Looks like it's time to visit the fertility specialist.

Miscellaneous and Personal Stuff I Must Share
41

We did 1 round of Clomid to start, monitored by ultrasound. My FS told us not to have sex that month as my polycystic ovaries were threatening to deliver multiples, so this can be a real risk to consider. I hesitate to give you advice, but I would be reluctant to let a general doctor prescribe meds without the ability to monitor an outcome like that.

The first thing my FS told me to do was to stop charting. I was really resistant, but he felt it was not actually achieving anything (which is right, you don’t get pregnant by charting!) and stressing me out. And he was right - when the first thing you do every morning is take your temperature and think about your infertility, it’s hard to let it all go. Recognise that you are trying to control an uncontrollable situation, and stop charting. Have fun sex every few days, and forget about the rest.

If you still want to keep tabs, charting only tells you when you’ve ovulated, which is too late to do anything about it. Instead, monitor your cervical mucus (and if you have irregular periods it’s a good thing to get comfortable with), which acts as the early warning signal that ovulation is approaching, which is really what you want to be able to know.

42

Ohhhh, yes, it is. I’m on Fertility Friend and there are a ton of ‘dumb fertiles’ on there. I stay in buddy groups with women who actually know what they’re talking about and only rarely venture out in to the dumb fertile forums.

I think you’re just fine doing what you’re doing. As long as you feel like you’re doing all right, you’re doing great! Sounds like you have a good balance going on and aren’t letting it run your life.

As for the vacation, I think you’re being 100% reasonable waiting to book. I would do the same thing considering you might lose a deposit if you’re medically unable to travel.

As for the Clomid - I was unmonitored for all of my Clomid cycles. I did three Clomid/timed intercourse and three Clomid/IUI’s. I had one ultrasound and that was only because I insisted (and had to pay out of pocket for it - normally it’s covered). They only did 7 DPO progesterone each cycle. This is standard for both Ob/Gyns and RE’s here for situations like mine (textbook cycles, no known issues such as PCOS).

43

Maryland requires that insurance cover three cycles of IVF, and it implies some level of required coverage for less-expensive procedures like IUI and Clomid. I’m not entirely clear on the details.

44

Well, I had a number of other health issues going on, and we had a hard time getting my dose correct - I started at 50 mcg and now I’m up to 188 which is quite a high dose, apparently; however, within a couple of weeks I was certainly feeling somewhat better. It took quite a while for my hair to fill back in and I actually used Rogaine to help boost it along - based on what my dermatologist said, it actually works better for women than it does for men.

Most important to the OP though, is that within about 3 cycles my period was basically totally normal.

I’m not a doctor, don’t play one on TV, and do a crappy job of impersonating one on the internet; however, based on what Antigen has posted regarding her symptoms, I’m hopeful that her fertility issues may have an easy fix - i.e. synthroid.

That being said, Antigen you’re really going to have to advocate for yourself when you see the doctor - they may see the ‘normal’ number and say you don’t need therapy - I would suggest pushing the issue a bit - particularly mentioning about the wide range of ‘normal’ and the possibility that your ‘normal’ is a lower number than you’re currently reading. Honestly, synthroid is a slow acting type of drug and trying a low does for a few months to see how your TSH levels respond, and more importantly how you feel probably couldn’t hurt anything.

I’ve had my dose swing all over the map all the way up to 225 at one point - when it was that high my TSH levels were 0.01; however, I still had no symptoms of hyperthyroidism - now, you wouldn’t want to maintain that level for any length of time, but testing the waters a bit won’t make you drop dead either.

45

Antigen, I can’t add to all the great advice already offered in this thread, but I did want to wish you luck. My daughter has fertility issues and has decided to adopt rather than continue treatments. Her odds of getting pregnant are fairly slim though. I do know it’s an emotional roller coaster.

Keep your chin up and know you’re not alone. I’m sending good thoughts your way.

46

I will give you the same advice I give to anyone who asks: Make an awesome, non-child-related plan for what you will do if it doesn’t work. It can be helpful to have something else to look forward to, just in case

We did six cycles of Clomid/IUI and three of IVF with no success. So far, we have not been emotionally or financially ready to seriously consider adoption. If I hadn’t made some other plans along the way, I don’t know how I would have gotten through it.

