[-]Have decided it's finally time to make an appointment with a RE for a fertility consultation. Does anyone have recommendations for REs in NYC or the general metro area?
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[-]day 33 of 35 day cycle, minor cramping and lots of thick white dicharge...pregnant or period coming?
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[-]Very basic ttc question: what is the purpose of clomid, particularly when used in conjunction with iui? Does it regulate your cycle, or is there more to it than that?
17 replies [ Reply | Watch | Options ]point of clomid is to make you ovulate, to make the egg "stronger", and, depending on dose, can make you ovulate more than one egg.
[ Reply | Options ]so then what are the injections for? i thought if you do clomid/iui w/out injectables, you are not as likely to release more than one egg..
[ Reply | Options ]you have to be on a really high dose to release more than one egg and not everyone ovulates on clomid. if you don't, you move on to injectibles.
[ Reply | Options ]actually, if you ovulate nrmally, likely produce more than 1 egg on Clomid. I produced about 3 eggs for each of my clomid IUIs. Moved on to injectibles (side effects were much better, but it required more monitoring) and produced 5 eggs each time. Eventually went to IVF....
[ Reply | Options ]OR: i have pcos and ovulated only one egg on 50mg. i am anovulatory BUT had ovulated cycle before starting clomid after being on metformin for 6 months.
[ Reply | Options ]so my point is, if you have NO ovulation issues ever (I was unexplained) it is very likely that you'll ovulate more than one egg on clomid. That is why women without ovulation issues are given clomid, to produce more than one egg ("superovulate") to increase chance of pregnancy. if this wasn't the case then the doctors would go straight to injectibles or do an IUI without medication!
[ Reply | Options ]I only have one working tube... so does that mean the possibility of producing multiple eggs is slim, or would I produce multiple eggs all on one side? Ugh. Feeling really dense right now..
[ Reply | Options ]>>Let me correct what I said above. I know that having one blocked tube would not prevent eggs from being released on that side, but I meant to say it's less likely that they would be "in play", so I'd have less of a chance of multiples, right?
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multiple eggs on each side? (or are they not able to tell?) also, do the injectibles refer to the trigger shot that happens after clomid has been taken, or is that a different process altogether? thanks for entertaining all my queries... I'm very green with this stuff.
[ Reply | Options ]I produced 3 mature eggs with clomid I think- with both sides having at least one mature egg. On follistim also had at elkast 1 mature egg on each side, and produced 5 mature eggs. Follistim is the "injectible"- instead of taking a clomid pill each day for five days you take shots for like 8-11 days-
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[-]Anyone been to RE Dr. Alan Berkeley at NYU? Did you like him? thanks.
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[-]I am looking for an RE at NYU. I heard it is very hard to get an appointment with Dr. Grifo - can anyone recommend someone else in his practice? TIA.
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[-]i'm very sad. over the past two years i had three miscarriages. i've consulted with 3 ob's, 2 perinatologists, and two referral organizations. the best suggestion was to try again, using blood thinners. i wanted something more definitive than a "hey, why don't you try this". it's so hard. hard on me physically, hard on me and dh emotionally, hard on our marriage, etc. i'm getting to the end of my mandatory wait to ttc again and i'm scared.
51 replies [ Reply | Watch | Options ]I understand. I had two second trimester losses and an early miscarriage. I remember the need to know why. BUT, why doens't matter. What matters is WHEN. When are you going to hold your beautiful baby in your arms? So, keep your eye on the prize. Keep focused. Do what you need to do. Once you are holding that baby, this won't be quite as bad. Best of luck to you!!!!
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Dr. Orli Ettingen gave me a great workup when I was concerned about this. She is at Cornell.
[ Reply | Options ]thanks. it seems like everyone is in agreement about what tests to run (all came up with no problems) and what the options are. but maybe i'll look into this doctor.
[ Reply | Options ]I had the official tests (which came up empty) and then went to her and she ran EVERYTHING, even that crazy stuff that you read on the web that "can be the cause of miscarriage"- all was negative and she went through it patiently with me. For the piece of mind alone, she was well worth it.
