# Update on consultation appt



## MandMtb (Mar 6, 2009)

Hi ladies,

Well today did not go as well as expected  

I had took the day off work but DW went to in the morning and ended up dealing with a crisis, resulting in her in collecting me late and forgetting to print off our questions and info about my cycles, so I was a bit stressed to say the least, whilst trying to be sympathetic to DW. However, with some speedy driving we managed to get to the clinic on time.

The trans-vaginal scan went fine, as most of you said it would. No pain at all and it was over within 5 mins, so no problems there. However we then had a 40 mins wait till our scheduled consultation and despite being told it would probably be earlier it ended up being in total a 70 min wait! 

But finally we got in, and although the Dr appeared very friendly and nice, he was extremely disorganised and impatient. He rushed through the various forms we had to complete, then said the scan's had shown normal ovaries (which reassured me) but then said he had not got the blood results, so went and asked the nurse to track these down. During this point he took various details from us, and asked what treatment we were considering. I explained we wanted to go down the IUI (natrual) route if possible, which he said was ideal given my age and no known fertility problems. After taking some more details the nurse came back with the blood test results, all okay, however then after assuming all was okay he said my Anti-Mullerian Hormone (AMH) test results were low for my age, I tested 12.9 and that put me in the low fertility bracket. This really worried and upset me, however the Dr told me not to be worried and to carry on with the treatment planned and just to ring up and book the treatment on the first day of my cycle when we wish to start, and that was that. I started to ask questions about being matched with sperm donor and how to know when to come in for treatment etc and he said I would discuss all that with the embrologist when I book my treatment. I came out upset about my results and shocked at the lack of information we had been given. I paid for my consultation and feel I didnt get my money's worth, the Dr's mobile also went off during our consultation, fortunatley he didn't answer it. I am also kicking myself for not having the confidence to ask more questions but I think after being told about my 'low fertlity' I was just to upset to keep asking questions, when he obviously wasnt interested in answering them. Does this sound similar to other people's expereinces of consultation's? I dont know if this is the norm or I am just being too sensitive. Also, has anyone else had a low AMH result? I dont know much about this,so am going to google now but assumed because I appear to ovulate each month I was okay, but does this mean the egg that is released is not that fertile?! Any info or advise would be much appreciated, as I dont know if I am overreacting or not. 

DW keeps telling me to stay positive, and we aim to start our first treatment in May, we had planned to try 2 unmedicated and then 2 medicated if no success and then re-evaluate, and save some more money. I dont know now though whether to start straight away with medicated, had hoped not to but feel it might give us more chance of success if I do have low fertility, any views?

Sorry I have not been more upbeat about today's appt. But I needed somewhere to vent.

Love S x x x


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## sallylouise (Jan 30, 2009)

Oh I'm sorry things didn't go as you were expecting them. I think we wait so long for these appointments and it's so important to us, it's really hard when things don't go as we planned. I'm sorry but I don't know anything about IUI's but I'm sure there will be somebody along soon who can give you some constructive advice. In our experience, everything takes longer than you think it will but you will get there in the end. 

I hope you manage to relax a bit this evening. Take care for now. xx


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## lesbo_mum (Dec 22, 2008)

Hiya Hun

Sorry about your consultation i can understand why you are annoyed i'd be livid! Can you phone them and say you have some burning questions and worries that just wont wait and is there anyone there who can help answer them...... give them   down the phone!

Em x


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## Battenberry (Mar 18, 2009)

Hi S,

So sorry you have had a stressful day that hasn't gone to plan.      
I think if I were in your shoes I would have been too stressed to ask the questions I wanted to as well, it takes time to collect your thoughts and to know what you want to ask too, and when you're trying to think about the process too it all seems so confusing.

How about ringing them tomorrow and asking to speak to one of the nurses? I am sure they will have all the info on a low AMH and how this affects your treatment (if at all), you can get your list of questions together. Probably better than doing internet research, which may be inaccurate or not in context of your circumstances, if you know what I mean. If you explain to the nurses you felt rushed in the consultation and it came as a shock I'm sure they will be sympathetic and give you the time you need to go through things. Also they may be able to help with your questions related to the donor, and help you get things together.

The positive thing is that your ultrasound scan was fine, and so were all the other tests, and you are able to start treatment in May.   That's a milestone getting to that stage, and if they were really concerned about your low AMH I'm sure they wouldn't have recommended you go ahead with IUI, or have suggested some other treatment.

I hope you can speak to them to feel reassured that things are ok. Although this is a setback it's not stopping you getting started, so try to keep positive. The sooner you can get started the better I say!

Lots of love,
B x x x


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## MandMtb (Mar 6, 2009)

Sally, Emma and B,

Thank you so much for your supportive posts.

B, thanks for your advise, we have decided to ring the clinic again tomorrow to ask further questions.

DW and I are certainly understanding the 'rollercoaster' of TTC now!

Love S x x x


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## ♥JJ1♥ (Feb 11, 2006)

I have also faxed the questions through that I want answering (sometimes 3 pages!!   me neurotic IVF mother ( to be I hope - never!!!) and ring saying that I am going to do this and wait the answers and for them to call me back!

Good luck
L x


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## Damelottie (Jul 26, 2005)

Thats a great idea JJ1. I might do that to my consultant xxx


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## annacameron (Dec 16, 2008)

Id read Little Jenny's in depth postings on AMH first. 

I would not ask a nurse about it - it is not their job to understand the technicalities of studies and statistics and analyses. I would also not bother asking a consultant about it, though it IS their job. They all have differing views. 

Read the papers yourself and form your own view. that's all they are doing anyway in a relatively new area such as this.


