IF Testing & Treatment Check-In w/o 4.5

[Deleted User]

This is a place for those of us who have already started TTC, but have started infertility testing and/or treatments. You can express your thoughts, feelings, and frustrations on infertility. TTC can be a long journey naturally, then add in the difficulties associated with infertility, and it becomes a whole new ball game. The road to infertility can be lonely, frustrating, and complicated, so let's make this a place where we can vent, ask questions, and support one another. Feel free to resurrect this thread at any point in the week if you have something to say. Treat this as an ongoing conversation.
<div><div>
</div><div>Diagnosis (if you've been):  

</div><div>Status (WTO/TWW/TTA):  

</div><div>What are you doing this cycle? (Testing? Treatment?):  

</div><div>How are things going?:  

</div><div>Any questions?:

</div><div>GTKY: What spring projects around the house do you have in mind this season?</div></div>

kiki047

Oh hiiii, I'm baack. 

Diagnosis (if you've been):  PCOS, RPL, MFI

Status (WTO/TWW/TTA):  IVF limbo (2-3wks of BCP prior to starting stims)

What are you doing this cycle? (Testing? Treatment?): *TW* Starting our 2nd IVF after a failed FET and back-to-back MCs. Now we're out of frozen embryos and have to start over again. 

How are things going?:  Ok I guess. Feeling better now that we actually have a plan to move forward. We're doing all of my tests over again since the last time they were done was Nov 2019 prior to our last IVF cycle so tomorrow I go to get my AMH tested, MH will do his sperm chromatin structural assay again (for DNA fragmentation, it was 17% last time). All my regular panels came back normal (TSH, thyroid, blood sugar, etc) and I'm told our genetic testing and RPL panels take anywhere from 3-4 months to get results. 

We're going to try to do a fresh transfer this time, and PGT/freeze all for the rest. Hoping for 3-5 embryos when it's all said and done based on my last cycle. 

Any questions?: A couple!
1. Talk to me about fresh transfers vs frozen. I had a rough go of it last time post-ER so I'm nervous about feeling poopy but at the same time, excited to try something different this time around. 
2. Has anyone ever been on a keto diet? Specifically for IF or just for weight loss? My RE is recommending I go keto, and if I get KU keep it up through to 12wks, because he firmly believes there's something about changing your body's chemistry that helps with fertility, especially for people with PCOS and/or RPL. I've always been very anti-keto as a weight-loss method because of how unsustainable it is if you're not planning on staying low carb, however I do see the merit for those with health conditions (e.g. diabetes, PCOS). I'm non-insulin resistant PCO however he still thinks it could help and I'm inclined to agree. 

GTKY: What spring projects around the house do you have in mind this season? It's all about the garden right now. I started my seeds indoors about 3 weeks ago and they're going strong. Have some sprouts coming up in the garden too (radishes, turnips, kale, arugula, spinach) but we're Zone 6 so even though it's beautiful outside this week I still fully expect it to snow at any moment. 

acleverusername

@kiki047

(Stupid spoiler isn't working so I can't put it in a spoiler!) Welcome back! I am of course shattered that you find yourself back at the beginning of your IVF journey. Sending you virtual hugs of support. I can't really comment about your fresh transfer cycle, but I wanted to share this spreadsheet with you (patient-contributed IVF cycle data); it was shared on a local IVF Facebook Group. There's a column in there for "diet type" and I've definitely seen keto & mediterranean come up frequently. Too bad that reason isn't listed. You may also want to search and/or ask your question in R e d d i t's IF sub (a great place to search; be careful when posting since their rules are much more strict than TBs). Good luck! 

Diagnosis (if you've been): My husband's gimpy sperm don't like my stale eggs 😭

Status (WTO/TWW/TTA): TWW but really WFAF ☹️

What are you doing this cycle? (Testing? Treatment?): Waiting for a new cycle to start; will use next cycle to finish our testing (ASA for DH) and will also starting convos with Canadian clinic where my 11 eggs lie frozen. 

How are things going?:  Not going to lie... I am VERY bummed that it's looking like this cycle was yet another bust; I am starting to lose hope. It's like my eggs want nothing to do with DHs sperm. I have no idea what's going on inside of me, but I am very very sad. 😢Going to take a break next cycle to regroup and decide if we do 1 more IUI cycle or just save our money and finally start IVF. I'm thinking the latter. 

Any questions?: NATM. 

GTKY: What spring projects around the house do you have in mind this season? 1) Get a dog 2) clean up the garden 3) finish cleaning the garage and set up exercise space.

keikilove

@kiki047

I’m so sorry for your loss and that you’re now in the RPL camp. Re: your question: I’ve definitely heard that keto helps many women conceive. I’ve tried it myself to bring down inflammation: I felt momentarily energetic & fine for the first 10 days or so, but then went off it because I just can’t consume that much meat. It makes me feel sick & sluggish overall, feels very foreign to my body to eat that way. However, the overwhelming number of anecdotes I’ve heard that it was THE thing that led to success for some people would make me reconsider if it was just for 4-6 weeks. Plus there are lots of websites & resources to make it manageable. Good luck with starting it! 

Lisa3379

@kiki047 I'm so sorry you're back, but I'm hopeful for your next steps, and I'm glad that you seem to be feeling optimistic about it. Sending hugs. 

