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Phone Consult w/ Dr. P on 6/22: What should I ask or expect? Updated w/ Consult Notes

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20-Jun-12 2:37 pm

 Hello!

I am WantWarriorPrincess, a formerly active member here from around 2005-09. I took a break after I had my third son, to enjoy the family I have and try not to obsess about the family I wanted. Now, 2.5 years later than planned, I am starting now a road I hope will end with IVF/PGD this fall and a (one!) girl pregnancy for me.

For a little bit more about me, there is this thread from November 2011: http://www.in-gender.com/cs/forums/t/237183.aspx

So I've submitted my patient registration forms and will await Dr. Potter's call from HRC on Friday evening. What should I expect? What should I be sure to ask?

 

TIA, you lovely ladies!

WWP

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20-Jun-12 8:23 pm

I think I remember you!

Here are the notes from my Dr. P consult in June 2009, if they help or provide ideas.  :)

GZ

Baby Boy 2005
MS/IVF/PGD Baby Girl Baby Girl OHW Mar 2010 - Thank you IG, Dr. P, Lori, HRC and MS! 
Age 31 at cycle time, with elevated FSH (12.5)
More info: visit my detailed HT blog and/or see my cycle info

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20-Jun-12 9:56 pm

 You should remember me--all Canucks are supposed to know each other! ;-)

TY, that was SO helpful. I will crib some of your questions about how many embies to put back. I told Stephanie already that my OB-GYN is totally non-judgy and well on board. That's why I've already done Day 3 and Day 24 hormonal tests, as mentioned in the post at the link in the first post of this thread. So hopefully that will give Dr. P more to work with.

*sigh* I really do miss having MS as an option.

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21-Jun-12 7:50 pm
Hey WWP! I don't get on line much these days, but WOOT WOOT WOOT!! You are finally getting your turn!! I didn't look at GZ's notes, but she tends to be rather amazing in her details! Did you have your blood tests dones already? Do you have a good FSH and AMH? Ask what your odds are based on those numbers. Best of luck! If you ever want to contact me, let me know! I'm ready to cheer you on WWP! More wooting! Can you hear me?
A lot of great kids, and a full time job mean very little time to play! Miss you all!!
Thank you In-Gender and Maureen for giving me a place to dream, and the tools to chase those dreams<3

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22-Jun-12 6:39 am

 CC! It's so good to see you. Hope you and yours are surviving and thriving!

Yes, GZ's notes are so excellent. I will try to add my own after tonight's consult, but I'm sure they won't be that meticulous.

Yes, I have had some Day 3 hormones and a Day 24 progesterone test back in Nov '11, although the thread on this board about how others' numbers changed in just six months has me concerned. My test results are in the post I linked to in my OP up above. No estradiol, though, or AMH. I don't even know what AMH is. The numbers for FSH (5.3), LH (4.2), TSH 0.64), prolactin (9.0), and progesterone (31.1) were all really good.

WWP

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22-Jun-12 7:22 pm

Probably will edit/add on later. It was a good, hour-long conversation with Dr. P, with me opening with my familiarity with him from IG.

He wants me to re-test all my hormone levels, in part because my doc did not test for estradiol, to see on how viable a candidate I am. He also wants to check my insulin levels because I am overweight (and I don't mean by 15 lbs) and to do an ultrasound to check the uterine cavity in general and specifically for fibroids, which are more common in women of African ancestry--and totally fixable given enough time before one cycles.

I asked about what kind of drug protocol he would look at given the numbers from my Nov tests, assuming nothing changes. He said we'd look at a long protocol with 1 Menapur and four Gonal F (300). (I think my notes are a little rough there, sorry!)

