All right veterans, this post is for you. I need some advice and seeing as I'm the only infertile I know in my group of friends and family, I am turning to you.
Today we received the news that our insurance has agreed to let us see a reproductive Endocrinologist. Too bad they hardly pay for anything, but whatever. I'll recognize the positives where I can.
Then, because I think the universe likes to confuse me, we were contacted regarding an IUI study that we may qualify for. Low cost IUI=Awesome. But participating in the study would mean we would bypass anything other options the RE may have recommended prior to moving on with IUI.
So...
1. For a woman who ovulates pretty darn regularly with normal labs and a man who has a marginally low sperm count, is IUI usually the first step? Or would meds alone usually come first? I'm just trying to get an idea of what our course would be like if we didn't go straight to IUI.
2. This is a study that involves IUI with ovarian stimulation using either Clomid, Letrazole, or Gonadotropins. Any experience with any of these. It's a random trial, so I don't get to pick the drug I receive.
3. Any other helpful thoughts? I'm currently making my way through (with my highlighter!) the 39 pages of consent...it's going to be a long night.
Thanks in advance!
Yay for insurance actually doing something helpful! And hopefully they pay for a little bit at least - everything counts when it comes to infertility costs. :)
ReplyDeleteNow for your questions:
1. Once you see the RE, IUI would be the first line of treatment for that situation, at least from what I've gathered. It was the first line for us (normal ovulation/mfi in our case too!) Meds alone are usually done by your ob/gyn before RE referral, but with low counts, they will probably skip that step. I think that's more for unexplained IF or ovulation issues.
2. I've taken Clomid 50mg and Letrozole 5mg. Both caused hot flashes and mood swings - the clomid was much more intense. Many people have strong reactions to Clomid (not trying to scare you, just stating facts) and find Letrozole to be much more pleasant. There are plenty of places to see the official and unofficial side effects for these meds - they're all true and not exaggerated. Although some women have no effects. I have no experience with Gonadotropins.
3. IUI is not scary at all. It seems it at first, but the procedure itself is no worse than a pelvic exam. The speculum is the worst part. I've heard stories of normally ovulating women who can produce multiple follicles with Clomid or Letrozole - I only had 2 and 1 respectively though Letrozole gave me a bigger follicle.
Good luck, and congrats on finding a trial! Keep us posted! I'm curious to see how it goes for you :)
p.s. Sorry about the extra-long comment.
I can only tell you what our doctor recommended for us, but we're waiting until spring to actually start the process.
ReplyDelete1. We are in a similar situation (I ovulate regularly, he has lowish count, low motility, and VERY low morphology). Our doctor went straight to IUI with Chlomid. She said because of his numbers, it would be best to add the chlomid to the treatment but chlomid itself wasn't "enough" to increase chances for us. But that is our situation and I've heard of people just doing chlomid (or other drugs) prior to going to IUI. It would depend on the situation.
2. I don't have experience with any of the drugs. As I said, we're not starting until spring.
3. Thoughts: Best of luck to you no matter what you decide. I'm learning quickly there really aren't many right/wrong answers to overcoming infertility. Each story is unique. Trust in a good specialist, but in the end you just have to do what feels right for you.
@JackieThanks for info...I've searched and googled and searched some more, but sometimes all I need to hear is the down and dirty "this is what happened to me", so I appreciate it.
ReplyDelete@WendyThank you! That's kind of what I was thinking. I would rather go low intervention, but if we're going to end up going the medication route anyway, I suppose we might as well maximize our chances and do IUI as well.
ReplyDeleteI think that IUI would probably be recommended for you in that case. IUI is pretty non invasive - doesn't really hurt aside from a tiny bit of cramping and the joy of a speculum. The meds weren't terrible for me. I was on Clomid, Letrozole and Follistim (not sure if that is a gonadotropin but it might be??) and didn't really have bad side effects with any of the meds. I ovulate normally and with the doses I was given, I only had one or two follicles with Clomid and Letrozole and the most I had was three with the Follistim.
ReplyDeleteI'm not sure what your RE is going to recommend, but I've heard that when male factor is involved, IUI isn't likely to be as effective as IVF. Just something to think about (and ask) as you go through your initial consultation.
ReplyDeleteI'm not sure what your RE is going to recommend, but I've heard that when male factor is involved, IUI isn't likely to be as effective as IVF. Just something to think about (and ask) as you go through your initial consultation.
ReplyDeleteI'm a little nervous for you about doing this clinical trial. If you are selected to do Gonadotropins, those are injectibles that could result in OHSS (hyperstimulation of the ovaries). My RE said that taking injectibles + IUI could result in higher-order multiple births because if your ovaries hyperstimulate you could drop several eggs at a time, and you can't control that (though you can control it during IVF).
ReplyDeleteI know the trial will save you a lot of money, but you also should think about how important it is to you that you have a team of medical professionals that you trust 100%. If you find that you don't really trust that the doctors in the trial are looking out for your best interest, you might not have the option to switch, you know? I've been seeing my RE since April 2010 and I have learned through this process just how important it is for me to have a team I believe in, so I thought I'd mention it.
@JulesThanks to everyone who weighed in! We have our first appointment next Tuesday to talk details and see if we'll even qualify. I'll keep you all posted!
ReplyDelete