Reproductive Endocrinologist

"We met with Dr. Bookout today.  First impression... he is very old.  William says I'm a horrible person for noting this.  Oh well.  The good news is, he has seen it all.  He remembers days before IVF and other treatments and has seemed to embrace each new advance.

He did a brief history, an internal sonogram (my fav), and then we talked about the "plan".

I liked how he complimented our decision to start trying now.  He said our prognosis was very good since we are both young and in good health.  He also said that couples going through IVF at an older age have a much higher chance of having a child with developmental disorders.  He said that my exam was normal.  So that's good.

So here's the plan.  We are changing drugs... I'm going to take Femara, which is a drug that promotoes FSH production by filling estrogen receptors in the brain. It's similar to Clomid... but different.  He said that while the old way of thinking used to only try one method per cycle (so like take 5 days of Clomid... then wait and wait and wait... even if you KNOW it didn't work), now studies have shown it's safe to piggy back treatments.  There is no "cycle" to mess up, so there is really no reason to wait.  I find that reassuring.  We might as well be efficient with our time.  So what's it going to look like this cycle?
We aren't sure.  He is going to "individualize" my treatment based on what my body does...YAY! I'm not a fan of cookbook treatments so this makes me happy.  Theoretically here is what could happen.  After my period I start taking the Femara.  We start at the lowest dose and take it for 5 days.  Then do an ultrasound to see if it worked... if it didn't, then we hit it will a higher dose of Femara... then an ultrasound... you get the idea.  He said that if we see follicles, but none of them select like last time, we could hit small ones with Follistim (straight FSH) to move them along.

He did bring up the scary M word several times.  We are at a very high risk for multiples.  I most likely have good eggs and once things start working they will work WELL.  He kept throwing out the words "twins" and "triplets".  Little does he know we would be thrilled... and I think we are going to have a house big enough by then!
Peyton