IF Testing & Treatment w/o 4.4

thankfullyamama · April 2022

@acleverusername I’m sorry you’ve been through so much IF/IVF treatments and whatnot already but your experiences and knowledge is such a valuable thing for all the other members here!

@mambo5-2 I’m glad your blood came back and you have a “reason” of sorts now! Have they discussed what’s happening moving foreward? I don’t know much about protein C deficiency

@anniemarie887 I hope the acupuncture works well for you!!

@opt@optimistgardener so sorry for being in between cycles and benched right now! Do You have an idea when they next treatment will start?

mambo5-2 · April 2022

@tryingktogku I chatted with the nurse. Haven't talked to the doctor yet.

thankfullyamama · April 2022

Little update for me!

im CD16 today and when I took clomid before my LH started surging the morning of CD16 and it hasn’t for me yet so I’m trying to remain optimistic and hopefully I’ll get the surge tonight or tomorrow still! i did however take the clomid in the mornings the first time and did it in the evenings this time so I am telling myself that’s why it’s going to be a little later lol

optimistgardener · April 2022

gonna take this opportunity to b**ch over here in our "infertiles/subfertiles club house only" thread about how frigging obnoxious it is to read the peggy/semi-peggy posts that are like "oh no we had a woopsie during my fertile week and now i think i'm possibly pregnant even though we were kind of planning to start trying soon anyways." please take your "problem" elswhere

acleverusername · April 2022

@optimistgardener I can vaguely remember when “oopsie” as it relates to getting KUed was a cute term to use. VAGUELY.

anniemarie887 · April 2022

@optimistgardener i know you feel this in your bones, but as someone who can't even TRY to get pregnant at the moment it makes me want to scream with rage

gingermama29 · April 2022

@optimistgardener seriously though. It’s infuriating having people rub their oopsies in our faces. I got pissed at a “friend” that posted a meme that complained about how 1 kid can turn into 3 real quick if you’re not careful. What any one of us would give to have that “problem.”

mambo5-2 · April 2022

I support everyone's need to scream in rage.

optimistgardener · April 2022

thank you all for your support, haha! mostly i'm just confused by why they're even posting here. like, what is the motivation? (it's ok don't bother trying to answer.)

meanwhile, i'm just waiting around over here for the nurse from my clinic to call me back so i can figure out what the heck is going on with my insurance/prescriptions stuff. I want to get that ball rolling asap. plus i should probably go buy some more sperm. super dreading that part.

acleverusername · April 2022

I just took a chance and searched for "sperm gif". It was OK.

anniemarie887 · April 2022

@acleverusername that's a gamble! lol

we got MH's sperm analysis back via email with a "the dr will go over it at your f/u appt" well dude we don't have a f/u appt set... assuming they are waiting for my other bloodwork and karyotyping. MH is finally doing his blood draw tomorrow. anybody wanna offer eyes on this sperm data? lol

acleverusername · April 2022

I've got my sperm goggles on @anniemarie887! Hit me up!

anniemarie887 · April 2022

I did feel kinda dirty being like “who wants to look at MH’s sperm…. Analysis” lol

acleverusername · April 2022

@anniemarie887 gurl! if you haven't shared YHs sperm info before, you're the odd one out! I'm pretty sure my first post in this thread was me brandishing MHs various semen analysis results and getting opinions.

Okay, here's my assessment. With a TMC (total motile count... volume x concentration x motility) of 279, you're laughing all the way to the (sperm? baby?) bank. The only things that are kind of "off" are morphology and [forward] progression. Still, morphology of 3 is still okay (morphology refers to how many heads and tails a spermatozoon has; 1 head and 1 tail is obvi the desired here). Forward progression is kinda low, but clearly given how much sperm there is, that's not an issue and we know this because your problem isn't getting pregnant. Here's the scale on which forward progression is graded:

Grade 4: Fast and forward progression where sperm move in a straight direction.
Grade 3: Sperm move forward but at a slower speed and/or in a curved direction.
Grade 2: Sperm move slowly and in a poorly defined direction
Grade 1: Sperm move but fail to progress forward.
Grade 0: Sperm show no signs of movement.

