IF Testing & Treatment w/o 11/21

bearmomma1

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 ballgame. 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.

Diagnosis (if you've been):

Status (TI/ICI/IUI/IVF/FET/benched):

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

How are things going?:

Any questions?:

GTKY: Thanksgiving lunch or dinner?

bearmomma1

Diagnosis (if you've been): old as F ovaries, LPD

Status (TI/ICI/IUI/IVF/FET/benched): TI for now, until maybe DE next year?

What are you doing this cycle? (Testing? Treatment?): absolutely nothing

How are things going?: um. I'm not sure. I had mentioned something to my H about waiting for our miracle, and then said actually our miracle will be next year whenever we get our donor eggs....and then he's like "I'm still not sure I'm on board with that yet. I still have so many questions, for you and for myself, before I make any decisions. Like why would you be OK with carrying a baby that has no relation to you but you don't want to adopt?" I was like wooooooah, I thought we were on the same page with this? soo, I guess we're not and we still haven't talked about it. I'm not exactly sure where we stand with everything.

Any questions?: nope

GTKY: Thanksgiving lunch or dinner? We usually have an early dinner, like around 5pm or so!

gingermama29

@bearmomma1 ugh that’s frustrating to think you were on the same page and finding out you may not be. Hopefully you can come to a decision that makes you both happy. 

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

Status (TI/ICI/IUI/IVF/FET/benched): IUI

What are you doing this cycle? (Testing? Treatment?): Gonal-F, ovidrel, Endometrin, IUI

How are things going?: I got my period on Saturday by surprise (11DPO) which is early for me. So I’m officially doing my first cycle of IUI. I’m a little apprehensive since I haven’t done this before and trying not to get too anxious about the timing of this cycle as I have a music ed conference on CDs 14 and 15. But I’ll make it work. I didn’t trigger until CD 15 last cycle so we’ll see. My RE just called me this afternoon to answer questions I had about the blood clotting gene I tested positive for which was really nice. It helped ease my mind about the ability to carry a successful and healthy pregnancy with it. Starting injections tonight.

Any questions?: anything you wish you’d known before doing IUI?

GTKY: Thanksgiving lunch or dinner? Dinner for sure! And then Thanksgiving sandwiches for lunch the next day!

anniemarie887

@bearmomma1 i'm sorry, that is so confusing. i hope you guys can talk through this
@gingermama29 woohoo for IUI!!

Diagnosis (if you've been): uncooperative uterus/RPL

Status (TI/ICI/IUI/IVF/FET/benched): WTO

What are you doing this cycle? (Testing? Treatment?): OPKs, temping, acupuncture, prenatals, extra folic acid, baby aspirin, and vaginal progesterone

How are things going?: just kind of in shock to actually be able to try again 

Any questions?: natm

GTKY: Thanksgiving lunch or dinner? lunch, and get everyone out the door at a decent hour.

stormageddon-darklordofall

@bearmomma1 Ugh. Sorry.  Good luck getting on the same page as DH   I know how stressful and upsetting it can be when you thought you were on the same page, and it feels like such a door slammed in your face to realize you're not.

@gingermama29 Good luck with the IUI!

Diagnosis (if you've been): Unexplained RPL

Status (TI/ICI/IUI/IVF/FET/benched):  IUD/self-benched

What are you doing this cycle? (Testing? Treatment?): Considering insurance options

How are things going?: you know me, as psychotic as usual...

Any questions?: So I'm crawling out of the woodwork here.  I'd gotten an IUD after my 5th MC, because I needed to be 'done' for a while.  However, there's a chance this year that I can change insurance and have IVF at least partially covered.  So DH and I are just starting to contemplate the possibilities of that.  It's a LOT to think about and I only have a few weeks to figure things out before Open Season ends for opting into a new insurance.  

Anywho, questions I have are:  In the past I've been chastised about my weight (During my first MC, I was 8 pounds heavier than the 'goal weight' my 2nd Opinion RE thought I should be to do IVF/have a baby on my own.  He essentially told me RE's wouldn't do IVF if I'm over the 'said' number and I'm now about 30+ pounds over that number.)  Anyone know if my extremely rotund self has a chance to get IVF this year being a huge porker, or if I'm just gonna get super f-ing angry and punch 3rd opinion RE in the face?

