IF/Testing Check in Wk 3/6

leekat14 · March 2017

I'm so glad you guys are here and people ask questions. So hold the presses...My obgyn have me a clomid script this week. We've already gone through testing for DH, I've had a hsg and laproscopy to remove endometriosis. Got an ultrasound this week, get another mid cycle after taking clomid and potentially get a trigger shot. Should I be concerned it's my Obgyn giving me this? Now I'm freaking out!

[Deleted User] · March 2017

@leekat14 I reallllly recommend seeking out an RE asap if you want treatment. What is your OBGYN's protocol for monitoring?

In general, trust an OB for paps, pregnancy, and deliveries. For infertility treatment always go to the RE.

kiki75 · March 2017

@TravelingCouple It's too bad you can't both just get a little toasted and talk it out. In the absence of that, maybe you could still meet up. People who haven't been there don't get it. But the way they start to get it is by hearing it from people they know or reading about it. Try sending her articles here and there that speak to you. I think this one is a good one: https://nymag.com/thecut/2016/09/ask-polly-why-do-women-obsess-about-babies-and-fertility.html And, try opening the lines of communication about other things. The stuff you would have talked about five years ago.

@hartmich Frankly, she should be happy you're sharing with her. A lot of people just flat don't share until later. I'm with @leekat14 I might tell my mom. Because she's pretty good with boundaries. H's mom, no effing way. She's super inappropriate. I think we weren't even engaged when we would leave family functions and she would holler, "Go make babies!" Not even kidding.

@wabash15 Thank you for remembering.

In all, it was good. AMH is just a titch below normal and motility is just a little below normal but she seemed pretty confident that we'll be able to get pregnant one way or another. We drew blood for a thyroid retest because she's thinking that she wants to bring my TSH down but my last test was a year ago, checking immunity for a couple things... some other stuff that I've forgotten now. If nothing we learn along the way changes the plan, we'll schedule an HSG next cycle, and then the next we'll move to medicated IUIs. Do three of those and then regroup. So, we have about a four-month plan for now. Which makes me feel a lot better.

@LoveInDC Did you already swap OB/Gyn's? Or was that someone else? Personally, even if you do end up with an RE, I might think about switching. It doesn't seem like you and she click. From here, it seems like she's more one to talk at you than to use her knowledge to talk through things with you and guide you, you know? I might give it a little more time to see if it's just a BCP regulation issue or if it's something more. Depending on how your insurance is, you may do well to have the initial testing done through an OB/Gyn as part of irregular cycles instead of infertility. But yes, if I were you, I would be running out of patience with this.

And, FWIW, my sister also has PCOS with very few of the symptoms.

LoveInDC · March 2017

@Kiki75 I started seeing this OBGYN in January. I loved my last one, but she's now 2 hours away on a good day (4 on a bad). I know I need someone local. This OB and I seem to click when it comes to pregnancy philosophies, but now that you mention it, she is very aggressive with the talking at v talking with. Ugh. There aren't many OBs around covered by insurance that deliver at my prefered area hospital (unless I want to drive 45 minutes to the city). We'll see how she is moving forward. But thank you for the insurance reminder. I do not need a referral, but IF isn't covered by my insurance. I'll make sure they code any testing correctly.

Everycol0r · March 2017

leekat14 said:

I'm so glad you guys are here and people ask questions. So hold the presses...My obgyn have me a clomid script this week. We've already gone through testing for DH, I've had a hsg and laproscopy to remove endometriosis. Got an ultrasound this week, get another mid cycle after taking clomid and potentially get a trigger shot. Should I be concerned it's my Obgyn giving me this? Now I'm freaking out!

If they are giving you proper monitoring, which is sounds like they are, I might be inclined to not freak out so much. It seems like your OBGYN at least understands fertility protocol and may have even done a fertility fellowship. All RE's are also OBGYN's but not all OBGYN's are REs.

The big big thing with fertility medication is proper monitoring.

