IF testing/treatment w/o 1/25

kiki047 · January 2021

This is a place for those of us who have already started TTC, but have started infertility testing and/or treatments. You can express your thoughts, feelings, and frustrations on infertility. TTC can be a long journey naturally, then add in the difficulties associated with infertility, and it becomes a whole new ball game. The road to infertility can be lonely, frustrating, and complicated, so let's make this a place where we can vent, ask questions, and support one another. Feel free to resurrect this thread at any point in the week if you have something to say. Treat this as an ongoing conversation.

Diagnosis (if you've been):

Status (WTO/TWW/TTA):

What are you doing this cycle? (Testing? Treatment?):

How are things going?:

Any questions?:

GTKY: If you could live in any fictional house (with or without the fictional people that live in it), what/where would it be and why?

kiki047 · January 2021

After an extended break, I hope it's ok that I pop back in here.

Diagnosis (if you've been): PCOS, MFI

Status (WTO/TWW/TTA): WTO (CD2)

What are you doing this cycle? (Testing? Treatment?): FET #3, last frozen embryo before we start all over again

How are things going?: Honestly, I'm stressed. TTCAL really messes with your head, and IF has eroded all my trust in my body to do what it's supposed to. That said, my RE is very cognizant of my trepidation in the process so he is doing some extra hand-holding this time around. Went for my baseline US this morning, added in some nasty chinese herbal supplements from my fertility naturopath that's supposed to help with blood flow to the uterus, along with L-arginine.

Any questions?: Anyone that's taken L-arginine in the past, I was told I need 6g but did you take yours in one dose daily or divided? I could only find 500mg pills so I need to take 12 of them a day (woof!) and I'm unclear on whether that should be all at once. Also, did it give you hot flashes? I've only ever had hot flashes like this on letrozole and when I was doubling up on my progesterone, neither of which I'm taking right now.

Image: https://media.giphy.com/media/8izoYfztxj9Ac/giphy.gif

GTKY: If you could live in any fictional house (with or without the fictional people that live in it), what/where would it be and why? I didn't think of an answer to my own question when I posted that so I need to think about this for a minute. As a throwback to my childhood, Hallie's Napa estate in The Parent Trap (yes, the Lindsay Lohan one) was kind of amazing because it came with its own vineyard and stable.

misshelen86 · January 2021

@kiki047 Happy to see you back here! Hoping so hard this FET will give you your THB. If anyone deserves this, it’s you

I took L-arginine and divided it 3 500 mg pills 4 times a day. It’s a lot! I started getting heartburn, which is something I had never experienced in my life. Google tells me that higher doses can cause this. I ended up lowering my dose after my lining check, since my lining was ok. I had no headaches or hot flashes! Are you doing anything else different this time?

photographerwife · January 2021

@kiki047 I’m sorry that you’re stressed right now.. praying and sending all the good vibes that this is the one for you! I’m glad that your RE senses your feelings and is being helpful this time around and I hope the herbals aren’t too bad! That house sounds so dreamy!

Hello, I’ve been a little Mia in the group for a while, so I hope it’s okay if I hop on here.

Diagnosis (if you've been): unexplained secondary IF? And I only have one tube after an TW: ectopic loss END TW in December/January 2019/2020

Status (WTO/TWW/TTA): WTO

What are you doing this cycle? (Testing? Treatment?): I have an appointment with my ob Wednesday to get started on a follow up appt for general fertility. I’m not sure what they’ll do right now, but they do want to see me for an HSG soon.
The office did some bloodwork last year, progesterone, testosterone, and thyroid which all were normal.

How are things going?: Okay, ttc had been so heavy lately, and getting to this point is kind of sad. But I’m just hoping this is a good next step. I’ve really taken a step back on posting and tracking so much lately. I suppose I need to get back to it.

Any questions?: not really, but if you have any suggestions for questions for ob that would be nice:)

GTKY: If you could live in any fictional house (with or without the fictional people that live in it), what/where would it be and why?

It would be cool to live in some of the homes from game of thrones, I love the castles and scenery! But I’d need people to help man the place, so let’s just not have all the murder instead. 😅

kiki047 · January 2021

@misshelen86 he always starts me on the same protocol and adjusts it as needed. The difference will be that he's going to monitor me more closely so we can act sooner. Normally I don't go back until CD10, and for my 1st FET on CD17 that was almost too late to make any last-ditch efforts to improve my lining at that point, and my 2nd US for my 2nd FET on CD22 wasn't until CD 16, so same idea. I did acupuncture leading up to FET #1 but not #2 because of covid, so I'll be doing that again this time. I'm going to ask about the HGH study that @keikilove sent me too. Thank you for the tips on the L-arginine, splitting it up into multiple doses sounds much more manageable.

@photographerwife welcome back - not that I'm happy to see that you're still here with us, but hopefully you know what I mean. There's an old thread that has a long list of questions to ask at your first RE's appt, but some of them may apply to an appt with your OB too. Maybe this will be helpful? https://forums.thebump.com/discussion/12710304/what-to-ask-at-your-first-re-appointment

inthewoods23 · January 2021

*hello just popping in for my girl @kiki047*

My dosage (also 6g) was divided into 3 for 2g 3x a day. My RE specified the Now Foods brand L-arginine and they do have a 1000mg version so it was 2 massive pills 3x a day. It says they should be taken on an empty stomach so I'd take the first dose shortly after waking up, the next around 3-4pm, and the last around 8-10pm right before bed. I don't recall getting hot flashes. Good luck!

acleverusername · January 2021

*popping in briefly to drop in some advice for @kiki047; will be back for more tags and to post my update sooooon*

@kiki047 The Egg Whisperer answered another lining thickness question in one of her shows last week. Questions starts at 20:39.

https://www.instagram.com/p/CKVHtv1hftB/

acleverusername · January 2021

Okay, back to regularly scheduled programming.

