Thinking about our next cycle: WWYD?

Manada · December 2012

So as we have gotten over the disappointment of last week's iui mistiming, we have begun the process of thinking about our next cycle which will probably begin Jan 2 or 3....

Our doc was insistent that we should do one cycle au natural, but we were also talking with a queer couple we know who is also seeing her and she told them she'd pretty much do whatever a couple wants in terms of meds or approach when using frozen sperm...

So for me, that begs the question: should we ask about clomid or femara this cycle? We will definitely talk about a trigger shot....

I am of two minds on this one:

1. Despite my ovarian issues, last month I had an almost normal AFC and a normal FSH and produced a good follicle and two small ones naturally. Seems like my ovaries are working for now without meds so why mess with what's not broken? I am fully expecting my ovarian function to drop dramatically in the next year or two, but if its working now....

2. As a lesbian couple, we don't have the luxury of unlimited amounts of sperm or money to buy it. given my fertility issues, I have committed in my head to trying only for four cycles before accepting that maybe we should focus on my partner. Many of the queer couples we know IRL end up turning to clomid to get the job done faster.... Seems like a reasonable idea, but am not sure...

How have you guys made these decisions?

We also have the third option on the table of just saving up money for IVF with my partners eggs, but my recent dx of having autoimmune antibodies means any pregnancy I carry could end up being highrisk anyway...

Just thinking of the options today, and not really sure how to weigh them out.

ball.and.chain · December 2012

Bearing in mind that I really wanted to do this naturally and waited 8 cycles to start fertility meds...if I was committed do only doing 4 cycles, and I really wanted to get pregnant in one of those 4 cycles, then I would go ahead with the meds, regardless of ovarian function.

I have no IF diagnosis and did not get pregnant in 9 IUIs, including one medicated (Clomid). I am probably not typical, but I just want to make the point that this can take a while WITHOUT a known problem. If you don't have a physical or ethical problem with the meds, go for it.

clairmeij · December 2012

I agree with ball.and.chain. Also, talk to your doc about drug preferences, my doc prefers not to use clomid. We went with letrazole/femara. I suppose my point is, that I think pushing for medicated cycles is great, but I think that its worth letting the docs recommend the specific drug and protocols.

JoySeattle · December 2012

I'm all for unmedicated if there aren't strict time/$ considerations, which as you mentioned there are for most LGBTQ families and for yours specifically with the 4 cycle plan. In your situation, I'd probably advocate for myself with the RE to "begin" with monitoring, letrazole/femara and a trigger. I completely understand wanting to have a trusting relationship with a healthcare provider, but based on your last cycle, I'd probably be very vocal and make sure you're both active decision-makers as you move forward. Best of luck!

Alysia82 · December 2012

JoySeattle:
I'm all for unmedicated if there aren't strict time/ considerations, which as you mentioned there are for most LGBTQ families and for yours specifically with the 4 cycle plan. In your situation, I'd probably advocate for myself with the RE to "begin" with monitoring, letrazole/femara and a trigger. I completely understand wanting to have a trusting relationship with a healthcare provider, but based on your last cycle, I'd probably be very vocal and make sure you're both active decisionmakers as you move forward. Best of luck!

I totally agree. After talking it over with your wife I would talk to the doctor about femara, monitoring, and a possible trigger shot. I had the same four tries thought and did three nonmedicated inseminations. I got a BFP on our third try but that didn't stick. It was the cycle with femara that I got my second BFP. I am now 14 weeks into my pregnancy.

2moms2b · December 2012

Like everyone else, I think this is a completely personal preference question. Our story is we tried for over a year at home, no medication, OPKs for timing but we had a KD so the money wasn't that big of an issue as each cycle we only paid for travle and hotel for a couple of days. We then discovered that wasn't going to work so we went to plan B, the RE.

When we met with an RE and talked to him, we felt we wanted to use medicated cycles out of the gate after my blood tests and monitoring cycle came back. We wanted to increase our chances as we were going to be paying about $1200 per try between monitoring, sperm and the procedure (all OOP). We also wanted to increase the odds of each chance as we knew we only had limited chances before we would have to take a break due to finances. We got our BFP with our twins on our first medicated cycle. I am not attributing it to the meds, but more the timing, heavy monitoring and luck.

If I were in your situation, I would at least advocate for the trigger shot. You responded well on your own for follicle growth so one more unmedicated cycle I wouldn't throw out the window if you truly want to try another natural cycle.

mollykelley · December 2012

I agree with the PPs, that you should go straight to medicated cycles since you are being monitored so closely anyway. Like me, you seem to be putting all your time and energy and money and hopes into each cycle. I was told in the beginning to expect to have to do several cycles and it has proven to be true. Now that we are into it I feel we would go to any length to make this happen. I will spend whatever time and money I have, even some that I don't have.

I would recommend going straight to femara rather than clomid. My doc says it is better in terms of symptoms and uterine lining, but Clomid is FDA approved in the US so that is why they always prescribe it first. I was so miserable on it, I wanted to quit and move to TTC with DW instead of me. Femara has been much better for me. Not sure what the deal is in Canada but something tells me it is probably easier to get prescribed.

Good luck to you!!

Manada · December 2012

Wow! Thanks for all your informative and supportive responses! We really appreciate it. We just spent the last day driving to Chicago so we're here now I am looking forward to the stuffed pizza!

It's nice to feel a bit better equipped going in to talk with our doc, she can be so upbeat it's hard for me to remember that I really need to be mindful of advocating with her, and that we ultimately need to demand a say in our course of action...

babiecake2002 · December 2012

It can be very hard to make a decision one way or the other. My wife and I were not opposed to or pro drugs but my doctor was driving the process and because we don't have an unlimited supply of sperm: I think she was a little agressive given I had no prior issues besides turning 34 lol. We tried at home with a known donor twice, we did OPKs for a year positive every month and home still didn't work. We told our Dr we were ready to go forward and her plan was to manipulate everything! clomid days 3 thru 7 of the cycle, low dose. Follicle study on day 12 which was a Friday. There were two viable sized follicles so she said okay we will inseminate on Sunday.. shocked was an understatement. Had the sperm delivered from CCB/ love them. we did a trigger shot of ovudril saturday morning 24 hours later we inseminated and we got our BFP 10 days later! I neer thought it would happen so quickly and we are blessed because we were prepared to do several cycles. I hope this helps and I hope it works for you soon!

Manada · December 2012

Thanks for weighing in everyone. This week we are having discussions amongst ourselves about weighing out our options plus the risk of multiples and things...

We will talk with our dr next week after our next bloodwork or monitoring appt next week sometime. I did a FRER test this morning, 11dpo, and got a BFN as suspected, so we are now officially looking at our Jan cycle.

Thinking about our next cycle: WWYD?

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