IUI #1 and unrest

May 8, 2013 § 32 Comments

*** Just a warning. This is going to be 5 straight minutes of me bitching. I don’t really like to bitch. And it’s a beautiful day here and I turned in my draft of my literature review and I leave for Ecuador in less than a week, so it feels really terrible to be in the mood to bitch. But here we are.

The night before last, the Artsy Engineer nearly passed out after administering my trigger shot. And this morning I was inseminated. Like an infertile heifer. Which was a little weird, of course, but not that weird, actually. And the small weirdness is not what I want to talk about.

If you all remember, I had this grand plan last week to talk to my RE about changing my letrozole protocol based on a couple of studies I read. Truthfully, I didn’t expect her to actually do anything differently. She is the expert. And she obviously has reasons for using the protocols that she uses. But I did expect her to be nice about turning me down. And, ya know? Her words were weren’t awful (mostly). It was just this “you KNOOOW who that sort a protocol is used for, don’t you?” kind of stuff. But her facial expression conveyed displeasure and her tone was accusatory and belittling and it made me feel like a child. During that appointment, she also scoffed at the fact that I choose to continue to chart, even though it “will just be confusing” because of the medications. I explained to her that I knew that, but that I liked doing it because it gave me a false sense of control over the situation. Which she clearly thought was a stupid reason, because she proceeded to “strongly advise” (her words) me to discontinue charting to “save myself a little time.” Come ON, lady. Taking my temperature in the morning takes me all of 18 seconds.

I knew her bedside manner left something to be desired before this, though, so I wasn’t too surprised by this whole interaction. I only thought, this woman is not my favorite. She and I are not going to be buddy, buddy. But that’s cool. Ok, fine.

Then, today, I went in for the IUI (the success of which I still feel totally hopeless about), and she managed to one up herself. Her mood was pretty light at the beginning, so much so that I thought, “Man, she’s actually being friendly! She must be having a really good day!!” I even made a clever joke after accidentally writing my own name where I was supposed to write in the name of the person who gave the semen sample they were about to inject into my uterus. And she laughed. But then when the whole thing was over and done with, I mentioned that I was opting out of the CD 21 serum progesterone test and the hcg test, because I was going to be out of the country.

And no joke. The woman shot me daggers. She then proceeded to tell me that I they would not have done the IUI if they had known that they would not be able to monitor me in the second half of the cycle. She asked if I had told anyone about our trip. Which, I did. And she asked what it was that made me think it would be okay for me to skip out on this portion of the protocol.

Now. Had I knowingly neglected mandatory portions of the protocol, I would deserve this kind of reprimand. But y’all. The last three cycles, I have been told repeatedly that the CD 21 progesterone test and the beta are OPTIONAL. Nobody mentioned that this changes to ABSO-FUCKING-LUTELY NECESSARY-OR-ELSE-THE-BABY-YOU-HAVEN’T-EVEN-CONCEIVED-YET-WILL-DIE when you go from timed intercourse to IUI. And why on earth would I even think to ask? Everything else about this cycle is the exact same as my last three. Why does husband versus catheter insemination make a difference? I’m completely stymied. Still. But, apparently (as she made very clear), it will be my fault if I have an ectopic pregnancy or a low-progesterone induced early miscarriage because I failed to follow the protocol.

Guys, this made me feel like shit. I know it’s silly. I’m not going to get pregnant from this. And, even if I did, the presence or absence of a progesterone test and a beta will not make a difference. I know this. I already supplement with progesterone. Yes, I could have an ectopic. But so could anybody who ever conceived ever. And, no. They won’t be able to see if the egg was fertilized, so they’ll have less data. I guess that’s a bit of a bummer, but I knew that going in.

But somehow this woman succeeded in making me feel like an asshole.

She treated me as if I am some unruly teenager, who isn’t taking this seriously and who is making decisions all willynillylike based on whatever and a bit of selfishness. And she is soooo wrong. And I know not everyone is going to like me and that’s fine. But for some reason, I desperately want this particular human to like me.

I think it’s because I’m relying on her for something so huge.

If her SART stats weren’t the best in the area, I would be looking for a new provider right now.

UGH.

But. On a more positive note.

I’m inseminaaaaaated! Even though this cold cold lady made me feel like I tricked her into it. (And, I know I keep saying there is no chance of it working, but of course I know there is a chance, albeit small. And of course there is a bit of hope, albeit tiny.)