@kiki047 Yay! So happy that you've been "unblocked" and starting your FET! I am PRAYING that this will be your sticky THB. 🙏🏻🤞🏻I've said it before, and I'll say it again: it's so wonderful that you have such a supportive RE in your corner. What are the nasty Chinese herbs that you're taking? Have you ever tried Castor Oil compresses to increase blood from to uterus? They're a bit messy and I really don't know if they work, but can't hurt right?

@photographerwife welcome back, though sucks to see you in the IF thread.

Regarding the questions, the link @kiki047 shared is great; that's where I started from with my RE back in July. The most "impactful" question is having a timeline in your head and asking "what would our treatment plan look like if we want to be pregnant by x month?" It really gets the conversation going. And obviously, you're not committing yourself to a deadline with that question.

@inthewoods23 & @misshelen86 👋🏻

Diagnosis (if you've been): Unexplained / AMA (I had "hypoandrogenic PCOS here previously but after my 2nd opinion consult last week, I'm dropping it because I feel like it's a really bad diagnosis, not supported by anyone except that one doctor in NY.)

Status (WTO/TWW/TTA): WTO

What are you doing this cycle? (Testing? Treatment?): Combo IUI (Letrazole + Menopur), saline sono (DONE), 2 x 2nd opinion consults (1 DONE; 1 next week)

How are things going?: Still good. I had my monitoring ultrasound this week and will more than likely trigger tonight. Still only 1 follicle at 21.4mm (I don't think my RE knows how to achieve superovulation unless we do an injectable round), but my lining was at 8mm! That's the best it's been since my very first medicated cycle in August. So, hopefully all my hormones check out (still waiting for that call) and we can proceed. IUI will likely be on Wednesday. And hopefully MH's sperm will be "sparking" again. 🤞🏻

Any questions?: It's more of an ask for recommendation... putting context in spoiler because it's loooong.

I'm questioning my RE's experience. She hasn't provided a satisfactory question to some of the questions I've asked her. For example, my Vit D is currently below normal range (range is 33-100; I'm at 30.2) and my RE doesn't seem to think it's an issue. She said: "Endocrine Society recommends levels of 25-35, so you're fine." Never mind that my level actually decreased from July to December, even though I added a 5000IU supplementation in July. The RE in AZ right away said: "it sounds like it's an absorption issue." Also, her recommendation for an IVF protocol is standard antagonist protocol because, in her words, "it works in 90% of the cases." It is VASTLY different from the protocol the RE in AZ recommends (really aggressive with priming because I tend to develop a lead follicle early on in my cycle). Anyway, over the weekend, I ended up looking her up on LinkedIn and turns out that even though she's mature, she's only been a practicing RE for 4 years (she's done a lot of education / certification and practiced in Turkey for many years.) In contrast, the doctor in AZ has been practicing for 8 years, and he's the medical director at his current clinic. The other things that feels "off" to me, is that my clinic is new, and doesn't have any SART scores or any success rates really. I've asked for some unofficial stats, and they haven't been able to provide those either. Also, of their embryologist, I just got "she used to work at a very busy fertility clinic in Baton Rouge" and "I would trust her to do my ER if I was doing it" and "I sometimes get emails from external testing laboratories with accolades for her". And these are all great qualitative feedback, but I'm just uneasy with the lack of quantitative feedback. Am I just looking for a reason to not do my IVF cycle where none exists? Or are these legitimate concerns?

GTKY: If you could live in any fictional house (with or without the fictional people that live in it), what/where would it be and why? I have to go with one of the houses in Big Little Lies. This one for example: https://www.realtor.com/news/unique-homes/carmel-coastal-compound-big-little-lies-52m/

quiltandknit · January 2021

@kiki047 yay for FET and glad your RE is supportive of your feelings.

@photographerwife awww sorry to see you're back here. I also have unexplained secondary IF. My guess is your OB would want to repeat BW and HSG if it's been more than a year.

@acleverusername yay for a good follicle and happy lining! Yay for IUI this week! and OMG Big Little Lies houses! Yes yes yes! I would say trust your gut on your RE--if you had a good feeling from the dr in AZ, I'd go with it.

Diagnosis (if you've been): unexplained (secondary) IF

Status (WTO/TWW/TTA): TWW

What are you doing this cycle? (Testing? Treatment?): We did labs, HSG, and SA at the beginning of the cycle, OPK and tried naturally. Today we had our consult for our options. As I expected, my RE wants to do 3-4 Clomid + IUI cycles. However, he also said IUI + Clomid only have a 15-20% success rate for women my age (31). Seems low to me from what I've read but I'll trust him if he thinks this is where we should start. So I have all my info if we aren't successful this month. We're starting Clomid 50mg days 3-7, then OPKs in the afternoons starting on day 10, I'll call when I see the LH surge and the IUI will be the next morning.