47

The SiL-the-doctor quote assumes hormonal birth control has previously been used, I’m not going to ask her for her sources because I doubt she’d be able to produce a reliable cite before I was wanting to strangle her during the Nth repetition of “the myriad things that can go wrong in the world”.
And sorry, but in the US, any visit to the doctor is a battleground between insurance and the patient. You have to go armed with your contract and details: every time I had to make a claim they denied it, every time I contacted them citing book, chapter and verse, every time they discovered that gee, they had to pay. Pain in the ass of a system, seriously.

48

Infertility is rough, no doubt. My husband and I started trying for kids when I was 28. Our son was born about 4.5 years later, after about 2 solid years of infertility treatments including 4 IVFs. So I know what a long, hard road it can be. I encourage you to find a local support group - the group I joined was a lifesaver. Hopefully your journey through Infertile Land will be relatively short!

If the infertility treatments weren’t hard enough, people also tell you, “All you need to do is relax!” I wanted to punch those people in the nose. Infertility is very stressful! Of course I can’t relax. But I am here to tell you that you CAN get pregnant without being calm and relaxed. So there!

With the insurance, I think the general M.O. of the insurance companies is to deny services and if some people don’t have the time or the means to challenge them, it’s more money for the company. So keep good records and be prepared to re-submit things.

Good Luck and let us know how it goes!

49

“Calm” and “relaxed” are two words that most people would agree do not describe me. I’m pregnant (though I didn’t have infertility treatments). Being calm and relaxed is neither a necessary nor a sufficient condition for getting pregnant.

You don’t need to tell everybody that you’re trying to conceive, or that you’re getting infertility treatments. If someone seems likely to say stupid things like “all you need to do is relax”, consider not telling them. Unfortunately, this is not 100% effective, as it’s not always obvious in advance who’s an idiot who would say a thing like this to someone trying to conceive.

Know that anyone who would say such a thing to someone who is undergoing fertility treatments is ignorant and is insensitive to other people’s feelings. They’re not worth listening to, at least not on this subject.

Same goes for anyone who would tell you something like “you shouldn’t have waited so long”. Even if you would have had an easier time conceiving if you had started earlier (which you don’t know, and neither do they), it’s not a helpful thing to say now. You can’t go back in time and change what you did in the past. The only thing that saying something like that now is going to accomplish is to make you feel bad, and maybe to make the person who is saying it feel better about themselves. I don’t know about you, but I don’t think much of people who think it’s acceptable to hurt other people to feel better about themselves.

There is nothing you can do now about anything you did in the past- what’s done is done. If there’s nothing you can do about it now, it’s not worth thinking about. It’s certainly not worth beating yourself up over. That makes you feel worse and accomplishes exactly nothing. Don’t beat yourself up about beating yourself up, but don’t think that beating yourself up about what you did or didn’t do in the past is necessary or helpful.

Dollar Tree has home pregnancy tests for $1. They actually do work. That way, when you get to day 28 and start testing obsessively (I think everybody who’s trying to conceive does this at some point), at least it’s not costing you a lot of money. There are Dollar Tree stores in Maryland.

50

I’ve barely told anyone about the fact that we’re trying, because I wanted to avoid all the questions. My Mom knows, and she’s the only one who ever tells me to relax, but I think that in her case she’s trying to tell me that it’s going to be okay either way and not to get too stressed out about it. I try not to take it the wrong way. I do sometimes beat myself up - when this cycle was a flop, I started wondering if the failures are because I’m still drinking coffee in the mornings - but so far I’ve been able to successfully shake myself out of that mood after a day or two.

I’ve been buying cheap tests on Amazon.com, so I’ve got that covered!

51

I recommend the book The Panic-Free Pregnancy. It has a chapter on trying to conceive, and that chapter specifically addresses the issue of things that can affect fertility.

52

Honestly, don’t sweat the small things like that. Harsh as it may be, my OB treated drug addicts etc who had all been able to get pregnant doing the most wretched things to themselves, so if it’s a factor, it’s probably a very small influence at best. (caveat: I did switch to decaf during my IVF and early pregancies as it is indicated as a factor in early miscarriages).

One thing noone may have mentioned to you is any lube you might be using - most are significantly sperm retardant, as is spit. Consider purchasing a special sperm friendly one, or I believe mineral oil and olive oil are OK too.

