New and looking for advice....

BelleAmie · 08-10-2009, 09:54 PM

Hey gang,

I don't know if this is the right board for this or not, but I am just going to jump in. I'm going to try to be speedy and concise.

I am trying to figure out if I should go on as planned with my 1st IUI as soon as AF comes or if I should call an audible and start planning for IVF. I am hoping that some of you can share your thoughts with me and help me decide.

Now for the personal info: I am 35 my husband is 39. We have been married for 8 years. In that 8 years we have purchased no condoms or taken any BCPs. Not even one + HPT. I never really thought about it much because we weren't really trying to get pg. About a year ago we decided we would actually start trying. At that point I thought it would be no big deal, after all I have a 15 year old son from a previous relationship. I really thought all we had to do is start having more BMS.

Long story short, 1 year later of really trying still no +HPT. I've seen the gyn she put me on clomid for a couple months, no +. I have since been to an RE and after all the tests (hormone levels within acceptable ranges HSG= right tube blocked at uterus) we did an ultrasound to look at my reserves (they were good) however we also found a cyst almost 7cm and a polyp. RE said probably no big deal, probably not keeping me from getting pg, but needed to be taken care of. Cyst removed and ready to move on. We met with the RE again in June to discuss the plan forward and at that time he said we were good candidates for IVF.

In full disclosure I have to tell you some fairly personal stuff, my apologies for the TMI. DH, best friend, love of my life's little swimmers are low and slow. Also he is diabetic and we have been slowly being taken over by the ED monster, so couple that with his back going out on him a couple of months ago and staying out it is like pulling teeth to even get to dtd.

At the meeting with the RE after he jumped right to the IVF I was kind of stunned. I am an eternal optimist and I have always thought all we really needed was to have the baby batter hitch a ride to the tubes so they don't get too tired to get there on their own. RE says IUI is a gamble due to the right tube being blocked. Still I thought I knew what was best for us and our pocket book and talked him into the IUIs. So he gave me a scrip for clomid and after discussing my long cycles (36 days or so) and his planned vacation we figured we would start with the August cycle. Well, we left the office and I decided that we were going to get pregnant for free if it killed us. So I got the OPKs and when we got the pos result we did the BMS several times over the next few days. I thought for sure we did it, but I couldn't even get an evaporation line. When AF came I decided it was time to start charting BBTs. (I really feel like a dummy for not charting sooner or learning more about my own body sooner. But that is water under the bridge.) At any rate, I started charting and watching my CM and doing my OPKs religiously. As soon as all the lights were green, I realized that my DH wasn't going to be able to bring his game so I ran down to the drug store and bought a medicinal syringe. Don't judge me I'm desperate! = ) Not only that but it worked for some friends of mine.
So I went back home and took what I wanted! I was able to get the baby batter where it needed to go for three straight days. They turned out to be the day before, the day of and the day after the big O. I was really excited and just sure we had timed everything just right this time. I even got an big fat implantation dip exactly 7 dpo! So, I am currently 15 dpo and not even an evaporation line. I am pretty sure that I have an 18 day luteal phase, but it shouldn't matter should it? Anyway AF will probably be here in the next couple days so I am coming to terms with the fact that in a couple days I will have to call my RE and start the IUI cycle. I just don't know if I should. I am starting to think that maybe we should just jump into the IVF afterall. I guess because I am starting to think that RE was right with only one tube in the game IUI is a gamble and it's an expensive one coming out of my pocket. I might be able to get my insurance to pay for it, but I am not going to hold my breath or anything. I don't want to waste money on the IUI, but I'm also scared of the IVF thing. I can't get hubby to comment one way or the other. I think he is more concerned at this point about the economy (we're self employed) I know he isn't going to want to spend the savings on IVF, but we have good credit so I am sure we could get a loan, but then I know he is also concerned about bringing a baby into the family when there isn't much economic stability. At this point I am getting very frustrated and depressed.

Anybody have advice?

Tia38 · 08-11-2009, 06:34 AM

My thoughts -- although I'm no doc....

I would try injectable-IUI rather than clomid-iui -- it is more expensive, both for the meds and the monitoring.... but they can also control things a bit more as well, and with the extra monitoring they can see if you are getting follies on your 'open' side or not.