@acleverusername I'm also sorry that this cycle didn't seem to work for you this time. Not that I have any confirmed success with IVF, but so far, it's been a positive experience for me, and I'm comforted by the fact that we're doing the most we possibly can to make this happen. But oh, the cost. My husband just informed me that we've already hit our insurance max coverage and we haven't done the transfer yet. Oy. Oh yeah - what kind of dog are you considering? 

Diagnosis (if you've been):  unknown/old

Status (WTO/TWW/TTA):  CD 6 of FET cycle 

What are you doing this cycle? (Testing? Treatment?):  Natural cycle FET

How are things going?:  Good, s'pose. I have an appointment this Thursday to see how things are progressing. I feel like I have a super busy week ahead - that appointment, I need to take my car in for service, my MIL is coming at some point this week, I need to figure out how we're paying for this cycle's prescriptions (insurance or OOP), order my dog's prescriptions, visit my parents... I just want to take a nap. 

Any questions?: nah

GTKY: What spring projects around the house do you have in mind this season? Oh man. *TW: mention of children* Since Covid hit, I've had my kids at home for over a year. I haven't been able to do ANYTHING regarding the house in that time. At all. They go back to school next Monday, and one of my projects this week - gah! another thing to do! - is to come up with a list of priorities regarding the house. I just want to systematically purge the house of all the needless crap. I also want to come up with a plan for housework, like Monday is floor day, Tuesday is clean the bathrooms day, etc. 

bows22

@kiki047 I wish you didn’t have to be here but I’m glad you decided to come back to TB!❤️ That’s so long for the genetic testing and RPL results! Will you wait for those or are you just going ahead with your plan in the meantime 

@acleverusername I’m so sorry that it’s looking like this cycle wasn’t successful. Do you have a beta scheduled?

@lisa3379 I’m glad you have some things that make the time go by quickly for you! But I hope you get your nap too!

Diagnosis (if you've been): No true IF diagnosis other than secondary unexplained, but I’m AMA, have a really thick endometrial lining, and DH had 1% morph in his SA. Things that may be slowing us down but shouldn’t be preventing pregnancy according to my RE. We’ve been TTC since December 2018 and I had a hysteroscopy in January 2020 to remove a polyp/thin my lining that apparently did nothing to help me. Prior to the hysteroscopy they also suspected I had endometrial hyperplasia because of the thickness/appearance of my lining, but apparently they were able to rule that out through the hysteroscopy. At the time I felt so thankful to even have the chance to TTC after, but somehow became bitter again in the last year ha.  

Status (WTO/TWW/TTA): WTO 

What are you doing this cycle? (Testing? Treatment?) Bloodwork tomorrow and SHG on Thursday 

How are things going?: Just excited to get back into it. I haven’t been posting here since we were just trying on our own, but after some issues I’ve been having, I’m repeating some of my testing to see if there’s any reason or if something has changed. 

Any questions? Has anyone had a 2nd SHG? My first one was a breeze and just curious if I will have the same experience or if there’s a chance it will be worse. 

Also - they told me I had to come with a full bladder, pee a little bit to take a pregnancy test, and then 30 minutes later I will have the SHG. Is that even possible? This was NOT the process last time and I don’t know how my body is even going to do that. I think it makes more sense to fully pee and then chug water for the 30 minutes?

GTKY: What spring projects around the house do you have in mind this season? I don’t know if this is a spring project but I’d like to get some more decor to make the house feel more homey!

Edit to add the second question after thinking through how little sense that makes 

bows22

@bumblebee0210 I missed this thread too - funny how just the omission of “IF” made my eyes skip right over it haha. Anyway, I’m so glad that your last cycle brought good results for you and that you have learned how to handle your clinic for next cycle! I hope AF shows soon so that you can get started!

kiki047

Will be back for more tags later but @bows22 I’ve had 2 SHGs and actually my 2nd one was better than the first. But the first was a nightmare tbh, nobody’s fault but it took them too long to get the catheter in, then I had a massive cramp and just flat out panicked. But my 2nd was fine, just some cramping. Definitely take Advil beforehand. 

@keikilove I am also apprehensive about eating sooo much meat, and I also don’t eat a lot of dairy because I’m lactose intolerant, so butter, cheese, sour cream, whipping cream, etc are all so daunting to me. Delicious, but there’s only so many avocados I can eat. I dunno. We’re going to give it a shot. I think it’s different if we’re not doing it for weight loss, so I might just need to try going strictly low carb and see how I feel. 

[Deleted User]

@bows22 I have had ... Four?  The first one was the only awful one, and I think that was for a couple reasons.  1. We were trying to actually check my tubes, too, watching for bubbles on the screen, so like using it as a diagnostic instead of HSG.  2. I also think that doctor hadn't done too many of them 😬 3. I think I was probably (rightfully) terrified. Lol

After hearing about my first experience, my own doctor assured me she would be very gentle, and has now done several for me that were all completely uneventful.  FX you have a good experience, too!  I literally probably didn't even need the advil, she just did what she needed to do, didn't push the saline hard, knew what she was looking for etc.  Totally, totally serene. 😇

[Deleted User]

@kiki047 Sorry you find yourself back here. 😞 But glad to have such wonderful company!? ((((Hugs)))) I haven't personally tried keto prior to transfer, but I have been saying I want to try it, [eta and I generally tend to enjoy being on it, too], so you may just help motivate me!  There are so many sweets in the house right now.... I told DH we should try to see what we can freeze. :/. I never had a fresh transfer, but my BFF did.