How are things going?: Trying not to get my hopes up too much because last cycle I did that (hoped for a Christmas miracle) and then felt completely crushed. Just trying to stay busy since I still have another week before testing/AF. Feeling like our timing has been much better with the OPKs the past couple of months so maybe we have a chance?

Any questions?: No questions. The IUI process seems pretty straightforward.

GTKY: If you could live in any fictional house (with or without the fictional people that live in it), what/where would it be and why? I was gonna say Big Little Lies. Hmmmm....probably some of the ones on Fixer Upper! So light and open, but cozy and home-y at the same time.

gingermama29 · January 2021

Popping in to offer some love and support. I'm currently benched for 2-3 months and mostly sticking to TTCAL so I probably won't participate in this thread a lot during that time but I still wanted to lurk and give support.

@kiki047 sending you all the positive vibes in your FET! And I love your house choice. That place is gorgeous and sign me up for having my own vineyard.

@photographerwife I'm sorry ttc has been heavy lately but I'm glad you've taken steps back and it's helping. Also yessss to a GoT castle!

@acleverusername sending you positive vibes and crossing everything for a successful IUI!

@quiltandknit wishing you luck as you start treatment. Hopefully he's low-balling the stats and your chances are higher. That number does seem low but I'm no expert.

acleverusername · January 2021

@quiltandknit Haha Wow! I'm glad I'm not the only one that thought about Big Little Lies. MH and I have actually been "window shopping" places in Carmel. If this work from home situation continues / becomes permanent, we might do that in a couple of years' time! So glad that you know the next steps in case this cycle doesn't work out. That protocol sounds bang on. Only suggestion for you is to watch out how your lining responds. Clomid really impacted my lining cycle after cycle. Like... by 2-3mm each cycle! But of course, as usual, hopefully you won't even need to go there!

@gingermama29 we'll be here for you when you're ready to restart trying!

Edited: fixed a grammar mistake or two. Or three!

photographerwife · January 2021

@kiki047 thank you! I’m not sure if they’ll send me to an RE right off or not.

@acleverusername glad your lining is looking good! Did you trigger? Hope everything goes well this week!

@quiltandknit that’s what I was thinking! They never did an hsg last year, so this would be the first! They tried at the end of the year but put it off for insurance reasons. Hope everything goes smoothly this cycle!

laura-kay · January 2021

Diagnosis (if you've been): unexplained

Status (WTO/TWW/TTA): TWW

What are you doing this cycle? (Testing? Treatment?): I’m on a break, but we do have an appointment with our RE on Thursday to try to figure out a way to prevent cancellation. Normally I’m on superovulation plus IUI (Gonal F and Ovidrel)

How are things going?: Meh. Better than last cycle though! We’ve been watching my sister in law’s dog while they are preparing to move. It’s been great to have him here and is very helpful emotionally as well

It’s been really important for our relationship (DH and me) as well to have a break.

Any questions?: NATM

GTKY: If you could live in any fictional house (with or without the fictional people that live in it), what/where would it be and why? I’m really not sure

If I could choose a real place then perhaps someplace in Italy? I love it over there in Tuscany.

inthewoods23 · January 2021

Just here to pop in with my 2 cents because why not

@acleverusername

I probably wouldn't worry too much over the vitamin D stuff. That may be based on opinion as I haven't seen anything that suggests certain levels for TTC. Last time I had my vitamin D checked I was at 77 and well within the normal range but the RE said she likes to see it more around 40 or something. So again, seems mostly like each doctor's opinion.

I'm not super familiar with all the different types of protocols when it comes to IVF, but there's nothing wrong with having patients follow a protocol that works for 90% of them. I'm sure they would change or tweak the protocol as they see necessary based on your various test results. And maybe that RE doesn't care about the lead follicle? I don't know, but couldn't they just let that one over-mature and only pay attention to the others that are growing at a similar rate?

If the SART score or success rate is of importance to you, then don't use that clinic. My clinic, which has been around for a while had their 2017 success rates posted in the waiting room - in 2019. Perhaps it's just not published data at this point? You have to figure part of a clinic's success rate includes live births so you won't know the true success rate for a given year until what, September of the following year if conception happened at the very end of that year?

I'm not sure what you would consider enough quantitative feedback on the embryologist, but consider that product reviews online are way more common than rating a doctor. Think about how many patients a doctor sees every day, I doubt anyone ever considers going online to write a review. And plus also, people have to start somewhere in their careers. Less experience doesn't necessarily equate to being a worse doctor compared to someone in the field for more years.

I think you'd do best trusting in your doctors that they know what they're doing. IVF isn't an exact science. I may have seen an article that mentions that doctors don't even know why fertilized eggs begin to split and develop into embryos and so on. There's clearly only so much we can control in this process and I think you're looking into nitty gritty details that may not matter for the end results. Have you asked both REs what they think of the other's protocol and why they think it may or may not work for you? And for all we know, maybe both protocols will yield similar results for you.

In essence, I don't see anything you've described as a concern and I get the sense that you're not 100% in on doing IVF at the moment so you're trying to find reasons to delay it. (maybe)

acleverusername · January 2021

@photographerwife I did trigger, but my LH also started to surge by that time, so I think timing is great! I'm pretty excited that my follicle wasn't too big this time before the surge started. Previously, I had follicles reach 26mm and 24.5mm and no natural surge!

@laura-kay So glad that having a "therapy" dog around is helping you feel better. Good luck with your RE appointment! Please post an update when you know what the next steps are.

