. I asked if I could take the day 3 blood test on day 4 and she said, no, we wouldn't know how to interpret it if it came back abnormal. Great, so I missed doing the clomid challenge by 1 day in October, and now the earliest I can do another IVF cycle is January (Nov for the clomid, Dec away for the holidays). Super. After all those lectures about how given my age, I need to to do this as soon as possible, I'm missing 3 months because my doctor's office can't be bothered to call me and tell me to take a blood test. I get the feeling she doesn't give me a moment's thought unless I'm sitting right in from of her. Does anyone get the feeling their RE is doing a good job of really thinking through when each step should happen or are all REs like this?

VISIT OUR SISTER SITES:
JustMommies Pregnancy Calendar	eHarmony Advice Dating Advice	Project Wedding Wedding Songs	Weddingbee Wedding Blog

Currently Active Chat Room Users: 0 \| Scheduled Chat Room Events
	Users in Chat Rooms: No one's chatting right now!

10-12-2009, 07:16 PM	#2 (permalink)
Dailystrength 0-99 post 2 of hearts Join Date: May 2009 Location: Chicago, IL Posts: 89	I had a similar experience and was very upset as I don't want to wait to cycle again. This process is hard enough!! I finished my 1st IVF cycle a few weeks ago (didn't make it to ET due to 7 embryos not making it to day 5). My RE said on day 3 of next period (10/7) come in and we will start baseline u/s and b/w. Everything looked good so I was thinking we would be doing a ER in November because of the RE wanting to do the short Lupron cycle. The nurse called to say it wouldn't be until the beginning of Dec. because of holidays. I was not happy as the RE had previously said I would be on BCP for 2 weeks due to migraines, but the new schedule would put me on BCP for 6 weeks!! I am waiting to hear back from the nurse because I said I wasn't sure if we were willing to go through that and that at other clinics the cycle would be a 4 week process (not 8). I totally get how you are feeling. They try to keep all the patients on the same cycle for some reason. What is the reason for repeating the clomid challenge test? I only had to do it prior to any treatments. Sometimes you have to fight for what you want in your treatment.

10-15-2009, 07:17 PM	#3 (permalink)
Hunter11 0-99 post 2 of hearts Join Date: Jul 2009 Posts: 17	Wow. That would irritate me too. "Because of the holidays" should not be an acceptable excuse for a fertility clinic. What medical professionals don't work holidays? I'm not exactly sure why I have to repeat clomid. I did it in May and got poor results, but we went ahead with IVF anyway. My doctor said it was because I turned 40. I'm not sure why a person who is 39 and 11 months with a bad clomid test is less of a risk than a person who is 40 and 1 month. Maybe it has something to do with the insurance rules.

10-16-2009, 01:17 PM	#4 (permalink)
Dailystrength 0-99 post 2 of hearts Join Date: May 2009 Location: Chicago, IL Posts: 89	Sometimes they are just looking for ways to charge you for more services. I would press the RE to see why it is needed. It just seems like more time that could be used to get to a BFP. I have found that you have to research everything and ask tons of questions to get to the right solution. I don't think the insurance puts stipulations based on age, but I guess it depends on your area and your plan.