Tell me about fertility treatment

In My Humble Opinion
1

(I am going to talk to my doctor and do some other research, but I’m looking for personal experiences if you wouldn’t mind sharing).

My daughter is almost 4 and we decided we’d like another chld. About 2 1/2 years ago. Before I was even pregnant the first time we blithely decided that we’d generally let nature take its course, and wouldn’t pursue any treatment/investigation if we had problems conceiving. That was a sound plan when I got pregnant with my daughter after only about 7 months, and wasn’t a bad plan when we started trying for this one. However, it’s starting to seem like a dreadful plan a couple of years down the line, particularly as I hit 40 three months ago and it feels like time is running out for me.

I now have a fertility monitor which I’ve been using for a couple of months, so I’m tracking my hormone levels to some extent. I suspect we have had a couple of very early miscarriages over the last couple of years (and we lost a baby before my daughter was born). So, whilst I was speaking to my doctor about something else last week I mentioned what was (not) happening and that I’d like to make an appointment to discuss it. He was sending me for some blood tests anyway, so he added a couple of lines to that order and told me we’d talk properly once those results were in.

In the interim, I realise I have absolutely no idea what our options may be, or where to look for that information. Dopers who have been through this - what sort of choices am I likely to be faced with? Can you point me to any good sources of information?

Thanks as always in advance. (Don’t know if you need any particular information about me to answer, but I’m happy to give it).

2

Do you use basal body temperature to track your morning temperatures and pinpoint ovulation as well? What type of monitor is it?

Here’s where I am:

I am 30 and we’ve been officially trying for 30 months this month, but unofficially for 8 years. I’ve had two early (~6 weeks) miscarriages, the most recent in July.

First my GP ran a bunch of blood tests at a random time during my cycle. This doesn’t really tell you much because you need to know where you are in your cycle to see if the numbers are good. I then got in with a much better GP and she did the same tests on specific days (Day 3 FSH and E2, and 7 days past ovulation P4. Here is a really good website outlining what tests are done when, and what the numbers should be:http://www.fertilityplus.org/faq/hormonelevels.html) and then referred me to an ob/gyn that specializes in fertility. During this time, the hubby also had three semen analysis done to check for a number of factors with the primary goal of ruling out Male Factor Infertility.

The new ob/gyn ran the same tests as the GP (everything is/wasnormal). They then suggested an Hysterosalpingogram (HSG) to check out my tubes and see if their were any blockages. When they attempted to insert the catheter through my cervix, they couldn’t, so the procedure was cancelled.

Next step, a few month later, was a laparoscopy to look for endometriosis and cysts. They also did the HSG while I was under (it’s a day surgery with general) and did a D&C to clear everything out. Everything was normal.

I was then put on 50mg of Clomid on days 4 - 9 of my cycle. I do ovulate regularly (like clockwork - typical 28 day cycle usually) but this was supposed to increase egg quality. Once I ovulated (detected through both Ovulation Predictor Tests and my temperatures), I went in for the 7 days past ovulation P4 test. They like to see certain numbers for medicated cycles to show a strong ovulation, and my numbers were all high.

The first month everything was good, strong ovulation, CERTAINLY felt like a strong ovulation, but negative on the pregnancy tests.

Second month, same thing, but with certain sex timing (Sperm Meets Egg Plan). Got pregnant (was in July), but lost it at six weeks.

After a few months of recovery from the miscarriage, I’m starting another round of Clomid next month if I’m not pregnant this month. We are now waiting to get in to the Regional Fertility Clinic to move on to IUI. I expect to get a call for an appointment in December.

That’s as far as I’ve gone so far. Best of luck to you! If you have any questions about Basal Body Temping, charting, etc., I’d be more then happy to answer them! I’m an old pro now.

3

Also, just wanted to add that the month we did get pregnant, I had also started fertility acupuncture. I still go, and apart from reducing cramping and helping out with a natural miscarriage, I feel great. I highly recommend adding acupuncture to your fertility treatments if you can (find one that specializes).

4

First you need to see a reproductive endocrinologist to determine if it is female infertility or male infertility or both. They do a bunch of tests and go from there as to the best treatment plan to get you pregnant.

5

Decide up front what you are willing to do or not do. How much you are willing to spend. How comfortable you are with adoption. How comfortable are you with staying childless. These are really personal things, but thinking about “what if it doesn’t work” and “when do we start saying no” can provide some sanity and some checkpoints before you discover (and may it never get this far for you) that you are $150k into fertility treatments with no baby and no answers and a marriage under stress from the effort.

