Is DHEA making me fat?…Why my ovaries are like dogs…And other stories.

Has anybody else put on weight while on DHEA? I’m up ~4 pounds since midsummer (and ~7 since 15 months ago when I was pregnant, but I can’t really blame DHEA for those extra 3 lbs…) DHEA is an anabolic steroid, and anabolic steroids cause weight gain, so I think it’s possible. The other reason I’m inclined to blame the DHEA is because of where the weight has been going. Not to my hips, thighs and butt (like usual), but straight to my belly. I have a beer gut. And now that I have to start dressing professionally again, all my work clothes are either unflattering, uncomfortable, or both. Ugh.

So, as you all know, we had our phone consultation with Dr. Schoolcraft on Monday. Overall, it went pretty well. (You can find his answers to my long list of questions here.)

Here are some other tidbits from our conversation with Dr. Schoolcraft that didn’t directly pertain to our questions:

  • Dr. Schoolcraft was late. He called us almost 40 minutes after our scheduled time. This wasn’t so much a problem in itself (the nurse had warned us that it was often the case), but – ever the healthcare practitioner – C pointed out that if he was that far behind schedule (it was 5:40pm his time), he almost certainly didn’t stop to look over our file before he called.
  •  Judging by the conversation, Dr. Schoolcraft almost certainly hadn’t reviewed our file. Again, this might have been fine in itself. (His answers were thorough, and he didn’t make us feel like he was in any rush.) But we found it annoying that we went to so much trouble to get our records, and to fill out an annoyingly detailed (and poorly designed) health history form online, if he wasn’t even going to read it. And, we now have one more question…which wouldn’t bother us if we felt like he had actually read our file before calling. (Specifically, we spent a lot of time with him talking about low-stim versus high-stim, the underlying assumption being that we had only tried low-stim and don’t know what would happen if we increased the dose…somehow we all forgot to consider the fact that we in fact tried IUI with pretty high doses of Menopur – 5 vials per day – and only got 2 follicles developing. I know that IUIs are different – I couldn’t take stims for as many days because I wasn’t taking anything to suppress ovulation – but still, the scientist in me is frustrated to think that we neglected an important piece of data!)
  • Dr. Schoolcraft thinks I have a “poor prognosis”. He just sort of let that slip out in the context of some comments about comparing SART stats between clinics. Not that it came as any big surprise, but it was more direct than Dr. Y has ever been (though not as bad as when Dr. L said I would go through menopause before 40…) I think it’s a good sign; it’s consistent with what I’ve heard from other patients (who described him as “direct” and someone who “doesn’t mince words”) and the last thing I want is a doctor who’s going to blow smoke up my ass…but it still stung.
  • I thought Dr. Schoolcraft’s advice for comparing SART stats was very interesting. He mentioned (and I’d heard before) that some clinics manage to inflate their stats by refusing to take patients with a poor prognosis (especially older patients). His advice, therefore, is to compare the ‘% of cycles resulting in live birth’ specifically for women under 35 (where there will have been the least selection bias). If you want to compare the quality of different embryology labs, then look at the success rates for donor cycles. It’s not perfect, but I thought it was an interesting way to get around some of the stat manipulation.
  • Naturally, the first thing C and I did after getting off the phone with Dr. Schoolcraft was to compare the SART stats for our local clinic to those for CCRM in the categories of women under 35 and donor cycles…and while CCRM was better on both counts, there really wasn’t a huge difference. So our lab really does seem to be quite good. But we also considered Dr. Schoolcraft’s point that CCRM sees mostly out-of-state patients who have already failed one or more IVF cycles. In other words, they see a disproportionate number of ‘hard’ cases. And yet, their stats (in just about every age group and diagnosis) are higher than anybody else’s I’ve found. This seems to back up Dr. Schoolcraft’s claim about having the best lab.

So, despite our mild annoyance, and “poor prognosis”, C and I decided that we should at least make the appointment and do the one-day workup. It’s not cheap, but it’s thorough, and after getting the results, we’ll be able to have a better sense of whether it’s worth our time to continue with my eggs…

C made the point that every month to my ovaries is like years to a normal set of ovaries. (My ovaries are like dogs, apparently.) And also reasoned, “We’ll probably spend money on a lot stupider things.”

I’m not feeling very optimistic about our chances of getting pregnant – even at CCRM, but it feels like something we have to do to feel like we’ve done everything we can.