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§ 32 Responses to IUI #1 and unrest

  • Wow! That seems ridiculous. I had 3 IUIs and was never offered any follow up testing after insemination (because it’s unnecessary). My instructions were to POAS and call back with results. Sorry that happened…don’t let her bum you out too much!

  • Infertility Can Suck It says:

    That is so crazy! I’m so sorry she made you feel that way. Totally uncalled for. After about a zillion injectable cycles and I only ever came in for the big HCG test after the 2 week wait. Never before. Especially since, like you, I was supplementing with additional progesterone. I hate to break it to your RE, but a blood test at day 21 will not prevent an ectopic. Sounds like it’s just her personality to be on the attack at all times, and nothing about you personally. Congrats on a successful insemination and have a wonderful time on your trip. You deserve it!!

  • ugh that is horrible. as if all of this junk isn’t hard enough, having that kind of an RE doesn’t help. a bit. i’m so sorry. i don’t have any words to offer other than do what you are doing. you know what’s best for you, and vacations are GOOD! especially when going through stuff like this. therefore, i hope your vacation is amazing, and i hope you have lots of pictures to post when you return!

  • Steph Mignon says:

    What a total B. She seems like a control freak, who is threatened by you as a research savvy patient. It’s too bad you can’t find a new doc because I know having one that rubs me wrong during such a delicate process would be a hard thing to get over! And I know exactly what you mean about wanting your RE to like you. It’s like getting approval from your RE almost dismisses the reason you’re there in the first place. Like if she warms up to you it’ll somehow make you more worthy of that baby you want so much. I’m not saying that these desires are rational, but I can TOTALLY relate to them. And I have hope for you this cycle too. One of my good friend’s got her BFP on their third IUI and she’s now 13-weeks pregnant. It CAN happen!!!!

  • Oh man I hate doctors that lack good bedside manner. Please don’t feel bad and fucking enjoy the shit out of your trip to Ecuador instead of worrying about what you aren’t doing later on in this cycle. After my three IUIs I never had a Day 21 progesterone test and I only went in for one beta- because with the second two I knew that I was just wasting insurance company money.

    Congrats on getting the turkey baster today.

  • I’m sorry you had such a shitty experience… it should have been something you walked away from with confidence and happiness and hope, not reprimand. listen to your gut/uterus. go on the freakin’ trip. she’ll get over it.
    now you… go think conceptualizing thoughts 🙂

  • Jens says:

    ugh. what awful things to say to you. I don’t think testing to see how much progesterone you have at day 21 will make or break a pregnancy. The only things you are missing are strictly for data on their part. I was never tested for progesterone in any of my IVF’s. And if you are taking supplements you are already taking care of any possibility of low progesterone. Ugh, just ugh. Plus, I am sure my RE never liked it when we went in asking about stuff we had read on the internet but he at least humored us and explained why it was or wasn’t a good idea. Forget about your rude doctor and have an amazing trip!

  • redbluebird says:

    How frustrating! My RE isn’t having me come in for a progesterone test (just having me supplement it) OR a beta. Unless I get a positive HPT two weeks later. I agree with Steph– she sounds like a control freak and a “you have to follow the rules no matter how unnecessary they are!” sort of person.
    Does that mean everyone trying on their own, without medical intervention, should be afraid of an ectopic pregnancy?
    Don’t let it get to you. Doctors just don’t like when patients question them. Even if what you say makes total sense.
    Good luck on this IUI cycle! There’s always a chance.

  • Gypsy Mama says:

    Oh Lentil… I am so sorry that your RE is such a cranky person! For something so monumental in our lives, It would be nice to at least like the person who is so integral in making our dreams come true. On the other hand, you could switch to a regular OBGYN after you get pregnant and you won’t have to deal with her anymore. The most important thing is that she has good stats.

    I hope this is your first and last IUI and you won’t have to deal with her for much longer. I know your trip to Ecuador will be worth it 🙂

  • Kristin says:

    WTFE! That woman is running a business that depends on the labs she orders, amongst other things. I’ve been to three REs and none of them required mid-luteal testing. Not a one. Send condescending right back at her when you get pregnant.

  • bustedoven says:

    Dude, lame. I hope you get SUPER PREGNANT this cycle just to spite her. Well, not just to spite her, also because I hope you get super pregnant! Anyway.

    Like everyone else has said, there’s no sense being monitored when you’re already on progesterone supplements, and there’s nothing they could do for an ectopic at that point anyway.

