Sunday, May 16, 2010

Meeting Dr. Puzzle

My first appointment with the RE (Dr.Puzzle) went pretty smoothly, well until the morning after when a had a mini-freakout. More on that later. So, I think I really like Dr.Puzzle, but he also seems to be a bit hard to read. I felt very relaxed with him, which is great. I'm the kind of gal that only goes to women doctors for her annual poking and prodding. I thought it kind of sucked that the majority (Like 95%) of REs out there are male doctors. I thought it would be a problem, but he was very relaxed and I felt really at ease with him.

The reason I call him Dr.Puzzle is because during our consultation he'd give me these looks, almost like he's giving me the evil eye. Kind of like if he looks at me a certain way I'll give up the key to my problem. It honestly was a little off-putting. That's when it dawned on me that he sees it as a puzzle, trying to look at it from different angles. He loves a puzzle, and a puzzle is what I gave him!

So, a bit of our history he wanted. We're both healthy, under 30 and unsuccessfully TTC for almost a year. I showed my charts which easily show that I ovulate, on average, between CD14 and CD16. No spotting, no difficult symptoms, no low or high temperatures and LP is normal. In fact, he wrote "Excellent Charts" in his notes. DH's numbers are a bit on the low side, but still normal. I got acquainted with Wandy rather quickly, and unexpectedly. Ultrasound showed everything was perfectly normal and he even showed where I had ovulated from my right ovary and pointed out the follicles that were still visible. The best looking ovaries he'd seen all day.

My case baffles him. I have mixed emotions about that. For me, the unknown is more scary and more frustrating that anything else. The diagnosis I would loathe to hear, "Unexplained Infertility". I know it could be worse, which is why I am comforted that it still looks like we're good to go, just that our number hasn't come up yet.

He asked me what I thought might be the problem, and I said I didn't know, that this is what is frustrating to us. I should have stated my position right there, that the reason I was there was to find a diagnosis and not just throw treatments at it. I was enamoured by the fact that I appeared to be fine (I was afraid I had cyst on my left ovary). Dr.Puzzle doesn't see the need to medically try to induce ovulation since I appear to be doing a capable job on my own. His recommendation was to head into an unmedicated IUI, and that he thinks the problem might like in the motility numbers and that IUI is all we'd need. At roughly $200 (!!!!!) a pop, not a bad deal at all.

We had a bit more conversation where we got to know Dr.Puzzle and his practice a little more. We met with someone from billing about insurance and fees and what not. That's where we learned that IUI is closer to $800 after all office visits, that the $200 was just the IUI procedure. IVF is $12,000-$14,000, which includes everything and cost depends on what stims are used. Insurance, of course, does not cover treatment at all. Then we waxed unpoetically about frustrations around the politics of it all.

I was instructed to call at CD1 IF it arrived (FX that it doesn't) and to call again the day I ovulate to get in for the IUI. It wasn't until after I left the office that I hadn't spoken about wanting a diagnosis and not just a treatment plan. Apparently it was bothering me more than I thought because when the cat woke me up the next morning I couldn't get back to sleep.

My biggest fear, that he had given an official diagnosis of infertility and that we'd go through with the IUI or several IUIs only to finally get an HSG scheduled and find out that I have blocked tubes. Almost $1000 a try, and then have to pay for the HSG out of pocket on top of it? It only makes sense to me to try the HSG first since insurance will cover diagnostic tests, plus HSG can help increase fertility by cleaning out the cobwebs.

So from 5am-8am I fretted about the fact that I'll probably not get the test done and that he's already flagged me for infertility. I left a message with the receptionist who called back a few hours later, and calmed me a bit. The visit was not coded for infertility and she'd pass the message to Dr.Puzzle after she got his dictated notes. Hopefully I'll hear something before CD1


  1. I agree about getting an hsg done sooner versus later. It could save you from doing unnecessary treatments and I've also heard it can possibly help clear out your tubes. Fingers crossed though that you won't have to worry about treatments at all! :)

  2. As much as I hated the HSG...I was so relieved with the results. It is just so much better to know what you are dealing with. I would definitely do that before starting any treatments.