June/July Trouble TTCAL check-in

BrightenMySky

Welcome to the Trouble TTCAL check-in, but sorry for your loss and that you find yourself here.  

I am hoping to get this going as a monthly board (and since it's almost the end of June, I'll make this one June/July) for those of us who would put ourselves in the infertility, trouble TTC, RPL, or other categories that involve working with an RE or doing medicated cycles and to discuss issues around IF and loss as well as fertility treatments and testing.  

To start off, let's do:

1. Intro 

2. Status (stims, WTO, TWW, benched, etc.)

3. Rants/Raves

4. Any questions the folks here might be able to help with?

BornReady

1. Intro 
 TTC # 2. MC in November @ 9 week. 

2. Status (stims, WTO, TWW, benched, etc.) Just triggered tonight after 7 days of stims for my first IVF. Egg retrieval is on Thursday AM. We are doing PGS testing so we will not transfer this cycle and will instead do a frozen embryo transfer hopefully in July/August. 

3. Rants/Raves: I had my thirst ultrasound appointment today and was informed that my left ovary was "exploding" with follicles. Apparently this is a good thing! In total we had 11 large follicles and some smaller, unmeasured follicles on each side. All but 3 of the notable follicles were on my left, further proving that my right ovary is a lazy thing. I've been tracking ovulation for almost 5 years and can remember 3 times I ovulated from that side. 

Overall this whole process has been no big deal. The shots have been easy and the only hassle is going for ultrasound and blood, but even that takes like 10 minutes. My biggest rave for infertility treatment though is YouTube. How did people do this without the benefit of watching YouTube videos pointing out every step of the way?

4. Any questions the folks here might be able to help with? No questions, but a thank you for all of your support! @RiverSong15 mentioned TTCAL is her safe place, and I honestly could not agree more. I participate over on the Infertility board, but this is my virtual TTC home. 

BrightenMySky

1. Intro: We've been TTC#1 for just about 2 years now.  After a year of trying, I got a rec from my PCP for an RE, and we ended up really liking him.  We got a kind-of diagnosis of MFI (I say kind of because the particular issue, morphology, is not considered a problem by all docs).  We started IUIs last fall--with me using Clomid to stim to increase the number of eggs and increase the chances of a good sperm finding an egg--and I got pregnant on IUI #3.  That ended in a mmc, discovered at 11 weeks.  It took a long time for my body to get back to normal, but I ended up getting right back into IUIs once I could and had a CP/early loss with IUI #5.  I have done acupuncture with most of the IUIs, as well as for morning sickness & to help with things post-loss.  

2. Status: Currently on IUI #6.  Just did my trigger last night and IUI tomorrow morning.  I never had a problem with the trigger shot before, but since my loss I've gotten kind of squeamish about it, but last night I did better, although I had DH next to me ready to help if needed.  

3. Rants/Raves: A big rave about sorting all this out post-loss is this community, and I look forward to talking about these issues with you all.  

Rants is that there is one nurse at my RE office that I just do not like very much.  It seems like she's impatient, bad on the phone, and not good at giving bad news to people.  I don't want to seem high maintenance (and I'm generally not, although I have a lot of anxiety with this process), but I have thought about requesting that we not interact to the extent possible.

4. Questions?  I guess I am mostly curious to hear from those doing IVF how the meds are--if the injections are hard to do, if the stims make you feel crazy, etc.--as I am constantly thinking about whether I want to push for that as a next step if this IUI does not work, but I am pretty conflicted.  

@BornReady glad to hear it hasn't been to bad for you so far.  With Clomid, I feel like my ovaries are going to explode and so bloated the days after I trigger.  Are you having that with the stims you're using?  I imagine it would be a lot more intense with all the follicles.  GL with your retrieval tomorrow!

BornReady

@BrightenMySky I think we triggered last time together too, good luck this cycle! Hopefully, you won't need to even think about IVF after this cycle.

AS for me, I feel a little larger with all of these eggs. Kind of like I went running after a big meal and have a stitch in my side if that makes sense? I have not had really any reaction to the meds other than being a little more sleepy that usual, but I'm assuming that might be my body working extra hard growing these things. No mood swings, maybe a little sore doing some things. I had intense bloating after my IUI for a few hours, I imagine this will be somewhat similar. 