Doing injectables with IUI may give some indication of how you will respond to the meds should you move to IVF.

Whether Clomid or injectable, I would definitely ask for a late u/s and trigger shot to time IUI, and confirm there is/are follie(s) on the 'open' side before doing IUI.

Some also think Clomid for 35+ is not the best idea and that it can think lining over time. But you'll see mixed info on it. At my clinic they try 3 rounds before moving you onto something else.

Having said all that, my RE put me on Clomid at 38 (with trigger+IUI) -- first cycle BFP but m/c. Subsequently non-responsive (no eggs). I wanted to move to IVF but he said injectable IUI. Success at 39 (second cycle) -- DD is 2.5.

TTC#2 at 40, again thinking needed to jump to IVF -- RE said let's try the same IUI again. I needed much higher doses for longer period of time, but after three tries got lucky. DD is 4+ months.

I recall someone on the IUI boards having one blocked tube -- you might want to post there?

As for the economics and such.... can't help there.

As for scared of IVF... post over on the IVF boards -- you'll get some good info and hopefully reassurance. I was a little nervous about injectables (so doing the injectable IUI was a bit of a baby step for me). I was scared of the PIO shots, but never had to do them. I think there's also some alternatives these days. Sometimes facing and naming your fears helps you deal with them. Sometimes just knowing others have the same fears and got through it helps.

You could also try the 35+ board -- there's a very active group (I think it's a bi-weekly thread). This Secondary IF board does not get much action these days.

Best of luck to you,
-tia

BelleAmie · 08-11-2009, 08:47 AM

Hi Tia,

Thanks for the response. I am such a newbie there are things you wrote about that I don't understand. First of all what do you mean by injectable IUI... is that just different meds instead of clomid? (obviously in shot form)

And what do you mean by trigger is that where they give you a shot to trigger O instead of waiting for you to do it naturally so there is less chance of missing it?

Also I have no idea what PIO is. thanks for all the other advice and I think I did post this on another forum area too.

I guess I will see what happens in the next couple days... waiting for AF... I hate her.

Tia38 · 08-11-2009, 12:21 PM

Thanks for asking for the clarifications -- it's easy to forget that 'newbies' may not be familiar with some of the language/acronyms/protocols.

Yes - 'injectable IUI' is my short-hand for using injectable meds rather than oral/pill form. Gonal-f or follistim (same med, different brands/formulations) are two common examples. Most injectable cycles will require more monitoring because they don't want to over stimulate you, and they have the ability to tweak (increase/decrease) your dosage during the cycle depending on how your body is reacting. With Clomid (pills) you take the med and see what happens. (There are hybrid cycles that combine pills and injectables but I don't know much about them.)

Yes on trigger shot. It's typically (always?) an HCG shot that will force O (although there is still some small chance that you still won't O). In my experience on Clomid cycles some REs don't use it, some do; with injectable cycles they usually do. If you're going to the expense of an IUI why not help bump the odds? (And in you're case presumably they wouldn't do the IUI if there were no follies on the open-tube side, so it sounds like you'd need the monitoring anyway -- I don't think the trigger shot is that much more $$$.) [Although it is usually self-administered, which can be scary/intimidating, but really is quite doable, especially if it is a sub-q shot (rather than IM/intra-muscular shot) -- sub-q is something like sub-cutaneous, the important part being smaller needle that you can do in your belly.]

PIO -- progesterone in oil. I think most/all IVF cycles use some form of progesterone support AFTER the IVF procedure. PIO is an IM (intramuscular) shot, which means bigger needle, and is usually done in hip/butt, often by partner, although many women do self-administer. This made me very nervous, although I never had to do it. My DH would not have been any help. There are now other progesterone tx that may be used with IVF, but I don't know details. In my case with IUI I used vaginal suppositories -- I had a demonstrated luteal phase (LP) defect. Some REs don't do progesterone for IUI. I think PIO is less common for IUI unless you have a demonstrated need.

Hope that helps and is not too much info. :-)

Keep asking questions -- here and in real life. Someone suggested to me to keep a notebook to write down q's and answers. It was very helpful early on, although I didn't do it as much near the end.

Also, read, lurk, and jump in -- most folks are very welcoming to new folks (newbies or veterans) but may forget to say so.