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Don't give up hope. I've had four miscarriages, have two DSs and am pregnant again - 22 weeks. First, pick up Coming to Term, by Jon Cohen. It's a few years old now but it's a good resource for multiple miscarriage treatment. It tells you where they started and what they are looking for in their tests. It should empower you to push more for certain tests. Blood thinners treat certain clotting issues but there could be many, many other causes (or none at all). The best stat in this book is that the overwhelming majority of people with up to 4 miscarriages go on to have a healthy pregnancy with no intervention. I think you are past OB and before perinatologist stage. You need a good RE like yesterday. Good luck!
[ Reply | Options ]i thought an RE was used for problems getting pregnant and a perinatologist was for problems during the pregnancy? and thanks very much for the book recommendation. i'm going to get it. i'm feeling very despairing. if they can't figure out a reason then it's just a craps shoot and we have to try and see if it works. (which, if you htink about it, really happens with every pregnancy anyway). but it's a very scary proposition to go through.
[ Reply | Options ]I think a perinatologist is a specialist who treats problem pregnancies, but they seem to get involved after the first trimester. An RE helps someone get and stay pregnant. Infertility is defined as not only the inability to get pregnant, but also recurrent loss. My RE was a Godsend (not in NYC though). He went through everything (and did additional tests from the Ob's workup) and told me how he could fix the various problems that often cause recurrent miscarriage.
[ Reply | Options ]Me again. And the good news is that if you've had all of the tests and nothing is wrong - there is nothing to be fixed. You are just getting screwed by the fates. This was my situation too. I would have preferred to have something to put my finger on, at some point, I think. But the great news is that the odds are on your side, overwhelmingly. Why and when did you have your losses? Chromosomal?
[ Reply | Options ]12-14 weeks. didn't test chromosomes on all but the one(s) that we tested didn't show a problem. they think it's clotting problems but the fetuses and placentas didn't show excessive clotting so that would've been a nice support to the theory.
[ Reply | Options ]I took a baby aspirin throughout first trimester in the pregnancy that resulted in my kids. Doc said it was ok.
[ Reply | Options ]They should have run chromosomal testing with each loss they did a D&C for. God forbid you have another, insist. 50% of miscarriages are chromosomal, and if you've had one, that changes your treatment/outlook in some ways. (I've had two, one normal, one too early to tell). It also will give you peace of mind to know that some things are just flukes of nature. They can karyotype you and your DH to see if something is in your genes that cause recurrent loss (balanced transolocations). If so, IVF with PGD to treat this. Cont'd.
[ Reply | Options ]Another thing, is a single aspirin can treat anticardiolipid antibody issues - if they are bad, you might need heparin. This is also an easy fix. If you have a single or double MTHFR variation, you need more folic acid, another easy pill fix. There is so much they can do! They just need to tune in. An RE can look at your file, see your tests and fine tune your treatments. Obs try to do it, but it's the jack of all trades, master of none bit. Cont'd
[ Reply | Options ]Another thing - did you m/c at 12-14 weeks after seeing a heartbeat at early scans? Do they follow your HCG early to see it rise, or are you only confirming the loss then because it's the first appointment where they are looking for a heartbeat but not finding one (i.e. you could be m/c earlier but not knowing since they aren't looking)? The timing of the loss sometimes indicates what's happening, too.
[ Reply | Options ]thanks for all these questions. (you seem very knowledgeable). i answered about chromosomal testing below. the m/cs were all after seeing a heartbeat, after things had been going very well. all were discovered at 14 weeks, with two measuring at around 13 weeks and measuring at 14 weeks. so everyone seems to be leaning towards clotting issues, with chromosome problems being the next best guess. so they never tested hcg b/c it wasn't a problem. i know both perinatologists i went to said my ob's had been very thorough in ordering tests. they tested for the thrombophilia/clotting disorders and nothing came up as a problem
[ Reply | Options ]How horrible for you. Each time, you thought you were safe and into the clear and then a loss - That must have been excrutiating for you. I'm so, so sorry. If it's a clotting issue, though, a baby aspirin and heparin are easy fixes. I think the baby aspirin is a low dose blood thinner, the other two are a little more of a big guns approach. In light of your history, I would think they would order the heparin. Unfortunately, as you know, the knowledge comes through experience because no one cares as much about the ultimate outcome as we do. That book is amazing, though! I hope you get it.