Honestly, the medications for me were no big deal. I did Gonal-F which comes in a pen that you just twist it to get the proper dose, a low dose hcg that came pre-mixed and another med I had to mix, but the entire set up for each shot came in it's own box with no fail instructions. Also, YouTube is your friend.

BrightenMySky

@BornReady I was thinking we triggered together last time!  Glad my memory isn't totally shot

It is really reassuring to hear that about the meds.  I used YouTube when I first started IUIs to see the trigger injection, so definitely agree with you on that.  

brooklyngirl18

hi ladies, i'm going to lurk here if that's ok. If I end up with another ectopic pregnancy, my dr advised I go straight to IVF which I'm pretty clueless about so I'd like to follow if that's ok.

RiverSong15

@BornReady I'm glad to hear you have so many follies! I hope retrieval goes well this week and that you get lots of perfectly healthy embryos!

@BrightenMySky, I hope this IUI works and you don't need to think about IVF meds.

As for me: 

1. DH and I are both 33. Started TTC#1 in November 2015. Two MCs: one at 7wks in December from unknown causes, and a BO in March/April (diagnosed at 7wks, actual MC at what should have been 10wks).

2. Benched until at least September.

3. Rants are many currently: My thyroid can't get itself together, and my TSH keeps going up despite med increases. I'm seeing an endocrinologist in July with experience dealing with thyroid issues in pregnancy, so we'll see what she says. We're benched until my thyroid is stable in goal range for two months. We've done most of the RPL testing, and everything came back normal except for one of the APS antibodies. We need to retest in August. I'm worried all these little things are adding up to a problem for us. Lots of nonTTC stuff going on too, unfortunately. It'd be nice to catch a break.

Raves: I'm holding onto the fact that we're getting a puppy soon, a mini schnauzer. Can't wait to cuddle my fluffball!!

4. Anyone know anything about APS? My ACA IGM came back "indeterminate". My OB says it usually goes away after retesting, but since I already have one autoimmune condition, I'm worried I'm at higher risk of APS. It's a gray area though - not positive but not negative. Anyone have a similar experience? How did things turn out?

ETA: we're thinking about scheduling an RE consult with an RPL specialist. I'm torn about whether to schedule an appointment before or after the APS is retested. My RPL work up was pretty extensive, minus 7DPO progesterone. Would you ladies recommend holding off until all my results are back? Or getting an appointment in even whole we're working on my thyroid and the APS stuff? Is there other testing the RE might do that we'd want to get moving on? It's all a little overwhelming, frankly.

BrightenMySky

@RiverSong15 yay so excited for you to get a puppy!   And I don't have specific advice about seeing an RPL specialist, but I will say that I felt really positive to meet my RE and get a plan in place for testing and possible treatments, so if you think you might feel the same, the appointment sooner could be good.  If you have multiple options in your area, might want to start meeting REs to see who you click with.  

chloe97

1.) Intro: We are TTC #1 and have had 2 losses- the 1st was a MMC at 10 weeks in Nov and the 2nd was a Triploidy dx at 12 weeks in mid-may.

2.) Benched for testing, which I think should start this week or next. See questions.

3.) Rants- Screw AF!!! So I'm having very light spotting and cramping (and other weird possibly related recital pain), but no actual bleeding. I had 2 periods between my first D&C and my next BFP and both of them started off like this. I'm not sure if this just my new normal or what, but this so strange for me normally. Also could the intense gas/reveal pain be related?

4.) Question: I am supposed to start DOR bloodwork with this AF, but I am supposed to go to my parents house out of town this weekend. If the bleeding starts Thursdaty, Cd 3 and 4 would not be possible, would I go on cd 2 instead? Would that work?

Also, I'm 37 and have already had a RE consult. She's ready to start testing me, but my OB thinks Im OK to try again naturally and ordered the DOR tests. I'd like to get the full work up from my RE just to have the info that it's all normal. Should I just do all the testing through the REs office?

