Should I run for the hills??? Our IUI "plan"

NickiChick

I had a stupid fantasy that our last month without help would be successful. HA! Spotting today and beginning to look like AF.

I saw an RE last month and this is the plan he came up with.

CD1- Call to get Clomid 50mg set up (no baseline US for IUI #1 He said he would start all other future rounds with a baseline US but this one should be fine) 

CD3-7 Crazy Clomid Pills

CD11- Begin testing for LH surg when I get a positive DROP EVERYTHING, call and drive in (I'm an hour away) for US and IUI same day.  

Then wait for AF.

There might be some blood draws in there somewhere, I can't remember.

It seems that everyone doing IUI on here has a trigger. Is this plan worthless? Should I go through with it and ask for a trigger with IUI #2 if this doesn't work? Any wise words for a newbie to IUI? 

 

NickiChick

I forgot to mention, I've done one Clomid cycle with TI in Dec. I went in the day after my surge for an US but I had already ovulated. 

DebateThis

I am assuming you just recently (like, in the last month) had CD3 u/s done which is why he doesn't think another baseline is necessary at this point. That seems pretty ok.

The fact that he has you relying on OPKs instead of midcycle (cd10-12ish) bloodwork and ultrasound as well as 7dpo b/w and u/s has me giving him a side eye. I would absolutely put my foot down and demand those things; if he won't do them, you need to find a new RE. 

I would also request a trigger shot, too, since they're fairly inexpensive and really help to time an IUI better.

IDK if you're OOP or not, but even if you are, you absolutely need the midcycle/7dpo monitoring and it's fairly important to do a trigger, too.

NickiChick

DebateThis:

I am assuming you just recently (like, in the last month) had CD3 u/s done which is why he doesn't think another baseline is necessary at this point. That seems pretty ok.

The fact that he has you relying on OPKs instead of midcycle (cd10-12ish) bloodwork and ultrasound as well as 7dpo b/w and u/s has me giving him a side eye. I would absolutely put my foot down and demand those things; if he won't do them, you need to find a new RE. 

I would also request a trigger shot, too, since they're fairly inexpensive and really help to time an IUI better.

IDK if you're OOP or not, but even if you are, you absolutely need the midcycle/7dpo monitoring and it's fairly important to do a trigger, too.

 

Thanks for your response. I actually never had a CD3 u/s because I was stupid and did one round of clomid with my OB before going to the RE. I did have an u/s on CD 14 which showed I had already ovulated and my lining was fine.

I am OOP but I have some funds. I never told him we were worried about cost so I'm not sure why he didn't offer these things. I definitely want everything I am supposed to have so we can be safe and as "successful" as we can be with each attempt. 

Can you tell me the reason behind the pieces he is leaving out? What does a CD3 u/s tell? I know a 10-12 day u/s shows follicle size but what does the blood work for midcycle and 7dpo tell him?

I am unexplained (no lap though) so I feel like I keep being treated as everything is fine. This is insanely frustrating because something ISN'T fine. They just don't know what it is!   

DebateThis

NickiChick:

DebateThis:

I am assuming you just recently (like, in the last month) had CD3 u/s done which is why he doesn't think another baseline is necessary at this point. That seems pretty ok.

The fact that he has you relying on OPKs instead of midcycle (cd10-12ish) bloodwork and ultrasound as well as 7dpo b/w and u/s has me giving him a side eye. I would absolutely put my foot down and demand those things; if he won't do them, you need to find a new RE. 

I would also request a trigger shot, too, since they're fairly inexpensive and really help to time an IUI better.

IDK if you're OOP or not, but even if you are, you absolutely need the midcycle/7dpo monitoring and it's fairly important to do a trigger, too.

 

Thanks for your response. I actually never had a CD3 u/s because I was stupid and did one round of clomid with my OB before going to the RE. I did have an u/s on CD 14 which showed I had already ovulated and my lining was fine.

I am OOP but I have some funds. I never told him we were worried about cost so I'm not sure why he didn't offer these things. I definitely want everything I am supposed to have so we can be safe and as "successful" as we can be with each attempt. 

Can you tell me the reason behind the pieces he is leaving out? What does a CD3 u/s tell? I know a 10-12 day u/s shows follicle size but what does the blood work for midcycle and 7dpo tell him?

I am unexplained (no lap though) so I feel like I keep being treated as everything is fine. This is insanely frustrating because something ISN'T fine. They just don't know what it is!   

OK, you definitely should have CD3 u/s and b/w done, then, too - it's to check your antral follicle count (AFC) which is resting follicles to get a baseline of how many you could potentially create in a medicated cycle + check to see if any previous cycles have left cysts behind - you absolutely do not want to start a medicated cycle if you have any cysts bc the meds will just fuel those cysts and it could be a dangerous situation quickly.  It's also important (prior to ANY fertility treatments) to have a complete testing workup done which should include the CD3 u/s and bloodwork to test various hormone levels. (Random side question: have you had an HSG? If not, you need one of those before you do IUI, too). 

The midcycle U/S will tell you how many follicles you have (if there's more than like 3ish, it's helpful to know that so you can cancel the cycle at that point and avoid sex to prevent high order multiples). And the bloodwork coincides with the u/s at this point to test your E2 (estrogen) levels - it'll give a good indication of the maturity level of any follicles that are seen on u/s. On average, for every mature follie, your E2 should be around 200ish. So if you have 4 follies visible on u/s but your E2 is only 400, it's a safe(r) bet that only two of them are mature.

Lastly, the 7dpo bloodwork confirms that you did, indeed ovulate and how strong the ovulation is by testing P4 (progesterone). It should be over 15 on medicated cycles and at this point, if necessary, the RE can Rx progesterone supplements to support a pregnancy. 

NickiChick

Thanks! This is super helpful. I did have all blood work (early in the cycle and after O)  and had an HSG done before my one and only clomid cycle, but I knew they missed some things. My DH also had the SA. 

I feel like there is so much to know. Just when I feel like I'm getting the hang of things there is stil more to learn. I wish we could trust the Dr.'s but you can't!  

Temp423319000008365

I personally would want a trigger shot. Opks can be a little unreliable at times and I wouldn't want to waste my time and money on an IUI if I didn't know for sure when I'm going to ovulate. It would probably require 2 trips to his office, on on CD 12(ish) to look at follie development and then going back in for your IUI. His plan almost seems like he's trying to save you a second trip to this office, which is nice and all...but in the end you want to get pregnant, not save on gas money

curlylocks3

I would definitely ask for a trigger shot to better time the IUI. Like PP said, you'd have to go in another time for a monitoring US but it will help time things and up the chances of success. 

I have only done 1 IUI so far and the only bloodwork I had was to check progesterone so I'm not sure its routine in every cycle. I had had CD3 b/w done fairly recently though and when I asked my RE said he anticipated the levels to still be abnormal and that I didn't need to repeat it since it wouldn't change the plan. As for mid-cycle b/w I have seen some women on here get it, especially when like DebateThis said they had multiple follicles and wanted to make sure there wasn't risk of HOM. I only had two follicles grow at all though, so perhaps this is why they skipped it for me. 

ky29

We are doing the IUI the day after I get a +OPK, only because I'm not taking any meds.  So yeah, I agree with the PP that there should be more monitoring involved!

herecomesthesun

I ovulate on my own (proven) so I have rarely needed the trigger before I had ovulated on my own. Usually, I ovulate before the monitoring ultrasound, even when scheduled as early as they think is possible. It's almost comical. I've only used the trigger twice, my first month with the RE and this last one.