@inthewoods23 Thanks for your input! Interesting about Vitamin D. It's so hard trying to reconcile different opinions. SART is not the only thing that's important, but it's one of the factors I look at. What's more important is the success rates, even if they're informal. Re: IVF, MH and I are willing to do 1 more IUI cycle before we move to IVF. So, that would mean IVF in March/April. 🤷‍♀️For the moment, I'm just happy we're not rushing into it and taking the time to learn all that we can / prepare the best that we can. In any case, I think the black strike against our current will be the $. I want to thaw/fertilize eggs I have from my 2019 ER, and they are charging $5K for the thaw. The clinic in AZ is going to charge $1K. A serious WTF re: price difference.

keikilove · January 2021

Wow, this thread is back to being busy! Glad to see everyone here—not that we are in IF, but that we are here together❤️.

@kiki047 So good to hear how the process is finally moving forward! Sorry that you’re feeling stressed, but it makes sense. There’s so much that goes into these cycles it’s hard not to stress about each step. Yay for your RE being so wonderful through it all!

P.S. Your gif game is on point today😄
P.P.S. I also never think of my answer first when I post the GTKYs, I just make them up. Then I have to really think, hahahah. Love your house selection—who wouldn’t want a vineyard and stables?!

@photographerwife Welcome back. It makes sense that you needed time away. Posting in this thread/seeking out fertility treatment is definitely a hard step to take but definitely worthwhile. I hope you get good responses that make you feel better about getting to this step when you’re at your OB appointment.

@acleverusername Congrats on the great lining! Good luck with this IUI—hopefully everything lined up and all your hard work with the second opinions was simply for peace of mind. Re: your spoiler—I agree with others that if your are doubting your current RE then it is time to switch doctors. It seems normal for a question to creep in here or there as we all go through this process, but an overall questioning of the RE’s competence hints at being better off with someone you trust more. Oh, and re: Vit. D—my RI wants it around 50 or higher for TTC. She recommended 10,000 IUs, then drop down to 4,000 or 5,000 once levels look good. She does everything based on research & quality studies so...

@quiltandknit Hooray for having a plan! I hear you when you say that your doctor’s suggestion of IUI success being 15-20% sounds low, but I guess it lines up with the likelihood of natural PG each month. I personally think the likelihood of success is higher since they’re delivering the sperm right where it needs to be waiting. I’m a big fan of IUI and think it has better results than people give it credit for in general—but I think it all depends on the reason someone is seeking out IF treatment. Wishing you luck this cycle! (Fixer Upper is such a great show

@gingermama29 Hey friend! So sorry you’re back. We understand if you stick toTTCAL, or if you end up feeling comfortable joining back in here.💗 You’re always welcome.

@laura-kay Good to hear that the break continues to benefit your mental health & relationship. Glad that the dog-sitting has been helping too!

Diagnosis (if you've been): RPL, DQ Alpha match, blood-clotting mutations, AMA, DOR

Status (WTO/TWW/TTA): WTO/ WFFET

What are you doing this cycle? (Testing? Treatment?): Doing a natural FET in about a week. Also doing IVIG & LIT in prep for that FET.

How are things going?: Well, but a bit stressful. It’s tricky trying to plan to travel for the transfer, since I have to watch my OPKs to get the timing right. I don’t want to fly out too early because that’s just wasting money to sit in a hotel, etc. It’s also been stressful recently because I now get an IVIG infusion every week, and it’s been making me super sick. I was out of commission for half of last week due to killer headache, nausea, vomiting, muscle aches, and general fatigue—all a reaction to the IVIG. I’m so grateful to be able to get this “miracle” treatment that should help the FET to be successful, but we are still trying to figure out the right dosing and additional fluids to halt these terrible reactions that keep me in bed for 2-3 days. Very few people have this reaction so I’m like, of course it would be me 🤷‍♀️

Any questions?: NATM

GTKY: If you could live in any fictional house (with or without the fictional people that live in it), what/where would it be and why? I’m with @laura-kay: some dream house in Italy ❤️ 🇮🇹

bows22 · January 2021

@acleverusername the only thing that concerns me out of everything you mentioned is if she’s doing a standard protocol that works 90% of the time and you have reason to believe you are in the 10%, that would bother me. I have seen firsthand how doctors get stuck on protocols that don’t make sense. So if you think the protocol won’t work for you because of x and she doesn’t have a good answer for how they will handle that, that would concern me. This is more coming from experience I have with non-fertility related issues, but it is a lingering beef that I have. Otherwise I agree with @inthewoods23 that you might be overthinking it.

LJMoon6 · January 2021

@kiki047 Something you said really resonated with me. “Trust in your body to do what it’s supposed to do.” I’ve definitely had that feeling of betrayal before. I feel betrayed by my own body. I’ve come to finally accept that my body just doesn’t want to do what other people’s bodies do naturally. I’m more at peace with it now. I’m glad your RE is doing some extra hand holding. Whatever it takes to calm your nerves and de-stress is the right amount.

@photographerwife I’m sorry to see you here and at the point of seeking out an IF diagnosis. This point is definitely hard. I think the link kiki047 shared is a great place to start. I would just also add to have a talk with your DH. Make sure you guys are on the same page. Know what you are both comfortable with and what your stopping point would be.