And finally, since my issue is likely bad egg quality/meiosis issues, does anyone have a diet or other things they are doing to improve egg quality? I'm taking CoQ10, I'm debating on whether to take DHEA- I'm reading mixed reviews. I'm going to stop drinking before we start TTC in September and will only be very lightly drinking before that. I'm about 90 days out from ovulating the eggs we will start TTC with do I've read that now is the time to me making changes to my diet. Any other ideas?

roxgibbons

@BrightenMySky thank you so much for starting this thread! I was just thinking this would be a good idea a couple of days ago. 

1. TTC #3 ( #3 for me and #1 for DH) since Feb 2015. MMC Feb 2016. We started working with an RE in September 2015. Our tests came out ok with no glaring issues. My AMH was borderline at 1.45 according to my OB but my RE thought it was a good number for my age and when he saw my AFC number and my FSH he wasn't worried at all and didn't think it was an issue. DH's SA was good but his motility was borderline and he's on supplements to help improve it. We did 2 medicated IUIs and got BFNs and conceived in December naturally while taking a break after my HSG showed some issues. We lost our baby at 10 +2.  Now that we are TTCAL we are resuming IUIs and working on different Ned protocols.  
 
2. Status. I am working on IUI #4. I was put on a higher dose of letrozole this time 7.5 mg. I really felt the difference this round and was very emotional and had tons of cramps and pain the last couple of days. I go in today for a follicle scan and should be doing and IUI in the next day or two.  If this IUI does not work we will be doing our last two IUIs with injectables. I have an appt with my RE next week to discuss. 

3. Rave. The TTCAL board and this thread, also my acupuncturist. She is such an advocate for me and always has sound advise and kind words. 
Rant. Work has been very stressful and I'm trying really hard to balance everything, tight deadlines, appts, etc while not allowing myself to get too stressed out. 

4. Questions: injectables: I'm guessing  I will be doing gonal-f if I move on to injectables- based on what @bornready said it doesn't sound too bad. I'm curious to see what the RE says next week. Any side effects? I was so super crampy and moody from the higher dosage of oral meds so I'm a little nervous at what injectables will do. 

@BrightenMySky good luck with this next cycle and @BornReady good luck with your retrieval  

roxgibbons

@chloe97 with regard to your testing question I believe you can go in CD 2 but not totally sure. My OB referred me to the RE so all the results got transferred over but My OB was initially a bit gloom and doom about my AMH but my RE was not at all and thought our chances were pretty good, so it was interesting to see the different interpretations. Maybe do all your testing through the RE that way you are dealing with 1 dr's interpretation of everything. The other thing I would suggest is to get all the tests done prior to starting any treatment, but since I believe you are doing IVF, I'm sure they will make sure everything is done prior to starting treatment anyway. I didn't do my HSG until two cycles in and didn't know I had fibroids. In hindsight I wish I had all that info before starting with treatments (details in my siggy)

As for dietary changes and supps, I am doing CO-Q10 but no DHEA as I'm also reading mixed reviews. The dietary changes I've made, are I've cut way back on alcohol and caffeine.  I'm eating as clean as possible but some days I'm better about it than others. I have also pretty much cut out gluten and sugar. I also go to an acupuncturist once a week so that's been very helpful with stress reduction. 

@RiverSong15 Maybe wait to get all the testing done that way you have all of your results? I know it's hard to wait though. I guess I just like having all the info in front of me. GL!

BrightenMySky

@chloe97 this is the TCM fertility diet guidelines that my acupuncturist gave me: https://www.westhauseracupuncture.com/wp-content/uploads/2014/08/Fertility_Nurtrition_Guidelines.pdf.   I was much better about sticking with it before my loss.  During my pregnancy and immediately after my loss, I gave myself a lot more leeway to eat what appealed to me regardless, now I've been trying to get back.

@roxgibbons thanks and GL with this IUI cycle!  Sorry the meds are taking a worse toll this cycle.

BornReady

@chloe97 I had all my "cd 3" blood work done on CD 2. I'm pretty sure it doesn't matter. 