TW<div class="Spoiler">She did one ER, one fresh day 3 transfer, had nothing to freeze and one perfect outside baby!</div>

acleverusername

@Lisa3379 Wow - I can't believe you've already met your lifetime max for IF treatments! Argh, and I just had someone tell me today that FET meds are more expensive than stim meds! Good luck figuring that out. I know that shopping around is key. There is so much variation in pricing between different pharmacies! Remind me again: are you doing a natural FET or medicated one? As for dog, we want a corgi. It's the perfect dog for us in every way! We're going to see 2 corgis next weekend (landlord stipulated that we must get an adult dog, not a puppy.) 

@bows22 not sure if it matters, but I actually had a HSG and then an SHG; the latter was much less painful. I'm really happy that you're getting the testing done this cycle; hopefully it will yield some answers! Are you thinking of signing up for your company's benefits this year so that you can get some IUI coverage? 

[Deleted User]

@Lisa3379 I am right there with you on the purging and the cleaning schedule! 😬 The Minimal Mom (Dawn) has a great YT channel for decluttering motivation, and there's a few others I like for cleaning motivation.  I can't even remember off hand right now tho, I'm so tired (shows you I probably need to replenish my cleaning mojo cup, also tho lol) The Organized Soprano, and But First Coffee are maybe only names I can remember right now.

//

I remembered - Faith and Flour has some (what I thought were good ones) about setting up a cleaning schedule:

https://youtu.be/HPbQCeFNPC4
https://youtu.be/kxzZGTygkMg

//

But anyway, helps me so much to space out watching other people clean for 15-20 min and then I just want to take on the world! Lol. Who knew that was a thing.  🤷  And GL Thursday!!! 😁

ETA PS my company also has no lifetime cap for IF... Not that it was the primary reason for my applying there or anything.... 🙄 Lol ...if anyone is looking for a career change.

bumblebee0210

Sorry for the duplicate this week! I think @BusinessWife and I were simul-posting. 

@acleverusername Ugh, I'm sorry man. How many days out are you now? 
@kiki047 Sorry you're back here, but hopefully you have a good plan moving forward. Did you do PGT testing last time?  Also, on keto-- I understand your hesitation. I worry a lot about extreme diets leading to disordered eating and a messed up relationship with food or a messed up metabolism. Also, this can't be very evidence-based since different (reputable) docs recommend totally different things (plant based and keto are basically total opposites). But maybe for a short period worth a shot?
@Lisa3379 That is crazy that one ER was enough to get you to a cap. Good thing you got so many good embryos! But still-- health insurance is such a joke.
@bows22 The way the bladder SHG thing was explained to me was that the full bladder was *only* so that they could do a pregnancy test. You don't actually need a full bladder for the test itself (it's transvaginal-- usually full bladders are only for abdominal scans, but somebody correct me if I'm wrong. 

Diagnosis (if you've been):  RPL, DOR

Status (WTO/TWW/TTA):  WFAF

What are you doing this cycle? (Testing? Treatment?):  ER #2 Starts CD2

How are things going?:  Good. I was really happy that at the end of an up-and-down cycle we ended up with 2 day-5 blasts for testing. I know we still have that hurdle, but at least I know that my eggs are still capable of making blastocysts, and it gives me confidence that with enough ERs we can get some healthy embryos to freeze (and of course, one or more to transfer!). Also I'm getting better at working the bureaucracy of my clinic and I am all set to start stims as soon as my body decides it's ready. 

Any questions?:  How long did you guys take to get a period after an egg retrieval with no transfer?

GTKY: What spring projects around the house do you have in mind this season? We are in the midst of renovating our garage/mudroom, but a contractor is doing it and it's away from the main house so not too intrusive. Also starting to plant veggies in the garden!

bows22

@bumblebee0210 oh that’s interesting - I definitely needed to have a full bladder for the actual test last time and they did a blood pregnancy test not a urine one. I was thinking I was losing it so I searched “pee” in my texts and found this 😂

But Google seems to agree empty bladder for SHG unless there is also an abdominal portion, which definitely could have happened last time although I can’t totally remember. 

optimistgardener

Hi y'all!

@bows22 By SHG do you mean a saline-infused ultrasound? I get so tangled up with all the terminology. Yeah, I did it twice and both times it was fine, just a whole lotta salty water all over the place. No pain or cramping to speak of. I had a very painful HSG early in my TTC journey that I'm a little PTSDish about, and so I was really worried the saline-infused ultrasound would be similar, but they were easy-peasy. Because I hated the HSG so much and I worry about my one remaining fallopian tube/ovary, I made them do something called a "bubble test" (edit: @businesswife already mentioned this procedure!) while they were in there during one of them. Doing so saved me from having another HSG later, for which I'm so grateful. I feel like as @bumblebee0210 says the full bladder thing is not actually necessary for the test. Having a pain reliever on board in advance is a good idea, though, just in case your body decides to cramp!