    My doctor, as great as she is, rolls her eyes when I come in with stats and research I’ve read, or present my charts to her. But you know what? If I didn’t request to do things a certain way, I would’ve been put on Clomid instead of Femara, and so far Femara is the only thing that’s gotten me to conceive. Also, I had to ask to be put on progesterone supplements, and even though my doc was like, “Well, there’s no proof that will help, but I’ll give you a Rx anyway because it couldn’t hurt.” Who knows, I might have had to endure another miscarriage or two before she prescribed me supplements without me asking!

    So, I say keep asking for and doing what you think is best. You might not always be right, but you’re looking out for you way more than your doctor is. DO YOU, GIRL.

  • Jane Allen says:

    You really only need the progesterone level to confirm ovulation if you are doubtful that it is happening, which doesn’t sound like the case. It totally sucks to be spoken to as if you are a child, and you deserve more respect than she showed you. I recently was lectured by the billing person at my office and then when I made some phone calls to my insurance company, she seemed annoyed at me for doing HER job. Some people just suck! Enjoy your time in Ecuador, as BTW you don’t need her permission for!

  • Jenny says:

    Ugh. She sounds like a pill. Why do a progesterone test when you’re already on supplements? Yeah, I guess she might want one to make sure you ovulated, but it’s not exactly the end of the world if you don’t find that out in this cycle. My clinic didn’t even offer the cd 21 test as an option and wouldn’t give me a beta until I was late. It’s a teeny bit crazy that she considers these mandatory and won’t do an IUI unless the patient agrees to them.

    Anyway…just forget about her control freak ass and have a fabulous trip. I’ll be keeping my fingers crossed for you!

  • knalani says:

    “And she asked what it was that made me think it would be okay for me to skip out on this portion of the protocol.”

    Lame. The last time I remember somebody talking to me like that was when I was a 10 year old Girl Scout; some other kid’s awful mom was chaperoning and thought any challenge to her authority justified talking to me like a stupid sub-human.

    It’s not okay to talk to 10-year-olds like that. And it is certainly not okay to talk to adults like that. Boo.

  • I know nothing about IUI’s but it sounds like you have some great advice here in the comments section and it sounds like your RE was being super controlling without significant justification. Now, when it comes to doctors with crappy bedside manner, I do have a bit of experience.

    My mom went to my same RE as me years and years ago when she had RPL’s and since she had three kids already, sweet Dr. Lady told her that she needed “…therapy, not more children. Who needs more than three? You must have something wrong in your head” she said. Yeah, very nice to say that to a grieving and confused miscarriage sufferer.

    I think you need to trust their expertise to some extent but more than that, trust your extensive research. And don’t worry your pretty little head about being away for CD 21. At this point, there’s nothing you can do – it is or it isn’t (and I’m gunning for ‘it is’). I have so much hope for you and no matter what, you have your good sense, your gut instinct and your superb data gathering skills. All of these things can only produce the best of results in the future. Good luck.

  • she needs a smack down!

  • uh, lentil, can you please delete the above comment from me (the one that reads “screen shot”) i have no idea what happened omg.

  • Aramis says:

    Jeebus. At my IVF-turned-IUI, they just shot me full of sperm and let me go home with my progesterone suppositories. I got my period before the beta was even due, so I never did go in for the test. No one noticed. I just think she’s one of those “I know best, did you go to medical school?” type of people who hates being questioned. I have a gyno specialist like that and I can’t wait to be rid of him. He actually said to me once “Well, you ask a lot of questions, don’t you?” Yeah I do, you mofo, when it’s your body maybe you would too. I am righteously pissed off on your behalf!

  • Sarah says:

    I had my first IUI on Saturday (also on 3-7 day regimen of Femara) and my RE just told me to go home, try not to stress out over the two week wait and come back if I got a positive test for a beta (no mention of any other required tests). I say take my doc’s advice instead, enjoy your vacation and here’s hoping that IUI #1 is successful for both of us!

  • jebhow515 says:

    Shit!!! The TWW is typically the only time I don’t feel completely scheduled! It is when I plan vacations! That is insane! Fuck her and enjoy your time off…and try not to obsess about sore boobs and the such (b/c that is pretty much what I do during the TWW).

  • Daryl says:

    I know stats are important, but so is not being made to feel like a child. There’s no excuse for her treating you like that. As everyone else has said, I can’t think of any reason why that kind of monitoring is even necessary, and it’s totally unnecessary for her to scold you for taking a vacation! Enjoy your trip, and I hope you come back pregnant!