@acleverusername Girl! What the heck happened this cycle!? So strange. Did you start your meds on CD2? I can’t remember. I’m glad your lining is looking so good! Did they say how high your LH was already? I thought it was a bad thing to start surging before your trigger? I’m also surprised they didn’t move your IUI to yesterday (O day). About your RE. I think, regardless of if she’s qualified or not, the fact that you’re questioning her means you need to move on. Find a doctor that you trust. Period. (as a side question, why did you have an ER in 2019??)

@quiltandknit The statistics are so hard to hear. My RE said we only had a 5% change of conceiving naturally on our own. That floored me. I think, on any given cycle for a couple without IF, they only give a 20% chance of conceiving. So for the IUI, they just try to get your chances back up to a natural cycle level without IF… if that makes any sense. Also, beware of clomid and the thinning of your lining like acleverusername said. I had to push, hard, for my RE to switch me to letrozole. I don’t know why it’s not the first drug of choice yet. There’s more and more evidence that it has a higher success rate and lower chance of multiples.

@laura-kay I don’t know what it is about a dog that just makes your troubles go away. I’m glad you’re having a better cycle this month. Can you remind me of your IF history, why do you keep getting cancelled?

@keikilove You’re getting soooo close! It all sounds soo stressful but I know it will be worth it in the end. I don’t know much about the IVIG treatment that you’re getting but will you continue it after the transfer??

Diagnosis (if you've been): Unexplained

Status (WTO/TWW/TTA): TWW

What are you doing this cycle? (Testing? Treatment?): Natural

How are things going?: This are going ok. I reached out to my RE last week and they treated me like I was a new patient. It’s a little frustrating but I’m not quite ready to move on to them anyways. I also reached out to my OB last week to see if I could start an unmonitored cycle with letrozole and TI. And she agreed!

Then I asked her her opinion on an article I had read about letrozole with TI vs clomid with IUI. Surprisingly the letrozole with TI had a significantly higher success rate. She wrote back a huge long response. I really feel so lucky to have her as an OB. I feel like I’m talking with a friend or a coworker collaborating on my care. Basically, she said that that study was encouraging and made her feel more comfortable prescribing letrozole to non-PCOS patients. She said it had always bothered her that clomid thins the lining and has so many other bad side effects. But then she essentially said that she takes all reproductive studies with a big grain of salt. Since pregnancy is a time sensitive thing and most women and physicians don’t want to wait and are throwing the most aggressive form of treatment at it. There are so many confounding factors at play. And patients usually aren’t willing to participate in a placebo-controlled trial… so… anyways. I thought everything she said was interesting. I’m still hopeful for next cycle with letrozole and TI regardless.

Any questions?:

GTKY: If you could live in any fictional house (with or without the fictional people that live in it), what/where would it be and why?

kiki047 · January 2021

@inthewoods23 I just looked up the NOW brand pills and they're available on Amazon again. When I ordered these ones back in November there weren't any in stock. This is only a 15 day supply so I'm ordering some more. Thank you for the tip on the empty stomach, I will keep that in mind too!
@acleverusername thanks for the link - I'll be honest, I do follow her but her clips are so long that I don't usually end up watching them. I am taking extra Vit E (on top of what is in my PNV), and she also mentioned HGH like keikilove posted about last week. It's too late to look into for this cycle but if it doesn't work I'll definitely ask my RE to consider it for next time. Also, OMG that estate in Carmel

As for your update, I'll put this in a spoiler too because it's long:

When you say "I don't think my RE knows how to achieve superovulation unless we do an injectable round", was your current letrozole + menopur protocol supposed to result in superovulation? Perhaps it's not a matter of not "knowing" how but rather that's just not a protocol she employs or is willing to use? Ethically my RE doesn't support superovulation because of the risk of multiples, and we always have to sign waivers to attest that we have been made aware of the increased risk with ART.
As for your questions, I agree with @in@inthewoods23, I wouldn't focus so much on your Vit D levels. Realistically most of the world's population is Vit D deficient and that's not the reason you're not getting pregnant. Is it a piece of the puzzle? Maybe. But IMO it sounds like you're just not happy with the level of care you're getting with your current RE and you're just looking for things to discredit her at this rate. If SART scores are so important to you then by all means, move on. It sounds like the first of your 2nd opinions went very well and with your consult with TEW coming up it's great you have options available to you. I paid no attention to the success rate of my clinic because based on some of the stories I've heard from friends who have worked with other clinics, you have to take those stats with a grain of salt anyway. I like and trust my RE, so that's enough for me (for now). I hope wherever you land, you find someone who ticks all the boxes for you too.

@quiltandknit I just want to echo what keikilove said about IUI - depending on what your labs/tests say, medicated IUIs realistically get a lot of people pregnant. If you figure your chances are 15-20% each cycle, and you try 4-5 cycles, in theory you could/should get pregnant within 5 cycles unless you have other issues working against you. IUI will bypass a lot of the most common IF issues (cervical mucous issues, low sperm count and/or motility, timing, etc) and cost-wise it is a lot more approachable to do a few IUIs rather than jumping straight to IVF when you may not even need it. The stats are hard to hear, but most people don't realize that the chances of success when trying naturally are about the same.
@gingermama29 sending you love and grace in this initial TTCAL period. I was in your shoes not too long ago, and my heart aches for you. Thank you for the support even with everything you're going through, it means so much

@laura-kay echoing LJMoon's question, can you remind us again why you've been cancelled in the past? Hopefully they can figure it out for you, cancellation is so frustrating.
@keikilove The further along we get the less stressed I am. I think a lot of it stems from uncertainty. As you know by now, I'm a planner and with so many variables that can go/have gone wrong in the past, my mind and heart get pulled in a lot of different directions. I'm so sorry the IVIG treatments are making you so sick - you're a wonder woman to put yourself through all of that to give that little embie the best fighting chance.

