IF Testing & Treatment w/o 9.14

inthewoods23

@keikilove yeah, snow storms are no fun! But I don't think I could live where the temperature doesn't fluctuate much. So glad you had a wonderful transfer! Sending a million more positive vibes your way!!

@acleverusername I'll call my clinic once AF shows which should be sometime next week. I'm 8do today so she's due Thursday for me. Don't feel too bad about misunderstanding O, I think for the longest time I didn't count my LP right! The Flo app definitely always places O after the last positive OPK. This cycle it says I O'ed on Sunday but that's well after my temp bump. Their algorithms must be different in that Flo puts more weight on your OPK results and FF considers your BBT more important.

@legallykate hope your lining gets its butt in gear!! 

mvt2003

*lurking*

Sorry @kiki047 just got your page! I changed internet providers and it's giving me spotty TB access!!!! 

@acleverusername MH has been on Clomid for almost a year, at this point it's a long term plan for him. His Clomid rx is specifically because during his workup we discovered he has low T, and Clomid helps bump up T without impacting sperm count, unlike taking actual testosterone. He has unfortunately not had a 3rd SA ordered since he started taking Clomid, so I can't verify any count improvement (we were already doing IVF with ICSI so no one even really cared about his count as long as he had a count!) but I can verify that it brought his hormones back into balance and he personally felt better. 

acleverusername

Thank you @mvt2003. This is very helpful. Were both his free testosterone and total testosterone low?

mvt2003

@acleverusername I'm pretty sure they only tested total testosterone. He also has a varicocele, so there is also a physical issue contributing to the low count. Just a word to the wise, if YH is going to the reproductive urologist, you should probably prepare him that at his consult there will most likely also be a physical examination, sometimes a varicocele can be felt during it. MH had no idea that was going to happen so I always warn people now. ! 

acleverusername

@mvt2003 hahahaha; yeah, I already mentioned to MH that there might be an exam involved. The first visit is virtual (I guess to discuss "what's next"?) but I expect he'll need to go in for more testing thereafter. 

acleverusername

Btw - I forgot to mention that my therapy appointment earlier this week was REALLY good. I really like this therapist; she specializes in IF so she's well versed in all the terms and processes. She also runs a support group IRL / via Zoom, and is suggesting that I join it for next session. I really think I will. Besides letting me talk out my feelings, we talked about "productive worry" and "unproductive worry" and she was pretty happy with how I've been handing things in general; said that most of my worry is in the "productive" bucket. I mentioned the concepts to MH and he tried to diagnose me with lots of "unproductive worry" and I said "actually no, most of my worry is of the productive kind." He then mentioned one particular instance of unproductive worry I had a few weeks back and I would have to agree with him... see spoiler to understand where my brain went: 

A few weeks ago, shortly after doing the IUI seminar and, you know, learning about risks such as cycle cancellation in case of overstimulation, I told my husband that I was freaking out that we'll end up with triplets and would have to move back to Canada to be near family, because there is no way we could possibly support raising triplets w/o family. 🤪Psycho, I know. Anyway, that's DEFINITELY unproductive worry. Less of that, more of appointment making. 🙂

misshelen86

Thanks so much everyone for the well wishes.. it means a lot to know so many were thinking of me yesterday.

The last 24 hours have been quite a roller coaster. I will put my story in a spoiler 

DH counts had dropped off again after previously being not bad.. His motility was 30% with a count of 14 mill/ml, which isn’t his worst ever but after the wash he was left with 0.7 million.. which shows the quality is poor. They retrieved 9 eggs. (ETA: They had no issues accessing my left ovary). I was expecting a few more since there were 14 follicles on my last ultrasound. So I wasn’t feeling very hopeful since usually 70% of the eggs retrieved are mature. That would leave us with about 6.  Knowing that DH’s numbers weren’t good, I was really worried about how many would fertilize. So we made a back up plan to go ahead with a fresh transfer if we only end up with one embryo. We decided if less than 4 fertilized, we would only grow them to day 3 so we don’t risk losing them. My head was all over the place and I was really upset that things didn’t seem to be going how we thought they would. I was definitely preparing myself for the worst. 

Today, we got a call from the lab saying that all 9 eggs were mature and 8 have fertilized (all ICSI)! I just can’t believe these results. Based on the statistics we were given, we should have been left with about 3-4 fertilized. I’m so happy with these results. We are going to try to grow them to day 5 and do PGT as planned. They expect us to be left with about 3 blasts in the end, but we will see. I’m still going to prepare for a fresh transfer in case only 1 makes it.

