RE-seers, please come in.

triple_sevens · August 2010

I know I should just wait and relax and see what happens at our RE appt in a few weeks, but I'm getting nervous and can't stop obsessing. I'm worried because I'm not really sure what if anything the doc can do for me to help speed/improve this process.

I know that I ovulate, so will throwing clomid at this problem help? What about IUIs? From googling it seems like their success rates are about equal with the rate of regular sex for any given month. In what situations/conditions do docs seem to recommend IUIs? MFI?

I guess I'm just trying to prepare myself for what our possible next steps could be, other than simply getting some testing done. From your experiences, is there a semi-standard series of procedures that doctors seem to recommend?

surfergirlkona · August 2010

It is very intimidating moving on, but I am so glad you are. You are right about IUI stats. It was a good option for me as I have low ovarian reserve which puts me at a lower success rate trying to conceive unaided. I will be curious what your RE proposes for you. Make a list of questions including how long each treatment will go on for.

jcath · August 2010

For your first consultation they probably won't talk about treatment options - they'll just take a history and tell you what testing they want to do, then you have all the testing which will usually start on your next CD3 (but if you are anxious tell them what CD you are on and see what they can start right away). Then after the tests are complete they will give you some treatment options.

All my tests were normal - we're doing medicated IUIs and not having lots of success I think the IUI statistics are depressing but I know lots of people who have gotten their BFP from them.

ERICA21779 · August 2010

GL with your first meeeting with the RE! I think that based on however your cd3 testing comes back and whether they want you to do further testing such as HSG, SHG, etc. (if u haven't already with your OB) also a sperm analysis for your DH, these will determine the first step. Although in my opinion, Clomid seems to be the first step in a lot of cases.

Scout05 · August 2010

The first appt. is just going to be paperwork and questions, so they are going to outline what they want to do then.

Chances are they'll order the testing at this time - RPL, etc.

I ovulate too, but this cycle was a Gonal-F/Ovidrel trigger/timed intercourse attempt because ovulate immature eggs. She found that out by studying my baseline hormone levels and realizing I have elevated estrogen early in my cycle.

I think baseline, some u/s to look for anatomical issues (maybe a HSN or HSG), and the blood tests are the standard. Anything else will be unique to you and your situation.

mlmtgg · August 2010

pretty much what previous folks have said, BUT I would recommend being a bit more aggressive on the "plan" - for us we were so nervous about the process and being pushed into things we didn't want to do that we didn't ask a lot of what do you recommend and when questions - just did the history, did the testing and then waited. What this resulted in was waiting a long time "on our own" while being monitored by RE, then going back for consult on "WTF what is next?" and then starting Femara. Then another WTF what is next when 3 months of that didn't work, and then IUI. I wish I had asked in the beginning for the RE to chart out what they recommend and when and why. (hope that makes sense).

SweetieD21 · August 2010

I ovulate on my own, but not strong enough (I have low progesterone), so clomid was prescribed for me. The clomid made me O stronger and gave me higher progesterone, but because clomid causes hostile cervical mucus, DH's sperm weren't swimming, so IUI was recommended. In addition to MFI, dr's might also recommend IUI with clomid, because of it creating a hostile environment for the sperm...IUI totally bypasses the cervix and places the sperm directly in to the uterus. When you're taking clomid, IUI increases your chances over regular sex, because of it bypassing the hostile cm and cervix.

Here is what my RE did for us:

Consult appt...went over test results from my b/w and hsg, and DH's SA. Scheduled more b/w.
One cycle at 50mg of clomid.
Next cycle at 100mg of clomid since I didn't respond well enough on the 50mg. Also did a post-coital test and saw that I had hostile cm and DH's sperm weren't swimming. But, I had a nice lining and follie size so we moved on to IUI.
That IUI was a BFN so my RE did a laparoscopy to check for other issues causing the infertility. Found endometriosis and uterine polyps, all of which he removed.
That next cycle we did another 100mg clomid and IUI. Got a BFP, but resulted in m/c.
We're now in the 2ww of another 100mg clomid and IUI cycle.

triple_sevens · August 2010

Thanks guys. I know I need the specifics that come from testing before I can really have a handle on what comes next. Your suggestions for how to communicate with my RE are good. I guess I'm just ready to get going with this already!

schen0510 · August 2010

I am going to ditto everyone else. We went directly to IUI because we are diagnosed MIF only. I ovulate naturally and my eggs are mature...but we needed to give DH's boys some additional help.

GL!

bbhalphen · August 2010

I ovulate, but around CD30 or so, so I was given Clomid in hopes that it would help me O earlier. It didn't work for me, so next we're moving onto injectables. Good Luck!

butterfly843 · August 2010

When I first went my RE ran a bunch of tests and looked at the charts I brought her. They also had my dh do a semen analysis. After we got all those results we did a few rounds of clomid and TI, and then moved to IUI and eventually IVF.

rjl07 · August 2010

I agree with everyone else. The initial testing for you and your DH will hopefully give you some answers and help your RE come up with a good plan for you. Good luck with your appt!

maceymay1816 · August 2010

My best advice is to come prepared. Bring your chart from FF, bring all your records from previous losses, tests, bloodwork, etc. and bring a list of questions. I had called the RE prior to making my appointment because I had no idea when it was appropriate to move to an RE from my OB and the doc talked to me on the phone for about 20 minutes. He actually ordered me to have bloodwork done prior to my appointment so that when we met we could have a really good conversation. I had had bloodwork done before but not an AMH test to determine my egg reserve.

My bloodwork all came back great so the next thing he ordered for me was the HSG. I honestly wasn't prepared for quite how complicated my situation would become, I thought I was a pretty simple endometriosis, multiple losses case. From the HSG I learned I have a tube that has to be removed due to a hydrosalpinx, another tube with a constriction and SIN plus scarring in my uterus. My followup appointment was a week later which gave me time to think about my situation and formulate all of my questions. I have a doc that is being aggressive and was very receptive to what my goals are and helping me to reach them. I was surprised at how quickly they have been moving on this process for me and you are so smart to get yourself prepared.

And remember to relax, Dr. Google is only going to drive you nuts. Best of luck!

BabyMimi · August 2010

Ditto to everything that was said so far, especially about bringing printouts of all your charts.

Also, I was under the impression that I ovulated just fine (based on charting and OPK's) however, when I started seeing the RE and he did 7 days post O bloodwork, it was realized that I actually was not O-ing on my own. My body was gearing up to O... I had a LH surge and a temp spike but I never actually released anything. Strange I know, but possible.

My point is your RE is going to test everything and you may think some of it is dumb but you never know what they are going to find.

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