This week, I have found out the urologists do things differently. Not sure why, but obviously, they do. On the forum, I chatted with some girls dealing with MFI and their DHs' urologist prescribed clomid to help increase counts.
My DH saw a urologist in the midst of all of our blood tests, work-ups, etc. pre-IVF. Our RE recommended it and the urologist. It was a very "brief" physical exam and then, we followed up with our RE. They discussed the urologist's opinion and said there were no structural concerns. End of story - proceed with IVF.
Well, after learning of other's experiences and really not knowing exactly what my DH's urologist checked/or didn't check - I decided to do some homework. I called his office yesterday and asked a few questions.
First, he does not specialize in fertility-related issues. (Oh, really? Wondering why we were sent to this guy? He was supposed to be "so great" according to our RE's office.)
If he has a patient with fertility concerns, he refers them on to a specialist - usually, our RE. (Oh, how convenient.)
I tell her about my conversations with some other women who's DH's have MFI and ask, he doesn't prescribe or offer clomid to men? The nurse says no, that would be dealt with the RE. (Oh, wonderful.)
So, what exactly did/does he check during our brief visit and his exam? Structure? Varicoceles? The nurse asks me to hold a few minutes while she reviews my DH's chart. (Doo-doo, Doo-doo, Doo-doo, Doo)
She returns to tell me it looks like structurally, all was good. No varicoceles. The urologist did not recommend any follow-up tests. Just to follow what the RE recommends.
Well, our RE recommended IVF w/ ICSI. BUT.....we did not try anything else. Nothing was offered. Nothing was discussed. What if we would like to try clomid? Just to see.....(because those pills are darn cheap!) DH wants to wait and talk to my Obgyn before we call our RE. I agree, so we will wait a few more weeks.
On a side note, my FIL (56yrs old) was diagnosed with progressive prostate cancer last month. He had surgery this past week that removed his prostate. He is doing well. FIL and DH talked about it and they think he (my DH) should be checked out now as there is a family history. FIL wonders if maybe there is something there related to MFI..... So, I brought this up to the urologist's nurse at the end of our conversation. The urologist was out yesterday but she is going to have him review DH's chart and call us next week.
We have more questions and no more answers, so frustrated. And I am so emotional today.
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I'm sorry you are so frustrated, Angie. The connection between your RE and your urologist deserves some explanation. Have you considered a second opinion with another RE and/or urologist? I know that is always easier said than done...
ReplyDeleteI share your frustration. We're with what is supposed to be one of the best fertility clinics in the country, and it took them two years to seriously look at J's sperm. Instead, we wasted cycle after cyle with IVF with ICSI. Turned out that we weren't able to salvage J's sperm after all, but who knows if we would have been able to do so earlier. (It was a progressive problem.)
ReplyDeleteI'd get someone who knows what they're doing (a sperm specialist) before you go into IVF with ICSI. Even with ICSI, if the sperm are crappy quality, you can just end up with one miscarraige after another.
Don't mean to scare you. But it'd be nice if someone would learn from our mistakes.
Good luck. And if the sperm can't work out there are other, really good, options.
I know. I wonder how many urologists out there actually "specialize" in MFI. Ours said she did, but she didn't suggest any of the more progressive ideas I've read about (clomid, some injections I don't remember, etc). Good luck figuring it all out...with MFI, it feels like the medical community has very little to offer.
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