That being said, they're not the expert and at some point if you don't get KU they are going to refer you on. You may have to repeat all those tests. What is it worth to you?

wabash15 · March 2017

@leekat14 I second @Everycol0r it sounds like you are being monitored which is the biggest thing but OB's are trained to keep you pregnant and RE's to get you pregnant.

leekat14 · March 2017

wabash15 said:

@leekat14 I second @Everycol0r it sounds like you are being monitored which is the biggest thing but OB's are trained to keep you pregnant and RE's to get you pregnant.

stuck in a box @wabash15 and @Everycol0r ....Phew. I do feel better. I also immediately went to google his background and it does seem that he has a lot of background with fertility issues. He stressed all of the internal ultrasounds and booked appointments but also began discussions of where he would refer me if IVF becomes our the next step. Fortunately there don't currently seem to be any issues other than my endometriosis. DH is fine and I do ovulate on my own.

leekat14 · March 2017

And I'm not trying to feed the crazy but I was supposed to get my period today and no sign of it at all. Many months I've already been spotting for 4 days but this month nothing. Obviously because I picked up the clomid script I am probably KU. Someone needs to calm me down! (I'll take a test tomorrow...)

eggplantface · March 2017

leekat14 said:

And I'm not trying to feed the crazy but I was supposed to get my period today and no sign of it at all. Many months I've already been spotting for 4 days but this month nothing. Obviously because I picked up the clomid script I am probably KU. Someone needs to calm me down! (I'll take a test tomorrow...)

The last time I "calmed" someone down they ended up being pregnant....so CALM DOWN you're totes not pregnant!

Image: https://p.fod4.com/p/media/4c92bfde64/rCcrn8zgSFWvWmlyqZ2R_w5.gif

kiki75 · March 2017

@eggplantface TODAY IS THE DAY!!!! Yay!!!

eggplantface · March 2017

@Kiki75 I'm impressed by everyone's memory here! I'm excited yet terrified I'll do it wrong.

Sidenote: H went to pick up the needles yesterday at the pharmacy and I texted him exactly what I needed, spelled phonetically ("Men-oh-pure supplies"). So he walks in, says "My wife is doing the IVF thing and she has Menopur but needs the supplies." So they just went and grabbed the needles and gave them to him, and he asked what he owed and they said they were included. Well, I didn't buy the Menopur from them, my friend had a ton left over from her cycle and gave them to me. So H called me and told me they were "included," and I said I didn't buy the drug there. So he asked if he should go back in and tell them I didn't buy Menopur from them, and I said "Are you crazy??" So free needles.

tamalahoops · March 2017

@eggplantface Good luck! It becomes second nature after about 3 days. I only had one bad stick and it was because I was rushing before work.

TravelingCouple · March 2017

@eggplantface Yay for free needles!

TravelingCouple · March 2017

My period came today, not unexpected. So now I'll go in Monday for the initial blood work and ultrasound before starting Femara and my first full medicated cycle. I am looking forward to seeing how it works for me!

Everycol0r · March 2017

TravelingCouple said:

My period came today, not unexpected. So now I'll go in Monday for the initial blood work and ultrasound before starting Femara and my first full medicated cycle. I am looking forward to seeing how it works for me!

Did you call your doctor? If CD1 is today then Sunday would be CD3, which is usually when you start Femara.

hartmich · March 2017

@travelingcouple Sorry for AF, but if it means a new cycle with new treatments, I hope that's a silver lining.

So we had our RE appointment yesterday, and it went even better than I hoped. I liked her even more than the first time I met her, and we are pretty sure we're going to go straight to IVF. After discussing it at length with her, she left the choice of IUI or IVF up to us. She said the best odds of the IUI would be 15% (or lower depending on the count after the wash), and IVF would be around 59%. So I think we're going to start BCPs at the beginning of the cycle after next, which would be around May 1.

I'm also starting Metformin right away, which is a little scary because of the side effect stories, but I hope my body will handle it okay. H is also starting a supplement that may help counts, and we're just excited to move forward.

Now onto more waiting.... I'm so grateful for this board because I have no idea how else I'd pass this time!

leekat14 · March 2017

@hartmich yay! I'm sure it feels good to be moving forward-the wait is a little less painful.

@travelingcouple woo hoo! If my period ever shows I'll be starting for my medicated cycle too! It was supposed to start yesterday but hasn't and it was a BFN this morning. Boooooo

laurad75 · March 2017

@hartmich That's really exciting. Oh the waiting, so much waiting.

magnolia131 · March 2017

@TravelingCouple I'm sorry for CD1 but yay for starting your medicated cycle! I hope this is the one for you.

