Treatment Plan
November 23, 2007OK, I’ll finish now. So, where was I? Umm…insulin, PCOS, no baby. Oh, yes… ‘How ready am I now?’ That’s what the doc ask me. Remember, Dr. T and I took a year off from anything resembling fertility stuff. Actually, we bought a car. I say she’s my adopted baby from Japan. And she is beautiful. And so well behaved. How ready? I failed to mention that I was ready three months ago when I called to book the appointment. So, if ‘ready’ was a banana, I’d have lots of those brown spots and I’d be getting a little mushy. Is that ready enough?
‘What do I want to do?’ That’s the next question. Uh–get pregnant. But he really meant, ‘How aggressive do you want to start?’ I’m one of those patients that fully supports and appreciates medicine and the science behind it. If you want to shoot me up, cut me up or poke me out, I’m game as long as you are doing something. My very pleasant response was ‘I don’t believe taking a pill will work. We are beyond pills. But a couple rounds of IUI might be nice.‘ And he agreed.
So we started to talk medications.
Baby Doc: Clomid.
Me: Ugh.
Baby Doc: FSH.
Me: Huh?
Baby Doc: More eggs. More babies.
Dr. T: Twins? Triples? AAAGH!
Me: One more drug?
Baby Doc: Letrazole.
Me: Yes!
Baby Doc: No.
Me: What?
Baby Doc: Not approved for infertility use.
Me: Pooie.
Baby Doc: Clomid.
Me: Ok.
That’s kinda the way it went. I have full confidence in the Baby Doc. I asked him what he thought was the best route for me. Clomid and IUI. The protocol is pretty simple. The second day of Aunt Flow’s visit I start 2 Clomid tabs until day 6, a total of 10 tabs. On day 12 I would be scheduled for an ultrasound (the not very fun ones that check you out from the inside!!!) From the u/s results, a HCG injection and the actual IUI would be scheduled. See, pretty simple. After that we wait.
I didn’t want to use Clomid due to the effects it can have on endo. Some studies say that it can make it more aggressive. FSH is even more aggressive. So, of my choices, Clomid is the gentlest. That’s why I agreed to it.
As for the Letrazole (Femara), about 2 years ago the pharmaceutical company that manufactures the drug came out with a statement against the use of Letrazole in any infertility treatment. It is a breast cancer drug, originally. The company strongly advocates against it’s use in IF treatment, because of the side effects. I guess. I was a little surprised. If a drug company can find more uses for it’s ‘invention’ it will go for it. They can sell more drugs! More drugs, more money. So if they are saying ‘We don’t care about the money, you can’t have our drugs’, there has to be a potential for a really big lawsuit. Only lawsuits stop cash cows- ’cause then you lose all your money.
And FSH is my second shooter. The one in the grassy knoll. I have 3 cycles with Clomid and 3 with FSH. Six tries. And if that doesn’t work I’ll see what else I can badger him into.
Your banana analogy really made me grin
You are ready, girl! Hang on for the ride!
The nice thing about entering into treatment is, if Aunt Flo doesn’t show up because you are pg – how ecstatic would that be! And if she does show up, it’s still a good day because you can *finally* get this show on the road. I have to say, back in the day when I thought it would just all happen for us, I would daydream about a baby born in the autumn. So you have perfect timing! I’m rooting for an October birthday myself, as I can personally recommend it as a great month for a birthday
As for letrozole – well it was the miracle drug for us (and another friend of mine) and I am happy it was available for us. Still, it hasn’t been used very long for IF so it hasn’t been as well studied as clomid. Here is an article that discusses all kinds of things about letrozole, and what is most interesting to me is the part near the end where they discuss the risks, etc.
http://www.soft-infertility.com/docs/PILetrosol.pdf
Apparently clomid was also subject to the same concerns, cautions, etc. early in its use too. Since then it has been extensively studied so more is known. I hope that will be the case for letrozole too.
In my view, the drug company doesn’t want to get sued or anything so it puts out this statement saying “it’s not for use in IF.” In order to say it *is* safe, they’d have to put a ton of cash into testing it. And if it works, it isn’t that profitable for them to make back their $$ – a couple would pay for a few cycles, get pg and that’s it – versus investing the money to show it’s a good breast cancer drug where patients take many doses for an extended period of time. I don’t think it is so significant that the drug company has covered its butt in this way.
So are you going to start cycling as soon as possible? That will mean being in the 2ww over Christmas, won’t it? It’s a tough time of year to be going through that.
IF is such a “hurry up and wait” game … how are you feeling? excited? anxious? impatient?
Thanks for letting us know how it all went!
Hugs,
Andie