There was a point in our infertility treatments where I called it off - the hormone shots were making me insane - like super-PMS all the time. And I said “I might have a baby at the end of this - but I won’t have a husband.” For us, knowing we could stop (we adopted), added some sanity when it was needed.

6

Just one more voice pointing out that adoption is one of your choices, OP.

On the one hand: expensive and invasive medical procedures that may or may not work (or give you a litter of multiples!) and if it does, adds to the overpopulation.

On the other hand: a kid who’s already been made, and is sitting around rotting somewhere, waiting for a home.

7

Disclosure: IANADoctor, but I work in the infertility medical sector. Check out books like **Conceptions and Misconceptions by Wisot **or The Infertility Survival Guide by Elizabeth Swire Falker.

Definitely go see a Fertility Specialist, i.e., a Reproductive Endocrinologist. Find ones close by at sites like AttainFertility.comand FertilityAuthority.com.

8

If your adding your voice to mine, please don’t as it completely misrepresents my views on the matter.

9

No offense meant. I know this is a volatile subject for a lot of folks.

To clarify, I meant that I was joining you (you did say you adopted, right? did I misunderstand that?) only and specifically in pointing out that adoption **is **an option - the OP is looking at all options currently, wants to know what they are and so forth - and then added my $.02 to editorialize a bit. Since she wants kids but might have trouble conceiving (and has already had at least one miscarriage) it stands to reason that taking in a kid that’s already been conceived skips over one hurdle on the path to her goal of having another kid. That’s all I meant.

10

It also came across as biased regarding fertility treatment (oh noes, multiples!!!) and blase about how easy adoption is. Depending on where she is and her situation, she may not be eligible for adoption (e.g. in Australia for example there’s generally a cutoff age for the parents - often 38 for women and you have to be married). It can take time and expense too.

She simply wants facts and experiences, not anyone’s judgment right now.

We underwent fertility treatment for our first, and are just getting things going for number 2. This was due to unexplained male factor infertility, which meant we skipped a lot of the investigative work they do when it’s perhaps a female issue.

Rule of thumb is to see your doctor for a range of tests (to check whether you’re ovulating and what his sperm analysis is like ) after 12 months of trying under 35, and 6 over 35. This is probably the first step - and I would suggest getting an ‘egg timer’ test done, which gives you an evaluation of your ovarian reserve, given your age.

We tried for about 10 months and had been temping, using OPK etc so I knew I was ovulating and we were timing things correctly before I asked the Dr for a referral to a specialist. I used Fertility Friend (online) so I had a stack of charts to show the fertility specialist who got both of us tested (bloods and dildo cam for me, bloods for him). I was found to have polycystic ovaries (but not PCOS) and he had a sperm count of 2 million. This meant straight to ISCI (where they inject a sperm into an egg), with no faffing about with Chlomid, IUI etc.

Be wary of being recommended Chlomid if the cause for your IF is unclear - it can be helpful to regulate/stim ovulation if that’s the issue, but it’s kind of used as a panacea and because it’s unregulated (meaning often not dildocammed to see how many eggs you could be releasing) can result in multiples.

IVF was not that bad - I say that being very very lucky to have needed only a low dose of the drugs to respond, and only needing 1 cycle to get my daughter. It’s still invasive, and there are risks involved like anaesthetic and ovarian hyperstimulation to consider. Then again, as I get things rolling again and have to start with a range of blood tests, dildocam this afternoon, new requirements for 10 years worth of police checks, the cost… it can seem really frustrating that it’s not a simple as it is for most people.

It can seem a huge hurdle, but remember that whatever your diagnosis, and whatever route you choose (assisted conception, adoption, or no child at all), you only have to do it one day at a time.

11

Adoption is definitely a possibility, but bear in mind: It is also expensive, it is invasive in a different way, and it takes even longer than most infertility treatments.

12

And costs about the same.

13

Okay, I’m just going to come back in to say I’m sorry if my initial post sounded judgmental - that was not my intention, but I can see how it came out that way - and I apologize if it sounded like I was speaking for anyone else but myself. With that, I’m going to bow back out of this thread. Charley, all the best to you and yours.

(**Dangerosa **- we cool?)