Best of luck,
-tia

cabttc · 08-13-2009, 11:07 AM

Hi. I am a newbie here and thought I'd chime in. We've recently gone through the hard choice of continuing IUI or moving to IVF. Ultimately, we went on to IVF as RE told as that is probably our best chance due to age me(42) DH (45). I tried two injectible IUI cycles (with Repronex) - first failed, second cancelled due to hyperstim. Althought our insurance covered part of the IUI and not at all the IVF - we still moved on to try to increase our chances as soon as possible.

The injectibles really aren't that bad. Once you get the hang of giving yourself the shots - it is very quick. It is best to have DH give any IM shots - Hcg for IUI and Hcg and PIO for IVF. Everyone has different reactions to the meds - for me, so side effects - so it hasn't been too bad.

It is so hard, but we all have to make the right choices for our life and, unfortunately, our wallets.

Hopefully, all of this stress and anxiety will pay off for all of us! The secondary infertility diagnosis is just heartbreaking and so confusing - at least it was for me. I probably waited too long to seek treatment because I assumed the second would come naturally as did the first.

Hang in there!

BelleAmie · 08-13-2009, 02:07 PM

Well AF has reared her ugly head and so time is up. I'm going to talk to hubby and I think that I will do one IUI with hubby's blessing and then see where the road leads after that.

On another subject a little rant if I may...

My bestfriend who, of course, knows everything about us TTC texted me a while ago about her doctor appt. I am in a pretty good spot most of the time with this, she has two year old and is getting ready to deliver in day now. So.... she wants me to come up and be there with her when her baby is born. They are talking about inducing on the 22nd. Well she just flat out asked me to come be there to watch the baby be born. I told her I couldn't cause I had a class I was taking that weekend. Which is true, but then she was just like well can't you get a refund or a reschedule it. (and I can't) But I just kept thinking that she knows that I just got AF again today and she knows that I am bummed to say the least and she just jumps in trying to figure out a way for me to be there for her. I'm not 100% suprised she is that kind of person who always tries to get what she wants. I guess it probably never entered her mind that maybe I didn't want to be right there watching the whole birth thing when I am trying so hard to get pregnant and she just decided one day to have a baby and bam she is pregnant. To top it all off she has a 16 year old daughter that she can't stand and is happy to have pawned off on her ex husband while she starts a new life with her boyfriend and her new babies especially when they haven't got a two nickles to rub together she's just having a new baby cause she wanted to try for a boy!

Well... I think I'll leave it at that cause I don't wanna say anything that I'll regret.

thanks for listening.

sunshine22 · 12-28-2009, 12:13 PM

Hello. First of all, I'm very sorry about your fertility issues. Sometimes people can be insensitive and think they know what you need. For example, your friend may think you would love to be there around a newborn, when inside it's killing you. A very good friend of mine became pregnant naturally at age 40 with her 3rd child (3rd husband too). She has known about my long fertility issues, but she says things like, "oh you must have another one b/c my first two are best buddies" and "just stand on your head" , etc. I know she's not purposefully being cruel, just not thinking. So I just try to laugh it off.
In the end, no one really knows what an infertile woman is feeling most of the time unless you are another infertile woman. I've learned that years ago when other women would say to me, "well, at least you don't have cancer". Really? Thanks.
So, in your case I would go straight for the IVF. I know you feel like it's leaving you with less choices if it doesn't work (I felt the same way). When I was 35 I started fertility treatments beginning with IUI's. Then IUI's with injectibles. My RE kept telling me I was wasting my money with the IUI's (he was right). I did 5 total then moved to IVF, and the first one worked for me - a miracle. It's hard to make decisions when money is involved. I'm dealing with that myself right now. So you have to do what's best for your entire family. Good luck!