@hartmich do you know if you're taking the extended release Metformin (XR) or the regular one? I found that the XR helped with offsetting the GI side effects. It also helps to take it in the middle of a meal instead of at the beginning or end. I'm on 1500mg (three 500mg pills) but my doctor advised taking only 500 the first day, 1000 the second day, and then finally 1500 daily starting on day 3 so that my body could better adjust. It hasn't been TOO bad. Just be careful about what you eat when you take it and do NOT mix it with even a little bit of alcohol because I've read that will make you miserably ill.

Again, I'm so excited for you! We are also in the midst of debating whether we wish to skip medicated IUI and go straight to IVF or not- our doctor wasn't as keen on the idea but we are getting a second opinion on that and a couple of other things the first week of April. It's a tough call but being OOP, we really do want to maximize our chances.

Bababatty · March 2017

Everycol0r said:

TravelingCouple said:

My period came today, not unexpected. So now I'll go in Monday for the initial blood work and ultrasound before starting Femara and my first full medicated cycle. I am looking forward to seeing how it works for me!

Did you call your doctor? If CD1 is today then Sunday would be CD3, which is usually when you start Femara.

This isn't always true and I think it depends on the practice. My practice starts clomid/letrozole/femara any time between CD2-5 depending on when you make it in for your u/s.

Sorry about CD1, @TravelingCouple, but good luck with this cycle!

[Deleted User] · March 2017

So exciting @hartmich!! I'll be starting BCP in May as well

seethosestars · March 2017

lurking... @hartmich - I took metformin for a few months when my GP thought I had PCOS (turned out to be way off base but that's okay)... I took it really slowly, increasing my dose every WEEK and had no GI issues. Definitely take it in the middle of your meal as @magnolia131 suggested as that helped me too. I found if I had an excessively carb-loaded meal (ie. pizza and then cake) I had issues but was otherwise fine. Good luck! I suspect many many people take metformin without difficulty and we only hear about the bad cases haha.

wabash15 · March 2017

@TravelingCouple i'm sorry for CD1 but so excited for you to start a medicated cycle. GL with your US on monday

@hartmich I am so happy for you, and its great that your really happy with your RE.

@eggplantface and @laurad75 how are you doing with your stims?

TravelingCouple · March 2017

Thanks ladies, I do feel hopeful.

@Everycol0r My RE said I could wait until Monday as my local office is closed on weekends and their satellite office is two hours away. She CD 4 is still fine and they start Femara up to CD 5.

I'm so excited for you @hartmich!

laurad75 · March 2017

@wabash15 I haven't started stims this round yet but in anticipation, I am super relaxed about it. Last time I had a whole lab set up in our guest bathroom with everything organized and all the instructions handy. This time, I'm all 'whatever - I'll just inject in the kitchen or wherever its convenient'.

hartmich · March 2017

@magnolia131 thanks for the tips! We are on XR and they recommend increasing it after a week! So hopefully it'll be alright. I wasn't sure what our doctor would say about doing IUI or IVF first because I sort of thought she'd push for IUI first (since that seems so common). But once we heard the the low success rates, H and I were shocked. And she was very open about what we wanted and said it's different for every couple, and there's no right answer.

@antoto IVF buddies!! Yay!

Everycol0r · March 2017

Bababatty said:

Everycol0r said:

TravelingCouple said:

My period came today, not unexpected. So now I'll go in Monday for the initial blood work and ultrasound before starting Femara and my first full medicated cycle. I am looking forward to seeing how it works for me!

Did you call your doctor? If CD1 is today then Sunday would be CD3, which is usually when you start Femara.

This isn't always true and I think it depends on the practice. My practice starts clomid/letrozole/femara any time between CD2-5 depending on when you make it in for your u/s.

Sorry about CD1, @TravelingCouple, but good luck with this cycle!

I said usually, I know it can be taken other days. Same with Clomid. I just was curious if she had called the dr given that it is her first medicated cycle. I didn't realize I needed to call mine my very first medicated cycle.