Second question... If I were to jump ship to a new insurance... I'd have to find/set up with a 3rd RE.  This is fine, should work out with a new OB I've gone to, that's all within the 'system' of the new insurance.  I also know the testing I had should transfer over for the most part.  If I do this, do you think (obviously doctors schedules depending) it would be possible to meet with RE and get an IVF cycle scheduled by end of 2023 calendar year?

Thanks for any/all help/fat chastisement you have IFers!

GTKY: Thanksgiving lunch or dinner? We do like 1pm in my family.  Then everyone can have pie a few hours later, followed by leftovers several hours after that for dinner, followed by MORE PIE!!!!  

gingermama29

@stormageddon-darklordofall so I asked my RE about the BMI limit for IVF because it’s different from clinic to clinic. She said the reasoning behind their limit has to do with how much anesthesia would be needed for a procedure. They’re allowed to administer a finite amount and have the BMI set at 45 for my clinic. It’s so frustrating to have so much stacked against us for infertility only to have treatment prohibited by weight as insult to injury. Also, yay for possible new insurance! 

stormageddon-darklordofall

@gingermama29 Thank you for the info!  Yeah, I'm nowhere near that 45 BMI limit.  Guess maybe I'll call and see if this RE has a BMI/weight limit for their IVF procedures.

optimistgardener

[lots of editing because i can't type]

hey @stormageddon-darklordofall and welcome out of the woodwork. i'm afraid i'm in a hanging out in the woodwork phase myself right now, so i should probably preface this post with a *lurkylurk* since i'm not even participating in the weekly check-ins right now, but if i'm not home in the IF thread, i dunno where i would be. aaaaaanyywaayys.... i agree with @gingermama29 re different clinics having different rules about bmi. i have seen people come through this board and over in r e d d i tland with very different weights, all going through ivf, and only some of them get crap from their clinics about this issue. my impression (hopefully this is true and not just my optimism breaking thru here) is that the weight requirement is going out of style w/ ivf clinics.
regarding the insurance, testing, timeline etc., congrats on the possibility of a workable insurance option that actually covers fertility!! gaining access to good insurance was absolutely lifechanging for me, and allowed me to carry on after my first 2 failed retrievals. so f*ck yeah on that. you'll probably find that the new RE, whoever they might be, is going to want to run a bunch of tests again. my doc likes my bloodwork to be less than a year old, and similarly likes to redo imaging stuff (SIS, HSG, hysteroscopy) regularly. even if they make you redo a lot of stuff, i think you're within reason to hope for an IVF cycle before the end of 2023, assuming they don't encounter too many roadblocks coming out of the testing.

spoilering the next bit:

as for what IVF might offer in your situation, and knowing you've had to face as many MCs as you have, have you ever had testing done for chromosomal issues with those MCs? have your doctors ever given you any other reasons for the MCs you've experienced? depending on what other things your doctors rule out, i think it would be good to explore doing PGT-A testing on whatever embryos you might produce through IVF. it is expensive but also might be a really useful tool for you. since we can kind of divide things here in IF land into the "getting pregnant" versus the "staying pregnant" camps, it's important that your RE be really attentive to your particular issue, which is the latter. sometimes you'll find clinics that are just like, cool, you're here for IVF? ok ticktickticktick and they shove you through the factory process to make a bunch of embryos and transfer them, hoping something sticks. you want an RE who will really foreground the "making them stick" side of things. especially considering how traumatizing it has been for you to go through the losses you've had, your clinic should prioritize reducing the risk of having more losses that result from IVF (for example, by only transferring tested embryos).

anniemarie887

@stormageddon-darklordofall that is so exciting about a potential insurance change and coverage! i have nothing to add re weight, i know my RE looks at it in both directions. she would like me gain weight, i hope i am not insensitive by saying that, i know weight is a delicate subject. my other .02 as someone who has had 3 back to back losses... my normal OBGYN felt like somewhere like shady grove wasn't a good fit for me. she meant no disrespect toward them, just that they kind of like a factory process for the masses and that my situation wasn't the ability to get pregnant, it's staying pregnant. she ref'ed me to a one woman show RE, which can have it's own quirks for sure. i would second @optimistgardener about testing, (not sure how much you've lurked of my saga) all of my bloodwork came back fine re hormone levels, thyroid, clotting disorders etc... but when we finally did the HSG it showed a filling defect... and upon hysteroscopy we discovered retained tissue and endometritis that took the last 4 months to work through. 

kiki047

I am also semi-lurking and not actively participating while I await my surgery (which has now been pushed back to Dec 21st, frig). 

