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IF Testing & Treatment - Week of 10/30

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Re: IF Testing & Treatment - Week of 10/30

  • @beachbunnyxo123 I go back CD 20 (so in 10 days) for a progesterone blood test, and she said US too, but I'm not sure if the US is that appointment or a later one. 


    Me: 28 & DH: 29
    Married May 31, 2014
    TTC 1 year
    Currently testing
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  • @twodreamscollide that’s pretty late for monitoring ovulation. If you’re on medication and this is your first medicated cycle they really should have you come in around cd 10 or 12 for monitoring to make sure you don’t over respond to the clomid and to measure your follicles. Cd 20 is usually for progesterone BW to make sure you ovulated. IMO an US on cd 20 would be pretty useless if you already ovulated then there’s nothing to see. Are you seeing an RE or OB?
  • @beachbunnyxo123 they didn't say why on they voicemail they left me.  I'll be starting progesterone tonight after we BD (I guess I better get on that because I really don't want to insert it right after. ).  I really hope you get clearance soon!  It's got to be frustrating thinking you could be missing out!
  • Ladies who have done medicated IUI cycles, when do you typically go in for a monitoring u/s? My RE wants me to come in for monitoring on cd 12, but I usually O on cd 12 or 13. The nurse seemed to think that the letrozole would totally change my O date and their typical monitoring schedule would work fine, but I have doubts. What have your experiences been?
  • @darkstar42 I don't O on letrozole, but my first cycle they had me go in on CD 10 I think since we didn't know how I would react. Just from my own experience at my clinic, CD 12 sounds a little late but I feel like I've heard other girls on here say that's when they go in for their first monitoring. Sorry I feel like this post may have ended up being no help at all. 
  • @darkstar42 I'm also on medicated IUI cycles. I'm taking clomid, however, and it did change my O date. I was Oing CD12 and now I'm usually CD14-16. Either way, CD12 monitoring does sound late - even with my later historical O dates on the clomid my RE has me come in on CD10 for an ultrasound to see how things are progressing. But if the letrozole makes you O late I guess it won't matter. Ok, so I'm obviously no help! FX your clinic is right about timing and you worried for nothing!
  • shortstack930shortstack930 member
    edited November 2017
    @darkstar42 on Clomid I ovulated CD 14-15 but on Letrozole I ovulated on CD 12. They brought me in on CD 11 this past cycle and I had gotten a positive OPK that morning and had a huge follicle that was ready to go. 
    TTC History
    Me: 35 DH: 34
    Married 07/2012
    DD born 07/2014
    DD2 born 10/2018
    DS born 10/2022

    IF history:
    TTC #2 since January 2016
    June-Aug 2017: 3 IUIs w/Clomid = BFN
    Sept 2017: Dx w/Endometriosis
    Oct 2017: IUI w/Letrozole = BFN
    Nov 2017: IUI w/Letrozole = BFN
    Dec 2017: pre-IVF testing
    Jan-Feb 2018: IVF--17 eggs retrieved, 13 fertilized, 9 frozen and 1 transferred on 2/10 = BFP on 2/19!!! EDD 10/29/2018
    FET Oct 2021: BFP on 10/31! MC at 5 weeks
    FET Feb 2022: BFP on 2/15! EDD 10/29/22


  • @darkstar42 when I was planning my first IUI I was on clomid and we missed O because I wasn’t being monitored soon enough. I rarely turned OPKs and had an irregular cycle. If it concerns you definitely request an earlier monitoring date. GL!
    History and blog link in spoiler
    2016 - dx with super low ovarian reserve; failed cycle with clomid, failed IUI, 
    2017 - egg retrieval #1 - 3 eggs, 0 embryos appropriate for transfer; ER #2 2 eggs, 0 embryos on day 3; ER #3 1 egg 0 embryos
    moved to donor egg in summer 2017; 35 eggs retrieved; 19 fertilized; 9 total embryos
    Fresh transfer Dec 2017= BFP!  baby boy born 8/22/18

    May 2019 - surprise natural pregnancy ended in MC
    Nov 2019 FET; MC at 9 weeks
    May 2020 FET; BFN
    July 2020 FET; CP treated with methotrexate
    Oct 2020 BFP! 