ETA: letrozole/Femara are also the same drug BTW.

vintageandrea90 · March 2017

I'm not sure if it's a US thing, but I think it's crazy that people are able to choose IVF so quickly! It's cool that you get that choice. For us, they go from least invasive to most invasive. I don't even know if we can just choose IVF before IUI.....we have to do 3 medicated cycles with timed intercourse, if that doesn't work we move on to IUI and do a few cycles of that....if that doesn't work then we start discussing IVF. At least that's how I understoof it. Luckily for us in Canada most of it is covered, I think we have to pay $500 for IUI and I'm not sure for IVF...some things are covered. But for meds and timed intercourse we don't have to pay anything (except the trigger shot because my insurance didn't cover it). I can see that if you have to pay for everything you'd want to just go with the best chance option right off the bat.

Bababatty · March 2017

Everycol0r said:

Bababatty said:

Everycol0r said:

TravelingCouple said:

My period came today, not unexpected. So now I'll go in Monday for the initial blood work and ultrasound before starting Femara and my first full medicated cycle. I am looking forward to seeing how it works for me!

Did you call your doctor? If CD1 is today then Sunday would be CD3, which is usually when you start Femara.

This isn't always true and I think it depends on the practice. My practice starts clomid/letrozole/femara any time between CD2-5 depending on when you make it in for your u/s.

Sorry about CD1, @TravelingCouple, but good luck with this cycle!

I said usually, I know it can be taken other days. Same with Clomid. I just was curious if she had called the dr given that it is her first medicated cycle. I didn't realize I needed to call mine my very first medicated cycle.

ETA: letrozole/Femara are also the same drug BTW.

Yes they are, but some don't realize that, which is why I listed them both out.

laurad75 · March 2017

@vintageandrea90 I don't that it is necessarily a 'US thing' but more dependent on insurance requirements and the opinion of the RE. In my case, I am 41 and have a 'very low' AMH level so my RE advised we be more aggressive after just a few medicated cycles (I had one IUI in that time) since we are racing the clock.

TravelingCouple · March 2017

Yep called the doc this morning. Thanks for looking out @Everycol0r @Bababatty

Yeah for us we could've gone straight to IVF but none of IF (not even diagnostics) is covered by our insurance.. So we wanted to take the slowest and least invasive route possible to try every angle before considering IVF.
@hartmich hopefully your insurance is covering IVF at least partially!

All IF treatment should be mandatory to be covered by all insurance. It's maddening how expensive it is to have a baby because just having sex doesn't work for some people.

[Deleted User] · March 2017

vintageandrea90 said:

I'm not sure if it's a US thing, but I think it's crazy that people are able to choose IVF so quickly! It's cool that you get that choice. For us, they go from least invasive to most invasive. I don't even know if we can just choose IVF before IUI.....we have to do 3 medicated cycles with timed intercourse, if that doesn't work we move on to IUI and do a few cycles of that....if that doesn't work then we start discussing IVF. At least that's how I understoof it. Luckily for us in Canada most of it is covered, I think we have to pay $500 for IUI and I'm not sure for IVF...some things are covered. But for meds and timed intercourse we don't have to pay anything (except the trigger shot because my insurance didn't cover it). I can see that if you have to pay for everything you'd want to just go with the best chance option right off the bat.

It really depends on your age/diagnosis/the attitude of the RE. My RE let me skip straight to IUIs instead of doing 3 months medicated with TI. Part of that was because we knew that I did sometimes ovulate on my own but I still wasn't KU. Also part of it was because my parents wanted me to do IUI and offered to help pay for it. REs often do the typical 3 TI, 3 IUI, and then IVF because IVF is so invasive and expensive and some women just need a teeny bit of help. My sister got KU on her second medicated TI cycle, but after 3 IUIs I'm still here so it's different for different situations. So glad I skipped the TI. That would have been a waste of my time. And I sort of wish I had magically known to just skip the IUIs and go straight to IVF because it would have saved me a ton of money and a lot of stress. But if you have reason to believe that it's your only chance and you're willing to fork over the money then I think that's fine.

hartmich · March 2017

@vintageandrea90 we have ridiculously amazing insurance that covers everything without having to try IUI first, etc. But I think I'm in the minority on that. If we didn't have the diagnosis we do, I'm sure our doctor would have different recommendations as well.