@stormageddon-darklordofall whoooaaa friend, that's a huge development if you can get some kind of insurance coverage for IVF. I can only imagine how many feelings that must be unearthing for you right now, having been somewhat "done" for so long now. I'm happy for you that you may get the chance to start a new chapter before you close the book entirely, so to speak. 

As for your questions, my clinic doesn't have a specific BMI limit here in Canada, however they do have a weight limit only because their surgical tables can only hold a certain weight so it isn't really a discriminatory practice, just a systemic limitation (some would argue it's all the same). I hope you find someone that is more open-minded about these things.

Re: starting before the end of the year, that would be impossible here because of wait times (my clinic is about 4-6 months) but again, Canada, that may be very different where you are. Even if they don't require it, I would insist on re-doing most of your tests (AMH, all bloodwork, semen analysis, maybe even a karyotype for both of you if you haven't already?). Tube test or SHG may not be as important right away if you're doing IVF but you'll 100% want to do it if/when you plan to transfer.

@gingermama29 so sorry for AF, but yay for IUI! Honestly not a whole lot to prepare for with IUI, it's pretty quick and painless, kinda like getting a pap (so not exactly comfortable but it's over pretty fast). Get used to holding your bladder, it will need to be done with a full bladder. Most of them aren't done using ultrasound guidance but I sometimes hear of some clinics doing it that way. YH will want to "clear the pipes" like 2 days before so we usually HIO EOD in the week leading up to the IUI and then the day after, if he can manage. Otherwise you don't need to do anything any differently, you can go back to your regular activities right after. 

anniemarie887

@kiki047 i'm really sorry your surgery has been pushed back. 

stormageddon-darklordofall

@optimistgardener Thank you!  Yes this would be the first time ANY amount of IVF would be covered at all, so if I can get the pieces together to try it out, it would be amazing.  I did have chromosomal testing.  I had like all the testing.  Good to know about the bloodwork.  I figured they'd have to redo several things, but hopefully not EVERYTHING I did.  Unfortunately, all of my losses were pretty early on (except the first one) and so they didn't get to test the tissue for any of them.  So they have no idea what my 'issue' is.  DH and I have had a serious talk about the IVF thing.  Basically, if they're getting an embryo, which should be "Good" and implanting it in the 'right' place, if I still have an early loss for seemingly no reason, then I'll probably be one cycle of IVF and completely done/out.  Because I don't want to beat a dead horse. 
Explain this PGT-A testing...  (I'm an IVF 'virgin')  Is this when they ensure it's a GOOD embryo (like, for sure-sies)?

@anniemarie887 You're good, no offense taken.  I just don't lose weight easily.  Even post-MC 4 when RE was like "you need to be X weight before even attempting PG again" I lost half of the 21 lbs he wanted me to, and was like 5 months in.  It was before the holidays, and I called up to be all "PLEASE.  LOOK at me... I've lost Soooo many inches.  I'm as healthy as I've ever been."  And the lady at the RE's office was all "Your chart says to lose X pounds before attempting ANY PG."  And I'm all like... bitch please, I could go get my boobs cut off tomorrow and be below that weight.  F U, pound sand!  And that was pretty much the end of 2nd opinion RE.