    Take a look at my blog


  • @beachbunnyxo123, they said it was a combination between my cervix being uncooperative and closed, and the type of catheter they were using not being ideal in my case. My RE said she'll be using a different brand of catheter for the transfer, so hopefully this doesn't happen twice. I didn't see the dialator (the drawer was by my feet and my "sheet" was blocking my view) but it was definitely not a suppository. It was a physical dialator. I'm glad they have a plan for you, though I completely understand your concerns and desire to have a second Dr available.
  •  @darkstar42 I definitely recommend getting in before that. I went in for monitoring on CD 9 and my follie was just about ready (19mm). They told me that clomid speeds things along bc I was shocked that things were that far along already. If you're worried you'll miss it I'd definitely ask to come in earlier. I had my IUI on CD12 this month and previous months without meds it was more like day 15 
    I hate to hear that a full cycle was a bust just bc of bad timing like that! 
  • @darkstar42 They had me come in on CD12 my first cycle (which ended up being a bust), and then switched me to CD10 after that. The Letrozole did change when I would O, but it has been kind of varied since then (I want to say I went from CD14, to 12, and then 13 this time). If you are afraid that CD12 may be too late mention it to you your Dr. I didn't say anything that first cycle but now I wish I had. 
    Me: 32 DH:33
    Married 9/2015
    TTC #1 6/2016
    BFP: 4/21/2017 - CP
    Dx Unexplained IF 6/2017
    Clomid + Ovidrel + IUI 7/2017 - Cancelled (overstimulated)
    Letrozole + Ovidrel + IUI #1 - BFN
    Letrozole + Ovidrel + IUI #2 -BFN
    Letrozole + Ovidrel + IUI#3 - BFP! EDD July 15 2018
    Baby Girl H - July 22 2018


  • @madspunk @cassafrass15 Thank you! Just hearing about other people’s experiences with this is really helpful!

    @shortstack930 That’s good to know! I think I’m definitely going to be moving my appointment to cd 10 or 11.

    @laurad75 Yikes! That’s what I’m afraid of happening. The nurse looked at me like I was crazy for asking, but it sounds like that is a real risk.

    @50wife When do you normally O? I’m thinking I should go in cd 10 or 11, but I’m paranoid I’m going to miss O! Were you on clomid or letrozole?

    @Pinky917 Am I remembering correctly that your first cycle was a bust not because you missed O, but because you over-stimmed? I’m definitely going to reschedule my appointment. 

  • @darkstar42 I'm not much help but.  I normally Od late (earliest ever was cd21).  This was first cycle on Letrozole.  I went in for my ultrasound on cd11 and I was good to trigger that night. (I'm still temping and FF I showing I O'd on cd 11 but I think the temps were skewed by the trigger & I O'd either late on cd 12 or morning of cd 13 like I should have after the injection)
  • @darkstar42 You are correct, I had over responded. However, keep in mind that was on clomid, not Letrozole. The risk of over responding is lower with Letrozole.
    Me: 32 DH:33
    Married 9/2015
    TTC #1 6/2016
    BFP: 4/21/2017 - CP
    Dx Unexplained IF 6/2017
    Clomid + Ovidrel + IUI 7/2017 - Cancelled (overstimulated)
    Letrozole + Ovidrel + IUI #1 - BFN
    Letrozole + Ovidrel + IUI #2 -BFN
    Letrozole + Ovidrel + IUI#3 - BFP! EDD July 15 2018
    Baby Girl H - July 22 2018


  • gimmiethebumpgimmiethebump member
    edited November 2017

    Diagnosis (If you've been): --------

    Cycle/CD: Cycle 6 (It takes a VERY long time for my cycles to start, I normally have to induce them with provera)/ CD 6

    Status (WTO/TWW/TTA):  WTO

    What are you doing this cycle? (Testing? Treatment?) We've done blood work for pcos and other conditions, the doctor said everything came back okay. I have an HSG scheduled Monday (I am terrified of the pain) and we are doing a semen analysis later on this month.

