First RE appt

It's been the most nerve-wracking, exciting, stressful, and optimistic 5 days. Our first RE appt was this past Thursday. My stomach was in knots. Though I was excited to hear his opinion...I was nervous about what'd he'd suggest. More importantly, I was nervous that we wouldn't leave the appt with a clear understanding of our options. Thankfully, I had absolutely no reason to worry. I am in LOVE (sorry, Hubby!) with our RE - whom I will call Dr. Optimistic.

The first part of the appt was pretty uneventful. One of the nurses took my height/weight/blood pressure - and even gave Hubby a hard time for looking! ("Doesn't he know the first rule in a marriage!? Never look at your wife's weight!") Then Dr. Optimistic's clinical nurse, Helaine, came in to go over our medical backgrounds and family histories. After she was done, Dr. Optimisic came in to introduce himself and examine me. Thankfully I zero pride at this point...so the idea of me lying there with 5 people in the room...totally doesn't phase me anymore!

After we got the "all clear" from Dr. Optimistic, we met him in his office to go over his recommendations and our options. Thankfully I had done my homework and this part of the appt was not nearly as intimidating as it could have been. Basically he told us that though the morphology numbers were low (2%), he doesn't want to put too much faith in the fact that that's the only reason why we haven't been able to get pregnant. He seemed shocked/impressed with my Type A personality - I could show him exactly how long my cycles have been for the last 12 cycles, as well as on what days I ovulated. He even told Hubby he was "lucky to have her" and that he'd rather have a patient that knows what she's talking about, versus someone that just goes with whatever he suggests. I took that as a compliment - my body, my decisions. I digress...

In fact, since I could show that I ovulate regularly, and because all our other tests have come back "normal", he said he leans more towards the "unexplained infertility" category. That being said, he won't be ruling out the low morphology, and will always keep that in mind as we move forward. I was also a little surprised that he spent a significant amount of time discussing my past issues with my cycles and their severity. He discussed the possibility of endometriosis, but said that since I only show a couple of the symptoms, he wouldn't want to put me through the surgery to know for sure. (Thank you, Dr. Optimistic!)

He then said that his initial recommendation for us would be to try 3-4 cycles of IUI with Clomid. However, when I explained to him our insurance, he would be more than willing to move on to IVF immediately if that's what we decided. Apparently his initial suggestion for couples in our situation is always IUI first, since most couples are paying some/all of their treatments out of pocket. IUI is much cheaper (approx $400-$600) than IVF (approx $10,000). Obviously, most couples can't immediately jump to IVF without at least trying IUI. Thankfully, with our insurance willing to pay for 6 cycles, we're left in a different situation. We want to get the most for our money; especially since we might need some of those cycles in the future. (Have I mentioned that I've always wanted 5 kids? ha!)

Dr. Optimistic completely understood where we were coming from. He did a great job re-explaining the different between the two procedures and the difference between the success rates. We'd have an approx success rate of 15% with IUI/Clomid and a 50-60% with IVF. It doesn't take a rocket scientist to see there's a HUGE difference. Especially when you consider that the "average couple" has a 20% chance each cycle on their own. Sadly, it's like we're starting out behind...even with treatment. He left us to talk with the insurance coordinator and told us to "keep him posted".

Going into the meeting with the insurance coordinator, we were leaning towards biting the bullet and going straight to IVF. After our meeting with Marie, however, we were second guessing ourselves. Long story short, she explained to us that though we have amazing insurance, they aren't going to want to pay for IVF before we have 2-3 documented failed IUI cycles. Obviously that makes sense...who would want to?? Though she said she would attempt to use the morphology numbers to get an exemption, she thought we'd have a better chance for an exemption if we tried IUI 1 or 2 times first. I don't know how to explain it, but there was a sense of complete calm when she suggested this. Like it was exactly what we should be doing. Though it stinks to know that we have to prove that we "fail" before we can move on to something with higher odds than the "average couple"... what if it works?