Meds

Wednesday, March 03, 2010

Okay. I need a lecture on how everyone is different and every doctor is different and obviously my RE has been doing this for a while, so he knows which meds he prefers.

But I am sort of freaking out.

Basically, the only additional med I'm on is lupron (versus my previous injectable cycles). So, I take lupron starting a week before my period is due, and then I add follistim. That's it. No menopur or repronex or bravelle or estrace or anything. Not to mention I have read that menopur helps egg quality and estrogen levels, and since I am not a super responder (i.e. I have never had more than 3 mature follicles, and my estrogen was about 200 points (or whatever units) lower than he estimated last cycle), I am worried that I need that, but that my RE is so conservative he doesn't normally prescribe that.

I feel a little meek calling my nurse and asking about this additional medication I have learned about from Dr. Goo.gle. I mean, it's not like they run their practice out of the back of a van or anything! It's a university medical system! They know what they are doing, right? (And to be honest, I guess an upstanding RE practice would not make it a habit of letting their relatively unschooled patients call the shots on what medications they need...)

Just to recap, here are my meds:
Lupron, Follistim, Novarel, and Prometrium

Does that seem too simple? I mean, when I see people's meds all set out on the table, it looks like an amazing amount! I'm barely going to have more than for our IUIs! And I do mean barely!

Ack!! Please tell me what you think!

Deep breaths. I am not their first ivf patient. I am not their first ivf patient. I am not their first ivf patient....

12 comments:

brigittemarie said...

I have no idea but don't freak out and I'm sure he wouldn't mind answering any questions or worries you have!!! Praying for you!!!

Al said...

I'm not familiar with those meds at all - but I really think you should call them ASAP and discuss your concerns. You will really regret not questioning them if you don't respond how you want - and you only get so many shots at IVF! Good luck! I hope you get some peace of mind or some more meds!

SuzeG said...

I would totally concur with Al's comment. I think it's absolutely critical that you understand (and feel good about) each medication you will take and why you will be taking it (i.e., why does your RE prefer this medication for YOU over other possible options). I think it's great that your RE is on the more conservative side (no reason to go all wild with these meds - it's hard enough as it is, not to mention expensive). Mine is that way too and I always appreciate it.

However, there is a real difference between, for example, Follistim and Menopur in that Menopur also contains LH (in addition to the FSH) and it is a urine-derived product, rather than recombinant. If I were you, I would want to know very specifically why he is choosing the FSH-only protocol and not just because that's the IVF protocol they always start out with.

You must have full confidence that your regimen is tailored to you and what you (and your RE) have learned about your body's unique responses during the many IUI/injectible cycles you have already had. There's a ton of information in your treatment history!

Keeping you in my prayers, too!

BelowAverageAthlete said...

I do agree that everyone is different. But, if you don't feel comfortable, I am sure they would rather you say something than not. I hate confronting people on stuff like that too. I had to do it with my FET because I had read about everyone else doing Lupron. I asked them about it 3 times, before I felt OK about not taking it. I hated it. Good luck!

Ann - Building a Nest said...

I completely agree with the above. Ask, ask, ask. I do not know the differences in the medicines, but do know that people respond differently. I only produced 1 follicle on Bravelle and that is why I was switched to follistim which I respond much better to. I know others are reversed.

Becky said...

I completely agree with the other commenters, you should definitely call them and ask them to explain things until you are comfortable. I know some REs get a little huffy over being questioned, but this is YOUR cycle. You are paying A LOT of money and putting your body through a lot to have a chance at pregnancy. You don't want to have any regrets. I know that you said before that you would probably only do one IVF cycle. Does your doctor know this? I think it might be important for him to know that he isn't going to have further opportunities to tweak your meds.

I only had 2 IVF cycles so I am not familiar with all the different protocols. I checked through my old paperwork to see if I could find a protocol similar to yours. The only one I found was a mini Lupron protocol,however it had a cetrotide bolus (very big shot) at the beginning in addition to Follistim and lupron. Also, I am surprised that you don't have any estrogen patches for during the 2ww. When you say those are the only drugs, are you only referring to drugs for stimming or for the entire cylce? A lot of the pictures people post also show their PIO, estrogen patches, antibiotic and steroids for after retrieval, and valium for transfer so it looks like a lot. Maybe your doctor is trying not to overwhelm you since most of these drugs aren't needed till later?

You are in my prayers. I hope you are able to get some answers from your RE and have peace and confidence about this cycle.

lowfatlady said...

I agree. Ask to make you feel better, to learn, and to see if they agree with you. I hope all goes well.

Ashley said...

I think you should ask if that makes you feel better. Of even get your hubby to ask? At the beginning of this process I was so nervous I had my hubby call once. But I wasn't on half of the meds you are on and I am on a whole different selection of meds that I was on. So you are right. Every woman is different. I had to remind myself not to compare my meds with other blogger's meds. Good luck!

Shanny said...

If its on your mind you should definitely ask. It may be that they know your body well enough to know that with an increase dosage of follistim and with the supression of Lupron you may produce more than enough quality eggies. But definitely voice your concern, we can tell you we are all different because we are but only they can give you the real reasoning behind their decision.

I like that its simple, less complicated and less needles for my taste. GL =)

Lisa said...

I was having my own mini freak out this morning worrying that maybe the timing of the trigger and IUI was off because it is different than my first cycle of IUI. And I had to remind myself that God is TOTALLY in control, He can make me pregnant if it is His timing regardless of the exact timing or medications or ANYTHING!! We do have to be smart patients but then to trust that the RE has the medical side of things under control and leave the rest to the Lord!

Leah said...

My first IVF cycle, that was very similar to what I was prescribed also. Do you know the daily dose of follistim they have prescribed for you?

You are right though. . . for the most part, these docs know what they are doing. :-D

Hillary said...

I seriously thought the same thing!! Then my meds arrived and I had a bunch of others that nobody had ever mentioned (ganirelex, antibiotics, PIO, vivelle patches...). I had no idea I was getting all of those - do you think that could be the case? Even if it's not, one thing I am already learning this IVF cycle is I have to trust my RE. Assuming you already have a trusting relationship, I can't play dr. based off of my internet knowledge. I agree with everyone else that you should ask so you're comfortable/ informed with the RE's decisions, but at the same time there are SO many things that I know I don't know (but like to think I do). Haha, sorry that's so long. And I know you are already feeling better, but please know I can relate!