  • The way she acted was so totally uncalled for and unfair to say to you. Honestly, I feel like infertility doctors are suppose to be the most sensitive! They are dealing with hormonal women that cannot bare children on their own…and boy do we get mad about that! Forget what she said to you…clearly she’s so insensitive. Go on your trip and have a fantabulous time! I’m so excited for you! Relaxation gives a much better chance for a baby to stick! Happy thoughts happy thoughts! Leave everything behind and have the trip of a lifetime!

  • LisaB says:

    What?!! I’m so sorry you had to deal with that! She is acting very ridiculous. I always charted during treatment cycles. I was the same way, it made me feel more in control. Nothing wrong with that at all!
    And that is just nonsense about the progesterone check and hcg test. I rarely had either of those done. I would just take an HPT at the end of my cycle.
    *hugs* I hope you have a wonderful relaxing trip and a BFP soon!!

  • YeahScience! says:

    OK, I will say that my clinic also had strict rules about notifying them of any travel plans, and fine, you could technically have an ectopic or whatever, but there is a proper way to inform patients about these things, especially patients who are very emotionally fragile! Oy. Also, I know fertility clinics are always anti-HPT, but seriously, even an ectopic will show up on a pee stick if you’re testing 14 DPO, so she should really just chill. Plus, most clinics do NOT do that progesterone testing at all, so there. Anyway — try to look on the bright side and keep your hopes up! IUI does work for a lot of people, so this could be it. 🙂

  • Lydia says:

    Um, my first two IUIs I skipped the progesterone blood test because I was out of town and my doctor did not care at ALL. An ectopic doesn’t show up any earlier than a normal pregnancy (to my knowledge) and you can always test on your own if you are really worried about it…she sounds like she just doesn’t like that you didn’t consult with her extensively before opting out. I’d ignore it! Use her for her uterine catheter skills only…

  • Persephone says:

    I don’t know your full history, but here (I’m also assuming different country) for IUI we have alternate day scans before insemination and then take our own pg test 16 days later. There are no other tests so don’t stress about CD21 tests and I was convinced my IUI wouldn’t work. It did.

    Positive thoughts and hopes x

  • Stasy says:

    She sounds….lovely. Let’s go with that. I’m sorry she made you feel like an ass, but please don’t let it bother you. Those tests aren’t absolutely necessary, especially since you’re already supplementing with progesterone.

    Fingers crossed!

  • Melissa says:

    I’m late to this commenting and I’m kind of a lurker here. But I just wanted to mention that my RE has horrible communication skills and makes me feel small and disempowered. If she weren’t the local endometriosis expert, I would find a more compassionate doctor. She has also made my husband feel super unwelcome. When you’re in such a vulnerable position, putting so much trust in someone else, it feels downright abusive to be treated so insensitively. So I just wanted to say that I understand, and I’m sorry this bullshit happened to you. Have a great trip!

  • Lentil, this is nuts – just some background about us – the two authors on our blog are physicians and we both have the same doctors. And it doesn’t matter how much you know or think you know – we need our doctors to explain things to us! And we rely on them to educate us and make us feel comfortable. The fact that this lady didn’t do any of the above is BullShit! Regardless of what the answer is to the progesterone question, you told them about your travel plans. I have voiced every paranoia to my doctor and he has been kind and comforting and made me LAUGH because he knows this all sucks the big one. And most importantly he answers my questions, even the dumbest ones. He called me in a prescription at 7am on a Saturday because my dumbass took it out of the fridge and left it out of the fridge when you’re not allowed to keep it at room temp – and he did it graciously without calling me out on my idiocy.
    My advice (hate to say it)… find someone better cause she sounds like she blows. This process is hard enough you don’t need someone to make you feel like crap.
    -M

  • Amber says:

    Umm, wow. That seems totally uncalled for. Seriously. When I did IUI, they only had me POAS. Also, it’s my understanding that if its ectopic, you won’t know that so soon anyway. And if you are already taking progesterone supplements, I don’t see what difference that makes either. Sorry you have to deal with such a witchy RE.

  • bustedoven says:

    I MISS YOU AND CAN’T WAIT TO HEAR ABOUT YOUR TRIP AND YOUR UTERUS! SORRY FOR SHOUTING ABOUT IT!

  • Jen says:

    Where’s the update! Hope you have good news!

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