Re-Intro.....Suggestions for next step?

elucas2011 · October 2014

Hey ladies!! It has been a while since I have posted, so I want to introduce myself again. Also, more info can be seen in my Siggy. Just a recap from this year: I met with my RE in January, after finding that I had one blocked tube (found during Nov 2013 surgery). I went for HSG in February, which showed both tubes blocked. Unfortunately I developed an infection after the HSG and was admitted to hospital for almost a week. That put our baby making plans on hold for several months, so I could allow my body to build it's strength back. On May 30, I had a surgery to my open tubes. After leaving recovery, my RE came in and told me that my surgery went great, both tubes are fully open and said that he told my Husband that he needed to get to work on making some babies. HA HA!! At my post-op appt in June, my RE told me he was going to send me home for 3 months to try to get pregnant. If I did get pregnant during those 3 months, I was to call his office BUT if I didn't get pregnant, I was to come back in mid September. Well....I guess y'all can figure out which of those two happened. So, September 15 rolls around and I go to my follow-up appt. My RE schedules me for another HSG to see if my tubes are still open. He said all I need if one of my tubes to still be open to continue treatment. I went for my HSG on September 19 and I was a nervous wreck b/c of what happened before. My HSG showed that my right tube had become blocked again; but thankfully I did still have my left one open. Since I had showed issues with ovulation while seeing a previous doctor, my RE prescribed me Letrozole to take on CD 2-6 (Oct 7-Oct 11). When I got my LH surge, I went for a PCT (1st time going for this test). The results from that visit: 1) Ultrasound showed that my uterine lining was thick and looked great, 2) Unable to detect which side I ovulated on, 3) Sperm and cervical mucus interaction looked normal, and 4) Unable to find vein to draw blood to confirm ovulation. I go for Progesterone Test this afternoon.

I am so sorry for such a long post. If you are still reading, then you are a blessing.

I am just trying to see what options are still out there before we decide to move on to IVF. If the one tube I do still have open becomes blocked also, IVF will then be our last hope. This is only my second cycle in the last 1 1/2 years to take medication, so I feel I don't know as much as some of you ladies who have done multiple medicated cycles, shots, IUIs, etc. Also, we have encountered many unfortunate events along the way that have benched us for periods at a time. I go back to my RE on Wednesday (10/29) for a followup.

What are some things I might need to mention or ask about at this point?

How many medicated cycle should I expect to do before we move on to something else?

Do you ladies prefer Clomid or Letrozole for ovulation stimulant? What's your likes/dislikes with either them?

Does an IUI help increase chance of conception? Would it seem helpful in my situation?

There are probably other questions I am forgetting, so if any of you ladies have any info or advice to offer, that would be wonderful. Thank you for taking the time to read my mini-book.

I hope I can post more now that I am not sitting on the sideline as much. Hope you ladies have a great day!!

BunnyBerry · October 2014

Welcome back! (But sorry your TTC journey didn't have a great ending this summer.)

Perhaps if you need another cycle, make sure to get an ultrasound before O, where they can see which side the follicle(s) is growing on, and make sure you don't overrespond with too many follies?

Perhaps get a repeat SA since it's been 1+ year, before deciding if IUI is worth it to you? With any MFI, it's great, but without MFI, it makes only a slight difference.

Consider that a blocked tube could (likely) be causing an unhealthy/inflammatory environment in the uterus that could prevent pregnancy, you may wish to consider IVF eventually as a possible option.

I take Letrozole and am happy with it (SEs are acceptable, never got multiple follies though). But after the 4th try, next month I'd move on to something stronger. Clomid scares me with all the SEs.

I hope you can avoid any more benching, and get that BFP soon!!

elucas2011 · October 2014

Thanks for your reply BunnyBerry. I use the Clear Busy Advance Digital OPK. When I got my peak surge, it was during a weekend, so my RE's partner is the one I met with for my PCT. She did a vaginal ultrasound to check my lining and also looked at my ovaries but was unable to tell which side I was ovulating on. With me being that close to ovulation, shouldn't she have been able to see something?? She took multiple pictures, so maybe my RE will be able to tell me more when I meet with him on Wednesday. I will also bring up doing another SA. I know if we do decide to move on to IVF, my RE will require a SA at his facility before proceeding. Thanks again for you advice. I hope you get your BFP soon too!

SND1231 · October 2014

I don't have any answers for you as I have just started this journey but did want to welcome you and say that I am sorry you have to be here. Hopefully your stay will be short!

BandM14 · October 2014

Hi and welcome! I have one blocked tube also and tried Letrozole last month, but unfortunately only got follicles on the blocked side. Do they know what is causing the blocked tubes for you? Like Bunny mentioned, if it's some sort of inflammatory process like an infection or endo, that can make the whole reproductive environment inhospitable for conception to take place.