He said I should stay on my current BC ("Absolutely!"), if only because he feared that going off it would result in my conceiving Boy #4 before we travel this fall, lol. ;-)

Best way to get high-quality eggs and sperm? He thought my Type I diabetic husband should try Cyvita supplements (three pills two times a day), that I could try 400mg of Co-enzyme Q10, and that he's more interested in me going low carb, cutting out white flour and refined sugars. He'd really like me to cut out any foods that come in a package. He wants good, low insulin numbers. He's more interested in my going low carb and avoiding sugar than he is in my losing pounds, per se. (I told him that I eat plenty of fruits and veggies, but am fat chiefly due to sugar and fat in the form of CHOCOLATE.) But I know if I cut sugar, weight will fall off.

He also would rather have me cycle at the end of our monster 17-day vacation that will include Disneyland (Cars Land!) and Legoland, meaning doing the egg retrieval and transfer just before going home, rather than doing it and then running after three kids in amusement parks all day.

Dr. P was very positive on the idea of a single egg transfer (SET). He said that the Natera 24 screening has improved the pregnancy rates over IVF/MS rates. "If you transfer truly healthy embryos into fertile women, IVF actually works really well." The trick is getting normal embryos of the desired gender. He said transferring one hatching blast that is 24-screen approved can have 80% pregnancy rates, while SETs for compacting stage are only 30%.

I finished with a twist on one of GZ's questions: What is the best advice you give that too many people ignore? "Be focused, but don't worry about things that are out of your control...[I said some stuff here to which he responded and then he finished] Be positive, and don't stress."

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22-Jun-12 9:30 pm
Oh honey, you don't need BC, do you? I love that you are one of the most fertile people alive! AMH is the Anti Mullerian Hormone. I would get it done, as it really is a good predictor of response to stims. My FSH was the same as yours, but I had a hard time stimming on the Long with 300. AMH wasn't around then though:) Would he put you on metformin prior to cycling anyway? If you have some pre diabetic issues, I'm curious why he wouldn't try that. Diet and exercise are all great, but even from skinny minnie me, I tested as insulin resistant. Hopefully your test will let you know. Chocolate....mmmmmm. I did 3 CoQ10/day and Omegas/Flax. Dh did Maca and the CoQ10 and Omegas too. Interesting concept about doing the ER at the end. I guess that would minimize how many visits you would have to find at a clinic here. Might save money. 17 days==WOW! I am impressed, that is AWESOME! And not worry about things out of our control---ya, ok! Not our personality type!! I think if you got a 24 probe female HB, you are in good shape. And even if they are not HB, you are still in good shape. I only ever had one hb:) Fingers crossed, and big breathe--you took a BIG step today!
A lot of great kids, and a full time job mean very little time to play! Miss you all!!
Thank you In-Gender and Maureen for giving me a place to dream, and the tools to chase those dreams<3

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22-Jun-12 10:00 pm

Hey WWP, good to see you!  This is ahimsa_malozzi, a fellow July '06 IG oldie.  So excited for you to do PGD!  Don't know if you remember my story, but you can see the details in my siggie.  Anyway, I did my first round of PGD/IVF with GSN (Natera) 24 panel in December.  Are you doing a day three biopsy with fresh transfer?  At my clinic they were really pushing the day five biopsy, which you could get a fresh transfer with on day six if you used their local aCGH but that had like only 90 - 95% accuracy for gender, so I went for a day five biopsy with frozen.  Had two normal XX blasts frozen and transferred in February, BFN.  SO crappy!  Then we cycled again in March and this time we did the day three biopsy with fresh transfer because the doctor said fresh was more important than day five biopsy.  On day five we had five normals, but only ONE XX, and she was a morula!  You can imagine how awful I felt, I mean I'm the queen of pessimism over here, but my SET morula stuck, and now I'm 15 weeks pg!  I guess I'm proof that it can happen even with one lousy morula!

I would ask Dr. Potter about Metformin as well.  I'm overweight too, probably not obese but significantly more than 15lb as well (never snapped back after DS3), and my doctor didn't even do testing for insulin resistance my second cycle, he just put me right on Metformin.  He said it was more because of my PCOS-like response (I made 34 eggs the first time, that's kind of a ton), but he says he puts women on it all the time after a failed cycle.  I took it starting about two weeks before ER through to almost thirteen weeks, started tapering off at eleven.  I think most people start like six weeks before a cycle, though.  Of course healthy eating can't hurt either, right?

