I'm probably crazy to even start asking these questions

dirtyvegas

I'm currently in the 2ww after IUI#1, but of course I'm already thinking about 5 steps ahead of it in case things don't pan out as hoped. If I start asking my RE all these questions, I'm sure she'd tell me to "slow down and take things 1 step at a time" but when has that ever really stopped me? So, here goes:

1. Can you/have you done back-to-back IUI cycles? If I get a BFN when I go in for bloodwork on 7/23, could I jump right into the next IUI?
2. #1 is probably actually a really ridiculous question for me to ask seeing as I'm going on vacation from 7/26-8/2, but if my issue isn't with ovulation, can you/have you done an unmedicated cycle with IUI? I should ovulate on 8/4 or 8/5 by my guess. Or, is my RE just going to say sit this one out completely and do TI.
   
3. From when you decided to start IVF, how long did it take from deciding to move forward to actually doing? What are the prep steps/testing involved?
   

I know these questions might seem crazy to ask so far in advance, but I'm trying to plan out a course of action since our insurance coverage year ends 12/31 and I've already hit my deductible for this year. If we need to move on to IVF, I'd love to get the first one done in 2014 so I can maximize my coverage. Just want to try to understand what a reasonable timeline might be. Although not sure I should even be thinking about this stuff -- this whole process has definitely made me feel like my body is laughing at my desire to have any sort of plan that I control.

BunnyBerry

Lol, I have the same thoughts about deductible. In fact, today our summary arrived in the mail and we're half way to our OOP limit, so I'm really raring for some 2014 treatments!

Perhaps it's true that the RE would feel it's moving too fast to take his/her to discuss it, know you are totally normal for this board and I'm sure we're all happy to oblige!

I was thinking, why not do an unmedicated IUI cycle if you've always O'ed, but then I noticed you used injectibles for IUI#1, so I was wondering if your RE has something in mind? It's certainly not unreasonable to call the nurse and ask for a plan for next cycle if you get a BFN. I think our office understands that it's pretty ridiculous to make women wait on AF or beta day to let them know what would happen with a BFN.

dirtyvegas

Thanks ladies for not making me feel like a crazy person!!

@NariaDreaming I know the rational thing to do is to likely sit the next cycle out, but in my head I'm like "I wonder if I could do 2 more IUI cycles and IVF #1 before the end of the year...." And I KNOW that's kind of ridiculous in terms of timing and to think that I could actually do that. I think it just seems like the process for everything takes so damn long. Any opportunity to make things faster (or at least seem like they're moving faster in my brain) somehow helps.

@BunnyBerry It's interesting that you bring it up. I'm not sure why they put me on meds if I've always O'd on my own. I should definitely ask about it. I kind of just assumed that they wanted to just help things along and/or see how I responded to them, but it would be good to know that. Thanks!

emmuffy

You can do back to back IUI but not while on vacation. Even unmedicated you will be monitored to watch the follicles develop so you don't miss the ovulation. At most I have only been able to leave town for two days, with my doctor's permission. I had to cancel a cottage getaway this cycle because my doctor wanted me in for daily monitoring because things were progressing really quickly (insemination ended up being on day 10).

ebliss444

#1: Definitely-- I've done two medicated cycles back to back. I actually don't schedule time to go in for a blood test to see if I'm pregnant around two weeks after. I just tell them I'll wait and see if my period comes and if so, I call on CD 1. Then, we schedule time to do the baseline ultrasound and I get the Clomid prescription (they also do a blood test anyway to confirm I'm not pregnant prior to starting the Clomid). 

#2: I did unmedicated to start off because I wanted to try before beginning the fertility drugs

#3. I don't have an exact answer (sorry this is lengthy), but I don't think it's too early for you to talk with your RE about future plans. Just before we moved into our second medicated IUI cycle, we met with our RE and put together a plan that says we're moving onto IVF if that doesn't work. In my experience she thought moving on to IVF is a great plan for us because our chances are just so much better with IVF (we have unexplained infertility). She also had me set up time to meet with an IVF nurse who outlined some pre-treatment tests and paperwork that needs to be accomplished before starting. It looks like you've crossed some of the tests off your list too. At my pre-treatment check-in, the nurse said if I start around July 20 I'd likely be looking at a September transfer date, if everything goes according to plan. 

Don't be afraid to talk to them a couple of steps ahead of where you are, it's most definitely a good idea! Good luck!

Edited to add: All indications are that I also ovulate on my own also, but I have also been on Clomid. I remember my RE saying it's a good first step for fertility treatment and you might also be increasing your chances: let's say you have two mature follicles on Clomid-- then maybe one of two (or less likely both!) will stick. My RE also cautiously explained the increased likelihood for twins in that case, but I was comfortable with that. 

dirtyvegas

@emmuffy That's awful. I feel like I'm always worried that a vacation/DH's travel schedule/my work travel schedule are going to get in the way. Trying to time things is so complicated, and I feel like I've put so many things on hold so that I don't plan over a good possible date.

@Rumbera28 What initial testing do they need to do for IVF? Anything on top of bloodwork, u/s, HSG, SA? We'd be using my own eggs. Is there some additional testing that typically gets done for that? I'm hoping too that all the worry is for nothing. Thanks so much for your thoughts!

@ebliss444 Thanks for the lengthy answer. I love a good lengthy answer! I think I will talk with her more to create a plan, especially since I'm thinking about wanting to try to get as much done in 2014 and the holidays being difficult to plan around, etc. If I can ask, what happened at your pre-treatment checkin in terms of testing and what would happen between July 20-September in terms of getting you ready?

lebradford

1. Yes, if you don't have cysts.

2. Yes, but the chances of success are pretty low, so I don't know if it would be worth the money, especially if they have you do monitoring (I'm not sure how that works).

3. IVF generally takes about 2 months, but other prep work might be necessary. My RE requires at least 2 weeks of BCPs, and you have to stop them at the same time as the other ladies doing IVF because they do batched cycles. For my cycle and my clinic's calendar, that means I'll be on BCP for 5 weeks if I do IVF. You'd have to ask what prep they require/if they do batched cycles/what days baselines are scheduled to know exactly how far in advance you'd have to start your first IVF.

As far as testing, there are usually additional tests past what's required for an IUI. My RE requires both my husband and I to do infectious disease testing, and I have to have some additional blood work. Some RE's will require a pap/HSG/SHG/SA to be more current. You should ask about those things now so you know how far in advance you'd need to start testing to be done with IVF by the end of the year.

As a frame of reference, my period is due on July 25th, and the earliest I can do baselines for IVF for my clinic is like September 5th.

ebliss444

@dirtyvegas I sent you a private message!