Wednesday, October 19, 2005

A golden ticket for the ART roller coaster

The consult with dr. Sunshine wasn't all about TED. After going over the test results, it was time to discuss options. Because our results didn't show anything wrong - well if you don't count the lack of ovulation - she recommended starting some mild medication: clomid. Alternatively, we - or better I - could continue on to the next set of tests starting with the HSG.

Now I am both a pessimist and a panicky person. This is not a good combination. It means that I keep telling myself that nothing is bound to work and that I should resign myself to this. Not constructive at all, and I'm working on it. Also, I'm very anxious that I'm wasting time, and by the time I 'graduate' to IVF, I will get a diagnosis of premature ovarian failure. Not that I have any reason to think this. It's panic talking.

I guess I've been doing too much research on the subject as well. I'm still in the 'got to read everything' stage. I don't consult dr. Google often, but read a number of IF blogs for moral support. In doing so, you pick up a thing or two.

I bought some books from my friend The Internet. One is a book by dr. S. Silber, an RE from St-Louis, with the obnoxious title 'How to get pregnant'. One of the chapters explains which tests and treatments you can expect, and the author gives his opinion on their usefulness. The author claims there is a test available that can give you an estimate of the time you have left until menopause: antral follicle count (AFC).
This can be performed with a good ultrasound machine.

Of course I would love to know if I can afford to waste time or if I have to hurry, wouldn't we all. So I brought it up with dr. Sunshine. I didn't demand such a test, but asked her if she thought it was possible to estimate the time left on my biological clock in this way.
Either she didn't agree with this research or wasn't familiar with it, I didn't quite understand. In any case, she wasn't inclined to do the AFC.
I'm really going to have to work on being a good advocate for myself. I'm also the non-confrontational type.

I decided to follow her advice, and we'll do a few cycles with clomid. Part of me wants to do a whole lot of research on AFC and present it to her next time, or move on to an RE who would be willing to do this. Part of me thinks I should give this treatment an honest chance. After all, it just might work, or they wouldn't prescribe it any more, right? (Give me a T!)

Alarmingly, Silber's book claims that RE's all over the world continue using treatments that have been proven ineffective by independent research. Not out of malice of course, but mostly out of habit and not being aware of the latest research. Of course, ask two doctors for their opinion and usually it will be different.

So, you see, I'm suffering from FUD. Fear, Uncertainty and Doubt.
But I'm also happy that we're finally doing something. I've gotten my ticket for the ART roller coaster, and am now waiting to get on board.