[ Reply | Options ]op: thank you. first time was like getting hit in the face with a hammer, it came from totally out of the blue. next time i was holding my breath thinking lightning wouldn't strike twice, but it did. third time was almost like having blinders on, just determined to believe that it wouldn't happen again. now i'm a wreck and i'm not even ttc'ing yet. i'm going to call the ob and discuss the heparin vs. the aspirin. i don't want to do too little but i'm also nervous about being on blood thinners if it's not necessary, kwim? but i'm really glad to see from so many people that the heparin and/or aspirin really can work.
[ Reply | Options ]One of the hardest things to wrap your brain around is that it *can* and and likely *will* be okay for you. You feel like Lucy is holding the football and you are Charlie Brown always falling for it, but you have to try to stay sane and positive. You have good facts (no big uglies that are causing problems) and so long as you don't give it, it will happen for you.
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Did they test for the clotting disorders? They can def cause miscarriages at that stage. I have factor v leiden and take lovenox for blood thinning throughout pregnancy, carried #1 no problem, now 31 weeks with #2.
[ Reply | Options ]I am the RE poster from above. My RE did a whole panel of blood tests on me. He found that I had one gene mutation for clotting (gosh I wish I remember what it was). He said that it wasn't two, so it's not technically a defect, but that it could benefit from baby asprin. He then referred me to a high risk OB to assess whether I needed to be a heparin (I didn't). Anyway, I took baby aspirin throughout and progesterone suppositories and my third pregnancy (after two MCs) ended up in DS. GL and hang in there.
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did they end up coming up with a reason for your miscarriages? i think the timing of mine is making it possible to rule out a lot of issues. thanks very much for this information. just "talking" about it with other people is very helpful to me.
[ Reply | Options ]My first one was genetically normal, and a twin pregnancy. Not sure why I lost that one. Second one was triploidy (a full extra set of chromosomes - freak of nature, two sperm, one egg thing). Third was too early to tell, almost a chemical pregnancy. Fourth one was Trisomy 20. Since I had chromosomal issues, I am slightly more likely to have them with an additional pregnancy (1% chance). I've had two healthy boys and all looks good for this pregnancy (girl). This has all been since 2004 - so 7 pregnancies, four losses in 5 years). I was on heparin and baby aspirin for both boys. This time, I'm not on anything.
[ Reply | Options ]wow. what a lot to go through. i'm so happy for you that you have your healthy dc. good luck this time. are you nervous about not being on aspirin or heparin? have they tested for chromosomal problems?
[ Reply | Options ]^^^i ask b/c it seems like you'd understand how i feel now. that i want to ttc, hope i get pregnant, but can't help but feel like i might be waiting for the other shoe to drop. it's very scary.
[ Reply | Options ]I'm not nervous about being off of everything this time - not sure why - you would think I would be. I think it's just that I came out the other side okay with my boys and it gave me faith again that my body could do this. When I was in your position, I doubted everything, that it could ever be okay. Now, it just feels differently. My situation was like yours that there was nothing they could definitely say was the problem. Cont'd.
[ Reply | Options ]We had first trimester screening done this time and everything looks okay. I'm hoping for the best. I hope time speeds up for you because I have faith that you will have a healthy baby - it's just that the road is often longer than we expect. And it's so scary and isolating because it seems so easy for other people. And there isn't much out there as far as support for recurrent loss.
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I had 3 mc's also, but have had 2 healthy kids. One mc before first DC; 2 after; then the baby (yep, she's a baby now). The view doesn't change till you succeed, is all I can say. I would never have believed things would improve - until they did!
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Listen, I feel bad for you but I'm assuming you have a child already and in my experience, people who have miscarriages always end up with a baby. It's the can't get pregnant infertiles (like us) who tend to struggle for longer. Make an appointment with an RE, try some lovenox or heparin and you should be fine. Remember, no one is sick, this will probably work out in the end and you will have wasted all this time feeling miserable. I've seen people go through infertility hell and you're not even in the ballpark. Hang tough. You don't sound like a very difficult case to me. Nothing some IVF and lovenox can't fix.
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[-]Anyone else trying a long time to concieve a 2nd child and it taking a terrible toll on your relationship?
12 replies [ Reply | Watch | Options ]Maybe if you concentrated more on your relationship and less on "TTC", you might have a stronger, healthier relationship.
[ Reply | Options ]Lots of factors at play, I'm sure. TTC can put a huge strain on the relationship, lots of pressure on DW.