    How are things going? I am trying to remain hopeful looking at everyone else's journey.

    Any questions? I've never asked my OB, but what happens after the HSG and semen analysis if everything is okay?

    GTKY: Did/are you doing anything to celebrate Halloween this year? I went with my friends bring their kids trick or treating, I can't wait to do the same one year.

  • purplepelicanpurplepelican member
    edited November 2017
    Lurker

     @darkstar42 - I haven't done IUIs yet but am on my 2nd cycle of letrozole (ok actually 4th but I didn't ovulate on the first 2 doses so they don't count). I ovulated CD 19 last cycle. This cycle was my first monitored cycle with a trigger. Because I O'd so late on the previous cycle and was out of town CD 11-13, they were comfortable letting me come in for my monitoring US on CD14. But that US on CD 14 showed I already had 2 mature follicles and was ready to trigger by that evening. So if you already ovulate CD12-13, I think an earlier monitoring US is better.
  • @gimmiethebump welcome to the IF thread- the thread where everyone is great but no one wants to be here! Don't be scared of the HSG- for most people its only mild cramping (my period cramps are worse). There are some people that have pain, but the majority don't have too much disconfort, or if they do, its really temporary (like just a few minutes or less). Is your OB doing these tests or an RE? If you are doing all this with an OB, it is strongly recommended to stop and do these things with an RE. An RE (reproductive endocrinologist) has had additional specialized training and they are much better at managing infertility patients with better results and in a  safer way (the number of people I have seen that take clomid from their OBs like candy scares me and can really affect your long term fertility if you are not being appropriately managed). 

    As for what happens if all your tests are normal? Well, if you don't really cycle on your own without meds that is not normal- which again, is why having an RE as opposed to an OB can help diagnose. I would say you probably won't fall into the 'unexplained' category since unexplained typically have normal cycles and normal symptoms and normal tests but just don't get pregnant, but since your cycles are irregular, you may fall into a 'dysfuntion' category (ovulatory dysfunction, luteal dysfunction etc..) or some form of PCOS maybe? But again, an RE can help you understand what is wrong and how to best manage it.
  • margorita30margorita30 member
    edited November 2017
    IUI mama’s.. if as far as the RE can tell, you are fertile with regular cycles, ovulate like clockwork, and have no known female complications, can you do IUI with out taking any medications or do they always recommend meds to up the chances of success?
  • kiwi2628kiwi2628 member
    edited November 2017
    @margorita30 there aren't a lot of studies that show just IUI with zero meds, but from what I have read, there is only a minute increase of success with just IUI, so meds are always strongly recommended/required. At least thats what I found from some studies.
  • @darkstar42 I normally O closer to day 16 or so. I was only on clomid and my body was obviously ready to rock and roll much sooner!! 

    @margorita30 my first 2 IUIs were no meds bc there were no issues on my end and they didn't see a need for adding anything to the mix. Only the trigger shot to make sure our timing was perfect.
    The past 2 they put me on clomid bc when you're under the microscope with all of the bloodwork, they can see your levels fluctuating so my doctor put me on clomid to make sure things on my side were looking as good as possible! 
  • @JuneRoseRuby cramps after IUI is normal, at least for me! 
    My first one, I feel like the chick who did it was kind of a newb and poked around a bit so I was very crampy all day.  They suggested sex that night and the thought of something in me with those cramps? Nah...
    The others were done by someone different and went much smoother. Still a bit of cramping but it was gone by the end of the day. 

    Fingers crossed for you!! I'm glad you had the most perfect timing ever!!
  • @kiwi2628 thanks so much! I am currently testing with my OB and have to go see the RE for my HSG and SA. I was thinking about switching to the RE because my OB told me the RE would be more agressive with achieving the pregnancy. I really appreciate you answering my question and giving me advice!!
  • @Avrilmai thankfully the shot wasn't terrible, just not as painless as I thought.  But on the other hand it was less nerve-wracking than I thought.  I'd do it again if needed!

