Is It Time to Schedule a WTF Appt? - Update in OP

BunnyBerry · October 2014

UPDATE - Scheduled for a consult on CD26, which should be around 8-10 DPO (too early to know with a trigger in my system, but it's what they had!). When I called and gave my name, the nurse actually asked me if the call was to schedule a consult - so it must be the protocol around there! Thanks everyone for sharing, I am getting excited (planning mode is always energizing) about IF treatments again!

We completed 2 unsuccessful IUI's with Letrozole since my laparascopy, starting meds for IUI#3 today.

I want to change something up for the 4th (or maybe 5th) IUI, then move on to IVF. When do I schedule a consult with the RE? It feels like I need to wait and see if a cycle is successful, but by then it's too late to switch things up for the next cycle.

Basically my question is, is it typical to schedule a consult during the TWW of the 3rd IUI?

Also, when and why did your RE's have you move up from oral meds to injects (if this is your situation)?

And, if you are doing multiple injects cycles, what is thought process compared going with injects compared with IVF?

Thank you, I am just really bummed and feel like this never ending path is yawning ahead of us, and need a bit of a picture of what to expect.

BethKate2 · October 2014

I'm not in that position yet, but at my last consult, my RE and I decided that we'd do one clomid IUI cycle, and then move on to injects + IUI. Her thought process with that was we've been TTC for over two years already, so she seems to think IVF might be our best bet. The only reason we're doing two IUI cycles first is because my insurance requires less aggressive measures before moving to IVF.

moto611 · October 2014

So my RE actually contacted me right after my 2nd IUI and said I had to go in and talk to him before moving on to the next cycle. I was actually really taken aback because I had just started my 2ww and I thought after just 1 failed IUI and 1 unknown IUI it was too early for the wft appointment. Turns out he was also counting my one TI cycle, and that for that office it's standard to go in and have a chat before moving on to your 4th cycle, even if you have not yet figured out the results of your third cycle.

That's my long-winded way of saying yes, I think it's time to make an appt to make sure your treatment is on track. Call now and make the appointment for sometime during your 2ww. You won't know yet if IUI #3 worked, but you'll feel so much better having a plan in place for IUI #4 just in case.

For me, this appointment was not particularly helpful. My RE started me on a combination of Clomid and Bravelle right off the bat. I guess it's "working" in that I usually have 1 or 2 follicles. So... there doesn't seem to be anything else to do except move on to IVF. So my WTF appointment was basically a hard-sell for IVF. Here's hoping your appointment is more useful!

kristyn831 · October 2014

It depends how aggressive you want to get with treatment. With our MFI diagnosis, we could have moved on to IVF after the first IUI. If you want to just get an appointment to discuss options, it's a good idea, even if you decide to try more IUIs.

jenmcD11 · October 2014

I would agree that scheduling an appointment to discuss options before finishing your IUI #3 cycle is a great idea. Being proactive and advocating for yourself is important and that way you don't have to waste a cycle, which is the worst! FX that it won't matter though because third time's a charm!

southernyankeegirl · October 2014

***** Grad / Ticker Warning *****

Hey Bunny, I really hope you don't mind me posting!

I also hope so hard you won't need a WTF as this is your cycle, but I know it's good to have a plan for next steps if needed.

I would go ahead and schedule the WTF for 11 DPO. It will give you time to order meds if needed, but also enough time to cancel if you get a BFP before the appointment.

We did step up to injects-only for our successful IUI, and I swear if we ever have to go through this shit again, we are skipping Letrozole (it thinned my lining) and going straight to the hard stuff - Follistim! There are several 3T grads whose successful IUI came with injects-only after several failed Clomid or Letrozole (or in my case, Letrozole/Follistim hybrid cycle) IUIs, though the increased risk of twins with injects-only is real.

If you are very twin averse and IVF isn't much more expensive than IUI, I would say consider skipping straight to IVF. Especially with MFI, having ICSI can really make a big difference in success rates and a few frosties can make it cheaper to keep trying in case of a BFN or for a future sibling.

If injects IUI is cheaper (or preferred, for whatever reason) and you aren't super afraid of twins, then definitely consider an injects-only IUI cycle. I am grateful I did mine, and I know others have had success with it. And if it doesn't work, your doc will at least have a better idea how you work on injects to tailor the IVF protocol so it's more likely to be successful.

FX so hard that all of this is unnecessary worry! Always happy to chat if you want to PM me!

BunnyBerry · October 2014

Thank you, thank you, thank you for all the helpful input!! I cannot describe how this is helping...both because it's great advice, and because it's really helping me out of this rut to think about some concrete steps we can take.

@moto611 Exactly, I'm hoping having a plan will make it easier to get through the next cycle!

@rainbowbridge14 That's a good point, I keep assuming that injects will be OOP but I need to check on that (was afraid of confirmation that it's not covered) - because if it's covered, we definitely want to switch earlier than later.

@firstarabesque That's probably why it's been bugging me, in a way this was the 3rd in a row already since we did a Letrozole cycle and attempted IUI before the lap. I'm afraid the RE won't be very aggressive...he have me a Letrozole prescription with 4 refills and in the back of my mind I've been thinking, oh no does he want us to do 5 IUIs with Letrozole? But it's probably just time to go talk to him!

@southernyankeegirl Your posts are always welcome! 11 DPO is a good plan. Thanks for the suggestion - it makes it easier to take action when someone tells me what to do, Lol. We're totally not twin averse - thankfully HSG showed a normal-shaped uterus. And it's really helpful to know that there have been some good successes on PAIF with injects IUIs after failed oral med IUIs.

emmuffy · October 2014

I'm sorry about the BFN. I think if you have questions and want some guidance in making a plan, it's time to schedule an appointment, regardless of where you are in your cycle. You should figure out if your RE supports trying an IUI with injects and what your insurance would cover. It's also a good idea to start the conversation about IVF, because the planning and prep takes quite awhile. Good luck.

mshandlebar · October 2014

I can't be of very much help since we are at about the same stage, but I think having the talk sooner rather than later is better. It will probably help to have a plan of attack for the future. I hope that it goes well, although what I am actually hoping is that it works out this time and you don't have to worry about any of that nonsense.

BunnyBerry · October 2014

@mshandlebar Thanks. Are you guys planning a consult before starting IUI#4 if it comes to that? Although I hope both of us never have to go there!

lisa89760 · October 2014

We had our WTF IVF consult without actually knowing if we were moving onto IVF yet or not, but it was something we were glad we did. We got a lot of information and questions answered. It ended up with us trying to do some inject cycles and then lap surgery before the end of the year and then regrouping and decide. We also have consults covered on our insurance so that helped make the decision for us.

We didn't just talk about IVF but about everything which was nice as well.

TTCBabyJ · October 2014

Well good luck with the new consult...hopefully they will do something a different or give you some answers...do they think it could be MFI?

BunnyBerry · October 2014

@ttcbabyj Thank you! Yes, we have an MFI diagnosis (low count, concentration, morph, and motility, and low T being treated with Clomid), but the RE thought IUI could counteract that without a problem. It was only after he discovered endo in my lap that he started talking like IUI was just a chance for us, but no guarantees. So I'm ready to get a reality check on what what kind of chances we have with different options.

mshandlebar · October 2014

That's fantastic. Yay for plans!

lebradford · October 2014

I missed chiming in before you already made your decision, but I still wanted to say good luck at your consult! I think I had my consult scheduled during the 2ww too. :-)

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