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## TwoBumps (Nov 22, 2007)

So sorry you were dissapointed by your 1st consultation. We can really relate to your experience & I'm sure most other people could too. We always went full of hope & questions & left feeling a little deflated. I think it's probably normal to still have questions as usually each answer raises yet another!  
I think the fax (or an email?) may be a good idea as you'll hopefully get your answers back in black & white so you can return to them as often as you wish.
Good luck & try not to be too disheartened, they wouldn't agree to IUI's if they were worried about your AMH level.

Lottie x


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## leoaimee (Jun 3, 2008)

hi s

to be honest i think our expectations are soo monulmentally high when we go for these appintments its kind of set up to fail from the beginning.

the fact that you guys felt back footed by your DW;s crisis at work, rushing through traffic and then not having your prepared questions meant you already arrived in a hightened state of stress ... adding to that the actual delay in waiting against the background of HOW MUCH we are all so desperate to have a family and HOW SCARILY FAR AWAY it all seems sometimes .... it would have taken someone with a vast depth of interpersonal skills, warmth and compasion to have really left you feeling like you had truly be 'seen' and 'understood'  in my experience this RARELY happpens!  especially with consultants.

gabs and my first consultation left me in tears and really heart broken ... but looking back i can see that my expectations were possibly half responsible .... combined with a bit of a crass dr.

i think all of us find with ttc that we have to drive the whole thing, you learn so much as you go along in terms of factual information, and also emotionally.  the highs you feel with every small success and the lows you feel with every percieved set back are so extreme because we all feel so passionate that we want to have families with our loved ones, and ultimately we are in the hands of the gods.

i would do your own reading on the AMH results if you feel you need to understand that better.  i havent ever heard of it ... sorry.

if the consultant wasnt worried and is happy for you to start for your may cycle, i think just go ahead.  most important thing is to be happy and relaxed ... although this is IMPOSSIBLE to force .... for me i dont think i could have had my first IUI feeling relaxed ... but it got easier as i went along.

Do keep in touch with the clinic about donor matching.

big hugs honey.  it IS a real rollercoaster just like you say.  

love ax


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## ♥JJ1♥ (Feb 11, 2006)

annacameron said:


> Id read Little Jenny's in depth postings on AMH first.
> 
> I would not ask a nurse about it - it is not their job to understand the technicalities of studies and statistics and analyses. I would also not bother asking a consultant about it, though it IS their job. They all have differing views.
> 
> Read the papers yourself and form your own view. that's all they are doing anyway in a relatively new area such as this.


Anna I don't mean to take offense but I would say that you have stereotyped nurses and dismissed them (and I can as a nurse!!  ) that some nurses do have an understanding of statistics, evidence based studies and practice that is core to nursing. As someone doing a phd, as are many of my colleagues, we have conducted research and understand it. Nurses are no longer mere hand maidens to Drs. I work with nurses and nurse consultants who carry out the same duties as their consultant counterparts, and others that I would prefer to give me care than a Dr.

However AMH, immunes, NK cells etc are slightly controversial and there will be a clinic approach to them and their significance etc

L


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## MandMtb (Mar 6, 2009)

JJ1, THANK YOU so much for your advise. We feel putting things in writing will work best for us, but didnt think this would be an option. DW rang the clinic today and explained our situation to the receptionist, and she agreed the best option was for us to send a list of questions via email, which we are doing this evening. She also said our consultant isn't in  clinic this week so it would be another Dr responding - we said this was fine by us, and we were happy about this and it is almost like we will be having a 2nd opinion. 

Aimee and Lottie, thank you both for your reassuring and supportive posts. I certainly have learnt a big lesson from our first consultation and agree my expectations were very high - but it is fustrating and sad to think we must have to lower our expectation, especially as we are paying for their services. Also I am trying to stay positive and think if IUI (natural) would not work with a low AMH level they would not have agreed, but I suppose I want to clarify this, as we had agreed this treatment before we had the blood results. Then when they came in the Dr looked dissapointed himself but said 'well let's still give it a go' - not very reassuring. 

Will let you all know if and when we get a response from the clinic.

Just a quick question...do most clinics scan for a folicle before treatment? 

Thank you to everyone again for you support.

Love S x


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## ♥JJ1♥ (Feb 11, 2006)

S- Most do an antral follicle count if that is what they are asking for? and also a pelvic ultrasound as routine

Good Luck


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## annacameron (Dec 16, 2008)

JJ, funnily enough, I have often thought on reading your postings that I wished you were any of my IF nurses!

It  isn't typical as you well know for nurses to do phds. It simply isn't part of their job or expected or required in the same way as in other branches. I am not making a negative comment - simply stating  fact. The post operative surgcially based ward nurses actually do a more honest job in terms of caring and the relentless grind of dealing with patients than the consultants. BUt no, i stand by the statement that few nurses (and indeed few consultants for that matter) will have either a degree in statisics or the understanding of the subject required for the counterintuitive leaps that are required.


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## whisks (Feb 10, 2009)

hi

just wanted to let you know and hopefully put your mind at ease a little.
my amh levels were also slightly low but as it is a relatively new test and it seems not fully conclusive from what i have read and what the nurses told me, i was told i needed to take the old test (fsh) which i did and it showed my fertility was very good. i doubt you will need to do this (i am going to donate eggs so it was necessary for me to have the test to prove i had good fertilty). but i wouldn't think you need to worry too much.

good luck i hope all goes well for you


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## sallylouise (Jan 30, 2009)

Glad all is well. x


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## MandMtb (Mar 6, 2009)

Whisks, thank you so much for taking the time to post. Your experience had made me more positive!

Thanks for you post to Sally. Everyone is so supportive  

No response yet to our email, will keep you all updated. 

Love S x


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