As far as whether to move on to the RE for all the testing, I think that's really your comfort level. Do you feel ready to be "all in" with the RE and begin next steps? For me I felt like my OB could only take me so far and I feel like I wasted my time with him TTC #1. He made me do testing with him before referring to the RE and I just didn't feel any urgency from him. With TTC #2 I skipped my OB completely and did all my testing with the RE. It was quick, in depth and she was able to explain everything she was doing and the results as it pertained to our treatment plan moving forward. It's been a bit of a whirlwind, but it feels like forward progress. 

I personally LOVE my RE. She is unbelievably smart, confident and committed to getting us pregnant, which is what I want from her. She is a total rock star in the infertility world and I like that too. 

In terms of supplements, my RE has me just doing a prenatal and vitamin D. My DH is on Ubiquinol (she said COQ10 is a waste of money) and a men's multivitamin. I read someone talk about melatonin for eqq quality recently?

BornReady

@roxgibbons I had no issues at all with the Gonal-F. Super easy to use and only some extra tiredness during stims. Good luck with this cycle!

chloe97

Thank you @roxgibbons, @BrightenMySky, and @BornReady! 

To provide a bit more perspective on my situation, I have No problems getting pregnant and I fact I'm starting to believe I'm super fertile, meaning my body accepts all fertilized embryos. My last MC was due to Triploidy which is in my case was caused by an egg that did not split during meiosis. My Dr believes since I carried this last pregnancy 13 weeks, it's VERY likely my first was a chromosomal abnormality as well. I'm in a weird place because I just need to ovulate a good egg. I've heard Clomid or Letrozapole treatment can help you ovulate a good egg, so we are considering it since we probably would need one more MC to qualify for IVF +PGD to be paid by insurance. I've mentioned before my concerns about using interventions if I really don't need them and trying to balance my limited fertile time left to have 2 kids with not wanting to use unnecessary interventions. My OB thinks I've just had to quote her "Shitty luck". 

Anyway, my very first step is to gage egg reserve and quality. If that looks like it needs to look, we may just try this diet thing and try again naturally. It's so hard to make these decisions, though. My ILs have offered to pay for IVF for us and part of me thinks we should just take them up on it so that we have the best chance of having 2 kids. I just really worry about the effect that the treatment would have on my body and the increased risks of autism and other delays. 

Thanks so so much for sharing your thoughts with me! I wish I had more feedback to give to you guys, but you are all way ahead of me in this process, so i will just say good luck and I'm thinking about you guys!!

BornReady

@chloe97 It is all so tough to think of these things isn't it? I think you're right to first look at egg reserve and quality, if that's what you think might be contributing to this. If it is an egg issue, I would doubt you'd have to fight insurance on IVF. My understanding is they go by the doctor's recommendation for treatment, and the only criteria once you get to that point is that they've done all the necessary testing to make this their treatment plan. 

As far as PGS (testing for chromosome issues)/PGD (testing for a specific genetic condition like cystic fibrosis) that's usually completely out of pocket unless you have a genetic disease you are screening for. We are paying for PGS (our IVF is 100% covered by insurance) and our RE thinks this will be common practice and paid for by insurance in the coming years as it increases success rates so significantly. 

That's awesome that your in-laws are so helpful!

roxgibbons

@BornReady thanks for the info- I'm interested to see what my RE has to say about it when I meet with him next week.

@chloe97 I totally understand where you are at. It's all overwhelming and you want to just get preggo with that one good egg and being AMA is tough as time is not on your side (trust me, I know how you feel). I think once you get your test results back especially AMH and FSH and if you go the RE route your AFC count (antral follicle count) you will have a much better idea of your reserve and what the best steps are and what plan would work for you and DH. I'm not sure if Clomid or Letrozole will give you better quality, but they will give you more eggs to work with for sure. It is a lot to think about and decide. You'll know what's right for you once you have more information.

I just got back from my follicle scan and I have 3 good looking follicles to work with better than my 1 from last cycle. I'm all about more targets. Trigger tonight and IUI Friday morning. Here we go again. One rave: I just moved into a new building at work and the RE office is only 5 minutes away now. I'll take the little victories.