I’m feeling okay physically. I was pretty crampy yesterday, but Tylenol and a heating pad helped. It’s not as bad today. The emotional side of this has been WAY harder than the physical part. I’m cautiously optimistic at this point and just taking it one step at a time. We get our next update on Monday (day 3) 🤞

misshelen86

@kiki047 Thinking of you as you get closer to your beta  

@keikilove So glad to hear your transfer went smoothly!! Sounds like it was a really good experience. Sending you so much love and positive vibes for your little embies to get all snuggled up in your ute ❤️ 

@legallykate Glad to hear you haven’t ovulated yet. Baby aspirin is supposed to help with implantation too. FX you’re ready to go next week!

@acleverusername Sounds like a really good session! I like the idea of dividing your worries into “productive” and “unproductive”. I think a lot of us Type A personalities think that our worries are productive but they really may not be.. That’s how it is for me anyway! I always feel like I need to have a Plan A, B, C and D.. when in reality, I’m usually just overthinking things (just see my previous post for example)!

@ramzlau Hope your IUI went smoothly!! 

acleverusername

Thinking about our dear friends @misshelen86 and @ramzlau; I hope everything went well for you both. 🤞🏻

Argh, I'm sorry for spamming this thread so much this week. I'm going to put a whole bunch of things into spoiler since ultimately, it's my mad rantings (in case you ever wondered how a project manager approaches fertility). TL:DR: we're probably gonna be NTNP for the next 3-4 months. 

So, I tested at 10DPO and 12DPO and both BFNs so at this point, I'm 99% sure we're out. I kind of new that since yesterday when some of my symptoms from earlier this week started to disappear, and the big temp drop, and RHR drop this morning confirmed it. Plus, ultimately, I'd been preparing for this since the IUI since – given MH's sperm report from IUI – we are not candidates for IUI. So, I've been given thought as to what's next. Our 2 big upcoming milestones are check-in with RE on Tuesday; and urologist appointment on 9/30. Here's where my (over)thinking led me: doing another IUI right now, would be a waste of money (we have no insurance coverage). We really need to understand what's happening on MH's side and that'll start to happen after the urology visit. I looked back at his blood tests from July and unfortunately, it doesn't look like our RE comprehensively tested him. For starters, she didn't requisition his SHBG, DHEA/DHEAS. So, while his total testosterone is mid-normal-range, his free testosterone is at the low end of "normal". And since "normal" does not equal optimal, ultimately what we have is an incomplete picture of his fertility.

So, step #1 would be to get him comprehensively tested, including probably a more thorough SA. What do we do in the meanwhile? Well, I will check with RE if doing a Clomid only (no monitoring, no IUI) cycle makes any sense while we figure out his side of things (this would be "just to do something / not to waste a cycle"). I would really only be okay with 1 such cycle given there's a max Clomid cycles one can do b/f a tolerance develops. The thing to keep in mind in parallel is that DH didn't start taking supplements that can help with motility & count until late July / early Aug, so we won't even see benefits from that supplementation until November (sperm takes its sweet time to mature... 90-108 days according to freedom pharmacy). Depending on what the urology testing produces, maybe DH will be put on Clomid treatment, which adds 3 months to our timeline, which takes us to Jan 2021. There's really no point in doing IUI while he's on that treatments; I'd rather save IUI until we know if that treatment worked (or if supplements worked). I guess the good news is that at that point, we'll know if supplements and/or treatments have done their magic. If they did, then we can try a couple more IUI cycles. If not, we can go straight to IVF. 

Of course, the downside is that I'll be 37 in 2 weekends' time, so my age is a factor. I have had my AMH tested several times over the past couple of years, and while it's on the downward trend, it is still "normal" for my age. The bigger worry is egg quality. Ultimately, I think if we're looking a IVF in Jan to Mar 2021 timeframe, my egg quality shouldn't take a deep dive. But, once again, I need to check with the RE. If anyone has thoughts and opinions on this, happy to hear it. 

Finally, another unplanned factor that's influencing all of this is that for the past 5 months, I've been harassing the benefits specialist in my company about why the heck we don't have infertility benefits, while so many other company in my field has it; it's a major perk in the Bay Area and quite frankly, it's what is making the costs of fertility treatments so high here. So, for those of us who don't have that benefit, it's a double-whammy. The good news is that benefits lady confirmed that they found a new broker for the upcoming year, and are in the process of negotiating fertility benefits. However, she did say it might not be ready for start of 2021 which is when our benefits renew.

In summary, I think that once we get to November, we'll have a better idea of whether supplements alone have helped MH and also if/when infertility coverage will be available through my employer. At that point, we can adjust the plan. The sucky part is that – at this point – NTNP for the next 3-4 months seems like the best course of action. 