@acleverusername dude I am so bummed for you that the cycle seems like it didn't take. That feeling of letdown after a particularly promising cycle is so frigging crappy (keeping my language PG here but feeling the stronger stuff with all my heart). I feel like that was me to a T at the end of my first medicated IUI a month and a half ago when I'd had a nice promising batch of follicles at trigger. When it didn't work I wound up doing one more IUI just because I had the medicine lying around and it was going to take the clinic a month or so to fit me on the schedule anyway for IVF, but I'll say my heart was really not in that 2nd cycle from the start. I just felt like, dangit, something is really not working out inside me. And then of course that cycle wound up being basically a bust. There's no wrong decision on doing another IUI or saving up for the IVF, of course, but it seems like you're already leaning and, I guess having just been through a similar set of decisions I think there's something to that feeling that it's probably time to try something different.

@kiki047 Hi! So sorry you're back here but pleased to meet you!

Diagnosis (if you've been):  only one old ovary gimping along, probably other stuff too, who knows

Status (WTO/TWW/TTA):  BCP for a while as my clinic works up an IVF plan. I can't believe I'm taking birth control pills again, so weird.

What are you doing this cycle? (Testing? Treatment?):  As above.

How are things going?:  Meh. I'm not jazzed about the amount of money I'm about to shell out, and honestly I'm having a hard time feeling optimistic about the process, but... I made a decision this would be my last big hurrah and so I am going to ride it out and see what happens. It is probably against all the rules but I have been taking advantage of being on a little mini-break of sorts to enjoy a beer with dinner the last few nights and a mid-day cup of tea in addition to my morning coffee. So that's been pleasant. To balance out my bad-girl inclinations though I'm being very rigorous about taking my supplements every day, and after encouragement from y'all I've added CoQ10 to the mix.

Any questions?: I just got my first dose of the moderna covid vaccine yesterday! 🎉 Yesterday was also my first day of eligibility as well, and I have to say I was shocked and a little bummed about what it says about my community's vaccine reticence to hop online and find lots of empty appointment slots for that very day. Anyway, my question about all of this is... I got the shot and then realized that my second dose will probably be due right in the middle of all my IVF stuff. I'll obviously chat up my clinic about that and ask what they recommend, but as a general rule with vaccinations has anyone heard of a reason not to have one while doing IVF?

GTKY: What spring projects around the house do you have in mind this season?

I feel like I only just a week or so ago got all the muddy dog tracks off the floor but now I'm looking at the floor and they're all covered in muddy dog tracks again so I should probably repeat that effort, but that's not really the big spring project this question is getting at. Ok here's my spring project: this house (which is sort of the family house, so a lot of what is here is only really "mine" in sort of a hazy, collective kind of way) is full of house plants that haven't been repotted in years, probably decades. I'd like to buy a few larger pots to accommodate the heftiest fellas and then repot everyone in the house into good new soil. ...And maybe "accidentally" mishandle a few of my less favorite plants in hopes of needing to replace them with more interesting varieties.

Lisa3379

@acleverusername I know! This stuff seriously adds up. I'm doing a natural FET, so the meds are really minimal compared to the ER (a trigger shot, some sort of cream, and a couple different progesterone suppositories I think) so it wasn't as bad. And Corgis are so cute! I hope you find your perfect buddy  

@BusinessWife Oooh, thanks for the suggestions! I'm definitely going to check those out. 

@bumblebee0210 I got my period 10 days after my ER, which I was so surprised at! My period is usually way later than I think it'll be, haha. When do you think you'll get your PGS results? 

@optimistgardener My second Covid shot is scheduled for right about when I'm doing my transfer. I told my doctor and he said if it conflicts with the transfer, re-schedule the shot for at least 3 days after the transfer. He was not concerned at all necessarily by the fact I was getting vaccines during the process in general. I have a feeling that the concern might be feeling sick as a result of the side effects and that affecting the procedure. If that makes sense. 

[Deleted User]

@bumblebee0210 mine were 11 and 10 days post retrieval.

acleverusername

@bumblebee0210 I got my period 7 days after my ER (although I spotted for 2 days prior). It varies person to person, with some ppl getting their 7 days post retrieval; and others closer to 12-14; it's also likely to change from one ER to the next. I'm praying that you get good news on those 2 blasts once they come back from the lab. Did you get a time estimate? AFM, I'm 12DPO today. Your post in dailies is encouraging, but I don't think I'm an outlier. I've gone through life thinking I'm at outlier in many endeavors only to find out that I'm perfectly average and I don't think this case is any different. 

@optimistgardener girl, you so perfectly expressed what I'm feeling. #soulsista. We'll see where we go from here. I'm perfectly content to skip this next cycle while we wait for the ASA test; but will also see what the doctor says. I sent her an in-depth e-mail with options as I see them along with "what's happening here?" As for vaccine during IVF, @keikilove had some input about this from her Reproductive Immunologist. Might be worth searching other threads for this. I think at the end, it might be a personal decision, but definitely ask your clinic. Good luck with all the repotting you're about to do!

acleverusername

Good resource on vitamins posted to a local IVF Facebook group (@optimistgardener might be useful for you) ; shared with a patient by an RE at one of the top clinics in SF: 

bumblebee0210

@acleverusername. Sorry man-- you are probably right. It's true for most of us in most things! That's literally what "outlier" means. 