BrightenMySky

@roxgibbons that's great.  I had 2 follicles, same size as of yesterday (left ovary was lazy this cycle).  Here we go again is right.  

roxgibbons

@BrightenMySky my left is generally lazy and only produced one follicle once on IUI#2 so I was pleasantly surprised that there was two follicles there this round. I forgot to add in my last comment. I have a nurse at my clinic too whom I don't like very much. She did my last IUI and she was super cold and rude. The NP I generally work with doesn't work on Fridays and my last IUI and this one fell on Friday. They set me up with a different nurse for this Friday so I am hoping for the best. I can't stand rude medical professionals and especially in a RE office I would hope most people have a better bedside manner. 

AandDM2014

Hey ladies! I can finally join over here!

1. Intro: It's all in my siggy, but basically I have PCOS, we did 6 IUIs, one ended up being ectopic, none of the others worked. We moved to IVF in September 2015, did stims and retrieval in October, got 9 good embryos and have since used 6 of them. My last FET ended up with a BFP, but at my 10 week appointment there was no hb and the fetus still measured at 9 weeks. I had a D&C 4 days later and have been benched ever since as my RE is super rigid about waiting an eternity after a miscarriage before starting again (like, my D&C was on April 12th eternity).

2. Status: I started a tiny bit of bleeding yesterday, but it didn't pick up early enough today for today to be CD1, so I'm going in for baseline on Friday morning and will hopefully get an idea of what the plan is.

3. Rants/Raves: I'd definitely love to rant about how crazy my RE has driven me with all this waiting around. When I last contacted my nurses I actually let them know that there could be fertile people who could already be pregnant again and know it at the time that I had to wait to contact them. And then he still wanted me to wait another 4 weeks before asking them to induce a period. Like dude, come on. My body doesn't need to recover from such an early loss for 3 months. Let me get on with it! But luckily he agreed to let us transfer our remaining 3 embryos. Hopefully one of them gives us a take home baby.

4. Any questions the folks here might be able to help with?: I don't think so, but I do appreciate this community so very much. I only know a few people IRL who have experienced a loss or infertility, and only one who has experienced both, so it is helpful to read others stories and advice.

BrightenMySky

@BornReady was sending you good thoughts this morning, hope the retrieval went well (or is going well)!

BornReady

Thank you for the love, @BrightenMySky! Ugh, well I've had a rough morning. I was feeling pretty positive about everything, but everything started going downhill at the surgery center. The nurse doing my pre-op questioning was saying how busy they are and was like, "Well people are focusing on their careers and education now a days and putting off having babies into their 30's. Well, our bodies want to make babies when we're 18, so that's a problem". Uhh, OK lady, I already feel pretty lame being in my 30's being here, and while I cognitively understand that, my emotional self feels guilt and shame from that statement.

Then the doctor comes over to discuss the procedure and discusses my most recent ultrasound and that they see about 11 eggs. I asked about my short stim cycle and he said that my follicles matured WAY faster than expected, so they basically had to retrieve or risk losing the cycle. His parting words to me, "We like to see 10-15 if you're doing PGS, looks like you have 9-11 to harvest. I guess we'll just hope for the best and see what happens". Now I'm really starting to go down hill.

At the egg retrieval the nurse put the IV in because the anesthesiologist was running late. Turns out she didn't do a good job and I was saying that I was in a lot of pain, they were like oh that will go away. When I wasn't falling asleep, they realized the med was infiltrating my arm which obviously caused a problem. Fortunately the anesthesiologist was in at this point and fixed it while I dozed off soon after.

Anyways, all in all they got 9 eggs, leaving ones behind that he didn't think looked big enough to harvest. I cried most of the way home. I just feel so defeated, after feeling so positive starting this process. I know many would be happy with 9, I guess I just had high expectations and then was brought down to Earth by the providers. Any good vibes, love, prayers etc. are welcome hoping we get a few to day 5 for testing!

But enough about me! How was your IUI @BrightenMySky? FX crossed for you @roxgibbons on your IUI tomorrow!

