Don't Waste Time With Your OB GYN
When I first told my doctor that I wanted to get pregnant, but wasn't having a hard time, I was referred to the "fertility specialist" in the office. Other offices might be different, but this doctor was only the "specialist" because he threw different drugs at me. I was first started on Clomid, which is typically the first drug doctors will start women on if they are having a hard time ovulating. Each month I was given a higher dosage of the drug, but I was never able to ovulate. After a few months, no one ever asked, "Why I wasn't ovulating?" but just assumed I needed more drugs.
I was then put on Menopur. Menopur involves injections each night into either a fatty part of your leg or abdomen. My first take with Menopur felt like someone throwing darts into the dark. Every few days I would go in and have an ultrasound to see if my ovaries were responding. When no response was seen my doctor would just have me increase the dosage. I began with 1/2 a vial and was injecting almost four at a time. Again, there was no real monitoring going on or awareness that this amount of Menopur could be harmful.
After two weeks of the injections I began to experience an acute pain in my ovaries, which then became unbearable. One night my husband took me to the Emergency Room and I was informed my ovaries were enlarged and had the potential of twisting. The reason for this dangerous enlargement was because of the over dosage of Menopur. Basically, my ovaries were freaking out.
After the trip to the hospital I was placed on bed rest for three weeks to ensure my ovaries didn't twist. Once I was off bed rest I returned the doctor's office for a follow-up and learned I was pregnant. Now, I wish this was the end of the story, but unfortunately, three weeks later, we were unable to see a heart beat and I suffered a miscarriage. At this point we decided to stop working with this specialist and find out why I was not ovulating, why I did, and why I had a miscarriage?
How To Find The Right Specialist:
When I finally decided to consult with a fertility specialist I wasn't sure where to go. I was given a few recommendations, but probably the best advice I got was to do some research on my own and determine the answers to the following questions:
- How long has the fertility clinic's medical director been there?
- How long have the doctors and technicians been there? High staff turnover can be a sign of bad management and can contribute to mistakes.
- Which procedures do you do, and how often? Be sure the clinic has a wide range of infertility remedies available and is familiar with the latest technology, such as something called blastocyst transfer.
- Do you have age limits for treatment? If so, it's a good sign that the clinic is concerned about ethical issues.
- When you do an advanced procedure that involves fertilizing the eggs outside the woman and then planting them inside her, who decides how many eggs go back in -- the doctor or patient? Wisot recommends steering away from a clinic that gives complete control to the doctor. This is important because the more eggs planted, the greater the chance for multiple births.
- How many cycles per year do you do? Wisot notes that some clinics handle so many patients -- each of whom may be treated for multiple menstrual cycles -- that patients end up feeling like a number.
- What does treatment cost? While you don't want to choose strictly on price, it's good to know costs ahead of time so you know what you're getting into. Beware of clinics that offer a money-back guarantee if you don't get pregnant -- the doctor may have a financial incentive to treat you more aggressively than you want.
California Fertility Partners:
Eventually, I chose California Fertility Partners because of their success rates, the facilities they had on site, the number of patients and because of Dr. Kelly Baek. From my initial interview I felt like Dr. Baek was going to approach my case as methodical as possible, and was going to find answers to my ovulation and miscarriage questions.
As before, Dr. Baek started me on Menopur, but with a small dosage and more visits to truly track my progress. Eventually, after a few rounds she was able to see that my body took a long time to respond to Menopur, therefore, upping the dosage wasn't the answer, but longer periods of the medication. Three times were able to get to the artificial insemination points, but each time I was unable to get pregnant.
Dr. Baek then tried a combination of Clomid and Menopur, which got me a little faster to ovulation, and then used Progesterone, after the inseminations for added hormone therapy, or as an attempt to stave off a miscarriage. Again, no success.
At this point Dr. Baek was troubled because she couldn't fully diagnose me. My blood work showed I was ovulating, but something was missing in communication from my brain to the ovaries. Consequently, Dr. Baek ordered a MRI. This decision was met with a lot surprise from her partners, me and my ob gyn, however, Dr. Baek was convinced I had a tumor in my pituitary gland, which was causing all my problems. And she was right. Apparently, the tumor was secreting a large amount of prolactin, which can cause you to experience headaches, which I did, not ovulate and can cause miscarriages.
Initially, Dr. Baek tried the drug Bromocriptine, but we still saw high levels of prolactin in my system. I was then referred to Dr. David Geffner, an endocrinologist, who put me on Cabergoline. This drug finally brought my prolactin levels down, and for the first time, without drugs, I was able to ovulate. Once I saw ovulation, Dr. Baek performed an artificial insemination and four weeks later we found out we were pregnant.
I understand my story is not like everyone's else, but what I can say from the experience is this:
- If you are serious about being pregnant - go to a specialist. They'll have you do blood work, perform x-rays to see that your fallopian tubes are working and open, will closely monitor the process and get results.
- Don't give up. Unfortunately, with infertility each test, each round takes weeks, months - don't give up.