(P.S. motility refers to how many sperm are moving; progression score is if they're moving in a straight line or if they're chasing their tail.)

MH's sperm usually comes back 2, at best 3. And that's why I usually add "lazy sperm / sperm that doesn't like to ask for direction" in my Dx.

(PS I hope I get bonus points for "spermatozoon" because I just learned that's the singular form of spermatozoa.)

anniemarie887 · April 2022

@acleverusername you da best. I started googling those two, because they were below the reference range. I don’t think I fully grasped morphology. Lol. Now I’m imagining MH sperm like Fluffy from Harry Potter. 🙃 maybe I should not have admitted that. Lol. So basically we’ve got quantity, and debatable quality. Lol. Rule of large numbers in my favor?!

I really appreciate you explaining that, I felt a bit overwhelmed trying to google after a long work day. And Spermatozoon is a new word to me!!

anniemarie887 · April 2022

@acleverusername also fx for an epic departure post from you tomorrow!

acleverusername · April 2022

@anniemarie887 can confirm that rule of large numbers IS in your favor. Also lol @ Fluffy! Hahahahaha. The visual is perfect. And yes, about right. After all, I think more heads are way better than more tails, right? What are tails good for anyways?!?

inthewoods23 · April 2022

*lurking*
@anniemarie887 just adding my two cents before asking a random question that doesn't even pertain to me.... my OB considered low morphology a yellow flag. I think most agree that there's no real sure fire way to help improve it. And as my OB said, we don't know how many couples out there have had no problems conceiving but the male partner had poor morphology. I believe it is possible for an abnormally shaped sperm to fertilize an egg. Count and motility are the easiest to improve. Over the course of the 3 months I did IUIs and had DH taking a basic men's multivitamin his motile progression when from "meh" for the first IUI to "pretty good" for the last one. Sometimes I feel half the battle is just helping the guys be more robust to get to where they need to go and/or last longer.

And onto my random question that has nothing to do with me but a friend.... if clomid doesn't help you ovulate, is letrozole more likely to help? Does higher dosage help? Or is this a case of likely needing injectables to ovulate? She hasn't asked for my input but I'd like to be more informed on the subject should she ever ask. She's just working with an OB right now so I don't believe she's had any big fertility workup either. Any input would be cool. Thanks

acleverusername · April 2022

@inthewoods23 I’m here to answer your question with… wait for it… SCIENCE!!!

It’s totally worth trying Letrazole if Clomid didn’t work because the 2 drugs work very differently. Clomid tricks the brain into thinking estrogen is low and causes the pituitary gland to produce more LH and FSH in the ovaries. Key here is “tricking”; it’s not actually the case. HOWEVER, Letrazole is actually what they call an aramatose inhibitor. Meaning: it blocks conversion of testosterone into estrogen. So the body is actually estrogen deficient which kickstarts all those other systems.

So, if one method doesn’t work, it’s for sure worth trying the other before moving on to injectables.

The CNY Fertility article on this topic helped me understand it way more than when my doctor told me this: https://www.cnyfertility.com/clomid-vs-letrozole/

@tryingktogku this good info for you as well.

thankfullyamama · April 2022

@acleverusername thank you! That is very informative!

Question: does anyone have any insight as to why someone would proceed with an IUI rather than timed intercourse if the male partner has (as my fertility clinic referred to it) super sperm? DH spent fest came back with flying colours which i guess It’s good we also don’t have that against us and it’s just me lol

thankfullyamama · April 2022

.

anniemarie887 · April 2022

@inthewoods23 thanks for chiming in! Of course MH was googling the fact that he has a cold what affect that could play in this. And I’m like let’s just accept the data we’ve been given my friend.

inthewoods23 · April 2022

@acleverusername thank you!

Image: https://us.v-cdn.net/5020794/uploads/editor/5m/uz5jef6zniyq.gif

@anniemarie887 yeah I wouldn't worry about a cold too much. I doubt it has any affect since it takes the body 3 months to create sperm.

thankfullyamama · April 2022

@anniemarie887 I think that his numbers are still relatively good though from what my clinic has a a “normal” range!?

acleverusername · April 2022

@tryingktogku what was the specific question?