My update (particularly for @optimistgardener and @acleverusername who I feel like might be headed down a similar road soon):

I had my postmortem with my doctor today, and she said all told, she thought the cycle went pretty well-- as good or slightly better than expected. She did say that there are other protocols that they can use to try to prevent a lead follicle (with estrogen priming), but it increases cycle length by 3 weeks or so. Since our goal is max embryos in min time, she thinks repeating the same protocol again is our best bet. Apparently these lead follicle things can just be random, so it will be informative if it happens again this time maybe we can change something up. Also-- she said when you change things you always risk throwing out the good with the bad, so since this cycle worked fairly well for us (esp given my AMH), it probably makes sense to just keep it as is for now. So, this is the road we are on for now-- ERs every 3-4 weeks until we get to 5-6 normal embryos, or totally burn out

acleverusername

Oh yay, we have a new diagnosis: fertilization related to sperm quality. And here's what the doctor had to say about the sperm quality issues: 

1. My thoughts after seeing the sperm is that it could genetic but not a gene we are able to test for and not something that makes me think you'll pass something on to a child. Here is the list that I'm talking about: https://www.fulgentgenetics.com/Infertility-Male. Knowing this isn't going to change what we will do from here, but it's just something for you to know, if you didn't already, that there could be a genetic component. We know it's not because of being overweight/lifestyle things we can modify or control.

1. ICSI should be able to overcome this more than what can do with IUI

Anywho, I kinda really want MH to get that panel done; I also ordered a cap-score sperm function test (currently on sale for $99 as opposed to $279). Anyone ever hear of that one? @keikilove you might know. Also wondering what that might mean for IVF. I.e. would doing activation with calcium ionophore be something we ought to try? 

keikilove

@acleverusername I don’t know how I completely missed your check-in. (I think I was just so *selfishly* happy to see Kiki interacting again that I wanted to welcome her back with hugs immediately.) I am SO sorry that you’re sure your IUI didn’t work.😢You have every right to feel super bummed and like you want to take the next cycle to regroup.♥️ This is such a hard friggin road to travel. I hope you & YH are able to get some perspective while you wait for his test results, and that you feel really good about whatever next steps you decide on together. 

@Lisa3379 Wow, it does sound like a busy week! Sorry you have to make those decisions about insurance vs OOP. FWIW, my understanding is that FET meds are usually quite simple and cheap: just progesterone and estradiol usually. Are you trying other meds for any reason? Edited: I see you’re doing a cream (probably progesterone?) and a trigger shot. Hope it doesn’t cost too much! 

@bows22 Hiiiii friend! So happy to have you back here—I hope you know how I intend that! It’s exciting that you’re finally able to get the testing started again. I completely agree with you to fully pee first, then chug more water after if it’s really necessary. Idk if I’m just weird, or have a high pain tolerance, or if I’m just all stretched out in there😮🤣 but I’ve had an HSG, SHG, and hysteroscopies,  and feel fine during & after all of them without any pain meds. (Granted, the hysteroscopies were under anesthesia so...) If you were fine before you should be ok on this second go-around. 

@kiki047 Oh yeah, low carb is a great way to go as well. My understanding is that keto is recommended to bring down inflammation, and low carb serves the exact same purpose. So you may be ok just going the low-carb route & not going all the way meathead keto. P.S. I’m so sorry about your lactose intolerance—you’re right: dairy is so delicious! 

@businesswife Between your superb baking skills and your cleaning reccs, I’m wondering if you yourself have a blog you run?😄  I just don’t know how people do it...// That’s amazing that your company doesn’t have a lifetime cap for IF! What kind of company is it/what industry? 

@bumblebee0210 Your attitude about your 2 blasts is exactly right: what a blessing that your body is making healthy eggs for strong embryos! I hope you get even better results with this next round of IVF so that you can feel super confident about sending them to test. I’m no help with your question, as my body was all wacky after DuoStim. 

@optimistgardener Hey there! I can chime in on a couple of things: my RI said that her patients who have been receiving the vaccine have elevated inflammation markers for about 2 weeks after getting the shot. If you can time it to avoid the inflammation happening around the time of the transfer then you should be fine. Also, yeah, the cost of IVF is astronomical. Clever might’ve already mentioned these, but there are some options for less expensive IVF: CNY in NY & CO: only $4k before meds. There are several reputable clinics in MX: Vida in Tijuana is @$4k-$6k for 1-2 rounds back-to-back. I did two retrievals and one transfer for less than what one round of IVF would’ve cost me in my home state. Feel free to message me for anymore info. 

*I hope I didn’t miss anyone; I’ve been trying to complete these tags & checkin all day. 

Diagnosis (if you've been):  RPL, DQ Alpha match, Blood-clotting disorders, AMA, DOR 

Status (WTO/TWW/TTA): TWW

What are you doing this cycle? (Testing? Treatment?):  We did a medicated IUI 12 days ago, but I ovulated 10 days ago. It’s interesting to think about. I’ve done 4 natural IUIs on the day of or hours before ovulation and TW

I only just now realized that the timing may be why those IUIs worked. I recently read some research that says the best day to do an IUI is on the actual day of ovulation. The only IUI I’ve had that didn’t take at all was the one that was done before my OPKs started to turn positive. That was also the first time I’d ever taken Letrozole, so I chalked it up to that medicine not working for me. But now I’m more convinced that we did it too early, as I’d suspected. With this most recent IUI, we had 3 eggs, 2 of which were “just about to ovulate” and one that probably released in the night/early morning hours on the day I have marked as O in FF based on temps. My RE does the trigger shot on day of IUI (best practice based on her own research), which is interesting. 