    @JuneRoseRuby wow!!  How cool on the timing. Were you able to actually tell on the screen or just the dr?
  • @gimmiethebump I’m currently CD 36 , took 2 test last week that were both BFN and called the RE nurse last week to see if we can get my cycle moving along. She told me to wait it out. I’m getting frustrated here as I would like to get these test going to see if what or if there is something going on. I may call her again if I don’t get it by Wed and see if we can’t induce it. Have you ever found anything natural to induce it? 
  • I did an intro and made several posts back in early spring.  Haven’t been active since (dailies were a bit much for me), but have been lurking.  I’ve been want to jump in this thread, but wasn’t sure when I should really “go here”.  Do I need to re-intro on the intro thread?  Summary, me 28 (this Friday) and husband 35.  Married 2 years.  Two dogs.

     

     @gimmiethebump  Okay, don’t be worried about the HSG.  It was not bad at all (at least in my case).  I had SHG on Friday and then like 30 minutes later went in for the HSG.  I didn’t take any OTC pain relievers before I had either one and only felt a tiny little pressure/sting maybe for like two seconds maybe when the dye went in and it wasn’t even bad.  I know some people really do have problems with it, but it doesn’t appear like that is the majority and being able to relax and not tense up helps a lot (easier said than done.  I know, I know).  Also, as far as obgyn vs RE for testing- let me tell you about my experience.  I was originally going to go straight to RE, but my regular gyn said she could do all these preliminary tests (bloodwork, ultrasound, SA) to have it all done before going to the RE and it would save having to drive several hours each way and money since she said sometime insurance doesn’t always cover stuff at RE.  Well, when I finally went to the RE I had to redo EVERYTHING since they said the testing they did was either out of date methods or not enough information collected and not useful.  Maybe it is just because I live in BFE and health care isn’t that great and somewhat behind the times, but I wish I would have not wasted several months and went directly to the RE.  Also, it could be just because I have good insurance, but it wasn’t any more expensive at the RE, my ultrasound was actually cheaper.  I would just hate for someone else to waste time, money, and energy for nothing, so I would say it is worth checking in to.

     

    Diagnosis (If you’ve been):  Possible MFI.  First SA showed low count and low morphology, but it sounds like it was an outdated method so doctor ordered a redo.  We should get results soon.  So far everything with myself has checked out ok, so we will see…

     

    Cycle/CD: 14ish/9

     

    Status (WTO/TWW/TTA): WTO

     

    What are you doing this cycle? (Testing? Treatment?):  Testing.  Met with RE on Tuesday and had day 3 bloodwork and ultrasound.  Had SHG and HSG and husband repeat SA on Friday.

     

    How are things going?  Eh. Kinda mentally giving up on the whole natural route until we find out more results from RE. 

     

    Any questions?  I’m sure I will after we get all the results back from the most recent testing.  I was really hoping we could go over all of it on the phone, but it sounds like I may have to go in for a follow up. Ughh.  When we were there he pretty much just went through our 3 options – nothing, IUI, IVF, and said he was okay going whatever route we wanted.  Originally I didn’t want to bother with IUI since we really didn’t want to do any medicated IUI cycles and figured the stats weren’t too promising with unmedicated IUI, but he was saying insurance would probably require 3 medicated IUI before they would cover IVF (we are very fortunate/lucky to have infertility coverage).  So basically we just have to decide if we want to start with the medicated IUI, unmedicated IUI and if that doesn’t work go to OOP IVF if insurance won’t cover since it was unmedicated, or direct to OOP IVF.  Of course we will wait until we get the rest of the results from testing to really decide what route to go.  I guess that wasn’t really a question.

     

    GTKY: Did/are you doing anything to celebrate Halloween this year?  We had to take a vacation day for our first appointment in Memphis on the 31st so we did all that fun stuff and then went to a late lunch and shopping.

