Only 1 follie, to IUI or not?

misshopeful1 · October 2015

My CD 12 scan was today. It was my worst medicated cycle so far. I only had one 16 mm follie, others were way too small.

That being said I don't know if we'll do an IUI this cycle. I haven't ovulated yet so the procedure is tentative. We both work and have typical hectic schedules. We may just continue with TI.

We hoped since my lap was in July to have more success but things aren't turning out that way.

I'm really upset and don't want to be at work.

LCK0830 · October 2015

I'm so sorry! IF is such a frustrating and upsetting process. I've had plenty of days where all I want to do is curl up on the couch in my pajamas and not talk to anyone. I think it's important to allow yourself time to be upset. This community is here for you when you need us!

tripledaggerWed95976 · October 2015

Does ur SO have male factor infertility? If not, maybe try the natural way this month? Does your insurance cover the cost of iui? If so, then if doesn't hurt to go ahead w the iui.

riveridgional · October 2015

I think @tripledaggerWed95976 asked good questions. To add to that, what were the results of your postcoital test? That's really the big indicator for TI v. IUI success. I know it's frustrating, but I'm sure that one is of great quality, and it only takes one!

misshopeful1 · October 2015

@LCK0830 thank you for the kind words.

@tripledaggerWed95976 SO does not MFI. Insurance covers some but we'd still pay almost $400.

@riveridgional idk. RE has never done or brought up postcoital test.

I'm frustrated because still no BFP post lap, this is my 7th cycle on femara, I'm 32 and have unexplained infertility. And the doc seems hesitant to change my dosage.

bsckgb7 · October 2015

misshopeful1 - an RE should give you the option of continuing meds for a a few days to see if the smaller ones will catch up!! How small where they?

ETA: after 7 cycles for Femara, I would be asking for injectables.

vssbrm · October 2015

I only have 1 visible follicle this mth (though bw says 2), we went ahead and did the IUI anyway... I am really torn about it, and this cycle in general haa been rocky and with surprises. I say go with your gut on this one!

misshopeful1 · October 2015

@bsckgb7 interesting. They said I didn't need injectable because I was (key word) responding well. And none of the past cycles I have been talked to about continuing meds.
Nurse didn't say how small they were but they didn't really appear on monitor so I'd say pretty tiny/immature.

@vssbrm good luck with your tww. I just don't think we'll proceed. Back to TI.

Can I go home yet? Yeah, didn't think so.

Thanks ladies.

bsckgb7 · October 2015

I respond just find the Letrozole/Femara too. I started injectibles because those eggs are stronger, better and more likely to fertilize. Simply taking injectibles ups your chances of pregnancy greatly.

For example, on oral meds I produce 3-4 good follicles. On Follistim, I produced 4-5. Seems about the same numbers to me, no worries. The nurse freaked out and talked about canceling because of how much better the quality of eggs are on Follistim and how much more likely they are to fertilize.

@babyexpress - didn't your doctor tell you the same thing? What were the stats?

babyexpress · October 2015

@bsckgb7 yes, I was just writing her this in the October IUI thread. Have you tried Follistim?

On clomid alone I produced 1 (although it was mature at 20mm i think) and with follistim it was more like 3-4. Both IUIs failed, but you only need 1 follie. Maybe he might cancel because he is unsure if it will be mature by the time you do the IUI? Most REs would like to see it measure at least 18mm.

riveridgional · October 2015

@bsckgb7 My doctor told me something g similar. He said the highest your chance of pregnancy will be on Clomid is 10% (I'm assuming this would also be the case for Femera). With injectables, your chance rises to 20% - finally on even playing ground with a perfectly fertile couple! I believe the general rule is not to try the same thing over 3 times as your chance of pregnancy drops signficantly after the 3rd (I believe just by virtue of the fact it hasn't worked yet).

bsckgb7 · October 2015

riveridgional - we must have the same RE!! Mine switches after 3 too!!