I always envied you guys who go out to HRC, it sounds like an amazing vacation!  Good luck WWP, can't wait to hear all about your cycle!  And again, welcome back!

Baby Boy June 2005 Baby Boy December 2007 Baby Boy November 2010

Two swaying opposites, two MS/IUI BFNs in 2009.  Good Luck CloverHoping and Pray that PGD/IVF works for us!Good Luck Clover                                                              Cycle #1 - straight to FET two GSN normal XX blasts - BFN  Cycle #2 - Fresh SET GSN normal XX morula - BFP!  Baby Girl due December 2012!

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22-Jun-12 10:34 pm
I haven't been on here in ages, but I heard about your post from CC and I just wanted to jump in and cheer you on as well! It's your turn!

Mom2RJA Baby Boy R, 2000 Baby Boy J, 2003 Baby Girl A, 2009 MS/IUI 10/2/07 at GIVF, natural cycle, 1 follicle, 94.7% sort purity, BFN MS/IUI 8/25/08 at HRC, Clomid + Ovidrel, 3 follicles, 92.99% sort purity, BFP!!! Beta #1 on 9/9 (15 dpo): 153, Beta #2 on 9/11 (17 dpo): 395 

mom2rja@gmail.com

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22-Jun-12 10:50 pm

 Aaaiiieee!!!!!!!!!!!!!!!!!!! It's awesome to see you all again! Happy  LOLHappy  LOLHappy  LOL

CC, OK on the AMH. Sounds like something to ask for. I have to take all the forms Dr. P just emailed me to my local OB-GYN anyway to get tests done.

Cultured Pearl, of course I remember you! So happy for your "crappy morula"! Dr. P mentioned a patient from last month who, if she had been monitoring at home instead of being on vacation monitoring at HRC like I will be, he would have told, "Those numbers are no good. Cancel your flight and hotel." But she was already there, they went through all the motions, got one embie at all worthy of transfer, and now she's pregnant. Like we say, it only takes one.

Yeah, we'll see if I end up on Metformin. I have no diabetic issues (insulin resistance, high blood sugar, etc) that I know of, and believe me, a number of doctors I've seen take one look at the number on the scale and make me take tests. But hey, I haven't done any testing for two years, and things change. Can't hurt to see.

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25-Jun-12 7:06 pm
Hi There, I am new around these parts. I have two beautiful boys 22months and almost three months and am looking into pgd to complete our family with a baby girl. I am just wondering how much did the phone consult cost? Thanks and good luck

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30-Jun-12 11:42 pm

Hello, and welcome, waitingforanja! I do not know how much the phone consult normally costs. I mentioned that I "knew" Dr. P from asking him question at this site, and the woman (Stephanie?) said, Oh, then the consult will be free if you were referred here from IG. I did not know that, expect that, or aks for that. It's just how the conversation played out.

Enjoy those beautiful babies! They're both younger than my youngest, and it's such a sweet, tender, fleeting age and stage. :-)

GL!

WWP

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1-Jul-12 10:27 am
Hi WWP, just wanted to wish you the very best of luck with your HT journey. Praying and FX for a pink healthy bean x I remember you posting back when I was swaying for my daughter. GL x

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2-Jul-12 10:10 pm

Oh, well, thank you so much for that, Another princess!

 

Charliecats and Mom2RJA, I'm WWP Smith, ready (finally!) to connect up with all you fine ladies. My Gold membership lapsed here, so I cannot send private messages, altohugh I can read them and read yours.

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3-Jul-12 9:01 pm
shot ya a message
A lot of great kids, and a full time job mean very little time to play! Miss you all!!
Thank you In-Gender and Maureen for giving me a place to dream, and the tools to chase those dreams<3
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