     

  • @becca07024411 Is there a particular reason you don't want to do medicated IUI cycles? As I understand it, they can improve chances, especially for mild MFI. It's a little unclear in your post, but does your insurance cover both IUI and IVF, or just IUI? Mine just covers IUI, so that's what we're trying. Fx the SA re-do shows better results!

    Speaking of medicated IUIs, I'm so exhausted from the letrozole! It raised my temps last night, which made it hard to sleep, and I'm just exhausted today. Do other folks typically get side effects like this? I'm on a 5mg dose.
  • @darkstar42 Well, at first we didn’t want to do anything to increase the chance of multiples, even if it was just a little. And yes, our insurance does cover IUI and IVF, although the doctor said it would most likely be a situation where they would probably require 3 medicated IUIs first before covering IVF. He did mention he though there was a chance we may have a leg to stand on about justifying not doing medicated cycles since I am ovulating normally on my own, but that would need to be verified. I live in Tennessee, but our insurance is through BCBSIL (thankfully) since that is where our company is located, so it is a little tricky figuring out how the coverage works exactly. He explained the insurance companies do not have all these rules/requirement written down and explained in writing, but something like a board reviews and decides what to pay and what not to pay- or at least that is how I understood it. I wish I had a better understanding of it all!!
  • @becca07024411 I would call your insurance to find out their infertility benefits to decide what to do next. I also have insurance, and they require 6 medicated cycles before they will approve IVF, which means doing an unmedicated IUI cycle for me wouldn't count for anything, but a medicated cycle with no IUI counts, so before moving forward, I would check with your insurance so you don't waste any time. I would hope medicated and/or IUI works for you, but if it doesn't and you do need to move on to IVF (like me) you will be mad if you wasted more cycles and money on cycles that don't count.

    @darkstar42 yay hot flashes! And yes, normal
  • gimmiethebumpgimmiethebump member
    edited November 2017
    @ndz2018
    I, unfortunately, am never able to start my cycles naturally :( but I have heard there are several other methods that help other women induce a cycle such as BD'ing, excessive and herbal remedies. Everyone is different though. Last cycle I went to CD 65 before provera was prescribed for me from my OB and I didn't start a new cycle until after CD 82 :(. What testing are you doing?

    @becca07024411
    Oh my! That would be so dreadful restarting everything all over again. I wanted to do everything with the OB for the same reasons you've done (insurance wise), because once insurance hears the word infertility you are on your own. I have to go to the RE's office tomorrow for the HSG so when I get there I will review the process from switching over from my OB to them.
    Also, thank you for the HSG advise. I have been youtubing and stalking message boards about the procedure and freaking myself out lol.
  • @gimmiethebump We had our first RE appointment on 10/27 and I was supposed to start AF around 2-3 days after that, well I’m still waiting. Doing the CD3 tests and then after that my HSG and saline sono but it’s all waiting on AF. I tried drinking parsley tea, warm lemon water and sex lol still nothin! I’m super frustrated right now. When I spoke to the nurse on Friday she told me I need to wait it out. I’m about 8 days late. Of course the one time I wanted AF to come on time she’s ridiculously late!
  • @ndz2018 how do you know you O'd? Its most likely you either O'd late or haven't O'd yet. Most REs/OBs won't induce a period until you are 60-90 days without one.
  • @kiwi2628 I’m thinking I O’d around the 16/17th I did get a positive (solid Smiley faces for two days) on the Clear Blue Easy OPK test on Oct 15th and after that on CD 18 I got I plain circle with nothing in it. 
  • @kiwi2628 Gotcha! They did do some blood work on 10/27 when I spoke to her this past fri she only told me that everything looked pretty good that I was a tad deficient in Vit D and my AMH level was 4.17 and asked if I had PCOS .. which to my knowledge I do not. They also did a US that day(10/27) and she said my lining was nice and thick like right before AF. I will def call in the morning to ask if they did a progesterone test as well. I supposed is should’ve asked when I spoke to her but I was at work and honestly I figured AF wouldve showed up this weekend. 
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