53

Yeah, I end up reminding myself that crack whores have a lot of babies, so my morning French Roast shouldn’t be such a big deal.

I got some Pre-Seed to use when we need a little extra help.

54

Great advice here so far. I second the “live your life” and “talk about the limits on how far you will go” advice. The only other things I would recommend are to resist the urge to test early and often, as well as try not to read anything into your body’s “symptoms.” You can really set yourself up for an emotional roller coaster of hope and despair with pregnancy testing during infertility treatments. I found it really helps to just wait until the day your doctor recommends to test, and not before. And, too, focusing a lot on your body can drive you nuts. I had the most unmistakable pregnancy symptoms (or so I thought) during the cycles I didn’t get pregnant, and then nothing in particular when I did get pregnant. Same with supposed ovulation symptoms. Just my two cents: as much as possible, give up control, stop hyper-focusing on the process, and get engaged in other things.

55

I managed to convince myself several times when going through infertility treatments that my symptoms were certain, and it never took.

We adopted, and while we were waiting (a stressful situation), we got pregnant (no, it doesn’t always happen that way, it happens very rarely that way and I know plenty of people who adopted kids and it didn’t turn out to the a fertility solution). And I missed my first trimester. Never occurred to me.

On the stressful situations, a former coworker had issues conceiving her first two - not huge sorts of IVF issues, but “try for over a year” issues (she was young). She was done with two when the baby ended up with a cancer diagnosis (which she recovered from). But guess when they spontaneously conceived?

56

If caffeine were an effective contraceptive, there would be a lot fewer pregnancies in the US than there are, given that at least 80% of US adults consume caffeine. Same goes for alcohol- about 2/3 of US adults drink. “I drank before I knew I was pregnant, will it hurt my baby?” is a very common pregnancy question (and the answer is, probably not).

You don’t have to entirely give up caffeine if you do get pregnant, though you should limit the amount you drink. The studies show that consuming over 200 mg of caffeine a day is linked to a higher risk of miscarriage, but amounts less than that are not reliably linked to miscarriage. I’ve limited myself to 200 mg of caffeine a day since I found out I was pregnant. It’s been by far the hardest part of pregnancy for me, since I’ve been addicted to caffeine since I was 14. I didn’t limit caffeine before I knew I was pregnant.

What I did as far as alcohol goes is, I drank only when I was having my period (I don’t have sex while I’m having my period). That way, I knew that, if I did get pregnant, I wouldn’t be drinking after conception happened, but I didn’t have to give up alcohol completely before I got pregnant. I found it to be a pretty good middle ground for me.

I wasn’t doing any kind of fertility treatment, though. You might want to ask the fertility doctor if caffeine or alcohol could interact with any of the medicines they give you.

Don’t beat yourself up over it if you do find yourself obsessing over the process. That’s not the best thing possible for you, but it’s normal.

Remember, you are not a failure if you don’t manage to have a biological child.

57

I hope it’s kosher to bump the thread with an update, since my appointment was today.

The office staff was wonderful and welcoming. My only complaint was that they insisted on going over the details of ovulation and conception with us like we were ignorant teenagers, even after I made it clear I’ve got a lab background and have done plenty of research. I guess they’ve just got a prepared “new patient” speech they go with, but seriously, the doctor’s first question was “So you’ve been having unprotected vaginal intercourse, with ejaculation in the vagina, for about a year now?” :smack: On the plus side, he did say that my charts are very encouraging and he has no doubt that I am indeed ovulating. There’s a chance that the eggs are of low quality, but at my age he says that’s not a huge concern. And he was very honest with us, saying that even if every test checks out and nothing appears to be wrong, the tests are very limited because there is a lot that’s still unknown about the process of conception and implantation.

We met with the doctor, a nurse who will coordinate all testing for us, and the financial counselor, who had already been in touch with my insurance company to see what might need pre-authorization. I’m really impressed at how much they’re handling for me, giving me less to be stressed out about. When my next cycle starts, I am supposed to call the nurse, and she will set up all my appointments for me. She says she checks her voicemail from home, so if anything worrying happens on a weekend, I can call and she usually gets back in touch the same day.