ETA: before starting Clomid, MH would need to get his prostate checked out since his dad has/had(?) prostate cancer and apparently men with familiar history are twice at risk for it. So that also needs to be part of his workup. 

ETA: oh, and while I came up with that plan on my own (*self five*), I presented it to MH this morning and he's 💯on board.

acleverusername

@misshelen86 so happy to see your update which you posted while I was writing my novella! EEEEEK. You're not kidding re: rollercoaster. But OMG, what wonderful news so far. I'm really really hoping for your 8 embabies! Lol. And your laying out your Plan B, C, and D in your post made me feel better about my own novella of a post. I will be anxiously awaiting your updates and 🤞🏻and 🙏🏻for you in the meanwhile. 

keikilove

@misshelen86 WOOHOOOOOO!!!! Your update is AH-MAZING!!  Me reading this:

“Today, we got a call from the lab saying that all 9 eggs were mature and 8 have fertilized”

That is so fantastic!!!!!!!🎉💗🎊 Man, if anybody deserves to have a moment to sit back and just “be” in this moment, it is you! What a reward for all the long waiting and waiting you’ve done. Of course, we all know that you will still be on pins & needles till you get your final results.  But I am so so happy for you that you can breathe a little easier right now. And I totally agree with what your plan B was—that was our exact plan as well.😊 Will be sending your little embabies positive thoughts of growth & development over the weekend! 

misshelen86

@acleverusername Thanks so much! Sounds like you have a good plan in place. It makes sense to save your money if you don’t think the IUI’s will work right now. It’s also a good idea to get things optimized now before moving on to more IUI’s or IVF. Hopefully the urologist will be able to give you some answers!

@keikilove Thanks so much for the kind words  I totally teared up reading your response. It just means so much to have people that truly understand the highs and lows of IF. I’m sending your embabies all the positive thoughts as well friend!

keikilove

@misshelen86 Agree 💯 with you. Having others to relate to through this whole process is invaluable.💓💓💓

@acleverusername Wow, That is a lot you have been thinking through! FX that the fertility benefits do kick in and that they line up perfectly with your proposed plan. As for your question re: AMH: my advice is to ignore it. There are women who get pregnant with 0.00 AMH, since they’re still ovulating. We already have enough things to stress about in this TTC adventure—take as many things off the table as you can to worry about. I liked what you shared about productive versus unproductive worry.😊 In the grand scheme of all the IF testing & health-related things that need to line up, AMH seems to be one of those things we really shouldn’t worry about unless we’ve hit menopause.😉

inthewoods23

@misshelen86 ICSI is absolutely amazing! We had an above average number fertilize as well (15 of 17). FX for a good update tomorrow!

@acleverusername glad YH is on board with your plan. That really sucks that you don't have fertility coverage! I hate that so much. Like great, people can pop them out after blinking at no cost while we're all here spending thousands trying to figure out what's wrong in our equation. I really hope you can get fertility coverage for next year! A lot of clinics have OOP prices though that is pretty similar to what you would pay if you did have coverage. I think I save 500 bucks doing the "package price" for a FET at my clinic than submitting it to insurance.

acleverusername

@inthewoods23 thanks for the info re: how much you still have to pay. To be honest, I haven’t really given that much thought though I probably should. I know at the big tech Co’s (Facebook, Google) fertility coverage is comprehensive; my friend, who works at Google, went through 2 rounds of egg freezing and paid nothing OOP. 

Anyway, the latest development is I’ve looked up pricing for infertility treatments in AZ and holy cow IUI are literally 50% of the cost. IVF is not quite as discounted but still probably 25-30% cheaper. And we have a place to stay in AZ, so MH and I have basically decided that if we don’t get fertility benefits through work, we’ll just go to AZ.

ETA: not to add but to fix spelling/ grammar mistakes.

ramzlau

@acleverusername whoa! I can’t believe how much cheaper it would be in AZ with those kind of discounts. It might make it worth the drive/or flight. Glad you have a plan and backup plans. I hope your urology appointment goes well next week. Sorry for your BFN this cycle! 

@misshelen86 I am so happy reading your report! Way to go! Keep growing little embryos! I am sure there is still lots of stress and unknowns, but hope you can take a moment to breathe and enjoy the achievement of getting to this point. 

@keikilove I am happy to hear your transfer went well! Sending warm snuggly thoughts your way! 

AFM: We has a few mixups on Friday, but got them straightened out and got the IUI done! Now we wait. I spent the weekend relaxing on the beach, the sound of the waves and smell of salt water always calms me. 

keikilove

@ramzlau So glad to hear that you were able to get the IUI done! Your weekend sounds absolutely lovely. FX during this TWW!