I hope more than anything that all of this will lead to your rainbow THB.
@LJMoon6 Hi!! Yes, it's absolutely that sense of betrayal that makes me feel like I have a reason to distrust my body. I have long felt like we're working against each other, and it is frustrating to no end. But *TW* I'm working on forgiveness because I know my MC wasn't my fault *end TW* so our focus has turned to just throwing everything we've got at this last FET and hope for the best. That's super annoying that your RE's office just treated you like any old newbie. I'm glad your OB sounds like she's on board to let you move on with letrozole at least. It's not like this is your first rodeo.

acleverusername · January 2021

@bows22 thanks so much for your important perspective. It's definitely a new lens to look at my concerns.

@LJMoon6 Sounds like you have a great OB in your corner; I'm so happy for you. Can you share that research with us? Either way, if you don't succeed naturally this cycle, hopefully you won't need to go beyond your OB. Regarding my ER, putting it in spoiler:

This is something I started looking into in 2017, shortly after I ended a long-term relationship (and before MH and I got serious [we were friends for a long time, and at the beginning, I thought he was only Mr. Right Now]). In late 2018/early 2019, I kept waffling on whether or not to do it because things were going great with MH. So, in Jun 2019, I asked MH to take a sperm test and was going to use that to guide my decision. Unfortunately that test came back with really poor results... 3.7M total motile sperm (I know now that at home tests aren't super reliable, but it was *a* data point; and we've had pretty conflicting SA results all this year), so I just went for it. MH proposed to me 2 days after my ER. Looking back, I sure am glad I did it. We might need those eggs.

@kiki047 have you also tried castor oil packs to increase blood flow to the uterus? I have no idea if it works, but I've heard that it might? Thanks for your 2 cents re: my RE anxiety. I think you're bang on re: my RE not willing to risk superovulation with me, even though I'm willing to do that (and I've seen research that 2-3 follicles is perfectly OK for someone my age.) The problem is that she hasn't come right out and said it. I don't want to have to double check what she says, and right now I'm doing exactly that. So yeah, I think the bottom line is that I just don't trust her. I want to have the same relationship with my RE as you do with yours.

AFM, a short (positive) update in spoiler:

Just got home from our IUI. Everything went really well! Total motile count was 60M! This is the best yet! MH and I were holding our respective breaths waiting for the semen analysis for this one as before we only had 1 data point of good semen analysis (December IUI). Now that we have 2 good data points, we can rest knowing that MFI isn't a factor for us.

At this point, we had a good follicle, a great lining, and great semen. We've done all that we can. Now we rest and wait...

Sadly, the coffee shop where we coffee whenever we go to the clinic is shutting down tomorrow. It might reopen in the future, but they just don't know.

It is/was our "post-fertility clinic treat". I am very sad for the employees who are losing their jobs. The guy we talked has worked there for 5 years! But, as I said to MH... maybe the coffee place closing is a good omen for us in that maybe we won't need to come back to the clinic b/c I'll get KU'ed this cycle! 🤞🏻

Lisa3379 · January 2021

Diagnosis (if you've been): No official diagnosis, but I've diagnosed myself to be old and running out of time.

Status (WTO/TWW/TTA): WTO, cycle day 3

What are you doing this cycle? (Testing? Treatment?): Well, just started my first IVF cycle yesterday! I have a few days of Clomid and my Menopur and Follistim injections start tonight. The plan is for PGT for whatever strong embryos we hopefully get, and then transfer next month.

How are things going?: Ok. I was hopeful I would be able to still work out for another couple of days, but Clomid has my mind hella fuzzy and I'm just generally listless. I'm also freaked out by my husband injecting me for the next couple of weeks. He'll do fine with it, I'm just the worst around needles.

Any questions?: nothing really

GTKY: If you could live in any fictional house (with or without the fictional people that live in it), what/where would it be and why? That's a tough one! Hmm. The only one I can think of is Axe's penthouse apartment in NYC in Billions. Or the apartment that Jennifer Aniston's character from The Morning Show lives in, also in NYC. I've never lived in a city like that and wish I had at some point... plus, those places are sweeeeeeet.

kiki047 · January 2021

@acleverusername that’s such great news about YH’s count - it sounds like you’ve nailed the trifecta so FX this is it for you...!! Then you’ll have an even better reason to not have to keep working with your RE. I remember you mentioning the castor oil packs before but I admittedly had no idea what it was. I just went down the rabbit hole on Google and it sounds really interesting. I go back for another US on Monday, and if my lining is looking dodgy at that point maybe I’ll give it a try. Sometimes I worry that there is such a thing as doing *too* much.

