Trouble TTC

Question Dump (Vit D, hypothyroidism, one tubed wonder)

Hi! I kind of have a couple of questions to pose so I wanted to ask them all at once. Figured it was more efficient this way. I just finished It Starts With the Egg and has me all kinds of thinking lol

1) I'm curious about getting tested for Vit D deficiency and hypothyroidism. Do I just ask for them? For ladies who are diagnosed should I be looking for certain symptoms first? Should I be concerned that my RE hasn't wanted to at least test me for hypothyroidism? Is Vit D worth it or is it easier to just be safe and take a supplement and keep it at that?

2) If I go on Friday for my HSG and find that both of my tubes are blocked and my only option if IVF should I even be worried about getting diagnosed with any other sub issues like above? It would be bypassing them all anyways?

3) Ladies diagnosed with antibody issues or things like hostile cervical mucus. What brought you to that testing? Long term infertility that didn't respond to treatment?

4) For any ladies with only one good tube. Do you mind sharing what your treatment plan has been. My RE thinks that likely both my tubes are blocked but I can't justify in my mind why my left one couldn't still be good due to my history. I'm just wondering what kind of options I may have with only one tube that aren't IVF.


To anyone brave enough to attack the above I thank you! Once I typed it all up it looks like a giant mess and I think I just committed the internet form of verbal diarrhea. My brain is just so full of questions and you ladies are my only sounding board!

Re: Question Dump (Vit D, hypothyroidism, one tubed wonder)

  • 1. I thought it was normal practice to test thyroid as part of IF workup with an RE. I don't know about D because I had that recently tested anyway.

    2. With 2 blocked tubes, it's still necessary to do a complete testing workup because there are still things to know - should you do ICSI, how will your ovaries likely respond to stimulation, what is the best protocol, do you need a hysteroscopy for any uterine issues, and do you need a laparoscopy to treat the tubes or other related issues to reduce an inflammatory environment which can reduce chances.

    3. We didn't test CM because doing IUI or IVF bypasses it entirely. We haven't done immune testing yet and our RE wouldn't do it unless IVF failure(s) indicated an issue. I don't know if that's typical.

    4. @bandm14 has one tube and uses oral meds to get more than one follie, then uses IUI as long as she has one on the unblocked side. My understanding is that it can be well worth a few tries if a tube is shown to be clear by HSG. 
    January 3T Siggy Challenge - New Year's Resolutions
    image
    imageimage

    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
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  • 1. I thought it was normal practice to test thyroid as part of IF workup with an RE. I don't know about D because I had that recently tested anyway.

    2. With 2 blocked tubes, it's still necessary to do a complete testing workup because there are still things to know - should you do ICSI, how will your ovaries likely respond to stimulation, what is the best protocol, do you need a hysteroscopy for any uterine issues, and do you need a laparoscopy to treat the tubes or other related issues to reduce an inflammatory environment which can reduce chances.

    3. We didn't test CM because doing IUI or IVF bypasses it entirely. We haven't done immune testing yet and our RE wouldn't do it unless IVF failure(s) indicated an issue. I don't know if that's typical.

    4. @bandm14 has one tube and uses oral meds to get more than one follie, then uses IUI as long as she has one on the unblocked side. My understanding is that it can be well worth a few tries if a tube is shown to be clear by HSG. 

    1) Back in March I had blood work done as a part of preconception counseling. However I only saw that lady once and I have had a hell of a time getting ahold of her office and looking for my results! I'm not sure why when my RE tested me for AMH he didn't test my thyroid.

    4) I wasn't sure if oral meds or IU was truly an option because my thoughts were how do they insure I ovulate out of the appropriate side? You can force one ovary over another to throw the egg? lol

    Thanks so much for your insight!

  • I take supplements for Vitamin D - D3 1 pill a day of 1000mg (I think it's 1000mg) as my levels came back on the low side of Normal. My hypothyroidism has been regulated since 2008 and I just had my antibodies retested and long behold they were very high for where my RE wanted them to be at. You can either have it monitored through your PCP or RE. My antibodies came back high for Hashimoto's so my diet changed due to the inflammation (leaky gut) and are attacking my thyroid tissues. Every RE is different, but both of the one's I've seen (been to 2 different clinics) TSH was something they tested for.
    image
    3T January Siggy Challenge: New Years Resolutions 
    TTC since 10/2010 (Rhythm method since 2007)

    Me (33) Sept 2012 - DX Low ovulation/progesterone, Luteal Phase Defect. HSG 5/2012: both tubes are open, cervix and lining look good;
    September 2014 DX Hashimoto's; November 2014: PCOS IR

