Fifth Doc's a Charm (Bullet Style)

Positive

• RE #5 is an affable, grandfatherly man; henceforth, he shall be known as Dr. Werthers.
• Dr. Werthers called our religious convictions about not freezing or discarding embryos "laudable."
• Dr. Werthers also seems to have a subtle, sarcastic sense of humor. I never knew for certain if he was joking or not, but he peppered his remarks with little asides (with his nurse as straight man). For example, while running through my history of doctors, he said something to his nurse about how many women like Dr. [Ego], how Dr. [Ego] is very handsome and knows it.
• Speaking of the nurse, she also seems caring and personable.
• The intake questionnaire, consultation, and exam were far more thorough than the other two clincics' were; my appointment lasted at least an hour and a half (not including time in the waiting room before the appointment even started).
• Dr. Werthers actually engaged in dialogue and took my opinions and preferences seriously.
• The doctor and nurse are hopeful that we can do egg freezing in conjunction with IVF and will do all they can to get insurance approval.
  

Not-So-Positive

• During the ultrasound exam, Dr. Werthers saw what could be a fibroid in my uterus. He'll look into it further once he has seen my X-ray films from last year's HSG.
• Every doctor I've seen now has offered a different explanation for our infertility. Dr. Peppy attributed it to a luteal phase defect. Dr. Owlish called it unexplained, possibly caused by mild endometriosis. The possibilities Dr. Werthers threw out: PCOS (!?... I have none of the normal indications for that), elevated male hormones (!? again... not exactly what a girl wants to hear), this potential fibroid, poor egg quality, etc. Now I know he's just brainstorming and wouldn't actually diagnose any of those things without further testing; but still, it doesn't inspire confidence that no doctor has agreed about the reason we can't conceive.
• Dr. Werthers still recommends transferring no more than two embryos for a woman my age, even with our history of failed IVF. He'll study our previous embryology reports, but his initial recommendation is to fertilize 3-5 eggs and then make a decision about how many to transfer based on embryo quality. We'll have to keep negotiating to find the right balance between being cautious (no, I don't want octuplets) and aggressive (I don't want to squander our remaining 2 IVF cycles, so I want to fertilize more eggs, but we are firm about transferring all living embryos).
  

What's Next

• Track down remaining records to fax to Dr. Werther (embryology lab reports, HSG X-ray films, most recent semen analysis).
• After they review those records, the nurse will call about any further testing needed.
• Figure out if egg cryopreservation is a viable option (will insurance cover the IVF cycle that yields the eggs? how much would we have to pay for cryopreservation and subsequent fertilization and transfer?).
• Do IVF, possibly adding heparin as a can't-hurt-might-help medication.