14

My sister went through in-vitro several years ago. (Successful, btw…she ended up with twins!) Other people will be along to tell you about the actual process–I’m not very knowledgable about all of that. But I do remember one thing from her experience…sometimes insurance companies *do *pay for it. Now, this all depends on how far you’re willing to go, what your career looks like etc., but what my sister did was research online what companies in her area carried employee insurance that covered the costs of invitro, then pursued jobs at those companies for the express purpose of getting the insurance coverage.

Just a tidbit of info for you. Hopefully you won’t need it!

Another thing to consider…I have no idea what your personal beliefs are, but my sister and her husband are firmly pro-life, and they decided beforehand that no matter what, they would not “throw away” any of their “babies.” That meant if they had sixteen viable embryos, they would give each of those sixteen a chance at life. As it turned out, they weren’t able to produce that many, and in the end only two stuck, but they did use all their embryos. (Not all at once, of course! My sister isn’t the octomom!) Anyway, something to settle with yourself beforehand. (Caveat: my sister’s beliefs aren’t my own, and I hope I came across non-judgy on this part.)

(My sister and her husband ended up adopting a third baby, too, so I’m also an advocate for that!)

15

For the record, there is the option of putting up frozen embryos for “adoption” if you don’t want to use them but want them to have a chance at life. Here’s a website with info about how to do it:
http://www.nightlight.org/adoption-services/snowflakes-embryo/default.aspx

16

We are, but you may want to be a little more careful in the future. No one should adopt who hasn’t made the decision on their own to adopt. It isn’t an “as good” choice for many people, and for those for whom its a second best choice, they shouldn’t adopt. My suggestion isn’t that they should adopt, but they should think about the end game now…where does this end. MAYBE that is adoption. Maybe its fifteen years of fertility treatments (I’ve known a few people who just keep trying). Maybe its eventually saying “we are going to be the best aunt and uncle in the world.” Hopefully, in a few months, its a pregnancy, followed by a baby.

The fertility roller coaster can be a long term ride, with lots of rounds of “this month for sure!” and “lets just try this one more thing!” Discussing your limits up front is helpful when you decide whether to try “one more thing” or get off the coaster.

17

Depending on where IVF is done, this can be handled directly by the lab. When we went through treatment we had to decide what would happen to any frosties in the event of us splitting up, dying or getting all the kids we wanted and having some leftover. So there’s quite a bit of talking to do between the two of you as a couple which can be quite enlightening - or challenging.

Our clinic would let us destroy them, donate them to another couple or donate to science. We chose the science route since we wanted to give back to the system, but couldn’t quite fathom our kid wandering around our city with different parents. Tough call whatever you decide. In the end though we only harvested 4 eggs, and only Baby From Mars was strong enough to make it to 5 days in order to implant - we don’t have any bubsicles so are starting from scratch again this time.

18

Fabulous advice. Because trying just one more month, or one more cycle can be so ‘easy’ to do, and suddenly you’re 5 years down the track and $50K in debt and you don’t have a baby to show for it (like friends of ours). They eventually decided to just be the best aunt and uncle to every baby they know, and I love them for it. Other friends are 13 cycles in and still trying. I know I couldn’t do that.

We gave ourselves a year of treatment, and were then going to give up the idea of having kids at all, and just enjoying ourselves travelling, and spoiling our cats and nieces/nephews.

Boy From Mars was not into adoption, although I would have entered this wholeheartedly - so trying to convince him wouldn’t have worked, and wouldn’t have been the best thing for the kid if we’d done it. I think Dangerosa’s right - it’s either the right choice for you, or it’s not the choice for you.

19

Also resolve.org is a good site to poke around in for infertility issues. I’m starting a new cycle of IVF with ICSI in a few months if everything works out okay and didn’t have any frozen ones from my first cycle that produced my daughter. For me it wasn’t as invasive or hard to do but everyone is different and their outlook on infertility treatments vary. But I just wanted to wish you luck. As someone said upthread that we had some of our diagnostic tests paid for by insurance and the actual procedures and drugs were out of pocket so check into your insurance as well.

20

Forgot to mention, Stirrup Queens is a group of infertility blogs from people all around the world (mine’s on there too!) All different causes and stages - some still waiting for a baby, going through treatment, secondary infertility (no problems TTC#1, but like you, difficulty with #2), adopting, etc and it’s worth poking around to see whether any appeal to you.