08-10-2009, 09:54 PM	#1 (permalink)
BelleAmie 0-99 post 2 of hearts Join Date: Aug 2009 Location: concord, ca Posts: 18	New and looking for advice.... Hey gang, I don't know if this is the right board for this or not, but I am just going to jump in. I'm going to try to be speedy and concise. I am trying to figure out if I should go on as planned with my 1st IUI as soon as AF comes or if I should call an audible and start planning for IVF. I am hoping that some of you can share your thoughts with me and help me decide. Now for the personal info: I am 35 my husband is 39. We have been married for 8 years. In that 8 years we have purchased no condoms or taken any BCPs. Not even one + HPT. I never really thought about it much because we weren't really trying to get pg. About a year ago we decided we would actually start trying. At that point I thought it would be no big deal, after all I have a 15 year old son from a previous relationship. I really thought all we had to do is start having more BMS. Long story short, 1 year later of really trying still no +HPT. I've seen the gyn she put me on clomid for a couple months, no +. I have since been to an RE and after all the tests (hormone levels within acceptable ranges HSG= right tube blocked at uterus) we did an ultrasound to look at my reserves (they were good) however we also found a cyst almost 7cm and a polyp. RE said probably no big deal, probably not keeping me from getting pg, but needed to be taken care of. Cyst removed and ready to move on. We met with the RE again in June to discuss the plan forward and at that time he said we were good candidates for IVF. In full disclosure I have to tell you some fairly personal stuff, my apologies for the TMI. DH, best friend, love of my life's little swimmers are low and slow. Also he is diabetic and we have been slowly being taken over by the ED monster, so couple that with his back going out on him a couple of months ago and staying out it is like pulling teeth to even get to dtd. At the meeting with the RE after he jumped right to the IVF I was kind of stunned. I am an eternal optimist and I have always thought all we really needed was to have the baby batter hitch a ride to the tubes so they don't get too tired to get there on their own. RE says IUI is a gamble due to the right tube being blocked. Still I thought I knew what was best for us and our pocket book and talked him into the IUIs. So he gave me a scrip for clomid and after discussing my long cycles (36 days or so) and his planned vacation we figured we would start with the August cycle. Well, we left the office and I decided that we were going to get pregnant for free if it killed us. So I got the OPKs and when we got the pos result we did the BMS several times over the next few days. I thought for sure we did it, but I couldn't even get an evaporation line. When AF came I decided it was time to start charting BBTs. (I really feel like a dummy for not charting sooner or learning more about my own body sooner. But that is water under the bridge.) At any rate, I started charting and watching my CM and doing my OPKs religiously. As soon as all the lights were green, I realized that my DH wasn't going to be able to bring his game so I ran down to the drug store and bought a medicinal syringe. Don't judge me I'm desperate! = ) Not only that but it worked for some friends of mine. So I went back home and took what I wanted! I was able to get the baby batter where it needed to go for three straight days. They turned out to be the day before, the day of and the day after the big O. I was really excited and just sure we had timed everything just right this time. I even got an big fat implantation dip exactly 7 dpo! So, I am currently 15 dpo and not even an evaporation line. I am pretty sure that I have an 18 day luteal phase, but it shouldn't matter should it? Anyway AF will probably be here in the next couple days so I am coming to terms with the fact that in a couple days I will have to call my RE and start the IUI cycle. I just don't know if I should. I am starting to think that maybe we should just jump into the IVF afterall. I guess because I am starting to think that RE was right with only one tube in the game IUI is a gamble and it's an expensive one coming out of my pocket. I might be able to get my insurance to pay for it, but I am not going to hold my breath or anything. I don't want to waste money on the IUI, but I'm also scared of the IVF thing. I can't get hubby to comment one way or the other. I think he is more concerned at this point about the economy (we're self employed) I know he isn't going to want to spend the savings on IVF, but we have good credit so I am sure we could get a loan, but then I know he is also concerned about bringing a baby into the family when there isn't much economic stability. At this point I am getting very frustrated and depressed. Anybody have advice? Last edited by BelleAmie; 08-10-2009 at 09:56 PM.