misshopeful1 · October 2015

The nurse called me back and IMO she was rude. She seemed annoyed we decided to cancel IUI. I asked about changing meds and she cut me off, telling me to be positive and that can be addressed if no BFP. She said no injectable because I'm on lowest grade femara.
I told her I had the right to ask questions and asked she let me talk.
Because of work idk if I can leave for day 21 progesterone which only thrilled her further.
This is the only RE in our area, not like I can change doc. Even though there are 2 docs nurses are same.
Rage attack.

bsckgb7 · October 2015

You need to make an appointment with the doctor and discuss changing up the protocol with him. Sorry your nurse sucks.

babyexpress · October 2015

misshopeful1 said:

The nurse called me back and IMO she was rude. She seemed annoyed we decided to cancel IUI. I asked about changing meds and she cut me off, telling me to be positive and that can be addressed if no BFP. She said no injectable because I'm on lowest grade femara. I told her I had the right to ask questions and asked she let me talk. Because of work idk if I can leave for day 21 progesterone which only thrilled her further. This is the only RE in our area, not like I can change doc. Even though there are 2 docs nurses are same. Rage attack.

I'm not understanding this part. They cut me back to the lowest dosage when I went on injectables, essentially cut my dosage in half. I'm so sorry they were being rude. This whole process is so stressful, so the last thing you need is to feel unimportant by your RE. >:D<

vssbrm · October 2015

That is so frustrating. Let it roll off your back and set up an apt with the doctor to discuss your next steps. You have to do what is right for you, not matter what the nurse thinks! This is hard enough with out everyone else's opinions.

bsckgb7 · October 2015

I agree with babyexpress. Obviously, the lowest dose Femara isn't working. So either up the dose and switch to Follistim. Typically Follisitm is for 6 days. I tend to get ready really early so they brought me a day early and I skipped the last dose. So if they are are concerned about over-stimulation on Follistim, they have ways to check that.

babyexpress · October 2015

@bsckgb7 exact same thing happened to me. RE told me to skip last dose so I wouldn't over stimulate. I ended up taking the last injection the day of trigger, which was day before IUI, once they saw how many follies I produced.

misshopeful1 · October 2015

Thank you everyone for feedback! We did cancel iui. Office is closed now but we'll make an appt with doc to discuss new plan/treatment. I believe we'll be done with femara. I'm interested in these injectable and/or clomid.
Thanks again. I'm still upset but not as furious.

babyexpress · October 2015

@misshopeful1 well watch your temp everyday and do TI instead.

tripledaggerWed95976 · October 2015

Sorry ur struggling with this :-( I can certainly understand ur frustration. Since going through with this months iui would be $400, my personal opinion would be to pass on this month and start injectibles next month. Personally I have little faith in IUI. I have 3 failed iui cycles under my belt and all DH and I had was a slight problem with his motility (it was about 30%). IMO, if ur gunna go the IUI route, definitely push for injectibles so u can give ur self the best chance possible :-)

bsckgb7 · October 2015

misshopeful1 - Clomid and Letrozole are both oral mediciations. I would go ahead and head for injectibles. Clomid can have some pretty nasty side effects.

misshopeful1 · October 2015

@bsckgb7 what's your opinion of injectables? I asked someone else about side effects and would like input on what to expect.

bsckgb7 · October 2015

I've been on them for 2 cycles. I think some ladies have side effects just because it's extra hormones. Maybe some moodiness, hot flashes, stuff like that. Nothing major. I don't personally have any side effects (other than the bruising). It's the Progesterone suppositories that are killer. They give you pregnancy symptoms (nausea, starvation, etc).

mclorn · October 2015

So sorry you're having a sucky Friday

I've had 3 IUIs and the only time I got BFP (although CP) was with a lonely single follicle, so BD away and it could happen!

misshopeful1 · October 2015

@mclorn sorry to hear of your cp! I'm just ready to get home! It's been a tough day. I'm this lady who cries in her office ugh (albeit discreetly as possible).