The doctor ordered baseline lab work for both of us - much more for me, obviously. One of the tests I’d never heard of before - anti-mullerian hormone. I had to look that one up. I zipped off to LabCorp after the appointment to get the ball rolling immediately. Everything else needs to wait until my next cycle starts, so for once I won’t be crushed to get my period. This time, it will mean I can start the important testing! I’ll be lined up for Day 3 blood work with ultrasound for follicle count, and then a HSG. He is concerned about my high TSH but said that if this result still comes back high, he wants to refer me to a medical endocrinologist, because if this is a long-term problem, he wants me in the hands of someone who can continue to follow me for years. I’m a little peeved about being handed off again, but we’ll see where it leads.

I was also offered genetic screening, and I’m not sure what to do with it. It’s expensive and I doubt it’s covered by my insurance. I’ll call Monday to ask about it. With my French-Canadian heritage, the doctor says I should be screened for Tay-Sachs, and since the carrier rate is high for things like Cystic Fibrosis and SMA, maybe I should do the full panel. Following Miss Getty’s story makes me feel like I really should be tested, but I don’t know what I would do with the result. I don’t know that I would do anything differently if I knew we were both carriers. Maybe I would. I need to think about it some more.

58

I havent seen this thread until today; not sure how I missed it. IANADoctor but I work for a company involved in fertility care. If you are in Maryland I probably know which practice you are going to and maybe even the doc.

Sounds like you are approaching things in a good way; if you have questions about the practice or ways to finance IVF or other general info, please PM me.

59

Glad your appointment went well and you’re getting some testing done. AMH is relatively new but is a good indicator of fertility. Not many doctors test for it yet, so I’m glad yours is.

I’ve had an HSG (twice, and an SHG), so let me know if you have any questions.

As for genetic testing, we had basic testing done and I’m thankful for it. If insurance covers it, or if it’s not too expensive, I’d recommend it. It can rule out some things that will cause infertility issues and you won’t be paying for expensive treatments that fail because of genetic issues you didn’t know about.

60

Another update, for those who are interested…

My bloodwork showed a high enough TSH that I’m now on a small daily dose of levothyroxine, so we’ll see whether that makes me feel better, at least.

My HSG hurt like hell. I was not expecting it to be so bad. I managed to make an ass of myself by almost fainting on the table, but the nurses were really nice about it. The good news is, everything is normal, so we can check that off the list.

Now for the bad news. I’m extremely irritated at the nurse we’ve been assigned at the RE’s office, because she talks down to us and doesn’t give us all the information. When I asked her why they wanted a repeat of all the thyroid testing I had just had done at my primary care doctor’s office, she emailed back “Please repeat all tests. Our bodies can change.” This woman is aware of the fact that I am a med tech - why talk to me like I’m a child? And she never gives us the numbers straight away, just things like “normal” or “high”, and I have to call back and clarify. I’ll be asking for a different nurse if we’re staying with this office, because I can’t imagine having her guide me through IUI or IVF or whatever the future brings.

Her email to me yesterday said: “SA normal except low sperm morphology (normal forms). Please have him repeat ASAP with an IUI preparation to confirm results”

That’s it. No details, no explanation about what the IUI prep entails, what it means for us, nothing. Now, I’m no expert, but shouldn’t he wait a few weeks before repeating the test, in case it’s a fluke? And why are they jumping straight to the IUI prep? I’m also tremendously annoyed that all she’s saying is “low”. Well, what is “low”? What is this office’s normal range, and how far below it do we stand? Is this the standard progression for testing? And is it weird that I want my nurse to explain things better?

Our next appointment with the doctor is in mid-August, so I don’t think we can really get a new nurse until then, although I do plan on calling the office manager and discussing the fact that we’re not quite compatible.

After two days, the nurse finally came through with the actual morphology result: their lab says anything over 4% is normal, and my husband’s morphology is 2%. Not great. She said the IUI prep is to see whether IUI or IVF is more suitable for the next step. Sounds like it’s not a matter of whether we need help to conceive, it’s a matter of what help to start with. So is 2% generally understood to be hopeless? Or are they steering us straight to interventions because it’s what they do and how they make their money? I don’t know. I don’t know how to know. This place was so highly recommended, and the doctor seemed pretty good, but the nurse is cold and uncaring, and I feel like a patient and not a person. :frowning:

I want booze and hugs and a nap.