08-11-2009, 06:34 AM	#2 (permalink)
Tia38 1000-4999 post queen of hearts Join Date: Aug 2005 Location: USA Posts: 3,510	My thoughts -- although I'm no doc.... I would try injectable-IUI rather than clomid-iui -- it is more expensive, both for the meds and the monitoring.... but they can also control things a bit more as well, and with the extra monitoring they can see if you are getting follies on your 'open' side or not. Doing injectables with IUI may give some indication of how you will respond to the meds should you move to IVF. Whether Clomid or injectable, I would definitely ask for a late u/s and trigger shot to time IUI, and confirm there is/are follie(s) on the 'open' side before doing IUI. Some also think Clomid for 35+ is not the best idea and that it can think lining over time. But you'll see mixed info on it. At my clinic they try 3 rounds before moving you onto something else. Having said all that, my RE put me on Clomid at 38 (with trigger+IUI) -- first cycle BFP but m/c. Subsequently non-responsive (no eggs). I wanted to move to IVF but he said injectable IUI. Success at 39 (second cycle) -- DD is 2.5. TTC#2 at 40, again thinking needed to jump to IVF -- RE said let's try the same IUI again. I needed much higher doses for longer period of time, but after three tries got lucky. DD is 4+ months. I recall someone on the IUI boards having one blocked tube -- you might want to post there? As for the economics and such.... can't help there. As for scared of IVF... post over on the IVF boards -- you'll get some good info and hopefully reassurance. I was a little nervous about injectables (so doing the injectable IUI was a bit of a baby step for me). I was scared of the PIO shots, but never had to do them. I think there's also some alternatives these days. Sometimes facing and naming your fears helps you deal with them. Sometimes just knowing others have the same fears and got through it helps. You could also try the 35+ board -- there's a very active group (I think it's a bi-weekly thread). This Secondary IF board does not get much action these days. Best of luck to you, -tia __________________ - Miracles and surprises happen everyday!

08-11-2009, 12:21 PM	#4 (permalink)
Tia38 1000-4999 post queen of hearts Join Date: Aug 2005 Location: USA Posts: 3,510	Thanks for asking for the clarifications -- it's easy to forget that 'newbies' may not be familiar with some of the language/acronyms/protocols. Yes - 'injectable IUI' is my short-hand for using injectable meds rather than oral/pill form. Gonal-f or follistim (same med, different brands/formulations) are two common examples. Most injectable cycles will require more monitoring because they don't want to over stimulate you, and they have the ability to tweak (increase/decrease) your dosage during the cycle depending on how your body is reacting. With Clomid (pills) you take the med and see what happens. (There are hybrid cycles that combine pills and injectables but I don't know much about them.) Yes on trigger shot. It's typically (always?) an HCG shot that will force O (although there is still some small chance that you still won't O). In my experience on Clomid cycles some REs don't use it, some do; with injectable cycles they usually do. If you're going to the expense of an IUI why not help bump the odds? (And in you're case presumably they wouldn't do the IUI if there were no follies on the open-tube side, so it sounds like you'd need the monitoring anyway -- I don't think the trigger shot is that much more $$$.) [Although it is usually self-administered, which can be scary/intimidating, but really is quite doable, especially if it is a sub-q shot (rather than IM/intra-muscular shot) -- sub-q is something like sub-cutaneous, the important part being smaller needle that you can do in your belly.] PIO -- progesterone in oil. I think most/all IVF cycles use some form of progesterone support AFTER the IVF procedure. PIO is an IM (intramuscular) shot, which means bigger needle, and is usually done in hip/butt, often by partner, although many women do self-administer. This made me very nervous, although I never had to do it. My DH would not have been any help. There are now other progesterone tx that may be used with IVF, but I don't know details. In my case with IUI I used vaginal suppositories -- I had a demonstrated luteal phase (LP) defect. Some REs don't do progesterone for IUI. I think PIO is less common for IUI unless you have a demonstrated need. Hope that helps and is not too much info. :-) Keep asking questions -- here and in real life. Someone suggested to me to keep a notebook to write down q's and answers. It was very helpful early on, although I didn't do it as much near the end. Also, read, lurk, and jump in -- most folks are very welcoming to new folks (newbies or veterans) but may forget to say so. Best of luck, -tia __________________ - Miracles and surprises happen everyday!

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08-11-2009, 08:47 AM	#3 (permalink)
BelleAmie 0-99 post 2 of hearts Join Date: Aug 2009 Location: concord, ca Posts: 18	Hi Tia, Thanks for the response. I am such a newbie there are things you wrote about that I don't understand. First of all what do you mean by injectable IUI... is that just different meds instead of clomid? (obviously in shot form) And what do you mean by trigger is that where they give you a shot to trigger O instead of waiting for you to do it naturally so there is less chance of missing it? Also I have no idea what PIO is. thanks for all the other advice and I think I did post this on another forum area too. I guess I will see what happens in the next couple days... waiting for AF... I hate her.