@kiki047 Yes!  Definitely all the feelings!  Including "Am I just too bitter and angry, with even less patience than God originally granted me" to raise my own kid at this point?  Am I maybe just better off as the super-cool aunt that buys my nieces ALL of the things instead?  "Like in a few years, here kids, here's a trip to Disney... sorry your mom is making you live off of ramen.  Phft!  Peasants!"  We did Karotyping. I did an SHG also. What is tube test?  Is that the blue dye thing they usually do before an SHG? (If so, checkmark also.)  Also, sorry about your surgery delay   Ugh.  

bumblebee0210

*lurking*

@stormageddon-darklordofall Hi! I had my first meeting with my RE in January 2021 for RPL and managed to do 6 retrievals and one FET (plus a hysteroscopy added in for fun) in calendar year 2021, with insurance. I think this is not unreasonable in a no-insurance situation, but is pretty uncommon with insurance. In my clinic, people were waiting 4-6 weeks for pre-approval for each cycle, in part because the insurance took a long time, but also in part because the finance people at the clinic took a long time to even submit the paperwork. I was able to get it done so quickly for a few reasons. First, my insurance did not actually require pre-approval, so that helped a lot. But the way I got through the queue at the clinic itself was by being unbelievably annoying. I called them every day. I found the email address of the clinic manager and emailed her when I got no response from the finance people. 

If you want to be spared endless delays, here is my advice:

(1) Talk to the doctor, and tell her directly that you want to do this quickly. Try to talk to the doctors directly as much as possible, because often the nurses/staff are trying to enforce arbitrary rules that the doctor can just break if they feel like it. I was told the clinic "didn't do" back-to-back or duostim retrievals, and my doctor just did them anyway.
(2) If you know something is just sitting on someone's desk, bother them incessantly. Then bother their boss. They don't have to like you, they just have to file the paperwork. 
(3) If the above doesn't work, drop by the finance office or manager in person. Cry if needed. I know multiple people this has worked for. 
(4) Talk to your insurance about exactly what they need, and be proactive in making sure you're dotting all of the i's and crossing all of the t's. Like you might need new testing that you have already had done, because levels have to be in the last year. You might need to do three IUIs (by the way IUIs don't help RPL so try to avoid this if possible). Whatever the hurdles are, figure them out and be proactive about getting them done.

Happy to talk about IVF/RPL stuff. My case is slightly different than what I know of yours, but it's a reasonably small club and I'm happy to chat about it. 

anniemarie887

@stormageddon-darklordofall i also should have added that the weight subject really irks me when drs use it as the end all be all re health. i just think that's BS. i'm sorry that's the care you recv'd from a 2nd opinion, that would've infuriated me. i would also echo @bumblebee0210 on her #1 bullet point, the front desk staff can be so gate keeper-ish, but i've ruined my REs lunch many days with fitting me in to do biopsies and other things that she agreed to do vs waiting. i also 2nd crying if need be, i had an appt have to be moved due to my 2nd d&c and the front desk girl tried to say they couldn't get me back in for 6 weeks... i left a sobbing voicemail and the office manager handled it. 

optimistgardener

@stormageddon-darklordofall ooh i love actually being competent to answer a question! spoilering only because i'm about to write a novel.

PGT-A is a genetic test in which, after the embryos are grown out to blastocyst phase (day 5-7), they take a small biopsy from the outer wall (trophectoderm) and send them to a genetics lab while they freeze the rest of the blastocyst and wait for news. quick embryo anatomy lesson: the trophectoderm is where all the cells go that will eventually form the placenta, whereas the inner cell mass will eventually become the fetus. early cell growth follows a pattern whereby "bad" cell development usually winds up with a big trashy pileup of reject cells in the trophectoderm. the genetics lab tests to make sure that the biopsy shows most cells are more or less normal, a process that usually takes 2-3 weeks. usually, "euploid" = <20% abnormal cells, all the other cells are happily ordered chromosomes all lined up like little soldiers; "abnormal" = >80% cells with chromosomal abnormalities [missing chromosomes, extra chromosomes, deletions and additions on individual chromosomes, etc], and "mosaic" is a messy middle zone about which I have a lot of thoughts and will happily have that conversation if the time comes, but short version of the story is mosaic embryos may very well be viable, albeit their stats aren't as good as euploid/normal. A biopsy that comes back euploid indicates that the blastocyst has every indication, from a chromosomal perspective, of being able to develop along a viable path and join us out here in the world. There are still reasons to be cautious (there are, for example, more subtle, untestable reasons why an embryo might self-destruct, plus uterine-specific uncertainties) but having myself made a lot of extremely eff-ed up embryos and, finally, 2 euploids that I will attempt to transfer in the new year, I am a big believer in genetic testing.
if you spend any time hunting for info on the internet about this, you'll see that in some circles, PGT-A is considered controversial. One of the main reasons presented is that there are purported cases/studies showing that transfer of "abnormal" embryos still results in live births. In my experience, these are usually cases/studies where mosaic embryos were inappropriately classified as abnormal. studies have repeatedly shown that when truly aneuploid embryos are transferred, they almost always result in either lack of implantation or early miscarriage.
prepare yourself, however. insurance still rarely covers this procedure (despite strong scientific basis) even in cases of RPL, and it usually costs upwards of $2k to test a batch of 8 embryos or so.