This time we did the IUI just before my OPKs started to turn positive. I got a High later that day and a Peak the next day, but it could’ve been the trigger shot causing the OPK to turn. They stayed positive for about 5 days after the trigger. 

How are things going?: Fine. I travelled today for another infusion, and the airports are packed with tourists. No more easy breezy quick travel. (Although visitor capacity is still only at about 30-45% of what it was pre-COVID, so it’s still easier to breeze through security than it was before.) In other news, MH got bloodwork done today to check his testosterone, etc. He may start Clomid soon to generate new sperm faster, but it depends on his testosterone levels after all that crap he was putting in his body recently. 

Any questions?: Has anyone heard of a sperm “wash-out cycle”? That’s what my RE called this time where we are trying to get MH’s crappy sperm out and fresh sperm in. I’m wondering if there are any other tricks to get him to generate new sperm faster. He’s finally looking up online what he should be eating and drinking—he actually told me that he’s not allowed to have McDonald’s anymore.

GTKY: What spring projects around the house do you have in mind this season? Ha! I am so consumed with this TTC stuff that it is my full-time preoccupation right now. Plus I have several new work contracts so that’s consuming my daily work hours. I will make a spring cleaning list eventually...

[Deleted User]

Hint: it may or may not be on this list...
https://www.monster.com/career-advice/article/companies-offer-fertility-benefits-1117

@keikilove

bumblebee0210

@keikilove @BusinessWife. My insurance also has no cap on infertility services, no pre-authorization required for IVF, and no weird requirements like 3 IUIs before IVF or whatever. (though it doesn't cover everything-- we will likely have to pay for ICSI since we have no MFI and PGT testing, and the rest is 20% co-insurance, except drugs which are quite cheap). I work for a university and I think they have such good IF coverage in part because it is a big attraction for LGBT faculty/staff. 

[Deleted User]

@bumblebee0210 yes, we have also started making everyone aware of our amazing adoption resources!  ...and then it wasn't until I was doing a training that it clicked for me that is also hypothetically a big LGBT draw. 👍 I am awake, I swear lol

anniemarie887

@BusinessWife so interesting that three of those businesses on that list are in maryland...  not shocked by the two universities!

acleverusername

@keikilove don't really know about the sperm "flush" cycle, but I do know that sperm is born every day, so depending on how long your cycle is naturally (I imagine you're not doing anything this next cycle?), by the time the next one rolls around, there's a decent chance that YH would have some "rejuvenated" sperm. I also have never heard of anything that would speed up new sperm development. But hooray for YH finally reading up on stuff and taking steps to get himself in tip-top shape for your treatment. I'm still so sorry that you had to find out the way you did. That's interesting insight re: timing & prior IUI success. I think that most ppl think that you O 34-37hrs after trigger, but I also read that it could be as early at 24hrs! And also that processed sperm doesn't live as long as "naturally injected" sperm, so timing really is critical. 

kiki047

@acleverusername whoa, that spreadsheet is awesome, thank you for sharing that! I'll do a deeper dive later but how cool to see it all laid out like that. I'm sorry you're already feeling out for this cycle. I also wonder wtf is going on inside of me, and that was the impetus for us to decide to go with IVF because it allows us to more carefully control the factors without so much outside influence, knowing I already didn't trust my body. As for FET meds vs stim meds, it depends, I just picked up my meds for this cycle and have all my bills out so I can break it down for you right now:

Stims:
Gonal-F - $1,022/900iu pen x 2
Lupron Depot - $1230
Menopur - $95/75iu vial x5 per box x 2 boxes 
HCG - $125 
Total $4,359 (does not include BCP, doxycycline or any refills needed) 

FET:
Estrace - $28/200 pills @ 6/day = $5.88/wk 
Progesterone - $48/12 suppositories @ 4 per day = $112/wk
PIO - $105/vial, 5 doses/vial = $147/wk 
Total ~$545 for the 2 weeks leading up to first beta, and then I stay on all 3 right up through to 2nd tri (if I ever make it that far)

I'm lucky to have insurance coverage so the Gonal-F, Lupron, Menopur, Estrace, BCP and doxycycline are all covered up to 80% by insurance. HCG and progesterone are all OOP. 

*Edited to add: these are all in Canadian dollars, so keep that in mind too. Everything is more expensive up here. 