Thanks for all of the love as usual ladies. This is such a roller coaster.

chloe97

Oh my gosh @bornready what a roller coaster of a day for you. First of all I want to punch that lady who made the comment about women focusing on their careers in the throat. If it had been me I would've said "Um no, I've been in the same job since 2006, I've just been waiting for a man who wanted to have kids with me, thank you for further activating my shame about my age. " Not okay at all. I would definitely say something to the Dr or the practice. That's the kind of thing that would cause me to leave a practice.

Second of all, what the F about the nurse who messed up your IV. That's like my biggest fear in the world. My IV before my D&C took forever to get in and I had an anxiety attack that I wouldn't actually go under. I was hypoventillating in the pre-op room before they gave me Valium to relax me.

Finally, just remember that all you need is ONE good embryo! The nice thing about PGS is that you know that what they're implanting is good. Sending good thoughts your way. Let us know when you find out how your blastocysts turned out!

BornReady

@chloe97 Thanks so much for your note. Yeah, I sat there when she said it and almost started crying. Internally, I was like, "was that as shitty as I thought it was or is it the meds getting to me"?. Umm, yup it was. The horrible part was that the women on each side of me were both in their 40's, one was 13 years older than me and turning 47 soon. What must they have thought?!?!

I'm feeling a little better after walking my dog and getting in the sun. So hopefully I"ll be on an upswing here psychologically!

roxgibbons

@BornReady  Thanks for the support! I'm so sorry about your day, and what a shitty thing for the nurse to say! Terrible bedside manner and I'm sorry about the IV part. Going through fertility treatments and just TTCAL in general is such an emotional roller coaster. I am glad you are feeling better and yes things are on the upswing. Just know you are doing everything in your power to make things work and that's all you can do. Screw the shitty people Can't wait to hear how things turn out.

@chloe97 Yesterday I forgot to mention- did you read the book, It Starts With the Egg? It has a lot of helpful information about egg quality and how to help it naturally etc. another thing I did based on info when I read that book was I changed  most of my products such as soap, lotion and deodorant to all natural with no phalates, parabens, chemicals etc. I also changed my water bottle to a glass one and all my food storage containers to glass as well to avoid BPAs and other hormone disrupting chemicals. I admit it's a little hippie but hey I'll try anything at this point. 

@AandDM2014 I am sorry for everything you've been through and the ridiculous amount of time your RE is making you wait. I hope you can get things going sooner rather than later and start the process. GL!

@brooklyngirl18 Please feel free to hang out!

BrightenMySky

@BornReady I am so so sorry.  I am glad you are doing a little bit better with your dog and getting some sun, although I hope you are resting, too, you just had surgery!  

I really like my RE because he is always positive.  One time I had another RE do an u/s when mine was out of town (it was actually when I was very early in my pregnancy) and he was awful.  I cried so much after what he said to me.  It makes such a difference.  And thanks for the good thoughts about my IUI.  We had good counts and it went fine, although was probably the most painful one yet.  I always feel the speculum the whole time, but it was actively very uncomfortable the whole time this time around (sorry if that's TMI).  

ETA: I just wanted to add as it may not have been clear--9 eggs retrieved sounds great.  Screw his parting word bs. 

BornReady

Thanks @roxgibbons and @BrightenMySky!

@brightenmysky Glad the IUI went well, minus the discomfort, fingers crossed for you! This was a different RE than I've met before, it seems they rotate doing the retrievals. They apparently average 26 retrievals a day!

@roxgibbons I also meant to mention "It Starts with the Egg", even though I"ve only read parts of it. I have also switched out many of my beauty products and use "BeautyCounter" products for most of my needs now and changed over the glass.

chloe97

@roxgibbons and @bornready I had switched to all glass and gotten rid of all the BPA in my life, but haven't changed my diet really or switched to Ell natural products. Good idea! I will also check out that book!!

ETA As for me, apparently the intense cramping and spotting from Monday was a false alarm? I'm so confused. On Sarurday I thought my body was gearing up to ovulate because I felt my ovaries and a sharp pain, and noticed the drying up of CM. Then Monday I started with crazy cramps and had a few tinges of brown when I wiped. Now I got nothing again. I guess I wait some more. Sigh.