stormageddon-darklordofall

I the advice to be 'annoying.'  PRETTY sure I can manage that. 

@optimistgardener Thank you!  VERY helpful    I appreciate your novel.

acleverusername

*always lurking, but sometimes behind*

@gingermama29 I listened to a podcast that had Christina Perri on as a guest the other day, and she talked about her experience with miscarriages due to blood clotting issues, and the fact that 55% of RPL is due to some kind of clotting issue. If you're into podcasts, it's worth a listen (but I do find the hosts a bit "bimbo'ish" so there's that annoyance you'd need to navigate. 

@stormageddon-darklordofall hiiiiiii! Okay, this might seem REALLY creepy (and well, that's alright by me) but I've been thinking about you. Especially in context of your many losses and the fact that I have a need to solve everyone's fertility problems (it's a disease, really). Anyways, I've been reading a bunch of books as research (for my own book which I would like to write) and currently on this read. I haven't finished it yet, but it talks a bunch about reproductive immunology, etc. but what's worth noting is the author experienced a lot of early MCs similar to yourself (all under 10 weeks). Anyways, I'm only about 3/4 through so I don't know how it all ends (but I do know she ends up with at least 1 child) but figured I'd suggest the read. 

Also, whereabouts in the country are you? I feel like you're in DCish area? If so, besides @anniemarie887, I have one other friend who started out with Shady Grove, did 3 rounds of IVF there: 2 rounds yielded 0 embryos; the last one was a fluke and ended with 1 euploid. She then moved to CCRM (which, as I understand, is a PITA to get to, but it's oh so worth it). She did 2 more rounds, and each yielded 2 euploids. So, I would just SHOP AROUND and DON'T TAKE ANY PRISONERS. 

stormageddon-darklordofall

@acleverusername Thank you for the book rec.  I'll have to check it out!  I used to read a lot about what I could, but after the 5th I kinda 'gave up' for my own sanity.

I AM sorta in the DC area.  I actually live in southern PA, but used to commute to DC area (pre-pandemic).  The first RE I went to was in Shady Grove.  (after 3rd MC) they did a bunch of testing and then was like "either IVF or try on your own, we can't find anything wrong with you."  The guy was a dick, and my husband hated him, so after 4th MC from trying on our own, we went to MD Fertility Clinic.  They did more testing, and then I got called fat for an hour, while RE explained that my chance of MC was the SAME as IVF chance of MC if I'd just lose 21 lbs. 
Who/what is CCRM?
If I change insurance it will probably be to UPMC, and I'd be going to outside of Pittsburgh (where DH and my families are from).  But I gotta call them and be all like "Look, here's the deal.  Are we doing this or not?"

anniemarie887

@stormageddon-darklordofall I’m going to PM you

stashattack

Sorry, totally lurking, but hey DMVers LOL. I was born and raised in the DMV. Now in Philly, but my family is still mostly located in/around DC so I go back a few times a year . Good luck with all of your journeys. 

mambo5-2

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

Status (TI/ICI/IUI/IVF/FET/benched): benched

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

How are things going?: Hi friends I miss you.  We have had lots and lots and lots of talks and we will be moving forward with a surgery for H that should help us moving forward and then we will talk about possibly transferring our last embryo as well or doing another retrieval cycle.

Any questions?: Nope

GTKY: Thanksgiving lunch or dinner? Lunch 

optimistgardener

@mambo5-2 heeeeyy old friend. i hope that a surgery does the trick for you and yh. 

anniemarie887

Posted on the wrong spot like a ding dong