I really hope you and your RE get a good game plan together and you get your BFP soon!!

shirleymaeby · October 2014

Welcome back! I'm sorry you're back here but hope you find success soon!

DharmaChick · October 2014

Welcome back! I'm sorry to read of the rough time you have had, and wish you lots of luck!

Personally, I have responded more quickly and with fewer side effects on Letrozole/Femara than Clomid, but both produced a mature follie. IUI increases your chances if you have any male factor or CM issues.

I would recommend asking your RE how many cycles you may have on the medication/plan suggested, and what may be next, so that you can be comfortable with knowing what is potentially ahead.

mmmKayy · October 2014

Welcome back! So sorry you have been having such a rough time. Hopefully your time here will be short and sweet!

mrskimmell · October 2014

Oh hun, I am so sorry you have to go through all of this! I don't really have much advice other than do research on any other treatments out there. Ask the RE if he/she knows of anything you haven't talked about yet. I don't know if it's something you are interested in but you can always look for homeopathic or less conventional methods to help with fertility. Something like acupuncture herbs oils candles those types of things. But if your RE wants to push for the IVF whilst you still have one tube open I would say go for it. If it's something you guys can financially manage. =]

elucas2011 · October 2014

@BandM14: Thank you for the welcoming. I am not certain what has caused the blockage to come back in my tube. Hopefully, I can find out more at my followup appt tomorrow. During both of my previous surgies, neither doctor found any sign on endo; I did have quite a bit of scar tissue removed during my first surgery but non was present during my second. I did, however, have hydrosalpinx, which was flushed when i went for tuboplasty. I do know that choosing to have the tuboplasty surgery added extra risks, it was just a step to try beforehand since IVF is not a covergae option with my insurance.

@DharmaChick: Even though I have only done 2 medicated cycles; one with Clomid and one with Ltrozole, I did not have any side effects with the Letrozole. Clomid gave me the awfulest hot flashes and caused me to have surgery to remove two very large cysts. I am always one to ask a million questions, so I have made a list of questions to ask tomorrow so I won't forget half of them. LOL. Thank you for your advice. It is greatly appreciated. I just feel like I am a little lost when it comes to medicated cycles. I lurk around and read other's posts and see all the info in their Siggy, and think "what in the world in some of that stuff?". Everytime we get ready to get back in the game plan, something medically happens and puts us right back on the sideline.

@mrskimmell: Thanks for your reply. I have bunch of questions for my appt tomorrow. Hopefully I won't seem to annoying. lol. I just want to make sure I have all information that I will need to help us decide on a future plan. My DH and I have already discussed the IVF option but have not yet asked for any further info from the clinic. I know the cost is in the $1000s, but not sure how high up it goes. I looked up the avergae cost in Alabama and almost had a heart attack. It will be completely OOP. My RE is very committed in choosing a plan(s) that have a good chance conceiving that are not as costly on our part before pushing us straight in to IVF. But he has made it very clear that if my only tube becomes blocked that I will have no other choice but IVF. At my last appt, he said he just wanted to try the Ltrozole to see what it would do, so if my Progesterone Test doesnt come back good, he may not try another medicated cycle. Thanks again for you reply. You ladies hear are always so nice and welcoming and offer great advice/support.

mrskimmell · October 2014

@eJucas2011 Don't even worry about being annoying! I was too at my very first apt. and the ladies on here reassured me I'm not the only one asking a million questions. I'm not the only one coming in there with a note pad full of questions and rumors and everything else. They are always open to questions. You asking is the best way for them to get the perfect plan centered around you guys, what you are comfortable with and what would be best cost wise for y'all. Good luck love bug!

elucas2011 · October 2014

Well, after a really good visit with my RE, we have a game plan that I am satisfied with. Unfortunately, my progesterone test is still pending b/c the local hospital I used (to save a 2 hr drive), failed to inform me that my blood work would travel to another facility and then to another facility before the test would be performed. I should get the result back this afternoon. My RE told me that if my test level came back below 10, he would increase my Letrozole dosage, but if it came back above 10 he would leave it the same. We are going to do at least more 3 Letrozole cycles. If we do not conceive during any of those 3 cycles, we may continue with another 3. BUT... he said we will most likely move on to IVF if we have 3 more failed cycles, since we do have tubal issues. My RE did go ahead and give me IVF booklet to allow me to gather more information and become more familiar with what all is involved. Although, it is expensive, it is not no where near what I though it was going to cost. Thankfully, we have already been putting money aside to help cover expenses through this journey.

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