@lisa3379 yay for FET cycle is finally here! Sorry this upcoming week is so crazy busy but hopefully it helps take your mind off of the wait and it'll be here before you know it. That's good to know that your Dr doesn't seem too bothered by the timing of your vaccine either - mine still doesn't want me doing it right in the thick of things but overall he is now more supportive of me getting something - preferably Pfizer but we don't really have a choice here - whenever I'm able to. 
@bows22 I missed the second part of your post about having to pee a little to POAS then sit there and wait. What?! I recall I was told to POAS at home, and come with a full bladder so they can do the pelvic US first, then I got to relieve myself and go back in for the SHG part. Having had to "let a little out" a couple times, I've been practicing at home lol. It's NOT easy but it can be done. 
@BusinessWife I've heard SO many success stories about people who have gone keto as well, I just don't know that I have the discipline to do it myself. I'm willing to try though, and maybe we can keep each other accountable. 
@bumblebee0210 Yes, we did PGT last time too and all 3 came back normal. That's exactly how I feel about those extreme diets - MH lost over 50lbs in 2019 with a low carb, no fat, moderate protein diet but has since put it all back on and then some. I do see some merit in keto for forcing your body into ketosis to burn fat for energy and I think there is something to be said about doing that short-term to purge some of the toxins and hormones that are stored in fat cells but beyond that... it definitely just feels like disordered/deprived eating and that is not the kind of relationship I want to have with food. That's great about ending up with 2 blasts to test, I was in and out during your last ER cycle so I saw some of the ups and downs. I hope your next cycle is less eventful and you can bank some more embies! Re: your Q about AF, mine came early, around 7dp ER (normal LP 13-14) and not gonna lie, it was a doozy (but I suffer from thin lining to begin with so with all the estrogen in my system my lining was thick and therefore my period was much heavier). 
@optimistgardener hi there! I've been lurking a lot so I've been following your journey over the last month or two. Happy to see a fellow gardener on here too. Having been at this for as long as I have (3+ years), I have given up on punishing myself unnecessarily for enjoying a beer or glass of wine here and there. I refrain during the TWW and usually leading up to IVF cycles but one glass isn't going to make or break anything any more than anything my body has working against me already. 
@keikilove I haven't heard of a sperm wash-out but I was doing some reading on DNA fragmentation and one study suggested that those who previously had >30% fragmentation with a 3-5 day hold period, then repeated the test 1-3x with only 1 day of abstinence saw markedly better, if not normal, results. What that study did not take into account is sperm count with only a 1 day hold, so in the case of MH where he has 17% DNA fragmentation and low-ish sperm count, I usually ask him to "clear the pipes" (ahem, lol) 3 days prior AND "prime the pump" the night before. Did your Dr say just how much he has to... clear out... before she considers everything left to be NEW sperm? And also, normally they say it takes around 3 months for lifestyle changes/supplements/etc to have any noticeable difference in sperm quality/etc so at what point is it "too little, too late"?  I'm very interested in this, lol. 

acleverusername

Well now I'm just imagining @keikilove's H jerking off daily from here until he's "cleared out". 🤣🤣🤣Doctor's orders!!!

bumblebee0210

@acleverusername. @keikilove
LOL. I always joke that MH's entire contribution to this effort is jerking off in a cup once a month, but every day, I mean, that's an effort. 

optimistgardener

Hey guys. So I finally have something concrete to report on, since the nurse at the clinic got a hold of me with the plan for my ivf (I'm supposed to start stims around the start of May after 3 and a half weeks on birth control pills). I'll be on menopur (225iu) and gonal-f (225iu) and they will be mixing in cetrotide as I get further into my stims (day 7ish) to try to slow down things down as I get closer to trigger and help any smaller follicles gain some time to catch up.

I've been told that in addition to CoQ10, my clinic recommends DHEA, and they want me on baby aspirin as well starting now. I went out and got myself these things, as well as some acai extract (thanks to @acleverusername and her useful supplement handout). I'm pretty sure I've never taken so many pills in my life. I'm leaning against Vit E for now as I feel like I've seen mixed reports about its effectiveness and there is already some in my standard prenatal. Re: melatonin (cancer reference):

my mom has been taking it in large-ish doses to try to regulate her sleep ever since a rare cancer diagnosis a couple of years ago significantly upped her general anxiety levels. After a big surgery she had in spring of 2020, she got a rather fearsome talking-to from one of the folks on her care team about how taking melatonin can train your body to become permanently reliant on it instead of manufacturing its own. I dunno why but that talking-to has stuck with me. It may very well be useful but I'll skip it.

One question that the clinic has for me is whether I want to do genetic testing on the embryos. I'm leaning towards yes, because more info is better and if the embryos are all genetically abnormal, I'd rather know that than to do a fresh transfer and just be disappointed and mystified two weeks later. But of course it's more expensive and requires that I set up a separate transfer cycle. Anyhow, I think I know what I want to do here but any thoughts would be most welcome.

My clinic works with IVFpharmacy, which is an Israeli company, and with Freedom Pharmacy in the US. Both companies' rates seem quite good, especially since I am paying out of pocket. I'd be happy to share costs if anyone is interested.

Also: hi @kiki047! I am fully in agreement with you in principle re: non-guilt on the occasional beer or wine. I've been trying to get this thing done (with some down time now and again) since 2018 and I am quite sure I would be a very unhappy lady if I'd not touched a drink in that time. I go through phases of being more or less paranoid about how careful I am outside of the TWW, when I'm usually teetotalling (except on cycles where I am pretty confident it's a bust, in which case I may have been known on occasion to grant myself a low-alc sympathy beer).