08-13-2009, 11:07 AM	#5 (permalink)
cabttc 0-99 post 2 of hearts Join Date: Aug 2009 Location: orange county, california Posts: 12	Hi. I am a newbie here and thought I'd chime in. We've recently gone through the hard choice of continuing IUI or moving to IVF. Ultimately, we went on to IVF as RE told as that is probably our best chance due to age me(42) DH (45). I tried two injectible IUI cycles (with Repronex) - first failed, second cancelled due to hyperstim. Althought our insurance covered part of the IUI and not at all the IVF - we still moved on to try to increase our chances as soon as possible. The injectibles really aren't that bad. Once you get the hang of giving yourself the shots - it is very quick. It is best to have DH give any IM shots - Hcg for IUI and Hcg and PIO for IVF. Everyone has different reactions to the meds - for me, so side effects - so it hasn't been too bad. It is so hard, but we all have to make the right choices for our life and, unfortunately, our wallets. Hopefully, all of this stress and anxiety will pay off for all of us! The secondary infertility diagnosis is just heartbreaking and so confusing - at least it was for me. I probably waited too long to seek treatment because I assumed the second would come naturally as did the first. Hang in there!

08-13-2009, 02:07 PM	#6 (permalink)
BelleAmie 0-99 post 2 of hearts Join Date: Aug 2009 Location: concord, ca Posts: 18	Well AF has reared her ugly head and so time is up. I'm going to talk to hubby and I think that I will do one IUI with hubby's blessing and then see where the road leads after that. On another subject a little rant if I may... My bestfriend who, of course, knows everything about us TTC texted me a while ago about her doctor appt. I am in a pretty good spot most of the time with this, she has two year old and is getting ready to deliver in day now. So.... she wants me to come up and be there with her when her baby is born. They are talking about inducing on the 22nd. Well she just flat out asked me to come be there to watch the baby be born. I told her I couldn't cause I had a class I was taking that weekend. Which is true, but then she was just like well can't you get a refund or a reschedule it. (and I can't) But I just kept thinking that she knows that I just got AF again today and she knows that I am bummed to say the least and she just jumps in trying to figure out a way for me to be there for her. I'm not 100% suprised she is that kind of person who always tries to get what she wants. I guess it probably never entered her mind that maybe I didn't want to be right there watching the whole birth thing when I am trying so hard to get pregnant and she just decided one day to have a baby and bam she is pregnant. To top it all off she has a 16 year old daughter that she can't stand and is happy to have pawned off on her ex husband while she starts a new life with her boyfriend and her new babies especially when they haven't got a two nickles to rub together she's just having a new baby cause she wanted to try for a boy! Well... I think I'll leave it at that cause I don't wanna say anything that I'll regret. thanks for listening.

12-28-2009, 12:13 PM	#7 (permalink)
sunshine22 0-99 post 2 of hearts Join Date: Jul 2008 Posts: 17	Hello. First of all, I'm very sorry about your fertility issues. Sometimes people can be insensitive and think they know what you need. For example, your friend may think you would love to be there around a newborn, when inside it's killing you. A very good friend of mine became pregnant naturally at age 40 with her 3rd child (3rd husband too). She has known about my long fertility issues, but she says things like, "oh you must have another one b/c my first two are best buddies" and "just stand on your head" , etc. I know she's not purposefully being cruel, just not thinking. So I just try to laugh it off. In the end, no one really knows what an infertile woman is feeling most of the time unless you are another infertile woman. I've learned that years ago when other women would say to me, "well, at least you don't have cancer". Really? Thanks. So, in your case I would go straight for the IVF. I know you feel like it's leaving you with less choices if it doesn't work (I felt the same way). When I was 35 I started fertility treatments beginning with IUI's. Then IUI's with injectibles. My RE kept telling me I was wasting my money with the IUI's (he was right). I did 5 total then moved to IVF, and the first one worked for me - a miracle. It's hard to make decisions when money is involved. I'm dealing with that myself right now. So you have to do what's best for your entire family. Good luck!