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keisha - November 1st, 2007 8:03 AM

hello dr thanks for your time i have a lenghthy question hope this doesnt sound like i am rambeling but there is only one fertility dr in my area and i kinda want a 2nd opinion when i first saw my re about tube reversal in 06 he explained some of the difficulties i could have but said it would be worth a try he kinda tried to get us to do ivf first but we could only afford the surgery so he went ahead and did it he said my tube lenghth was borderline 31/2 in and 4 in i think i had the surgery in june of 06 got pg during my aug cycle hcg never doubled then hcg kinda went up and down i had u/s to check for ectopic they didnt see anything but gave me a methotrexate my numbers slowely dropped out they finally said they thought i had two and one held on longer than the other no ectopic then later in feb 07 i had another bfp i didnt see re i went to ob dr who started beta first one was 24 then less than 5 then 0 then 06-07 another bfp during weekend by monday though had started my period only about 3 days late didnt go to dr for beta but made appt to see re again who said we should try clomid and progesterone and estrogen this is my 2nd cycle and i am on cd 21 i hate to say it but i dont think it is working and i dont really see how it could help anyway if i already o on my own i am now taking 100mg clomid cd 3-7 then 200mg progesterone 3x day after o and 2 mg 2x day after o of estrogen or estrace my question is if these 3 months on the meds dont work should we consider going straight to ivf or is there something else we should be doing i know you arent my dr but i am only asking your professional opinion on protocol for a situation like mine we will not be in a position to try ivf for a few years so anything else we could do in the mean time would at least be a comfort that we were doing something

B. Jacobs, M. D. - November 1st, 2007 10:27 PM

I stopped doing tubal reversals a number of years ago. IVF is cheaper and safer, if tubal ligation is done correctly. Also, I stopped prescribing Clomid almost 15 years ago. Pregnancy rates are not very good. For more information, please see our web page, <www.texasfertility.com>.
Good luck.

keisha - November 2nd, 2007 7:18 AM

once again i would like to thank you soo much for your time what would you suggest in my situation i live in tennessee my dr says ivf could run over 20,000 for one try thats why we decided to go for the surgery which costs around 7,000 i only know of one other fertility clinic in my area which is nashville fertility i think and they cost even more than my dr i cant afford that kind of money right now but if you know a good person who could help me within tn. or surrounding area id be glad to give them a try i noticed your ivf costs were much more reasonable i guess i should have mentioned i do have 3 children from before tubal ligation never had any trouble at all getting pg thought it would go back to normal after my surgery boy was i wrong!!! That was an awful painful surgery to have and then not get the results you want i can see why you dont do it anymore.

B. Jacobs, M. D. - November 3rd, 2007 8:08 AM

In our practice, A cycle of IVF probably costs $10,000 to $12,000 for EVERYTHING, unless we have a severe male factor problem. If we have to inject sperm into eggs to create embryos, there is an extra $1650 charge. That is a long way from $20,000.


keisha - November 3rd, 2007 3:10 PM

well dr it is a shame you arent in tn i would see you in a min.


B. Jacobs, M. D. - November 3rd, 2007 5:21 PM

Your choice of clincs is yours. We do hae patients from out of state, coming to the Dallas area from New Mexico, Minnesota, and even the Carribean. Please see the information on our web page, <www.texasfertility.com>. If you would like us to work with you, I will be happy to do so.

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