Aera11

@BornReady what a crazy day!  When I had my D&C, the nurse couldn't get my IV in then either...she tried FOUR times and finally had to get another nurse.  I've never had trouble getting an IV or blood drawn.  I was so annoyed and my hormones wanted to say, "lady, isn't this your damn job??"  Anyways, FX for those 9 eggs!  Keep us updated

@chloe97 & @roxgibbons I've read, "It Starts with an Egg"!  I skipped around at first and finally read through it.  It was very insightful and I feel like it helped me understand egg quality.  I've tried to change our lifestyle as much as I could; even if it doesn't help, at least I feel like I am do everything I can to give us the best possible chance.

roxgibbons

Well IUI#4 is done and I actually feel better than I have in a while. The NP I had was new and she was amazing. She was so friendly and kind. A big difference from the ice queen that did my last IUI. She was upbeat and positive and was telling DH that we have to go out on a nice dinner tonight as a reward. I have an acupuncture treatment scheduled later today and I am looking forward to it big time. Hope everyone is having a good day.

BrightenMySky

@roxgibbons nice dinner sounds perfect! 

chloe97

@roxgibbons FX this is your month! Sounds promising to me!

For those working with REs, can I ask how you chose to work with the ones you are currently working with? I was referred to an RE who is a one Doc shop by my OB. This RE left a different practice last year so she has no info on IVF success rates. I was fine with her and I really liked her office staff, but she's so far away and I feel like I'd be more comfortable with a larger practice with REs that have RPL expertise. I live in a major city with lots of options, so I feel like I should take advantage.

I made an appointment with a large practice that has an office 20 minutes away, but now I'm reading on their website that their PGS tests for chromosomal aneuploidy, but not Triploidy. From what I understand from other message boards only Natera and some large scale practices test for Triploidy in PGS, and since our baby had Triploidy, we'd think it would be stupid to even consider IVF +PGS w/o a test for that abnormality. I hate to start off with one clinic for testing to have to switch to another for IVF. Has anyone had to switch? 

I feel like this is probably a question I'd get more responses from on IF, I wish that the IF board wasn't do intimidating!! Anyone tried to wade in over there at all?

BornReady

I see a very big practice that my OB suggested. It's huge, but feels small due to personal attention and working very closely with the nurse coordinators. Knowing what I know now, I would probably choose a bigger practice anyways for the sheer convenience. Treatment requires so much monitoring, blood work, visits, communication that I honestly don't know how a 1 doctor practice could provide that on any time scale. I have read of women on the IF board who had REs that they had to work around their schedules for treatment and who batched their patients for treatment so everyone was on the same schedule. Which wouldn't fly with me. My RE office is open 365 days a year and my treatment is based on my personal time line, nobody else.  Ofcourse that all means I have to be OK with someone else doing certain procedures etc. and I am. 

I occasionally contribute over on the IF board. It is overwhelming, lots going on over there! I agree that you would probably get the most feedback from them, especially in regards to the choosing an RE and the PGS stuff. These women are experts. 

Best of luck, keep us posted @chloe97!

BrightenMySky

My PCP recommended a particular doctor at a practice in my city.  We met with him and were very happy with him, so we never shopped around.  I like that he is generally upbeat/positive, he tells us things based on studies and seems very well-read/knowledgeable, and he encourages me to ask questions based on my own research/reading and isn't threatened at all when I push to understand his advice better.  The clinic is open 365 days a year, which is good--like @BornReady said, some places will structure your treatments on their schedule, or not let you do a cycle if you would have to come in on a weekend, etc.  The office I go to is close to my home and workplace, and monitoring is drop-in between 7:30 and 9:30 each morning.  My IUI protocol has me there at least 4 times/cycle (IVF is probably more frequent), so being able to go before work is a huge plus.  

I agree with you that if we did IVF with PGS (and we'd also use ICSI), we would want to do PGS that would pick up triploidy, as our baby had that as well, at least for peace of mind.  I think my RE said the PGS they do would detect triploidy--we discussed when we had our post-loss meeting with him but ultimately decided to keep trying IUIs for a while.  