[ Reply | Options ]I have a wonderful, fantastic husband and marriage. That's quite a leap you made there from my question to assuming my relationship is a mess. Suggest you read more Oprah psychobabble books...
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We have been ttc #1 for almost two years. It has been a very difficult time (compounded by the fact my husband was laid off for a few months), but I think if our relationship has changed at all, it's for the better. I guess we've never really been tested before this and the experience has made us realize that we really can rely on each other. So I guess it can go either way. If IVF doesn't work for us, our only option will be adoption, and we're not really on the same page with that, so I expect working through that decision will be a challenge.
[ Reply | Options ]It can be a tough road but hang in there together. You might disagree on some issues but try to talk through them together. Patience is important. My DH thought he would never adopt but eventually he was willing to consider it. We finally decided to be content with just one and got pregnant with #2 after 6 years of trying. Ultimately, our marriage is a lot stronger because we have been through so much together.
[ Reply | Options ]It took us 13 months, one miscarriage before it "took." I think you both have to make up your mind that it's NOT going to take a toll on your relationship. If one of you finds yourself getting worked up, take a break. Figure out a plan that will work for both of you. If you are together and already have one child, keep counting your blessings and know that, worst case scenario, you will be a fine and happy family as-is. More than likely everything will work out in time!
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[-]If you were 39 and TTC, at what point would you go to a specialist? Been trying 2 months, miscarried the 2nd month and OB thinks I should try longer before going to an RE. I am worried that I don't have much time.
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I'd at least make the appt for an RE (it may take a bit of time to get your first appt w/them, esp if it is someone popular.) You can always cancel if things change closer to the appt. date. If you are in NYC there are many wonderful drs -- I saw Dr. Pak Chung at Cornell/Weill and liked him a lot, but I'd suggest anyone there who takes your insurance. gl
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[-]Dr. Lawrence Grunfeld at RMA? I just made an appointment to see him on a loose recommendation--anyone have any experiences w/him to relate? We've been ttc six months and I have spotting issues (in a nutshell I bleed lightly from a few days after ovulation until I get my period), so it's time to get checked out. Thanks.
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[-]TTC baby #2. Conceived DS #1 w/clomid/IUI. Am now 37. RE keeps saying all is fine, numbers are fine, DH has super sperm. However, now have had 2 failed clomid/IUIs. exhausted, depressed, and emotional. would you do another IUI and if yes, another with clomid or move on to injectibles? we can't start IVF until Jan. what would you do?
16 replies [ Reply | Watch | Options ]Clomid is counterproductive, move onto injectables. Why do you have to wait until Jan? I suppose it is around the corner now though
[ Reply | Options ]bc the office goes on a hiatus for lab maintenance for a few wks in Dec and then i am away for the holidays to see family, a vacation which was booked almost a year ago, when i had no idea i would be in this awful place. curious, why do you say clomid is CP? i'm also TERRIFIED of doing the injections. i don't know if i can really do this.
[ Reply | Options ]A lot of people say that it messes with your body so much that it causes problems, not solves them . But if you are not going to do IVF until Jan you may as well give it another go or two, but try something different, mix it up a bit. The injections are seriously not a big deal. Can you get dh to do them? Good Luck
[ Reply | Options ]thank you for the advice. i just watched the video for doing the injections and am having anxiety. i can't even watch when the do the blood draws or the ovidrul. i have no idea how i will do this myself, and as much as i love DH, i can't see him doing this either. the clomid did make me feel like crap. but i don't know if its my emotions and anxiety that are causing me to question it. the doc said that typical is 3 cycles of clomid, but he said i could move to injectibles too. im so confused and scared.
[ Reply | Options ]Get dh to do it. You are doing enough, and you won't even feel it. And your doctor knows your situation the best, so do what he says, imo, but if he says injectables are worth a go next cycle, suck it up, and go for it.....
[ Reply | Options ]not a question of "suck it up." i have serious genuine anxiety and fear about needles. i'm still amazed i ever had a baby and made it through childbirth at all. how do you get the strength to stick it in? it's not about whether it hurts, it the anxiety of knowing that something is piercing your skin. i am truly truly scared.
[ Reply | Options ]np: I know someone who hired a nurse to come and give the shots. It was a little expensive but not outrageous as it only took a minute and she found someone who lived nearby. Try this and maybe that will make you relax, even if it costs a few hundred dollars extra.