@lisa3379 welcome! I’m sorry you’re finding yourself here, but you’re definitely in the right place to support you through your first (and hopefully, only) IVF cycle. The needles seem really daunting but get yourself some small gel ice packs and ice the area for 3-5 mins before and after, you will barely feel them. I hated menopur but found that if I mixed the diluant and powder around 30 mins before I injected it, it had a little more time to dissolve and it didn’t sting/burn as much. Good luck!!

laura-kay · January 2021

So far I’ve have had one full IUI (Gonal F) cycle which was not canceled and one that was canceled. The first seemed promising - everything went really well. The second cycle seemed so strange in many ways. The second cycle had a great lining, and eventually had follicles that would have been a good size, but my tests indicated that I was ovulating during my last monitoring appointment. It took much longer to get the follicles at the right size and to get me estradiol to go to the right level. They stayed small for a long time, and they were concerned that they were staying in a resting state at the beginning. It was a very very expensive cycle considering how many extra ultrasounds and bloodwork visits they had - especially with us not being able to actually have the IUI.

LJMoon6 · January 2021

@acleverusername The study was done by Jorge Rodriguez-Purata, et al (link in spoiler), and published in the Journal of Reproductive Medicine in 2016, for patients with unexplained IF. The short version of what is says is that letrozole with TI has a success rate of 15%, clomid with TI is only 11.8%. It goes on to look at letrozole with IUI at 12.3% vs clomid with IUI at 11.5%. Then a look at letrozole with TI vs clomid with IUI (15% vs 11.5%), which I don’t necessarily think you can draw too much information from (there are so many factors as to why a woman does TI vs IUI). I had also read a study about the different doses of letrozole compared and which one had the most success rate, and I think it was the lowest dose (it’s been a while since I’ve read that article). I just thought that was interesting. Anyways, I’m glad you were proactive in getting an ER done! I’m hoping you wont even need them tho. It’s so hard to see small business struggling right now. I hope they’re able to come back after all this.

https://www.researchgate.net/publication/309049553_Comparision_of_Letrozole_with_Timed_Intercourse_Versus_Clomiphene_Citrate_with_Intrauterine_Insemination_in_Patients_with_Unexplained_Infertility

@Lisa3379 Hi! I hope the needles go ok for you. I’m sure you’ll get use to them in no time. Good luck with your IVF cycle. Keep us posted on how your checks go!

@laura-kay Why did they jump right to doing an injectable IUI? That had to be incredibly frustrating about all the extra U/S and bloodwork (and money!) all to just be cancelled! I would be pissed!

laura-kay · January 2021

They did give us a choice, but the outlook they gave for regular IUI was pretty dismal. With our statistics (8% with regular IUI with clomid), they suggested that our chances would be much better with injectables. That said, it was only 10-15% chance - but it’s better than 8%. It’s definitely better than the 3% witho it intervention. Hearing those stats was honestly devastating. I also had about a year and a half with infertility testing, including some pretty bad experiences, with a different RE, so I was well into my second year of seeing doctors about this when we started the injectable IUI.

We debated for a long time, but with age concerns (37) and other medical concerns (such as controlled epilepsy which highly recommends lower than 40, preferably lower than 38), we took the more aggressive route.

Yes i was extremely frustrated! We could have triggered a day or two earlier with one mature follicle. It wouldn’t have been a perfect cycle but at least would have had more of a chance! To top it off, it was over Christmas when we hosted 8 people and had services I was supposed to be at; etc. - and it was extremely stressful emotionally. I didn’t have a single day over Christmas break when I wasn’t up and going for some reason (such as being the doctors) before 7:30am, except for Christmas due to the unexpected “extra” couple days to let it get bigger.

Injectables also can be a doozy emotionally and physically (and financially for those who don’t have insurance covering it). For anyone doing those treatments involving injectables, take time to have self care for yourself as well!

<break>

All that said, it was really good to have a break. I think it is helpful for us going forward. We have an appointment in a half hour for next steps, and I’m hoping we can go forward with a clearer more balanced mindset. I finally am meeting with my doctor. This last cycle was with his partners and I don’t trust them as much as I trust my RE. I am hoping our conversation can give us a good path forward and some more hope.

photographerwife · January 2021

So my appointment yesterday went well. My ob offered to do some testing in her office, but overall after talking about our journey so far, recommended going straight to an RE. She called them an REI, is that a normal term? Since neither one of us think I have pcos or anything that can be treated with meds in her office I think this is the better route. But I’m so nervous. After losing my right tube I’m afraid that they’ll go in and find the remaining one blocked. My ob said that that point they usually remove that tube and go straight to ivf. It sounds so daunting. Financially, I’m not sure that we can afford ivf right now, not without saving for the next year or so. We just bought a house and spent a ton of money on ground work and contracting and ugh! I do live in a state that mandates fertility coverage, Arkansas, but I know employers can deny it and I don’t know how all that would work out. Anyway. I’m just rambling on anxious thoughts. The REs office should reach out soon to see us. Hope you guys are having a good week!

@Laura-Kay I hope your appointment goes well today! I love having my animals for that reason. Maybe you need a dog!

@keikilove I hope things are going well In preparation for FET! and that Your meds aren’t making you feel so sick this week!

@ljmoon6 We talked, and we’re pretty much on the same page. He would be very hesitant to go to Ivf, as would I, but we’ll take it as it goes I guess. We have no idea where we’ll go from here. Sorry your RE was rude, that’s nice that your ob will do that for you though!

@lisa3379 good luck with your cycle! I’d be nervous to let dh do the injections too! But I wouldn’t be able to do them myself. 😬 I hope the side effects calm down soon.

