update on RE appointment

Getting to downtown Toronto via train during morning rush hour was not nearly as bad as I thought it would be. That was my #1 concern today. And the clinic is about a 15-minute walk from Union Station, which is a bonus. So monitoring - should we make it that far - won't be too terrible, except that I'll have to get up at 5 a.m. to be there on time. Blech. Am not a morning person. But I do love Toronto.

As for Dr Hannam, I was reservedly pleased. He was much more open and congenial than most doctors I've ever run across. We got 45 minutes to talk to him, and I felt that he would have stuck around as long as we needed. He took time to review our info before the appointment, which was much appreciated, as many Canadian infertility specialists don't, in my experience. And he was concerned that we understood what he was saying (in terms of the medical jargon - I did, but that's because I have a Google U Ph.D.; I don't know what DH knows, though). He also comes highly recommended by current patients on www.ivf.ca.

Hannam's impression, as we've already realized, was that my PCOS has deflected attention from the male factor. We'll never know what caused the mf, but he suspects DH's history of chemical exposure, since no one in his family has ever had mf issues (and yes, we know that for sure). And so he made his recommendations and referrals: semen culture, DNA integrity assay, y-microdeletion, scrotal ultrasound (or something like that - can't remember what it was called) and physical exam by the best urologist in the city, and a karyotype/chromosome analysis. This probably sounds obvious - of course some licensed idiot should order this stuff, considering what we've been through with unruly sperm - but our other clinics WOULD NOT order any of these things! Not even the physical exam! So I'm thrilled that DH is finally getting checked out, and we didn't have to beg. The only test we have to pay for is the DNA test, which is $200 - big deal. And I'm so excited that there's virtually no wait for the urologist - where we're originally from, I bet $100 that we'd be on a year-long waiting list, at least.

Hannam also recommended ramping up DH's antioxidants, so I guess I wasted my money on those Puritan's Pride products. What we need to buy is going to cost around $90/month. Oh well. We got a month's worth of hyper-antioxidants for free from the clinic. And really, we just need to purchase 2 months' worth extra - either from the clinic or direct from the manufacturer - since DH only needs to take them for the 3 months leading up to the egg retrieval. (Ugh, I cringed at typing 'egg retrieval' - I can't believe I have to go through that again. It was so painful - they ended up having to put me out for it. And I was horrendously constipated for 3 days afterward. Yuck.)

I'm also getting the following tests: sonohysterogram, y-microdeletion, and karyotype/chromosome analysis, as well as the standard bloodwork (e.g., thyroid).

Incidentally, I also liked the fact that Hannam believed me when I said that I controlled my PCOS on my own, with diet and exercise, and he was excited about it. (Doctors, for whatever dumb reason, rarely believe me when I say that I did it without drugs, even though I can prove it with my medical records.) I also said that I would not do Metformin or Glumetza ever again, and he did not argue with me, as my previous doctors have done.

The cycling cost won't be quite as bad as I'd feared. The $11,000 I was quoted on-line (by other patients at www.ivf.ca) covers IVF, ICSI, and AH, plus embryo freezing and storage. And I can get the drugs at Glen Shields, which should save me a small bundle. So we'll spend around $3000 more than the last time. But my gut says we've done the right thing, and I always go with my gut. Yes, it's still going to cost a lot more than it did at our previous clinic. $3000 is a lot of money for us. When I'm teaching full-time, that's how much I take home in 6 weeks. But I reason that it will all come out the same in the end, since Hannam's success rate is almost 20% higher than any other clinic around here. So it's ok. Right?

He said that, if we decided to become his patients, considering the timeline we laid out for him, we need to get a cycle going this spring, after the test results come in (hoping, of course, that none of them is too bad). He's talking March. I groaned, since that means my beta will happen just before the time I'm prepping for my thesis defense. He looked concerned about those two things happening simultaneously, but we all agreed there wasn't much else we could do. He sounded guardedly optimistic about the potential IVF outcome, since I did get pregnant last time, and it is possible that that miscarriage could have been a fluke, since many pregnancies do end that way, especially for first-timers.

Anyway. Yikes. March is not far away. I'm thinking that April is more realistic, since we need to gather the results of all our tests, first, and those things always take longer than expected. I am not proceeding until we get the result of the DNA test.

Now, to deal with the professor I've been avoiding. *Sigh* Seems that seeing her on Monday will be unavoidable, as I have a meeting in her vicinity. She really upsets me -our personalities just don't click - and I don't know how I'm going to handle this. I would never tell her about the infertility stuff - although it might help her realize that she needs to back off from nagging me about working for her, and finishing the paper we started writing together - because she (think ultra-prim Victorian poster child here) can't handle that information. It would embarrass her so much, and I'm trying to protect her from that, as I'd feel terrible. And then, despite her discomfort with the topic, she'd bring it up all the time and ask me pointedly, with a cocked head and an exaggerated look of concern, "How are you doing, really? ... Ok, are you sure? ... When should we meet about the paper? ... "