Confused: fertility consult today, dr said we choose treatment

sassy1 · September 2010

I went in to discuss all the results of my labs/ultrasounds/sonogram, expecting that he would tell me the next step to take.

He said my ultrasounds showed a good ovarian reserve, sonogram showed no blockage in tubes, & that my problem is that I'm not ovulating (hypothalamic pituitary dysfunction). He then said that it's totally up to us, whether we start with Clomid or injectables, or go straight to IVF. I feel overwhelmed! I reminded him that I will be turning 40 next month & asked if he had ANY leaning in terms of a recommendation. He said, "Well, I guess if you were my daughter, I'd say possibly to try injectables, but again it's up to you two."

We have to decide by the end of this weekend, because AF is probably going to arrive tomorrow. So, when they open up again on Monday, I will already be on day 3. I have a lot of reading to do, because there's so much we don't know!

Any thoughts?

madelyn07 · September 2010

So this would be your first medicated cycle, right?

I definitely wouldn't jump right to IVF...I'd recommend doing injects for one cycle first to see how you respond, find a good dosage, ect. If it works, great, if not, you have a better understanding of your body going into IVF.

vanessagorc · September 2010

Hummm, i'd be confused too. I have always been given my options THEN a clear reccomendation.

jani7 · September 2010

You have to do what you are comfortable with. It is nice to see how you respond in an injectable iui cycle before doing ivf. I did 5 iui's and if I would have jumped right into ivf I would have always wondered if an iui would have worked. With that said I now kind of regret wasting time on 5 iui's when our RE suggested we go straight to ivf. So i guess if i could start from the beginning again I would have done 2-3 iui's first. (I'm also a little younger so time isn't as big of an issue) GL with your decision!

SheWoreScarletBegonias · September 2010

honestly if it were me, I would most likely try Clomid first and maybe a hcG Trigger (to help you ovulate), and of course, insist you be monitored during your cycle. (some doctors will put people on Clomid and not do ultrasounds).

Since you are still in the very early stages of educating yourself on your options, I would go the Clomid route for a month simply to see how you respond. Some ladies are superstar responders on Clomid. If it doesn't work, then I would talk to your RE about injectibles and IUI.

I think you will find a lot of the decisions you make may also depend on if you have insurance coverage for treatment. Without insurance out of pocket costs can and will add up very quickly. (for example, a cycle of injectible medications can run you anywhere from $1K to $3K (or more) and that doesn't include IUI's or IVF itself.

Good luck and definately educate yourself as much as possible. I have worked in healthcare for 20 years and I always encourage people that you have be your advocate to ensure you get the care you deserve.

Jenn

Bella2u07 · September 2010

madelyn07:
I definitely wouldn't jump right to IVF...I'd recommend doing injects for one cycle first to see how you respond, find a good dosage, ect. If it works, great, if not, you have a better understanding of your body going into IVF.

I agree! Also, has your Dh had an SA done?

NiddyDiddy · September 2010

One thing to think about is if there is ANY kind of programs you would miss out on if you started treatment after age 40? (Any kind of IVF shared risk alternative or price break?)

A friend of mine went to a fertility clinic that offer 3 IVF tries for a discounted price, and a refund if the treatments didn't work. She qualified for the program, and was told by the clinic staff...but opted to do IUIs first, only to be told that, now that she aged past the shared risk cutoff, she was no longer eligible for the program.

She didn't realize by doing IUI she'd miss the window for the IVF program, and has regretted it.

...That said, if you're not missing anything with your birthday coming up, then I would try a less invasive treatment first. If you're not ovulating at all, a few cycles of clomid could even have the potential to work for you...

theworms · September 2010

Bella2u07:
madelyn07:

I definitely wouldn't jump right to IVF...I'd recommend doing injects for one cycle first to see how you respond, find a good dosage, ect. If it works, great, if not, you have a better understanding of your body going into IVF.

I agree! Also, has your Dh had an SA done?

this is great advice

if i were 40 or turning 40 i would want to be more agressive and skip clomid (which sucks, hated it even though i am an excellant responder)

jamielynnohio · September 2010

I would suggest at least 1 IUI to see how you respond to meds. IF is such an intense process, I would want some time (if age isn't a serious factor) to educate myself just a little. Best wishes in whatever you decide.

njohnson1972 · September 2010

I am also AMA. I would consider doing an inject cycle. They are much easier than doing IVF. But I wouldn't wait long before moving to IVF. Good luck.

sassy1 · September 2010

Thank you for taking the time to respond.

To answer some questions: Our insurance will cover everything, including (surprisingly) 4 rounds of IVF. DH did have a SA done & everything is fine on his end.

lizl · September 2010

If I were in your shoes and I had the money, I would definitely go straight to IVF. We have the same problem, not ovulating. I'm doing injections Gonal, plus Clomid then hopefully my follies grow then a trigger shot Ovidrel for ovulation. My RE recommends we try IVF next if this does not work since that has a higher success rate just a lot more expensive.

GenRN45 · September 2010

madelyn07:
So this would be your first medicated cycle, right?
I definitely wouldn't jump right to IVF...I'd recommend doing injects for one cycle first to see how you respond, find a good dosage, ect. If it works, great, if not, you have a better understanding of your body going into IVF.

i agree with this! good luck!

Yellow_Daisy · September 2010

sassy1:

Thank you for taking the time to respond.

To answer some questions: Our insurance will cover everything, including (surprisingly) 4 rounds of IVF. DH did have a SA done & everything is fine on his end.

Since you have insurance coverage and your ovarian reserve is good I would do one or a couple IUI's with injectables, like Madelyn said to figure out how you respond, the right dosages, etc. If the IUI's don't work then you can move onto IVF with a clear idea of what meds work best and more mentally prepared for what is ahead. If I had your insurance coverage I would still be doing IUIs.

That said I would make sure that in addition to those 4 IVFs that there isn't a lifetime max $$$$ amount that they cover. They may say we will cover all IF and up to 4 IVFs or max lifetime coverage of $20,000. You can use up $20k of coverage pretty fast with the cost of injectable meds so just make sure you don't have a limitation like that because if you do you might not be able to get 4 IVFs and multiple IUIs out of the max coverage amount.

Want a personalized experience?

Confused: fertility consult today, dr said we choose treatment

Re: Confused: fertility consult today, dr said we choose treatment

Choose Another Board

Search Boards