eggplantface · March 2017

vintageandrea90 said:

I'm not sure if it's a US thing, but I think it's crazy that people are able to choose IVF so quickly! It's cool that you get that choice. For us, they go from least invasive to most invasive. I don't even know if we can just choose IVF before IUI.....we have to do 3 medicated cycles with timed intercourse, if that doesn't work we move on to IUI and do a few cycles of that....if that doesn't work then we start discussing IVF. At least that's how I understoof it. Luckily for us in Canada most of it is covered, I think we have to pay $500 for IUI and I'm not sure for IVF...some things are covered. But for meds and timed intercourse we don't have to pay anything (except the trigger shot because my insurance didn't cover it). I can see that if you have to pay for everything you'd want to just go with the best chance option right off the bat.

It's a "Canada has better health insurance options" thing

Some insurance companies, if you have IVF coverage at all, require you to do a certain number of TI or IUI cycles before they'll cover IVF. Because I have zero ART coverage I decided it was better to spend the money on IVF than IUI cycles.

First night of stims went well! I did it in the living room in front of the computer with the video showing me the steps. After I was done and cleaned everything up, H goes "Are you not doing the shots tonight?" I said "I just did them." He goes "Sitting at the table??" As opposed to the sterile operating room in our basement? What the hell is he talking about?

I felt a little strange after the shots but had no issues with sleeping like I did after Ovidrel.

That reminds me, I have a question: Do you have to do them at the same time every night? Or if I were to do it at 8pm one night and 11pm the next night, is that ok? I never thought to ask my nurse that.

[Deleted User] · March 2017

@eggplantface yay first night of stims!!! I'm so nervous for that...

@hartmich Welllll right after I wrote that to you my district sent an email saying we are switching health insurance companies during the summer... so I think I might bump up my IVF so I don't have to deal with swapping halfway through treatment. Also the new company doesn't even cover any diagnostic work, unlike my current one. Sigh.

eggplantface · March 2017

@antoto I still had that moment of having to psyche myself up for the injection, but, as with the Ovidrel, I didn't even feel it. I was nervous about mixing the menopur correctly though!

tamalahoops · March 2017

@eggplantface I was doing Gonal-F and microdose HCG and I was told to do them at the same time every night. My husband was an insane person about doing them at the same time down to the minute. The cetrotide had to be done less than 24 hours when I added that. So I did it in the morning and pushed it back 30 minutes every morning. First one at 9:00, next day at 8:30 and so on and so forth.

vintageandrea90 · March 2017

@laurad75 @antoto @hartmich @eggplantface Thanks for your responses! I guess it was a pretty blanket statement....that's what they're doing for me and my situation...but it's true that everyone has a different situation so they suggest different routes to different people!

[Deleted User] · March 2017

eggplantface said:

@antoto I still had that moment of having to psyche myself up for the injection, but, as with the Ovidrel, I didn't even feel it. I was nervous about mixing the menopur correctly though!

Yessss mixing is the worst part. When I had to mix some Gonal-F I was shaking so hard from anxiety. When you know how much this shit costs (money and you know... the potential of making a baby) it suddenly feels like having to defuse a fucking bomb.

kiki75 · March 2017

TravelingCouple said:

Yep called the doc this morning. Thanks for looking out @Everycol0r @Bababatty

Yeah for us we could've gone straight to IVF but none of IF (not even diagnostics) is covered by our insurance.. So we wanted to take the slowest and least invasive route possible to try every angle before considering IVF.
@hartmich hopefully your insurance is covering IVF at least partially!

All IF treatment should be mandatory to be covered by all insurance. It's maddening how expensive it is to have a baby because just having sex doesn't work for some people.

And yet they're still debating about if these poor picked on dudes actually have to pay for insurance that covers prenatal/maternity care. Mandatory IF coverage is probably a long way away.

https://www.washingtonpost.com/news/powerpost/wp/2017/03/09/is-that-not-correct-male-gop-lawmaker-asks-why-men-should-pay-for-prenatal-coverage/?utm_term=.e80547b16194

IF/Testing Check in Wk 3/6

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