[ Reply | Options ]thanks for the suggestion. im now trying to think of anyone i know who could do it for me.
[ Reply | Options ]np, and i absolutely 100% understand your needle fear. i was TERRIFIED. got my sister to come do it, and was absolutely in a panic the first time she did it. next time it was bad but not as bad, and gradually got better and better. it can be scary and if you really don't feel comfortable doing it, you shouldn't put yourself through that.
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[-]need advice. short question is: can i go back to my former ob-gyn for a consultation even if i don't want to use him for regular care, or is that offensive/rude? longer story: i was using an ob, i ended up switching practices and since hten have been having unexplained miscarriages. i think my original doctor is very intuitive and i trust his opinion. i'd like to go to him for advice but then would probably not use him for regular ob care, assuming i get pregnant. wwyd?
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the two main reasons were that i don't like his office staff and that the office he has near my home is his second office and he's only there twice a week. after my first miscarriage (which i had while i was his patient) i knew i needed someone that was there every day for all the times i panicked and wanted a sonogram or a fetal heart check asap.
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I didn't go back to a doctor for a consult after I hadn't been to her in 3 years, though I was sorely tempted. Felt too weird.
[ Reply | Options ]I think you should level with your former ob and see how he reacts. Doctors need to be clued in to why patients switch. He might be really understanding and help you with a referral. If you have liked him otherwise, you owe him your honesty.
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[-]have been ttc for #2 for 6 months by now. really want to get help now. should i see my OB first, or should i go to a fertility specialist directly?
6 replies [ Reply | Watch | Options ]see your OB first and ask for the standard tests. something might be obvious and it would save you a load of $$
[ Reply | Options ]have you been charting? and how old are you (just relevant b/c they often say to wait for a year if you are in your 20s-early 30s and have already conceived once). we had tried for a year, and then i went to see my OB. she told me to chart for 6 cycles, i did, and got pregnant on my own in two cycles. wish i would have done that in the beginning! GL.
[ Reply | Options ]yes have been charting. turning 34 soon. the problem with me is that if i don't get preg within 3 months, i will have to wait for another year to try again due to the nature of my work. so really want to get help now.
[ Reply | Options ]i understand, it was kind of like that for us too. i would try your OB first, i think. i'm sure she will tell you to go to a fertility specialist if needed. even charting, i think it can take up to a year for many people... totally frustrating! ARTs present so many of their own problems, though.
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[-]Seriously, have been TTC # 3 for 4 months, keep screwing up the dates. I have got it now, and it's this Thursday through Monday. My mom comes in town those exact dates. We have a small apartment. Do I ask her to leave for the 5 minutes it takes? Do we try to do it outside the home somehow? We cannot possibly do it with her here - she would hear everything. I don't want to miss another month. Dying for a spring baby, now it's a summer baby.
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Ask her to do an errand for you - like find a shampoo. I always find that aisle like a black hole.
[ Reply | Options ]Sorry. I know, TMI, but the moment it happens, my husband is loud - the living room is right outside my bedroom. I don't even have a TV in my bedroom. I guess I can muzzle him?
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[-]Is there any risk at all if I have shots of novocaine at the dentist's office during the two-week wait? Been ttc for 15 months. Had a m/c 6 months ago. Don't want to take *any* chances. I'm now 3 dpo and from the pain it seems a cavity I had filled at the start of this cycle will need to be redone. Is it okay for me to have that done now, or better to wait until I know whether I'm pg?
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[-]ttc here and Expecting period on Tuesday. Took pg test this morning and negative. Am I wrong to think it's not going to happen this cycle? I don't feel any different. Tia.
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[-]Please recommend someone who is a specialist in fibroid removal/treatment. I've had 3 MC and I'm starting to think I need to get it taken out in order to TTC. Someone kind and compassionate would be a real bonus. TIA!
6 replies [ Reply | Watch | Options ]Rogerio Lobo did this for me. He is a reproductive endicronoligist at Col Pres. Offices at Columbus Circle and uptwon. He is GREAT. I consulted with 4 doctors about my fibroids. He was the only one who did not want to put me on Lupron or make me have a verticle incision. Has done many myomectomies to save fertility. I had 17 firbroids and a 5mo uterus. I went on to 2 vag deliveries. I did not need any kind of medical intervention to get or stay pregnant. Avoid Dr. Keltz at SLR.
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