MFI...or not? — The Bump

MFI...or not?

I had a checkin with my RE this morning, bloodwork and dildo cam. I heard him tell the nurse who was taking notes that I had 7 follicles on both sides less than 10mm. I'm assuming that's good since I'm on BCP and haven't started meds yet. We're waiting for insurance approval this week, he wants to see me again next Monday and thinks we will start meds on Wednesday the 6th, which should put ER somewhere in the Aug 17-19 range.

After talking through all of this, the PA was like oh, did you want your husbands latest SA results? And she and the RE looked on her screen and compared them to the first SA. Big improvement and it actually seems like everything is in the normal range now?? I was not expecting that at all, my DH had chemo 8 years ago for testicular cancer and we assumed the first (poor) SA results were due to that. The 2nd SA was done just to confirm for insurance approval, they wanted 2 SAs and my day 3 results before authorizing treatment. I asked if he still recommended IVF and he said its still a reasonable plan due to my age and the better success rates, so assuming Aetna doesn't give us a hard time now with the normal SA I guess we are moving forward. Of course, now I'm wondering if we could get PG naturally after all, or with IUI, but at 36 I don't want to waste much more time. I haven't even had an HSG because we thought IUI was out of the question due to MFI, and it wouldn't matter if my tubes were blocked for IVF. But if the MFI diagnosis was a fluke, maybe there is something wrong with me after all? Anyone experience anything like this? I'm wondering if I should ask them to do an HSG anyway just so I know for future reference. My insurance will cover 2 rounds of IVF, and up to 6 IUIs. I'm hoping the first IVF is successful (as I'm sure you all have hoped) so I won't have to stress about what to do next.

Re: MFI...or not?

  • I think it would depend on how long you have been trying. If it has been less than a year, I would probably do an HSG and give IUIs a shot at least for a couple months first. If you have been trying for over a year or two, then in would probably go straight to IVF for better odds. If the 1st SA was just a fluke, then you probably have been working with decent numbers most of the time (if not all of it) that you have been trying. That's why I say if you have been trying for a while, I would just go straight to IVF. Also, my H's urologist said that SA are usually lower than with sex just because of nature. And if the SA is normal, IUIs don't have that much higher of a success rate than just the good old fashioned way! Good luck on whatever you decide!

    ********Siggy/Ticker Warning***********

    Me (35) no known issues DH (37) MFI. TTC 21 months (24 cycles)
    Dx MFI with low to normal count, low motility, morphology 3%
    HSG normal, ultrasound and labs on me all normal. 

    1 cycle of Clomid 50mg and TI, unmonitored by OBGYN= BFN
    1 cycle of Clomid 50mg and IUI, unmonitored by OBGYN= BFN
    Started seeing an RE!!
    2 more cycles of clomid 50mg (great response), with IUI and Pregnyl trigger (4.8-8 mil good ones after wash) = all BFN
    1 cycle of clomid 50mg (3-7) followed by Follistim 75iu (7-11) + IUI = BFN
    December 2013 DH saw urologist and is taking Anastrozole, CoQ10, and L-Carnitine
    IUI #5 natural cycle (needed a med break) = BFN
    IUI #6 Follistim 75iu (CD3-10) + Pregnyl (CD11) + IUI (final count after wash 300K) = BFN
    IUI #7 Follistim 75iu (CD3-9) + Pregnyl (CD11) + IUI on 2/20 (post wash count 12.5 million)= BFN
    IUI cancelled (DH OOT) Clomid 50mg (CD3-7) 1 follicle +(not well timed) TI = BFN
    IUI #8 and last one!! Clomid 100mg (CD3-7) +OPK before US + IUI 4/17 (post wash 8.5 mil)= BFN

    Pre-IVF testing complete! SHG great and measurements taken! Labs for infectious diseases completed, FSH (5.4), TSH (1.6), Prolactin (11), AMH (2.6), Estradiol (40).

    Started BCP 5/29 and Lupron 6/11 prep for IVF #1! Started follistim 225u/day on 6/28. Monitoring on 7/2 >15 follicles measuring 11-14, E2 758. Monitoring on 7/5 all ready to go!! Great follicle sizes and lining is at 9. Tigger 7/5, ER 7/7 16R 9M 3F. Stimmed too fast in just 7 days. 7/10 3dt of 2 8-cell grade 2 & 4. 7/14 P4 >60.
    Holy crap BFP!!!
    Beta #1 (14dpo) 7/21 112 Beta #2 (16dpo) 7/23 286 a Beta #3 (18dpo) 7/25 761 Beta #4 (21dpo) 2631!!! Hold on tight little embies!!  First Ultrasound 8/7- 1 perfect little bean with a beating heart 117bpm!! EDD 3/30.
    Second ultrasound 9/2 Little bean measuring a few days ahead with a heart rate of 161!

    PAIF/SAIF/All Welcome!


    Pregnancy Ticker

    March 15 Siggy Challenge: You had one job

  • I agree that how long you've been trying would definitely play a part in my decision. Personally, I'd go straight to IVF with that kind of coverage, but it is invasive obviously, so you have to be comfortable with that decision for yourself.

    The HSG (or SHG) is a good thing to have done, because it can give you some more information about your body. Uterine abnormalities or a hydrosalpinx can greatly affect the outcome of a cycle, so you'd want to know and take care of any issues there before moving forward.

    image imageimage

    TTC #2 with assistance since 03/11
    Me: 33, Autoimmune (Hashimotos and FMS/CFS)
    Treated with Synthroid, acupuncture, TCM and supplements
    DH: 33, MFI (very low on all counts, high antibodies, hemochromatosis)
    Many treatments tried, none successful

    IVF/ICSI #1 05/14 - EPP/Antagonist, Gonal-F and Luveris, 18R, 14M, 13F - SET of 1BC, all arrested on day 5 - C/P
    Genetic testing = normal, DNA Frag = excellent
    IVF #2 03/15 - Long protocol with Suprefact, Gonal-F, and possibly Luveris, adding in PICSI
  • I had the saline sonogram done, so I think my RE has seen what he needed to check in my ute. My understanding was that the HSG would be pointless since the recommendation was to go straight to IVF, so the condition of my tubes was irrelevant.

    Meds were shipped today and will arrive tomorrow, so I think I'm taking a leap of faith and hoping this first round works. If it doesn't, maybe I'll ask to take a step back and do the HSG and ask DH to have another SA in case it's still close to normal at that point. I am 36 and we had been trying for 7 cycles, not including last month. We didn't really try last month because we had been told we had MFI and needed IVF. Part of me wonders if that could have been the month...
  • Thank you, @IFinTN‌ and @tptbabe‌. I'm going to send the nurse an email to see if there is still time to do an HSG without delaying the cycle. My RE had led me to believe it was irrelevant unless we were doing IUI, and my insurance didn't require it for IVF (only IUI) so I assumed I didn't need it. I had not heard of hydrosalpinx but just did some reading, and now I see where you're coming from. I'm still amazed by how much there is to be learned from this board, although it's unfortunate that there is so much "experience" here. Hoping we all have success soon.
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