Lisa3379 · January 2021

Thanks everyone! Like with everything else, I stressed about the injections way more than I had to. It wasn’t that bad! 😂

laura-kay · January 2021

@photographerwife We would love a dog! We always keep our eyes open, but we had been holding off during the treatment. I may go ahead though once we no longer are dog sitting since I don’t want to keep it on hold forever! I’d love to have my sister in law’s dog stay with us long term but I know that he will be going back to his people sometime

We also are thinking about possible fostering dogs.

acleverusername · January 2021

@Lisa3379 Glad you're finding the injections tolerable; I guess it helps if someone else does it for you, so good for YH for being such a supportive partner.

@photographerwife REI = Reproductive Endocrinology and Infertility so yes, perfectly normal. I hear that term used often, but myself use RE (it's shorter! plus doesn't confuse it with the REI co-op stores).

@laura-kay looking forward to your update after you meet with your doctor!

acleverusername · January 2021

@LJMoon6 Thanks for sharing that article! I love me some research! (Lol... but I've learned that you can find research to support basically any hypothesis you might have.) I started looking at the sample size in research papers I skim (cause I don't actually read them all...)

bows22 · January 2021

@photographerwife they call it REI at my office too! It always sounds so weird to me since I’m used to RE on here. I think the odds are your other tube is fine, but it will be good to check it out to know for sure. I hope you can get in soon (or that you get KU and don’t need to!)

laura-kay · January 2021

@acleverusername I’ll be sending an update soon! Just need a bit more time after work when I can research things at the same time.

Good news is that we aren’t out of the running yet, so to speak.

laura-kay · January 2021

OK, so apparently I have premature luteinization (https://drgeoffreysherivf.com/premature-luteinization-premature-lh-surge-happens-can-prevented/ ) in reaction to the superovulation treatments. He said that it occurs in about 15% of patients - but that if someone experiences it, they have a 50/50 chance to have it occur in future cycles. That was the reason for my cycle cancellation. My body reacted to the level of estradiol caused by lots small follicles and interpreted it as a larger follicle, causing me to ovulate before the egg is mature. I will need to have another shot to go along with the Gonal f. The medicine is Ganirelix. We will use that in our next treatment cycle.

We were going to start with our next cycle (March), but unfortunately it looks like we will have to wait until April. My husband had a COVID exposure - so we are quarantined for 2 weeks until we are sure we aren’t sick.

acleverusername · January 2021

@laura-kay oh no about your hubs! I really hope he doesn't get sick (and that you don't get sick), but it's shitty that you're gonna miss a cycle because of quarantine requirement Stupid COVID!!! At least you've got a good plan for a future cycle. Ganirelix is the same thing as Cetrotide (those meds are called "antagonist") which is what I'd planned to ask my doctor for. Alas, my secondary follicle was too small.

Edited: I removed my earlier complaint pertaining to my fertility clinic as DH thinks that - depending on what the outcome is - we might be asked to sign something about non-disparagement.

laura-kay · January 2021

@acleverusername That is so not cool! So sorry to hear that happened!

Lisa3379 · January 2021

@acleverusername I'll be honest, I think I followed maybe half of everything you said. I did a lot of Googling in the past 5 minutes. There's a lot I have no idea about regarding this stuff. But that sounds like a horrible experience, and I'm so sorry you had to go through all that. Hopefully the director can do something, maybe a refund of some sort? I know it doesn't get you any of the time or stress energy back.

LJMoon6 · January 2021

@acleverusername Ok. Now I need to know what happened. PM me if you feel comfortable. Also, I don’t think you’ve ever said the name of your clinic here so you should be fine to just share what happened, right?

Lisa3379 · January 2021

I had my first ultrasound after starting Clomid, Follistim, and Menopur. Things seemed to be progressing well, but now I have to start Ganirelix tomorrow in addition to the others. Clomid stops after tomorrow, which is also my birthday. Three shots on my birthday (after getting what felt like 50 vials of blood taken today). Giddyup.

acleverusername · January 2021

Happy Birthday @Lisa3379! How are you feeling on all these meds? I know Clomid really affect's some people mental/emotional wellbeing.

@keikilove any update on when you fly out for your transfer? When/where will you do your LIT treatment? At the same place as your transfer? If I recall correctly, you were doing them at a different clinic initially.

Lisa3379 · January 2021

@acleverusername Thanks! So far it's been pretty mild - I'm more tired, but that may be also due to the fact that I've cut my caffeine consumption by probably 75%, haha. I'm kinda waiting for the side effect shoe to drop - like, the more hormones I keep pumping into my body, will side effects get worse? Or is it more like, you either have them or you don't.

quiltandknit · January 2021

@keikilove and @kiki047 Thanks for the kind words about the IUIs. I'm trying to stay hopeful, I know IUI has helped a lot of people. Since I think my irregular cycle and unclear CM might be some of the biggest factors, (although my testing all came back normal) I'm hoping the clomid plus IUI gives my body the push it needs. But we shall see...sooner than I expected because AF came 3-4 days early. And thanks for the head's up about Clomid thinning the lining, will be sure to ask about that when they ultrasound me before the IUI.

@Lisa3379 GL with your IVF cycle!

@acleverusername sorry to see you had a bad experience with your clinic. Hope they can make it right!

@laura-kay sorry to hear about your hubs. Hoping you both stay healthy and sending you all the healthy vibes!

So now that I know I'm definitely starting Clomid, any wisdom about potential side effects/best time of day to take it. My RE cautioned about mood swings, hot flashes, and basically feeling like I'm menopause so yay?!

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