As for the IF board, I was over there a bit before I got pregnant, but I always felt like kind of an impostor since I had *only* been trying for a bit over a year at that point and I was *only* doing IUI (no one made me feel that way, it was just my own neuroses).  I guess my feeling is you should post if you want to and be sure to use appropriate TW in your title/post, but these are also things I'd expect clear answers on from my RE in any case.  

roxgibbons

@chloe97 thanks for the support! 
My insurance is part of a large network so when I was working with my OB she referred me to the REI clinic that is part of the network and the OBs all know the RE etc. I still read up on them and checked out their IVF success rates on sart.org and they ranked really high in our area. Also two of my friends went there and had good experiences.  At that point I didn't shop around as my insurance coverage was great for my IUI treatments,the convenience of location etc. and when I met the RE I really liked him so that was it. Unfortunately IVF is totally OOP for us so if we go that route at that point we could shop around but ultimately I think I would choose to stay with them since they have all our info and I know the staff and the convenience is awesome. 

I occasionally post on IF on the IUI boards and lurk on IVF boards just to get a sense of the IVF protocols and they do have monthly IVF/FET boards but yeah it can be overwhelming plus I only do IUIs and I get the sense some of those posters think IUI is a waste of time etc.. That said those women are so knowledgeable so you may want to do an intro and ask some questions. 

GL in your search! Living in a big city is a huge plus. Keep us posted  

roper2617

Hey ladies! 
We haven't started medication yet, so for now I'm just going to lurk if you don't mind. 

Intro: DH and I have been TTC since 2014. First and only pregnancy ended in a MMC discovered at 12+5. I'm 25(basically 26) and he's 28. This is our 7th cycle TTCAL and our last to try without medication. I'll be starting Clomid next cycle.

2. Status: TWW,  4 DPO so we still have a little wait ahead.

3. Mini rant: My Dr wants me to count spotting as CD1, which is confusing as heck because I've been spotting almost daily between periods. That should be fun to try and figure out. 

4. No questions as of yet, but I'm sure they'll pop up. 

BornReady

Welcome @roper2617, lurk and participate as much as you'd like!

I think you've mentioned this spotting thing as CD 1 before, it's amazing how different doctors do things so differently. Like you I would never be able to figure that out some months. Are you working with an RE? Will your doctor be monitoring your clomid cycles?

roper2617

Im working with an obgyn currently. At first I was under the impression that they wouldn't be monitored cycles (which made me anxious) so I called and they clarified that they will be monitored. If in a few months there's no success with Clomid (or sooner if the Clomid just isn't working), we'll explore other options. 

Cmckenzie

1. INTRO-  Hi I just was told about this board and have come from miscarriage/ loss and infertility boards.  TTC since March 2013. 6 chemical pregnancy/miscarriages. I start clomid Wednesday and am having a HSG in a little over a week. 

2. STATUS- CD1 will know more after HSG

3. RANT- the nurse at my OBs office is awful! She is not helpful and me me feel stupid for asking her if I needed to worry about any symptoms from clomid or the HSG

4. Questions- have you had an HSG done? How did it go? What about your clomid cycles, any symptoms to look out for? 

BrightenMySky

I did have an HSG when we first started working with an RE. I found it a little uncomfortable but not particularly painful, although it seems to vary. My doctor suggested I take otc pain meds an hour before the procedure, and I think that helped. 

SnobunnieMel

1. Hello all!! I am officially over in this little niche I think. MMC at 8+6 with diagnosis of XXX, tetrasomy 11 and deletion on 1. CP mid April and CP 2 weeks ago. Just had our first RE appointment today. 

2. Benched until we get more answers

3. My RE is a tad weird but moves quickly. We are doing karyotyping on me and DH. Saline ultrasound tomorrow to eval for adhesions after the d&c. I already had everything except CD3 labs so those will be done after AF. Also has plans for progesterone when trying and then will make further plans once we get typing back. Basically if either of us comes up + we will plan on IVF with PGS 

My NP is also sending me to a perinatologist/MFM specialist in 2 weeks so it will be interesting to see if there is a difference in approach. 

4. Questions? Not quite sure right now. Just trying to find more answers. Even my RE is stumped on how the mieosis happened to create our crap ass first embryo