IUI number 3 and consult with RE

I know what you’re all thinking, A switched her blog and stops talking about what’s going on in her lady bits? NOT COOL! {Sidenote: seriously, if you want the latest on my lady bits, Twitter is the place. I am way better at talking real time in 140 characters or less! Follow me there if you’re on twitter.}

I do plan to talk about my wonky reproductive bits (and my husband’s. Hiii, C! Love you). I promise to share TMI as I always have. (You’re welcome.)  I use my blog to keep track of it all, after all.  This will be a long update, as we had our 3rd injectibles IUI on Friday and a consultation with our RE about next steps this morning.

Details from fo.llistim IUI #3

  • CD 3 10/30/12: FSH 7.5, Estrogen 36, but my lining is 11. Directed to bleed 2 more days, start meds on CD5 at 150 units of follistim.
  • Took 150 units of fol.listim CD5-10.
  • Wednesday monitoring CD 11: E2 376, Follies 20 mm, 2 15 mm and 14 mm. Ovidrel trigger at 9 pm.
  • IUI on Friday 11/9/12 morning CD 13. Hubs’ sample was good (163 mil 93% motile). Having a full bladder was painful and uncomfortable as always, but the procedure went off without issue.
  • Started Endometrin Saturday morning
  • Beta Friday, November 23. To pee or not to pee, that is the question. May POAS on Thanksgiving. Or not. not sure what the best idea is as I see my 20 weeks pregnant SIL that day.

Consult this morning:

  • Our issues are equal parts male and female factor. My husband has low morphology percentage and I have egg quality issues. So I have eggs that are harder to penetrate than normal and even if his sperm make it to the egg, they can’t always break through the harder exterior of my crappy egg because the shape of the sperm makes it difficult. {I think I got that right. Right, Internet Dr. SRB?} This is somewhat new information, while we were TTC the first time, it was thought that our fertility issues were all on my end and that I had diminished ovarian reserve. Not so, my FSH is high, but regular AMH and responsive ovaries seem to lead them to believe more quality issue. It was only the Kruger test of morphology that showed the morphology issue for C this year, they didn’t do this test earlier.
  • Fertilization without IVF / ICSI clearly isn’t impossible – there is proof of that laying on my bed watching PBS as I type this. However, it usually would happen within 3-4 IUI cycles if it’s going to happen, so one more IUI is reasonable if that’s what we would prefer to do.
  • But, RE suggests moving forward with IVF using a follistim/ganirelex / menopur protocol. They would do ICSI to fertilize the eggs  (if we have >12 eggs, they may fertilize 12 w ICSI and let the rest fertilize on their own), and a day 5 transfer if we have more than 4 embryos. If we have less than that, we would do a day 3 transfer. We would transfer 1 or 2 embryos depending on quality.
  • We could also take a treatment break for a while and TTC on our own before moving forward. It’s possible that it could happen without treatment. Again, L is proof of this and it is possible  though who knows how many more years it would take or if it would happen.

I left the appointment with an IVF packet with a million and one forms to be signed and notarized. And feeling, just …numb, weird, deja vu-y. It’s all so mind boggling – we’ve been here before. We’ve had this IVF consult before – TWICE! Once in the two week wait with our 3rd IUI last go around before I got pregnant with the ectopic, then again in August right before we knew I was pregnant with L without assistance. We were set to move forward with IVF – and then we had the biggest and best surprise ever – our amazing boy.

I know we’re not going to jump into an IVF cycle right away, before the holidays. I’m pretty sure both C and I are set on taking a break at least until the first of the year. After that, I’m not sure. I need to hear what C’s thinking. I need to turn it over and over again in my mind.

The one very attractive thing about IVF is how diagnostic it is. We would be able to see exactly where things are going wrong. We would be able to know if most of my eggs are really poor quality. Obviously, I hope that’s not the case, but it would be great to know. We would be able to see if the sperm and the egg just don’t enjoy each other’s company and don’t fertilize.

There is obviously a lot to contemplate. The expense. the decisions that come with IVF (how many to fertilize? what to do with leftover embryos if something happens to either of us?). The emotional cost. The physical cost. How it will affect L. Who to tell ( we will likely need help with childcare).

Oh, but there is still the shot that IUI #3 will work out for us. Stay tuned….

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13 thoughts on “IUI number 3 and consult with RE

  1. Oh MM, this brings back memories. Not good ones, but memories nonetheless.

    This can be a hard decision for some. For us – it was our only option so that was actually nice. I am hoping that your IUI worked (wouldn’t that be awesome!?) but if it doesn’t, you know where to find me. I’m an open book and am willing to talk about IVF with anyone who wants to talk about it.

