We were early, having left home at 12:30 p.m. to beat any potential Memorial Day weekend traffic heading south, so we arrived with an hour to spare. We hadn't eaten, so we found the cafeteria at the adjacent hospital and had a quick lunch.
The second we stepped onto the floor where the clinic was located, we were instantly confused. There were no windows in the corridor, just plaques on the wall to indicate which business was behind each solid metal door. Not terribly friendly.
Inside, it was very dimly lit and sort off-putting. The walls were painted in heavy browns and blues with sterile artwork on the walls and Newsweek and Time magazines on the coffee tables...no images of women and children, no pregnancy books, nothing to suggest we were anywhere other than perhaps a proctologist's office.
We didn't wait long before we were ushered back by a nurse to, "Stand right here, oh, you can sit in this chair so I can take your blood pressure, no, wait, I need your weight first, ok, now you can sit, oops, I need a photo of the two of you for your chart, stand together right here." WTH?? Get it straight, lady! It turns out, after all that, the doctor wasn't ready for us so we were sent back into the unfriendly waiting area to wait a little more.
Finally, the doctor came to get us. It went downhill fast from there. Between his apparent need to debate why he thinks we lost the twins; to his overt attempts to discredit most everything Dr. M. has done and said the past two years ("I see your doctor has your medication dosages here in this little handwritten calendar [waves hands around dismissively], but why don't you tell me what your dosages are...this really doesn't make sense to me..."); to his snide remarks about how they have patients fly in from Dublin, Ireland and China so several drives per week to and from Portland really shouldn't be too much trouble for Paul and me, to his overall arrogance...let's just say I was seriously pissed off within 10 minutes of being in his office. (I'm still not very good about standing up for myself in the moment...if I'd had my wits about me, I would have said, during his goings on about the twins, "You know what, today is the one-year anniversary of our positive blood pregnancy test...it's a little tender, so if you wouldn't mind, please move onto another topic. And, no, we DON'T need a third (actually, fourth) opinion by a Portland MFM. Give me a break.")
Personalities aside, we did learn some things:
- I need to have a Clomid challenge test done to check my follicle stimulating hormone (FSH) levels. This involves an FSH blood test at day 3 of my cycle, five days of Clomid pills to "test drive" my ovaries on days 5-9, followed by a repeat FSH test. If the results come back high, I cannot do IVF with my own eggs. Period, end of story. They charge $500 for this test, and I have to do it in Portland (i.e. two back-and-forth trips).
- I need a repeat hysteroscopy done, and if there are still polyps, I must have them surgically removed or they will not do IVF at all, with my eggs or anyone else's.
- I am too old to qualify for a multi-cycle discount, so we would need to pay the $15,000-16,000 per cycle as we go. However, I will qualify for the discount if we use donor eggs (less risky for the clinic because the success rates are so much better). The quoted amount (apparently, although we have nothing in writing) includes intercytoplasmic sperm injection (ICSI) - which is a must between my assumed poor response and Paul's sperm issues - and the freezing of any leftover embryos.
- DHEA is "a thing of the past" and he doesn't like to see his patients on it. The CoQ10 I started taking two weeks ago is fine, but I should discontinue the DHEA that Dr. M. prescribed.
- It's "doubtful" the Metformin has had anything to do with my poor response, but since I don't have PCOS, it's not necessary for me to take it.
- Dr. M. didn't stim me correctly for IVF, in his opinion. With patients like me, you have to start with the maximum dose right out of the gate, not step up. (That's good information to pass along to Dr. M. if we decide to go back...maybe he can do something different.)
In all, the whole visit left a very, very bad taste in our mouths. We had to stop and pay the $350 consultation fee on our way out and I could not get that over with fast enough. The more I think about the whole thing, the more upset I am. Paul left completely overwhelmed, mostly because he needs time to process information and didn't come into the appointment with as much background on IVF as I already have. He awoke the next morning and said, "You know, the more I think about it, the more I think he was really just trying to say they don't need our money." Exactly. Seventh in the nation for my age group absolutely does not trump asshole-ishness.
So, where does this leave us, besides wanting to run, crying, back to Dr. M.? I know, that sounds insane, but really, wow. Anyway, I will be calling Dr. M.'s office this week to find out whether they do the Clomid challenge and how much it costs (it's bound to be less expensive there). I purchased the book, Making Babies: A Proven 3-Month Program for Maximum Fertility a couple of months ago after it was recommended by my hypnotherapist, and we've decided to take the next three months to try and get my body into tiptop shape using the techniques in the book, which include both Western and Chinese medicine along with dietary changes. If the Clomid challenge isn't too expensive, I'll have it done soon, otherwise, we'll wait until the three months are up. That way, if my FSH does come back high, we'll know we did all we can to improve it, and hopefully the decision to adopt or use donor eggs will come more easily. I'll also have Dr. M. repeat the hysteroscopy, and if he can't remove the polyps in his office, then I'll schedule surgery closer to home.
Past that...I think we'll be looking for a third clinic option. Dr. M. doesn't do ICSI ("Oh, I didn't know there were still clinics around the U.S. who didn't do ICSI," said Dr. Asshole, as if to say how disturbing/charming that was). Now that the Portland clinic is out, that leaves clinics in Seattle and surrounds (and possibly OHSU in Portland). We can cross that bridge when we come to it.
It would have almost less disappointing to hear, "Sorry, it's too late to help you" as my dream predicted than experience the sheer arrogance and dismissal we got at our appointment.