Btw, for any husbands out there who want for info, R e d d i t has a subreddit on male infertility.

https://www.reddit.com/r/maleinfertility/

thankfullyamama · April 2022

@acleverusername my questions was why someone would choose to do an IUI instead of timed intercourse if there are no issues with the sperm!

my clinic is very pushy to do an IUI and I’m feeling like it’s a money thing because I don’t understand moving forward with an IUI when we haven’t figured out how to get me to ovulate yet. Like I have the fertility issue not my husband lol so I feel like as long as we can BD during our “fertile window” it’s just as effective as an IUI no? Because he has no sperm issues! Like I get doing an IUI if you have sperm issues too!

optimistgardener · April 2022

@tryingktogku for IUIs, an argument can be made that they help get sperm "past the gates" of the cervix, which is a challenging barrier because it is unfriendly to sperm (if i remember my readings on this correctly, the vaginal canal can be a toxic environment for them especially if you're outside your fertile window OR if your body insists on making the wrong kind of mucus even in the run-up to ovulation, which is a thing that happens sometimes). So if you suspect you may be someone with this problem, or if you have larger structural (usually scarring-related) issues with your cervix, an IUI can be quite useful in delivering the sperm safely to the departure gate. I personally do not think that the IUI offers a huge uptick in success rates over TI for folks though where the sperm quality is good and where cervical issues/suspected unfriendly cervical mucus are not at play. but i did not go to school to study this stuff, so proceed with caution.

thankfullyamama · April 2022

@optimistgardener okay thank you I never even thought about scaring/cervix/mucous to be honest so that makes a lot of sense!!!

I know I’m going to do a trigger shot and progesterone next cycle I’m just trying to figure out if we will do an IUI or TI. I obviously want the best chance but an IUI Is about $2 grand and I’ll have to travel 4 hours to the clinic often which will also require time off work!

optimistgardener · April 2022

@tryingktogku it is amazing to me how much prices vary for the same procedure from clinic to clinic. The IUIs I've paid for have ranged from $250-600 (not including medications or monitoring). If you are doing a bunch of monitoring I can see why it might hit 2k, though.

thankfullyamama · April 2022

@optimistgardener it does vary greatly! And I’m on Ontario Canada lol I find most people just assume it’s covered but it’s actually quite expensive and my husband and I both have benefits they just don’t really cover much for IF other than the meds! If it was only $300 I’d do an IUI probably no problem lol but the cost along with the time off work would be more like a $4grand loss total for me 😬

thankfullyamama · April 2022

Just wondering if your clinics have a standard progesterone test at CD 21 or if they do it based on your ovulation day! My clinic is CD21 only but if I ovulate on CD19 I’m not sure if my progesterone would have risen by then to confirm ovulation?

acleverusername · April 2022

@tryingktogku your clinic should adjust the progesterone test based on when you ovulate. It's only called "Day 21 test" based on the "average cycle of 28 days." Don't listen to the nurses on this; ask the doctor. I know we have some nurses amongst us, and I know ya'll are a bunch of smart ppl, but sadly my experiences with nurses at fertility clinics have proven to me that they don't get much domain training on the job.

Re: IUI versus TI, @optimistgardener is right. So, there's such a thing as anti-sperm antibodies, and it exists on both female and male side. The CM can be "hostile" (aka have anti-sperm antibodies) that will essentially kill the sperm before it get to the uterus. Doing an IUI bypasses that, and because of this, most clinics don't even test for ASA. But... see spoiler

if you're gotten pregnant with TI before, that's probably not your issues. There are studies out there that show that if sperm parameters are normal (i.e. that there's absolutely no male fertility issues), then it's as effective as IUI. See: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/j.1600-0412.2010.01063.x

thankfullyamama · April 2022

@acleverusername thank you for your input as always! I’m not 100% sure if I had a positive OPK/ LH surge TBH (see OPK thread) but if I did I still would ovulate tomorrow or the next day so CD19/20 and a CD21 progesterone test wouldn’t pick it up lol I’ll call the clinic Monday see if I can do it later!

As for if we were unsuccessful this cycle you’ve definitely helped me decide to do a medicated cycle again with a trigger shot but not an IUI!

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