    Are you considering a fourth IUI cycle after this one (IF it doesn’t work – still hoping it does) or are you thinking make the switch to IVF and forget IUI #4?

    Like you, I liked the idea of IVF “showing” us what was going on. It was so nice knowing every-other-day how things were going, and what specifically all those tests were telling us.

    I could comment on this post forever, but instead, I will leave you alone… for now 😉

  2. Decisions…decisions…I like Courtney could comment on this FOREVER….however, I will make this as short as I can(so 3-5 pages instead of 100 🙂 )

    Moving to IVF from IUI was a very VERY hard decision for me. I struggled with the invasive nature of it and had some “religious” issues to accept before I was ready. However, I think it was the best decision I have ever made. After all, I did get my daughter out of it 🙂

    If you have any questions or concerns let me know…I’m also like Courtney in that aspect…my IVF along with all my IF stuff is all an open book. And if you’re worried about child care, I’d be happy to help if you want to keep things quiet with outside folks. It’s good to know some local people for instances just like this!

    I have an email page on my blog if you have any questions….

  3. I can’t imagine facing this, or facing TTC #2 in general – I’m sorry you’re having to go down this road twice! And yet, when I remember where it can lead… to that toddler on the bed watching PBS (even if he wasn’t exactly the direct end result, he was still a part of that journey!) I just wish you all the best of luck, and I am hoping so hard that you won’t need to even consider IVF after you get some good news at the end of next week!

  4. Now that they have identified dual factors, it would be interesting from a diagnostic point of view to get more info on exactly what the egg quality and morphology issues are. Embryologists are freaking wizards like that. It’s so hard to pin down anything more than “we think it’s a quality issue” from bloodwork. Like, uh, yeah…I figured Doc, thanks. Definitely wait until you are both ready to start down that path. If you think another IUI is what’s best, do that first! We squeezed in one more before what was to be IVF#1 and we got HGB. Who knows why. It’s the not knowing *anything* that hurts the most, eh?

    That said, I am hoping that yesterday’s consult was a giant waste of time with all my heart! 🙂

  5. I’m curious to know how, since you have yet to do IVF, they found out that you have egg quality issues. I have the same thing, but it took my first IVF to find out. We retrieved 8 eggs and did three with ICSI, but only one fertilized normally. The other five, that we didn’t do ICSI on, did not fertilize at all.

  6. Man, You sound exactly like I did two years ago at exactly this time. We were in the middle of our 4th (5th total) IUI and said that if that didn’t work–which it didn’t–we’d take the holidays off and start IVF in January. I have to say: IVF didn’t actually tell us anything about our troubles. It basically just confirmed that there’s no rhyme or reason why we couldn’t get pregnant naturally, with Femara cycles, or with IUIs. We’re basically just broken and don’t know why. Sigh. BUT, in your case, it sounds like you could find out more, and knowledge is definitely power. I’m not sure how much of IVF is covered for you, but if it’s considerable, I would honestly skip IUI #4 IF you get to that point. We did IUI #4 simply because IVF wasn’t covered and the difference between a $500 IUI and $26,000 IVF is, um, considerable. But if IVF is mostly covered for you, I’d totally go to that and not do a fourth IUI. I just feel like, if it’s going to work, the odds say by the third time it will.

    Of course, this is all to say that I know IUI #3 IS going to work and you will be pregnant with #2 here very soon. As for POAS on Thanksgiving–wait. Can you just get a beta on Friday instead? I’m really against POAS–it brought so many tears that I’m not sure I can ever do one again unless I’m like 20 days late. But if you feel you have to, do it. My theory is, do whatever keeps you sane.

    Hang in there. Only 7 more days. xoxo

  7. I totally didn’t realize you had an IUI done the morning we saw you! Your husband was the one talking to JJ at dinner about what they each had gone through. I know JJ felt at ease after talking to another guy who has dealt with IF too. Just thought you should know that. I really hope there is no reason to even look at that packet b/c in a couple weeks you will have a positive HPT! Like Courtney asked, would you consider a 4th IUI or do you plan to jump straight to IVF IF needed? I’m hoping for the best, and we’ll be here to support you along the way!

  8. Im impressed, I must say. Really rarely do I encounter a blog thats both educative and entertaining, and let me tell you, you have hit the nail on the head. Your idea is outstanding; the issue is something that not enough people are speaking intelligently about. I am very happy that I stumbled across this in my search for something relating to this.

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