Lisa3379

Ok, @BusinessWife, I don't know whether to thank you or be pissed at you for leading me down the cleaning video rabbit hole with that lady! Haha. I've watched two from Faith and Flour and I've ordered stuff to make my own cleaning spray, am looking at a new duster, and making detailed plans for my routine. I'm excited  

@optimistgardener We did PGT-A on our embryos, and it was an obvious decision for us (but can understand why people would choose not to). It was a bummer to have to wait a bit for a transfer, but a huge weight is off our shoulders knowing that the embryos all checked out and are ok. (*TW: loss mentioned* We had a pretty awful loss almost exactly this time last year and doing everything we could to lessen that chance was important to us.) We figured that if we're going through this process, let's not leave anything to chance. It's also why we opted to do another round of genetic testing for ourselves, since the test had added a lot more conditions to test for than when we did it back in 2016. 

optimistgardener

Oh! And the clinic seems unconcerned about my 2nd dose of the moderna vaccine. It is presently scheduled for early on in my stims, which they think is unlikely to affect anything. They do say there are no studies and so basically everything is asterisked with "but we don't really know."

@Lisa3379 Thanks for the thoughts on your decision-making process.

laura-kay

Diagnosis (if you've been):  unexplained infertility 

Status (WTO/TWW/TTA):  WTO 

What are you doing this cycle? (Testing? Treatment?):  Superovulation IUI + Ganarelix 

How are things going?:  It’s fast this month!  Day 8 and my IUI is scheduled for Saturday.  Today I had 1-19mm and 2-14mm follies.  I took Ganarelix yesterday and today. They want me to take one more dose of Gonal F tomorrow around noon.  We are hoping this will push one or both of the other follicles to be mature.  Trigger is tomorrow and IUI is on Saturday.  F/X that I get more than one mature follicle....I’m hoping the extra few days will allow that to happen!

Any questions?: NATM 

GTKY: What spring projects around the house do you have in mind this season?  Gardening!

[Deleted User]

@Lisa3379 
<img src="https://us.v-cdn.net/5020794/uploads/editor/4i/iydwqdawwvsy.gif" alt="">

Wow! That is fast! @laura-kay GL with trigger tomorrow and iui Saturday!!! 

acleverusername

@laura-kay hooray for hopefully 3 mature follicles! I can't remember: how long have your previous stim cycles been? How are you feeling this cycle? How is your mental health? Hopefully you can find ways to relax and take it easy leading up to the IUI and then through TWW. 

@BusinessWife LOL. 🤣

Y'all... I found a new fertility hero; this is for those of you who like science experiments and statistics. Putting in spoiler as I'm sure I'll get cited otherwise because it's a R e d d i t link. 

https://www.reddit.com/r/infertility/comments/bcvmip/split_cycles_on_being_a_human_science_experiment/

[Deleted User]

@optimistgardener I thought of you as I was resetting my vitamins for the week! 🤣 It's a lot!  We were advised to take melatonin to get on a better sleep schedule, but then also to taper off of it after idk, 6-8 weeks maybe?  3-4?  I agree - it's not something you want to take indefinitely and become reliant upon, but I do believe it can have some benefit when used short term.

acleverusername

@optimistgardener agreed with what @BusinessWife said: I've heard numerous times of ppl adding melatonin just for stim cycle (and a bit before / after) and then stopping it. 

optimistgardener

Thanks @BusinessWife and @acleverusername. Maybe I'll rethink my melatonin thing!

I have been having seriously circular thinking about both the genetic testing decision and how I feel about my clinic's proposed dosing. At first I'm like, yeah, milk that puppy for all the big fat follicles, it can take it, and then I get paranoid that I'm going to overstimulate (since I stimulated so fast both times before). I have emailed the nurse to try to get some reassurance/clarity on this. But wow, this process sure does pose a lot of doozies.

inthewoods23

@optimistgardener re: the genetic testing - my clinic defaults to having all embryos PGT-A tested and then a frozen transfer with a normal embryo. I don't think they do fresh transfers at all. They did allow us to opt out of the testing if we wanted though. I'm glad we did it as it was reassuring to find out that of the 6 embryos we had, 5 of them were normal. Plus, when our one transfer failed, we knew a reason for the failure couldn't have been that it may have been abnormal.

I'm with you that the more info we have, the better. Just look at the link from @acleverusername - if you don't try things or test things, how will you really know what the true problem is?

After my failed transfer in 2019, we did some additional tests to make sure the timing of the transfer was right and that all came back normal. At that point everything for us was still unexplained (except for DH's low morph of 1% but that's not a smoking gun). That's when I went on the GF/DF diet as my RE said all her patients that do have a successful 2nd transfer. We went down that path when covid hit so we took a break from IF treatments to try on our own again because I always wondered about diet and how gluten and dairy can cause inflammation. *tw* and surprise, surprise, I unexpectedly got KU in September in the cycle right before we were going to go back to the RE for a 2nd transfer. That ended in a MC unfortunately *end tw*, but that proved that diet may have been the reason for our unexplained diagnosis all along. We never would have known had we not tried it!

optimistgardener

@inthewoods23 Thanks for the reply, especially regarding the genetic testing. I definitely feel my first inclination is for the testing. Also, gaaaah, I love bread and I have an energetic sourdough starter that I use in my weekly baking, but I do know that my gut is very reactive when I eat a lot of wheat. Maybe I'll consider that as well. I really can feel myself slipping into a rabbithole here....