Consult

Tuesday, July 31st was our long awaited appointment with Dr. Br.averman. We live in Upstate NY and planned to make the drive down for the appointment. I scheduled it a few months ago and then the weekend prior I got an email confirmation about it. I thought I had scheduled the appointment for the NYC office, but the email said it would be on Long Island. No biggie, it was actually good for us because it meant we wouldn't have to navigate around the city and leave our car at some bus or train station as was our plan.

The appointment was at 5:45 so we left really early in order to have some time on the beach. We spent about 3 hours on Jo.nes Beach and had a great time. It was totally surreal to be sitting on the beach on a Tuesday of a work week. It's a really beautiful beach and it wasn't busy at all. 

We left the beach with lots of time to get to our appointment in case there was traffic. We arrived at the office at about 5:30 and walked in.

All of the lights were shut off. I called the number and it rang and rang. Finally we saw a receptionist in the office despite it definitely being closed. W and I knocked on the door repeatedly and she came over.

I showed her the email and she told me that Dr. Br.averman was in the NYC office on that day. She suggested she call over and see if we could still make it on time to see him since he was running a bit behind.

It took her a while but she finally came back and said she didn't think he would be there by the time we got there. She gave me his cell phone number and we said we were going to try to make it since we had come so far to see him.

So, at 6:00 we were heading from Long Island into NYC with crazy traffic. We never intended to drive into Manhattan so we were both a little overwhelmed. On the way, Dr. B called me himself and told me he would wait for me so not to kill ourselves trying to get there.

We got into midtown Manhattan with the use the map on my phone and W dropped me on some random corner in order to go find parking. I power walked a few blocks and made it to the second floor. I poked my head in a random office and they said his office was down the hall. I went down the hall and wandered around some random office that has no signs of being open.

At that point I pulled out his cell phone number and called him. Somewhat annoyed he asked me how I got that address since it was an old one. I told him it was on my iphone and I just followed what it said. At that point it was about 7:10 and he said he would wait for me but probably not be able to stay for long. He said, "It's not your day, is it?"

I called W frantically and he was just about to pay $25 for parking. Luckily it was just in time and he was able to pull out of the garage and head towards where I was. He picked me up and we headed to the correct address.

He once again dropped me at the corner and I hustled a few blocks to the office. Finally, around 7:30 I arrived in the right place.

Immediately Dr. B was super apologetic. He said that the email was something that didn't happen regularly but took fault in that. It had to do with the company they use to book appointments. He called them and changed it for the future. He then said the app version of his website had the old address and he called his tech guy and had it fixed. All in all, two computer errors led to a ton of stress!!

One of the first things he said to me was that he is positive that I am going to have a baby. He said he has seen a lot of cases like mine and that he was very confident that changing a few things would have a positive result. 

He talked about three different issues: 1) Simulation protocol affecting egg quality 2) Immune issues/inflammatory response related to PCOS 3) Clotting problems

We made a plan for my next IVF cycle. The changes are the following:
Lupron trigger instead of HCG to prevent OHSS
A higher dosage of Gonal-F to start and then dropping it down shortly after
Adding ganirelix or cetrotide after about 6 days of stimulation to prevent ovulation
Allowing the majority of follicles to reach 18-20 cm before triggering
More closely monitoring hormone levels and testing 7 days post retrieval
The possibilty of a freeze all if estradiol levels get too high in order to increase success rates

Dr. B mentioned a shortage of Ganilrex and Cetrotide and told me to start looking for it now. Does anyone happen to have any extra???? I would be forever grateful to you!! 

Dr. B ordered a ridiculous amount of immune and karyotype testing for us. I've spent a bunch of time talking to the company and trying to figure out insurance coverage. We're getting closer to figuring out how things will work. I've been told it will be about 30 tubes of blood for me and about 8 for W.

We tried a lab on Saturday but they weren't sure what they were doing and needed to call the doctor's office to confirm. They were going to do some research and figure everything out and then I'm supposed to call Monday afternoon to see what they have to say.  

There is an additional fee to use Dr. B, but I think it will be worth it. He said he doesn't really manage cycles at other clinics any more, but due to everything that happened he was willing to do it. The success rates at his clinic are 75% for women my age and amazingly high for all ages. See for yourself: Success Rates.

I'm feeling super positive and excited (did I just say that?) for our next IVF cycle. I am hopeful it will work and really feel like we will be making some positive changes to help improve our chances.

So the plan is to get the blood work done ASAP. It will require two separate draws but insurance should cover most of it if we do it that way. With my period I will start birth control pills and await the results of the blood work. They may take a few weeks to receive the results. Therefore, I may stay on the pills a little longer while we wait, but hopefully not much longer. In addition, I am supposed to find Cetrotide or Ganirelix... anyone????