    ***
    DH (37) Sept 2012 SA Normal; October 2014 Mild MFI count 42 Million, Motility 36%, Morphology 2%. Clomid 50mg,
    ***
    2004 Cyrosurgery, LEEP
    May 2012 - HSG Clear; June 2012 - Appointment with RE
    July 2012 - October 2012 - Clomid 50mg W/ TI & Progesterone 3 mature follicles- BFN
    January 2013 IUI #1 (900,000 post wash) Clomid 50mg, TI & Progesterone 2 mature follicles - BFN
    February 2013 IUI #2 (1.3 Mil post wash) Clomid 50mg, TI & Progesterone 4 mature follicles - BFN
    March 2013 IUI #1-3 (2.5 mil post wash) Clomid 50mg, Baby Aspirin (lining thinned) TI & Progesterone - 2 mature follicles BFN
    April 2013 Benched due to cyst, May 2013 WTF appointment
    June 2013 DH SA mild MFI break for 2 months to re-test; August 2013 - DH SA 36 Mil count, 36% Motility, Morp 2%
    September - December 2013 - Mental sanity Break
    January 2014 - IUI #4 switches to natural due to scheduling conflict Femara TI & Progesterone - 1 mature follicle - BFN
    May 2014-June 2014 - DH Appointment w/ Urologist to check Bi-lateral Varicocele; 2nd opinion w/ another urologist - bi-lateral varicocele dx is slight no surgery
    July 2014 DH starts clomid 25mg daily SA 53.8 Mil count, Motility 37%, Morph 3%;
    September 2014 DH Repeat SA after being on clomid for 3 months 42 Mil Count, Motility 36%, Morph 2%
    October 2014 Me: Hashimoto's DX, DH taken off clomid;
    November 2014 Me: new RE PCOS IR Diagnosis
    December 2014: IUI #4 Follitism 75iu 7 days, TI, IUI & Progesterone, BFMFN

    January 2015: IUI #5
    Gonal-F 75iu 7 days, TI, IUI & Progesterone, Another BFMFN onto IUI #6
       image

  • 1. RE tested for TSH and for Vitamin D levels at my irs appointment. It was part of the full work-up. They also tested or CA-125, AMH, and a bunch of other stuff (10 vials of blood total!)

    3. It's my understanding tat an IUI will bypass CM so it wouln't matter if it was hostile. I think that only matters if you're TI.

    No answers for the blocked tubes, but it looks like PP's covered that as well!

  • w+c3 said:
    1. I thought it was normal practice to test thyroid as part of IF workup with an RE. I don't know about D because I had that recently tested anyway.

    2. With 2 blocked tubes, it's still necessary to do a complete testing workup because there are still things to know - should you do ICSI, how will your ovaries likely respond to stimulation, what is the best protocol, do you need a hysteroscopy for any uterine issues, and do you need a laparoscopy to treat the tubes or other related issues to reduce an inflammatory environment which can reduce chances.

    3. We didn't test CM because doing IUI or IVF bypasses it entirely. We haven't done immune testing yet and our RE wouldn't do it unless IVF failure(s) indicated an issue. I don't know if that's typical.

    4. @bandm14 has one tube and uses oral meds to get more than one follie, then uses IUI as long as she has one on the unblocked side. My understanding is that it can be well worth a few tries if a tube is shown to be clear by HSG. 

    1) Back in March I had blood work done as a part of preconception counseling. However I only saw that lady once and I have had a hell of a time getting ahold of her office and looking for my results! I'm not sure why when my RE tested me for AMH he didn't test my thyroid.

    4) I wasn't sure if oral meds or IU was truly an option because my thoughts were how do they insure I ovulate out of the appropriate side? You can force one ovary over another to throw the egg? lol

    Thanks so much for your insight!

    Thanks for tagging me, @BunnyBerry. OP, I've done 4 medicated cycles so far with Femara, and at the monitoring they are able to tell if I have follicles on the left (my open side), so we go from there. The first cycle I had three follies but they were all on my right, so we didn't do an IUI... DH and I still had sex, as the doctor said there is a "small chance" of the good tube moving to pick up the egg from the opposite ovary. Luckily, the next 3 cycles I always had at least one on my left. I seem to get 2-3 follicles every time with Femara, so I guess there's a pretty good chance that at least one of them will be on the good side. If they know for sure you have one open and one blocked, they can adjust oral meds to give you a better chance of having multiple follicles (and thus, a better chance at one or more on the open side).

    To your other questions, I think thyroid is an important part of a fertility workup... my TSH was slightly elevated and I had no symptoms, so it was good to know so I could start Synthroid. As PP said, IUI bypasses CM, so since that was my treatment choice I never tested for hostile mucus... and for your second question, yes it is important to get the whole picture even if you are planning to do IVF because of bilateral blockage. Good luck!

    Me: 27 DH: 35

    TTC #1 Since July 2013

    Started RE Testing July 2014

    2 HSG tests: Right tube is blocked, possible endo.

    TSH elevated, started Synthroid 25 mg daily.

    October, 2014: Femara 5 mg + TI ---> 3 follies on blocked tube side ---> BFN

    November, 2014: Femara + Ovidrel + IUI#1--2 follies (on the good side), 46 mil. motile sperm=BFN

    Nov-Dec 2014: Femara + Ovidrel + IUI #2 (1 follie, 76 mil. motile sperm) + Endometrin=BFN

    January, 2014: Femara + Ovidrel + IUI #3 (1 follie, 38 mil. motile sperm)=???

    New RE appt. scheduled for 1/14.


    3T January Siggy Challenge: New Years Resolutions

    Mine: Lose the weight I put on from booze and cookies over Christmas.

    image


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