@bbsckgb7 hm. I feel so emotional as is. But I feel I need to keep pursuing different options. What about these suppositories? I have good progesterone levels, wonder if I'll still have to use?!

mclorn · October 2015

I'd be surprised if anyone here has NOT cried in her office! UGH!

bsckgb7 · October 2015

misshopeful1 - I think it depends on doc. I did Letrozole/Femara for 3 cycles with no suppositories and had good Progesterone each time. When I was switched to Follistim, the Progesterone was automatic. I had my 7DPO labs and Progesterone was over 30. I still continued the Progesterone. The suppositories supposedly don't show up in bloodwork, so that 30 wasn't the suppositories.

I think my RE just does it with the injectibles automcatically to kinda throw everything at you hoping something works. The progesterone helps make your Ut nice and comfy-cosey. Not all REs do that. There's a thread near the top about Progesterone where lots of ladies are talking about that.

KidShrink · October 2015

@misshopeful1 : another option is a combo of Femara and Follistim, which is what I did on my succesful cycle. I previously had 3 cycles of 5mg Femara which were unsuccessful despite 2-3 good follies each time. Then I had a lap in July as well, and despite our PCT being perfectly fine, we told our RE (with me bawling in his office) that we wanted to take things one notch up after the surgery, to which he agreed. So we did 5mg of Femara days 3-7, and 75 IU of Follistim days 6-11, with my IUI on day 13 as I was having my LH surge at my day 12 monitoring. On day 12, I had one 19mm on the right, and two 15mm on the left, so we though I'd have one extra day. Turns out it didn't go that way, and so we know for a fact I had only one good follie.

I'd agree that after 7 cycles of Femara with no change and no pregnancy, you need to sit down with your RE and see what's his plan, but also tell him what you want. I had bitchy nurses too, but the RE always saved the day. Best of luck to you!

misshopeful1 · October 2015

@KidShrink good info! I like idea of combo femara and injections. My dose is 2.5 days 3-7 of femara. It does get tricky with work and having to ask for time off etc. Is there extra monitoring involved with shots?
@bsckgb7 I do wonder how doc will want to address all those issues.

KidShrink · October 2015

I was monitored quite closely with Femara only (CD3, then usually every day from CD9 on to trigger, which was CD12 or 13). This time, I had CD3, CD6 (before starting injects), CD9, CD11 and 12 (we skipped CD10 this time because growth was slower, which I found discouraging, but it all worked out). As PPs have said, injects are supposed to lead to better quality follies, so just that might do the trick. Are you able to go to work after your monitoring? I guess having to take time off all the time would be super inconvenient, but the monitoring is SO important (I feel like I've seen so many people trigger when they have follies have 15-16mm because that's their schedule/the RE isn't opened on weekends for IUI, and I'd run away from any clinic that runs on their schedule and not your body's).

bsckgb7 · October 2015

I had an extra day of monitoring with the shots because on Letrozole, I would get ready really early (we almost missed O once). So on Follisitim we did monitoring extra early (with the intention of having 2 appointments). The first cycle, I was close and came back the next day (so 1 extra day of monitoring). This past cycle I was ready (on the "early" appointment) and only had the one day of monitoring. So for me personally, I had no extra monitoring on Follistim.

misshopeful1 · October 2015

@KidShrink yes I go back to work after appointments. I just feel bad for any inconvenience, etc. My follie was 16 mm but they didn't want me to trigger until late Sunday night and iui would have been Tuesday.
I can appreciate being monitored. I will likely give my boss a heads after we meet with RE and have a better idea of what to expect.
I appreciate your input.

KidShrink · October 2015

You're welcome!! I'm lucky to be self employed, so I just had to push an appointment with a client the day of my IUI and get up earlier on the other days. I had lots going on in the months prior to this cycle, and so when we decided to go with more 'intense' treatment, I decided to ditch a few projects to make baby-making my priority. It's definitely harder to do that when you have a boss, but my experience (from when I was employed) is that people get it when you explain a bit. You should have no reason to feel bad for this! Best of luck to you!

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