IUI question

ceebeetee

I just met with RE after day 3 letrazole ultrasound check to talk about plan of action. He agreed to skip the second ultrasound and hcg shot since I know I ovulate on my own every month from opk and charting. This also saves us some since we are totally oop. Has anyone else skipped those steps? I was the one who asked about if they were necessary, but I also am nervous about skipping the second u/s. Thanks!

kendra316

The second u/s seems like the important one to me. It shows how many mature follies you have, what size and if you are ready to have the IUI. That is usually when they trigger you, then the IUI follows the next day so they know for sure you will O with good timing of the IUI. It seems like not doing those 2 things with an IUI is leaving too much up to chance. And im sure the IUI itself is expensive oop. 

74dragonfly

Ditto above. We will do second IUI this month. We only do one ultrasound day 12 so we can ensure there are follies but not too many. We trigger so all follies release. My understanding is without a trigger they may not all release.

ceebeetee

hmmm. I actually only asked about the necessity of doing the hcg -  i told them that i always ovulate on day 11 or 12, and the doc said that the shot is essentially the same as having an LH surge, and the main point of the shot is to time the IUI correctly. thats why i asked about not doing it, because it sounded to me like the timing would be the same if i got a positive OPK versus the shot. he said the second u/s is to check my response to the letrazole and to time the shot, so he said if we weren't doing the shot the u/s wasn't really needed. i had 5 follicles on one side and 8 one the other with one really big lead one. maybe since i had one good looking one already its not that big of a deal? this is so confusing!  But I think you are right the trigger releases all follies vs regular ovulation only releasing the lead one. I think I am going to go ahead and schedule it. If we are doing this I want to do it right!

queenbone

I might consider skipping the trigger shot, but never the second monitoring u/s. I want to be sure that I haven't over responded to the drugs and have too many mature follicles.  (I basically don't want to be like J&K+8.) I think it is very irresponsible of your dr to not check you at that point.

I skipped the trigger shot during my letrozole cycle because my b/w showed I was already having a LH surge. I think if I had a positive OPK then I'd be comfortable skipping the trigger, but it is only $95 so in the grand scheme of things it is one of the least expensive things and might be better to go ahead and do it to make sure the IUI timing is right.

GL!

ceebeetee

Thanks everyone for your advice. I decided to schedule the u/s and trigger, after reading your input and doing some research. It was a super annoying day, I spent almost 3 hrs there, most of it waiting, then didn't even get to talk with my regular RE since I was squeezed in. I think the doc I spoke to was a resident so may not have gotten the best answers.

jeannaqueena

I agree with the prior 2 posts.  I think the trigger shot and u/s are important and not as costly as you think.  I am completely out of pocket and the shot is apx $100 and the u/s $175.  For instance, I am spending $2500 for my follistim injectable cycle we are doing timed intercourse, b/c I have been PG 3 times so we know the tubes and the juice work.  I think spending the extra $ and making sure we really time things correctly is important.  You may also find out the size of your follies at the 2nd u/s.  What if you IF issue ovulating immature eggs?  What if you are reading the OPK's wrong (it has happened to many of my IRL friends)?  I would hate to time it wrong.

You asked for opinions.  I hope I am not over stepping any boundaries, but I am sure your RE knows what they are doing.   

jeannaqueena

jeannaqueena:

I agree with the prior 2 posts.  I think the trigger shot and u/s are important and not as costly as you think.  I am completely out of pocket and the shot is apx $100 and the u/s $175.  For instance, I am spending $2500 for my follistim injectable cycle we are doing timed intercourse, b/c I have been PG 3 times so we know the tubes and the juice work.  I think spending the extra $ and making sure we really time things correctly is important.  You may also find out the size of your follies at the 2nd u/s.  What if you IF issue ovulating immature eggs?  What if you are reading the OPK's wrong (it has happened to many of my IRL friends)?  I would hate to time it wrong.

You asked for opinions.  I hope I am not over stepping any boundaries, but I am sure your RE knows what they are doing.   

 

Don't know why my post took forever to show up!  Glad you decided to go ahead I think you will be happier knowing you are doing all you can! 

ceebeetee

thank you for your opinions, i appreciate it!  the doc i spoke to totally didn't act like the u/s and trigger were that important, so its good to know all this stuff.  wish i had gotten to talk with my regular one.  and i do wonder about me ovulating immature eggs since my problem is low amh and about once every 3 or 4 months i have a very short lp, which apparently can be an issue with the first half of my cycle rather than my second.  anyway, like i said if we are going to do this i would rather do it 100% rather than cut corners.  

kendra316

Another thing i'll add in, as its something to consider. Last cycle I started showing signs of ovulation very early (EWCM and O pains), so I took an OPK on CD8 and 9 and both were positive. I went in on CD9 had an 18mm follie and they checked my LH surge number to see if I was really ovulating. It was only 12, well over 24 hours of a positive test. The RE said nothing happens until the number is at least 20. So OPKs can be way off and make you miss your timing with the IUI. 

Def a good decision to do both. GL